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PRACTICAL TRAINING REPORT

ON

CANCER HOSPITAL AND RESEARCH INSTITUTE, GWALIOR (M.P)

Submitted to

Centre for Hospital Administration

Jiwaji University, Gwalior (M.P.)

Towards Partial Fulfillment of Requirement ForMasters in Business Administration (Hospital Administration)

1 st Semester

Submitted By

Vikash Kumar Pulaiya

MBA (HA) 1st Semester

December 2010

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1. Certificate.2. Declaration. 3. Chairmans message. 4. Acknowledgement. 5. History. 6. Vision & Mission. 7. Future Plans. 8. Hospital Profile. 9. Process of Registration and Admission of patients At

Reception. 10. Functioning and Various Departments within Hospital. 11. OPD Services.12. Pharmacy13. Wards.14. Personal / H R Dep. & Public Relation.15. Library in Hospital.16. Marketing.17. Laboratory Services (Investigation).18. Billing and Discharge.19. Conclusion.

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I declare that the practical training report is my originalwork.

I further declare that to the best of my knowledge and belief, the practical training report does not contain any

part of my work, which has been submitted for the award of any degree either in this university or in any other university.

Vikash Kumar PulaiyaMBA (HA) 1 semester

Jiwaji University, Gwalior (M.P.)

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Dear student,

Dr.B.R.ShrivastavChairmanCHRI Gwalior

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In the preparation of this project I have received great help from many of our teachers, friends in number of ways, I take thisgolden opportunity to thank all of them the normal constructionand sentence pattern of this project are introduced gradually,systematically and are well drilled at every stage. I hope that this project report will cater to their need on this subject.

Lastly I should be failing in our duty if we do not express our gratitude to our family members who have given us great encouragement to complete this report.

Vikash Kumar PulaiyaMBA (HA) 1 semester

Jiwaji University, Gwalior (M.P.)

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Cancer Hospital and Research institute, Gwalior has a tragic back ground in its foundation. In March 1971, Shri & Smt. Shitla Sahai hadlost their only son Rajiv, who was suffering from bone sarcoma. Hardlyany facilities were available then in Gwalior for the treatment of cancer.Undaunted by the grief, this family vowed to start a Cancer Hospital toprovide benefit to cancer patients in Gwalior. With this aim in view, acharitable trust Jan Vikas Nays was founded in May 1971.Surmounting difficulties and with untiring efforts of the bereavedfamily, Cancer Hospital was Started in 1977, which has graduallydeveloped to a modern Cancer Hospital with facilities for diagnosis andmanagement of the diseases. Government of Madhya Pradesh had beengenerous to allot 266 acres of land for this noble cause on a hill top of Mandrel Ki Mata. The construction of the main hospital building and

patients attendants hostel was taken up initially and then the fullcampus with all amenities developed in phased manner. The institutewas recognized as early as in 1980, as one of then 10 regional CancerCenters for Research and Treatment by the Government of India. TheInstitute is serving not only to the people of Madhya Pradesh but alsofrom the neighboring districts of Uttar Pradesh and Rajasthan besidessome patients coming even from far distant states. With meagerresources at hand and with generous though a limited quantity of Grant-in -aid from Government of India and some contributions fromGovernment of Madhya Pradesh, the institute, which started fromscratch, has developed into a modern hospital with facilities to provide

all the three modalities of treatment for cancer viz., Surgery,Radiotherapy, Chemotherapy. The institute also has modern diagnosticfacilities in the department of Radio- diagnosis, Pathology, Biochemistryand Microbiology and in addition palliative care to cancer patients.Department of Radio diagnosis has been playing an important role inearly diagnosis of Cancer and other non - cancerous diseases. It isequipped with modem CT scanner, MRI, and U.S.G. Colour Doppler,Mammography, Portable Ultra Sonography, 300 MA X- ray unit and

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two mobile X-ray units. Addition of latest high resolution multi slice (16slice) C.T. Scanner, Portable Colour Doppler, Digital X-ray system thisyear makes Radio diagnosis department in this area modern to providemany imaging techniques like 3D reconstruction (useful for cancerous

patients and orthopedic purposes), virtual bronchoscope andcolonoscopy, non - invasive whole body angiography and non - invasivecoronary angiography under one roof with assured image quality anddiagnosis. Portable Ultra Sonography and Doppler is a useful tool forbed - ridden patients and provide bed side services .Department is alsoengaged in complicated interventional imaging guided procedures VIZ.CT and USG - guided FNAC, fluid and abscess drainage,USG - guidedPTBD and nephrostomy..

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Our mission, vision and strategy are a reflection of the things thatwe aspire and that we seek they are our goals, our beliefs andour aspirations.

VisionTo be the most sought after organization of the 21st century .

Mission

Imbuing all our operations with the motto of fair businesspractices, family values and high growth-high profitability.

To be sought after by, Customers for trust and deliverance Our team for creditworthiness Authorities for transparency Environment for conscientiousness Society for socio-economic transformation Stakeholders for value enrichment.

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1-Process Of Registration And Admission Of Patients At Reception.

RECEPTION

ADMISSION COUNTER

REGISTRATION DEPARTMENT

RECEPTION

Reception is the FACE OF THE HOSPITAL creating the firstimpression of the services which is the entrance to the clinical area. Firstimpression are powerful and long-lasting, they said the tone for all theinteraction that follow. They shape the individual perception about thefacilities, services in the hospital.

In the front office, the receptionist guide the patients, there relatives and

reassures them. Receptionist must do other duties like registration,renewal, consultation.

WHEN PERSON COMES TO THE HOSPITAL, FIRSTLY GOTO THE REPTION COUNTER FOR FURTHER ENQUIRES.

SUCH AS.

o ABOUT THE HOSPITALo PATIENT ENQUIRYo DOCTORS AVAILABILITY o VISITING DOCTORSo MEDICAL FACILITYo EMERGENCY FACILITYo INVESTIGATION FACILITY, ETC

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Location of the department..

Front office is located near the main entrance in such a way that itbecomes that first sight of the hospital.

Front office is located with a best impression near the billingcounter.

General waiting area and OPD are also located near the frontoffice.

REGISTRATION DEPARTMENT

Registration is the process of recording patients full details. And medicalhistory in the registration form and in computer system.

Admission Department

At the admitting department, the patients will require to provide personalinformational sign consent forms before being taken to the hospital unit orward. If the individual is critically ill, then, this information is usuallyobtained from a family member.

Process of registration

The registration is also a very important part of the hospital organization.

It gives registration to-

New OPD Follow-up IPD

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Steps.

1) File making of new admit patients and entry2) Entry of OPD patients(old, new)3) Entry of follow-up (old admitted patients)

Collection and deposition of files of the patients Store files of all the patients after the complete treatment ..

Files are color coded in the registration room.

The purpose of color coding of the file is for patients benefit as well asregistration department for keeping and storing. When consultant ask aboutthe previous history of the disease of the patient then patient cant explain socolor coding are to be used by the hospital at the bottom of the files. Thedifferent Color coding are used in various diseases. Such as..

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2-FUNCTIONING OF VARIOUS DEPARTMENTSWITHIN HOSPITAL

A hospital is an integral part of a social and medical organization, the functionof which is to provide for the population complete health care, both curativeand preventive, and whos out patients services reach out to family and itshome environment; the hospital is also a center for the training of healthworkers and biosocial research.

The various departments of the hospital are as.

1. CLINICAL SERVICES Out Patients Departments Emergency service departments In patients departments Operation theatre

Intensive care unit PMR services

2-DIAGNOSTIC &THERAPEUTIC DEPARTMENT

Laboratory service Radiology departments Pharmacy departments

Transfusion departments3-SUPPORT AND UTILITY DEPARTMENT

Medical record department(MRD) Central sterile supply department(CSSD) Linen and laundry department Dietary department. Hospital housekeeping department. Hospital engineering department.

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Hospital transportation system. Hospital equipment management. Mortuary services of hospital

4-RISK MANAGEMENT

Hospital waste management. Nosocomial infections. Disaster management. Hospital security services.

5-ADMINISTRATIVE DEPARTMENT Account department Purchasing department

Marketing department Public relation department. Material management

The functions of various departments within hospital are as

CLINICAL SERVICES-

Outpatient department- To provide specialist diagnostic, medical opinion to outpatient. To treat patient on ambulatory basis. Screen patient for hospitalization. Follow up treatment of discharged patients. Provide primary health care ,by means of

Health education Immunization clinics Well baby clinics Voluntary counseling and testing centre [VCTC] for HIV/AIDS.

Inpatient department- Admitting the patients and maintain admission register. Transferring the patient among the wards and specialty. Generating appropriate patient record. Therapeutic and medical care to the patient.

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Helping for discharging patient.

Operation theatre

To provide high degree of asepsis. To provide complete environment control.

Intensive care unit- Close observation and treatment of critically ill patient. With centralized highly skilled manpower and equipments to providespecialized treatment.

Care for post surgical patient. To provide life support to critically ill patient.

PMR services-The PMR means physical medicine and rehabilitation is the need of the hour.it is the combined and coordinated use of medical,social,educational,andretraining of individuals to the highest possible level of functional ability. itincludes physiotherapy, occupational therpy,education,social work, vocationalguidance and placement services.

DIAGNOSTIC AND THERAPEUTIC DEPARTMENT- Laboratory department- Laboratory examinations help the physicians for better and more precisediagnosis. The hospital laboratory dedicates itself in providingcomprehensive, high quality laboratory services to the communities, physicianand patients.

Radiology department-

Radiology is the medical specialty directing medical imaging technology todiagnose and something treat diseases. Originally it was the aspect of medicalscience dealing with medical use of electromagnetic energy by emitted by x-ray machine or other such radiation devices for the purpose of obtaining visualinformation as part of medical imaging .radiology that involves use of X-rayis called roentgen logy . Today extensive training, radiologists, direct an arrayof technologies [such as ultrasound, computerized tomography, and magneticresonance imaging] to diagnose or treat diseases. Interventional radiology is

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the performance of medical procedure with the guidance of imagingtechnologies. As a medical specialty, radiology can be classified broadly into

Diagnostic radiology it is the interpretation of image of the human body tohelp in diagnosis and prognosis of diseases.

Therapeutic radiology it utilizes radiation for treatment of diseases such ascancer. There is now separate sub specialty as radiation oncology.

Pharmacy department- Provide specification for the purchase of drugs, chemicals biological etc Proper storing of drug. Maintaining liaison between medical staff, nursing staff and patients. Discarding the expired drug and container with worm and missing

labels. Patient counseling service while supplying drugs especially for

outpatient department. Filling and labeling of all drug containers from which medicines are to

be administered. Dispensing of drugs as per the prescription of the medical staff of the

hospital. Dispensing and sterilizing parental preparations which are manufacture

in the hospital.

Transfusion department- Screening the blood donor. Maintenance of donors records . Ensuring the safety of the donor. Protecting the patient receiving the transfusion.

Ensuring the safety of laboratory and clinical staff.

SUPPORT AND UTILITY DEPARTMENT- Medical record department-

Reporting Retainable of record. Storage and retention of records Analysis and statistics.

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And external transportation.

Mortuary services of hospital- To shift the dead body immediately to mortuary, till other formalities for

handling over the dead body to the claimant are completed and also to keepthe dead bodies in the mortuary till they are handed over to the authorizedpersons.

RISK MANAGEMENT-S Hospital waste management- Control the waste material of the hospital such as general waste, sharps,infected waste, chemical waste, radio active waste, cytotoxic drugs etc.

Nosocomial infection-Nosocomial infections are a major public health problem in hospitalsthroughout the world. The impact of infection upon the patient, hospitalpersonnel, family and community are such that nosocomial infections are animportant challenge to those committed to health of the people. Prevention of nosocomial infection is becoming more challenging as a result of the everexpanding use of new invasive and immune compromising diagnostic andtherapeutic techniques, and the increasing prevalence of the chronic diseasesthat dispose to infection.

Disaster management- To prepare a hospital disaster plan. To prepare departmental plan in support of hospital plan. Establishment of criteria for the emergency care. Supervise the mockdrialls.

Hospital security services- Provide security services to all the staff of the hospital. Protection of the hospital property Analyses the security threats Surveillance program.

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ADMINISTRATIVE DEPARTMENT- Account department-

Audit analyses. Staff salary

Billing Turnover Budgeting etc.

Material management- Material planning and budgeting. Purchasing. Receiving and inspection. Stocking and distribution. Inventory control. Cost reduction Value analyses Disposal.

Public relation department- Service provided by the hospital- if hospital enjoys a good reputation in

respect of the services provided by the hospital to the public e.g. Thequality of medical care.

Hospital administration must attempt to find out the need and demand of the public, what is there need?, what is demand which kind of services?, what are the requirement of the people?.

The management should feel social responsibility and should beresponsive to the societys needs.

The public must have easy access to the information of the hospital;many a times people feel that the hospital does not provide the

information in the desired manner. The information must be userfriendly.

The publicity should be relevant, accurate and no exaggeration.

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3-OPD SERVICES

The out patient services provide the main linkage of the hospital with thecommunity. The outpatient department interacts with the neighborhood.Efficient outpatients produce favorable public image .out patient is the personwho is given general or emergency diagnostic, therapeutic or preventivehealth services provided through the hospitals fa cility or health program andwho, at the time is not registered as an inpatient in the hospital.

The outpatient is four types they are:-

1) General patient(Un Referred or new patient) general out patient is aperson who is given diagnostic or therapeutic services and care, whohas not been directly referred for such services by his attendingphysician and who is not coming for emergency situation.

2) Referred patient a person referred directly to the opd by his attendingmedical practitioner for specific diagnostic or treatment procedure ,for

O.P.D

un referredcases

emergency&

accidents

referred casesfrom privatepractitionersdispensaries

and peripheralshospital

dischargecase fromhospital

(fallowup )

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other than emergency condition ,and who will return to the practitionerfor further care and disposition is called referred out patient.

3) Emergency out patient-emergency out patient is a person who is givenemergency or accident care for condition determined clinically or byallied services.

4) Follow-up patients- when patient discharge from the hospital after cure,after sometimes patient come back for routine examination. So thistypes of patient called as follow-up patients.

LOCATION OF THE OUT PATIENT DEPARTMENT-

The OPD of hospital nearer to the main road and close to main hospitalentrance.

Free from noise and dust pollution. They separate from IPD wards and other departments but connected

with them,can function more efficiently in terms of scheduling andcommunications, easier for patients to find their way around, lesspatient and attendant traffic through hospital, kept closed when not inuse, and easier to expand, should a need arise.

INFRASTRUCTURE

-

OPD

REGISTRATION MATERNITY PAEDIATRIC SURGERY

TELIMEDICINE MEDICINE E.N.T. RADIOLOGY

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The importance of OPD1) The OPD contributes towards reducing the mortality and

morbidity, therefore, provides a stepping stone to health

promotion and disease prevention.2) It reduces the number of admission to a hospital to raise thethreshold of admission.

3) It ensures that only those patients are admitted who reallyinpatients need care.

DemandDemand of the OPD services is based upon the following factors..

1) No. of out patients visit per person per year from populationliving in the formal catchments area of the hospital.

2) Reattendance rate per new outpatients registered.The average number of outpatients visits per population per year

is the most commonly used and simplest parameter of outpatientdepartment.

Function of OPD

1) To provide specialist diagnostic, medical opinion to outpatients.2) To treat patients on ambulatory basis.3) Screen patients for hospitalization.4) Follow-up treatment of discharge patients.5) Provide primary health care, by means of.

a. Health educationb. Immunization clinicsc. Voluntary counseling and testing centred. (VCTC) for HIV/AIDS.e. Training and education and of medical, paramedical and

nursing staff.f. Collection, analysis of medical records.

Physical facilities-

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The physical facilities of the OPD can be categorized in to the followingareas-

1) Patients areas

2) Clinical areas3) Administrative area4) Circulation area

Patients area-a. Entranceb. Receptionc. Registration

d. Record roome. Waiting areaClinical areas

a. Consultation roomb. Consultation roomc. Special examination roomd. Dressing room

e. Minor OTf. Pharmacyg. Laboratoryh. Radiologyi. Blood bank

Administrative area

a. Administrative officeb. Business officec. Housekeepingd. Store rooms for-

General storeDrug storeLinen store

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Circulation area The circulation area includes:

a. Stairs

b. Corridorsc. Liftsd. Conveyor belts

Equipments :Following types of equipments are usually made available in the OPD:

I. Wheel chairsII. Stretchers

III. Work tablesIV. Physicians desk V. X-ray view box

VI. Revolving stoolVII. Chairs

VIII. Examination couchIX. Wash basin

X. Instruments trolley XI. ECG machine

XII. Ultrasonography machineXIII. EEG machine.

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4. PHARMACY

The Pharmacy Module deal with the Retail Sale of medicines to OPD patients and Issue of medicines to the In-patients in the hospital.

Its function includes clinical trial of drugs (chemotherapeutic drugs),inventory management and billing of drugs, consumables and sutures.This module is closely linked to the Billing Module and In-patient

Module. All the drugs required by the patient can be indented from thevarious sub stores.

HOSPITAL PHARMACY may be defined as that department of the hospitalwhich deals with procurement, storage, compounding, dispensing, testing, andpackaging, of drugs. it also concerned with education and research inpharmaceutical services. A hospital pharmacy is controlled by a professionallycompetent and a qualified pharmacist.

It deals with

Supply of drugs, medicine, and ailed products to the nursing units andother such services.

Filling of special prescriptions for out patients and dispensing as per theintention of a physician.

Storage and dispensing of narcotic and biological products.

Supply and storage of ancillary products and article required in thehospital

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TYPES OF MATERIALS STOKED

Capsules, tablets liquid dosage form and injection etc.

Biological, antibiotics are stored properly in refrigerator.Narcotics and psycho tropic substances are stored under lock andkey.POISON is stored in separate closed rack labeled as POISON Large bulk items on bottom.Vaccines and other thermo labile drugs are required to be stored at cold stores2c -10c.antibiotics , vitamins, liver preparation etc.should be stored at cooltemperature ( 15c -20c) STORAGE CONDITIONSCold storage- 2c -8c Cool tem.- 8c -25c Room tem.Warm- 30c -40c Excessive heat- above 40c

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5-WARDS

For most of the people hospital means the ward .it is in reality also .basically

people go to hospital for two purpose; either to seek out door consultation in theOPD of the hospital or for admission to hospital and treatment as inpatient .theconsultation can be done in the consulting chamber outside the normal OPD of ahospital also. For hospitalization we necessarily require an inpatient department.The IPD of hospital consists of the following component.

Nursing stationThe bedsNecessary services, storage workPublic area.

WARDS AND ROOM-there are three types of wards in the hospitalGeneral ward.Specific ward.Private ward.General ward- in the hospital

Specific ward-in specific type two types of ward are included chemotherapeuticward and radio therapeutic ward.Private ward/deluxe ward this is just like a five star room in which every type of facility are available like air condition, T.V., refrigerator, furniture etc. this isspecially for vip.

NURSING SERVICES-the quality of ip care is highly dependent on the servicesprovided by the nurses and doctors .the nursing must have the following facilities.It must be centered between the wards to make maximum observation of patients.It should have direct access from the corridor.It should be provided with toilet facilities for the nurse.It must be provided with tables and chair and the electrical panel to indicate callsfrom rooms.

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Treatment and dressing room should also be provided.

DIETARY SERVICES-diets are important part of inpatient medical care. A centralizeddietary service is a must in all hospitals. A qualified and experienced dieticianshould be the in charge of the dietary department. She/he interacts with theconsultants and advices them regarding the dietary requirement of individualpatients.

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Rewards Compatibility of individual goals with those of an organization Maintain high moral

Role of human resource management system: Activities Sub-systems

BASIC OVERVIEWS OF HUMAN RESOURCE MANAGEMENT

Human Resource Management is the organizational function that dealswith issues related to people such as compensation, hiring,performance management, organization development, safety, wellness,benefits, employee motivation, communication, administration, andtraining.

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GETTING THE BEST EMPLOYEES

RECRUITING:- (General information , Advertising for job candidate ,online recruiting )

SCREENING JOB APPLICANTS

Interview

Conducting background checks

Testing job candidates

Selecting

PAYING EMPLOYEES

Minimum wage Equal pay Holiday pay Student loans

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SAFE WORK ENVIRONMENT

Clean work spot

Maintenance of equipment

Add safety feature

Work with concentration

TRAINING EMPLOYEES

The right employee training, development and education, at the right

time, provides big payoffs for the employer in increased productivity,

knowledge, loyalty, and contribution. Learn the approaches that willguarantee your training brings a return on your investment

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HIGH PERFORMING EMPLOYEES

Employee evaluations are an important part of maintaining a motivated andskilled workforce. Employee should be following qualities.

work processes and results

communication skills

decision making skills

leadership skills

planning skills

Program/project management

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7-LIBRARY IN HOSPITAL

A depository built to contain book and other materials for readingand study.

RULES OF LIBRARY

Entry Working hours

Membership General Information Computer use policy Terms and Conditions

DIFFERENT SECTION OF LIBRARY

REFERENCE SECTION READING ROOM SECTION JOURNAL PERIODICAL SECTION BOUND JOURNAL SECTION TECHNICAL SECTION CIRCULATION SECTION STAKE ROOM

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REPROGRAPHY SECTION

TYPE OF REGISTER

USER WRITTEN REGISTER ISSUE WRITTEN REGISTER JOURNAL REGISTER BOOK DEMANDS REGISTER ACCESSION REGISTER

LIBARARY SERVICE

REFERENT SERVICE. CURRENT AWARNESS SERVICE. SDI (SELECTED DESIMINATION INFORMATION). OPAC (ONLIINE PUBLIC ASK COLLECTION). DOAJ (DIRECTORY OF ACCESS JOURNAL).

ARRENGEMENT OF BOOK

CLASSIFICATION WISE. SUBJECT WISE.

MEDICAL RELATED BOOK

Pathology

Surgery Gynecology Radiotherapy and Chemotherapy Oncology cancer Paramedical Physiotherapy Anatomy

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X-ray diagnosis/ultrasound Immunology Enzymes and enzyujm mology Microbiology Bacteriology and virology Biochemistry Cell biology

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8-MAARKETTING

Definition & meaning of marketing

The key word in this marketing definition is "process"; marketinginvolves researching, promoting, selling, and distributing your productsor services.

Marketing is a process of planning and executing the conception,pricing, promotion and distribution of ideas, goods and services to createexchanges that satisfy individual or organizational goals.

Some common points emerge from these definitions. These are----Marketing is management process.Marketing offers and exchanges ideas, goods, or services.Marketing is identifying and anticipating customers requirements. Marketing is giving customers what they want.Marketing involves pricing, promotion, and distribution of ideas, goodsor services.

Marketing Channels Press releases Education and training In-house journals Health exhibition Special events Medical camps Sponsorship Internet

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What is Services..??

Service has been defined as any activity or benefit that one party canoffer to another that is essentially intangible and doesnt result inownership of anything. Its production may or may be tied to a physical

productMarket segmentation:-Market segmentation Is the concept of dividing the market in to similar,identifiable segments. Market segmentation occupies a key role inmarketing. Strategy of successful organization. Segmentation techniquesare integral to an organizational entire marketing process from initialmarketing research through marketing communication.The process of market segmentation is in of dividing a total market in toa series of sub market. The market segmentation approach is concernwith

Considering in interactive basis for segmentation. Choosing the specific segments or a single segments within the

base.

Determining appropriate service levels for these segments.

Traditionally, 7 broad elements are used in considering marketsegmentation-

1) Geographical segmentation2) Demographic and socioeconomic segmentation

3) Psycholographic segmentation4) Benefit segmentation5) Usages segmentation6) Loyalty segmentation7) Occasion segmentation

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The marketing mix for services Product Place Price Promotion Physical Evidence process People

9-Laboratory Services (Investigation)

DEFINITION OF laboratory:

Diagnosis of disease through examination of organs, tissues, bodily fluids, andwhole bodies (autopsies) of the patients.

OrA room equipped for making scientific experiments, test and clinical studiesof the materials obtained from the patient.

OrLaboratory section provides information about lab tests your doctor may useto screen for certain diseases or conditions.

What are lab tests?Laboratory tests are medical procedures that involve testing samples of blood, urine, or other tissues or substances in the body of the patients.

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Why does your doctor use lab tests ?

Your doctor uses laboratory tests to help: identify changes in your health condition before any

Symptoms occur diagnose a disease or condition before you have

Symptoms plan your treatment for a disease or condition, evaluate your response to a treatment, or Monitor the course of a disease over time.

How are lab tests analyzed?After your doctor or lab technician collects a sample from your body, it

is sent to a laboratory. Laboratories perform tests on the sample to see if itreacts to different substances. Depending on the test, a reaction may mean youdo have a particular condition or it may mean that you do not have theparticular condition. Sometimes laboratories compare your results to resultsobtained from previous tests, to see if there has been a change in your

condition.

Objectives of laboratory services

Early detection of disease Level/grade of infection Diagnosis confirmation

Doubt clearance

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COLLECTION DEPARTMENT

BLOOD COLLECTION URINE COLLECTION RAPID CARD TEST

E.g. ( HIV, HCG. Etc) LABORATORY EQUIPMENTS

Calorimeter Water bath Hot air oven

Microscope Autoclave Incubator Refrigerator Auto analyzer PH meter ELISA reader

ELISA washer Wax melting box Hot plates Centrifuging machine

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Hematology

BLOOD. Hemoglobin Total Leucocytes Counts Differential Leucocytes Counts Erythrocyte Sedimentation Rate ( ESR) Platelet Count Packed Cell Volume (PCV) MCV/MCHC/MCH Reticulocyte Coun Bone Marrow Examination Blood Group/Rh Type Malaria Parasite

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URINE. Routine & MicroscopicBence Jones ProteinsKetene BodiesBile Salts

STOOL. Routine/MicroscopicOccult Blood

BIOCHEMISTRY: -

Blood Sugar- Fasting/P.P./Random Urine Sugar-Fasting/P.P. S. Cholesterol S. Creatine S. Calcium S. Urea/Uric Acid S. Inorganic Phosphate

S. Albumin Sodium/Potassium Protein SGOT/PT Bilirubin-Total/Direct Lipid Profile Alkaline Phosphates'-Total/Prostatic

Fraction

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a

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What makes the Clinical Pathology Management module valuable to apathology laboratory? Provides instant access to clinical pathology test results Shows only those results that are relevant to the current case Optimizes workflow Reduces turnaround time Produces a more complete and accurate pathology report

BASIC DIFFERENCE B/W PATHOLOGY & LABORATORY

PATHOLOGY IS THAT BRANCH OF MEDICAL SCIENCE IN WHICHNATURE, CAUSES OF DESEASE, FUNCTIONAL & STRUCTURALCHANGES OF THE BODY, CAN USE BY STUDY.LABORATORY IS A ROOM EQUIPPED FOR MAKING SCIENTIFICEXPERIMENTS, TESTS OR CLINICAL STUDIESOF THE MATERIALSSUCH AS BLOOD, SPUTAM, URINE, STOOL, ETC. OBTAINED FROMTHE PATIENT.

Radio therapy departmentWhat is radiotherapy?

Radiotherapy is the treatment of cancer and other disease withionizing radiation.

Ionizing radiation destroying the DNA inside cancer cells,

inhibiting their ability to grow. Although radiation damages both cancer cells and normal cells,

the latter are able to repair them and function properly.Type of Radio therapy

External beam radiotherapy Internal radio therapy

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External beam therapy

Theratron 780 c (cobalt 60)

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LocationDepartment divided into three part-

Waiting roomPhysician room

Therapy room

Infra structure Thickness of wall, floor, and ceiling should be such as to prevent

escape of radiation. Therapy room 13.5 thick and 6thick RCC roofs are adequate and

paint with lead paint. Inter lock system.

Precaution Prevent expose to radiation. Protect patient normal tissue TLD apply all staff Radiation attempt by experience staff and specialist

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Never inter therapy room when red bulb indicated.What is the risk?

These are the unwanted, but mostly temporary effects of

successful treatment. The side effects are very dependent onwhat part of the body has been treated.

MAGNETIC RESONANCE IMAGING (MRI)

DIFINITION OF M R IMagnetic resonance imaging (MRI) is a test that uses a magnetic fieldand pulses of radio wave energy to make pictures of organs andstructures inside the body. In many cases MRI gives differentinformation about structures in the body than can be seen. MRI alsomay show problems that cannot be seen with other imaging methods.

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ABOUT MRI MACHINEFor an MRI test, the area of the body being studied is placed inside aspecial machine that contains a strong magnet. Pictures from an MRI

scan are digital images that can be saved and stored on a computer formore study. The images also can be reviewed remotely, such as in aclinic or an operating room. In some cases, CONTRAST MATERIALMay be used during the MRI scan to show certainStructures more clearly

USE OF MRI

IT IS USED TO FIND PROBLEM SUCH AS:- TUMOR BLEEDING INJURY B.V.D. INFECTION ETC.

AN MRI SCAN CAN BE DONE FOR THE:-

HEAD CHEST BLOOD VESSELS ABDOMEN&PELVIS BONES &JOINTS SPINE

SOME INFORMATION ABOUT MRI IF CONTRAST NEEDED THE TECHNOLOGIST WILL PUT IN IT I.V. DURING TEST MAY BE ALONE BUT TECHNOLOGIST WILL WATCHYOUTHROUGH A WINDOW

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YOU WILL NEED TO TAKE OFF ALL OR MOST OF CLOTHES (GOWNTO USE DURING TEST)

TIMING:- USUALLY TAKES 30 TO 60 MIN. BUTCAN TAKES AS LONG

AS 2 HOURS. YOU CAN NOT MOVE DURING TEST IF FEEL NERVOUS CAN BEGIVE MEDICINE (SEDATIVE)

PRECAUTION OF MRIYOU MAY NOT BE ABLE TO HAVE THE TEST FOLLOWING CONDITION:-

IN PREGNANCY

MEDICAL DEVICE (ELECTRINIC) SUCH AS PACEMAKER &MEDICINE INFUSION PUMP

MEDICAL DEVICE (METAL) :- IUD INABILITY TO REMAIN STILL DURING TEST OBESITY REMOVE ATM .MOBILE. ETC.

COMPUTED TOMOGRAPHY SCAN (C T SCAN)

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DIFINITION OF C T SCANA CT scan stands for Computed TomographyScan. It is also known as a CAT (Computer Axial Tomography) Scan. It is

a medical imaging method that employs tomography. Tomography isthe process of generating a two-dimensional image of a slice or sectionthrough a 3-dimensional object (a tomogram).

USES OF C T SCAN(A.) IT IS USED TO FIND PROBLEM SUCH AS:-

CACER C V D INFECTIOUS DISEASE APPENDISITIS TRAUMA MUSCULOSKELETAL DISORDER

B. C TSCAN CAN BE DONE FOR THE:- INTERNAL ORGANBONE

SOFT TISSUESBLOOD VESSELS

ABOUT C T SCAN

The CT scanner is typically a large, box like machine with a hole, orshort tunnel, in the centre. You will lie on a narrow examination tablethat slides into and out of this tunnel. Rotating around you, the x-raytube and electronic x-ray detectors are located opposite each other in aring, called a gantry. The computer workstation that processes the

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imaging information is located in a separate room, where thetechnologist operates the scanner and monitors your examination.

ADVANTAGE Of CT SCAN ITS ABILITY TO IMAGE BONES SOFTS TISSUES & BLOOD VESSELS IT IS FAST & SIMPLE(SAFE LIFE) IT IS LESS SENSITIVE TO PT. THEN MRI(CAN MOVEMENT)

IT CAN BE PERFORMED IF YOU HAVE ANY MEDICAL DEVICEUNLIKE MRI

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Blood Bank:-

A well organized blood transfusion service provided by hospital. It is a vitalcomponent of any health care delivery system. Blood Bank and transfusionand collect, process, store, and provide human Blood intended for transfusion,perform pre transfusion testing and finally in fusion in to a patients.

Function of blood transfusion services Screening the blood donor. Maintenance of donors record. Insuring the safety of the donor. Testing the to make sure the blood or

Blood product is safe for use.

Components of blood RBC (H B.) WBC & Platelets Plasma

Infrasture and Facilities. Registration and medical examination room with adequate furniture and

facilities for registration and selection of donor. Blood collection rooms are available. Rooms for laboratory for blood group serology are available. Room for laboratory for transmissible disease like hepatitis, syphilis,

malaria, HIV anti bodies are available. Sterilization and washing room. Refreshment room. Store and record room.

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Equipments-

Equipment such as for blood collection room the following would beneeded.

Donors beds or tables Bedside table Sphygmomanometer and stethoscope. Recovery beds for donors. Refrigerator for maintaining temperature. Alarm device.

Weighing machine.

BLOOD CONTAINER-

Disposable plastic packs Blood collection bottle. Anticoagulants- Disposable sterile bleeding sets. Blood transfusion sets.

Personnel- a medical officer trained in blood banking for six month aregistered nurse and to trained technicians.

For AIDS test, the hospital can have its own testing facilities are available.

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10-BILLING AND DISCHARGE

Bill is an itemized statements of charges for goods supplied or service

rendered.Billing services is a process of recording the transaction in a systematic way.

In another way a willing service is a entity that assist a provider bills forservices performed.

Types of billing in hospital- In patients billing Out patients billing ICU billing Laboratory billing Radiology billing Pharmacy billing CT scan/MRI billing

Bill serves as Record Proof Claims Insurance Item charged

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CASH COUNTER ROOM NO 6

Charges of OPD, Reg. and Admission

OPD Charges. --Rs.5/-

Registration charges --Rs.100/-

(file making)

Admission charge -- Rs.100/-

Follow up charges (after one month)

General OPD -- Rs.5/- Cancer Pt. --Rs.75/-

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OPD BILLING

For billing of any OPD service like Pathology Tests, or any imaginginvestigation, the patient moves to cash (billing) counter. Here theservices are charged as per the rates already defined for variouscategories/ penal/ time etc to the patient with his Patient ID. ThePayment is collected for the service provided and a receipt is generated.

All services will be automatically entered into the respective moduleswherever required like lab & Imaging reporting.

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INDOOR BILLING

Indoor billing has a supervisory role. The entries for billing are automatically transferred to the

patient bill by the respective departments, which provide The service. The services are charged as per the category(WARD/ICU

Etc.)Applicable. Bill is compiled and the payment collected from time to

Time.

Provisional and Final bills are generated which provides

complete information about the Services availed, its Charges, Advance collected, appropriate Receipts, Refunds, Credit notes, Concession allowed, etc

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CHARGES..

SPECIAL ROOM CHARGES Rs. 700/-

A/C ROOM Rs.900/-

A/C DELUXE ROOM -11 Rs.1200/-

HEATER ISUSED IN ROOM Rs.100/-

NEBULIZATION CHARGES Rs.70/-

BED SIDE E.C.G. Rs.200/-

C.T CHARGES ONE DAY Rs.350/-

C.T CHARGES MORE THAN ONE DAY Rs.500/-

ASCITES & PLEURAL TAPPING Rs.300+300CYTELOGY

DRESSING IN O.T Rs200/-

DRESSING IN ROOM Rs.100/-

BLOOD TRANSFUSION Rs.300/-

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I.C.U CHARGES

I.C.U CHARGES Rs.300/-

BLOOD TRANSFUSION Rs.150/-

DRESSING SMALL Rs.50/-

DRESSING BIG Rs.100/-

CHEMOTHERAPY Rs.350+700/-

MORE THAN ONE DAY Rs.500+700/-

NEBULIZATION Rs.70/-

PLEURAL/ASCITES Rs.300/-

PLEURAL/ASCITES CYTOLOGY Rs.300/-

CENTER LINE Rs.500/-

BED SIDE E.C,G Rs.200/-

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Process of discharge

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CONCLUSITION-Front office is the face of the hospital. The prime objective is to guide thepatient and attainders. It should be located near the main entrance .receptionist

is a person who is handling the front office department. He/she must possesssome basic qualities and full knowledge about the hospital layout andfacilities. The main process of the front office department is registration.

The outpatients are becoming more and more important.ambulatory care reduces dislocation of work, is cheaper and at the same timegives access to the various investigative and diagnostic facilities of thehospital .there is three types of outpatient: general outpatient, referredoutpatients and emergency outpatient. Outpatient department is the linkage toother department in the hospital; it should be located near the main entrancearea. It must have basic facilities for waiting area, treatment room, recoveryroom, etc.

IPD is the heart of the hospital. it provide the quality of servicethrough nursing services, wards and rooms with sufficient space, dietaryservices and sanitary facility.

The emergency/casualty services provide immediate, emergencydiagnostic and therapeutic care to the patients. Proper recording in thisdepartment is essencial.In emergency department, various record aremaintained. Physical facility in administrative area and clinical area should bemaintained. Proper instruction must be given to medical officer who is incharge of emergency department.

The importance of laboratory department cannot be under oroverestimated because the practice of medicine today requires laboratory

examinations. A hospital laboratory service can be a high income generatingservice and economic asset to the hospital.lab service is one of the mostimportant services in health sector. Special attention should be given for itspolicies and procedures. Clear idea must be obtained regarding area of labservices.

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To main function of radiology services is to assist clinician inthe diagnosis and treatment of diseases through the use of the radiographyprocedures.

Rehabilitative medicine encompasses field like physicaltherapy, occupational therapy, recreational therapy, speech and hearingtherapy, bracing, prosthetics and pulmonary medicine, therapy is indicated asa result of surgery, trauma and other functional impairment. The fourfunctional areas of physical therapy department are a hydrotherapy area, agymnasium area, a treatment cubicle area, space and facility of support andother non-treatment purpose. The location, facility and requirements of different fields are highlighted.

Bill is a statement of changes for goods supplied or service is aprocess of recording in a bill. Different types of billing are done in thehospital. Computer plays an important role in billing services.

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FEEDBACK

1-Maximum facility is available-

In the hospital, facility are available such as blood bank, radiodignosticcentre, bank, telemedicine, availability of special radiotherapy (thereto780c cobalt 60,brachy therapy micros electron HDR, inclinator. but sometype of facility are not available like ATM and well established pharmacy.2-The infrastructure of whole hospital are well situated such as waitingroom, patients room, physicians room, therapy room.3-Quality services good transportation services are provided for staff andpatient by hospital.Provide proper health care.4-Cooperative staff the staff of the hospital are very cooperative and theyhelps to patient as well as students regarding their queries.

SUGGESTION

Computerization facility must be available in each and everydepartment.Code blue system must be available in ICU.