sidhartha satpathy

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Challenges in implementation of

FMS as per NABH stds

Dr. Sidhartha Satpathy

Professor De tt of Hos ital Admn

AIIMS, New Delhi


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Why is safety required?

Stan ar s in FMS

Challenges faced in hospitals

Country specific issues!

Conclusion


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Forms ma or com onent of the structure

criteria defined by Prof. Donabedian. Gets a lot of attention as it is tangible!

Consumes substantial amount of the capital

expenditure in any hospital/project.

A large number of statutory issues have to be co-ordinated with various agencies.

Covers disaster management issues involving thehospital and local agencies.


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Provision of a safe and secure environment for

patients, families, staff & visitors. Conducts regular Facility Inspection rounds, and takes

Provides for safe water, electricity and manifold

system.rogram or c n ca an support serv ce equ pment an

management.

Plans for emer encies within the facilities and the

community.Manages hazardous materials in a safe manner

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Massive fire at AMRI hosp, 90+ persons

lost their lives incl 4 staff


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against hospital TNN Oct 27 2012 04.23AM IST Neonatal Intensive Care Unit| Institute of Medical Sciences

KOLLAM: The parents of a two-day-old baby, who died at the Shanker's Institute of MedicalSciences (SIMS) here on October 19, has alleged negligence on the part of the hospital authoritiesfor the death. Based on a complaint by Shyamkumar, the father of the newborn, Kollam East police

.

Shyamkumar has alleged that the hospital authorities cheated him and his relatives by hushing upthe real reason behind the death of the child. "There was a large burn on the back of the child andwe were not informed about it," he said. It was on October 17 that Shyamkumar's wife, Bismi, wasadmitted to the hospital for her second delivery. She gave birth to a baby girl the next day. The child

. . ,

baby was taken to the Neonatal Intensive Care Unit (NICU) by one of the nurses saying that thechild had developed some complications. Shyamkumar said the child looked healthy then. By nextday morning, he was informed that the baby's condition was serious and it was put on ventilator.But, it was on Sunday last that Shyamkumar got to see the large burn mark on the back of the babyin the photographs taken during the time of preparing the inquest. One of his relatives, a doctor,suggested that the burn might have been caused by the incubator or warmer in the NICU.


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2010, faulty indigenous equipments blamed


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Disaster affected hospital, where 50+ patients died


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..system in place to provide a safe

and secure environment,

implementation, .....

at ent sa ety ev ces are nsta e across t e

organization and inspected periodically.

Facility inspection rounds-Once or twice/year,documented, corr & prev action taken

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FMSFMS..22::The orgns environment andfacilities operate to ensure safety

, ,

visitorsFacilities are appropriate to the scope of services of

the organization.Up-to-date drawings are maintained which detail

the site layout, floor plans and fire escape

.Adequate space, signposting, potable water &electricit , testin , and maintenance lan

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FMSFMS..33 The organization has a

programme for engineering

a) The organization plans for equipment

qu pmen s se ec e , ren e , up a e orupgraded by a collaborative process.

maintained as required.

,documented maintenance plan for elec, HVACwater tanks, DG sets, BMW equipment etc

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First Revision 1983

Second Revision 2005

pages

Published by BIS


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Sin le document in which info from various

Indian Standards is compiled It lays down minimum provisions designed to

protect the safety of the public esp. withregard to

Provisions related to EQ safety

Fire hazards & safet

Health Aspects of buildings


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It also covers aspects related to

administration of regulations development control rules

stipulations regarding construction materials

rules for design of electrical installations, lights, A/c, lifts requ rements o vent at on an accoust es

requirement of plumbing services viz. water supply,drainage and sanitation

measures for safety of public/workers rules erection of signs and outdoor display structures


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Part 1: Definition Part 2: Administration

Part 3: Development Control Rules and GeneralBuilding requirement

Part 4: Fire and Life Safety

Part 5: Building materials ar : ruc ura es gn

Loads, forces and effects

Soils and foundation

Timber and Bamboo

Masonry Concrete (Plain, reinforced, pre-stressed)

Steel

Prefabrication, systems building and mixed/components construction


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-

safety

Lighting and ventilations

A/c, Heating and mech. Ventilation,

Installation of lifts and escalation

Part 9 : Plumbing services

Part 10: Landscaping, signs and outdoor


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FMSFMS..44 The organization has a

programme for bio-medical

a) The organization plans for bio-med equipment

qu pmen are se ec e , ren e , up a e orupgraded by a collaborative process.

maintained as required.

staff, periodically inspected & calibrated, propermaintenance plan.

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`Medical device'- means any instrument, apparatus,

imp ement, mac ine, app iance, imp ant, in vitro reagent or

calibrator, software, material or other similar or relatedarticle:

a) intended by the manufacturer to be used, alone or in combination, for humanbeings for one or more of the specific purpose(s) of:

-diagnosis, prevention, monitoring, treatment or alleviation of disease,-diagnosis, monitoring, treatment, alleviation of or compensation for an injury,

-investigation, replacement, modification, or support of the anatomy or of aphysiological process,

-supporting or sustaining life,

-control of conception,-disinfection of medical devices,

-providing information for medical or diagnostic purposes by means ofin vitro

b)


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e ca ev ce e n on

which does not achieve its primaryintended action in or on the human body

by pharmacological, immunological ormetabolic means, but which may be

assisted in its intended function by suchmeans.


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,

maintenance, repair, user training and-

by clinical engineering. Medical equipment is

treatment of disease or rehabilitation

.


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-

injured in adverse events involving medical devicesas er stud in NHS, UK

In a stud ublished in 2004 b Brockton J Hefflin etal in USA, during a one year period, reports of 10,395

medical deviceassociated adverse events were

accumulated using the National Electronic InjurySurveillance System(NEISS)


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-

database (maintained by the Agence Francaise deSecurite Sanitaire des Produits de Sante), devices for

ventilation and infusion, and monitors of all kinds

accounted for most of the reports, representing 37%,an respec ve y, o a repor s.


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Technology Review(2012) 664 medical equipments at

Beth Israel Med Center were found using outdated

opera ng sys ems w r s o ma ware n ec ons


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FMFM .. Th r niz i n hprogramme for medical gases,

vacuum an compresse air

procurement, handling, storage, distribution,

usage and replenishment of medical gases.b) These are handled, stored, distributed and

used in a safe manner

c) Safety issues, alternate sources, operational& breakdown plan should be available.

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FMSFMS..66 The organization has plans

for fire and non-fire emergencies

w t n t e ac t es

early detection, abatement and containment of

fire and non-fire emer encies.

b) Documented safe exit plans must be available,

c) Mock drills shd be held at least twice in a year,

.

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Table top exercises and mock drills will

not succeed during actual disasters!!


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FMSFMS..77 The or anization lans for

handling community emergencies,

ep em cs an o er sas ers

emergencies.

e organ zat on as a ocumente saster

management plan, tested at least twice/year

c) Prov of medical supplies, eqpt; along withstaff training reg their role.

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FMSFMS..88 The organization has a plan

for management of hazardous

a) Hazardous materials are identified within theorgan za on.

b) The organization implements processes for

transporting and disposal of hazardousmaterial.

c P an or manag ng sp s w t sta e ucat onand training in handling such cases.

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PLEASE

REGISTER

TOCONTINUE

USING THIS

SOFTWARE


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Safety Cultureafety Culture

done around

.

looking!

Stuart Matthews

sidhartha satpathy

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