Vol. 4 No. 11 November 2007
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This Issue Features..
Outpatient Management

Introduction
Outpatient Examination Process
Layout Models
Resource Planning
PROCESS
  - Waiting Time
  - Communication
  - Employee Behaviour
  - Ambience
  - Health Education
  - Application of it
Patient Friendly OPD
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Dear Readers,
  The outpatient services often are the first point of contact with a hospital. It is an extremely busy area as all the patients have to pass through this area. It is important it is well managed, as the first impressions get shaped during this process.
     This issue of Sitenews on the theme "eyecare outpatient management" provides an overview of the various outpatient examination processes that are there for an eye hospital both at primary and secondary level. The next section provides an overview of e-resources to help plan the layout and the resource requirement of the outpatient department. Some of the major management challenges in outpatient management are waiting time, communication, employee behaviour for promoting service excellence, ambience for creating healing environment, and health education. Each of this is looked at to get different perspectives on how to address it in a patient friendly way. Another important aspect of OPD management is leveraging the use of information technology.
     The featured organization is Disha Eye Hospitals and research centers which provide high quality eye care services at an affordable cost for the patients.
     Hope this issue will impart the resources which are worth to be read. Looking forward to come up with more resources in future.
     We wish you an experience of learning that is very practical. Your feedback will let us know how we can improve. Please write in your feedback at eyesite@aravind.org. We look forward to your feedback.

We wish our readers an informative reading!

Happy reading!
Regards,
Vision 2020 e-resource team
Introduction
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“All patients get their first impression of the hospital from the Outpatient Department. It has been described as the first point of contact between the hospital and community and which, in many instances, can make or mar the reputation of the hospital. The importance of the Outpatient department lies in the following:
  • An outpatient department is the first point of contact with the hospital and the entry point into the healthcare delivery system.
  • It is an inseparable link in the hierarchical chain of healthcare facilities
  • It contributes to the reduction in Morbidity and Mortality
  • It’s a stepping stone for health promotion and disease prevention
  • It helps reduce the number of admission to inpatient wards, thus, conserving scare beds.
  • It acts as a filter for inpatient admissions, ensuring that only those patients are admitted who are most likely to benefit from such care.
  • It’s the “shop window” of the hospital.”
Outpatient Examination Process
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“One of the most frequently heard criticisms of the hospital is the prolonged and seemingly interminable waiting a patient is subjected to at various stages of his visit to the outpatient department – in front of the registration, at the doctor’s office, at the cashier’s, laboratory, pharmacy and for and in between appointments. This is annoying to patients and bad public relations for the hospital. Large numbers of patients attending clinics are not the only reason that makes people wait. Incompetent and inadequate staff, cumbersome and time consuming procedures and forms, poor design that has not taken into account, the circulation and workflow in the department are some of the process that contributes to this malady. There is no denying the fact that things can be better. Hospitals should study the problem. Expeditions handling of workable and efficient system and record completion and transportation contribute to the efficiency of staff and satisfaction of patients.”
Layout Models
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This section consists of few resources which helps you to design the layout of eye hospital.
  • ARAVIND EYE HOSPITAL, THENI


  • CIRCULATION IS CRITICAL TO HOSPITAL FACILITIES PLANNING


  • BASIC EYE CLINIC LAYOUT NHS

    • Abstract
    Planning criteria for an Eye Clinic. Different design considerations and Space determinations are focused.

  • QUALITY CATARACT SERIES - ARCHITECTURAL DESIGN MODULE

    • Abstract
    Architectural Design consists of examples and models, design principles such as hygiene, technology, function, community design, beauty, economic issues, and development process. This module is useful for several different architectural projects such as building anew facility on a new site, adding another building to the current site , acquiring an existing building and renovating it, renting an existing bilding and negotiating with the landlord to make changes to and redesigning and renovating the current building.

  • HOSPITAL INFRASTRUCTURE

    • Abstract
    This article tells in detail about how to plan the hospital infrastructure to afford quality health care in tertiary hospitals of private sector. It also lists out the tips that could be considered in paving the effective infrastructure in the hospitals.
Resource Planning
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Eye care providers in developing countries face issues different from there colleagues in developed countries including widespread poverty. Overpopulation, illiteracy, malnourishment, limited resources, and an imbalanced distribution (between urban and rural) of an already insufficient number of eye care professionals. The problem, therefore, must be dealt with by an optimal utilization of medical personnel and resources, in the most efficient and economical way possible. Utmost care must be taken for optimum utilization of the available resources as well as infrastructure.
PROCESS
Waiting Time
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In an OPD, the majority of the complaints that any hospital receives will be on the prolonged waiting time. This often turns visible when the patient gets agitated and shouts at the staff for the delay in the OPD procedures. The patient will be arriving with pain and grief. Thus they will be in a less emotional quotient to perceive the duration of time they wait in the hospital without getting the final word on their ailment.
    The patient irritants can be avoided if the patients are provided with the probable time taken for various examinations. This will provide them with a pre assumption of the duration of entire OPD procedures before they get the final word on their ailment. This detail can also help in them in managing the time. For instance the patient can have their lunch if he finds that the laboratory test will take an hour, rather than skipping their meals.
Communication
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The role of the more educated empowered and demanding health care consumer was further energized by the Internet, dedicated health channels on cable television, direct to consumer marketing, and cultural change. The changing role has been recognized by healthcare consultants and futurists who have termed this movement “healthcare consumerism”. As such today’s healthcare consumers is more information oriented. They need the accurate and adequate information within no matter of time. Hence it is our responsibility to provide the information they ask for.
Employee Behaviour
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Ambience for creating Healing Environment
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The patient spends a considerable amount of time waiting for various services in the hospital thus it is necessary to make the stay comfortable and pleasant. In order to provide a pleasing ambience we should provide the lobby and waiting with an adequate design in order to present a warm, cheerful and pleasant atmosphere with emphasis on patient and visitor comfort. Sufficient waiting space both in the main lobby as well as in the clinic should be provided with relaxing, caring and welcome atmosphere.
    Need of decorating the waiting area with meaningful literature is essential as most of the patients and their relatives who wait outside the OPD feel insecure and are afraid of the consequences of the disease they are suffering from. Moreover the congregation of different categories of patients make the situation still more serious. Its is suggested that the hospital authorities must decorate Outpatient waiting hall can be easily adapted and utilised for medical education by suitable displays, including educational films or videos. Suitable paintings, indoor plants go a long way in making interior cheerful and at a low cost. Imaginative use of colour and lighting is equally important. Aphorisms displayed artistically on the walls can be educative.
Health Education
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Illiteracy and ignorance of diseases and its treatment contribute to increasing the number of people who do not access health care despite having a problem. Since most of the patients live in rural areas, it is necessary to train the primary care physicians to recognize patients and refer the patients with high risk to the tertiary centres for management. Health education is essential for making people more aware so that utilisation of health care services increases.
Application of it
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The concept of Centralised Patient Service Centre is a step ahead from a sheer information desk that works on adapting the concept of telemarketing. It integrates both the HMS and the technology of telecommunications. The centre provides with real time information concerning each and every aspects of a hospital like the specialties, availability of consultants, admissions, appointments and a wide range of other services that comes under the purview of a hospital.
    The staff are trained in various aspects of marketing, PR and telemarketing. They will have a whole range of information (online or in conventional files) at their finger tips. An outsider crafts the first impression from his conversation with the person at the Patient Service Desk. To add, what they expect is personalised service and care. Hence the staff should be capable of providing authoritative and timely information to the caller. They will follow up the old patients for their revisits and well being. This kind of a real time services gives an added value to the more sophisticated patients of the hospital. This will also add on to the image of the hospital.
Patient Friendly OPD
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  • HOW USER FRIENDLY IS YOUR OUTPATIENT DEPARTMENT?

    • Abstract:
    This booklet was commissioned by the Royal College of Physicians following a joint Working Party of the College and the NHS Confederation that examined the organisation of medical outpatient departments. It is designed to help medical outpatient clinics provide a more user-friendly service. Each section has a checklist, which may be used by staff to assess how patient friendly their service is.
Featured Website
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Disha Eye Hospital and Research Centre
Disha Eye Hospital & Research Centre started its journey on 1st May, 1997. Disha was born to provide high quality eye care services at an affordable cost for the patients of West Bengal as well as for the neighboring states. Optimum utilization of technology reduces the cost of treatment yet profitable, was the main thought behind the conception of Disha. Understanding this fact, Dr. Debasish Bhattacharya, the lone practitioner in the small town of Barrackpore called three of his junior friends, Dr. Tuhsar Hazra, Dr. Samar Basak & Dr. Tushar Sinha to form a hospital where they want to put patient's "EYE" before "I". The governance was technocratic; relationship with the patient was direct with the doctor. This helped the patients to build up confidence on the hospital and Disha reciprocated by providing more space for hospital services, more comfort for the patients, and newer equipments with advanced technology. Disha grew every year in terms of OPD services, in patient services and also in academic forum at state, national and international level.
    Now after ten years Disha feels the need of extending its services out of the premises of Barrackpore. West bank of river Hooghly is rich in culture, education and economy. But the river is a real barrier in communication with the East bank due to less number of bridges and and primitive ferry services. So, Disha decided to provide eye care services of same quality for the people of West bank of river Hooghly and constructed the hospital on G.T. Road at Seoraphully, named as Disha Eye Hospital [Hooghly] Pvt. Ltd. The new companionship and a newly constructed 25000 sq. ft. hospital building with elegant design and modern facilities is a bold expression of Disha reflecting its state-of-art technologies and promising to keep the expectations of people.

Visit our website : www.dishaeye.org

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Vision 2020 e-resource team,
Lions Aravind Institute of Community Ophthalmology,
1, Annanagar, Madurai - 625 020,
Tamil Nadu, India,
E-mail:eyesite@aravind.org
Phone: 91-452-4356500

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