The document discusses the critical importance of medical facilities on highways, highlighting the severe impact of road traffic accidents (RTA) and the need for accessible and effective healthcare services. It presents statistics on RTA deaths, particularly in India, and outlines a comprehensive plan for hospital infrastructure, staffing, and administrative support to address emergency medical needs. Key concepts include the golden hour for trauma care and the essential services required for patient management and rehabilitation.

1. Medical Facilities on High Ways Dr. Avadhesh Agrawala MBBS, MHA Dr. Sweta Tikkiwal MBBS, DPH (Public Health)

2. Health State of complete Well Being Physical Social Mental

3. Medical Facility/Hospital Hospital – A Residential Establishment Long Term & Short Term Care Preventive, Promotive, Curative, Diagnostic, Rehabilitative services Sufferings or Suspected to be Sufferings

4. Some Facts & Figures Every day, there are 3300 deaths and 6600 serious injuries on the road in the world. The global annual cost of RTA is almost 230 billion dollars and 1.2 million people Die every year due to Road Traffic Accidents (RTA). 850,000 deaths -< 45 years of age in developing countries -sole bread-winners. Road Traffic Accidents cause injury to about 50 million people in the world. Every tenth bed in the hospital is occupied by an accident victim. The average cost of RTA in developing countries is estimated at 65 billion dollars, Out of 700000 Accidents globally, 10% happens in india

5. Indian Scenario………. 1.27 Million People in India sustain serious injuries due to RTA and 0.12 Million Die India - 1% of the world’s motor vehicles- 6% of the total global RTA deaths. The cost of these accidents and death is Rs.550 Crores or 12.5 billion dollars every year in India. A majority of major accident survivors are either confined to the bed or wheel chair bound for the rest of their lives due to brain injury or spinal cord injury. Trauma related death occurs in India every 1.9 minutes

6. Medical Issues for Highway Medical Emergency Surgical Emergency Accidents & Trauma Fractures of Bone Soft Tissue Injuries Spinal and Neurological Injuries GOLDEN HOUR……..

7. Concept of Care….. “ Available”, “ Accessible”, “ Acceptable”, “ Affordable”, “ Appropriate”

8. Functional Master Plan Physical facility : Buildings and Building Blocks, Engineering Services, Hospital Utility Services and Support Services. Departmentation Plan Equipment Plan Manpower Plan providing for Medical Staff, Technical & Nursing Staff, Administrative and Support Staff Hospital Supply Systems: Medical & Surgical supplies, Sterile Supplies and other needed supplies for Housekeeping, Catering and maintenance. Hospital Administrative Structure and Basic Hospital Administration Plan

9. Patient Care Units IN-PATIENT UNIT Intensive Care In-patient unit Emergency In-patient unit Nursery Private Rooms (1 bed in each room) Semi-private Rooms (2 beds in each room) General Ward (5 beds in each room) OUT PATIENT DEPARTMENT Consulting Room Emergency Rooms

10. Clinical Support Areas CLINICAL SUPPORT AREAS General Surgery Suite Operating Rooms Complex Obstetric Suite Delivery Room Complex Imaging Dept. Rooms Complex General X-Ray Machine Ultrasound CT Room Pathology Dept. The Stat Laboratory Clinical pathology Laboratory Advanced Analytical Laboratory Micro Biology Laboratory Blood Bank (Replacement Only) Mortuary Ancillary Therapy Physiotherapy

11. Other Support Areas ADMINISTRATIVE SUPPORT AREAS Hospital Administrative Service Department Central Reception and Patient Relations Service Department Hospital Medical Records Department Hospital Engineering Services & Bio-Medical Engineering Services Department Hospital Laundry Service Hospital Catering Service Hospital Pharmacy Service Hospital Stores & Supply Department Hospital Sterile Supply Service Department House Keeping Services Hospital Security Services Patient Utility Services OTHER SUPPORT AREAS (THESE MAY NOT BE LOCATED ON SITE) Single Status Accommodation Married Status Accommodation Garages

12. Human Resource Medical Staff Full Time Consultant Visiting Consultants General Duty Medical Officers Nursing Staff Hospital Matron Sister In Charge Staff Nurses Nursing Orderlies & Ayahas Technical Staff Anaesthesia Asst. Bio-medical Technician Laboratory Technician Operating Room Asst. Pharmacists Physiotherapist Radiographer Social Worker Ultra Sound Technician Administration Medical Superintendent Managers Supervisor House Keeping & Others Ambulance Asst. Cashiers Cookmates Cooks Drivers Gardeners General Clerks Storekeepers Sweepers Washer-men IT Dept Staff

13. Hospital Engineering Services Air Handling & Conditioning Plant Boiler House Electric Distribution Plant Electric Stand By Generator Electric Substation Engineering Services Office Engineering Services Store Fire Detection System Fire Fighting System Horticulture Incinerator Lifts Loading Platforms Roads & Parking Lots Sewage Lines & Trunks Sewage Treatment Plant Storm Water Drains & Handling Plant Street Lights & Perimeter Light Tradesmen Workshop Waste Water Handling Plant Water Storage Tanks Water Treatment Plant & Distribution Plant

14. … .contd Hospital Mechanised Transport Service Ambulances Service Hearse Van Service General Vehicle Hospital Biomedical Engineering Service PMG Manifold Room Services Biomedical Engineering Workshop Service Maintenance Of Clean Room Equipment

15. Issues of Prime Importance Accessibility Availability Transport facility Information sharing facility Competent Service Providers Laboratory Investigations Radiology Investigations Operation theatres Availability of Doctors & Support Staff Referral Services Central Sterile Supply Department Laundry Reception and Information counter Medical Equipments Drugs and supplies Stretchers & Trolleys Medical Records Water Supply Uninterrupted Electrical supply & Back Up Patient care area/ Ward/ ICU Telemedicine Parking place for ambulance Structure Related Issues

16. Process related Issues Pre Hospital Care & First Aid Basic medical care during transportation Timely Information Initial Stabilization Scope of Services Timely referral Care component in Hospital Continuity of Care Empathetic attitude Round the clock Services Management during Non availability of beds Informed decisions & Consent Multidisciplinary Care Discharge summary Handling of medico legal formalities Information sharing among Hospitals

17. Matrix of Processes

18. Conclusion Highway Designing Medical Facility Planning Ambulance & Emergency Services Air Ambulance Provision of Basic Trauma related services

19. Any Suggestions…………….