Anil Pandit

Analysis of Cost Reduction Techniques Adopted in Hospitals in and Around Pune

Purpose: The purpose of this study is to analyze the various techniques implemented with respect to cost reduction in privately owned hospitals in and around Pune. Design/Methodology/Approach: A total of 30 privately owned hospitals were randomly selected for the purpose of the study. The methodology comprised administering the questionnaire along with a personal interview with the administrative/finance officer. The hospitals included for the study were selected based on the following characteristics: Hospitals with capacity of 50–100 beds were termed as small hospitals and hospitals with more than 100 beds were termed as large hospitals. Further they were segregated as general hospitals (<100 beds) and speciality and super speciality hospital in multiple urban locations. These organizations were for-profit hospitals. Findings: The results predominantly highlight the key techniques required to be used by most of the hospitals as the cost reduction method, and also the various aspects on which improvement and further development is required to keep on providing better health care service delivery with effective cost containment in the city of Pune.

A Study of Compliance to Quality Monitoring Indicator in Cardiac PICU of a Tertiary Care Hospital with a View to Suggest Recommendations to Improve it

The aim of this study was to understand the compliance of the quality monitoring indicator in the Cardiac PICU of a tertiary care hospital and to identify problems in the use of the set standardized methodology and to increase compliance. The WHO recommended five key moments when health care workers should practice hand hygiene; before patient contact, before an aseptic task, after body fluid exposure risk, after patient contact, and after contact with patient surroundings. This direct observational study mainly focused on the hand hygiene compliance of the various health workers involved in the care of patients of the Cardiac PICU. The hand hygiene opportunities of various healthcare workers were captured which included Nurses, Doctors, Physiotherapists, and Technicians, Housekeeping staff, Visitors and others.

Medication Errors in Critical Care Units in a Tertiary Hospital

Medication errors in critical care are frequent, serious, and predictable. Critically ill patients are prescribed, twice as many medications, as patients outside of the intensive care unit (ICU) and nearly all of them suffer, a potentially life-threatening error at some point during their hospitalization. Today, in the health care profession, all types of medication errors including missed dose, wrong dosage forms, wrong time interval, wrong route, etc., are a big deal, for quality patient care. Problems related to medications, are common in the healthcare profession, and are responsible for significant morbidity, mortality, and cost. Several recent studies have demonstrated that patients frequently have difficulty in reading and understanding medication labels. According to the Institute of Medicine report, “Preventing Medication Errors”, cited poor labeling as a top most cause of medication errors in the USA. Evidence suggests that specific content and format of prescription drug labels, facilitate a better communication to minimize apprehension by patients regarding medication errors.

To Study the Emergency Department Patient Process Flow in Hospital

Growing spectrum of disease and population has resulted in an increasing public demands and with the drive towards effective service delivery, continuous performance and process improvements are essential to the vitality of any Healthcare organization. ₁

Identifying discharge process factors causing an increased length of stay

Introduction: The purpose of continuous quality improvement programs is to improve health care by identifying problems, implementing and monitoring corrective action, and studying its effectiveness. Aim: The present study aims to find out the present length of stay (LOS) of inpatients at a superspeciality hospital. Objectives: 1. To study the existing system of discharge process of patients, 2. to find out the reasons for the delays, 3. To recommend suitable suggestions to reduce length of stay. Mehodology and Results: By considering the LOS of 128 random patients, 32 from each ward A, B, C, and D. The average LOS (ALOS) was found to be 5.69. Factors have been identified by studying the delays through time and motion study in the discharge process. Recommendations: Recommendations have been made for appropriate changes to be considered to reduce ALOS and bring it to 5.0 so that proper resource utilization occurs, and at the same time, there is an improvement in bed turnover rate and thereby in bed occupancy rates.

A Study to Ascertain the Adequacy of Observance of Standard Precautions in Acute Medical and Surgical Wards of a Large Teaching Hospital

The present study was a cross-sectional analytic epidemiological design to assess the frequency of observance of universal precautions in acute care wards of a large teaching hospital and to assess the epidemiological determinants of such observance. A total population of medical officers, nurses, paramedical and ancillary workers working in acute medical and surgical wards was studied using direct observations recorded on a pre-tested, structured format. The study revealed that hand washing was more frequently practiced by medical officers and ancillary staff (68–93 per cent) as compared to nurses and paramedical staff (38–58 per cent) (p < 0.01). A significantly higher proportion of medical officers in medical wards (93 per cent) and nurses (63.3 per cent) and ancillary workers in surgical ward (89 per cent) were practicing hand washing (p < 0.01). The practice of usage of gloves was significantly more frequent among medical officers and ancillary workers (72–100 per cent), while it was quite inadequate among nurses and paramedical staff (28–36 per cent; p < 0.001). However, the use of gloves was significantly better among nurses in the surgical ward and paramedical in the medical ward (p < 0.05). A linear trend analysis of the use of protective clothing revealed that the odds of nurses adequately using the same were much lower, while those of ancillary workers were much higher as compared to medical officers, the trend being highly significant in both types of wards (p <0.001). The study reveals a definite need for stepping up educational and motivational methods for observance of universal precautions by health-care workers in large teaching hospitals. In particular, nurses and paramedical workers have been identified as high-risk groups, needing concerted efforts for observing these precautions.

Achieving quality in primary health care

This review article tries to provide an insight into how we can improve the quality of primary health-care services provided in a primary health center (PHC) setup. Primary health care is essential health care made universally accessible to individuals and acceptable to them through their full participation and at a cost that the community and the country can afford. Unlike the previous approaches (e.g. basic health services, integrated health care, and vertical health services) that depended upon taking health-care services to the doors of the people, primary health-care approach starts with the people themselves.