Souvenir on International Conference final Conference on Modern Healthcare Accessibility &...

International Conference on Modern HealthcareAccessibility & Innovations

8 & 9 April 2017 Kolkata INDIA

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C O N T E N T S

Messages Page 2-4

About MEDICA Page 6-9

About the Conference Page 11-13

Page 14-35

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Page 46-50

Articles

Paper Presentations

Paper Presentation by Students



ndian Healthcare industry is growing at a phenomenal rate with tertiary care making inroads into small towns and districts Iacross the country. This holds particularly true for the eastern

region which has always had the reputation of being a laggard as far as growth and development are concerned. The biggest challenge in the healthcare sector in our country today is making quality healthcare available to all our citizens at a cost that is affordable. The greater part of our country has neither the access nor the means to procure basic healthcare for themselves and their families. This makes our job, as healthcare providers, more challenging.

Globally, healthcare trends are changing with the focus now more on Preventive Care, and nowhere is this more required than in a country like ours where given the vast geographical and socio-cultural differences, accessibility to healthcare is a major challenge. Over the years, healthcare dimensions have undergone a sea change and with it also has the life of a healthcare provider. Earlier healthcare was a relationship between the Doctor and his/her patient, with nurses on the fringes. Today, many more layers have been added and patient care and satisfaction depends on a number of touchpoints in a healthcare facility. Managing a human being has become the prime responsibility of healthcare providers.

In organizing this conference on Modern Healthcare: Accessibility & Innovations, it was our aim to bring to a common platform stalwarts from various fields of healthcare, to debate and discuss the changing dynamics vis-à-vis the role of research, infrastructural needs, changing management trends, and above all enhancing patient care and experience. It was heartening to see the very encouraging participation and enthusiasm of the participants and the audience. Talks and presentations delivered by our extremely knowledgeable panel of speakers served as great learning experience for the attendees – delegates and students.

The conference was a culmination of hard work put in by the entire organizing team and we look forward to organising more such events in the future.

M E S S A G E S



Dr Alok RoyChairmanMedica Hospitals

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e are indeed privileged and delighted to host the International Conference on Modern Healthcare: WAccessibility & Innovations, in Kolkata, the City of Joy.

We express our sincere thanks to the office bearers of Academy of Hospital Administration, Kolkata Chapter, Academic Institutions, Hospitals and other stakeholders, for giving us an opportunity to host this conference. Such a herculean task would not have been possible without the voyage traveled by the delegates coming from different parts of the world.

The conference programme has been planned to deliver the most recent advances in healthcare industry by eminent professionals across the globe, that can benefit the country and community as a whole.

Dr (Col) Soumen BasuGroup Medical DirectorMedica Hospitals

M E S S A G E S 3



t is a matter of immense pleasure for me to note that the 1st International Conference on “Modern Healthcare: Accessibility I& Innovations”, was organised by Medica Superspecialty

Hospital, on 8th and 9th April 2017 at ITC Sonar, Kolkata.

The theme chosen of the conference is of topical interest. Medica has the reputation of providing world-class health care in eastern India.

I congratulate the organisers for arranging such an enriching event and I am sure that at the end of the conference the participants were charged with newer thoughts and ideas to serve the community in a much better way.

My heartiest congratulations on the success of the conference.

Prof (Dr) Krishnangshu RayDirectorInstitute of Health & Family Welfare - WB, Kolkata

am happy to learn that the 1st International Conference on “Modern Healthcare: Accessibility & Innovations” was held on I8th & 9thApril, 2017 at ITC Sonar, Kolkata organised by the

Medica Superspecialty Hospital, Kolkata.

The theme of the Conference "Modern Healthcare: Accessibility and Innovations" was aptly chosen considering the rapid progress of medical technology and its application into practice.

I offer my heartiest kudos to the Medica Superspecialty Hospital for arranging such a wonderful conference.

I am sure that at the end of the Conference the participants will be charged with newer ideas, skills and thoughts.

My heartiest congratulations on the success of the conference.

Prof (Dr) Bhabatosh BiswasVice ChancellorThe West Bengal University of Health Sciences

M E S S A G E S4

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Since: 2012...



edica Hospitals, one of the most reputed and leading healthcare chains in Eastern India today, has built and Mm a n a g e d a n u m b e r o f M u l t i s p e c i a l t y a n d

Superspecialty healthcare facilities across the region over the past few years.

Beginning its journey with Medica North Bengal Clinic (MNBC) in Siliguri in 2008, the Group launched its flagship Hospital – Medica Superspecialty Hospital (MSH) – in Kolkata in 2010. Soon after Medica Cancer Hospital in Rangapani, Siliguri, fulfilled the dire need of a comprehensive cancer facility in North Bengal, and the trust hospital R.C. Agarwal Memorial run by Medica in Tinsukia brought quality multispecialty healthcare to Assam.

Medica tied-up with Tata Steel in 2014 to run the operations of Kantilal Gandhi Memorial Hospital (an existing unit in Jharkhand) and with the Jain Samaj for Bhagwan Mahavir Medica Superspecialty Hospital (a new venture in Ranchi). Tata Steel Medica Hospital in Kalinganagar, Odisha, began operations in 2015. In 2016 Medica took over the operations of Medica Gamma Hospital (developed as a boutique healthcare unit in the heart of Kolkata). Two specialized heart care units (Medica Heart Institute) were launched in Dhanbad and Patna, along with a unit in Burdwan- Bengal Faith Medica Hospital.

Medica Group of HospitalsTouching new heights in healthcare delivery in the east

KOLKATA

SILIGURI

RANCHI KALINGANAGAR

DHANBAD JAMSHEDPUR

About MEDICA

Medica Superspecialty Hospital, KolkataA unit of Medica Synergie, the Kolkata Hospital, located in Mukundapur, off EM Bypass, is today one of the most respected and trusted healthcare providers in Eastern India. Filling a huge lacuna in tertiary healthcare in the east, Medica has kept its promise of delivering quality healthcare using ethical practices in a transparent set up. Medica has revolutionised healthcare delivery in the region through not just technological advancements and innovative treatment techniques, but also in the area of patient care.

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A B O U T M E D I C A 7

Our Specialties

Outreach Programmes

Medica has eight Centres of Excellence – Neurological Diseases, Cardiac Sciences, Orthopaedics, Gastroenterology & GI Surgery, Kidney Diseases, Critical Care, ENT and Breast Diseases – headed by renowned specialists and surgeons, with comprehensive treatment facilities.

The Hospital also has departments of Obstetrics & Gynaecology, Paediatrics, Endocrinology & Diabetes, Dermatology, Plastic Surgery, Internal Medicine & Surgery, Bariatric & Metabolic Surgery, Comprehensive Hernia Surgery, Endocrinology & Diabetes, Psychiatry & Psychology and international standard Physical Therapy & Rehab services for post surgery and medical management of patients along with specialised services in Sports Injury Management and Counseling.

M e d i c a ' s E m e r g e n c y Department is manned by specialists in Emergency Medicine. Fitted with the most advanced equipment

and support systems, the department is geared 24x7 to deal with all kinds of emergencies – accidents, heart attack, stroke, GI bleeds, child birth etc – that need immediate medical or surgical intervention. The department has 24x7 Consultant coverage and fully equipped ambulance service for quick and safe transport of patients.

Other facilities include 10 modern Operation Theatres with Green OT certification ensuring 100% compliance of safety standards, and 24x7 Imaging and Lab services fitted with the latest equipment and technology like the Molecular lab which helps doctors in preparing customized and the most effective treatment plans for patients.

A perfect amalgam of superior skill and latest technology is what makes Medica's healthcare delivery system among the best in the country today.

In its endeavour to make superior healthcare more accessible and available to the masses living in remote areas, away from major cities, Medica has undertaken a number of pioneering ventures.

Medica Flying Doctors is a unique project launched by the hospital group in early 2015. Senior specialists from Medica Kolkata are flown periodically in a 9-seater plane to smaller towns to hold health camps for the local populace in various districts of West Bengal, North Bengal, Bihar, Jharkhand and Odisha.



Medica launched the Chest Pain Rapid Responder Service in December 2016 to transport probable heart attack victims to advanced heart care units to ensure treatment within the Golden Hour. Fitted with video conferencing facility and manned by trained Emergency Medical Technicians, the necessary treatment can begin in transit with supervision by a Cardiologist.

Medica Home Care Service provides complete care at home for elderly, bed-bound or chronic patients, reducing the necessity of repeated hospital visits and expenditure, apart from need-based requirements like a doctor or nurse's home visits, basic health check-up at home, Physiotherapy Services and Care Managers for regular monitoring. E-health book services have been recently introduced to enable the members to keep all their medical records organized and easily accessible.

The Hospital has a strong academic wing imparting regular Paramedical Courses for young boys and girls looking for a career in healthcare. Workshops and training sessions are held regularly as part of the continuous medical education programmes. Medica's academic wing has tie-ups with various national and international institutions/universities for courses and research and training programmes. Last year the hospital tied up with UK's George Washington University for Masters in Emergency Medicine Course.

Medica Superspecialty Hospital has instituted a number of innovative projects/schemes keeping the welfare of patients in mind.

KARMA (Kolkata Accident Response & Medical Assistance) was launched by Medica in collaboration with Kolkata Police in March, 2012. The project provides 24 hours trauma care service for victims of road accidents in the city, transporting them to healthcare facilities closest to the site of trauma. 18 ambulances are kept stationed 24x7 at various locations across the city. The emergency calls to the KARMA helpline are received at the Command Centre run by Medica on its premises and the ambulance stationed nearest to the accident location is directed to attend to the victim. The movement of the ambulances is monitored by the Command Centre. This project has been replicated in Jamshedpur and Ranchi also.

Healthcare for Overseas Parents and Elders (HOPE) is a project for the benefit of the elderly parents of young professionals settled abroad, who do not have any support system here to deal with medical emergencies.

The hospital runs a trust for BPL patients and has special packages for the economically underprivileged sections of the society. It also supports a number of city-based NGOs and has tie-ups with some offering special packages and discounts.

Academic excellence

Social Welfare Projects instituted by Medica

Project HOPE

For BPL patients

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Caddy Scheme

Special Cardiac Surgery Packages

Swasthya Mitra

Launched at Royal Calcutta Golf Club, in association with the club authorities, the scheme provides the benefit of medical insurance to the caddies and their families. Regular check-up camps are held at the club and over the counter medicines dispensed free of charge.

Highly discounted Cardiac Surgery packages are provided for the underprivileged sections of the society, with the support of Rotary International.

A scheme introduced mainly for the benefit of the elderly population, the initiative trains young men and women to conduct basic health check up including blood pressure and blood sugar tests, height and weight monitoring and emergency first aid care, to enable them to use their training to provide a basic health support to the senior citizens. These are our Swasthya Mitra who have become a source of great support for a number of elderly citizens of Kolkata, who depend on them for their regular health monitoring and also in times of emergency

A B O U T M E D I C A 9

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About the ConferenceInternational Conference on Modern Healthcare Accessibility & Innovations

his focused two day event organised by Medica Superspecialty Hospital was held at ITC Sonar and was Kolkata's first and Eastern India's most significant event in Tthe field of medical science and technology, which added

a new dimension to clinical practices, procedures and technology. The International Conference provided a common platform to world's top healthcare professionals, doctors, related organisations and experts to explore new avenues for accessing the latest and most sophisticated solutions in healthcare. The sessions and interactions over the two days helped all to understand the challenges in this field and provide renewed impetus to innovation and research. Healthcare Professionals and experts from all across the country gathered here to share their views and experiences on varied topics with the aim to improve modern healthcare accessibility and ways to deliver the highest quality of patient care.

The first session focussed on Planning & Designing. Dr. Merzi D Marker (Medical Director – Bhagwan Mahaveer Jain

Hospital, Bengaluru), spoke about the various challenges faced in the planning and designing of modern hospitals. Today the complexity of functioning of hospitals has

increased, he said, with aesthetics, p a t i e n t s a f e t y , s t a t u t o r y

compliances and environment coming into the picture. Mr Kunal Bhattachar ya

( D i r e c t o r, H e a l t h c a r e Planning & Design, RJB Architects Pvt Ltd, Kolkata) speaking on 'Evidence-

based Designing for Safety, E f f i c i e n c y & C r e a t i n g a Therapeutic Environment', said hospital designing is not a stroke

explained UK's NHS system, focusing on the benefits and flaws. of genius, it is a collaborative Dr Girdhar Gyani, Director General Association of Healthcare process that involves the vision Providers of India, New Delhi, elaborated on the 'Role of Hospital of an informed client along with Management in delivering Modern Healthcare'. He said growing the architect. The design has to private healthcare in our country has made the role of hospital be evidence-based, should be management extremely important. Modern healthcare systems measurable and have an in-require different service delivery teams to work in tandem and built flexibility keeping the this is where management plays a big role, he added. future requirements in mind.Col R.N. Basu, Advisor Quality & Academics, Medica

The next session had the British Superspecialty Hospital, spoke on the need of enhancing patient Deputy High Commissioner, experience. He said it is necessary to make healthcare providers Kolkata, Mr Bruce Bucknell, understand the need of humanising their patients and not deal

speaking about the difference in with them as objects. It is important to make the patient healthcare delivery systems participate in his/her treatment and care.

in UK and India. He

Mr Bruce Bucknell

Prof Krishnangshu Roy Dr Phillip Dellinger

Dr Girdhar Gyani Dr Merzi Marker

Mr Partha Dey Mr A Velumani

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Dr Uday Kr Maiya

Air Marshall Pawan Kapoor and Mr Kanchan Dasgupta

with Ms Aruna Nair

Mr Kunal Bhattacharya

Ms Soma Bhan

The post lunch session had Sr Cardiac Bengaluru, Mr Uday Kr Surgeon and Vice-Chairman Medica, Dr Maiya, elaborated on the Kunal Sarkar, moderating over a panel need for home healthcare. He

d i s c u s s i o n o n said in a country like India 'Advancement in where accessibility remains a M e d i c a l major challenge, chronic and

Technology'. The geriatric care at home can panel members make a big difference. It would i n c l u d e d D r be cost effective and would

R a g h u B a s i b o i n a also serve the purpose of (Director, Diagnostic avoiding over burdening of Lab, PerkinElmer), Mr the already stressed healthcare facilities.Himangshu Laiker The second day of the conference focussed on 'Quality, (Director, Strategy & Accessibility and Medico-legal Aspects of Healthcare'. The day B u s i n e s s opened with a session on quality and accreditation. D e v e l o p m e n t , Air Marshal Pawan Kapoor, Chairman Accreditation Medtronic India) and Committee NABH, Indian Mr Nitin Deshpande Armed Forces, New Delhi, ( C E O – G l o c a l opened the session with his Products, LLC). The talk on 'Quality and Excellence discussion focussed in Healthcare – Best practices'. o n t h e n e e d o f Starting with statistics to

indigenous advancements in medical technology, the only way show where Indian healthcare to control cost and increase accessibility to modern healthcare. stands today in terms of

In the next session focussing quality, the he went on to on 'Advancements in Medical demonstrate that any error in Technology', Dr A Velumani, treatment is actually not an Promoter, Chairman, MD & individual mistake, it is a CEO – Thyrocare Laboratories, system failure. Senior Business Associate – LIC India, Mumbai, stole the show with Mr Kanchan Dasgupta followed with his presentation on the his unorthodox presentation role of “Health Insurance as a Vehicle to Access Modern on the establishment of an Healthcare”. He spoke on the need of the Government empire as he shared the story spending more on healthcare and the importance of making of how he single-handedly the common began Thyrocare and brought man aware of it to its present height only by the need of

using common sense and practicality. Mr Partha Dey, health insurance.Healthcare leader and SME, IBM Healthcare, New Delhi, made a

presentation on 'Healthcare in Digital Age: Transforming Healthcare through Information System'. He spoke at length about the forms of digital technology that can be useful in healthcare. Prof Niranjan Bhattacharya, Professor – Dept of Regenerative Medicine ad Translational Science, School of Tropical Medicine, Kolkata – spoke on the importance and benefits of Stem Cell Therapy. Speaking about the 'Scope of Healthcare in India', Medical Director of Portea Medical,

Dr Alok Roy

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The next two sessions focussed on 'Accessibility to Healthcare'. Col (Dr) Soumen Basu, Group Medical Director MSH, spoke at Speaking on 'Application of Modern Techniques and Practices length on the in Nursing Service Administration', Prof Mahasweta Bose, importance of

P r i n c i p a l – Doctor-Patient C o l l e g e o f relationship. He N u r s i n g , stressed on the C h a r n o c k need team work College, Kolkata to deliver the – elaborated on best possible the need for p a t i e n t c a re . nurses to stay E m i n e n t up-to-date with Advocate Mr Jayanta Das Gupta, spoke at length on the

the innovations and advancements in medical science. present Healthcare Bill, discussing the pros and cons.Mr Arindam Bhattacharya, CEO – Technocratz, Kolkata, The last session of the day on Modern Critical Care, Dr R Phiip presented his case on 'Reaching the Unreachables with Medical Dellinger (Director, Cooper Adult Health Institute) discussed Technology'. He spoke about the various factors that make 'Critical Care in accessibility to healthcare a major challenge in a country like the Digital Era' India. with Dr Arindam

K a r, D i r e c t o r Prof Barun Kanjilal, Health Economist – Indian Institute of MICC, MSH.Health Management Research (IIHMR) Kolkata, spoke on the

Role of Research in improving Healthcare for Vulnerable T h i s w a s P o p u l a t i o n . f o l l o w e d b y R e s e a r c h i s p a p e r o f t e n presentations by restricted to M r S o u m e n p u b l i s h e d Mukherjee (Asst Professor TIPS – Joint venture with Tripura s t u d i e s a n d Govt) on 'Patient Satisfaction Level Study of a Tertiary Care not connected Hospital in Tripura', Ms Jhulan Roy (Asst Proffesor, Pailan College t o g r o u n d of Management & Technology) on 'Stress at Workplace for r e a l i t i e s . F e m a l e R e s e a r c h e r s Employee in the a n d p o l i c y H o s p i t a l

makers need to work together to find gaps in healthcare and Industry' and Mr plug them. Renowned Internal Medicine specialist, Anurag Patra Prof (Dr) Sukumar Mukherjee, discussed the transition in (Management healthcare in India. He said it is important for a shift from T r a i n e e , 'curative' to 'preventive'. He felt Public-Private partnership is C o v e n t r y the way forward. Prof A Venkataraman, Faculty of University, UK) Management Studies (FMS), New Delhi, spoke on 'Public on 'Internet of Private Partnership in the provision of health services for the Things in Healthcare'. Some NSHM students also presented poor'. He pointed out that 30% of Community Centres are their papers on patient feedback & satisfaction.without doctors, and districts do not have specialty services.

The two-day conference proved to be a very useful for the more The post lunch session was on Medico legal Aspects. Speaking than 300 attendees, including management students looking on 'Ethics, Etiquette and Professionalism in Medical Practice, towards a career in hospitals, with stalwarts associated in Prof (Dr) Krishnangshu Ray, Director – Institute of Health & various areas of healthcare sharing their views, experiences, Family Welfare, WB, said the foundation of medical care can advice and vast knowledge. only be laid on mutual trust between Patient & Physician.

Mr Arindam Bhattacharya

Prof Mahasweta Bose

Prof Niranjan Bhattacharya

Panel Discussion

Inauguration of Medica Institute of

Healthcare Innovations & Research

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Articles

Dr Udaya Kumar MaiyaMD, DNB(RT), DCCF (Paris)Medical Director, Portea MedicalBangalore

Delivering Home Healthcare : The Portea way

aving completed more than two million patient visits hospitals to more effectively engage with and treat patients since inception in 2013, Portea Medical has had the who are critical and often require a full continuity of care.Hopportunity to serve thousands of patients across the

Finally, home healthcare is also good for insurers. By country by providing a range of primary care and disease integrating home care into their policies, insurers can reduce management services, elder care and post-operative support. the amount of time that their beneficiaries stay in the hospital Our experience has shown that homecare offers a true “win-(and therefore reduce costs) as well as prevent unnecessary win” to all stakeholders, in a scenario where all parties benefit. readmission to the hospital. In the West, home care is one of

Home healthcare is undeniably good for patients. From a the most important levers that insurers use to control costs. As clinical perspective, it has been demonstrated to lead to lower healthcare providers become more accountable for both the rates of nosocomial infections, early discharges, lower rates of quality and cost of patient care, health outcomes and readmission, and faster recoveries. In addition, patients prefer affordability improve. to be treated in the home. Therefore, it is not surprising that in

Home healthcare in India is still at a fairly early stage but has countries like the United States, and increasingly so, here in become an integral part of healthcare delivery in India over India, home healthcare is an integral part of the healthcare the last 3 years since Portea was established, bringing benefits delivery system which is used to discharge patients from the to both patients and healthcare providers. While patients and hospital as soon as possible after a procedure and keep the hospitals have been the first adopters as their needs are the elderly and those with chronic diseases in the home instead of most acute, over time insurers have also come to recognise the at the hospital. The size of the industry speaks to its potential and are increasingly open to adopting to concept of importance; according to last year's data, home healthcare in home healthcare. the United States was over a 100 billion USD industry, larger

than all of Indian healthcare. Care administered by home healthcare professionals include, administering oral medication, injections, oxygen and stoma Home healthcare is good for hospitals. Usually the hospital-care, assistance in ambulation (moving the patient around), insurer dynamic is seen as zero sum: what is good for one is managing feeding tubes, ADL (Activities of Daily Living- necessarily bad for the other. Home healthcare is a rare managing cleaning, grooming, bathing and feeding), exception to this general rule. A hospital's most expensive monitoring vitals of the patient (blood pressure, pulse, asset is their infrastructure and by discharging patients sooner respiratory rate, etc.) and physiotherapy. Besides physical (using their facility more effectively) they can treat more wellbeing, the attendants also seek to provide much needed patients and improve both their top and bottom line. In companionship to the ailing family member. Home healthcare hospital parlance, hospitals are able to decrease their ALOS has also emerged as a key plank to tackle chronic disease (Average Length of Stay) and increase their ARPOB (Average management with or without the use of remote monitoring Revenue PerOperating Bed). Home healthcare also allows

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devices. Other services include chemotherapy at home as well medical care are brought into the medical mainstream to a as ICU-At-Home services. All of these are delivered in a way great extent. This is especially true for patients with chronic that ensures the specialist or the referring physician is diseases and elderly. In the long run, this is expected to change periodically kept informed of the condition so that outcomes the way primary care is delivered to the most needed patient are optimised. population effectively.

Home health care delivery ensures that a majority of non-compliant patients who otherwise would not have sought



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he theme of this conference reminds me of one of the Technology has never stopped thinking beyond its f a m o u s s a y i n g o f A l b e r t E i n s t e i n - boundaries and that has resulted in the advancement of T"the true sign of intelligence is not knowledge but mankind in every field. Modern healthcare has access to

imagination" highly effective technology solutions like telemedicine, tele radiology, tele-ecg, and many other tools for interchanging of

Imagine you are on a video call with one of your patient, 500 medical data and information. It must utilise these to enhance miles away and while on the call, you get access to all the vitals their reach and make the overall healthcare accessible to more of that patient on a pop up window in your phone. You have number of people. This overall process in itself is an the data and you have the patient - both virtually; hence you innovation. Once you increase your access to more number of can advice your treatment. This explains how modern patients, you can even minimise the factors of inaccessibility healthcare can become accessible through innovations. A because of cost; this may sound abnormal. Technology is a part of this process is already doable and a major part of it is cost; so how is it possible that I reduce cost by adding cost? It is still under imagination, which down the line technology will possible ! Think of a situation that a physical OPD handles 400 find a solution to achieve. patients per day. This has a cost and a revenue. Think of

running a telemedicine OPD from the same premises In today's world a lot of development has happened in

and treat another 200 patients per day utilising the same medical science in respect to patient care in each of the

infrastructure. You spend a little bit more, but you end up - disciplines; the rate of overcoming a disease or medical

(a) earning more revenue (b) reaching more patients who problem has increased in multiples of percentage compared

were inaccessible to you and vice versa. to old days. Modern healthcare is much more armed and equipped to face and treat multiple diseases; but is it Every stake holder in modern healthcare system should think accessible to all ?? of making healthcare more accessible and that is only possible

through different innovations primarily technology and this This is where still the challenge remains. Accessibility of such

can happen only through imagination. So, imagine treating developments is still limited. This is not because of lack of

anybody anywhere anytime from anywhere…resources or technology, but because of lack of awareness and acceptability.

Mr Arindam BhattacharyaFounder & CEO TechnoCratz

Modern Healthcare Accessibility and Innovations

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Mr Kanchan Das Gupta

Health Insurance A Vehicle to Access Modern Healthcare

Senior Business Associate LIC of India, Kolkata

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ith progress of science and technology modern Advancement of Healthcarehealthcare has brought great relief for many Healthcare has developed and changed throughout history. Wacross the globe and has enhanced life The experiences and discoveries of the past have led to the

expectancy. In ancient times, diseases or illness had different advances of today. The trials and errors of the past have acted interpretations and were treated according to the beliefs and as the foundation for today's success. If we can understand the practices in countries. It is needless to say that ill health is a primitive beginnings of medicine, we will be able to major area of concern today. Today's lifestyle coupled with appreciate the medical advancements made during the pollution has given rise to numbers and complexity of past 5,000 years.diseases. Modern Healthcare offers comfort and cure from many ailments but its accessibility remains a major challenge Modern Healthcare facilities have enabledin a country like India. People to be healthier and live longer.

New procedures and inventions to change lives that Health insurance is a financial tool that covers the cost of an include :insured individual's medical and surgical expenses.

Eliminating diseases through genetic research.Depending on the type of coverage, either the insured (policy

Transplanting organs from donor to recipient.holder) pays costs out-of-pocket and is then reimbursed, or The ability to reattach severed body parts.the insurer (insurance company) makes payments directly to Use of technology to help with patient care.the provider (Hospitals, Nursing Homes etc.) through a third-

party administrator (TPA). TPA is an organization that Non-invasive intervention for improving wellbeing and quality of lifeprocesses insurance claims. Cost of the policy depends upon

age and the quantum of benefit opted for by the insured. Advancements in caring for unborn foetus.

ChallengesHealth Insurance in our country is guided by 'Insurance Lack of awarenessRegulatory and Development Authority of India (Health Health Insurance penetrationInsurance) Regulations, 2016'. Various Insurance companies Fund allocation by GOI in health sectorboth in public and private sector offer a wide range of Health

Insurance schemes. Inequitable health infrastructure

Way ForwardRashtriya Swasthya Bima Yojana (RSBY, literally 'National Proactive role by media and social sectorHealth Insurance Programme' is a government-run Health Reaching the unreachedInsurance scheme for the Indian poor. The scheme aims to

provide Health Insurance coverage to the unorganised sector Creation of awarenessworkers belonging to the BPL – Below Poverty Line category Lobby for greater resource allocation & equity in health and their family members. services

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had different interpretations and were treated according to Conclusionthe beliefs and practices in countries. It is needless to say that Health Insurance can act as an important vehicle in ensuring ill health is a major area of concern today. Today's lifestyle good health through modern healthcare. This can become coupled with pollution has given rise to numbers and reality when people at large are aware how health insurance complexity of diseases. Modern healthcare offers comfort and can benefit every individual and come forward to become cure from many ailments but its accessibility remains a major part of a movement towards developing a healthier nation. challenge in a country like India.

Abstract:Health Insurance is the most practical and effective vehicle

With advent of science and technology, modern healthcare to access Modern healthcare.

has brought great relief for many across the globe and has enhanced life expectancy. In ancient times diseases or illness

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edical Ethics refers to a system of values common to centered as the case may be. A Physician who strictly offers Medical Profession and application of those values diseases-centered talks has been referred to as 'Voice of Mto practice of medicine. It is the standard of Medicine'. The latter category aims to identify the psycho-

behaviour by which physicians evaluate their relationship social issues of the illness so as to ascertain the patient's belief, with patients, colleagues and society. Breach of medical ethics priorities and preferences. The average time of consultation is known as malpraxis and misconduct. Professionalism is a ranges between 8-20 minutes that covers active listening concept or behavior in accordance to a set by some followed by and participatory communication. Appropriate independent professional bodies. It is different from the term use of 'therapeutic dialogues' and 'therapeutic privileges' 'humanism' which means an intrinsic conviction about one's could reduce number of return visits.obligations towards others.

Illness is a social deviance that impairs the normal role 'Therapeutic Relationship' between physician and patient performance and affects smooth functioning of the society. sounds a socio-medical bonding between the two parties. The magnitude of illness is controlled by socially prescribed This issue had raised attention since the period of Hippocrates. roles for doctors as well as patients. Unfriendly, non-Clinical, psycho-social and behavioural outcomes of such empathetic attitude of care-givers and cross-cultural relationship has been described in various forms and differences between the care-seekers should be addressed determinants. Age-old paternalistic relationship in the past with high priority. Etiquette Based Medicine is an advanced has been modified to many models over the period of time. skill that needs to be imbibed inside the entire medical The primary reasons of such transformation could be fraternity. Introduction of refresher's training with intense explained in terms of human development, scientific monitoring in undergraduate curriculum is the order of the advancement, socio-economic movements, political will of day. Exposure to soft skill 'ATCOM' (Attitude and the contemporary rulers and profit-maximization concepts. Communication), a new proposition by the Medical Council of Present relationship between the two parties are based upon India is a positive step towards fostering the continuity in the participatory, consumerist, mutuality and default models. understanding of psycho-social aspects of the illness. Giving However considerable variation in the nature of the due importance to the voice of ethics and professionalism relationship between physician and patient cannot be could protect the progressive decline in physician-patient explained entirely in terms of medical condition. It is also relationship in present days. Necessary road maps may be influenced by the expectations of both physician and patient formulated by the policy makers to incorporate physicians in as well as the structural context of the consultation or medical the movement in the interest of our patients. Let us not forget encounter. that 'Voice of Medicine' expresses the value of the medical

profession.The major factors influencing the ethical relationship between a physician and patient includes some 'soft skills, “Physician-Patient Relationship is not a relationship

between fish and fisherman but always the fish and communication, patient characteristics, bed-side manners, water “. non-verbal cues and consultation time'. These skills reflect the

differences in the attitudes and orientation towards the -Anonymousmedical task. It may be either physician-centered or patient-

Ethics, Etiquette and Professionalism in Medical PracticeProf (Dr) Krishnangshu RayMD PhD MBA DA, Director, Institute of Health & Family Welfare (Govt. of WB)Formerly, Director, School of Tropical Medicine, Kolkata Director, Drugs Control, Govt. of WB

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ack of credible evidence on health challenges of The presentation also provides suggestions regarding the vulnerable populations is a fundamental barrier to future discourse on the direction of public health research. In Lreach equitable health outcomes. There is need for addition to the traditional analysis of the evidences usually

mobilizing various stakeholders using evidence through meant for scientific publications, the researchers should also effective research/policy linkages. This process is seldom address issues related to translation of knowledge for the use linear and needs to account for stakeholder needs, wider of policy actors; for example, (1) how to measure the socio-political context, policy development process, vulnerability of a particular group of population (2) how to changing priorities of stakeholders and differences in their involve the stakeholders in the research process (3) how to knowledge and ability to use evidence. translate the research evidences into a package of usable

inputs for policy and action, and (4) how to draw attention of To integrate research findings into the policy making process the key stakeholders to the questions on designs or gaps in and to communicate research findings to policymakers is a service delivery that are usually neglected. key challenge world-wide. This is especially difficult in the context of improving health care for vulnerable population as the perception about vulnerability varies across the stakeholders. This presentation reflects our experience of conducting a 'knowledge intervention' research program for improving the health service delivery at the Sundarbans – one of the most vulnerable regions in India – which shows that knowledge translation strategies need to move from static dissemination outputs to multi-method, responsive and dynamic modes of engagement with multiple stakeholders, including non-health actors. For this shift to positively impact collaborative action, capacity building is a prerequisite.

Prof Barun Kanjilal

How can Research Engage with Stakeholders for Improving Healthcare for Vulnerable Populations?

Health Economist - Indian Institute of Health Management Research (IIHMR), Kolkata

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ursing administration is a body of knowledge which The role of Nurses have changed and improved with results in output of clients whose health is introduction of modern techniques and technologies. Nunavoidably deteriorating, maintained or improved Strong nursing leadership is required for effective function of

through input of personnel and material resources used in an healthcare organizations.orderly process of nursing services.

Quality assurance methods to be practiced in nursing Nursing Service Administration at any level is the application administration for increase in the output of work and of the principles of administration for the ultimate purpose of obtaining an efficient healthcare system. The methods such as providing nursing service to the individual. management by objectives, Six Sigma, and PERT.

The director of nursing service must be a nurse and she will Modern techniques and technologies must be incorporated delegate her responsibility of organizing the nursing service. and utilized in order to achieve the highest level of efficiency

in nursing service administration.Management practices such as proper balance between production efficiency and reliability, trust throughout the organization, managing the process of change, involvement of workers in decision making and using knowledge management practices, to be followed in order to achieve success and efficiency.

Application of Modern Techniques and Practices in Nursing Administration

Prof Mahasweta Bose

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Principal College of Nursing, Charnock CollegeKolkata

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ystemic deficiencies has steadily eroded the ability of experience, examines various models of ongoing health public health system to meet the burgeoning demand sector PPPs across India and other countries, and highlights Sfor health services effectively in India. As a result a the operational and policy level challenges in engaging the

substantial proportion of people, who rely on publicly funded private sector. health facilities, are 'forced' to seek health care services from

If well designed and implemented in stages, Public Private the private sector that has expanded remarkably. In the Partnerships (PPPs) offer contextually appropriate, innovative absence of widespread health coverage, significant solutions that may ensure equitable access to health services proportion of population pay for their health care expenses for the underserved sections of the population. But in order to from out- of-pocket, with debi l i tat ing economic optimize the potential benefits of PPP in health sector, consequences. The private sector is not only expensive, but conducive and enabling ecosystem needs to be created. are poorly regulated affecting quality, patient safety, Government should provide leadership with sector specific equitable access and accountability. Governments across the PPP policy, create institutional structure and build capacity to world are exploring partnerships with the private sector, to manage partnerships. Ideal strategy for PPP in health sector address the challenge of equitable access to affordable health should be complemented by effective licensing and care services for the poor, under the rubric of Universal Health regulation and strong accreditation system. PPPs are Coverage (UHC). Private sector is also critical for not only professional contracts and ought to be managed well. improving the health infrastructure (hospitals, beds, human It would be unfair to describe PPPs as “privatization” as it only resource) in the country, but manage and provide services complements government role in service delivery in a from decrepit government health facilities that are grossly collaborative process that mutually benefits both the sectors. under-utilized. This presentation, based on extensive research

Prof A Venkatraman

Public Private Partnership in Health Sector in India: Opportunities and Challenges

ProfessorFaculty of Management Studies, University of Delhi

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Dr (Col) Soumen Basu

Green Hospitals and Barrier Free Design

Group Medical DirectorMedica Hospitals

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ospital Project and its management has always been off to position the building with long axis runninga challenge. The multiplicity of issues and aspects, east/west versus north/south. Putting overhangsHcoordination across numerous agencies, resource above windows to the south to keep the high

crunch, legal mandates, opportunities and threats make summer sun from coming in. It is in fact best toit one of the most difficult tasks for any project manager. study the movement of Sun before the longitudinal

axis of the building is decided.The basic form of a hospital is, ideally based on its Minimizing storm runoff. Reduce asphalt paving where functions: you can. Consider alternative products, such as porous

asphalt that lets water drop through it. Install a gravel bed Bed related inpatient functionsunderneath the asphalt for storm-water retention.Outpatient related functionsAnother possibility: cellular paving, patterned Diagnostic and treatment functionsconcrete blocks with holes that grass can grow

Administrative functions through. One can drive across it but it absorbs water just like a lawn. This could be a good option Service functionsfor fire access roads and overflow parking.

Research and teaching functionsConserve energy

Two key issues that draw high level of importance are: Increase insulation in walls and in roots

Use insulated and tinted glass to reduceGreen buildingsheat gain into buildings

Barrier free HospitalsIncorporate an economizer function intoyour rooftop mechanical unit so onForty percent of the energy consumed worldwide istemperate days you can bring outside airdirectly linked to either fabrication or construction ofinside without heating or cooling itmaterials actual building construction, or buildingUse a heat-recovery system-an air-to-airoperation and uti l it ies. Ever y building makes aheat exchanger-to precondition the airdifference. We must consider these issues as we craftbeing brought into the buildingo u r d re a m p r a c t i ce , a n d m a k e o u r h o s p i t a l a

responsible member of society: Solar PanelsU s e N a t u r a l l i g h t . I n c o r p o r a t e n a t u r a l d a y Water treatment and reuselighting and ventilation in the building to reduceelectrical lighting, and heating and ventilation Use Smart lighting solutions. First, use photosensitiverequirements. For example; Interior glass walls and/or occupancy-sensing switch-on fighting. Thenhelping in maximizing borrowed fight. Hospital reduce incandescent lighting, and use high-efficiencywith surgery rooms facing into a glass-walled fluorescent lighting. Compact fluorescent lights saveatrium the doctors got a nice view and the energy.benefit of the natural light.

Green hospital concepts will play an important part inOrientation of the building. Orient your buildingsthe curative process in time to come. Instead of beingto minimize heat load from the sun. Most of thereferred to as a place that houses healthcare amenities,heat is gained on the West wall. So it is better

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hospitals of tomorrow will now focus on wellness and deployment of technologically advanced energy be transformed into welcoming spaces to get well. management systems that leverage onsite renewable energy Health administrators are increasingly looking to sources.introduce green Initiatives and environment-friendly These transformational energy solutions, coupled with the practices into the design, building and management of implementation of efficient water management and a focus healthcare facilities. This shift to sustainable healthcare on the reuse of resources can greatly reduce the overall facilities is primarily centered around reducing the environmental impact of healthcare facilities, increase carbon footprint of hospitals and the incorporation of efficiency, and reduce cost of operations.modem 'Green Building' design elements into thehealthcare environment to improve patient care and Besides the goal of reducing carbon footprint, hospitals are allow hospital occupants to feel more at ease. also looking at how to introduce the increased use of daylight

lighting and natural ventilation into the healing environment. Most architects today are already familiar with green To raise the standards of patient care a sustainable hospital building concepts, as both the public sector and private design should also look at improving air quality by exploring businesses and increasingly committed to an array of ways to reduce the amount of harmful toxins and environment-friendly principles 'Green Hospital'. contaminants used across clinical departments.

In fact, it was recently reported by market research, that green A significant but perhaps less heralded development in new building renovations are set to increase significantly through green hospital initiatives is the growing integration of 2015. A growing number of infrastructural projects will focus advanced workflow optimization into the early stages of on energy efficiency and the use of green building materials to facility design and construction process. This form of strategic differentiate from standard construction techniques. As such, planning enables hospitals to put in place leaner processes to the hospital and healthcare industry is expected to be one of raise operational efficiency and increase overall patient the leading sectors to witness a substantial growth in green satisfaction.construction.

Major improvements are made possible today through lean Tomorrow's environment solutions simulation tools, from which workflow design can be

optimized to drive multiple benefits such as the elimination of As hospitals typically use significantly more resources and waste, increased staff productivity and decreased congestion. produce more waste than comparably sized commercial For instance, hospital owners can now make use of process buildings, the effective deployment of environmentally simulation applications and sophisticated tools such as driven strategies to improve resource management is of "workflow spaghetti charts" to analyse patient flow patterns critical importance in the development of sustainable in order to cut down on congestion and back tracking through healthcare facilities. A World Health Organization (WHO) the facility. It also allows iteration of the model and arrives at report published last year urged hospitals to proactively the optimum mix of workforce given the patient load and address the environmental footprint of the healthcare sector needs.by reducing power consumption, utilizing alternative energy

generation, and through the recycling and conservation of The integration of modem healthcare IT across the various resources.clinical specialties of a hospital will also become increasingly critical to streamline workflow through digitization and to A range of energy efficiency measures, which rightly form the reduce error, waste and cost. The digitization of healthcare starting points for many global green hospital initiatives, are systems ranges from the use of advanced software for medical being adopted both in the renovation of existing facilities and procedures to improve the quality of patient care, to the the construction of new hospitals. Core measures include the installation of integrated IT networks for patient records to use of energy efficient medical equipment and lighting become more easily accessible to healthcare providers.systems for hospitals to reduce energy expenses, as well as the



for people of all ages and abilities in different situationsBarrier-free Designand under various circumstances.Building modification consists of modifying buildings or

facilities so that they can be used by people who are Design for All has become a mainstream issue because of the differently able or have physical impairments. The term is used aging of the population and its increasingly multi-ethnic primarily in Japan and non-English speaking countries, while composition. It follows a market approach and can reach out in English-speaking countries, terms such as "accessibility" to a broader market. Easy-to-use, accessible, affordable and "handicapped accessible"dominate in regular everyday products and services improve the quality of life of all citizens. use. An example of barrier-free design would be installing a Design for All permits access to the built environment access ramp for wheelchairs alongside or in place of steps. In the case to services and user-friendly products which are not just a of new buildings, however, the idea of barrier free qualify factor but a necessity for many aging or disabled modification has largely been superseded by the concept of persons, Including Design for Alf early in the design process is universal design, which seeks to design things from the outset more cost-effective than making alterations after solutions to support easy access.are already in the market. This is best achieved by identifying and involving users ("stakeholders") in the decision-making Freeing a building of barriers means:processes that lead to drawing up the design brief and educating public and private sector decision-makers about the benefits to be gained from making coherent use of Design Recognizing the features that could form barriers for (for All) in a wide range of socio-economic situations.some people

Thinking inclusively about the whole range of The Principles of Universal Designimpairments

Equitable useReviewing everything - from structure to smallest

Flexibility in usedetailSimple and intuitiveSeeking feedback from users and learning

from mistakes Perceptible information

Tolerance for errorNational legislation: Persons with Disabilities (Equal Opportunities, Protection of Rights & Full Participation)Act, Low physical effort1995 NEW DELHI: The office of the chief commissioner for Size and space for approach and usepersons with disabilities has asked Medical Council of India (MCI) to issue directions for barrier-free access of disabled These principles are broader than those of accessiblepeople at all colleges and hospitals. It has also asked MCI to design and barrier-free design.inform the court about the action taken.

Examples:Design for All (DfA): The term Design for All (DfA) is Smooth, ground level entrances without stairsused to describe a design philosophy targeting the use

Surface textures that require low force to traverse on of products, services and systems by as many peoplelevel, less than 5 pounds force per 120 pounds rolling as possible without the need for adaptation. Design forforceAll is design for human diversity, social inclusion and

equality (EIDD Stockholm Declaration, 2004). According Surfaces that are stable, firm, and slip resistant per ASTM t o t h e E u r o p e a n C o m m i s s i o n , i t " e n c o u r a g e s 2047manufacturers and service providers to produce new Wide interior doors, hallways, and alcoves with 60" x 60" technologies for everyone: technologies that are turning space at doors and dead-endssuitable for the elderly and people with disabilities, as

Functional clearances for approach and use of elements much as the teenage techno wizard". The origin ofand componentsDesign for All lies in the field of barrier free accessibility

for people with disabilities and the broader notion of Lever handles for opening doors rather than twisting universal design. knobs

Single-hand operation with closed fist for operable Design for All has been highlighted in Europe by thecomponents including fire alarm pull stationsEuropean Commission in seeking a more user-friendly

society in Europe. Design for Alf is about ensuring that Components that do not require tight grasping, pinching environments, products, services and interfaces work or twisting of the wrist

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Components that require less than 5 pounds of force to Speed controls on auditory outputoperate Choice of language on speech outputLight switches with large flat panels rather than small Ramp access in swimming poolstoggle switches

Closed captioning on television networksButtons and other controls that can be distinguished by

Signs with light-on-dark visual contrasttouchWeb pages that provide alternative text to describe Bright and appropriate fighting, particularly task lightingimages

Auditory output redundant with information on visual Instruction that presents material both orally and visuallydisplaysLabels on equipment control buttons that is large printVisual output redundant with information in auditory

outputConclusion

Contrast controls on visual outputHospital project offers umpteen numbers of issues and

Use of meaningful icons with text labels challenges. Two new, contemporary and important issues Clear lines of sight to reduce dependence on sound were discussed to sensitize the future planners and

practitioners for incorporation in the new hospital projectsVolume controls on auditory output

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Sushrut Medical Devices

Solutions for Orthopedic Surgery



Dr Mohua Golder

Medical Negligence and Its Relevance Today

DMSMedica Superspecialty Hospital

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egligence can be defined in simple words as the judgement of Bolam and maintains that the true test for omission to do something which a reasonable man establishing negligence in diagnosis or treatment on part of a Nwould do or do something which a prudent or doctor is whether he has been proved to be guilty of such

reasonable man would not do. The general concept of failure as no doctor of ordinary skill would be guilty of, if acting negligence is closely related to its specific use in cases of with ordinary care.medical negligence.

It was also stated in Hunter vs Hanley case that deviations from Negligence consists of a breach of a legal duty on behalf of the ordinary professional practice is not necessarily an evidence of defendant to administer suitable care which ultimately causes negligence. A deviation should be warranted by the particular damage to the plaintiff. The defendant is the medical circumstances.practitioner and the plaintiff is the patient.

The doctrine of Res Ipsa Loquitor can be discussed in this Medical Negligence has become extremely relevant in the context. It means “ The things speak for itself”. This can be very current health care scenario especially with a sharp rise in the well explained by a case where a piece of gauze is found in the number of cases being filed against medical practitioners. It patient's body post operatively which clearly indicates the can also be mentioned here that quite a few landmark negligence of the concerned practitioner and requires no judgments concerning medical negligence from the Supreme further proof.Court have alerted the medical fraternity in recent times.

The Supreme Court ruling in case of Jacob Mathew vs State of The main purpose of this article is to discuss the concept of Punjab clearly mentions the following points medical negligence with relation to some of the standard cases quoted over the years and also draw an inference as to “Mere deviation from normal professional practice is not how the medical fraternity should effectively deal such necessarily evidence of negligence,” situations.

“Mere accident is not evidence of negligence,”The classic case of Bolam vs Friern Hospital Management Committee has remained the gold standard for judging “An error of judgement on the part of a professional is not medical negligence. This is very widely known as The Bolam negligence per se 'Test. Although it might be known to many it will be wise to recapitulate the salient points of the case. The plaintiff in this “Just because a patient has not responded favourably to case was given electro convulsive therapy as a result of which treatment given by a physician or a surgery has failed , the he sustained fractures. It was argued that the doctor was doctor cannot be held liable per se by applying the doctrine or negligent as he did not give muscle relaxants. However during res ipsa loquitor”those days the practice of administering muscle relaxants was not popular as it could lead to respiratory paralysis of the With advancing years the importance and utility of patient. Hence the doctor was found non negligent as he had consumerism has been felt considerably. In this regards the acted in accordance with the accepted practice of his peers. Consumer Protection Act 1986 was designed to aid and

protect the consumer by exerting legal, moral and economic Therefore it is important to note that a practitioner cannot be pressure on the defaulter against inadequate services. All held negligent if he meets the standards in his particular field private healthcare establishments come under the purview of which is expected of him. this Act.

The judgement of Hunter vs Hanley also agrees with the Healthcare has gradually developed into a service providing



industry where patients are now the consumers. Vital parameters were not recorded regularly while she was admitted in the hospital. No haematocrit, blood gas

Due to an increased amount of awareness amongst the analysis or electrolyte values were recorded in files.patients and relatives and availability of addressing their She should ideally have been shifted to Burns Ward or ICU grievances through Consumer Redressal Forums the number which was not done.of cases being filed against doctors and hospitals on grounds

Intravenous fluids were not given which is a necessary of medical negligence have rapidly increased.supportive treatment for TEN.

Two recent landmark cases can be discussed here; After perusing the salient points of both these cases it can be concluded that documentation, maintenance of proper and First is the case of NIMS vs Prasanth S Dhanuka where the adequate records and effective communication with the doctors were held medically negligent and a huge patient and relatives should form the three main cornerstones compensation of about 1 crore was awarded to the the plain of efficient medical practice.tiff in 2009. I am highlighting the complaints based on which

the compensation was granted so that we develop an insight Despite the above rulings it can still be said that the Law does into the case not unnecessarily victimize doctors. Specially in the light of

the judgements of the standard cases discussed in this article The plain tiff Mr Prasanth Dhanuka was diagnosed with a mass a fair and rational approach has mostly been taken while in left hemithorax for which he was operated .evaluating medical negligence of doctors giving them their

However postoperatively he became a permanent paraplegic. due respect. I would like to mention the case of Suresh Gupta He lodged the following complaints; vs Govt of NCT Delhi where a young man undergoing

Medical records supplied to him did not indicate any surgery for DNS ( Deviated Nasal Septum ) expired. The reason immediate danger to complainant's life. stated was “not introducing a cuffed endotracheal tube of

proper size as to prevent oozing of blood from the wound into The complications of the surgery were not mentioned respiratory passage”. However the doctor was not held and required preoperative tests not done.negligent and as per the Court it was not an act of intentional

A neurosurgeon was not consulted prior to surgery harm but a want of skill.despite the mass being a probable neurofibroma.

It is true that in recent times an increasing number of cases Consent was taken for excision biopsy whereas complete relating to medical negligence of doctors are being filed many excision of the tumour was done.of which have no relevance and justification. However it is also

Operating surgeon did not communicate the status of true that if the medical fraternity is aware and updated about the patient immediately after surgery to the patient's the maintenance of medical records, is prudent enough to relatives. follow proper documentation and is mature and

Second one is the very recent judgement of the case of Kunal understanding enough to strike a suitable conversation with Saha vs AMRI Hospitals where a compensation ( amounting to the patient and relatives explaining all details at all stages of 6 crores) was granted to the plaintiff holding the three senior treatment; a lot of confusion can be avoided leading to a doctors and the concerned hospital medically negligent. It decrease in filing of such cases. As we all know good was proclaimed to be a landmark and unprecedented communication can work wonders. There are several medical judgement in the history of this nation. professionals who believe that such judgements and a rise in

cases are pressurizing doctors to practise defensive medicine The patient Ms Anuradha Saha had developed Toxic which need not always be true. A methodical, human and Epidermal Necrolysis and was admitted to a leading hospital diligent approach towards treatment and abiding by the in Kolkata. She finally expired in a hospital in Bombay. The specific rules shall therefore help the medical fraternity to main allegations made by her husband were; concurrently safeguard its own profession and also as evolve

into better caregivers.Unusually high doses of steroids (depomedrol) was administered to the patient in initial stages of the disease.

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Mr Soumen Mukherjee Assistant Professor & Research Scholar TIPS, Agartala

ackground: The concept of health and health care has a selected variables. Methodology : The aim of the study was to wide canvas and it is the filial duty of a country to evaluate the level of patient and their relatives satisfaction Bprotect and promote the health of its citizens. The from the service they received from a tertiary care hospital.

hospitals we consider as a place where patients lookup to find The study was conducted in Tripura Medical College & BRAM cure from illness have a huge responsibility towards those Teaching hospital Hapania, Agartala, Tripura West. The authors patients and their relatives. Patient means a person who is propose a multiple regression model to measure the suffering from illness or using health services. Other industries satisfaction level of the customers. Data were collected using a have been paying attention to customer satisfaction for years. structured questionnaire using confidence interval approach It was declared by White B in the year of 1999 that to compare of probabilistic sampling technique. The respondents were healthcare with other industry is a prehistoric thought and to mainly the attendants and relatives of patients with high level ignore the input from the patient or their desires are irrelevant of ailments and in some cases the patients volunteered to be with the reality. In present scenario, if we consider the the respondent with low criticality in ailment. The instrument healthcare as service industry, where patient is considered as a carries seven variables with one dependent and six consumer of this industry definitely those consumers and independent variables where the variables have been their relatives have some expectation from this industry measured using altogether 53 items arising out of extensive where they are ready to pay any amount to get the quality literature review measured in 7 point Likert scale. The service. Today the consumers are more sophisticated than in instrument was administered over a thousand respondents the past and now there is increasing demand of more accurate over a period of one month and the collected data were and valid evidence of health plan quality. Patient and their analyzed using SPSS. The collected data when run for relatives, not only expect the good treatment from the generating the regression equation produced high reliability hospital, they expect their comfort ability relevance with this among the variables proving the accuracy of the constructs industry, and their demand also the value of their money. picked up for the study. The results were also free from

multicollinearity and heteroscedasticity. The Probability plot If any shorts of delivery service by the healthcare industry like describes the linear relationship among the variables hence quality of the treatment, hospitality from the hospital staffs, the hypotheses proves that there is a significant positive financial comfort, other hospital operational facilities put the relationship among the patient's overall satisfaction level and patient and their relative in a discomfort zone then those the health care services rendered at the hospital. However, the customers who are directly or indirectly attached with the same model needs to be tested at different hospitals to healthcare industry become dissatisfied. Now healthcare generate a generic equation which will normalize the value of organizations are operating in an competitive environment regression co-efficient. Conclusion: The authors found after and where giving the patient satisfaction becoming the the study that customer satisfaction has become a prime challenge to maintain the market share. Aim : The objective of concern in the tertiary teaching hospital also. Patient as a the study were to assess the consumer satisfaction level with consumer are better informed about the service which they the service deliver by a tertiary care hospital of a Northeastern are purchasing from the industry for that reason they make state like Tripura and to identify the impact of this satisfaction their own decision. Through this study authors tried to level of the consumer with the hospital service with some measures the satisfaction level of the customers of Tripura

Paper Presentations

Impact of Satisfaction Level Analysis of the Consumers for Tertiary Care Teaching Hospital An Empirical Study at Tripura Medical College & BRAM Teaching Hospital Agartala

Dr Debarshi Mukherjee Associate Professor Dept. of Business Management Tripura University

Dr Rajesh ChatterjeeAssistant Professor CSSIEP Tripura University

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Medical College where most of the patient totally depends on study which will give benefit to this Tripura Medical college in this hospital because of the different parameters like price, their operational aspect . distance, availability of the doctors ,etc. and some of them are not. Different suggestive method had come out from this



Key words : Health care, Hospital, Service Industry, Patient satisfaction , Quality service, Multiple regression

Authors contact details: [email protected], 9862398818

[email protected], [email protected] ,9862036128

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Ms Jhulan RoyAsst Professor Health Science Dept Hospital Management Pailan College of Management Technology

A Pilot Study on Stress at Work Place Among Female Health Care Personnel in Hospital Sectors


ow a days stress is most common factors in work to share their problem with superior. 60% female employees place. In health care industry we are dealing with were strongly agreed upon the fact that their family is Nhuman life. So our employees may expose different supportive but 43% were faced problems due to balancing

types of stress during their service period. Female employee their dual role (family life and work life) and it was the cause of may expose to the stress due to balancing their dual role stress. It can be conclude from the pilot study that the main (family life and work life). These stresses cause the imbalance cause of stress at workplace is work environment, Support at the front of handling family responsibility as well as hospital from superior, due to their dual role at work and family, etc. in work. The focus of the pilot study is identification of cause of the hospital. So it is the responsibilities of hospital authority to stress, incidence of stress and determines the stress affect in provide healthy and co-operative working environment to the profession of emergency at workplace. The pilot study is based female employee. As well as stress free one, on order to make on convenient sampling methods and the study groups is the employees life happily and healthy and also provide white collared female employee. A sample of 30 female quality service to the patients.employees from metropolitan city in Eastern India participated in the pilot study. The data was collected through

Keywords: cause of stress, work stress, family stressquestionnaires that consist of two set of variable to find out the level of stress, one is personal variable and other one is job related variable. The majority of percentages were 43% female employees belonging from 25- 29 years of age group and 57% were married out of which and 27% having baby. it has been observed that 46% female employee were agreed upon the fact the feeling of stress at workplace occurred due to work environment and 43% were emphasized on they couldn't able

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Internet of Things in Healthcare

Mr Anurag PatraManagement Trainee Coventry University, United Kingdom


ith the rapid expansion of technology in the last analyze the information and then releases it to the caretakers few decades, it is predominant that the usage of for further analysis. This process is highly beneficial as it not Winternet and interactive devices has increased only replaces the frequent visits of health professionals, but

quite significantly. At present, advancement in technologies is also provides a continuous automated flow of information.impacting every sector. Internet is playing an important role in

Remote Monitoringaddressing many problems. The digital space has witnessed major transformations in the last couple of years and would IoT increases the accessibility to quality healthcare services. continue evolving. The latest entrant to the digital space is the The Remote Patient monitoring device, which is equipped Internet of Things (IoT). with sensors captures patient's health information and sends

the data wirelessly to the health professionals, Internet of Things (IoT) is an ecosystem of connected physical instantaneously.objects that are accessible through the internet. In a nutshell, IoT is a system of physical things embedded with sensors, Early Intervention/Early Treatmentelectronics to allow it to perform better by exchanging It is not about only about continuous health monitoring of information with other connected devices. only patients, but also about healthy people as well as the

elderly people at home. These health monitoring devices can The healthcare industry has witnessed significant rise in usage

also be used by older adults who live alone at home to keep of technology in improving the life expectancy and standard

track daily behaviors. The IoT device catches any of living. Several healthcare organisations are experiencing

abnormalities, automatically detects the change that takes unmatched challenges to enhance the quality, improve

place and sends wireless alert to emergency responders or access, and eliminate waste and to focus on innovation.

family members. It makes use of sensors to monitor the Hence, the healthcare sector is on the verge of a drastic

activities and accordingly report it to the closed ones via change. IoT plays a significant role in the healthcare segment

smartphones.from managing chronic diseases at one end to preventing

Advantagesdiseases at the other end.

The major advantages of the Internet of Things in the Role of Internet of Things in Improving the Healthcare healthcare organizations comprise of the following:Sector

Decreased Costs - By cutting down unnecessary visits to IoT plays a significant role in the healthcare segment from doctors as real time monitoring is available, both patients managing chronic diseases at one end to preventing diseases and health institutions can save costs. There is also

reductions in hospital stays and re-admissions.at the other end. IoT is used in the following cases:

Improved Outcomes of Treatment - Caregivers have Clinical Caremuch more relevant and latest patient information that is Patients, whose physiological status needs close attention, are synchronized with cloud computing.

monitored constantly by sensors connected to the body Improved Disease Management - Continuous which is attached to the monitor. The sensors equipped device monitoring leaves less scope of missing key changes in

collects physiological information and makes use of cloud to health conditions of the patients.

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Reduction of Errors - The use of IoT helps recording Awarenessprecise data and automatic workflows combined with A key problem with Internet of Things is the lack of awareness data dependent evaluations and also help significantly in of the concept. More education, marketing and promotions the reduction of errors. need to be provided to communicate the advantages of

interactive devices.Augmented Patience Experience - The integration of IoT in healthcare helps achieve this as patient needs are given more importance. Security and Privacy

Better administration of drugs - Using IoT, the drugs Since the devices are communicating over the Internet, can be administered in a better way, which will reduce personal information is being transmitted from one device to costs significantly. another which are in different locations or networks. Thus, the

concerns for security and privacy are apparent.Challenges

InteroperabilityHowever, with the usage of technology there are numerous problems associated with them. The challenges majorly Patients would like to gather the various types of information comprise of security and privacy, healthcare reforms and while operating with different medical instruments relying on mandates, technology adoption. But, apart from these there the functions of the device as well as arranging the physician.are several other obstacles present.



Future of Internet of Things:

4 3PA P E R P R E S E N TAT I O N S




The future for IoT looks bright. One area for improvement for of problem, diagnosis and treatment. But the new model has IoT is in healthcare. It is estimated that the market will reach the components of prevention and training or wellness almost $117 Million by 2020. The ability to diagnose patients activities. The concept of IoT was explored in further detail, by gathering continuous data about the patients' condition, including its advantages, challenges, and future scope. But which enables the medical practitioners to deliver treatments most importantly, the focus is on how IoT can change the way quickly and accurately, proves the potential for growth in IoT healthcare services are delivered in the years to come. healthcare. However, very little can be discussed to explain the

possibilities that IoT can have in the next decade, as Conclusion technology is fast changing and evolving rapidly. The The paper is a desk based research and data is collected from direction and pace of growth is difficult to see, all that can be renowned journals. This research paper was indented to said at this moment is that there will be industry explore the trend of Internet of Things and its application reconfiguration and the society will need to be ready to accept towards healthcare management. As a contemporary study of the rapid changes.healthcare trends, this paper identified the challenges Keywords: Internet of things, Digital healthcare, existing in current and traditional healthcare models as in the Telehealth, Technology in healthcarecase of wellness which used to comprise of a linear approach

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Sayantani RayStudentNSHM College of Management and TechnologyKolkata

Patient Expectation vs Experience Study In OPD



Paper presentation by Students

uality is a continuous process it is not a cliché. It has to find out to find the services were matching expectations be done in a day in and day out in all the facets of the or not.Qhospital. Hospitals OPD is no exception and it is

Service quality can be conceptualized as a Simple Equation rightfully called “the shop window of the hospital” so utmost care must be taken to meet the patient expectation and actual

SQ= P-Equality. My study is based on finding the feedback in an OPD set up at a well known tertiary care in Kolkata. The feedback Where SQ is Service Quality and P is Individuals perception of had questions to be filled up by patients in OPD. The feedback given service delivery and E is Individuals expectation of form will be based on the concept given by SERVQUAL. I had quality. Through this study I want to come to reach to a clear made the same patient fill up two sets of the feedback form picture of what the customer want from us and to what the once when they were entering the hospital and the other customer is actually getting.when they finished their consultation. The main points of expectations and experience are as follows: Keywords: patient satisfaction SERVQUAL model OPD

expectation vs experience Reliability

Responsiveness

Assurance

Empathy

Tangibles

My sample size is 100 people approximately. The persons who are doing the feedback will rate the parameters on a scale of ten. Then the comparative analysis was done to

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4 6



Annwesha PaulMHA- 1ST YEARNSHM College of Management & TechnologyKolkata

Modern Approach in Healthcare- Continuous Quality Improvement (CQI) in Inpatient Department

ith recent advances in healthcare, Quality has Also to check whether the patients appreciate the become a pertinent issue. The demand for following benefits of Accreditation:Whealthcare is rapidly growing with mounting

Patient safety is improvedpopulation base and increasing levels of affordability, so is the demand for quality healthcare services. The Quality

Provides a competitive advantage in the Healthcare accreditation has been observed to be more effective in industry and strengthens community confidence in promoting good safety practices. The purpose of this study the quality and safety of care and treatmentwere -

Improves risk management and risk reductionTo evaluate Quality Assurance programs in the In-patient department. Increase in cases of Insurance reimbursements

To measure the effects on outcomes, process or With this study of mine I found that in the current era of health structure of in-patient care. care complexity and risk, Accreditation contributes to

ensuring that care meets the highest standards of health care To assess patient satisfaction and identify the gap decision-making and provision.

analysis for improvement as per NABH guidelines.

Key Words: CQI, Accreditation, Gap analysis, Patient satisfaction, Patient safety, Health improvement,

Standards, Risk management.

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4 7PA P E R P R E S E N TAT I O N B Y S T U D E N T S



Aratrika BasuSTUDENT, NSHM

Patient Experience: an Increasingly Critical Hospital Indicator

4 8 PA P E R P R E S E N TAT I O N B Y S T U D E N T S

In recent years, perception of performance O u r f i n d i n g s i d e n t i f i e d s e v e r a l c o n c e p t s a n d and quality of healthcare organizations have begun to recommendations to consider with regard to definition of Bmove beyond examining the provision of excellent patient experience. Firstly the patient experience refers

clinical care alone and also embrace the patient experience as occurrence and events that happen independently and an important indicator. Patient experience goes beyond collectively across the continuum of care. Also it is important patient satisfaction and makes patient happy. Patient to move beyond results of survey, that those capture concepts experience exclaims that there are some evidence to suggest such as 'patient satisfaction' because patient experience is that patients can be used as partners in identifying poor and more than patient satisfaction alone. Embedded with patient unsafe practice and help enhance effectiveness and safety. experience is a focus on individualized care and tailoring of

subject to meet patient needs and engage them as partners in their care. Next, the patient experience is strongly tied to OBJECTIVE: The objective of the synthesis is to –patient expectation and whether they were positively realized

Identify the key elements, constructs and themes beyond clinical outcomes or health status. Finally, the patient that are commonly and frequently cited in existing experience is integrally tied to the principles and practice of definitions of 'Patient Experience' patient-and-family centered care.

Summarize these findings into what might be CONCLUSION: As patient experience continues to emerge as considered a common shared definition an important focus area across the healthcare globally, the

need for a standard consistent definition becomes even more Identify important constructs that may be missing evident, making it critical to ensure patient experience from and enhance existing definitions remains a viable, respected and highly embraced part of the

healthcare conservation.The overarching premise was to identify and promote working definition of patient experience that is practical and applicable for research, quality improvement efforts and general clinical practice.

RESEARCH and FINDINGS: A total of 13 approaches were identified that provided proper patient tangible and explicit definition of patient experience. A narrative synthesis was undertaken to categorize literature and other sources according to the constructs of the definitions provided.

ackground:

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Binata Sarkar, Sajal Das, Suvankar Chakraborty



Transforming Healthcare through Social Media - for the Journey that is Life

MHA- 1st Year Second SemesterNSHM College of Management and Technology

5 0 PA P E R P R E S E N TAT I O N B Y S T U D E N T S

ocial media including internet has moved beyond need for brand monitoring is not only to respond to a problem being a tool for young individuals to share their private or complaint but also to measure marketing effectiveness and Slife to foster the serious discussion on technology and create new channels for visibility and eventually sales by

business. Increasingly driven by regulatory pressures, "the offering services like online consultation, availability of need get it right the first time" and minimize cost remains a appointments / doctors, special discounts on the pharmacy concern in the Healthcare industry. Customer feedback to products, booking operation theatres for minor procedures improve business has become very important. Discussions etc.around personal health and by extension Healthcare are no

Conclusion - Developing a social media policy is no longer an longer private issues. Citizens today are taking keen interest in option today, it is a necessity .Healthcare organisations need their health and prefer sharing health related information to understand how the cater in the social media Universe can with their peers. With governments across the world re-be harnessed meaningfully to grow in business and visibility, looking at their health care system and taking measures in a while some organisations have taken the lead in the area, bid to extend Health Care benefit feedback many citizens as many others are struggling to understand this new medium of possible. Public health and associated policy remains a key opportunity. topic of discussion.

Keywords: Effectiveness, future implications, patient Prevalent models of social media engagements feedback, health awareness, improved health and

in the Healthcare industry - cost minimising.

Eradication

Introducing new services and patient education

Awareness creation

Social media in Healthcare could become the number one source of brand monitoring. In the Healthcare industry, the

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