Introduction to hospital managementPresentation Transcript
INTRODUCTION TO HOSPITAL MANAGEMENT
Material & Equipment Management
Blood Transfusion Services
Story # 1
It's a fine sunny day in the forest and a lion is sitting outside his cave, lying lazily in the sun. Along comes a fox, out on a walk. Fox: "Do you know the time, because my watch is broken" Lion: "Oh, I can easily fix the watch for you" Fox: "Hmm... But it's a very complicated mechanism, and your big claws will only destroy it even more“
Lion: "Oh no, give it to me, and it will be fixed" Fox: "That's ridiculous! Any fool knows that lazy lions with great claws cannot fix complicated watches" Lion: "Sure they do, give it to me and it will be fixed"
The lion disappears into his cave, and after a while he comes back with the watch which is running perfectly. The fox is impressed, and the lion continues to lie lazily in the sun, looking very pleased with himself.
Soon a wolf comes along and stops to watch the lazy lion in the sun. Wolf: "Can I come and watch TV tonight with you, because mine is broken" Lion: "Oh, I can easily fix your TV for you" Wolf: "You don't expect me to believe such rubbish, do you? There is no way that a lazy lion with big claws can fix a complicated TV“ Lion: "No problem. Do you want to try it?"
The lion goes into his cave, and after a while comes back with a perfectly fixed TV. The wolf goes away happily and amazed.
: Scene :
Inside the lion's cave. In one corner are half a dozen small and intelligent looking rabbits who are busily doing very complicated work with very detailed instruments. In the other corner lies a huge lion looking very pleased with himself.
: Moral :
IF YOU WANT TO KNOW WHY A MANAGER IS FAMOUS; LOOK AT THE WORK OF HIS SUBORDINATES .
Management Lesson In the context of the working world :
IF YOU WANT TO KNOW WHY SOMEONE UNDESERVED IS PROMOTED; LOOK AT THE WORK OF HIS SUBORDINATES.
Story # 2
It's a fine sunny day in the forest and a rabbit is sitting outside his burrow, tippy-tapping on his typewriter. Along comes a fox, out for a walk. Fox: "What are you working on?" Rabbit: "My thesis." Fox: "Hmm... What is it about?" Rabbit: "Oh, I'm writing about how rabbits eat foxes." Fox: "That's ridiculous ! Any fool knows that rabbits don't eat foxes!"
Rabbit: "Come with me and I'll show you!" They both disappear into the rabbit's burrow. After few minutes, gnawing on a fox bone, the rabbit returns to his typewriter and resumes typing. Soon a wolf comes along and stops to watch the hardworking rabbit.
Wolf: "What's that you are writing?" Rabbit: "I'm doing a thesis on how rabbits eat wolves." Wolf: "you don't expect to get such rubbish published, do you?" Rabbit: "No problem. Do you want to see why?" The rabbit and the wolf go into the burrow and again the rabbit returns by himself, after a few minutes, and goes back to typing.
Finally a bear comes along and asks, "What are you doing? Rabbit: "I'm doing a thesis on how rabbits eat bears." Bear: "Well that's absurd ! " Rabbit: "Come into my home and I'll show you"
: Scene :
As they enter the burrow, the rabbit introduces the bear to the lion.
IT DOESN'T MATTER HOW SILLY YOUR THESIS TOPIC IS; WHAT MATTERS IS WHOM YOU HAVE AS A SUPERVISOR.
Management Lesson In the context of the working world:
IT DOESN'T MATTER HOW BAD YOUR PERFORMANCE IS; WHAT MATTERS IS WHETHER YOUR BOSS LIKES YOU OR NOT.
EQUIPMENT, APPARATUS AND SUPPLIES PROCURED, STOCKED AND UTILISED BY AN ORGANISATION
TYPES OF STORES BROAD CATEGORIES CONSUMABLES NON CONSUMABLES
TYPES OF MEDICAL STORES
X RAY FILMS
NON EXPENDABLE STORES
EQUIPMENT & SPARES
LIFE CYCLE CONCEPT SHORT LIFE LONG LIFE
PRESERVATION REQUIREMENT STORE REQUIRING UPTO 2-10 0 C TEMP STORE REQUIRING ABOVE 10 0 C BUT LESS THAN 30 STORE REQUIRING LOW TEMP AND NO HUMIDITY NO RESTRICTION OF TEMP
CATEGORISATION OF DRUG ITEMS
FUNCTIONS OF STORES MANAGEMENT
MATERIAL PLANNING & PROGRAMMING
FORCASTING THE LEVEL OF INVENTORIES
AVAILABILITY OF FUNDS
PLANNING AS PER CASH FLOW
RECEIPT & INSPECTION
FUNCTIONS OF STORES MANAGEMENT
STOCKING & DISTRIBUTION
INDENTING OF STORES
TYPES OF PURCHASES
Stockless Purchasing (Just in Time)
“ THE QUANTITY OF GOODS OR MATERIALS ON HAND” (WEBSTER)
“ IDLE RESOURCE OF ANY KIND PROVIDED THAT SUCH A RESOURCE HAS AN ECONOMIC VALUE” (FRED- HANSSMAN)
IMPORTANT TERMINOLOGIES USED IN INVENTORY CONTROL
BUFFER STOCK (SAFETY –STOCK OR RESERVE STOCK)
ECONOMIC ORDER QUANTITY
INVENTORY CONTROL COSTS
INVENTORY CONTROL TECHNIQUES
ABC Based on annual usage value
VED Vital, Essential & Desirable
VEN Vital, Essential & Non-Essential
SDE Scarce, Difficult & Easily available
SAP - Scarce, Available & Plenty
INVENTORY CONTROL TECHNIQUES
FSN Fast, Slow & Non- moving
HML High, Low & Medium cost
XYZ Value of Items in Store
GOLF Source of Supply
SOS Nature of Supply
MUSIC-3 D Multi Unit Selective Inventory Control
MBASIC- Multiple basic selective inventory control
ABC Analysis (Based on Usage Value) Equal attention to all items - expensive. Basic analysis to identify & prioritise areas of attention Based on Pareto Analysis - Vilfredo Pareto 10 % item accounts for 70% of value -’A’ 20 % item accounts for 20% of value -’B’ 70 % item accounts for 10 % of value -’C’
Vital Essential Desirable V E D Analysis S D E Analysis Scarce Difficult Easily S A P Analysis Scarce Available Plenty Scarce items -Not easily available -Requires source development -Long lead time -Difficult to manufacture -Few manufacturers
BLOOD TRANSFUSION SERVICES
Blood bank means, a centre within an organisation or an institution for
Distribution of Whole human blood or Human blood products from selected human donors.
CATEGORIES OF BLOOD BANK
3-7 units of blood/bed/year
100-400 bedded hospital
<5000 units collected
-8-15 units of blood/bed/year
400-1000 bedded hospital
5001-20,000 units collected
>16 units of blood/bed/year
>1000 bedded hospital
>20,000 units collected
DRUGS & COSMETIC ACT 1945
Part X B, amended in 1999.
“ Requirements for collection, storage, processing & distribution of whole human blood, human blood components by blood banks & manufacture of blood products”.
Apheresis -process by which blood drawn from a donor, after separating plasma or platelets or leucocytes, is retransfused simultaneously into the said donor.
Autologous blood- the blood drawn from the patient for re-transfusion into himself later on.
Blood components- means a drug prepared, obtained, derived or separated from a unit of blood drawn from donor.
Blood products- means a drug manufactured or obtained from pooled plasma of blood by fractionation, drawn from donors.
Donors -A person who voluntarily donates blood after he has been declared fit after a medical examination, for donating blood, on fulfilling the criteria, without accepting in return any consideration.
Professional donor- A person who donates blood for a valuable consideration, in cash or kind, for any source, on behalf of the recipient patient and includes a paid donor or a commercial donor.
Replacement donor- A donor who is a family friend or a relative of the patient recipient.
PREMISES OF BLOOD BANK
The premises of Blood bank consists of the following different segregated sections:
Donor Recruitment Area
Medical Officer’s Room
Sterilization and Washing room
Bleeding should be smooth and painless
Strict aseptic procedure to be followed and all disposables used.
Venipuncture site should be free of skin lesions
Donor bag, sample tube, and donor record should be properly identified and labeled before drawing blood.
Each bag should be examined for defects and anticoagulants
Thorough mixing is essential.
TESTS ON DONORS BLOOD
ABO and Rh typing for confirmation of donor’s blood group and antibody screening.
Every donor’s blood must be tested for:
HIV I and II
Hepatitis B & C
STANDARD COLOR LABELS Group Color of label O A B AB
Flow of Donor Donor Registration and Examination Room Interview, Rh , Blood group, Weight , Hb of the patient If suitable If unsuitable Reject Donor Phlebotomy done & collection of pilot tubes for processing Refreshment Room & observation Sent home
ROLE AND FUNCTION OF LAB
Attend to ailing patients
Carry out investigations asked
Prompt issue of accurate result
Provide diagnostic information to physician for further management
FUNCTIONAL COMPONENTS OF LABORATORY
Organ, tissue, cell examination
Examination of body fluids-blood, urine,
sputum, stool, pleural & peritoneal fluids
Examination of bacteria, viruses, parasites etc.
Examination of blood and blood components
BIOCHEMISTRY (CHEMICAL PATH.)
Examination of chemical substances e.g. hormones, enzymes, etc.
CLINICAL RESEARCH LABORATORIES
TYPES OF LABORATORY
Round the clock services
Restricted Emergency Services
NABL NATIONAL ACCREDITATION BOARD FOR TESTING AND CALIBERATION LABORATORIES
Laboratory accreditation is a procedure by which an authoritative body gives formal recognition of technical competence of testing and or calibration for a laboratory to carry out specific tests. This is based on third party assessment against set standards.
NABL accreditation is a formal recognition of the technical competence of a testing or calibration laboratory for a specific task following ISO/IEC 17025 Standard.
Medical lab ISO 15189:2003
This is based on third party assessment.
National Accreditation Board for Testing and Calibration Laboratories (NABL) is an autonomous body under the aegis of Department of Science & Technology, Government of India, and is registered under the Societies Act.
NABL website is updated continuously with respect to status of accredited laboratories and their scope of accreditation.
TYPES OF LABORATORIES
Small lab. 100 patients/day
Medium lab. 100-400 pts./day
Large lab. >400 pts./day
Scope of Accreditation
Haematology and Immunohaematology
Microbiology and Serology
Nuclear Medicine (in-vitro tests only)
National Accreditation Board for Hospitals & Healthcare Providers (NABH) is a constituent board of Quality Council of India, set up to establish and operate accreditation programme for healthcare organizations.
The board while being supported by all stakeholders including industry, consumers, government, have full functional autonomy in its operation.
DEFINITION OF ACCREDITATION
A public recognition of the achievement of accreditation standards by a healthcare organization, demonstrated through an independent external peer assessment of that organization's level of performance in relation to the standards.
The standards for hospitals have been drafted by the Technical Committee of NABH and contain complete set of standards for evaluation of hospitals for grant of accreditation.
The organization is evaluated against 100 standards and 512 objective elements contained in 10 chapters.
Particulars Standards OE 1 Access, assessment & continuity of care (AAC) 15 78 2 Patients Rights & Education (PRE) 05 30 3 Care of Patients (COP) 18 104 4 Management of Medication (MOM) 13 61 5 Hospital Infection Control (HIC) 09 46 6 Continuous Quality Improvement (CQI) 06 39 7 Responsibility of Management (ROM) 05 25 8 Facility Management & Safety (FMS) 09 43 9 Human Resource Management (HRM) 13 47 10 Information Management System (IMS) 07 41
PREPARING FOR ACCREDITATION
Step 1 Obtain a copy of NABH standards
Step 2 Carry out self assessment on the
status of compliance with the NABH
Step 3 Ensure that NABH standards are
implemented and integrated with the
Step 4 Obtain a copy of application form
Step 5 Fill & submit the application form in
Step 6 Pay the accreditation fee.
Step 1 Application for accreditation ( submitted by the Healthcare Organisation)
Step 2 Acknowledgement for accreditation (by NABH secretariat)
Step 3 Pre assessment visit ( by Assessor )
Step 4 Final assessment of hospitals (by Assessment Team)
Step 5 Scrutiny of the assessment report (by NABH secretariat)
Step 6 Recommendation for accreditation (by Accreditation Committee)
Step 7 Approval for accreditation (by Chairman NABH)
Step 8 Issue of accreditation certificate (by NABH secretariat)