Category: Hospital Administration

Neuro and Spine

Sorry state of Emergency Departments of Indian Government Hospitals

The origin of this post comes from the concerns over the deficient universal precaution practices and instrument sterilization in emergency departments at government hospitals. In the course of my education and career, I have worked/ observed the practices in quite a few government hospitals across India.

I am currently working at a government hospital in Tamil Nadu. As a part of my job I am regularly posted in the emergency department of the  hospital where we are supposed to see the trauma patients.

My hospital is a mid sized tertiary care government hospital. Our emergency department gets around 50-100 patients/day with varying degrees of trauma. The majority of cases(50-60%) come with minor lacerations which need to be sutured, after doing the math it comes to around 25-50 patients per day of cases for whom we do suturing and dressing. Whereas there are larger hospitals which get 3-4 times of the above numbers daily. So you can just get an idea of the big number of patients that visit the emergency departments of government hospitals for outpatient emergency care everyday.

But speaking of the supplies of few basic things required for suturing wounds like sterile gloves, suture materials, sterile suturing instruments and dressing materials; many a times we are forced to follow practices which may possibly directly contribute to spread of communicable diseases such as HIV and Hepatitis B.

I am sure if you have ever worked in a government hospital emergency department/ casualty in India you will agree that sterile gloves, sterile instruments and sterile dressing materials are considered a luxury and are always in short supply. Ever heard somebody asking you to complete 6 debridements /dressings with 3 gloves? This is a common argument given for not wasting the [disposable] sterile gloves!

Being publicly funded and providing crucial healthcare free of cost, I am aware that there is not much you can ask for in a government setup. But cutting upon the basics is definitely a thing to worry about, both from patient and healthcare provider perspective. On one hand, the patients come to the hospital to be cured and not to get infected with another unrelated disease. While on the other hand, it is the front line healthcare providers who put their life at risk just because of unavailability of basic supplies such as soap for hand wash and gloves for  patient/ self protection.

Will end this blog post with a question: Is your hospital emergency department actually one of the factors contributing to the incidence of HIV and other blood borne communicable diseases?

If you are an administrator or a decision maker in any of the government hospital in India, it is the time for a little introspection and action.

The Arogyada
www.arogyada.in
February 10, 2015 / by drsandeep.net

Healthcare IT : What Indian Government is doing and what it should do?

From outcomes perspective, many studies have shown that Health IT has the potential to enable a dramatic transformation in the delivery of health care, making it safer, more effective, and more efficient. Taking lessons from developed nations and looking at the trends, in future healthcare IT is not going to play a side role but it is going to take a central stage in all healthcare business operations. With this background, it seems to be a crucial time to come up with National Health Information Technology policy, guidelines and standards to ensure uniformity in HIT adoption and use across the country…..Read More at HospitalInfraBiz.com

The Arogyada
www.arogyada.in
February 18, 2012 / by drsandeep.net

Five key differences between Indian and US healthcare systems

Just a FYI post to understand the basic differences between Indian and US healthcare system. This kind of comparative study can help us understand the good features and flaws in both the systems.



  1. In India the total expenditure as percentage of GDP is as low as 4-5 %. Whereas in US it is well beyond world standards, as high as 16.2 % of GDP. With highest per capita expenditure in the world US is ranked on 37th position, which indicates that increasing expenditure on healthcare is not the only solution to improve the health status of the citizens. On the other hand, India ranks quite low and stands at 112 which is well below countries like Sri Lanka(76) and Bangladesh (88). 
  2. The Indian Healthcare system can be considered as a Mixed Healthcare System where there is a government health infrastructure which provides healthcare at primary, secondary and tertiary levels. In addition to this there is a strong presence of private healthcare infrastructure which is growing stronger by the day with decline of trust of people in public hospitals. While in US the system is majorly privately funded where the employers are supposed to fund for the employees working with them. There is public funding is available only for unemployed people who cannot afford to purchase health insurance.
  3. Out of the pocket payments account for 70% of healthcare costs in India which warrants a work up on strengthening of financing mechanisms like insurance. On the other hand in US the out of pocket expenditure stands at around 10-12%.
  4. With the perspective of  outcomes, in India the Life expectancy at birth m/f (in years) is 63/66 while that for US is 76/81. Another important factor is Probability of dying under five (per 1000 live births) which indicates the load of infective diseases which affect children and the ability of the healthcare system to deal with them . In India the Probability of dying under five is as high as 66 per 1000 live births while that of US is 8 per 1000 live births.
  5. India has a universal health care system run by the local (state or territorial) governments. Government hospitals provide treatment at taxpayer expense. Most essential drugs are offered free of charge in these hospitals. However, the fact that the government sector is understaffed, underfinanced and that these hospitals maintain very poor standards of hygiene forces many people to visit private medical practitioners.. The United States does not have a universal health care system; it is a proposed reform. The Obama administration health care reform, the Patient Protection and Affordable Care Act (PPACA) as amended by the Health Care and Education Reconciliation Act of 2010, seeks to have near-univesal healthcare insurance coverage to legal residents.
The Arogyada
www.arogyada.in
September 1, 2011 / by drsandeep.net

How to select between the courses at School of Health Systems Studies, TISS ? (Part I- Hospital Administration)

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Last week i received some scraps from SHSS aspirants asking me about the selection procedure, how to choose between the courses and tips for preparation. Well I thought it will be useful for some of you if I post this information on Health and Karma.

To start with, you have a option of choosing between four courses i.e MHA Hospital Administration, MHA Health Administration, MPH Social Epidemiology and MPH Health Policy, Economics and Finance. Number of seats in each of these courses as of 2010-2012 are:
   1. Hospital Administration: 43
   2. Health Administration: 33
   3. Public Health – Social Epidemiology: 22
   4. Public Health – Health Policy, Economics and Finance: 17
In this post i will be talking about MHA- Hospital Administration. Some of the prominent subjects in MHA-HO are Quantitative and Qualitative research methods, Basic Economics and Health Economics , Organizational Behavior, HRM, Materials Management, Operations Research, Management Accounting,Clinical and Support Services, Health Insurance, Hospital Planning, Legal Framework for Hospitals, Systems Development and Information Resources, Management in Medical Staff  and Clinical Services, Medical Technology Management, Quality Management, Marketing Management, Financial Management and Business Development Strategies with a Project that has to be submitted at the end of the course.
As it is apparent that this course has been designed keeping in mind the complexity of modern hospitals and the diverse knowledge needed for achieving superior clinical results and patient satisfaction while satisfying the stakeholder interests.
In today’s hospitals there is no room for variations in outcomes and there is a need for pinpoint precision in all the activities. This warrants strong managerial skills which explains strong roots of this course in contemporary business disciplines.
Project work is one of the important academic requirements for hospital administration students which has to be taken by the students as per their interests and guidance of the faculty . The compulsory project work gives opportunity to the students to explore their interests, apply their knowledge and to gain personal experience by working with real problems. Project work needs involvement in terms of problem identification, data collection, analysis and interpretation and preparation of action plan.
Some examples of kind of projects that were taken up by the students are:
  • Quality Management in Super-Specialty Services
  • Establishing Cost Information System in Hospital incorporating both costing and pricing policies
  • Employee Recruitment, Planning and Compensation in Hospitals
  • NABH, JCI accreditation and quality standards monitoring and information systems
  • Impact of Branding on Hospital Performance
  • ICU Planning for Hospital
  • Development of a recruitment model for a Tertiary Care Hospital
  • Planning a Joint Replacement Program for an existing hospital with orthopedic services
  • Designing & Developing  a medical tourism strategy for a hospital
  • Systems Development for Quality management in a Government Hospital
It is finally the time to transform healthcare as we see it today and the way the healthcare services are delivered. You can act as a catalyst in this…how does this sound? So for all of you who think that hospital is the place to be but core clinicals sound to be too much and for all those who somehow feel that something is not right and things can be done in a better way….yeah this is the course for you.
As you know that Hospitals are not just about operations(not the surgical ones) and there are other aspects also like Hospital Planning, Quality Management, Medical Technology Management; Information Technology and Systems Development which brings into picture opportunities in Hospital Consultancies, IT companies, Insurance companies, TPAs, Healthcare Technology and Marketing firms.
P.S : For any more queries please join TISS MHA/MPH Aspirants Community on orkut.
The Arogyada
www.arogyada.in
June 5, 2010 / by drsandeep.net