Hospital infrastructure and maintenance tips

A quality assurance program's success is largely determined by the commitment and interest of administrators, nurses, paramedical staff, and physicians.

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Hospital infrastructure and maintenance tips

Tips on choosing hospital flooring

​Flooring can be broadly classified in to two categories, such as hard and soft flooring.

Hard flooring includes substances like, cement/concrete, terrazzo, marble, brick, ceramic tiles, Kota stone, and wood. In addition to these, there are some special types of flooring such as linoleum, rubber the false flooring, PVC or Vinyl flooring.

Typically, low-density carpeting is used in corridors. This helps patients who walk and to roll of equipment such as IIV poles and carts. As controlling infection is important to every hospital, concurrent with the need to reduce nosocomial infections, carpeting in the corridors is a good choice since it serves to trap airborne germs, which can later be vacuumed.

However, flooring in spaces like a hospital’s lobby go with marketing considerations such as ceramic tiles, porcelain and terrazzo, despite the usually high price tags.

In many operating theatres, especially designed seamless vinyl is frequently installed. This type of product comes in large sheets that have welded seams for infection control and have no joints between the wall and the floor.

Department Type of Flooring

1. OPD Marble / Kotah Stone Vitrified / Ceramic
2. ICU Vinyl (anti- bacterial) Joints, thermo-sealed self leveling epoxy
3. OT Self-levelling jointless epoxy / Vinyl (anti-bacterial) static dissipative, joints. thermo sealed
4.Laboratory Self-levelling jointless epoxy / Vinyl (anti-bacterial) joints, thermo sealed / vitrified jointless
5. Day Care Vinyl (anti-bacterial) joints thermo sealed / Self levelling epoxy 

Tips on selecting right HIS

To be sure that you are selecting the right HIS, each module of HIS should provide the functionality in clinical (registration,OP management,IP management, pharmacy management,OT,medical records, blood bank) and service(billing, appointment, Gas lant, CSSD, BMW, store/inventory, dietary service,HR, accounts) aspects. While there are hundreds of software packages on the market, you can fairly quickly narrow them down using these processes and criteria.

Too many hospitals let software salesmen drive the selection process. Only you know what exactly you want. Therefore, it’s critical to map out your ideal workflow and how you interact with office staff to complete a patient visit.

Get the right HIS for the speciality of your hospital. Some tips while selecting a software:

  • Ease of implementation and ease of use
  • Software’s ability to fit the business
  • Functionality and price of software
  • Whether software works with existing hardware
  • Growth potential of software
  • Level of support provided by the vendor/developer
  • Quality of documentation it provides
  • Developers/vendors track record of performance

Tips on feasibility study before beginning a multi-specialty hospital  project

The purpose of market feasibility study is to assist a hospital in identifying market competition, potential markets, and market analysis to assess a business idea. It needs both primary and secondary data to evaluate the local market conditions.

For example: For a 200 bed hospital, a market feasibility report will tell you whether it is feasible to start with 200 beds at once or should go phase wise (100+ 100).Also it is usually done along with financial feasibility which is also a bankable document if you going for any loans or financial support to bankers or investors.

Conducting market feasibility/marketing research early in the project stage can provide a “reality check” on your idea as well as help define your hospital services to ensure its appeal for the patients. This type of market research is used to determine:

  • Unmet needs that could be addressed by a new service
  • Overall demand for new products, services, or ideas
  • Potential barriers to successful introduction of your service
  • Characteristics of likely customers (such as demographics and buying behaviour)
  • How much of a demand is there for the services you are considering?
  • What are your potential customers’ needs and expectations?
  • Who are your competitors and what are their strengths and weaknesses from your potential customers’ perspective?
  • How competitors are likely to react when your product or service is introduced?
  • How can you design your services most effectively, given the needs of your target market and the competitive environment?
  • How best to market, advertise, and communicate about your service

This will help you in preparing a marketing plan which will map out specific ideas, strategies, and campaigns based on feasibility study that are intended to be implemented.

Tips on importing  hospital furniture and interiors from abroad

Firstly you need to have a Import Export License and then a license called EPCG (Export promotion Capital goods) for the purchase of the goods from abroad in high quantities. You need to pay a minimal amount to the Government as import duty for the same. There is a duty saving of almost 25-27 per cent and this is given to hospitals and hotels. The items for hospitals that can be imported are equipments, furnitures ranging from beds and accessories, tables, and stools to wheelchairs, racks, and trolleys etc.The export-import trend in this industry is catching up fast.

Non-medical furnitures and other electronic items such as LED lights,bulbs,TV’s, plumbing materials (WC, sinks, valves etc) can also be bought.

The import licences issued under this scheme shall be deemed to be valid for the goods already shipped/ arrived provided, the customs duty has not been paid for the goods have not been cleared from the customs. Licences are issued, under this scheme by the director general of foreign trade or his regional officers.

Tips to design a Modular OT

A true modular concept allows you to modify, shift and maintain without any major wastages and time loss. In addition, this design allows you to carry out extension at any time without any hassles.
The most complex and challenging area of hospital construction is the operating department.
Modular OT accommodates the most integrated functions and features. Cleanliness and the safety can be maintained to the highest standard in such design.

Benefits of a Modular OT:

  • Short construction.
  • Re-fitting can be carried out quickly and cleanly
  • Coving is given in the corners reduces infection rate.
  • Superior hygiene
  • Specialised wall, ceiling and door systems produced at one source.

Tips on lighting in hospital

Lighting is a significant component of hospital energy use, representing more than 10 per cent of energy consumption. Further, lighting boosts the demand for cooling because every watt of electricity used for lighting generates heat. Energy-efficient lighting strategies, whether used in new construction or in retrofits of existing facilities, yield major savings and have a short payback period. 

Hospitals can benefit from:

  • Installing light-emitting diodes (LEDs) in exit signs.
  • Replacing incandescent lamps with fluorescent lamps
  • A lighting awareness campaign to train staff to turn off lights when rooms are not in use.
  • Incorporating exterior motion sensors
  • Day lighting is an important element in building design- making use of natural light
  • A strategy should standardize technologies, apply control measures consistently (e.g., dimming, occupancy sensors, day lighting), and ensure a consistent look and feel throughout the hospital.

Tips on Accreditation Process

Begin with accreditation process by education: Educate the leaders and the managers and explain the benefits, advantages, process, timeline, etc. of the accreditation.

Baseline Assessment: Use knowledgeable and credible evaluators (either internal or external consultants) (PRAXIS takes on consulting assignments for accreditation process) who will critically and objectively assess each area and conduct a detailed baseline assessment of the organisation’s current adherence to the standards and each measurable element. Score as Met, Partially Met, or Not Met and cite specific findings and recommendations. Also collect and analyse baseline quality data as required by the quality monitoring standards e.g. medication errors, hospital-associated infection rates, antibiotic usage, surgical complications, etc. Establish an ongoing monitoring system for data collection (e.g. monthly, with quarterly data analysis) to identify problem areas and track progress in improvement.

Action Planning: Using the findings of the baseline assessment, develop a detailed project plan starting first with priority areas of the core standards. Responsibilities, deliverables, and timeframes should be assigned. E.g. Revise informed consent policy, develop a new informed consent statement, educate staff in the next two month time period.

Chapter Assignment: Look for good people skills, time management skills, and consensus building skills and assign oversight of each chapter of standards to such a respected champion/leader who will identify team members from throughout the hospital and carry out the process.

Policies and Procedures: In addition to overall project plan, it is often helpful to compile a list of all required policies and procedures that will need development and revision.

Continue to monitor your progress in meeting the standards, such as through a mini-evaluation of each chapter at regular intervals (e.g. quarterly).

Final Mock Survey: Plan for a final ‘mock survey’ at least 4-6 months in advance of the target date of the actual accreditation survey. Use evaluators (internal or external consultants) who were not involved in the baseline assessment and preparation, who will look at the organisation with a fresh and objective eye. Need to plan final revisions and corrections based on the findings of the final mock survey.

Final Survey
The success of any quality assurance programme depends almost entirely on the commitment and interest of the administrators, nurses, paramedical staff and physicians. Leaders of quality assurance programmes must be able to generate interest and commitment without burdening clinical and administrative staff with an activity they neither understand nor believe in. This will help move quality assurance out of its current paralysis in some hospitals. Quality assurance is to succeed in its goal to identify and correct problems and to improve the quality of patient care.

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