Medical Facilities on High Ways

Dr. Avadhesh Agrawala MBBS, MHADr. Sweta Tikkiwal MBBS, DPH (Public Health)

Health

• State of complete Well Being• Physical• Social• Mental

Medical Facility/Hospital

• Hospital – A Residential Establishment• Long Term & Short Term Care• Preventive, Promotive, Curative, Diagnostic,

Rehabilitative services• Sufferings or Suspected to be Sufferings

Some Facts & Figures• Every day, there are 3300 deaths and 6600 serious

injuries on the road in the world. • The global annual cost of RTA is almost 230 billion

dollars and 1.2 million people Die every year due to Road Traffic Accidents (RTA).

• 850,000 deaths -< 45 years of age in developing countries -sole bread-winners.

• Road Traffic Accidents cause injury to about 50 million people in the world.

• Every tenth bed in the hospital is occupied by an accident victim.

• The average cost of RTA in developing countries is estimated at 65 billion dollars,

• Out of 700000 Accidents globally, 10% happens in india

Indian Scenario……….• 1.27 Million People in India sustain serious injuries due to RTA

and 0.12 Million Die• India - 1% of the world’s motor vehicles- 6% of the total

global RTA deaths.• The cost of these accidents and death is Rs.550 Crores or 12.5

billion dollars every year in India.• A majority of major accident survivors are either confined to

the bed or wheel chair bound for the rest of their lives due to brain injury or spinal cord injury.

• Trauma related death occurs in India every 1.9 minutes

Medical Issues for Highway

• Medical Emergency• Surgical Emergency• Accidents & Trauma• Fractures of Bone• Soft Tissue Injuries• Spinal and Neurological Injuries

GOLDEN HOUR……..

Concept of Care…..

• “Available”, • “Accessible”, • “Acceptable”, • “Affordable”, • “Appropriate”

Functional Master Plan• Physical facility : Buildings and Building Blocks,

Engineering Services, Hospital Utility Services and Support Services.

• Departmentation Plan • Equipment Plan• Manpower Plan providing for Medical Staff, Technical

& Nursing Staff, Administrative and Support Staff• Hospital Supply Systems: Medical & Surgical supplies,

Sterile Supplies and other needed supplies for Housekeeping, Catering and maintenance.

• Hospital Administrative Structure and Basic Hospital Administration Plan

Patient Care Units• IN-PATIENT UNIT• Intensive Care In-patient unit• Emergency In-patient unit• Nursery• Private Rooms (1 bed in each room)• Semi-private Rooms (2 beds in each room)• General Ward (5 beds in each room)• OUT PATIENT DEPARTMENT • Consulting Room• Emergency Rooms

Clinical Support Areas• CLINICAL SUPPORT AREAS• General Surgery Suite Operating Rooms Complex• Obstetric Suite Delivery Room Complex• Imaging Dept. Rooms Complex• General X-Ray Machine• Ultrasound• CT Room

• Pathology Dept.• The Stat Laboratory• Clinical pathology Laboratory• Advanced Analytical Laboratory• Micro Biology Laboratory• Blood Bank (Replacement Only)• Mortuary

• Ancillary Therapy• Physiotherapy

Other Support Areas• ADMINISTRATIVE SUPPORT AREAS• Hospital Administrative Service Department• Central Reception and Patient Relations Service Department • Hospital Medical Records Department• Hospital Engineering Services & Bio-Medical Engineering Services Department • Hospital Laundry Service• Hospital Catering Service• Hospital Pharmacy Service• Hospital Stores & Supply Department• Hospital Sterile Supply Service Department• House Keeping Services• Hospital Security Services• Patient Utility Services• OTHER SUPPORT AREAS (THESE MAY NOT BE LOCATED ON SITE)• Single Status Accommodation • Married Status Accommodation• Garages

Human Resource Medical Staff Full Time Consultant Visiting Consultants General Duty Medical Officers

Nursing Staff• Hospital Matron• Sister In Charge • Staff Nurses• Nursing Orderlies & Ayahas

Technical Staff• Anaesthesia Asst.• Bio-medical Technician • Laboratory Technician • Operating Room Asst.• Pharmacists • Physiotherapist• Radiographer • Social Worker• Ultra Sound Technician

Administration• Medical Superintendent• Managers• Supervisor

House Keeping & Others• Ambulance Asst.• Cashiers • Cookmates• Cooks • Drivers• Gardeners• General Clerks• Storekeepers• Sweepers • Washer-men

IT Dept Staff

Hospital Engineering Services• Air Handling & Conditioning

Plant• Boiler House• Electric Distribution Plant• Electric Stand By Generator• Electric Substation• Engineering Services Office• Engineering Services Store• Fire Detection System• Fire Fighting System• Horticulture

• Incinerator• Lifts• Loading Platforms• Roads & Parking Lots• Sewage Lines & Trunks• Sewage Treatment Plant• Storm Water Drains &

Handling Plant• Street Lights & Perimeter

Light• Tradesmen Workshop• Waste Water Handling Plant• Water Storage Tanks• Water Treatment Plant &

Distribution Plant

….contd

Hospital Mechanised Transport Service• Ambulances Service• Hearse Van Service• General Vehicle

Hospital Biomedical Engineering Service• PMG Manifold Room

Services• Biomedical Engineering

Workshop Service• Maintenance Of Clean

Room Equipment

Issues of Prime Importance

• Accessibility • Availability• Transport facility• Information sharing facility• Competent Service Providers• Laboratory Investigations• Radiology Investigations• Operation theatres• Availability of Doctors & Support

Staff• Referral Services• Central Sterile Supply

Department

• Laundry• Reception and Information

counter• Medical Equipments• Drugs and supplies• Stretchers & Trolleys• Medical Records• Water Supply• Uninterrupted Electrical supply &

Back Up• Patient care area/ Ward/ ICU• Telemedicine• Parking place for ambulance

• Structure Related Issues

Process related Issues

• Pre Hospital Care & First Aid• Basic medical care during

transportation• Timely Information• Initial Stabilization• Scope of Services• Timely referral• Care component in Hospital• Continuity of Care• Empathetic attitude• Round the clock Services

• Management during Non availability of beds

• Informed decisions & Consent

• Multidisciplinary Care• Discharge summary• Handling of medico legal

formalities• Information sharing among

Hospitals

Matrix of Processes

Conclusion

• Highway Designing• Medical Facility Planning • Ambulance & Emergency Services• Air Ambulance• Provision of Basic Trauma related services

Any Suggestions…………….