Health Care - Security, Challenges & Opportunities

1. Health Care - Security, Challenges & Opportunities By Dr. P.H.Mishra Chief of Medical Administration Indian Spinal Injuries Centre Sector- C, Vasant Kunj New Delhi- 110070

2. Indian Spinal Injuries CentreNABH & NABL Accredited Organization

3. Threat at Hospital To Staff , Patients & Visitors- refers to the prevention of theft, fire, Hospital acquired infections and other emergencies.

4. Threat to Staff, Doctors from internal & External Enviornment like Mob, Relatives. Hospital Aquired Infection.

5. Risk Management Identifying and analyzing situations or practices that create financial risk for the hospital and medical staff. Develop strategies to eliminate, avoid or minimize the risk.

6. To manage risks to the quality of services provided & the safety of patients & visitors. To manage risks to staff & subsequent risks to service quality. To manage risks to the reputations of the hospital risk management aims

7. To identify the major sources of risks to hospital, staff & visitors. Develop regular statistical & qualitative risk management reports establish mechanisms to maintain & develop structures & processes for a cohesive approach to the management of clinical & non clinical risk

8. Conduct operational reviews of departments to identify deficiencies & potential areas for improvement.

9. To reduce safety risks; The exec. housekeeper must, be aware of potential safety hazards develop procedures to prevent accidents develop ongoing safety training programs be aware of the laws that regulate the work environment

10. Unsafe Work Environments cause; insurance and liability concerns - expensive medical costs - legal problems e.g. fines or lawsuits - decreased productivity employee moral and management concerns - negative employee morale - low performance

11. Potentially Hazardous Conditions Managers must train employees to recognize potentially hazardous conditions and take corrective actions before they cause injuries like sprains, strains, falls; - wet floors and slippery walkways - messy floors - equipment left out in the way - improper lifting techniques

12. Ladders; when selecting a ladder, inspect its condition, height and footing. do not use broken or defective ladder do not use aluminum or metal ladder when working near or on electrical equipment use rubber footing on tile floors and in kitchen floor must be dry and clean should be high enough never stand on the top step never place a ladder against a window or uneven surfaces should be well-balanced

13. when climbing, face the ladder and have clean and dry hands and feet mark the area underneath the ladder with caution signs Machines; employees should be authorized and trained to use them before operating follow the instructions and train and supervise the staff safety guards of the machines should not be removed, protective eye goggles should be worn

14. never leave them unattended, turn off and store never use a machine that is not operating correctly, have it repaired Electrical Equipment; never operate electrical equipment with wet hands or cloths do not operate near flammable liquids, chemicals or vapors turn off them when sparks, smokes or flames are seen check the wires and connections periodically never unplug them by pulling the cord

15. keep the cords out off traffic areas when cleaning guestrooms, room attendants should check for frayed wires, loose connections, loose plugs, broken switches Chemicals; when used improperly, they can cause nausea, vomiting, skin rashes, cancer, blindness and even death. Potentially hazardous chemicals are used to kill insects and rodents or unstop clogs in toilets. continual training in chemical safety is necessary

16. Safety Training 1. Begins the first day of the job with an orientation about safety rules and regulations. 2. Does not end at orientation. Every employee should participate in an ongoing safety education program at least once a month.

17. Security Is the task of protecting both people and assets by; guestroom security key control perimeter control emergency procedures lighting security records

18. Security Issues Suspicious Activities; The individuals allowed in guestroom areas are; guests, their visitors, and on-duty employees establish a policy on how to approach and handle unauthorized or undesirable people. Suspicious people are those; checking doors, knocking on doors, or looking nervous.

19. employees who are not in their designated area should be asked if they need help. Depending on the person’s response and manner, report to security. friends and relatives of employees should not be allowed in guestroom areas or employee locker rooms

20. Theft; (a) Guest Theft can be reduced by; using fewer items with logos reduces temptation to steal keeping storage rooms closed and locked fixing or bolting guestroom items and fixtures to appropriate surfaces when cleaning, notifying the front desk or security for any missing items securing all first floor windows and sliding glass doors

21. (b) Employee Theftcan be reduced by; acting as a good example as managers writing down the consequences of stealing in the employee handbook and implementing them for everyone without discriminating screening applicants (background check) before making a job offer having good inventory control procedures, taking physical inventory every month keeping records of stolen or missing items keeping all storeroom doors locked and changing the locks periodically

22. designating employee entrances and exits with security staff establishing claim-checking and parcel-pass systems restricting employee parking in large hotels, using identification badges to prevent strangers

23. Bomb Treats As housekeeping, helping in the search for any suspicious objects that could be bombs. Searches often include stairways, closets, ashtrays, trash containers, elevators, exit areas, window sills If a suspicious looking object is found, it should not be touched or moved, notify the person in charge of the search team Avoid using radios, walkie-talkies, or beepers The safety and security manual should include evacuation plans The local police should be notified of all bomb threats

24. Fires; are grouped into four - Class A, wood and paper products; Class B, flammable liquid, grease, and gasoline; Class C, electrical, Class D, combustible metals. In the lodging industry, electrical malfunction and arson are the two most common causes of fire. installing fire detection systems - smoke detectors, suppression systems (sprinklers) , alarms (pull stations) fire safety training - in evacuating the building, reporting fire, emergency escape procedures and duties, escaping from a smoke-filled room, putting out a small fire (fire extinguishers, type ABC) using fire-resistant fabrics and materials

25. Key Control; housekeeping is concerned with emergency (open all doors even those have doublelocked), master (three levels -the highest level is the grand master opens every hotel room and HK storage rooms, the next level is the section master opens rooms in one area, the lowest level is the floor key opens the rooms on the allocated floor and storeroom) , storeroom and guestroom keys.

26. Lost and Found; handled by housekeeping should be stored in a secure area items should be tagged (with numbers), logged (to record the date, time, place, person) ex. 8, pg. 195, secured (keep at least 90 days, donate unclaimed items) Guestroom Cleaning; room attendants should; not open guest luggage or packages be careful when removing linens, dusting the top of closets and under lamps, since guests sometimes hide valuable belongings

27. Immediately notify the HK, Security or FO; if any of the following items are noticed; guns/weapons drugs cooking/unsafe electrical appliances foul odors pets ill guests large amounts of cash or valuable jewelry Keep the door open and the cart rolled in front of the entrance to block access from outside, when cleaning guestrooms

28. Politely ask the guest name and see the room key, if a guest wants to enter the room while the attendant is cleaning Never leave a room unattended with the door open After cleaning the room, check all windows and sliding doors whether they are locked, check the guestroom as well to see that it is locked

29. Challenge: Burden of Diseasein the new millenium • India faces the twin epidemic of continuing/emerging infectious diseases as well as chronic degenerative diseases. • The former is related to poor implementation of the public health programs, and the latter to demographic transition with increase in life expectancy.

30. Economic development, Education and Health • Economic deprivation in a large segment of population results in poor access to health care. • Poor educational status leads to non-utilization of scanty health services and increase in avoidable risk factors. • Both are closely related to life expectancy and IMR. • Advances in medicine are responsible for no more than half of the observed improvement in health indices.

31. Human Development Indicators: A challenge for all Longevity, literacy and GDP per capita are the main indicators of human development Longevity is a measure of state of health, and is linked to income and education Weakness in health sector has an adverse effect on longevity India ranks low (115th) amongst world nations judged by HDI

32. Health Care in India Expenditure on health by the Government continues to be low. It is not viewed as an investment but rather as a dead loss! States under financial constraints cut expenditure on health Growth in national income by itself is not enough, if the benefits do not manifest themselves in the form of more food, better access to health and education: Amartyo K Sen

33. 1990 2020

34. Distribution of deaths from three groups of causes, by region: 1990 Murray and Lopez, 1994

35. Probability of death in males 0-14 years from three groups of causes Murray and Lopez, 1994

36. Top causes of death in 1990 and 2020

37. Top causes of death in 1990 and 2020

38. Health Care in India India has 48 doctors per 100,000 persons which is fewer than in developed nations Wide urban-rural gap in the availability of medical services: Inequity Poor facilities even in large Government institutions compared to corporate hospitals (Lack of funds, poor management, political and bureaucratic interference, lack of leadership in medical community)

39. A day in hospital:

40. Health Care in India Private practitioners and hospitals major providers of health care in India Practitioners of alternate systems of medicine also play a major role Concerns regarding ethics, medical negligence, commercialization of medicine, and incompetence Increasing cost of medical care and threat to healthy doctor patient relationship

41. There is a marked shortage of trained nurses

42. Components of healthy life style Abstinence from tobacco use Regular physical exercise Balanced nutritious diet rich in vegetables and fruits, and low in fats and refined sugar Avoidance of pre and extramarital sex Yoga and meditation Avoidance of alcohol and substance abuse

43. There has been an explosion of high tech diagnostic, therapeutic and preventive interventions in the field of medicine and surgery This has resulted in physicians spending less time in history taking and physical examination.

45. Rational Drug Use Can prevent emergence of anti-microbial drug resistance, and reduce drug toxicity, adverse drug reactions, and the cost of treatment Requires coordinated approach: Patient and physician education, antibiotic policy, hospital infection control team, regional and national antibiotic resistance surveillance

46. Emergence of antibiotic resistant bacteria Cohen;Science 1992;257:1050

47. Health Care in Developing Countries Existing infrastructure for health care needs to be strengthened. Health should be perceived as an investment and receive greater budgetary allocation Education, safe water and sanitation need priority Vaccination coverage to be improved Better implementation of national health programs Judicious use of the scant resources by promoting most cost-effective strategies for disease prevention Inclusion of all level of stakeholders in planning and policy making using tremendous human resource available in the country

48. Three Rules for safe, accident-free work environment 1. Take adequate time 2. Correct unsafe conditions immediately 3. Do it safely the first time

49. Safety Tipsfor potentially hazardous conditions in the HK Lifting; incorrect lifting may cause, strained or pulled muscles and back injury, and cuts and scratches.

50. Thanks