situational analysis retina
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^Situational Analysis Presentation – Vitreo-Retina Department
Sadguru Netra Chikitsalaya
March 18-20, 2014
My life time experiencePerformance summary
2012-13
2013-14
Growth
New OPD
7576 16729 120%
Review OPD
7883 10752 36%
OT 2867 3432 19.7%
My life time experienceHuman resource-Staffing pattern
Manpower -Current
S.no Cadre Available in number
1 CONSULTANT 3
2 JUNIOR CONSULTANT 2
3
LONG TERM COMPREHENSIVE
FELLOW 6
4 LONG TERM RETINA
FELLOW 2
5 PARAMEDICAL STAFF 7
6 HELPING STAFF 4
7 SUPERVISOR 1
Total 25
My life time experienceHuman resource-Training and development
Training Received (in last 3 years) Training needs•Uvea clinic•ROP screening •Oncology services•In house/external training of paramedical staff•Optometrist workshop and conferences
Training- Can offer for external candidates •Structured programs for long term and short term training •Exclusive short term retina fellow can be tagged with one consultant•Advertisements about our training program should be more elaborate •Yearly exams for fellows and affiliations with recognized universities• Internal •ERG Training for the candidates
My life time experienceQuality assurance
• Current Situation
Highly qualified and competent consultants and doctor’s are available
All the world class tests and Investigation procedures are done here.
World class equipment's and instruments are available
All the advanced surgical procedures are performed under Retina Dept.
Monthly clinical audit : internal External audit:6monthly Lack of well defined consent forms. Protocols for Both Clinical procedures
and Non-Clinical interventions has been implemented according to ISO
• Requirements
Medical retina training protocol has to be made
Standard Operating Procedures has to be prepared as per according to NABH Standards and implemented.
My life time experienceInfrastructure-Equipments (Key equipments introduced in the department in
the last 3 years)Equipment No's
B-Scan Probe Cable(29/02/2014) 1
B-Scan (Marvel )with Probe(04/03/2014) 1
Optomed fundus Camera Probe with Adaptor(SL) (26/02/2014) 1
RE-INVERTER(2/09/2013) 1
Visulas-532S (Green Laser) (08/04/2013) 1
OCT (RTVUE)(28/5/2013) 1
Camera (Sony) (30/09/2013) 1
Electrophysiological (ERG)(22/12/2012) 1
Indirect Ophthalmoscope(LED Wireless)(27/8/2013) 2
Fundus Camera(12/9/2012) 1
ACCURUS 800CS (29/05/2012) 1
.S L T YAG Laser (2010) 1
My life time experienceInfrastructure-Physical space/others
Current Situation
Individual Clinic is dedicated for Retina Dept.
Separate ward is dedicated for the Retina subspecialty.
All the essential amenities are present for facilitating the services.
Restricted Waiting Area
Requirements
More space required for Retina OPD.
Patient waiting lounge with pictures/LED screen/information brochures
Proper Space Planning required. Proper sitting arrangements for
the Consultant’s and Doctor’s. Renovation in Retina OPD
needed. Construction and Renovation
needed in Retina Ward.
My life time experienceManagement Information system
Current Situation
Clinical Management System(CMS)is
available.
Qualified Data Entry Operator’s are
assigning for operating CMS.
All the patient related entries like OPD,
Admission, Discharge has takes place.
ICD Codes are in practice but not
been updated since long.
Requirements
New Diagnosis , Procedures & Treatments should be updated (ICD Codes needs to be updated)
Patient Entry report should be generated after 7:00 P.M
Camp Patient Entry option should be available in CMS Software
EMR(Electronic Medical Records) should be developed
Systems should have complete list of doctor’s (Acc. to Doctor’s roster)
System hanging should avoid All the essential patient related information
should incorporate(Both Clinical and Non-Clinical).
Treatment given to the patient section should be adequate/Complete.
There should be proper use of CMS by the Data Entry Operator’s
My life time experienceSWOT
Strength
Efficient & Dedicated clinical and non-clinical staff
Highly competent and qualified Medical personnel (Consultants & Doctor’s)
Treatment for almost all retinal ailments
FFA/OCT/B-Scan/Lasers/ERG Retinal surgeries (RD, VH,
Diabetic Vitrectomy, IOL drop, nucleus drop, IOFB)
Vitrectomy for endophthalmitis
Growth Rate: OPD:40-50% OT:15%
Weakness
Manpower Requirement Equipment’s required Strict Protocols
implementation is lacking Lack of training assessment
and documentation of employees
Research work needs to be enhanced
Behavior of the staff s the prime concern
My life time experience
• Opportunity :
Formulating Marketing Strategies to promote the department. Quality Assurance by implementing quality standards acc. to
NABH Guidelines for ensuring patient satisfaction and increasing the patient volume.
By encouraging the efficient and effective operational activities Enhancing and nurturing the Human Resource by training and
Development. Incorporating the implications for improving the current situation
and to overcome the shortcomings mentioned. For getting the majority of the patients from different places
following Establishments should be done for the same:• Uvea clinic• ROP clinic• Oncology clinic Structured fellowship training Research and Development Initiatives.
My life time experienceSWOT
Threat Departmental Threats (If we will not prompt to take the desired implications then: It may create the unsatisfaction among the clinical personnel and we may
face the difficulty in the retention of the consultants It may leads to Patient unsatisfaction and will create a negative image of
the dept. We may get the low patient volume during the peak time (i.e., from Oct –
March every year) It will hamper the employee satisfaction level We will not achieve the desired departmental objective for its betterment.
We may loose the brand loyalty of the patients who are coming from different premises/ Places.
Hospital related threats:
It may hamper the brand image of Sadguru Netra Chikitsalaya.
We may not get the NABH Accreditation
It will hamper the efficiency and effectiveness of the department.
Both patient and staff will suffer if we will not take the corrective actions.
My life time experience
Strategies:
Structured research program Incorporation of Diabetic retinopathy project Focus on urban areas including literate and elite class along with
rural areas Workshops and CME has to be conducted once in 3 months of
every subspecialty On Website – There should be detailed description of team and
services provided by every subspecialty Enhancing the Media publicity Hoardings should be placed in public places (e.g. Railway station,
bus stand) Can add pamphlet/booklet (about services provided with subsidies)
with discharge summary Pamphlets with greetings for treating physicians/ophthalmologists
in surrounding districts about services we offer for referring patients
Establishment of chain of hospitals under the brand name of” Sadguru”
My life time experience
Strategies
In house/external training has to be conducted for paramedical staff (e.g. Optometrist workshop and conferences)
World diabetes day celebration to create awareness w.r.t Diabetic Retinopathy.
Camps organized in surrounding areas for identifying treatable retinal disorders
Monthly internal clinical audit :
External audit : within every 6month
All major disease protocols along with all relevant clinical and non-clinical protocols has to be documented and implemented
Proper training and development programmes for all cadres of Human Resource.
Information Brochures / Pictures has to be prepared.
Incorporation of Consent Forms.
Consultant Panel should be established as per OPD Schedule.
There should be Waiting Lounge with pictures of Retinal Disorders
Key strategies to address weakness
My life time experience
Strategies:
LED should be placed for Demonstration of video related to retinal disorders and services available
Counselors should be hired who are esp. trained in demonstrating Retinal Disorders (Can be Paramedical Staff)
Follow-up : special emphasis on follow –up and its importance Establishing Sadguru Eye Museum for promoting our Hospital and Utilizing
the waiting time of the patients. Organizing Nukkad Natak Review of training of long term comprehensive and long term retina fellows
(Review of complication rate/ OPD performance) Increased space* ( Depending on the shifting of OPD section to new building will be done ) Patient waiting lounge with pictures/LED screen/information brochures
Plan for adding newer surgical /clinical procedures like AUTOFLOURESCENCE IMAGING,ICG IMAGING, Intravitreal ozurdex and lucentis (routinely),Patterned lasers (PASCAL),Sx with use of keratoprosthesis
My life time experienceHow do you visualize SNC and your department by the year 2020
• SNC:• “ Center of Excellence”
• NABH Accredited first eye hospital in central India.• The most renowned Eye Care Institution in India and overseas
and Get collaborated with the international giants.
• Vitreo-Retina Department: • One of the most vital efficient and renowned department.
(People should come at the name of Retina Dept. in SNC)• Benchmark in No. of Retinal surgeries done and the most
trusted institute for the fellowship training aspirants in national and international front.
• “Intellectual pool” with respect to research and publications.
16
Thank you
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