Student Dissertation

Agency : ICU; Intensive Care Unit; Gap Analysis; SOPs; Quality Control

Objective : 1. To review the standard operating procedures in ICU of AHI in terms of inventories, laundry and linen, training and HR, housekeeping and quality control. 2. To design a checklist for checking compliance of ICU with standard operating procedures. 3. To identify gaps between standard operating procedures (SOPs) and current existing practices in ICU. 4. To give corrective actions and implement best practices in ICU to increase its efficiency.

Background : Gap analysis is the initial step in the review of the available service delivery system. It is an efficient base to implement a modern management system. It can be measured against preset standards (Standard Operating Procedures). It reveals the areas of improvement in the existing service system. It focuses on the components of the management services and how effective they are. Care of the critically ill patients is resource-intensive, and 15-20% of hospital budgets are spent in the ICUs. The focus on quality and safety of medical care is increasing because of the high cost of health care and potential for harm. Poor quality care is not only costly but also causes human suffering because poor quality care results in increase in morbidity and mortality. Quality Improvement (QI) initiatives in the ICU to decrease noso comial infections have been shown to improve outcomes as well as decrease costs. The study will help to identify the gaps between the SOP’s and the current existing practices and to increase the overall efficiency and quality of care in ICU by bridging gaps of operational and clinical process in ICU.

Methodology : Study Design – Descriptive and observational study Setting –ICU-1 (3rd Floor) & ICU-2 (2nd Floor) of Asian Heart Institute and Research Centre, BKC, Mumbai. Duration of Study – 2.5 months Study Population – Doctors, nursing and housekeeping staff of ICU-1 (3rd Floor) & ICU-2 (2nd Floor).

Findings : • Data was calculated for a period of 60 days where the observations were categorized into 3 specialized parts as: Infection control, operational and clinical. • Maximum noncompliance was seen in operational (56%), followed by clinical (30%) and infection control (14%).

Recommendations : After these observational findings the gaps between ideal (Standard Operating Procedures) and current practices were identified and according to the non-compliances observed, best practices around the world were identified for Asian Heart Institute, Mumbai and implementation plans were given for the same.