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PROJECT ON

ILS HOSPITALS
STANDARD PROCEEDURE MAINTAIN IN OPD
IMPROVING EFFICIENCY OF WORKFLOW IN AN OUT PATIENT
DEPARTMENT
PROJECT SUBMITED BY:

NAME:

ANIRBAN DAS

ROLL:

122422

COURSE:

BHM

YEAR:

2012-13

SELF DECLARATION

I, Anirban Das hereby declare that this


declaration is based on the original project study
conducted by me.
Submitted in partial fulfillment of the requirements
for the degree of Bachelor in Hospital Management.

CERTIFICATION

This project report of Anirban Das '' OPD is approved


and is acceptable in quality and form.
I

PROJECT GUIDE
Mr Parantap Dasgupta
Deputy manager Human Resource , ILS
dumdum

ACKNOWLEDGEMENTS

THE MEDICAL HEAD DR DEBASHIS SHARMA


MEDICAL ADMINISTRATOR DR SAMEER SITAL RAJ
PROJECT GUIDE DR SHUVRO ROY CHOUDHURY
RADIOLOGIST PROF DR S. K .BASU
ROYCHOUDHURY
RADIOLOGIST DR SALIM PARVEZ
RADIOLOGIST- DR RAJESH GHOSH
RADIOLOGIST DR GUNJAN GUPTA

ABSTRACT

It is hereby inform that the out patient department in ILS


Hospital Dumdum is in the 1st floor, the radiology section
is also under the OPD bt this particular department has
separate location in the hospital & that is in the ground
floor.

Radiology & imaging Department


1.X-Ray (C.R system)-This is computer
radiography system
2. CT Scan (64 slides)-This is multi detector
computer tomography scan machine
3. MRI (1.5 tesla)-This is high resolution magnetic
resonance imaging
4. INTRAVENTIONAL RADIOLOGY-This is x-ray
machine with I. I. TV to guide the radiologist to do
the interventional procedure.
5.USG- This is ultra sonography machine
6.MAMOGRAPHY This the imaging of soft tissue
of breast
The aim of the project is to reduce the time of
imaging and in emergency to show all the
images only on a single click. Patient will get
only one CD.No film,no envelop, no plastic carry
bag.No pollution.

CONTENTS:

Diagnostic imaging

Formerly known as X-ray, this department provides a full


range of diagnostic imaging services including:

general radiography (X-ray scans)

scans for A&E

mammography (breast scans)

ultrasound scans

angiography (imaging of blood vessels)


interventional radiology (minimally invasive procedures, eg to
treat narrowed arteries)

CT scanning (scans that show cross sections of the body)

MRI scanning (3D scans using magnetic field).

RADIOLOGY PREPARATION

X-RAY L.S.SPINE / K.U.B / ABDOMEN

BOWEL PREPARATION. (2 TAB. DULCOLAX &


FESTAL- N AFTER DINNER.
TO COME TO RADIOLOGY DEPARTMENT IN THE
MORNING WITH EMPTY STOMACH.

H.S.G

HSG DONE BETWEEN DAYS 8 TO 12 OF MENSTRUAL


PERIOD
BARIUM STUDY

BA. SWALLOW OESOPHAGUS - NO FEED FOR 4 HRS.


BEFORE STUDY
BA.MEAL F.T - BOWEL CLEARANCE & EMPTY
STOMACH

BA. MEAL I.C.R - BOWEL CLEARANCE


BA. ENEMA- BOWEL CLEARANCE

MAMOGRAPHY

NO PREPARATION REQUIRED.
I.V.U

2 TABS. CREMALAX OR DULCOLAX & 2 TABS.


FESTAL N AFTER LUNCH & DINNER 1 TO 2 DAYS
PRIOR STUDY
DAY OF STUDY- NO FOOD / WATER AFTER 6 AM
INVESTIGATION- UREA, CREATININE, PREVIOUS XRAY, USG, IVU, OPERATIVE NOTES IF AVAILABLE.

QUESTION TO ASK PATIENT


WHETHER DIABETIC?
INFROM DOCTOR BEFORE EXAM
AVOID ANY RENO TOXIC DRUG.
ANY KNOWN ALLERGY?
ANY HISTORY OF REACTION TO CONTRAST?
WHETHER ASTHAMATIC?

USG WHOLE ABDOMEN


BOWEL CLEARANCE & EMPTY SOMACH WITH ONLY
WATER INTAKE TO MAKE FULL BLADDER (HOLD
URINE / NOT PASS URINE.)

USG LOWER ABDOMEN / KUB


NO NEED OF EMPTY STOMACH WITH ONLY WATER
INTAKE TO MAKE FULL BLADDER (HOLD URINE /

NOT PASS URINE.)

USG UPPER ABDOMEN


EMPTY STOMACH, WATER CAN BE TAKEN

USG DOPPLER OF RENAL ARTERIES / SPLENO PORTAL


AXIS / ABDOMINAL VESSELES
BOWEL CLEARANCE & EMPTY STOMACH
( PREFERABLY) WITH ONLY WATER INTAKE

USG T V S
EED OF FULL BLADDER, FOLLOWED BY EMPTY
BLADDER.

USG TRUS
GOOD BOWEL CLEARANCE

USG FOLLICULAR STUDY


NO NEED OF FULL BLADDER

C.T. SCAN ABDOMEN / KUB / LOWER ABDOMEN / PELVIS


BOWEL CLEARANCE & EMPTY STOMACH

EMERGENCY- NO PREPARATION

INTRODUCTION :
For research analysis this is very much difficult to know the
starting of the exact time of investigation and the end of the
investigation. This project is the study of the imaging service in
a quicker method.
OBJECTIVES :
Reduce the time of imaging and at so pollution free imaging.

HYPOTHESIS :
To reduce the environment pollution.

METHODOLOGY :

In this project no film or carry bags or chemicals are used.. If


we do not use the films X- Ray, CT, M. R. I., Mamography in
imaging it can reduce the environmental pollution and give
faster services.

SCOPE :
Easy to carry and the record will be kept for a long time. This is
the real study where all data and information are given by the
patients or the patient relatives visited to the FORTIS Hospital,
Anandapur, Kolkata. They gave their valuable opinions and
signed the forms by themselves.

LITERATURE REVIEW :
In radiology tests and procedures will take different period of
time. So this is difficult to know the exact time of investigation.
Moreover after the investigation it will take more time for post
processing the image and filming. In Indian culture our
radiologist or consultants prefer to film than C. D.

If we use C. D. it will give more information more accuracy and


perfection. It can be saved for a long time.

A BRIEF DESCRIPTION OF OPD IN ILS


The floor consist of 8 opd with diagnostic room
accordingly Sample Collection, Mammography,
Echo,TMT/ Holter , ECG, Endo Gastro, Physiotherapy
,Proccedure room, executive health, Dental, Ent ,One
billing desk , One co - ordination desk along with waiting
lounge. There is also a floor manager room in front of
the billing desk & have a cafeteria too.

THE MAIN PARTS WHICH I HAVE LEARNED


THROUGH BILLING DESK
Its all about communication which have to be perform
with the patient during the working time of billing. The
first & foremost function of any executive is to be query.
1.Ask the patient be politely & softly about the
problem. Therefore ask the patient about the
purpose, either they want to consult doctors or want
to do diagnosis .
2. The second part is to ask patient whether he/she
is in the hospital for the 1st time or not. If for the 1st
time fill up the registration form with entering name,
age, address, phone number .After put all this data
into the system through HMIS ,the operator
automatically generates a MR no against the
individual patient.
3.Next step is to provide information about the fee &
make bill to whom the patient may want to consult.
4.After that the duty have to be perform by the coordination desk which is behind the billing desk.
Their main duty is to adjust the room for the
doctors , making the patient to maintain a que to go
to the doctors room serially.
5.After consultation patient comes to the billing desk
for query is there any test is given by the doctor or

not,if yes give about proper information about the


tests and also tell about its preparation and about
the costs too.
In case of any former patient who have
already registered their name ,it will be much easier for
us to put the data into the system by entering the MR no
in the HMIS system.

FACILITIES WHICH HAVE PROVIDED BY THE


HOSPITAL AUTHORITY IN OPD
1.10 % discount for the patient who have crossed the
age of 60.It will be applicable only with the diagnosis
and for this the patient party have to be provide a
identity proof .
2. Sparsh card.
i) 15% discount on all opd investigation.
ii)10% discount on health check up packages
iii)10% discount on IP services excluding medicines,
consumables , and doctor's fee.
iv)physician visit at home for general check- up and
consultation once in two months

v)Blood sugar (random), blood pressure & weight


check up at home every month.
vi) One free sample collection & delivery of reports
at home every month.
vii) Free ambulance service,if hospitalized in ILS
hospital
viii) Cardholders will receive priority in admission.
3.Privilege card
i) A handling charge of 100 shall be payable by the
customer .
ii) The card shall be valid for a period of 1 year from the
date of issue.
iii) The management reserves the right to issue the
card .
iv)The cardholders should be entitled for a)15% discount on outdoor bills for all diagnostic
tests done at ILS hospitals .No doiscount shall be
allowed on doctors fee ,health check ups, diagnostic
packages,medicines etc.
b) 10% discount on all indoor bills including
diagnostic tests being conducted at ILS hospitals. No
discount shall be allowed on doctors fee,medicines,,
bought out items and packages for treatment included in
indoor bills.
4.Health Check up

VISION

Globally
Respected
Healthcare
Organization
Recognized For Clinical Excellence and Distinctive
Patient Care

MISSION

To Be The Preferred Super Specialty Healthcare


Provider Of International Standards Known For Patient
Centric Care And Clinical Excellence Through Continual
Improvement Of Processes And Outcomes.

DYNAMIC LEADERSHIP

MR.

MALVINDER

MOHAN

SINGH

--

GROUP

CHAIRMAN,

MR. SHIVENDER MOHAN SINGH -- VICE CHAIRMAN,

MR. VISHAL BALI -- CHIEF EXECUTIVE OFFICER,

MR. ADITYA VIJ -- CHIEF EXECUTIVE OFFICER,

MR. ASHISH BHATIA -- CHIEF OPERATING OFFICER,

MR. HARSHVENDRA SOIN -- CHIEF PEOPLE OFFICER

MR. VARUN KHANNA-REGIONAL DIRECTOR (EAST &


WEST)

MS. RICHA S DEBGUPTA -- FACILITY DIRECTOR

A BRIEF HISTORY
Fortis Hospitals, Anandapur commissioned on 9th
january, 2011. It is a 400 bed super specialty hospital
located on EM Bypass road. It is a part of Indias
leading health care providers - Fortis healthcare (India)
ltd, focusing on the tertiary care of super specialty like
Cardiology And Cardiac Surgery, Bone & Joint Care,
Brain & Spine Care, Digestive Care, Urology &
Nephrology, Emergency Care And Critical Care.

Our amenities include 24 hour accident and


emergency service including Trauma Treatment,
Ambulance Services, Blood Bank, Fully Functional
Operation Theatres, Cat lab, Preventive Health Check
Ups, Diagnostic pathLabs,Radiology etc

OUR VALUES

PATIENT CENTRICITY:
Committed To Best Outcomes And Experience For
Our Patients.
Treat Patients and Their Care Givers
Compassion, Care and Understanding.

with

Our Patient Need Will Come First.

INTERGITY:
Be Principled, Open and Honest.
Model And Live Our Values.

Demonstrate Moral Courage To Speak Up And Do


The Right Things.

TEAMWORK:

Proactively Support Each Other And Operate As


One Team.

Respect and Value People at All Level with


Different
Opinions,
Experiences
and
Backgrounds.
Put
Organization
Department/Self Interest.

Needs

Before

OWNERSHIP:
Be Responsible And Take Pride In Our Actions.
Take Initiative And Go Beyond The Call Of
Duty.
Deliver Commitment And Agreement Made.

INNOVATION:

Continuously Improve And Innovate To Exceed


Expectations.
Adopt A Can-Do Attitude.
Challenge Ourselves To Do Things Differently.

INTERNATIONAL PATIENT SAFETY GOALS


GOAL: 1
Identify Patients Correctly Use At Least Two Identifiers
For
Patients
Before
Giving
Medicines,
Blood
Transfusion, Taking Samples, Etc.
These Can Be:
NAME
UHID No / IP No
YOU CANNOT IDENTIFY A PATIENT BY THE BED NO

GOAL: 2
Improve Effective Communication
Improve Process for Verbal Orders
Improving imaging & Reporting Of Critical Test

Improve Hand Off Practices

GOAL: 3
Improve the Safety of High Alert Medications
Maintain Safe Custody of Concentrated Electrolytes
Beware Of Lasa (Look Alike Sound Alike Drugs)
Know The High Risk Medications.
Read the Medication Management Manual

GOAL: 4
Ensure Correct Site, Correct Patient, Correct
Procedure / Surgery
ImplementTime Out
Ensure All Documents Are Present Before Surgery
Begins
Practice Site Marking
GOAL: 5
Reduce the Risk of Health Care Associated
Infections
Comply With Hand Hygiene Guidelines
Ensure Proper Waste Management Practices
Ensure Segregation of Waste at the Source

GOAL: 6
Reduce The Risk Of Patient Harm Resulting From
Fall
Fall Risk Assessment And Re Assessment Of
Patients.
Restraint Policy
Monitoring For Fall

PATIENT RIGHTS & RESPONSIBILITIES:


Patients Rights and Responsibilities Have
Been Defined and Informed to the Patients and
Families.
Management
Requests
Strict
Compliance
with
Patients
Rights
and
Responsibilities.
PATIENT HAS THE RIGHT TO
APPROPRIATE CARE
VOICE A COMPLAINT
INFORMED CONSENT
RIGHT TO PRIVACY
CONFIDENTIALITY OF INFORMATION
INFORMATION
TREATMENT

ON

EXPECTED

COSTS

OF

RECEIVE TREATMENT IRRESPECTIVE TO THEIR


CASTE, AND CREED AND ECONOMICAL
STATUS
TO REFUSE TREATMENT
ASK QUESTIONS AND PARTICIPATE IN CARE
DECISIONS
GET ADDRESSED REGARDING THEIR SPECIAL
NEEDS
EMERGENCY CARE
GET TRANSFER AND GET DISCHARGED
ACCESS TO MEDICAL RECORDS
TO
KNOW
OF
RELATIONSHIPS

THIRD-PARTY

CARE

SENSITIVE AND COMPASSIONATE CARE


.TO RECEIVE TIMELY RESPONSE TO CARE
NEEDS
TO PAIN MANAGEMENT

PATIENTS RESPONSIBILITIES

ANSWER QUESTIONS CORRECTLY


PLEASE
PROVIDE
ACCURATE
INFORMATION
ABOUT YOUR HEALTH INCLUDING PAST ILLNESSES
OR HEALTH PROBLEMS, HOSPITALIZATIONS,
ALLERGIES AND THE CURRENT OR PAST USE OF
MEDICATION.

MAKE SURE YOU UNDERSTAND


ASK QUESTIONS OR REQUEST AN EXPLANATION
FROM YOUR DOCTOR OR HEALTHCARE PROVIDER
ABOUT ANY PART OF YOUR MEDICAL CARE THAT
YOU DO NOT UNDERSTAND.
READ
ALL
MEDICAL
FORMS
INCLUDING
CONSENTS THOROUGHLY.ASK TO HAVE THE
INFORMATION EXPLAINED TO YOU PRIOR TO
SIGNING IF YOU DO NOT UNDERSTAND.

FOLLOW THE TREATMENT PLAN RECOMMENDED


BY YOUR HEALTH CARE PROVIDER.
.HELP US TO SERVE YOU BETTER
.BE CONSIDERATE OF THE HOSPITALS PERSONNEL
AND PROPERTY
.PLEASE OBSERVE FACILITY POLICIES AND
PROCEDURES, INCLUDING THOSE REGARDING
SMOKING,NOISE AND NUMBER OF VISITORS.

PROCEDURE

1.FORTIS HOSPITAL HAS A MEDICAL INFORMATION


MANAGEMENT PLAN TO MEET THE REQUIREMENT FOR
INFORMATION OF THE CLINICAL CARE PROVIDERS,THE
MANAGEMENTS NEED OF SUCH INFORMATION AND
ANY OUT SIDE AGENCY REQUIRING SUCH
INFORMATION.

2.THIS INFORMATION MANAGEMENT PLAN IS


APPLICABLE TO ALL INFORMATION-MEDICAL AND NON
MEDICAL INFORMATION PERTAINING TO IN
PATIENTS,OUT PATIENTS & HEALTH CHECK UP
CANDIDATES.

3.OUTPATIENT RECORDS-EVERY PATIENT WHO AVAILS


OF A CONSULTATION WITH ANY CONSULTANT WILL
HAVE A UHID NUMBER.
4.THE REGISTRATION AND DEMOGRAPHIC DATA
CAPTURE IS AT THE BILLING COUNTER BY THE
CUSTOMER CARE FACILITATOR(SOP/CC/OPD BILLING/01
AND REGISTRATION FORM)

5.THE ORIGINAL PRESCRIPTION SHALL BE GIVEN TO


THE PATIENT WHILE THE SECOND COPY WILL BE
STORED IN THE HOSPITAL RECORD.THIS COPY WILL BE
RETAINED FOR 3MONTHS,HIS SHALL BE MAINTAINED
AGAINST UHID,PATIENTS NAME,FINDINGS,ADVISED
INSTIGATIONS,AND THE STATUS TO GUIDE THE
PATIENT FOR BILLING OR TO HELP FOR PROVIDING
ESTIMATES INCASE OF ANY SURFERIES.

6.REPORTS OF ALL INVESTIGATION CONDUCTED AT


FORTIS HOSPITALS LTS.ANANDPUR ARE
ENTERED,RECORDED AND RETAINED IN THE HIS
UNDER PATIENT FOLDER/UHID.
7.PRIMARY DATE LIKE THE ECG RECORDING/X
RAY/MRI/CT/ULTRASONOGRAPHY ECHO
CARDIOLOGY/DOPPLER STUDIES FILMS/CD WILL BE
HANDED OVER TO THE PATIENTS AT REPORT DISPATCH
WITH APPROPRIATE SIGN OFF.
8.THE PRIMERY DATE IN MRI/CT AND
ECHOCARDIOGRAPHY IS RETAINED IN ELECTRONIC
FORM FOR 2 MONTHS.
9.THE CATH LAB PRIMARY DATE IS RETAINED IN CD;S
FOR 5 YEARS.
10.THE PATIENT DATA GENERATED AT THE INTERSIVE
ARE UNIT MONITORS AND THE CATH LAB IS AVAILABLE
VIA A PASSWORD PROTECTED TRANSACTION TO THE
CONSULTANTS ON THE SIEMENS WEB VIEWER/PACS
WEB.
11.SECURITY OF THE HIS SYSTEM/WIPRO HEALTHCARE
IT ENSURES INTEGRITY,EASY RETRIEVAL AND
SECURITY OF PATIENT RECORDS AND IT ACCESS TO IT IS
CONTROLLED BY THE FORTIS HOSPITALS LTD
INFORMATION TECHNOLOGY TEAM.

MAIN BODY :

At present the patient come for X Ray, C. T. scan or any


other investigation we will create a registration number against
the patients. Then the bills are made as per prescription. After
that the patient / patients relatives are to fill up the consent
form.

Before the test the patients are to be prepared. After having the
preparation, the tests are done. Then the post processing of
the films are done. Next the reports are made. At least the
reports and the films are given and kept in a carry bag to the
patient or patients relatives. Whole process will take at least
24 hours.

In my project at the time of registration the consent


is taken. After that, the patients are sent to the
respective department for test. After the procedure the
patient will get the C. D. which carries the images and
reports within half an hour. It will not only save the time
of the patient but also reduce the cost of the test. In this
way we can also control environmental pollution. The
films and papers which are given to the patients are
destroyed after a long period of time and they pollute
the environment. In stead of film, if we use the C. D. it
will give us a great benefit. A survey has been done
regarding this new method.

RESULTS :
After survey of this project we can come to
final results. This no doubt can be helpful
to patients.
CONCLUSION
This project had been an excellent piece of
practical exposure for me where I came across
the complications that often arise in the
radiology & imaging process . Further I was
also
lucky
enough
to
witness
the
inconveniences faced by the patients as well as
the those by hospital staff.