This case study was done to evaluate Kokilaben Dhirubhai Ambani Hospital in Mumbai on grounds of Disabled Friendliness (Accessibility) and finding further scopes of improvement in this zone.

1. CASE STUDY-TO EVALUATE THE HOSPITAL ON THE
GROUNDS OF DISABLED FRIENDLINESS
(ACCESSIBILITY) AND TO FIND FURTHER SCOPES OF
IMPROVEMENTS
By: Dr. Deepika Verma
B.D.S, M.H.A (TISS)

2. Location: KOKILABEN DHIRUBHAI AMBANI HOSPITAL,MUMBAI

3. Introduction
• Disability is the consequence of an impairment that may be
physical, cognitive, mental, sensory, emotional,
developmental, or some combination of these. A disability
may be present from birth, or occur during a person's lifetime.
Key facts
• Over a billion people, about 15% of the world's population,
have some form of disability.
• Rates of disability are increasing due to population ageing and
increases in chronic health conditions, among other causes.
• People with disabilities have less access to health care
services and therefore experience unmet health care needs.

4. Problem
• People with disabilities encounter a range of
barriers when they attempt to access health
care including the following.
Prohibitive costs
Limited availability of
services
Physical barriers
Denial/Negligence

5. AIM
• To see if the hospital is disabled friendly and cater to their needs in an efficient
manner along with analyzing gaps and finding more steps to improve the same
OBJECTIVES:
• To audit the hospital on the grounds of disabled friendliness
• To check whether the hospital is disabled friendly in aspects of Infrastructure,
Technology, Workflow, Process.
• To find out the gaps in different aspects of the hospital unfulfilling the criteria to
give disabled friendly atmosphere to the patients.
• To suggest recommendations for improving the infrastructure, technologies,
process and workflow of the hospital to make it disabled friendly hospital.

6. METHODOLOGY
NCPEDP audit of the hospital covers various aspects of the hospital-parking
areas, Ramp , elevators , cafeteria, public telephone, patient examination
rooms , staircases, corridors , washrooms, hospital wards, counters and
corridors
PRIMARY DATA: observation, interview
INTERVIEW of following people were taken: Disabled patients, Relatives of
disabled patients, Porter boys, Receptionists, Rehabilitation therapists,
Facility manager
Secondary data-architectural guidelines manual,
Internet
National Centre for promotion of
employment of Disabled patients

7. NCPEDP AUDIT( BY NATIONAL CENTRE FOR
PROMOTION OF EMPLOYMENT OF DISABLED
PATIENTS)
• Set of 115 questions

8. Observations
Number of patients who say they are being provided with
special care by the hospital and satisfied with the hospital
Number of patients who said that they faced difficulties in
accessing the areas in the hospitals
Yes
No

9. Number of patients who said further improvements are
needed to make this hospital disabled friendly
Number of patients suggesting the most awaited areas of
improvement to make the hospital more disabled friendly

10. Recommendations• The ramp at the entrance of the hospital building has only one hand rail on one
side. There is glass window on the other side of the ramp. As per the architectural
guidelines manual there should be two handrails on either side of the ramp.
• When there is rush at the gate , The entrance landing area becomes insufficient. It
becomes a hurdle for the patients on wheelchair to cross the area, therefore at
that place effective management is required to make the area obstruction free.

11. • There is no drop off area within 30 meters of
area from the entrance. There has to be a
drop off area located there with a big signage
made on the ground showing the drop off
area and disabled patients can land safely.

12. • Special parking area should be made for disabled , 50 meters away
from the main entrance door of the hospital. It should carry a board
symbolizing parking for disabled. The parking for them should be
free of cost.
• Elevators should have handrails on three sides with a proper
contrasting colour. elevators should also be provisioned with audio
signals on arrival of respective floors. Elevators must also include
instructions in Braille and the buttons in Braille pattern. There are
only two elevators with Braille button patterns.
• There should be a menu card available in BRAILLE in the cafeteria so
that visually impaired people can access the menu. A notepad
should be kept with the staff there so that people who cannot hear
and speak can write on it what they want.
• There should be one public telephone provided in the hospital at
the ground floor which the disabled people can use in emergency.

13. • Training and Orientation of staff
• Wheelchairs should be kept at every floor.
• During fixing of the appointment, the employees should definitely ask the
patients or the relatives fixing the appointment about any special
assistance required so that they can be ready with it.
• There should be a generalized system such as a violet tag on the file of the
patients with special needs and a violet band tied on their hand, so that
where ever they go, they get special care.
• WASHROOMS for disabled don’t have pivoted doors opening on both the
sides and they also don’t have provision so that the doors have emergency
release system from outside. Such doors should be facilitated. Every
washroom should have an emergency nurse call system. The
housekeeping staff should be cautious to clean the washrooms of disabled
frequently so as to avoid any cases of slipping due to water pilferage.
• The examination tables in the hospital are not disabled friendly. An
examination table with adjustable height equipped with padded leg
sports. Exam table should have elements to stabilize and support a
person- rails, straps, stabilization cushions, wedges or rolled up towels.

14. • With the upcoming technologies, latest technology weighing machine that
can be used by the people on the wheel chair should be provisioned. This
machine calculated the weight of both the patient and wheel chair,
patient’s weight can be calculated by subtracting the weight of wheelchair.
The only hospital that provides it in India is INDIAN SPINAL INJURY
CENTRE,NEW DELHI.
• JOSEPH EYE HOSPITAL has come up with a new idea of employing disabled
people in tasks in the hospital, there a visually impaired person sells stuff
in canteen. Similar notion can be adopted by our hospital.
• MOBILE CARTS can be made available in the hospital which includes three
chairs excluding a driver’s seat.
• There should be a facility of pick and drop patients in the hospital for the
disabled on call.
• GURU TEG BAHADUR HOSPITAL has created disabled friendly ATMs with
a ramp and a landing area so as the patients on wheel chair can access
them. Our hospital can do the same.

15. • Special health check up camps should be conducted by the
hospital free of cost on WORLD DISABLED DAY in the hospital
for the people with special needs .This would not only be an
activity of CSR and attract more disabled patients towards our
hospital to seek treatment but also it would be a strategy to
enhance the brand of the hospital.

16. Never ignore somebody with a disability, You don’t realize how much they can inspire
you!!