xcellence Wins” In Healthcare Achieving The Dream of Quality Healthcare for All, Miles to Go Ahead to Realise This Dream.

Excellence Wins” In Healthcare Achieving The Dream of Quality Healthcare for All, Miles to Go Ahead to Realise This Dream. (Fixing Our Healthcare System: A Call to Action-PART II&III) ----------------------------------------------------------https://risingkashmir.com/fixing-our-healthcare-system-a-call-to-action-cdc5aa9f-180a-4aa5-bbcc-9cbfbe0bc5c4 Healthcare continues to provide hospitals with the latest and greatest methods for how to improve patient-centred care, it is of the utmost importance for healthcare providers (HCPs) across the UT to stay on top of the newest hospital improvement ideas that could solve some of their biggest pain points in how to improve patient care and progress even further . DR FIAZ MAQBOOL FAZILI --------------------------------------------------------------------------------- Is Healthcare A Right In India? "Right to health is a fundamental right guaranteed under Article 21 of the Constitution of India. Right to health includes affordable treatment. For achieving the healthcare-for-all dream, Healthcare policy planners need to revisit the Challenges, Priorities, And the Road Ahead.”. The Successes and Drawbacks of India’s Healthcare System. Healthcare has risen to become a desperate need today. The Covid-19 Pandemic has had hospitals and healthcare providers, across the globe, stress-ridden for over 2 years. This calls for a critical look at our healthcare system to celebrate its successes and feed its deficiencies. Most government hospitals and clinics across the country may be a shabby sight. But for the poor, they are the only affordable medical treatment option available. Yet, most of the poor prefer to borrow and go to private health centres, as revealed by the findings of the National Family Health Survey-5 OUR EXPECTATIONS FROM HEALTHCARE? Patients don’t want more or less care, they visit hospitals primarily to address their healthcare concerns to receive appropriate treatment at the right time, from the right people through right methods. While hospitals are not designed to provide luxury accommodations like four-star hotels, patients do have certain expectations regarding the care they receive. These expectations include: Proper Diagnosis: Patients expect healthcare professionals to accurately diagnose their medical condition. They want to understand the cause of their symptoms and receive a clear explanation of their diagnosis. Effective Treatment: Patients anticipate receiving the appropriate treatment for their condition. This includes receiving the right medications, therapies, surgeries, or other interventions necessary to address their healthcare needs. Timely Care: Patients expect to receive treatment in a timely manner. They hope to have their healthcare concerns addressed promptly to prevent further deterioration of their condition or alleviate their symptoms. Skilled and Knowledgeable Staff: Patients want to be cared for by competent healthcare professionals who possess the necessary skills and knowledge to provide effective treatment. They expect doctors, nurses, and other staff members to be experienced and well-trained in their respective fields. Clear Communication: Patients desire clear and open communication with their healthcare providers. They expect doctors and nurses to explain their condition, treatment options, potential risks and benefits, and any necessary lifestyle changes or precautions in a way that is easily understandable. Compassion and Empathy: Patients hope to be treated with compassion and empathy throughout their healthcare journey. They want healthcare professionals to listen to their concerns, address their fears or anxieties, and provide emotional support during difficult times. Clean and Safe Environment: While hospitals may not provide luxurious amenities like hotels, patients do expect a clean and safe environment. They want hospitals to maintain high hygiene standards to prevent the spread of infections and ensure their safety during their stay.. Why do I feel anxious and panicky when visiting a hospital? An intriguing question which haunts me often. Every day, thousands of Valleyities receive health care that helps to maintain or restore their health. A visit to a hospital is often viewed with great anxiety.? Where do things go wrong? How dissatisfied patients respond to poor service quality? Many patients are concerned that the care delivered is not, essentially, the standardized one they deserve. It is not Nosocomephobia (Fear of Hospitals) a type of anxiety disorder related to other fears associated with hospital milieu . But the fear I am talking today is different, what we (have not) learned in healthcare service failure how to address issues like; (1) Deficient infrastructure (protocols & processes of provision of care), junked and non-operational tools, diagnostic or therapeutic modalities not up to date (2) Non-availability of specialists or lack of skilled professional manpower (3) Unmanageable patient load (4) Equivocal quality of services & essential safety requirements (5) Non-availability of essential medicines & high out of pocket expenditure on cancer drugs (6) Long stay in queues, waiting times, appointments compounded with “sufarish or VIP preferential culture. While assessing Health Care Quality from the Patient’s Perspective--beyond “Pads, pens, prescriptions. “It’s not just political correctness. It’s good medicine. To achieve the improvement in the quality of medical care: building bridges among professional pride and patient satisfaction –All need vision and health care reforms and above all a human touch. To achieve success in this mission, we need honesty and facts, bold statements. Not fear and half-truths –with your own organisation, abiding by the “praise in public, criticise in private” philosophy can help contribute to a smooth sailing ship, but there are times when you can invoke the family clause with integrity. A healthcare facility where patients expect to receive treatment filled with expectation, hope, and empathetic healing, patient dissatisfaction arises when patients perceive that the service is insufficient, unsatisfactory , not up to standard or worse .Poor hospital conditions and system of delivering care is an increasing problem in India .Reflecting the need for urgent action, under public and media outcry, on the high rate of Mortality and Morbidity in our public hospitals, FMEA – Failure Mode and Effects Analysis, is not used as tool to improve the system for fundamental change to close the gaps, which describes a fragmented and inefficient system of healthcare leadership, clinical governance and accountability posing many risks that are preventable. What makes a good hospital? Different people have different perceptions about this grading. Expectations, with reference to healthcare, refer to the anticipation or the belief about what is to be encountered in a consultation or utilising services in the healthcare system. It is the mental picture that patients or the public will have of the process of interaction with the hospital system. Patients come to a consultation with expectations which they may or may not be overtly aware of. These expectations may be openly presented in the system, or the physician may have to attempt to elicit them. Reactions to unmet expectations can range from disappointment to anger. Exploring patients’ expectations is crucial for improving delivery of healthcare of the highest quality. Every patient who comes for consultation has expectations based on his understanding of the illness, health beliefs, attitudes, tall claims on the services available made by healthcare leaders and managers in the media. The price healthcare providers and hospitals have to pay for dissatisfied patients is indeed high, thus the investment of some time to understand this issue is certainly worth the while. Some of the general expectations of patients include: the need to be listened to, the need to receive clear explanation and instructions about their condition, to be treated by staff who show care/concern/compassion and to be treated by staff who are professional in their work. As a QPS (Quality & Patient Safety ) healthcare standards expert and accreditation surveyor when we inspect hospitals for compliance on KPIS (Key performance indicators) , there are five questions we ask. Is it safe? Is it effective? Are its caring processes standardised? Is it responsive to people’s needs? Is it well-led? Patient satisfaction (experience) is on the top of our assessment and considered as the strongest KPI, indicator of good performance of your hospital. On KPI’s I am confronted with a problem in our local HCOs. Is the medical care provided by our healthcare staff in accordance with any standards (benchmark)? Are any evidence-based consensus statements, protocols or clinical practice guidelines followed? These questions show two sides of the definition of the standard of care in the medical setting. In quality terms, a standard of care is used as the benchmark against a healthcare provider’s actual work. CHOOSING A GOOD HOSPITAL FOR YOURSELF OR YOUR DEAR ONE is a formidable task.Time and again we hear of the importance of provision of quality of care in our hospitals. However, what everyone needs to know is that quality of care and adherence to safety practices while delivering care goes beyond simply ensuring our patients get the proper level of help, guidance when they’re in our facilities. Because as we all know, low-quality healthcare causes great human suffering, workplace-related health impairments, injuries and illnesses and incur high costs, both for those affected and for society. In the long-term costs not only time and money, but precious limbs or lives too. Best practices for boosting patient satisfaction involve small changes that save lives. Guide to prevention of harm and good practice in the healthcare sector aims at improving health and safety standards in health institutions through compliance on Key Performance Indicators. What can’t be measured cant be managed , KPI ‘s in healthcare are specific and measurable elements of practice that can be used to assess quality and safety of care. It’s Time for A Fundamentally New Strategy. Do not only criticise, suggest viable solutions and professional remedies. Do it Right, the First Time, Every Time. This definition of Quality, as it relates to patient health care, is conformance to the established requirements or standard of any organization. Unfortunately, the value of these indispensable ideals we appreciate only when you or your loved one is amid a severe illness. Patient centred care (PCC) is an approach gaining much emphasis these days. It is one where we consciously adopt patients’ perspectives and mainstream them into all aspects of the healthcare system and its related processes. It involves navigating the healthcare system through patients’ eyes. PCC represents customized patient care, viewed as a commitment to treat, and manage patients as thinking and feeling persons with the ability to change and develop. It requires healthcare personnel to be open, flexible, and respectful in the provision of all aspects of care. It is also a partnership between patients and their healthcare providers. PCC is alignment with the 21st century, modern patients who are increasingly asking to be partners in their own care, highlighting also, ownership of their health, and healthcare.177 The Challenges Confronting Public Hospitals in India, Their Origins, and Possible Solutions In my opinion as healthcare quality control, policy planning expert there could be several reasons why some Government hospitals are not able to deliver optimum care. Limited resources: Government hospitals often face constraints in terms of funding, infrastructure, and availability of medical equipment and supplies. This can affect the overall quality and availability of healthcare services. Overcrowding and high patient load: Government hospitals, particularly in densely populated areas, may experience high patient volumes, leading to overcrowding and long waiting times. This can strain resources and impact the quality of care provided. Emergency department (ED) crowding is recognized as a critical threat to patient safety, while sub‐optimal ED patient flow also contributes to reduced patient satisfaction and efficiency of care. As a Quality improvement expert when I conduct many sessions of VSM -Value Stream Mapping to understand the patient flow of value in the process and Provider in triage (PIT) programs, CTAS —which typically involve, at a minimum, a physician or advanced practice provider conducting an initial screening exam and potentially initiating treatment and diagnostic testing at the time of triage—are frequently endorsed as a mechanism to reduce ED length of stay (LOS) and therefore mitigate crowding, improve patient satisfaction, and improve ED operational and financial performance. . Effective Triage helps recognize the urgency among patients. An accurate triage decision helps patients receive the emergency service in the most appropriate time, and filters non urgent cases from the urgent and Immediate category to be served in any emergency department. Staffing challenges: Shortages of skilled healthcare professionals, such as doctors, nurses, and support staff, can be a significant issue in government hospitals. Inadequate staffing levels can result in increased workload, fatigue, and a decreased ability to deliver optimal care. Lack of specialized services: Government hospitals may not always have the same range of specialized medical services and advanced technology available as private healthcare facilities. This can limit the treatment options for complex medical conditions. Bureaucracy and administrative challenges: Government hospitals are often subject to bureaucratic processes and administrative red tape, which can slow down decision-making and hinder the efficient delivery of care. Lack of accountability: In some cases, there may be a lack of effective systems for monitoring and ensuring accountability in government hospitals. This can contribute to a lower quality of care and less focus on patient satisfaction Overcrowding, Queues, Long Appointment dates -Causes and Solutions.? Lack of resources: Hospitals may be experiencing a shortage of essential resources like staff, beds, equipment, and funding. Insufficient resources can lead to longer waiting times and overcrowded facilities. Increased demand: The demand for healthcare services may have increased, surpassing the capacity of hospitals to meet the growing needs of the population. This can result from factors such as an aging population, the prevalence of chronic diseases, or inadequate primary and secondary healthcare services. Inefficient processes: Hospitals may have inefficient administrative and operational processes, leading to delays in patient flow and appointment scheduling. Poor coordination between different departments or lack of effective communication systems can contribute to longer waiting times. Limited accessibility to primary and secondary care: If primary and secondary care services are not readily available or easily accessible, patients may resort to seeking care at hospitals, which can further strain the system and lead to overcrowding. To address these challenges and improve hospital services, the following measures can be considered: - Increase funding: Allocating more resources to healthcare, including hospitals, can help improve infrastructure, hire additional staff, and acquire necessary equipment. Adequate funding is crucial for expanding capacity and reducing waiting times. Focus on preventive care: Emphasize the importance of primary and secondary care and preventive measures to reduce the burden on hospitals. Encouraging regular check-ups, promoting healthy lifestyles, and educating the public about managing their health can help prevent the progression of diseases and minimize the need for hospital care. Enhance coordination and communication: Streamlining administrative processes and improving communication between departments can help optimize patient flow and reduce waiting times. Implementing effective scheduling systems and utilizing technology to manage appointments and patient records efficiently can contribute to smoother operations. Expand healthcare workforce: Increase the number of healthcare professionals, such as doctors, nurses, and support staff, to meet the growing demand. Incentives can be provided to attract healthcare workers to areas experiencing shortages. Utilize technology: Implementing electronic health records, telemedicine, and other digital solutions can improve efficiency and accessibility. Many steps in this direction like Which QR code based OPD registration implemented in many hospitals reducing waiting time drastically. Telemedicine can help reduce the number of in-person visits, while electronic health records can streamline patient information and facilitate better coordination among healthcare providers. Strengthen primary and secondary care services: Enhance the capacity and quality of primary and secondary healthcare facilities to provide comprehensive care and effectively manage common health issues. to ensure that patients can access timely and appropriate care closer to their communities. This can help reduce the need for hospital visits for non-emergency cases. This can include improving infrastructure, training healthcare providers, and ensuring adequate medication supply.. Reducing referrals to tertiary care hospitals and promoting alternative healthcare options can be achieved through various strategies and outreach programs. Here are some solutions you can consider. Establish Specialty Clinics in Primary and secondary Care Centres allowing patients to access specialized care without the need for hospital referrals. This can include clinics focused on cardiology, orthopaedics, gynaecology, gastroenterology etc. Health Education and Awareness: Conduct community outreach programs to educate the public about common health problems, prevention measures, and available treatment options. This can be done through health campaigns, workshops, and seminars. Telemedicine Services: Implement telemedicine services to connect primary and secondary care providers with specialists. This can help in obtaining expert opinions remotely, reducing the need for referrals to tertiary care hospitals. Specialist Training Programs: Organize training programs for primary and secondary care providers both at District and Sub District levels in collaboration with Tertiary care Hospitals to enhance their skills and knowledge in managing complex health conditions. This can empower them to handle a broader range of cases, reducing the need for referrals. Mobile Health Clinics: Set up mobile health clinics in underserved areas to provide basic healthcare services and screenings. This can help identify health issues early on and provide appropriate treatment at the community level, minimizing the need for hospital referrals. Collaboration and Networking: Foster collaboration between primary and secondary care providers and tertiary care hospitals through a coordinated E -health program and make it mandatory to seek consultation on cases before referral to tertiary care hospitals. This can involve regular meetings, case discussions, with consultants of specialities and sub specialties as per rota are such joint initiatives through a communication electronic grid to ensure a seamless referral process and improve communication. Health Insurance Programs: Advocate for the inclusion of more diseases, interventions, hospitals, primary and secondary care services and outpatient care in health insurance plans like PM-JAY(golden card ). This can incentivize patients to seek care at the primary and secondary level and reduce the burden on tertiary care hospitals. Community Health Workers: Train and deploy community health workers to provide basic healthcare services, health promotion, and disease prevention activities. They can act as a bridge between the community and healthcare system, helping to reduce unnecessary referrals. Research and Data Analysis: Conduct research to identify patterns and reasons for tertiary care referrals. Analyse the data to understand the root causes and develop targeted interventions to address them effectively. USING AI To Improve Healthcare; Health care leaders and policy makers have tried countless incremental fixes with AI enforcing practice guidelines, reducing errors, making patients better “consumers,” implementing electronic medical records, QR code based OPD registration. We need more time to see its impact. SUCCESS in 2023. Around the world, every health care system is struggling with issues of accessibility and affordability, rising machinery costs and uneven quality despite the hard work of well-intentioned, well-trained clinicians. While much of what’s left to be done is up to the government, to implement the necessary policies and procedures to ensure success, there are things that can be done collaboratively at the hospital level to prepare successful healthcare leaders to understand how to standardize and personalize patient care, concurrently. Together they will implement standardization and personalization that complements one another so that patients do not feel they are being subjected to a “one-size-fits-all” “standard” care experience. (ARTICLE TO BE CONCLUDED; How state healthcare reforms ,initiatives can improve healthcare services?.PART IV ) (DR FIAZ FAZILI is a Certified Qualified Professional in Quality Healthcare Policy Planning and has worked as Director Total Quality management & Team leader with national and international accreditation Bodies like JCI- CBAH_ NABH: GE healthcare international can be reached at drfiazfazili@gmail.com) --