Name : Dr Abhay Dhawale Roll. No.

112099 Subject: Hospital Support Services

Q7. Explain the role of Support services in the hospital. Ans: Support services form the backbone of the functioning of any major hospital. Without these services it is impossible to work in the hospital. Support services includes: 1. 2. 3. 4. 5. 6. 7. Food Service Department Central Sterile processing The Pharmacy Linen services Engineering and Maintenance Safety and Security Material Management

Food Service Department Food suitable for patient forms the important part of the patients treatment. The food service department is responsible for all the activities involving food , nutrition dietic care to both inpatient and outpatients. Ancillary services include the dininig facilities for employees, visitors and physicians, catering and vending services, meal service for children, providing education in nutrition for all campus facilities, clinics . Economics and and convenience dictate the setting up of food service department. The department work load hinges upon the number of meals served. Operational factors such as food production methods, menu selection, staffing, and hours of operation play a key role. Central Sterile processing Central sterile supply department is a service whereby medical/surgical equipment and material , both strerile and non-sterile are cleaned, prepares, processed, stored and issued for patient care. The purpose of the sterile services department is to concentrate the skill and responsibility for the supply of sterile material and to reduce risk of error. The department is divided into three zones to accomplish the function of decontamination 1. Decontamination zone 2. Assembly/ Sterlization zone 3. Storage and distribution zone. Primary Activities undertaken within Central Sterile Processing 1. Cleaning and disinfecting processes for instruments, trays, utensils, containers and etc. 2. Preparing and packaging contents of trays and packs. 3. Sterile trays and packs and disinfecting items acceptable for patients use 4. Storing non sterile materials components. 5. Distributing process and purchased goods to users.

The Pharmacy:

The pharmacy serves the whole hospital. It stores pharmaceutical products manufactured elsewhere and may also store dressings. It supplies all wards and other departments, often on the basis of daily requirement. It is also one of the highest revenue generating centers. There are three primary services of the hospital pharmacy: 1. Receipt and preparation of prescriptions 2. Dispensing 3. Clinical consulting. Environmental and Linen services: The environmental services deparment is responsible for maintaining a clean and sanitary environment in the hospital., including floors, carpeting, tile, drapery, windows , lights, vents and upholstered items. Environmental services typically contract with outside vendors or arrange with the maintenance department for pest control, waste removal, exterior window washing, furniture repair,etc Linen service is typically contracted with vendors. Clean linen storage may be located in clean workrooms or linen storage alcoves. Soiled linen may be collected in carts in corridors and then transferred to soiled utility rooms for pickup by vendor. Engineering and Maintenance: This deparment is typically responsible for the entire physical plant and ground of the hospital. Services include preventive maintenance, corrective maintenance, casualty prevention, minor constructions, and construction administration. Work load and departmental need are directly related to the scope of the facilities and the campus for which the department is responsible. Safety and Security: Safety and security services within the hospital setting provide general security, guard patrol, preliminary investigation, fire prevention, control policies and training, disaster planning and training, and other measures for general safety of staff, patient and visitors. The department operates 24 hours per day , seven days week . Materials and Management: Materials management is responsible for the acquisition, general storage, daily inventory, and restocking of most of the consumable materials used within a facility. This service may be provided for several facilities within a healthcare system to increase efficiency of operations , reduce total space requirements, and maximize purchasing power.

Q7. Brief the functional activities of dietary departments.

Ans: The department primary function is to provide nutrition and dietetic care to both inpatient and out patients. Ancillary services may include the operation of dining facilities for employees, physicians catering and vending services. The department work hinges on the number of meals served. Operational factors such as food production methods, menu selection , staffing and hours of operation play key role. Product should flow as follows: 1. Receiving area: Locate near loading and unloading dock for quick, safe food receiving. 2. Kitchen: Locate near servery, conference/meeting rooms, service elevator to patient rooms and auxillary services 3. Floor Pantries: Locate near service elevator core. 4. Vending: Locate next to the employee dining facility, to accommodate late 5. service and at other strategic points 6. Physicians dining: Locate near next to servery and dining room. 7. Employee dining room: Locate adjacent to kitchen and food production area. Several method s are used to deliver food. Food mmay be transported to each ward in a bulk container by heated trolley and served on plate by ward staff. More recent method are for individual meals to be portioned and plated up in the kitchen or served there in insulated and compartmented trays. The catering may be be run by the hospital or contracted out to the external organisation. The washing and cleaning of utensils is done with efficient steam sterlization. In general layout , the most important factor tobe bourne in mind is the logical work flow that is, receiving supplies, storing and refrigerating them, preparing and serving food, returning trays and washing dishes. The space and facilities should be adequate. One of the latest development is the food court and market designs, similar to the malls. Employees, Physicians, visitors and outpatient can freely choose among the different type of food. On production side , new technologies and equipment have allowed kitchens to consolidate function. Q5. Discuss the importance of Medical records. How will you organize a medical records department? What standard operative procedure are required for its effective functioning. Ans: Medical records have traditionally been compiled and maintained by health care providers, but advances in online data storage have led to the development of personal health records (PHR) that are maintained by patients themselves, often on third-party websites. Although the storage equipment for medical records generally is the property of the health care provider, the actual record is considered in most jurisdictions to be the property of the patient, who may obtain copies upon request. The information contained in the medical record allows health care providers to determine the patient's medical history and provide informed care. The medical record

serves as the central repository for planning patient care and documenting communication among patient and health care provider and professionals contributing to the patient's care. The traditional medical record for inpatient care can include admission notes, onservice notes, progress notes (SOAP notes), preoperative notes, operative notes, postoperative notes, procedure notes, delivery notes, postpartum notes, and discharge notes. Personal health records combine many of the above features with portability, thus allowing a patient to share medical records across providers and health care systems In addition, the individual medical record anonymised may serve as a document to educate medical students/resident physicians, to provide data for internal hospital auditing and quality assurance, and to provide data for medical research. FUNCTIONS, ACTIVITIES & SERVICES PROVIDED BY THE DEPARTMENT In brief the major and important ones are : 1. Computerised new and revisit registration of ambulatory care (OPD) patient (between 8.00 AM 11.00 AM) & collection of annual fee/ duplicate card fee under token and display system. 2. Computerised new and revisit registration of emergency care patient(round the clock service) & collection of annual fee/duplicate card fee. 3. Issue of health care clinical notes to various ambulatory care (OPD) clinics. 4. Pasting of various types of reports in the respective ambulatory care-health record charts (OPD file) 5. Providing case summary of Medico-Legal cases to police authorities & patients on written request. 6. Providing medical information to insurance agency on prescribed form of insurance company on written request by deceased nominee/insurance authorities. 7. Collection of various investigations/tests charges etc. and issue of receipt at both the counters, emergency (round the clock) and at fee section of OPD from 8.00AM to 12.30 PM. 8. Round the clock admission registration, documentation, security collection at the emergency and issue gate passes. 9. Round the clock discharge of patients at the emergency counter, security adjustment/ refund services. 10. Providing information and guidance to patients, attendants and visitors. 11. Compiling statistics of various data & services. 12. Issue of health record charts to faculty members, administrative authorities for various purposes. Last but not the least, the Medical records department and management is the CUSTODIAN of ambulatory, emergency and inpatient care health record charts, including Medico-Legal and death cases etc. Q4. Discuss the management of the maternity services in a 500 bedded hospital?

Ans: The maternity differs from the other department becused it is designed to house the happy event. It is dealing with the continuous process, may be from IVF to pregnancy to delivery to postnatal care of both mother and child. The department is divided largely into two parts: The outpatient clinics The inpatient accommodations concerned with delivery and post natal care. The best primary maternity services demonstrate the following features: 1. high quality care enabled by evidence-based practice 2. care is coordinated according to the womans clinical need 3. health professionals work together in a collaborative multidisciplinary approach 4. continuity of care through pregnancy, birth and the early postnatal period 5. enable woman-centred care which gives women a sense of control of their birthing experience 6. care is culturally appropriate and reduces health inequalities 7. enable continued access to best practice care at the local level A highly trained, qualified and effective primary maternity service workforce, working collaboratively, to use increasingly scarce respective skills efficiently, is the key to developing and sustaining qualityprimary maternity services. Good models of primary maternity care demonstrate the principles of woman centred care which: is focussed on the womens individual, unique needs, expectations and aspirations, rather than the needs of institutions or professions recognises the womans right to self determination in terms of choice, control and continuity of care encompasses the needs of the baby, the womans family, significant others and community, as identified and negotiated by the woman herself follows the woman between institutions and the community, through all phases of pregnancy, birth and the postnatal period is holistic - addresses the womans social, emotional, physical, psychological, spiritual and cultural needs and expectations.