Study of Outpatient Department AT Johal Super specialty Hospital

Submitted to :-

Submitted by :-

Ms Gurpreet Kaur
(HOD) Lovely Professional University

Col lakhwinder Singh

Regd No 11100306 A -18

JOHAL MULTI SPECIALITY HOSPITAL

Based at Jalandhar The Hospital was founded in 1999 by S. D S Johal (Managing Director) and is being professionally run by Dr. B S Johal (Director).

Multi-purpose and modern architectural facility

Specialties 20 plus Bed capacity - 100 The Hospital holds State-of-the-Art Operation Theatre at Par with International Standards. It is among the few hospitals to receive the prestigious ISO 9001:2000 certification from QA Technic. Medical staff are of the highest caliber and provides a multi-disciplinary care team approach.

Infrastructure
100 bedded facility infrastructure offers :OP & IP department PHPs (preventive healthcare programs) OTs (Operation theaters), Cath Lab, ICUs, HDU, Ambulatory Care. Blood Bank

Endoscopy
Oncology Day Care Dialysis 24 hrs. Pharmacy 24 hrs. Lab Services

Services and facilities:

Key Specialties Urology Trauma & Orthopedics Neuro Sciences Surgical Services Diagnosis 1. Radiology & Imaging 2. MRI 3. CT Scan 4. X-RAY

Mother & Child care

Critical Care Emergency & Trauma Dentistry

5. Fluoroscopy
6. Mammography 7. Bone Densitometry 8. Ultrasound etc.

AIM AND OBJECTIVE

Studying OPD and its role in the hospital.
Describing parameters of planning, organization and staffing.

To find the problematic areas in the OPD.

Quality of the service provided. The behavior of the staff. Suggestions to overcome the problems.

METHDOLOGY
Evaluating Planning and Organization of OPD department which would highlight feature like location, equipment, etc. Interaction with the staff for knowing working conditions in the department. Policy and Procedure related to organization structure, staffing pattern, working hours, OPD timings, etc. Interaction with 100 patients through questionnaires to assess quality services provided by the department, Interaction with the staff through questionnaire. Analyzing all the data.

Observations
Outpatient Department in Johal Multispeciality hospital, Jalandhar is located on the ground floor to the extreme right end from the main entrance. It is very well visible from the main road. LOCATION

PUBLIC ZONE

AMBULATORY ZONE Cardiology Cardiac surgery Gastroenterology

Nephrology and urology

Neurology Orthopaedics and Joint Replacement Physiotherapy Dentistry Opthomology ENT DIAGNOSTIC AND SUPPORTIVE STAFF ZONE CIRCULATORY ZONE EQUIPMENT STAFFING (Medical staff, Nursing staff, Ancillary staff and clerical staff).

Medical Staff
Psychiatric
Neurology Neurosurgery Gynecology Nephrology Orthopedic Ophthalmology

1
1 1 2 1 2 2

Urology Dentistry Physiotherapy Dermatology Gastroenterology Cardiology Dietician

1 1 2 2 1 2 1

Gen surgery

E.N.T

Nursing Staff
Consultants Chamber Cardiac Unit 2 2

Ancillary Staff
Radiographer, Laboratory ECG Technician Front Office Cardiac Unit 2 2 2 2 2

Clerical Staff
Registration 1

Billing
Report Collection Record room Pharmacy

2
1 2 6 (2each in 3 shifts)

OPD TIMINGS
In Johal Hospital, OPD timing have been kept from 8:00 am to 2:00 pm All OPD services are available 6 days a week. Cardiologist Gastroenterologist Neurologist Nephrologist Orthopedic surgeon Gynecologist General Surgeon Available on call also

Urologist

FLOW CHART OF OPD

RECEPTION / ENQUIRY OPD ENTRANCE

REGISTRATION

WAITING

RECORD ROOM FOR VITAL CHECK

CONSULTATION AND EXAMINATION

IPD

X-RAY

LABORATORY

OTHER DIAGNOSTIC AND THERAPEUTIC FACILITIES

DIAGNOSIS

PHARMACY

MOT/INJECTION/DRESSING

CHANNEL OF WORK FLOW

OPD OPD NEW PATIENT OLD PATIENT

RGISTRATION NUMBER IS ALLOTEED

REVISIT FEE

FILE PREPARED

OLD FILE CHECKED

SEND TO CONSALTANTS CHAMBER

INVESTIGATION BILLING AT OPD

CARDIAC UNIT

IMAGING DEPARTMENT

IPD ADMISSION

DIAGNOSIS

TREATMENT

HOME

Inferences drawn from the data collected

Age Group of Patients Maximum number of patients coming to the OPD are of the age group of 4660 years and very few in the age of 0-15 years and 16-30 years. The trend clearly shows that a lot has to be done to educate more people below the age of 15 years to avail the OPD services of the Hospital
Age Group
60 51 50

40 0-15 years:1 30 29 16-30 years: 5 31-45 years: 29 46-60 years: 51 20 14 10 5 1 0 No.of patient 60+ years: 14

Level of satisfaction Patient were asked if they could find their way inside the hospital with the help of the signage, 75% of them said that they had no problem. Most of them were satisfied with the parking facilities and the seating arrangements but the only problem common to many of the patients and their relatives was with the refreshment and eating facilities. Most of them complained about the food being very expensive and unavailability of food stuff other than the bakery items. They even complained of stinking toilets and water on the floor.
Satisfied Not satisfied

Seating arrangement

84

16

Refreshment and snacks

37

63

Parking facilities

62

38

Directional Signs

75

25

20

40

60

80

100

120

Adequacy of staff Data reveals that the receptionist sends the patients to the right consultant according to his/her ailment. One of the major issues of concern is that, that at a number of occasions the consultants are not present in their chambers during OPD hours. 62% of the patients said that they have to wait for the consultant. There was a mixed response from patients when asked about the sufficiency off clerical staff, 56% said yes and 46% said no.
100 90 90

80
70 60 50 40 30 20 10 0 10 38 62 54 46 Yes No

Receptionist sends you to the right deptt.

Doctor in his chamber during OPD hrs.

Sufficient staff at the reception

Behaviour and attitude of doctor and clerical staff Patients and their relatives were all praises for the courteous nature of the doctors and their pleasant and warm nature. They were satisfied with the nature of the clerical staff. Some of the patients wanted them to be a little more polite and helpful.
Behaviour and attitude of doctor and clerical Staff
60 50 No. of Patients 40 30 20 10 8 30 20 39

53

50

0
Polite Satisfactory Fair

Doctor

Clerical staff

Status of the doctor Updated The staff would update the timing of the consultant regularly
Status of the doctor Updated

100 90 80 70 60 50 40 30 20 10 0 Every time Sometimes Never 11.1 0 88.8

Reasons for opting for this hospital Varied answers were given. Many of them said because of highly qualified doctors and either advised by friends and relatives or referred by other doctors

Willingness for next visit Patients are very happy with the services provided by the hospital as 69%, when asked, if they will visit this hospital again, said yes. Very few said that they were not sure if they will come again to this hospital.
Willingness for next visit
5 15

Well visit again Don't Know Never

80

Age Group of staff in the OPD It was found that the staff working in the OPD is very young, most of them below the age of 30 years. As they are young, they are full of enthusiasm and eager to learn more.
Age Group

60

55.5

50

38.8

40

30

20

5.55

10

0 21-25 yrs. 24-30 yrs. 31-35 yrs.

Job Satisfaction The data reveals that maximum number of the staff is satisfied with their job. The staff not satisfied with their job complains of high work load due to deficient staff, low pay scale and less scope of

promotion.

Job Satisfaction

22

YES 78

NO

Records Maintained

The records are maintained regularly in the record department.

OBSERVATIONS
Only one record room available in the OPD, but due to increase in the flow of patients day by day patients have to spend more time in waiting area. After 2 pm most of time staff are not available. HIS are attached with the UPS ,sometimes due to electricity problem systems stop thereby causing delay .

Numbers are not mentioned on some of the doors of consultant chambers.

Consultant Doctors name or schedule is not mentioned in the OPD. Patients face problems in Pathology Dept due to lesser staff. Changes (adequate cash) is not available on the Front counter of OPD Less no. of Supportive staff and lack of training of supportive staff at the OPD. The cafeteria does not have necessary food items and are highly priced The toilets are not hygienically maintained and some toilets are used by the staff and doctors as also by the public Physicians sometimes are not available due to various commitments such as morning rounds conferences/meetings No basic guidelines mentioned in the OPD

RECOMMENDATIONS
One more record room should be added in the OPD, to reduce patients waiting time at the OPD,

Physicians should be available at the prescribed timings

Strict action should be taken against staff, who are missing from their assigned duties. Number should be mentioned properly on all the doors of consultants chamber. Provision of proper power backup to all computer system. Consultants Name and schedule should be mentioned properly in the area of OPD Sufficient number of staff should be deputed in the Lab for collecting the specimen of the patients. Sufficient no. of GDA recruited in the OPD and provided the proper training. Cafeteria should be stocked with all necessary food items at reasonable rates.

Recommendations contd
Sufficient number of staff should be present at the reception so that they can cater for more and more patients at the same time. The toilets should be clean, hygienic and should not stink. An OPD counselor should be present in the OPD for providing medical and social counseling of the patients. Some basic guidelines should be mentioned on the ground floor like :-12 yrs and below children not allowed in the SICU, MICU etc. - Flowers are not allowed with the attendant of the patients. -Visiting time should be mentioned.

Doctors timings of rounds, conference, meeting etc except in case of emergency, should not clash with OPD timings, so that they are fully available during the OPD working hours, thus reducing overcrowding of the patients in the waiting area.

Conclusion
Despite the short comings Johal multispecialty is one of best Hospital providing best healthcare at affordable cost The Hospital holds State-of-the-Art Operation Theatre at Par with International Standards. Johal Multi Specialty Hospital i provides the best quality medical care and services to their patients in a consistent and ethical manner, keeping abreast of changing technology as well as ongoing research and developments offered in the various specialties. The Hospitals medical staff are of the highest caliber and provides a multi disciplinary care team approach The use of Latest state-of-the-art technology enables patients to be fully diagnosed and treated under one roof in a caring and friendly environment

Thank you