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INTRODUCTION TO HOSPITAL MANAGEMENT
<ul><li>Material & Equipment Management </li></ul><ul><li>Blood Transfusion Services </li></ul><ul><li>Laboratory Services...
Story # 1 <ul><li>It's a fine sunny day in the forest and a lion is sitting outside his cave, lying lazily in the sun. Alo...
<ul><li>Lion: &quot;Oh no, give it to me, and it will be fixed&quot; Fox: &quot;That's ridiculous! Any fool knows that laz...
<ul><li>The lion disappears into his cave, and after a while he comes back with the watch which is running perfectly. The ...
<ul><li>Soon a wolf comes along and stops to watch the lazy lion in the sun. Wolf: &quot;Can I come and watch TV tonight w...
<ul><li>The lion goes into his cave, and after a while comes back with a perfectly fixed TV. The wolf goes away happily an...
: Scene :   <ul><li>Inside the lion's cave. In one corner are half a dozen small and intelligent looking rabbits who are b...
: Moral : <ul><li>IF YOU WANT TO KNOW WHY A MANAGER IS FAMOUS; LOOK AT THE WORK OF HIS SUBORDINATES . </li></ul>
Management Lesson  In the context of the working world : <ul><li>IF YOU WANT TO KNOW WHY SOMEONE UNDESERVED IS PROMOTED; L...
Story # 2 <ul><li>It's a fine sunny day in the forest and a rabbit is sitting outside his burrow, tippy-tapping on his typ...
<ul><li>Rabbit: &quot;Come with me and I'll show you!&quot; They both disappear into the rabbit's burrow. After few minute...
<ul><li>Wolf: &quot;What's that you are writing?&quot; Rabbit: &quot;I'm doing a thesis on how rabbits eat wolves.&quot; W...
<ul><li>Finally a bear comes along and asks, &quot;What are you doing? Rabbit: &quot;I'm doing a thesis on how rabbits eat...
: Scene : <ul><li>As they enter the burrow, the rabbit introduces the bear to the lion. </li></ul>
:Moral: <ul><li>IT DOESN'T MATTER HOW SILLY YOUR THESIS TOPIC IS; WHAT MATTERS IS WHOM YOU HAVE AS A SUPERVISOR. </li></ul>
Management Lesson In the context of the working world: <ul><li>IT DOESN'T MATTER HOW BAD YOUR PERFORMANCE IS; WHAT MATTERS...
MATERIAL MANAGEMENT
DEFINITION <ul><li>EQUIPMENT, APPARATUS AND SUPPLIES PROCURED, STOCKED AND UTILISED BY AN ORGANISATION </li></ul>
TYPES OF STORES BROAD CATEGORIES CONSUMABLES NON CONSUMABLES
TYPES OF MEDICAL STORES <ul><li>EXPENDABLE STORES </li></ul><ul><ul><li>DRUGS </li></ul></ul><ul><ul><li>DISPOSABLES </li>...
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 REQUI...
CATEGORISATION OF DRUG ITEMS <ul><li>Tablets </li></ul><ul><li>Capsules </li></ul><ul><li>Injections </li></ul><ul><li>Liq...
FUNCTIONS OF STORES MANAGEMENT <ul><ul><li>MATERIAL PLANNING & PROGRAMMING </li></ul></ul><ul><ul><ul><li>NEED ASSESSMENT ...
FUNCTIONS OF STORES MANAGEMENT <ul><ul><li>STOCKING & DISTRIBUTION </li></ul></ul><ul><ul><li>INVENTORY CONTROL </li></ul>...
INDENTING OF STORES <ul><li>PERIODICITY </li></ul><ul><li>DAILY </li></ul><ul><li>WEEKLY </li></ul><ul><li>MONTHLY </li></...
TYPES OF PURCHASES <ul><li>Rate Contract </li></ul><ul><li>Running Contract </li></ul><ul><li>Stockless Purchasing (Just i...
INVENTORY CONTROL
INVENTORY CONTROL <ul><li>INVENTORY </li></ul><ul><li>“ THE QUANTITY OF GOODS OR MATERIALS ON HAND” (WEBSTER) </li></ul><u...
IMPORTANT TERMINOLOGIES USED IN INVENTORY CONTROL <ul><li>LEAD TIME </li></ul><ul><li>BUFFER STOCK (SAFETY –STOCK OR RESER...
INVENTORY CONTROL TECHNIQUES <ul><li>ABC  Based on annual usage value </li></ul><ul><li>VED  Vital, Essential & Desirable ...
INVENTORY CONTROL TECHNIQUES <ul><li>FSN  Fast, Slow & Non- moving </li></ul><ul><li>HML  High, Low & Medium cost </li></u...
ABC Analysis   (Based on Usage Value) Equal attention to all items - expensive. Basic analysis to identify & prioritise ar...
Vital  Essential  Desirable V E D Analysis S D E Analysis Scarce Difficult Easily  S A P Analysis Scarce Available Plenty ...
BLOOD  TRANSFUSION  SERVICES
BLOOD BANK <ul><li>Blood bank means, a centre within an organisation or an institution for </li></ul><ul><ul><li>Collectio...
CATEGORIES OF BLOOD BANK <ul><li>Category-I </li></ul><ul><ul><li>3-7 units of blood/bed/year </li></ul></ul><ul><ul><li>1...
DRUGS & COSMETIC ACT 1945 <ul><li>Part X B, amended in 1999. </li></ul><ul><ul><li>“ Requirements for collection, storage,...
DEFINITIONS <ul><li>Apheresis </li></ul><ul><li>Autologous Blood </li></ul><ul><li>Blood components </li></ul><ul><li>Bloo...
<ul><li>Apheresis -process by which blood drawn from a donor, after separating plasma or platelets or leucocytes, is retra...
<ul><li>Blood products-  means a drug manufactured or obtained from pooled plasma of blood by fractionation, drawn from do...
<ul><li>Professional donor- A person who donates blood for a valuable consideration, in cash or kind, for any source, on b...
PREMISES OF BLOOD BANK <ul><li>The premises of Blood bank consists of the following different segregated sections: </li></...
PHLEBOTOMY <ul><li>Bleeding should be smooth and painless </li></ul><ul><li>Strict aseptic procedure to be followed and al...
TESTS ON DONORS BLOOD <ul><li>ABO and Rh typing for confirmation of donor’s blood group and antibody screening. </li></ul>...
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...
LABORATORY SERVICES
ROLE AND FUNCTION OF LAB <ul><li>Attend to ailing patients </li></ul><ul><li>Carry out investigations asked </li></ul><ul>...
FUNCTIONAL COMPONENTS OF LABORATORY <ul><li>HISTOPATHOLOGY </li></ul><ul><ul><li>Organ, tissue, cell examination </li></ul...
TYPES OF LABORATORY <ul><li>OPD SERVICES </li></ul><ul><li>WARD SERVICES </li></ul><ul><li>EMERGENCY SERVICES </li></ul><u...
NABL NATIONAL ACCREDITATION BOARD FOR TESTING AND CALIBERATION LABORATORIES
ACCREDITATION <ul><li>Laboratory accreditation is a procedure by which an authoritative body gives formal recognition of t...
NABL <ul><li>NABL accreditation is a formal recognition of the technical competence of a testing or calibration laboratory...
<ul><li>National Accreditation Board for Testing and Calibration Laboratories (NABL) is an autonomous body under the aegis...
TYPES OF LABORATORIES <ul><li>Small lab.   100 patients/day </li></ul><ul><li>Medium lab.  100-400 pts./day </li></ul><ul>...
Scope of Accreditation  <ul><li>Clinical Biochemistry  </li></ul><ul><li>Clinical Pathology  </li></ul><ul><li>Haematology...
NABH ACCREDITATION
<ul><li>National Accreditation Board for Hospitals & Healthcare Providers (NABH) is a constituent board of Quality Council...
<ul><li>  DEFINITION OF ACCREDITATION </li></ul><ul><li>A public recognition of the achievement of accreditation standards...
<ul><li>The standards for hospitals have been drafted by the Technical Committee of NABH and contain complete set of stand...
Particulars Standards OE 1 Access, assessment & continuity of care (AAC) 15 78 2 Patients Rights & Education (PRE) 05 30 3...
<ul><li>PREPARING FOR ACCREDITATION   </li></ul><ul><li>Step 1   Obtain a copy of NABH standards   </li></ul><ul><li>Step ...
<ul><li>ACCREDITATION PROCESS   </li></ul><ul><li>Step 1  Application for accreditation  ( submitted by the Healthcare Org...
Application fee Annual Accreditation fee Upto 100 beds Rs. 25,000/- Rs. 1,00,000/- 101-300 beds Rs. 50,000/- Rs. 1,50,000/...
LEGAL ASPECTS OF HEALTHCARE  AN OVERVIEW
Statutory Obligations <ul><li>There are about 85 licenses and statutory obligations which are applicable to hospitals, but...
<ul><li>Building Permit  </li></ul><ul><li>NOC from Chief Fire Officer </li></ul><ul><li>Bio-medical Waste Management </li...
<ul><li>Code of Medical Ethics </li></ul><ul><li>Indian Nursing Council Act  </li></ul><ul><li>MTP Act </li></ul><ul><li>M...
Radiology Services
RADIOLOGY SERVICES <ul><li>TYPES </li></ul><ul><ul><li>X-RAYS </li></ul></ul><ul><ul><li>ULTRASOUND & COLOUR DOPPLER </li>...
CAT SCAN
MRI MACHINE
ULTRA SOUND IMAGE
RADIATION HAZARDS <ul><li>BIOLOGICAL EFFECTS OF RADIATION HAZARDS </li></ul><ul><li>TYPES OF CELLS OF BODY/ DOSE </li></ul...
RADIATION PROTECTION <ul><li>WALL THICKNESS ONE MM OF LEAD EQUIVALENT </li></ul><ul><li>8-12 CM CONCRETE/ 12-15 CM BRICK <...
RADIATION SAFETY MONITORING <ul><li>CONTINUOUS MONITORING </li></ul><ul><li>RADIATION DOSIMETERS </li></ul><ul><li>RADIATI...
APPLICATIONS OF NUCLEAR MEDICINE <ul><li>IMAGING OF VARIOUS ORGANS </li></ul><ul><li>THYROID FUNCTION STUDIES </li></ul><u...
<ul><li>? </li></ul>
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Transcript of "Introduction to hospital management"

  1. 1. INTRODUCTION TO HOSPITAL MANAGEMENT
  2. 2. <ul><li>Material & Equipment Management </li></ul><ul><li>Blood Transfusion Services </li></ul><ul><li>Laboratory Services </li></ul><ul><li>NABH Accreditation </li></ul><ul><li>Legal Framework </li></ul><ul><li>Radiology Services </li></ul>
  3. 3. Story # 1 <ul><li>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: &quot;Do you know the time, because my watch is broken&quot; Lion: &quot;Oh, I can easily fix the watch for you&quot; Fox: &quot;Hmm... But it's a very complicated mechanism, and your big claws will only destroy it even more“ </li></ul>
  4. 4. <ul><li>Lion: &quot;Oh no, give it to me, and it will be fixed&quot; Fox: &quot;That's ridiculous! Any fool knows that lazy lions with great claws cannot fix complicated watches&quot; Lion: &quot;Sure they do, give it to me and it will be fixed&quot; </li></ul>
  5. 5. <ul><li>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. </li></ul>
  6. 6. <ul><li>Soon a wolf comes along and stops to watch the lazy lion in the sun. Wolf: &quot;Can I come and watch TV tonight with you, because mine is broken&quot; Lion: &quot;Oh, I can easily fix your TV for you&quot; Wolf: &quot;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: &quot;No problem. Do you want to try it?&quot; </li></ul>
  7. 7. <ul><li>The lion goes into his cave, and after a while comes back with a perfectly fixed TV. The wolf goes away happily and amazed. </li></ul>
  8. 8. : Scene : <ul><li>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. </li></ul>
  9. 9. : Moral : <ul><li>IF YOU WANT TO KNOW WHY A MANAGER IS FAMOUS; LOOK AT THE WORK OF HIS SUBORDINATES . </li></ul>
  10. 10. Management Lesson In the context of the working world : <ul><li>IF YOU WANT TO KNOW WHY SOMEONE UNDESERVED IS PROMOTED; LOOK AT THE WORK OF HIS SUBORDINATES. </li></ul>
  11. 11. Story # 2 <ul><li>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: &quot;What are you working on?&quot; Rabbit: &quot;My thesis.&quot; Fox: &quot;Hmm... What is it about?&quot; Rabbit: &quot;Oh, I'm writing about how rabbits eat foxes.&quot; Fox: &quot;That's ridiculous ! Any fool knows that rabbits don't eat foxes!&quot; </li></ul>
  12. 12. <ul><li>Rabbit: &quot;Come with me and I'll show you!&quot; 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. </li></ul>
  13. 13. <ul><li>Wolf: &quot;What's that you are writing?&quot; Rabbit: &quot;I'm doing a thesis on how rabbits eat wolves.&quot; Wolf: &quot;you don't expect to get such rubbish published, do you?&quot; Rabbit: &quot;No problem. Do you want to see why?&quot; 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. </li></ul>
  14. 14. <ul><li>Finally a bear comes along and asks, &quot;What are you doing? Rabbit: &quot;I'm doing a thesis on how rabbits eat bears.&quot; Bear: &quot;Well that's absurd ! &quot; Rabbit: &quot;Come into my home and I'll show you&quot; </li></ul>
  15. 15. : Scene : <ul><li>As they enter the burrow, the rabbit introduces the bear to the lion. </li></ul>
  16. 16. :Moral: <ul><li>IT DOESN'T MATTER HOW SILLY YOUR THESIS TOPIC IS; WHAT MATTERS IS WHOM YOU HAVE AS A SUPERVISOR. </li></ul>
  17. 17. Management Lesson In the context of the working world: <ul><li>IT DOESN'T MATTER HOW BAD YOUR PERFORMANCE IS; WHAT MATTERS IS WHETHER YOUR BOSS LIKES YOU OR NOT. </li></ul>
  18. 18. MATERIAL MANAGEMENT
  19. 19. DEFINITION <ul><li>EQUIPMENT, APPARATUS AND SUPPLIES PROCURED, STOCKED AND UTILISED BY AN ORGANISATION </li></ul>
  20. 20. TYPES OF STORES BROAD CATEGORIES CONSUMABLES NON CONSUMABLES
  21. 21. TYPES OF MEDICAL STORES <ul><li>EXPENDABLE STORES </li></ul><ul><ul><li>DRUGS </li></ul></ul><ul><ul><li>DISPOSABLES </li></ul></ul><ul><ul><li>LAB REAGENTS </li></ul></ul><ul><ul><li>X RAY FILMS </li></ul></ul><ul><ul><li>MEDICAL GASES </li></ul></ul><ul><ul><li>IV FLUIDS </li></ul></ul><ul><li>NON EXPENDABLE STORES </li></ul><ul><ul><li>EQUIPMENT & SPARES </li></ul></ul>
  22. 22. LIFE CYCLE CONCEPT SHORT LIFE LONG LIFE
  23. 23. 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
  24. 24. CATEGORISATION OF DRUG ITEMS <ul><li>Tablets </li></ul><ul><li>Capsules </li></ul><ul><li>Injections </li></ul><ul><li>Liquids (Syrups) </li></ul><ul><li>Ointments </li></ul><ul><li>Drops </li></ul><ul><li>Powder </li></ul><ul><li>Fluids </li></ul>
  25. 25. FUNCTIONS OF STORES MANAGEMENT <ul><ul><li>MATERIAL PLANNING & PROGRAMMING </li></ul></ul><ul><ul><ul><li>NEED ASSESSMENT </li></ul></ul></ul><ul><ul><ul><li>FORCASTING THE LEVEL OF INVENTORIES </li></ul></ul></ul><ul><ul><ul><li>SCHEDULING ORDERS </li></ul></ul></ul><ul><ul><li>BUDGETING </li></ul></ul><ul><ul><ul><li>AVAILABILITY OF FUNDS </li></ul></ul></ul><ul><ul><ul><li>PLANNING AS PER CASH FLOW </li></ul></ul></ul><ul><ul><ul><li>CAPITAL/REVENUE BUDGET </li></ul></ul></ul><ul><ul><li>PURCHASING </li></ul></ul><ul><ul><li>RECEIPT & INSPECTION </li></ul></ul>
  26. 26. FUNCTIONS OF STORES MANAGEMENT <ul><ul><li>STOCKING & DISTRIBUTION </li></ul></ul><ul><ul><li>INVENTORY CONTROL </li></ul></ul><ul><ul><li>COST REDUCTION </li></ul></ul><ul><ul><li>VALUE ANALYSIS </li></ul></ul><ul><ul><li>DISPOSAL </li></ul></ul>
  27. 27. INDENTING OF STORES <ul><li>PERIODICITY </li></ul><ul><li>DAILY </li></ul><ul><li>WEEKLY </li></ul><ul><li>MONTHLY </li></ul><ul><li>ANNUAL </li></ul><ul><li>SUPPLEMENTARY INDENT </li></ul><ul><li>EMERGENT INDENT </li></ul>
  28. 28. TYPES OF PURCHASES <ul><li>Rate Contract </li></ul><ul><li>Running Contract </li></ul><ul><li>Stockless Purchasing (Just in Time) </li></ul><ul><li>Repeat order </li></ul>
  29. 29. INVENTORY CONTROL
  30. 30. INVENTORY CONTROL <ul><li>INVENTORY </li></ul><ul><li>“ THE QUANTITY OF GOODS OR MATERIALS ON HAND” (WEBSTER) </li></ul><ul><li>“ IDLE RESOURCE OF ANY KIND PROVIDED THAT SUCH A RESOURCE HAS AN ECONOMIC VALUE” (FRED- HANSSMAN) </li></ul>
  31. 31. IMPORTANT TERMINOLOGIES USED IN INVENTORY CONTROL <ul><li>LEAD TIME </li></ul><ul><li>BUFFER STOCK (SAFETY –STOCK OR RESERVE STOCK) </li></ul><ul><li>REORDER LEVEL </li></ul><ul><li>ECONOMIC ORDER QUANTITY </li></ul><ul><li>INVENTORY CONTROL COSTS </li></ul>
  32. 32. INVENTORY CONTROL TECHNIQUES <ul><li>ABC Based on annual usage value </li></ul><ul><li>VED Vital, Essential & Desirable </li></ul><ul><li>or </li></ul><ul><li>VEN Vital, Essential & Non-Essential </li></ul><ul><li>SDE Scarce, Difficult & Easily available </li></ul><ul><li>or </li></ul><ul><li>SAP - Scarce, Available & Plenty </li></ul>
  33. 33. INVENTORY CONTROL TECHNIQUES <ul><li>FSN Fast, Slow & Non- moving </li></ul><ul><li>HML High, Low & Medium cost </li></ul><ul><li>XYZ Value of Items in Store </li></ul><ul><li>GOLF Source of Supply </li></ul><ul><li>SOS Nature of Supply </li></ul><ul><li>MUSIC-3 D Multi Unit Selective Inventory Control </li></ul><ul><li>MBASIC- Multiple basic selective inventory control </li></ul>
  34. 34. 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’
  35. 35. 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
  36. 36. BLOOD TRANSFUSION SERVICES
  37. 37. BLOOD BANK <ul><li>Blood bank means, a centre within an organisation or an institution for </li></ul><ul><ul><li>Collection, </li></ul></ul><ul><ul><li>Grouping, </li></ul></ul><ul><ul><li>Cross-matching, </li></ul></ul><ul><ul><li>Storage, </li></ul></ul><ul><ul><li>Processing & </li></ul></ul><ul><ul><li>Distribution of Whole human blood or Human blood products from selected human donors. </li></ul></ul>
  38. 38. CATEGORIES OF BLOOD BANK <ul><li>Category-I </li></ul><ul><ul><li>3-7 units of blood/bed/year </li></ul></ul><ul><ul><li>100-400 bedded hospital </li></ul></ul><ul><ul><li><5000 units collected </li></ul></ul><ul><li>Category-II </li></ul><ul><ul><li>-8-15 units of blood/bed/year </li></ul></ul><ul><ul><li>400-1000 bedded hospital </li></ul></ul><ul><ul><li>5001-20,000 units collected </li></ul></ul><ul><li>Category-III </li></ul><ul><ul><li>>16 units of blood/bed/year </li></ul></ul><ul><ul><li>>1000 bedded hospital </li></ul></ul><ul><ul><li>>20,000 units collected </li></ul></ul>
  39. 39. DRUGS & COSMETIC ACT 1945 <ul><li>Part X B, amended in 1999. </li></ul><ul><ul><li>“ Requirements for collection, storage, processing & distribution of whole human blood, human blood components by blood banks & manufacture of blood products”. </li></ul></ul>
  40. 40. DEFINITIONS <ul><li>Apheresis </li></ul><ul><li>Autologous Blood </li></ul><ul><li>Blood components </li></ul><ul><li>Blood products </li></ul><ul><li>Donor </li></ul><ul><li>Professional donor </li></ul><ul><li>Replacement donor </li></ul>
  41. 41. <ul><li>Apheresis -process by which blood drawn from a donor, after separating plasma or platelets or leucocytes, is retransfused simultaneously into the said donor. </li></ul><ul><li>Autologous blood- the blood drawn from the patient for re-transfusion into himself later on. </li></ul><ul><li>Blood components- means a drug prepared, obtained, derived or separated from a unit of blood drawn from donor. </li></ul>
  42. 42. <ul><li>Blood products- means a drug manufactured or obtained from pooled plasma of blood by fractionation, drawn from donors. </li></ul><ul><li>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. </li></ul>
  43. 43. <ul><li>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. </li></ul><ul><li>Replacement donor- A donor who is a family friend or a relative of the patient recipient. </li></ul>
  44. 44. PREMISES OF BLOOD BANK <ul><li>The premises of Blood bank consists of the following different segregated sections: </li></ul><ul><li>Donor Recruitment Area </li></ul><ul><li>Bleeding Complex </li></ul><ul><li>Medical Officer’s Room </li></ul><ul><li>Laboratories </li></ul><ul><li>Issuing Counter </li></ul><ul><li>Teaching Facilities </li></ul><ul><li>Refreshment Area </li></ul><ul><li>Stores </li></ul><ul><li>Sterilization and Washing room </li></ul>
  45. 45. PHLEBOTOMY <ul><li>Bleeding should be smooth and painless </li></ul><ul><li>Strict aseptic procedure to be followed and all disposables used. </li></ul><ul><li>Venipuncture site should be free of skin lesions </li></ul><ul><li>Donor bag, sample tube, and donor record should be properly identified and labeled before drawing blood. </li></ul><ul><li>Each bag should be examined for defects and anticoagulants </li></ul><ul><li>Thorough mixing is essential. </li></ul>
  46. 46. TESTS ON DONORS BLOOD <ul><li>ABO and Rh typing for confirmation of donor’s blood group and antibody screening. </li></ul><ul><li>Every donor’s blood must be tested for: </li></ul><ul><ul><ul><li>HIV I and II </li></ul></ul></ul><ul><ul><ul><li>Hepatitis B & C </li></ul></ul></ul><ul><ul><ul><li>VDRL </li></ul></ul></ul><ul><ul><ul><li>Malaria </li></ul></ul></ul>
  47. 47. STANDARD COLOR LABELS Group Color of label O A B AB
  48. 48. 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
  49. 49. LABORATORY SERVICES
  50. 50. ROLE AND FUNCTION OF LAB <ul><li>Attend to ailing patients </li></ul><ul><li>Carry out investigations asked </li></ul><ul><li>Prompt issue of accurate result </li></ul><ul><li>Provide diagnostic information to physician for further management </li></ul>
  51. 51. FUNCTIONAL COMPONENTS OF LABORATORY <ul><li>HISTOPATHOLOGY </li></ul><ul><ul><li>Organ, tissue, cell examination </li></ul></ul><ul><li>CLINICAL PATHOLOGY </li></ul><ul><ul><li>Examination of body fluids-blood, urine, </li></ul></ul><ul><ul><li>sputum, stool, pleural & peritoneal fluids </li></ul></ul><ul><li>MICROBIOLOGY </li></ul><ul><ul><li>Examination of bacteria, viruses, parasites etc. </li></ul></ul><ul><li>HAEMATOLOGY </li></ul><ul><ul><li>Examination of blood and blood components </li></ul></ul><ul><li>BIOCHEMISTRY (CHEMICAL PATH.) </li></ul><ul><ul><li>Examination of chemical substances e.g. hormones, enzymes, etc. </li></ul></ul><ul><li>CLINICAL RESEARCH LABORATORIES </li></ul>
  52. 52. TYPES OF LABORATORY <ul><li>OPD SERVICES </li></ul><ul><li>WARD SERVICES </li></ul><ul><li>EMERGENCY SERVICES </li></ul><ul><ul><li>Round the clock services </li></ul></ul><ul><ul><li>Restricted Emergency Services </li></ul></ul>
  53. 53. NABL NATIONAL ACCREDITATION BOARD FOR TESTING AND CALIBERATION LABORATORIES
  54. 54. ACCREDITATION <ul><li>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. </li></ul>
  55. 55. NABL <ul><li>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. </li></ul><ul><li>Medical lab ISO 15189:2003 </li></ul><ul><li>This is based on third party assessment. </li></ul>
  56. 56. <ul><li>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. </li></ul><ul><li>NABL website is updated continuously with respect to status of accredited laboratories and their scope of accreditation. </li></ul>
  57. 57. TYPES OF LABORATORIES <ul><li>Small lab. 100 patients/day </li></ul><ul><li>Medium lab. 100-400 pts./day </li></ul><ul><li>Large lab. >400 pts./day </li></ul>
  58. 58. Scope of Accreditation <ul><li>Clinical Biochemistry </li></ul><ul><li>Clinical Pathology </li></ul><ul><li>Haematology and Immunohaematology </li></ul><ul><li>Microbiology and Serology </li></ul><ul><li>Histopathology </li></ul><ul><li>Cytopathology </li></ul><ul><li>Genetics </li></ul><ul><li>Nuclear Medicine (in-vitro tests only) </li></ul>
  59. 59. NABH ACCREDITATION
  60. 60. <ul><li>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. </li></ul><ul><li>The board while being supported by all stakeholders including industry, consumers, government, have full functional autonomy in its operation. </li></ul>
  61. 61. <ul><li> DEFINITION OF ACCREDITATION </li></ul><ul><li>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. </li></ul>
  62. 62. <ul><li>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. </li></ul><ul><li>The organization is evaluated against 100 standards and 512 objective elements contained in 10 chapters. </li></ul>
  63. 63. 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
  64. 64. <ul><li>PREPARING FOR ACCREDITATION </li></ul><ul><li>Step 1 Obtain a copy of NABH standards </li></ul><ul><li>Step 2 Carry out self assessment on the </li></ul><ul><li>status of compliance with the NABH </li></ul><ul><li>standards </li></ul><ul><li>Step 3 Ensure that NABH standards are </li></ul><ul><li>implemented and integrated with the </li></ul><ul><li>hospital functioning </li></ul><ul><li>Step 4 Obtain a copy of application form </li></ul><ul><li>Step 5 Fill & submit the application form in </li></ul><ul><li>NABH office </li></ul><ul><li>Step 6 Pay the accreditation fee.  </li></ul>
  65. 65. <ul><li>ACCREDITATION PROCESS </li></ul><ul><li>Step 1 Application for accreditation ( submitted by the Healthcare Organisation) </li></ul><ul><li>Step 2 Acknowledgement for accreditation (by NABH secretariat) </li></ul><ul><li>Step 3 Pre assessment visit ( by Assessor ) </li></ul><ul><li>Step 4 Final assessment of hospitals (by Assessment Team) </li></ul><ul><li>Step 5 Scrutiny of the assessment report (by NABH secretariat) </li></ul><ul><li>Step 6 Recommendation for accreditation (by Accreditation Committee) </li></ul><ul><li>Step 7 Approval for accreditation (by Chairman NABH) </li></ul><ul><li>Step 8 Issue of accreditation certificate (by NABH secretariat) </li></ul>
  66. 66. Application fee Annual Accreditation fee Upto 100 beds Rs. 25,000/- Rs. 1,00,000/- 101-300 beds Rs. 50,000/- Rs. 1,50,000/- >300 beds Rs. 50,000/- Rs. 2,10,000/-
  67. 67. LEGAL ASPECTS OF HEALTHCARE AN OVERVIEW
  68. 68. Statutory Obligations <ul><li>There are about 85 licenses and statutory obligations which are applicable to hospitals, but all of them might not be applicable to all hospitals. </li></ul>
  69. 69. <ul><li>Building Permit </li></ul><ul><li>NOC from Chief Fire Officer </li></ul><ul><li>Bio-medical Waste Management </li></ul><ul><li>Radiation protection Certificate in respect of all X-rays & CT Scanners from BARC </li></ul><ul><li>Narcotics & Psychotropic substance Act </li></ul><ul><li>Consumer Protection Act </li></ul><ul><li>Dentist Regulations </li></ul><ul><li>Drugs & Cosmetics Act </li></ul><ul><li>Employees Provident Fund Act </li></ul><ul><li>ESI Act </li></ul>
  70. 70. <ul><li>Code of Medical Ethics </li></ul><ul><li>Indian Nursing Council Act </li></ul><ul><li>MTP Act </li></ul><ul><li>Minimum Wages Act </li></ul><ul><li>National Building Code </li></ul><ul><li>Payment of Gratuity Act </li></ul><ul><li>Pharmacy Act </li></ul><ul><li>PNDT Act </li></ul><ul><li>Registration of Births & Deaths Act </li></ul><ul><li>License for Blood Bank </li></ul><ul><li>Transplantation of Human Organs Act </li></ul>
  71. 71. Radiology Services
  72. 72. RADIOLOGY SERVICES <ul><li>TYPES </li></ul><ul><ul><li>X-RAYS </li></ul></ul><ul><ul><li>ULTRASOUND & COLOUR DOPPLER </li></ul></ul><ul><ul><li>COMPUTER ASSISTED TOMOGRAPHY </li></ul></ul><ul><ul><li>MAGNETIC RESONANCE IMAGING </li></ul></ul><ul><ul><li>POSITRON EMISSION TOMOGRAPHY </li></ul></ul><ul><ul><li>MAMMOGRAPHY </li></ul></ul><ul><ul><li>NUCLEAR IMAGING </li></ul></ul>
  73. 73. CAT SCAN
  74. 74. MRI MACHINE
  75. 75. ULTRA SOUND IMAGE
  76. 76. RADIATION HAZARDS <ul><li>BIOLOGICAL EFFECTS OF RADIATION HAZARDS </li></ul><ul><li>TYPES OF CELLS OF BODY/ DOSE </li></ul><ul><li>SOURCE OF RADIATION </li></ul><ul><li>ACUTE RADIATION EFFECTS </li></ul><ul><li>CHRONIC RADIATION EFFECTS </li></ul>
  77. 77. RADIATION PROTECTION <ul><li>WALL THICKNESS ONE MM OF LEAD EQUIVALENT </li></ul><ul><li>8-12 CM CONCRETE/ 12-15 CM BRICK </li></ul><ul><li>WITHIN X-RAY ROOM TWO HIGH RISK AREAS </li></ul><ul><ul><li>WALL BEHIND CHEST STAND </li></ul></ul><ul><ul><li>WALL OF DARK ROOM </li></ul></ul>
  78. 78. RADIATION SAFETY MONITORING <ul><li>CONTINUOUS MONITORING </li></ul><ul><li>RADIATION DOSIMETERS </li></ul><ul><li>RADIATION PROOF APRON </li></ul><ul><li>PROTECTIVE GLOVES </li></ul>
  79. 79. APPLICATIONS OF NUCLEAR MEDICINE <ul><li>IMAGING OF VARIOUS ORGANS </li></ul><ul><li>THYROID FUNCTION STUDIES </li></ul><ul><li>CENTRAL NERVOUS SYSTEM </li></ul><ul><li>ABSORPTION STUDIES IN G I TRACT </li></ul><ul><li>NUCLEAR HAEMATOLOGY </li></ul><ul><li>RENAL FUNCTION STUDIES </li></ul><ul><li>NUCLEAR CARDIOLOGY- STRESS THALLIUM </li></ul>
  80. 80. <ul><li>? </li></ul>
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