Abstract:
Introduction: Many a times, Doctors’ hand-written prescriptions are difficult to read and interpret. This contributes to medication errors and jeopardizes safety of patients. This study essentially focussed on ‘Prescription Audit’ and reported incomplete and illegible handwritten prescriptions from Indian context.
 
Objective: To explore legibility and completeness of hand-written medical prescriptions.
 
Methodology: Hand-written medical prescriptions for 106 patients were collected by convenient sampling technique from the outdoor patient department (OPD) in a multi speciality tertiary care hospital of a teaching institute. These prescriptions were photographed and attached to the structured survey questionnaire, and were assessed by four experts from Pharmacy, Nursing and Medical Profession. 
 
Results: Out of 106, 88 prescriptions had patient’s first name written; whereas, only 33 prescriptions mentioned patient’s last name. None of the prescriptions had patient’s address on it. 66 prescriptions had legible drug name, whereas only 58 prescriptions had mentioned clear directions for the patient. All the prescriptions were incomplete with respect to the information related to patient’s age, gender, weight, registration number of prescriber and date. 
 
Conclusion: The majority of handwritten medical prescriptions were illegible and incomplete. This increases the risk of error in dispensing and administration of medication. This study suggests number of solutions in order to minimize prescription writing errors.
 
Keywords: illegible and incomplete prescriptions, prescription audit, prescription standards, prescription errors.  
 
Abstract
Introduction: As a part of digitization, the hospitals are converting all their manual records into the Electronic Health Records (EHR) which can be maintained as one record in digital format. The EHR can be of two types: single vendor EHR and multiple vendor EHR.
Objective:
To compare end to end EHR solution (single vendor) and multiple vendor products. 
Material and Methods: Studying the relationship between the variables such as number of beds in a hospital and the type of EHR implemented, type of challenges, location of hospital (urban/rural), and number of modules by using MS Excel for analysis.
Results:
In our study,54% of hospitals had single vendor EHR and 46% had multiple vendor EHR. Maximum hospitals in urban area had EHR implemented. 61% had 3 to 5 modules. Among the hospitals with multiple vendor, 91% of hospitals faced challenges while implementing EHR. The major challenge faced was integration of multiple functionalities on single platform.
Conclusion:
The single vendor EHR is better than the multiple vendor EHR as the challenges faced are lower compared to the multiple vendor. It would reduce the issues such as integration of software and staff training. Single vendor EHR should be applied in hospitals as a comprehensive solution as it would provide better features and security.
 
Keywords: electronic health record, hospital, multiple vendor, single vendor.
 
ABSTRACT
Objectives: The study aims at evaluating the informed consent form filling practices in various patient care areas.
Method: Data was collected retrospectively for one year by referring through the patient files. A checklist was used to ensure the complete filling of informed consent forms in patient’s medical records which includes the entries such as diagnosis, consenting language used (English / local), doctor’s name and signature, patients/ surrogates signature and witness signature. A total of 218 medical records (n=218) were verified from departments such as Surgery (64), Paediatrics (46), Medicine (30); other departments include Urology, Nephrology and OBG (78).
Results & Conclusion: Study results showed that the diagnosis information of the patient, doctor’s name and patient signature were filled satisfactorily. Whereas language used for consent, doctor’s signature and witness signature needed improvement.
Keywords: 
Informed consent, Medical records, Consent forms 
Abstract: Knowledge, Attitude and Practice (KAP) surveys are basically carried out to understand the human behaviour to certain subject topics. These studies are generally used to assess the KAP of the population in the current scenario and also help in conceptualisation of definitive interventional strategies.  KAP surveys are generally conducted in six steps beginning from defining the survey objectives, followed by the survey protocol, designing the questionnaire, with the implementation, analysing and the usage of the collected data in the appropriate format. Focussing on knowledge and the attitudes of the respondents, the study helps to identify the key aspects frequently shared by the population or the target population about the particular issue.   Hence these surveys should be used as theoretical skeleton to understand and analyse human behaviour rather than as explicit methodology.  These surveys still help to analyse the local conditions and can be used as basic step for the improvement and assessment for a program or an intervention strategy.
 
Key Words: Knowledge, Attitude, Practice, surveys, models
 
ABSTRACT
Keywords: Emergency colour codes, Patient safety
Background: Hospital emergency codes are used as coded messages to alert hospital staff during critical events. These are often developed independently by each healthcare facility leading to variability which creates a source of confusion to healthcare providers and may also jeopardize patient safety. The purpose of this study was to evaluate the variability of emergency colour codes among hospitals.
Methods: A prospective survey was carried out by using a semi structured questionnaire which was completed by the Quality department/hospital administrators of each hospital on general hospital characteristics, emergency colour codes used, code meaning and code mock up. 
Results: Thirty eight hospitals out of forty two participated in the survey. Eleven different types of emergency colour codes were used across hospitals. Most uniformly used codes across all hospital are Code red, blue and pink. Single emergency colour codes have different meanings in different hospitals, greatest number of colour codes an individual hospital had was ten. There is also variability in the meaning that each code had with greatest number of different usages for Yellow (six meanings).
Conclusion: There is clearly lack of uniformity in the type and meaning of emergency colour codes used by the hospitals which could compromise patient safety because of confusion to responders. There is a need to standardize emergency codes by accreditation bodies and government agencies.
 
Abstract: 
The need for cost containment in hospitals has prompted the re-consideration of many aspects of medical care. Awareness about environmental responsibility in recent times has redesigned the way we approach the use of surgical gowns in operating rooms, with more hospitals switching back to reusable gowns. This study was conducted to estimate the amount of biomedical waste that would be generated if the Cath lab preferred disposable gowns to the traditionally used reusable gowns and to make decisions considering the economic viability of both the options in a teaching hospital setting. Data with respect to various costs incurred in the handling and disposal of single-use and reusable gowns and amount of biomedical waste generated was collected from respective contributing departments. Results reflected the additional environmental burden of disposable surgical linen in terms of medical waste generated and huge cost-savings that the reusable gowns are capable of. Thus, in an era where reusables are being replaced inevitably in the name of betterment of healthcare quality and seemingly “effortless” disposal of its counterpart, efforts must be made to re-consider if the trend to switch over is cost-effective and environmental-friendly in an already overburdened terra-firma to ensure that quality never compromises safety of patients and the general population.
 
ABSTRACT
 
Operation theatre is a complex area in any Hospital and Surgery is a collective team effort of surgeons, anaesthetists, nurses, technicians, paramedical staff, support staff supported by Administrative staff, Billing, Corporate/ TPA staff, Vendors etc. The delay in performing these procedures can be attributed to inept performance by any of the team member. Operating room delays can negatively impact patients directly, their family members and the staff. Most instances of delay are due to lack of appropriate planning or inadequate utilization of available resources. Delays in the operation theatre cause significant loss of resources and time. If the first surgery of the day is delayed then, all the subsequent surgeries in the hospital are automatically delayed.
 
This present article studies the causes of delay in operation theatres. The Management using ‘Total Quality Management ‘principles did a continual study to mitigate the delays. As an initiative this article did comparison with its own study, introduced new parameters as factors for delay. The study is analysing the reasons of delays in Operation Theatre.
 
Abstract

Purpose: Prominent evidences have demonstrated that the healthcare delivery system falls short of care that is safe, effective, efficient, patient centred, timely, and equitable. Today when healthcare service has become a trade concept and with the insurance sector having entered the healthcare field, the society has become more aware of their rights to quality healthcare. The demanding trends have made it of utmost importance to identify ways to assure and provide quality and safe healthcare service.This could be done by healthcare leaders taking an initiative to implement a culture of Lean Six Sigma (Further referred as LSS) practices in their organizations. While LSS has been steadily revolutionizing a diverse range of industries, the approach is relatively new to the hospital industry and health care fraternity. A Secondary research was done to access case studies of LSS applications in healthcare, internationally; to analyze adaptive techniques utilized and the likely hospital / healthcare indicators that could be measured in a process under consideration for performance improvement (Further referred as PI) and its impact.
Methodology:33 case study results, (Further referred as CS) papers that were free to access on the internet; were accessed, to study LSS deployment in healthcare. The results were analyzed to identify adaptive techniques and hospital processes / indicators that are generally impacting successful outcomes in terms of PI.
Findings: The secondary research not only provided evidential impact factors that were treated with LSS methodologies for a process improvement but also assisted in identifying significant healthcare / hospital management indicators to be considered as critical tangible measures relevant to is specific process under consideration
The Originality value: The secondary research study outcome added evidential value to the focused approach to identify appropriate LSS projects and also assisted in defining relevant healthcare indicators to be considered as critical to quality measures of the respective healthcare service process.
Keywords: Lean Six Sigma in Healthcare, Performance Excellence in Hospital Services,

 

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