Student Dissertation

Agency : Operational Parameters; Patient Satisfaction; Hospital Operations

Objective : • To study the key operational parameters of different departments of hospital • To analyse gaps in the hospital operational processes • To suggest recommendations to fill the gaps in operations of the hospital

Background : Key operational parameters not only include elements of hospital performance improvement areas, but it goes beyond them because of the emphasis it places on improving care delivery and patient satisfaction. A variety of process improvement and change management concepts and approaches are used to increase operational efficiency and reduce clinical variability; the ultimate objective is to drive down the total cost of care while maintaining or improving care quality. However, hospitals are still lagging behind to use key operational parameters as a strategic tool to optimize its performance within the limited resources. Wockhardt hospital, Rajkot is one of the leading sources of healthcare delivery in the catchment area.

Methodology : Study Location: The study was carried out in Medical Admin, Diagnostics, OPD, Billing, Marketing, Housekeeping, Security, CSSD, OT, Cathlab, Laundry and material departments of the hospital. Referring to the standard operating procedures of different departments, processes were observed for fifteen days and the gaps in them were analyzed. Study limitations: This study is only being carried out in Medical Admin, Diagnostics, OPD, Billing, Marketing, Housekeeping, Security, CSSD, OT, Cathlab, Laundry and material departments of the hospital as suggested by Corporate office of Wockhardt Hospital, Mumbai. No data is collected in any of the department as limited time was provided in each department. Standard operating procedure is used to find out the gaps.

Findings : Salient findings of the study: • Lack of coordination in-between Altius Nagpur & Customer care Rajkot for appointment system • Work overload on ward secretary which leads to inefficiency in completing billing audit on daily basis • Inventory of consumables at nursing stations are kept open, there is no use of lock and key to avoid pilferages. • Medication errors are common like Transcription Errors, Error prone Abbreviations, Indent Errors, Dispense Errors, Reconciliation Errors, Prescription Errors, Documentation Errors & Audit for all discharge summaries are not done on regular basis • Rush of follow-up patients (surgical & postoperative) in emergency department due to absence of procedure room in OPD • In patient dissatisfaction due to exposure of external environment towards CT & MRI& Increased waiting time of Ultrasonography Reports • Use of PPEs & practice of Hand Hygiene do not meet to the standards in critical areas

Recommendations : • Yellow card should be updated on real time basis. • Nursing supervisor can enter the rendered services in HIS • Storage area must be secured for consumables in wards to avoid pilferages • TPA team should have at least one medical graduate to address the queries. • All major areas should be covered under CCTV surveillance. • Security officer should monitor the CCTV cameras daily (to ensure they are up and working properly) • Staff frisking, and guest baggage checking should be must to avoid pilferage