PART III
Healthcare continues to provide hospitals with the latest and greatest methods for how to improve patient-centered 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.
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. Some of them are as follows:
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, orthopedics, gynecology, 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 specialties 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. Analyze 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.
(To be concluded…)
(DR Fiaz Maqbool 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 [email protected])
