Situation

1. 1
^
Situational Analysis Presentation –
Vitreo-Retina Department
Sadguru Netra Chikitsalaya
March 18-20, 2014

2. My life time experiencePerformance summary
2012-13 2013-14 Growth
New
OPD
7576 16729 120%
Review
OPD
7883 10752 36%
OT 2867 3432 19.7%

3. My life time experienceHuman resource-Staffing pattern
Manpower -Current
S.no Cadre Available in number
1 CONSULTANT 3
2 JUNIOR CONSULTANT 2
3
LONG TERM
COMPREHENSIVE
FELLOW 6
4
LONG TERM RETINA
FELLOW 2
5 PARAMEDICAL STAFF 7
6 HELPING STAFF 4
7 SUPERVISOR 1
Total 25

4. My life time experienceHuman resource-Training and development
Training Received (in last 3 years) Training needs
•Uvea clinic
•ROP screening
•Oncology services
•In house/external training of
paramedical staff
•Optometrist workshop and
conferences
Training- Can offer for external
candidates
•Structured programs for long term and
short term training
•Exclusive short term retina fellow can be
tagged with one consultant
•Advertisements about our training
program should be more elaborate
•Yearly exams for fellows and affiliations with
recognized universities
• Internal
•ERG Training for the candidates

5. My life time experienceQuality assurance
• Current Situation
 Highly qualified and competent
consultants and doctor’s are available
 All the world class tests and Investigation
procedures are done here.
 World class equipment's and instruments
are available
 All the advanced surgical procedures are
performed under Retina Dept.
 Monthly clinical audit : internal
 External audit:6monthly
 Lack of well defined consent forms.
 Protocols for Both Clinical procedures
and Non-Clinical interventions has been
implemented according to ISO
• Requirements
 Medical retina training protocol
has to be made
 Standard Operating Procedures
has to be prepared as per
according to NABH Standards and
implemented.

6. My life time experienceInfrastructure-Equipments (Key equipments
introduced in the department in the last 3 years)
Equipment No's
B-Scan Probe Cable(29/02/2014) 1
B-Scan (Marvel )with Probe(04/03/2014) 1
Optomed fundus Camera Probe with Adaptor(SL) (26/02/2014) 1
RE-INVERTER(2/09/2013) 1
Visulas-532S (Green Laser) (08/04/2013) 1
OCT (RTVUE)(28/5/2013) 1
Camera (Sony) (30/09/2013) 1
Electrophysiological (ERG)(22/12/2012) 1
Indirect Ophthalmoscope(LED Wireless)(27/8/2013) 2
Fundus Camera(12/9/2012) 1
ACCURUS 800CS (29/05/2012) 1
.S L T YAG Laser (2010) 1

7. My life time experienceInfrastructure-Physical space/others
Current Situation
 Individual Clinic is
dedicated for Retina
Dept.
 Separate ward is
dedicated for the Retina
subspecialty.
 All the essential
amenities are present for
facilitating the services.
 Restricted Waiting Area
Requirements
 More space required for Retina
OPD.
 Patient waiting lounge with
pictures/LED screen/information
brochures
 Proper Space Planning required.
 Proper sitting arrangements for
the Consultant’s and Doctor’s.
 Renovation in Retina OPD
needed.
 Construction and Renovation
needed in Retina Ward.

8. My life time experienceManagement Information system
Current Situation
 Clinical Management System(CMS)is
available.
 Qualified Data Entry Operator’s are
assigning for operating CMS.
 All the patient related entries like OPD,
Admission, Discharge has takes place.
 ICD Codes are in practice but not
been updated since long.
Requirements
 New Diagnosis , Procedures & Treatments
should be updated (ICD Codes needs to be
updated)
 Patient Entry report should be generated after
7:00 P.M
 Camp Patient Entry option should be available
in CMS Software
 EMR(Electronic Medical Records) should be
developed
 Systems should have complete list of doctor’s
(Acc. to Doctor’s roster)
 System hanging should avoid
 All the essential patient related information
should incorporate(Both Clinical and Non-
Clinical).
 Treatment given to the patient section should
be adequate/Complete.
 There should be proper use of CMS by the
Data Entry Operator’s

9. My life time experienceSWOT
Strength
 Efficient & Dedicated clinical and
non-clinical staff
 Highly competent and qualified
Medical personnel (Consultants &
Doctor’s)
 Treatment for almost all retinal
ailments
 FFA/OCT/B-Scan/Lasers/ERG
 Retinal surgeries (RD, VH, Diabetic
Vitrectomy, IOL drop, nucleus drop,
IOFB)
 Vitrectomy for endophthalmitis
 Growth Rate:
 OPD:40-50%
 OT:15%
Weakness
 Manpower Requirement
 Equipment’s required
 Strict Protocols implementation is
lacking
 Lack of training assessment and
documentation of employees
 Research work needs to be enhanced
 Behavior of the staff s the prime
concern

10. My life time experience
• Opportunity :
 Formulating Marketing Strategies to promote the department.
 Quality Assurance by implementing quality standards acc. to NABH Guidelines
for ensuring patient satisfaction and increasing the patient volume.
 By encouraging the efficient and effective operational activities
 Enhancing and nurturing the Human Resource by training and Development.
 Incorporating the implications for improving the current situation and to
overcome the shortcomings mentioned.
 For getting the majority of the patients from different places following
Establishments should be done for the same:
• Uvea clinic
• ROP clinic
• Oncology clinic
 Structured fellowship training
 Research and Development Initiatives.

11. My life time experienceSWOT
Threat
 Departmental Threats
 (If we will not prompt to take the desired implications then:
 It may create the unsatisfaction among the clinical personnel and we may face the
difficulty in the retention of the consultants
 It may leads to Patient unsatisfaction and will create a negative image of the dept.
 We may get the low patient volume during the peak time (i.e., from Oct –March every
year)
 It will hamper the employee satisfaction level
 We will not achieve the desired departmental objective for its betterment.
 We may loose the brand loyalty of the patients who are coming from different
premises/ Places.
 Hospital related threats:
 It may hamper the brand image of Sadguru Netra Chikitsalaya.
 We may not get the NABH Accreditation
 It will hamper the efficiency and effectiveness of the department.
 Both patient and staff will suffer if we will not take the corrective actions.

12. My life time experience
Strategies:
 Structured research program
 Incorporation of Diabetic retinopathy project
 Focus on urban areas including literate and elite class along with rural areas
 Workshops and CME has to be conducted once in 3 months of every subspecialty
 On Website – There should be detailed description of team and services provided
by every subspecialty
 Enhancing the Media publicity
 Hoardings should be placed in public places (e.g. Railway station, bus stand)
 Can add pamphlet/booklet (about services provided with subsidies) with discharge
summary
 Pamphlets with greetings for treating physicians/ophthalmologists in surrounding
districts about services we offer for referring patients
 Establishment of chain of hospitals under the brand name of” Sadguru”

13. My life time experience
Strategies
 In house/external training has to be conducted for paramedical staff (e.g. Optometrist
workshop and conferences)
 World diabetes day celebration to create awareness w.r.t Diabetic Retinopathy.
 Camps organized in surrounding areas for identifying treatable retinal disorders
 Monthly internal clinical audit :
 External audit : within every 6month
 All major disease protocols along with all relevant clinical and non-clinical protocols has
to be documented and implemented
 Proper training and development programmes for all cadres of Human Resource.
 Information Brochures / Pictures has to be prepared.
 Incorporation of Consent Forms.
 Consultant Panel should be established as per OPD Schedule.
 There should be Waiting Lounge with pictures of Retinal Disorders
Key strategies to address weakness

14. My life time experience
Strategies:
 LED should be placed for Demonstration of video related to retinal disorders and services
available
 Counselors should be hired who are esp. trained in demonstrating Retinal Disorders (Can be
Paramedical Staff)
 Follow-up : special emphasis on follow –up and its importance
 Establishing Sadguru Eye Museum for promoting our Hospital and Utilizing the waiting time
of the patients.
 Organizing Nukkad Natak
 Review of training of long term comprehensive and long term retina fellows (Review of
complication rate/ OPD performance)
 Increased space*
 ( Depending on the shifting of OPD section to new building will be done )
 Patient waiting lounge with pictures/LED screen/information brochures
 Plan for adding newer surgical /clinical procedures like AUTOFLOURESCENCE
IMAGING,ICG IMAGING, Intravitreal ozurdex and lucentis (routinely),Patterned lasers
(PASCAL),Sx with use of keratoprosthesis

15. My life time experienceHow do you visualize SNC and your
department by the year 2020
• SNC:
• “ Center of Excellence”
• NABH Accredited first eye hospital in central India.
• The most renowned Eye Care Institution in India and overseas
and Get collaborated with the international giants.
• Vitreo-Retina Department:
• One of the most vital efficient and renowned department.
(People should come at the name of Retina Dept. in SNC)
• Benchmark in No. of Retinal surgeries done and the most
trusted institute for the fellowship training aspirants in
national and international front.
• “Intellectual pool” with respect to research and publications.

16. 16
Thank you