Re-engineering the outpatient process flow of a multi-speciality hospital

Manufacturing concepts such as Just-in-Time, Lean and Six-Sigma, Japanese 5S, Materials Requirement Planning, Scheduling and Capacity Management have been applied in the Healthcare industries in the West for the last decade and has yielded positive results. In this study, these concepts and philosophies have been applied to an Indian Multi-speciality Hospital to improve its OPD process flow and increase patient satisfaction. The Outpatients Department (OPD) is usually the most crowded sector in a hospital. The frequent problems encountered include the waiting period for consultation, an unpredictable number of Walk-in patients, insufficient and operationally deficient OPD reception staff and unattended appointment patients. This study aims at, identifying methods to standardise OPD operations management. It has made the process more efficient through optimum resource utilisation. This will increase patient satisfaction by meeting and exceeding their expectations while maintaining quality of care. This research was conducted by mapping the process flow and using the data that was collected through an observational, cross-sectional, non-interventional study. Though there were a comprehensive set of recommendations at the end of the study, only a few could be implemented due to the introduction of a new Hospital Information System (HIS) software putting the implementation plan on hold

Knowledge and attitude of nursing staff towards nebulization therapy in a tertiary care hospital

Background: Nebulization is an important tool in the treatment of respiratory conditions. Nurses are primary health care providers for using the nebulizers in a hospital setting. The examination of nurse's knowledge and performance regarding the nebulizer therapy is of utmost importance for proper nebulization. Aim of the study was to access the knowledge and attitude of staff nurses towards nebulization therapy.Methods: A cross sectional study was conducted at the RL Jalappa hospital, Kolar, Karnataka, India. 50 nurses working the intensive care units and wards were given a questionnaire regarding the key aspects of nebulization therapy. A workshop was then conducted for the same participants on correct nebulization techniques and the questionnaire was given and the results post workshop was analyzed.Results: In pre-study, most nurses had unsatisfactory knowledge with respect to breathing pattern during nebulization (72.2%), types of masks used (83.3%), changing of filter (62.5%). On comparing satisfactory knowledge level of nurses pre-and post, it was found statistically significant increase in knowledge for breathing pattern during nebulization, knowledge of types of nebulization, nebulization time, nebulization end point, types of drugs used, type of dilution, proportion of dilution, ideal volume of drugs in medication, replacement of tubing, changing of filter, types of disinfections used, types of nebulization and types of mask (p <0.05).Conclusions: The knowledge of the staff nurses regarding the nebulization therapy was unsatisfactory which was reflected by improvement in the knowledge post workshop training. The staff nurses should be provided periodic training on nebulization therapy to give effective and safe care to patients

Opinion of Health Care Professionals towards Submitting a Research Article to a Journal.

There are no specific criteria to measure a journals quality, but indexation of a journal in a reputed database such as PubMed/Medline, SCOPUS, EMBASE etc, and whether the journal is having an impact factor produced by Thomson Reuters are looked upon. Many more indexation database have come up recently, and authors are publishing more articles than before. This questionnaire based study was conducted in November 2012 in two medical colleges in south India with the aim to know the opinion of health care professionals towards submitting a research publication to a journal. Prior approval was taken from the Institutional Ethics Committee to conduct the study. The selected participants were from tutors to professors. The information was recorded and analyzed using Microsoft Excel (2007 version). A total of 297 respondents participated in the study, out of which 263 completed the questionnaire. Assistant professors had more number of publications and also had the maximum number of publications as first author. Among the papers published <10% were published in journals which are pubmed indexed. Highest percentage of pubmed indexed journals were published by professors which was around 10%. The knowledge about impact factor was higher among the junior faculty than the professors. The knowledge regarding quality of a journal, with respect to indexation and impact factor of a journal is grossly inadequate among the doctors. Necessary steps should be taken by editorial board of reputed journals and associations such as International Council Of Medical Journal Editors or regulatory authorities such as Medical Council of India to spread the knowledge about quality of a journal

जलवायु परिवर्तन और नीति (Climate Change and Policy-ClimEd Series:4B)

ClimEd Series IV- This instructional material “Climate Change and Policy” has been developed as a part of the Belmont funded project titled “Global Understanding and Learning for Local solutions: Reducing Vulnerability of marine dependent coastal communities” as a means to create awareness and impart climate change knowledge across the target populace

Ferrock: A Carbon Negative Sustainable Concrete

In this fast-growing world, people are focusing on the infrastructural development, where construction sector plays an important role. Cement is the most prominent material being used in construction that emits approximately 6-8% of the total carbon dioxide in the world during its production which is the major constituent of global warming. Thus, focusing on the carbon emission reduction and also utilization of the waste products for a better environment, a product named Ferrock was constituted. This paper is a review over a product that is stepping towards carbon negativity and waste management. It shows the best usage of iron ore waste powder obtained during the mining process that is just dumped away from the mines, causing air pollution, health hazards and also consuming larger area. The product indirectly reduces the carbon dioxide released by its unique strength gaining mechanism, which is in contrary with that of the cement and thus stands out among many other supplements of cement. Ferrock involves a curing process with carbonation and air curing in varied number of days for better strength in terms of compression, tensile strengths and achieving desirable properties. Ferrock is thus a more promising eco friendlier binding material in terms of its carbon negativity and in best usage of the waste

A Review on Ashwagandha Ghrita

Ashwagandha (Withania somnifera (L) Family - Solanaceae) known as Indian ginseng is an effective immunomodulator, aphrodisiac, sedative and adaptogen. Ashwagandha Ghrita is a ghee based Ayurvedic formulation which is available in the market, but Ashwagandha Ghrita containing Rasasindura and Tamra Bhasma along with Ashwagandha and Musta Churna is also mentioned in classical text which many of us are not aware of. As we all know that the action of Rasaushadhis are quick and require very less dose the one mentioned by Vagbhatacharya (author of Rasaratnasamuchaya) is the need of the hour for the immunomodulation

अधिगम एंव जलवायु परिवर्तन से सामना (Learning & Coping Climate Change-ClimEd Series:2B)

The GULLS project funded by the Belmont Forum addresses coastal vulnerability issues,- specifically the challenges that arise in food security and sustaining coastal livelihoods as a result of global warming and increasing human coastal populations. It seeks to identify adaptation options and strategies for enhancing coastal resilience at the local level and in doing so will contribute to capacity building and local empowerment. The goal of the project is to provide insight to coastal communities to adapt to climate change through trans-disciplinary approach

Rehabilitation Needs of Persons with Schizophrenia and their Families

Schizophrenia, a major mental illness, is associated withdisability in almost all areas of living.&nbsp; A psychosocialrehabilitation programme that comprehensivelyaddresses the needs felt by users is essential for themanagement of this disability. This paper aims at givinginsights about the perceived rehabilitation needs ofpersons with schizophrenia and their primary caregivers.The sample consisted of 30 out-patients diagnosed withSchizophrenia (ICD-10 criteria), and their respectivecaregivers (30 in number). Perceived rehabilitation needswere assessed using the Rehabilitation Needs AssessmentSchedule (Nagaswami et al, 1985). The major needsidentified by patients as well as caregivers were attitudemodification, employment, and help for the family.Additionally, caregivers expressed a need for skillstraining and options for leisure time engagement for theirwards.&nbsp; These findings have implications for planningpsychosocial rehabilitation programmes

Primary Leiomyosarcoma of the Kidney

Primary leiomyosarcoma of the kidney is a rare tumor with an aggressive behaviour. A 55-year-old woman presented with a left sided abdominal mass in our outpatient department. Radiologic investigations revealed the mass to be renal in origin with colonic adhesions for which radical nephrectomy and hemicolectomy were done. The tumor completely appeared to replace the left kidney and had a whorled character focally on cut section. Microscopically, spindle cells having malignant features with cigar shaped nuclei were seen. The smooth muscle origin of the cells was confirmed by immunohistochemical positivity for smooth muscle actin. Sarcomatoid variant of the renal cell carcinoma was ruled out as the tumor was negative for cytokeratin. Tumors with spindle cell morphology in the kidney should not always be taken for a sarcomatoid variant of renal cell carcinoma and should be investigated thoroughly

A review on the citations of Ratnas in Garuda Purana

In Ayurveda, one can get various references regarding Yuktivyapashraya Chikitsa (a treatment modality which is based on logic) and Daivavyapashraya Chikitsa (a modality of treatment based on past deeds and pleasing of God). Ayurveda has always utilised plant and mineral origin for the purpose of Chikitsa. Scholars all over the world are searching for new ideas, concepts, processes, products by looking backward for getting the knowledge from the ancient books and traditions. Indian epics and ancient scriptures like Puranas contain majority of knowledge accumulated during past thousands of years. Gem stones are very amply discussed in Hinduism scriptures. Especially in the Puranas, we find many descriptionson gemstones, embedded in its Sanskrit verses along with fascinating mythological origins. Hence the present article aims to review regarding origin, identification and test of genuineness for gems as described in Garuda Purana