Introduction
One of the primary concerns in the healthcare sector is the issue of patient satisfaction. In today’s market, individuals have different options available when deciding on a specific healthcare provider. Quality and service stand out as two essential elements that influence the selection of healthcare providers. Quality patient/customer service is for many, a readily understood healthcare standard. Thus, a healthcare organization’s reputation for its commitment to quality and patient-centered customer service stands as the main criteria for individuals in choosing a healthcare service provider.1
“Therefore, measurement of patient satisfaction and incorporating results to create a culture where service is deemed important should be a strategic goal for all healthcare organizations”1.In today’s competitive world, patient satisfaction is a bench mark of the success for any health care provider. It is an important input from the patients to help management to improve the organization. Satisfaction is an important element in the evaluation stage. Adequacy of satisfaction is a result of matching the actual past experience with the expected reward. Patients experience with the facilities leaves them either satisfied or dissatisfied.2The truth about patient satisfaction surveys is that they can help us identify ways of improving our practice. Ultimately, that translates into better care and happier patients. It will have five key elements. They are Expectations, Performance, Comparison, Confirmation / Disconfirmation and Discrepancy.2
 
Purpose of the study:
1. To monitor quality of health care provided. 
2. To assess the expectations and demands of the patients.
3. To make recommendations to improve patient satisfaction.
 
Abstract
 
Delhi – the bustling metropolitan capital of India - has the dubious distinction of having a very high accident and injury rate. As such, the prevention of traumatic injury and the provi-sion of trauma care must be regarded as essential public services central to the mission of public health agencies.
As no comprehensive data was available regarding the status of Trauma Care System in Delhi, this study was conducted to evaluate the existing system in the NCT of Delhi against International Standards and recommend a roadmap to develop an ideal Trauma System in the state based on the gaps identified.
Various components of the Trauma Care System for Delhi were evaluated in line with the HRSA’s “Model Trauma System Planning and Evaluation” (MTPSE) guidelines which include 24 Benchmarks, 113 Indicators and 678 Scoring Options i.e. Benchmark, Indicators and Scor-ing (BIS) tool. Scoring of various indictors was done based on key informant info on a pro-gress scale of 0-5, with 0 = Not Known, 1 = No Progress, 2 = Minimal Progress, 3 = Limited Progress, 4 = Substantial Progress and 5 = Full Progress.
 
In this study, Delhi received a median score of 1.5 indicating that the existing Trauma Sys-tem in the NCT of Delhi has made no or very minimal progress. The components which are in existence were also not found to be functional optimally and there is no co-ordination amongst various agencies.
 
Definition of Quality Circle
A Quality Circle is volunteer group composed of members who meet to talk about workplace and service improvements and make presentations to their management with their ideas. [1] These are related especially to the quality of output or services in order to improve the performance of the organization/department and motivate and enrich the work of employees. This group carries on continuously as a part of organization-wide control activities, self and mutual developments and control and improvement within the workplace utilizing quality control techniques with all the members participating.  The members receive training in problem solving, statistical quality control and group processes. 
Quality Circle generally recommends solutions for quality and services by using “Lean Concept” which simply means a systematic approach to identify all types of waste, [2] to make optimum utilization of available resources, ensure continuous improvement, ensure smooth flow of the product in the process and meet customers demand. Thus Quality Circle is not merely a suggestion system or a quality control group but extends beyond that because its activities are more comprehensive. [3]Furthermore, it is a permanent feature of the organization 
Abstract:
Capacity has long been a significant issue for healthcare organizations particularly in the public sector due to a considerable demand-supply gap in a country like India. For this we need to calculate, scientifically, the optimum number of patients that can be seen by a doctor in OPD and project the demand for the resources, both men and material, accordingly. This study was done to measure the maximum handling capacity of ENT Out Patients Department at AIIMS, New Delhi. A questionnaire was distributed to treating doctors & direct observations were made at OPD. A spreadsheet was developed with the data. It was found that the maximum number of patients that can be seen by a doctor, providing due care, in ENT OPD is 28. Accordingly with the given strength of doctors in the OPD, the maximum handling capacity of ENT OPD is 131 as against the actual load of 360 patients for year 2007-2008. To analyse the change in the situation over the period of time maximum handling capacity was found to be 131 as against the actual load of 336 patients for year 2011-2012.This clearly shows that actual load in OPD is much more than optimal load in both the years and the trend over four years shows that situation of patient overload persisting. As the no. of working hours and no of OPD days remaining the same there is need to increase the no. consultants and senior residents in the ENT OPD of AIIMS.
 
Abstract:
Capacity has long been a significant issue for healthcare organizations particularly in the public sector due to a considerable demand-supply gap in a country like India. For this we need to calculate, scientifically, the optimum number of patients that can be seen by a doctor in OPD and project the demand for the resources, both men and material, accordingly. This study was done to measure the maximum handling capacity of ENT Out Patients Department at AIIMS, New Delhi. A questionnaire was distributed to treating doctors & direct observations were made at OPD. A spreadsheet was developed with the data. It was found that the maximum number of patients that can be seen by a doctor, providing due care, in ENT OPD is 28. Accordingly with the given strength of doctors in the OPD, the maximum handling capacity of ENT OPD is 131 as against the actual load of 360 patients for year 2007-2008. To analyse the change in the situation over the period of time maximum handling capacity was found to be 131 as against the actual load of 336 patients for year 2011-2012.This clearly shows that actual load in OPD is much more than optimal load in both the years and the trend over four years shows that situation of patient overload persisting. As the no. of working hours and no of OPD days remaining the same there is need to increase the no. consultants and senior residents in the ENT OPD of AIIMS.
 
A Pre-experimental Research to Investigate the Retention of Basic and Advanced Life Support Measures Knowledge   and Skills by Nurses Following a Course in Professional Development in a Tertiary Teaching Hospital
 
Abstract:
Lack of resuscitation skills of nurses in basic life support (BLS) and advanced life support (ALS) has been identified as a contributing factor to poor outcomes of cardiac arrest victims. The hypothesis was that nurses’ knowledge on BLS and ALS would be related to their professional background as well as their resuscitation training. 
 
Pre-experimental research design was used to conduct the study among the nurses working in medical units of B.P Koirala Institute of Health Sciences, where CPR is very commonly performed. Using convenient sampling technique total of 20 nurses agreed to participate and give consent were included in the study. The theoretical, demonstration and re-demonstration were arranged involving the trained doctors and nurses during the three hours educational session. Post-test was carried out after two week of education intervention programme. The 2010 BLS and ALS guidelines were used as guide for the study contents. The collected data were analyzed using SPSS-15 software. 
 
It was found that there is significant increase in knowledge after education intervention in the components of life support measures (BLS/ALS) i.e. ratio of chest compression to ventilation in BLS (P=0.001), correct sequence of CPR (p <0.001), rate of chest compression in ALS (P=0.001), the depth of chest compression in adult CPR (p<0.001), and position of chest compression in CPR (P=0.016). Nurses were well appreciated the programme and request to continue in future for all the nurses. 
 
At recent BLS/ALS courses, a significant number of nurses remain without any such training. Action is needed to ensure all nurses receive BLS training and practice this skill regularly in order to retain their knowledge.
Abstract:
It is well known that many new HCO are propping up in India, catering to a growing middle class and even foreigners are looking for inexpensive, quality care. While India is gaining a good reputation for its medical talent, the construction codes and public safety regulations are lagging behind. Recent devastating fire in one of the reputed private five star hospitals of Kolkata (Calcutta, India) was not only shocking for entire world but also a lesson to be learned by everyone who is connected with medical profession and governance at large.
Though the cost of ensuring that the infrastructure of the building is compliant to fire safety norms is Rs 50 -70 per square foot, but this gets sacrificed in the cost reduction drive. Also in order to maximize the use of every square inch of space to squeeze in beds for revenue generation, space for areas like Fire exits and landings get compromised.
The design and construction of the building should ensure that fires are detected at the earliest possible opportunity, contained & dousing mechanisms kick start. Robust design &adhering to the Fire Safety norms, can only go so far as preventing &/or controlling the Fire upto a certain extent. These factors play a very important role in limiting the fire, extent of damage& in buying the extra time before the fire becomes unmanageable. Once the Fire occurs, Fire safety Plan, standard operating procedures for firefighting, regular training of all staff on using extinguishers, firefighting equipment, procedures to be followed in emergency, evacuation plans& mock drillsbecome the real saviors for the patients as well as the staff. The frequency of such trainings & mock drillsare the most important factors which ensure that in case of the disaster striking, the staff do not panic, & take control of the situation to save precious lives.The fact that many of the patients are either bed bound or on critical lifesaving equipment, makes the role of the staff all the more critical in such situations.
The government regulations demand proper building design, following fire safety norms, but a very important aspect, that of staff preparedness to cope up, when the calamity actually strikes is overlooked. In spite of the best design, Fire Safety norms, there can be instances when the fire does not get controlled. In such circumstances, it is only the staff preparedness which shall make the difference between preventing disaster, or it being labeled as a disaster.
 
We as responsible HCOs must go a step further and bridge these lacunae. 
Abstract
Introduction:In India, there is a paucity of morbidity and mortality information de-segregated at facility level. Present study was undertaken to report the morbidity and mortality of in-patient at a secondary care hospital with aim to identify key areas that require improvement in the existing health system. 
Materials and Methods:
Study was conducted in secondary level hospital at Ballabgarh (Haryana). It is a record based retrospective study. Diagnosis is coded as per ICD 9. Relevant information pertaining to socio-demographic indicators, diagnosis and outcome at discharge about inpatients (1/1/1994 to 31/12/2007) were retrieved from HMIS archives. Descriptive analysis was done. 
Results:
Total 47,965 admissions were done from year 1994 to 2007. Infectious and parasitic diseases were the leading (35.7%) cause of morbidity among adults. Admissions in paediatric ward due to infectious and parasitic diseases (Diarrhea and respiratory illness) were 56.7%. One out of every six patients admitted in was referred to higher health care facility. Median duration of stay in the hospital during 1994 to 2007 was 2 days. The average bed occupancy rate at Civil Hospital, Ballabgarh was 47 %. Overall mortality rate was 20.3/1000 admissions. One-fifth of inpatient mortality was due to infectious diseases. 
Conclusions:
Provision of round the clock obstetrician and infrastructure to manage non-communicable diseases are the two most important interventions identified to optimize service utilization.
Keywords:ballabgarh, inpatient,secondary care hospital, health system policy and planning
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