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04/11/2304/11/23 11
Evaluation of General Hospital Evaluation of General Hospital Sirsa as a Sirsa as a Health Promoting Health Promoting HospitalHospital
Presented by:-
Dr.Jaideep Dr.Jaideep Master in public health (Student)Panjab university, Chandigarh
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I want to give special thanks to I want to give special thanks to DR.S.K.SHARMADR.S.K.SHARMA M.D. (Forensic medicine)M.D. (Forensic medicine)
C.M.O. General Hospital, SirsaC.M.O. General Hospital, Sirsa DR.S.L.AGARWALDR.S.L.AGARWAL Medical Superintendent Medical Superintendent General Hospital,SirsaGeneral Hospital,Sirsa DR.VIRESH BHUSHANDR.VIRESH BHUSHAN M.B.B.S.,D.H.A.M.B.B.S.,D.H.A.
R.M.O. General Hospital, SirsaR.M.O. General Hospital, Sirsa
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Hospitals in India: Traditional Hospitals in India: Traditional ModelModel
HOSPITAL
Building
Staff (Medical/paramedical
Health care facilities
OPD
(Patients andEscorts)
Indoorservices
Mainly curativeHealth services
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Health Promoting Hospital: Changing Health Promoting Hospital: Changing scenarioscenario
Ottawa Charter Declaration in 1986Ottawa Charter Declaration in 1986
Integration of health promotion into all the Integration of health promotion into all the activities of the institutionactivities of the institution
Creation of healthy environment for staff and Creation of healthy environment for staff and clientsclients
Against this background,I conducted my study Against this background,I conducted my study
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ObjectiveObjective
To evaluateTo evaluate GENRAL HOSPITAL SIRSA GENRAL HOSPITAL SIRSA
as a Health Promoting as a Health Promoting HospitalHospital
Key words: HPH (Health Promoting Hospital)Key words: HPH (Health Promoting Hospital)
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Introduction To Hospital:
General Hospital Sirsa strives for the best spirit of Health Care and Welfare. This hospital is 120 bedded multi specialty hospital located in urban area of Sirsa city catering to population of more than 3 lacs. This is main Dist. Hospital in Sirsa in Govt. sector. It has specialist wards for the patients requiring care by specialists like Physician, General Surgeon, Orthopaedic Surgeon, Eye Surgeon, Gynaecologist & Obstetrician, Pediatrician, ENT Surgeon, Dental Unit and Physiotherapy Centre. All the specialists also give their services in the OPD. Hospital is having a separate casualty and ICU facility having 8 beds catering to patients of different kinds needing intensive care. ICU, OPD’s, Gynae Unit, and Operation Theatres are fully equipped with all modern and latest facilities. Almost 5-7 major General /Orthopaedic/ Gynae/ Eye Surgeries are being performed including Emergency Care. Family planning operations are done every day. Lower strata of society are taking the full advantage of this Govt. hospital as most of the services are provided without any cost or on a nominal fee.
The Radiology Dept. has State of Art facilities like Spiral CT, Color Doppler, 500 MA X-Ray fixed and portable.
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Gen. HospitalGen. Hospital
BedBed 100 100
Daily OPD:-Daily OPD:-600 600
Bed occupancy rate :-Bed occupancy rate :-8585
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Methodology Study Area :- General Hospital, Sirsa, Haryana.
Study Period:- January 2009
Study design:-Crossectional & observational study
Study Tools:-1.Self assessment for Health promoting indicators of the hospital.2.Interview of Health workers 3.Observation of functioning of the Hospital.
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1.Green cover:Partialy covered1.Green cover:Partialy covered
Evaluation of HPH indicatorsEvaluation of HPH indicators
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2. Noise level2. Noise levelNoise level is not lies with in permissible limitNoise level is not lies with in permissible limit inside hospital and OPD due to marriage palace inside hospital and OPD due to marriage palace situated near the hospital.situated near the hospital.
marriamarriage ge palacepalace
Common boundary wall of hospital & marriage palace
Hospital
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3. Natural light and ventilation3. Natural light and ventilation
Limited assess to fresh air and natural light at all levels
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4.Disabled friendly4.Disabled friendly
•Ramps availableRamps availableNo adequate Wheel chairs are availableNo adequate Wheel chairs are available
No lifts for handicapped patients No lifts for handicapped patients
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5.Seating facility
Adequate Adequate seating facility seating facility for patients in for patients in hospital OPD.hospital OPD.
No seating facility for No seating facility for attendant of patients attendant of patients inside hospital IPD.inside hospital IPD.
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Water cooler without water
No sufficient water coolers found to be at required places inside hospital.
Bio-medical waste
Open panel
6. Safe drinking water :-
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Water cooler with water
04/11/2304/11/23 1717Water tank with water
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Incinerator of hospitalStarted in 1998,Cost 9 lakhs 19 thousand. (Not used by hospital authority)
7. bio-medical waste management7. bio-medical waste management
04/11/2304/11/23 1919 Availability and position of dustbins in wards
Card box was used as dustbin
04/11/2304/11/23 2020 Medical Ward
Card box was used as dustbin
04/11/2304/11/23 2121Surgical Ward
04/11/2304/11/23 2222Ortho Ward
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Gyn.Ward
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EMERGENCY WARD
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Guidelines for use of Red dustbin
Red dustbins in civil hospital
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Red dustbins in civil hospital
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Guidelines for use of yellow dustbin
Yellow dustbins in civil hospital
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Yellow dustbins in civil hospital
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Yellow dustbins in civil hospital
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Guidelines for use of blue dustbin Blue dustbins in civil hospital
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Bio-medical waste mixed with Municipal waste in G.H.Sirsa campus
Human Placenta
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Medical waste
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Rag pickers with BMW
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Transportation of BMW from G.H.Sirsa
04/11/2304/11/23 3535Toilet/Bathroom Cleaning
8.Sanitation8.Sanitation
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Toilet/Bathroom Cleaning
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Toilet/Bathroom Cleaning
04/11/2304/11/23 3838Near the canteen & Trauma center
CLEANLINESS
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Backside of hospitalOn the First floor
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Backside of hospital Backside of staff residence
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Backside of Gyn. ward
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Parking facility near Parking facility near hospital hospital without any shed without any shed for vehicles. for vehicles.
No security measures for No security measures for parked vehicle at night.parked vehicle at night.
No speed level < 20 No speed level < 20 Km./hr board is displayed Km./hr board is displayed inside campus to avoid inside campus to avoid mishaps.mishaps.
9.Traffic safety9.Traffic safety
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04/11/2304/11/23 4444Dead generator
•Generators are not in working Generators are not in working condition.condition.•Open electrical wires and panels Open electrical wires and panels are present in hospital building.are present in hospital building.•Only one electrician for entire Only one electrician for entire hospital.hospital.•Generators are declared to be Generators are declared to be dangerous to building and human life dangerous to building and human life by hospital authority.by hospital authority.
Dead generator
10.Electrical Safety and Power backup
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Open electrical wires and panels
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No Fire safety measures are applied in the hospital .
No Fire safety measures are applied in the newly constructed Trauma center .
The building of C.T.Scan Center is The building of C.T.Scan Center is accompanied by all the fire detecting & accompanied by all the fire detecting & fighting equipments .fighting equipments .
11.Fire safety11.Fire safety
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View of Autoclave Room
only a small gate for entry & exit
12.Safety in Autoclave Room
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No security measures are No security measures are applied for the security of applied for the security of hospital furnitures and staff.hospital furnitures and staff.
13.Security
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14.Work place health promotion14.Work place health promotion
Strategy to reduce health Strategy to reduce health risk to staff:risk to staff:
Apron compulsory to Apron compulsory to staff nurses while at staff nurses while at work .work .No gloves, masks, gowns No gloves, masks, gowns used by staff.used by staff.No needle destroyer at No needle destroyer at placeplace
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15. Health promotion services for patients and their relatives15. Health promotion services for patients and their relatives
No May I help you No May I help you desks inside desks inside hospital hospital
No News paper No News paper stands at places stands at places inside hospitalinside hospital
No meeting place No meeting place for voluntary for voluntary groups like alcohol groups like alcohol Anonymous (AAA), Anonymous (AAA), Breath free groupBreath free group
1.1. Free counseling Free counseling centre like VCTC centre like VCTC ..
2.2.Blood bank Blood bank society, society, Thallasemia Thallasemia society to help society to help needy patientsneedy patients
3.3. Langar( free Langar( free meal/milk) by meal/milk) by voluntary voluntary agencies for agencies for poor patients poor patients and their and their attendantsattendants
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No posters and No posters and panelspanels
No gushing No gushing fountainsfountains
No television setsNo television sets No beautiful view No beautiful view
inside hospitalinside hospital
16.Recreational and IEC services16.Recreational and IEC services
No recreational and IEC services are available in the hospital
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17. Health promotion services for staff17. Health promotion services for staff
No Health No Health promotion promotion services are services are available for staff.available for staff.
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18. Welfare activities for staff18. Welfare activities for staff
No welfare activities No welfare activities are planned for staff.are planned for staff.
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19. Social and cultural activities19. Social and cultural activities
No social and cultural No social and cultural activities are organised activities are organised in the hospital campus.in the hospital campus.
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No No Temples, Temples, Gurdwara Gurdwara and and Church Church inside inside campuscampus
20.Religious sentiments20.Religious sentiments
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Canteen of Hospital
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View of the gallery of O.T.
21..Sterilization in the Operation theater
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View of the gallery of O.T.
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View of the gallery of O.T.
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At the gate of main O.T.Room
Gate of main O.T.Room
View of the gallery of O.T.
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The scene of the condition & The scene of the condition & working in the main operation working in the main operation theater was not captured, theater was not captured, because permission was not because permission was not granted by the authority by granted by the authority by giving the reason of sterilization giving the reason of sterilization ..
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Bathroom was locked.
22.Sterilization in Burn Ward
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Two pediatricians are available in the hospital but both are working as program officer and do not have sufficient time for pediatric care.
23. Child Care in the hospital
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Machine is not in working condition
24.Family Planning measures
04/11/2304/11/23 6565
Furniture without care
Furniture without careFurniture without care
25..Furniture care
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Old New
Steps to make hospital building more attractive
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Old Floor New Floor
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Equipments available in I.C.U. for critical care of patients.
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ResultsResults
Strengths:Strengths:Many types of modern medical Many types of modern medical
equipments & machines like equipments & machines like C.T.Scan, ventilators, cardiac C.T.Scan, ventilators, cardiac monitor, digital X-ray machine etc. monitor, digital X-ray machine etc. are available in hospital. are available in hospital.
Steps are taken by the authority to Steps are taken by the authority to make hospital building more make hospital building more attractive.attractive.
Strengths and weaknesses of HOSPITAL as per HPH standards
Strengths and weaknesses of HOSPITAL as per HPH standards
Weaknesses:• Lack of man power (medical/para-Lack of man power (medical/para-
medical/others) for proper functioning medical/others) for proper functioning of health services.of health services.
• Programme for quality assessment for Programme for quality assessment for health promotion activities not health promotion activities not
available. available. • No criteria is maintained for No criteria is maintained for
expenditure on health according to expenditure on health according to patients need.patients need.
• Lack of coordination between the Lack of coordination between the different dept. working for health different dept. working for health services.services.
• No project formation is prepared & No project formation is prepared & reviewed reviewed before & after implementation before & after implementation of different strategiesof different strategies by the by the specialized persons of Public health.specialized persons of Public health.
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ConclusionConclusion
Though the score of HPH standards is very low, but lot of positive HPH aspects of Though the score of HPH standards is very low, but lot of positive HPH aspects of HOSPITAL were witnessed during my study (not tailored as per scale but own HOSPITAL were witnessed during my study (not tailored as per scale but own initiative of the hospital administration). initiative of the hospital administration).
Suggestion for improvement:-Suggestion for improvement:-
The possible ways to overcome low score and to improve the image of HOSPITAL as a The possible ways to overcome low score and to improve the image of HOSPITAL as a HPH:HPH:
By assessing the need of man power and other things for hospital work and by fulfilling of all the requirements
Criteria for expenditure on health should be maintained according to patients need.Criteria for expenditure on health should be maintained according to patients need. Clear cut HPH policy should be framed.Clear cut HPH policy should be framed. HPH activities should be declared and labeled as Health Promoting activities.HPH activities should be declared and labeled as Health Promoting activities. Quality assessment of Health promoting activities be done from time to time.Quality assessment of Health promoting activities be done from time to time. Specific personnel need to be deputed to promote HPH activities.Specific personnel need to be deputed to promote HPH activities.
The will and spirit of HOSPITAL fraternity is the main thingThe will and spirit of HOSPITAL fraternity is the main thing
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Thanks !Thanks !
! !