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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

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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 !

! !