Summer Training At Santokba Durlabhji Memorial Hospital Cum Medical Research Institute “Average Length Of Stay at SDMH, Jaipur” PRESENTED BY: NARENDRA NAGA PG/11/056 ABOUT HOSPITAL Santokba Durlabhji Memorial hospital is a 467 bedded trust managed, autonomous, private hospital. OUR MISSION:- To offer a broad spectrum of cost effective and humanistic clinical services of a quality that meets the highest international standards to all patients irrespective of their caste, creed or class, to serve as a continuing medical education center (CME) for doctors, teaching center for D.N.B. candidates and for those categories of paramedical staff (such as nurse, technicians and radiographers) that are invariably in short supply and to provide a base for innovative research in our constant endeavor to improve health care. OUR VISION: To surpass current professional quality standards, to come up to the highest expectations of those we serve and to ensure a congenial and invigorating work environment that spurs all employees to reach their full potential. Average Length of Stay in Hospital refers to the average number of days that patients spend in hospital. ALOS ALOS = Total length of stay by discharged patients for a given period Total Number of discharged patients in same period Hospital length of stay is an important performance indicator for hospital management and a key measure of efficiency in health care. Also the type of reimbursement or health insurance plan plays a significant role in the patient’s length of stay in hospitals. RATIONALE OF STUDY ALOS is used to calculate future bed needs or helps in forecasting future bed requirements & helps in to set contract figures, helps in patient categorization and also helps in analysis of changing current elective admission policy. These calculations are very useful or necessary to fulfill the needs of bed allocation and forecasting requirements while planning and managing bed capacity. OBJECTIVES General Objective:To calculate the average length of stay of patients in SDM Hospital, Jaipur. Specific Objectives: To calculate the department wise (General wards, ICUs & Private rooms) ALOS in hospital. To study the disease pattern in hospital & calculate the ALOS according to patient’s disease profile. To identify the factors those are responsible for prolonged LOS in hospital & suggest methods to overcome the existing problems. METHODOLOGY Study Area SDM Hospital, Jaipur Study Design Cross-sectional, Descriptive Study Population All the Inpatients of hospital Sample Design Convenient Sampling Sample Size 491 (282 from Wards, 138 from ICUs & 71 from Private Rooms) Data Source Secondary Data Duration of the study April 20 to May 20, 2012 STUDY FINDINGS ALOS IN All General Wards (in days) 5.7 6 5 4 3 3.8 3.6 3 3.4 3.6 5.1 4.2 3.2 4.7 4.4 4.4 3.9 3.8 2.4 2 1 0 ALOS IN All General Wards (in days) 2.9 Cont… ALOS in All ICUs (in days) 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 3.8 4.1 4.4 4.4 2.7 1.8 ALOS in All ICUs (in days) 2.3 1.7 Cont… ALOS in Private Rooms 5 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 4.6 4.1 3.1 3.1 2 NDX MPW FPW SDX ALOS in Private Rooms PRW Cont… Lenth of stay in SDMH (in days) 3.2 3.9 General Wards Private Rooms ICUs 3.4 RECOMMENDATIONS • Availability of resources should be appropriate. • Discharge process should be pre planned. • Billing services for admission and discharges should be • • • • • performed on a single window to save the time of patients. Separate windows should be made for different processes at IPD counter. Duplication of work should not be there. Categorization should be done in wards according to disease profile of patients. IPD visiting time by the doctors should be fixed. Once patient gets discharged, they should empty the bed and wait for discharge summary in waiting area. Cont… Some extra beds should be added to Gynae ward. So the every patient will take benefits of maternity services. Interdepartmental coordination should be improved within the hospital. Appointment given prior to the surgeries to reduce the waiting time and length of stay. Due to this Surgeons or doctors can perform the surgeries on given date or time. CONCLUSION After analyzing or evaluating the above study, we conclude that the ALOS of this teaching hospital is ideally good. Due to lower number of beds and higher patient load in Maternity Ward (FGW), there is an undue pressure on the hospital to discharge patients in this ward. For a better patient satisfaction, more number of beds should be added in this ward. And attention should be paid towards quality of services & disease characteristics of patients (The hospital has a highest admittance rate in diseases like Abdominal Pain, Acute Pancreatis, Anaemia, Chest Pain, Cholilithiasis, CKD, COPD, DM, Fever, HTN, Hysterectomy, LSCS, and LVF etc.) so that the patient satisfaction level can be maximized. A CASE STUDY ON DOCTOR WISE IPD ADMISSIONS IN VARIOUS DEPARTMENTS AT SDM HOSPITAL, JAIPUR INTRODUCTION In-Patient Department (IPD) is also known as indoors or wards. The patients who need continuous nursing care, monitoring or medical/ surgical interventions are admitted to IPD in a hospital. The IPD is nursing care intensive department and constitutes the largest functional area in a hospital. Scope of services :The following services are available to patients through IPD: Nursing care- continuous monitoring, drug administration Preparation for surgery and post-operative care Minor procedures Medical consultations Diets OBJECTIVE To know the trend of doctor wise IPD admissions in various departments at SDM hospital, Jaipur. METHODOLOGY The study is conducted among 6089 patients attending IPD of SDM Hospital, Jaipur during the period from 01/01/2012 to 31/03/2012. The required secondary data is collected from MRD. STUDY FINDINGS Total No. of IPD Admissions in SDMH (from Jan.1 to March 31,2012) 1000 931 900 800 700 600 500 780 739 612 569 525 439 400 304 300 237 211 197 200 128 91 100 78 73 71 54 45 5 0 Total No. of Patients Cont… S.No. DOCTOR’S NAME DEPARTMENT % OF PATIENT ADMITTENCE NEAR COMPETETOR % OF PATIENT ADMITTENCE 1. Dr.Sanjeev Gupta Cardiology 42% Dr.Atul Kasliwal 27% 2. Dr. Anurag Govil Gastroenterology 46% Dr.Dinesh Agarwal 26% 3. Dr. B.K. Malpani Medicine 24% Dr.R.Patni/Dr.Vinita Govil 22% 4. Dr. S.C.Taparia Neurosurgery 40% Dr.Vipin Khandelwal 32% 5. Dr. S.Fayyaz Obst. & Gynae. 56% Dr.Nishi Gupta 16% 6. Dr. Aashish K.Sharma Orthopedic 26% Dr.S.Shrivastava 26% 7. Dr. Rajeev Bansal Paediatric 61% Dr.G.C.Bothra 15% 8. Dr.D.N.Kalla/Mighl ani Urology 53% Dr.Uma K.Raghuvanshi 34% RECOMMENDATIONS The hospital beds in each ward and ICU are distributed among doctors of hospital. Before this study bed allocation among doctors are not done scientifically. Therefore, the study is carried out to know the doctor wise trend of IPD admissions in various departments. The study will help in reallocation of hospital beds among doctors according to their percentage of contributions in IPD admissions. We can expand our inpatient services according to their department wise contribution of patient load in hospital. It can be also suggested that the doctor who have the highest percentage of patient load in IPD section, his or her bed allocation should be done nearby the OPD of that particular doctor. By doing this it will help in time saving during doctor’s rounds in IPD section. CONCLUSION It is conclude that the Medicine Department has the highest number of In-Patients during these three months and then followed by Pediatrics and Obst. & Gynecology department. The patients of Dental Surgery department has the lowest percentage in IPD unit And then followed by ENT & Neonatology department. After analyzing of all the available data a list (as shown in Table No.5) is come out which shows the highest percentage of patient admittance rate in IPD unit by doctors in various departments. This will help in allocation of beds among doctors according to their percentage of contribution in IPD section. REFERENCES 1. B. Senthilkumar and R. 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