Papers by Dr. Jawahar S K Pillai
Curēus, Apr 26, 2024
Background: Hospitals are complex places with a large number of employees, patients, furniture, e... more Background: Hospitals are complex places with a large number of employees, patients, furniture, equipment, etc. Healthcare workers (HCWs), patients, or the general public are vulnerable to injuries and illness due to unseen hazards at the workplace. This study aims to identify the hazards and assess the risks at a hospital to ensure safety for HCWs, patients, and the public and generate awareness about the same. It helps in reducing the financial obligation of the institution due to the treatment of illnesses of staff, absenteeism, and service disruption and slows down manpower turnover. Hazard Identification and Risk Assessment (HIRA) helps reduce human errors and promote safe behavior. Objective: This study aims to identify and study the hazards in a hospital, assess the risks associated with the hazards, and recommend methods to reduce or eliminate the hazards based on the outcomes of the study. Methodology: An observational study was conducted at a 1000-bed tertiary-level teaching public sector hospital in eastern India. A checklist was used for direct observation, conducting staff interviews, and document reviews. A risk scoring tool was used, and hazards were ranked as per the risk score. Results: Thirty-eight hazards were identified in the study and classified under the categories of natural, physical, chemical, biological, ergonomic, psychological, and safety. The fire risk and occurrence of cyclones had the highest risk scores. Conclusions: The study identified hazards through direct observations, record reviews, and staff interviews. These findings can guide the prioritization of areas requiring necessary action in risk reduction, ensuring a safe workplace for healthcare workers (HCWs), patients, and the public. They can also help the institution shift from a reactive approach to a proactive method for HCW safety.
Ivey publishers, 2024
This case presents an intriguing picture of AIIMS, Bhubaneswar, India’s apex medical institution ... more This case presents an intriguing picture of AIIMS, Bhubaneswar, India’s apex medical institution that has been established with a vision to impart high-quality medical education, research, and patient care under the aegis of the Ministry of Health and Welfare. The case draws attention to the need to balance the polarities of research, teaching and patient care and operationalize the same into the current system. The medical industry today has the unique need to recognize and operationalize strategic goals and maximize excellence in service and quality. The case addresses the critical dilemma that AIIMS Bhubaneswar faces in engaging and inspiring the mission and vision and realizing the strategic objectives of the institution. The pertinent questions and discussion drawn between Prof Jena and Dr Pillai take centre stage in the case. The case draws the attention of the readers towards understanding the importance of shared vision in today’s context, especially in the healthcare scenario. and presents the need for a shared vision as the pivotal need for AIIMS, Bhubaneswar to engage its stakeholders towards driving the cause. This case would be a good discussion material in strategic management to engage participants in taking through the alignment of long-term goals with strategic objectives and presents a detailed insight into appreciating the importance of operationalizing the strategic objectives. The case has a high potential to elucidate the need to develop an integrated management system that helps in implementing the strategic goals and performance deliverables. Importantly, the focus on a pivotal healthcare organization like AIIMS is of great relevance to appreciate the gap that lies in building higher-order values and engaging them in the system without oversight. The case provides the scope of having a detailed understanding of the importance of shared values and being able to balance the key social, economic, and environmental concerns in a service-driven government institution like AIIMS. The case builds scope for identifying and building fundamentals and reinstates systems for aligning and strengthening the goals bysystematic management systems and presents detailed discussion material for the need for building agility and customer responsiveness, by not losing focus on service delivery and customer responsiveness
JAHA
Background: The current healthcare systemis highly dependent on variousmedicat equipment fo assis... more Background: The current healthcare systemis highly dependent on variousmedicat equipment fo assis/ in diagnosing, monitoring, and treating patients. There are several studies on the improvement of patient care by adopting heatthcare technotogies along with an in-house efficient engineering division.As abroad, the division of engineering in hospitals is now a mature enough concept in tndia also. This study aims to evaluAte ]he perceived effect of an in-house hospital engineering division on patient care seruices in a hospital. Methods: This cross-sectional study with a descriptive research approach was conducted in a 250 bedded super specialty hospital in South tndia. A pre-tested survey questionnaire was developed,
curues
Background: Hospitals are complex places with a large number of employees, patients, furniture, e... more Background: Hospitals are complex places with a large number of employees, patients, furniture, equipment, etc. Healthcare workers (HCWs), patients, or the general public are vulnerable to injuries and illness due to unseen hazards at the workplace. This study aims to identify the hazards and assess the risks at a hospital to ensure safety for HCWs, patients, and the public and generate awareness about the same. It helps in reducing the financial obligation of the institution due to the treatment of illnesses of staff, absenteeism, and service disruption and slows down manpower turnover. Hazard Identification and Risk Assessment (HIRA) helps reduce human errors and promote safe behavior. Objective: This study aims to identify and study the hazards in a hospital, assess the risks associated with the hazards, and recommend methods to reduce or eliminate the hazards based on the outcomes of the study. Methodology: An observational study was conducted at a 1000-bed tertiary-level teaching public sector hospital in eastern India. A checklist was used for direct observation, conducting staff interviews, and document reviews. A risk scoring tool was used, and hazards were ranked as per the risk score. Results: Thirty-eight hazards were identified in the study and classified under the categories of natural, physical, chemical, biological, ergonomic, psychological, and safety. The fire risk and occurrence of cyclones had the highest risk scores. Conclusions: The study identified hazards through direct observations, record reviews, and staff interviews. These findings can guide the prioritization of areas requiring necessary action in risk reduction, ensuring a safe workplace for healthcare workers (HCWs), patients, and the public. They can also help the institution shift from a reactive approach to a proactive method for HCW safety.
Curues
Context: The generation of biomedical waste (BMW) in hospitals presents a significant hazard to b... more Context: The generation of biomedical waste (BMW) in hospitals presents a significant hazard to both healthcare workers (HCWs) and the environment. The management of BMW is a challenge regarding inappropriate behavior among HCWs, leading to improper segregation of the BMW, which deserves attention. The indiscriminate BMW management issue in India has attracted the attention of the highest judicial bodies. The rise in the incidence of needle stick injuries is a severe threat to waste handlers and is mainly due to improper segregation practices. Aim: This study aimed to identify the challenges in BMW management in the institute and develop a strategy to improve the knowledge and practices of healthcare professionals (HCPs) in BMW management. Methodology: A process-based intervention was developed and implemented that involved facility inspection rounds, focused group discussions with HCWs, preparation of information, education, and communication (IEC) materials, signage, staff training, and improved infrastructure and supplies for waste collection. A questionnaire-based evaluation of the staff's knowledge of BMW management was conducted, and the impact of the intervention was assessed from the hospital infection control audit reports. Results: Multiple reasons for poor compliance with BMW segregation practices were identified, and it improved from 57% to 91% with interventions. A significant difference was noted in the knowledge level of staff before and after the interventions. Post-intervention score was highest among the nurses (98.5%), followed by sanitation staff (92.7%), doctors (89.25%), and paramedics (81.7%). Conclusions: Incorrect segregation practices of BMW and incidents of occupational exposure to blood and body fluids are reduced with interventions in the study. Robust supply chain management with regular training of staff is vital to ensure compliance in BMW management.
IJPH, 2024
Pandemics, often undocumented, cause fear and uncertainty among the public. The 2019 COVID-19 pan... more Pandemics, often undocumented, cause fear and uncertainty among the public. The 2019 COVID-19 pandemic, first reported in Wuhan, China, was declared an International Public Health Emergency in January 2020. [1] The Government of India took early warning seriously and implemented effective strategies to control the pandemic. This institute implemented steps for continuous patient care, health-care worker protection, and reviewed crisis management at administrative and clinical levels. This narrative observational review done during the period from March 2020 to December 2020, in an 840 bedded tertiary level academic institution of national importance under Govt of India in Eastern India with 4000 health-care workers serving the public with an average 3000 outpatient footfall and 100 admissions per day. This study was made to outline the challenges and strategies in managing the COVID-19 crisis in the hospital. All the circulars, minutes of meetings, E-mail communications, WhatsApp group communication, and feedback from patients and health-care workers were taken into consideration to collect the data for the study. It was found that there were approximately 47 circulars and minutes of meetings included in this study. Apart from several E-mail communications, nearly 10 WhatsApp groups were considered. The hospital implemented several infrastructural modifications for infection control in COVID-19 units, including continuous education and training for staff. Special services were implemented for sample collection, diagnostics, waste management, patient transportation, telemedicine, dead body management, dietary services, signages, emergency and critical care services, and administrative control room [Figure 1].
Journal of Family Medicine and Primary Care
Introduction: Mortality from coronavirus disease 2019 (COVID-19) pandemic has left footprints acr... more Introduction: Mortality from coronavirus disease 2019 (COVID-19) pandemic has left footprints across all ages and socio-economic strata. The deaths because of COVID-19 are usually multi-factorial. The study aimed to assess the health system factors related to COVID-19-related deaths. Materials and Methods: A hospital-based retrospective study was conducted at a tertiary care hospital of eastern India. A total of 272 COVID-19 deaths that occurred between April and November 2020 were investigated. Data were extracted from Medical Record Department, and telephonic interviews were conducted to assess the different delays related to death. Data were analysed using Statistical Package for Social Sciences. Travel time, travel distance, delay in testing, and delay in receiving quality care were presented as median with inter-quartile range. Results: Complete information could be collected from 243 COVID deaths of the 272 deaths (89.3%). The duration of hospital stay was 1–7 days for 42% of ...
International Journal of Community Medicine and Public Health, Dec 29, 2022
All organizations always have a moral duty to keep employees safe. Occupational Safety and Health... more All organizations always have a moral duty to keep employees safe. Occupational Safety and Health (OSH) may also protect co-workers, family members employers, customers and many more who are affected by the workplace environment. 1 OSH should aim at the adaptation of each man to his job and of work to man. 2 OSH in a hospital is associated with the type of occupational hazard associated with each department of the hospital. OSH includes physical, chemical, biological, mechanical and psycho social hazards. 3 Emotional stress is the main health hazard. Among healthcare workers of United Kingdom, there were instances of 59% alcoholism and 41% drug addiction. 4 Since 1950, International Labour Organization (ILO) and World Health Organization (WHO) jointly adopted occupational health but in 2003, the thirteen session of joint ILO and WHO at Geneva, the committee recognized the need to raise occupational health issues at the global, regional and national levels and the national OSH programmes was made essential to achieving this goal. 5 In a study at Sahibabad, UP, shows that most of the staff were aware of the risk of injuries from sharps and needles, which is rated as highest. Musculoskeletal health problems like ABSTRACT Background: Occupational safety and health (OSH) is important for moral, legal and financial reasons for any organization. Aims of the OSH programs include encouragement of a safe and healthy work environment. This study aimed to study the occupational safety and health among healthcare workers at a tertiary care hospital. Methods: The cross-sectional descriptive type of study in a tertiary care hospital at south India. In this cross-sectional descriptive study, 120 health care workers were subjected to a pre-tested questionnaire. Along with questionnaire and interview method, inspection round and review of Incident register with 32 case reports were used as secondary source of data. Simple statistical methods were used to analyse the data. Results: Risk assessment shows out of physical hazards (n=120) 21% Musculoskeletal disorder followed by 13% burns and 10% strain due to uncomfortable posture. Chemical hazards identified were 8% dust, 7% chemical inhalation and 6% sterilization gases. Biological hazards were 12% needle stick injury, 11% splash and 5% sharp injury (n=120). Equipment hazards reported more among nurses. Among psychosocial hazards shift duty stress was highest (17%). Incident register showed slips/falls (28%), equipment hazards (23%) and needle stick injury (19%) as most common hazards (n=32). Conclusions: The percentage of occupational hazards in the study setting was less compared to national and international standards available. Risk assessment should be done periodically and periodic training and awareness programs for hospital employees directly influences on the quality of patient care.
Journal of Family Medicine and Primary Care, 2022
The whole world was shaken with the pandemic of Coronavirus Disease (COVID-19) in end of the year... more The whole world was shaken with the pandemic of Coronavirus Disease (COVID-19) in end of the year 2019. Due to its novel origin, it was required to follow all precautions possible. Dealing with the massive amount of infectious healthcare waste became an enormous challenge. This review identifies the impacts of the pandemic on biomedical waste management. This systematic review was made by using keywords “biomedical waste” and “COVID 19” in open access databases like PubMed, Science Direct, Scopus, Google Scholers etc. 2124 articles downloaded and 765 found duplicate and 634 not related to the topic. after scrutiny with inclusion criteria 102 articles were considered to analyze the practices related to biomedical waste management during pandemic using PRISMA guideline.. The COVID-19 waste segregation, collection, storage, transportation, and disposal are a big challenge with all stakeholders. In order to control the virus spread, strict monitoring of the complete waste management cycle is required. Adoption of appropriate guidelines is paramount to worker safety and containment of infection. Sustainable recycling methods are needed to deal with the ever-increasing plastic waste resulting from mandatory personal protective equipment (PPE) usage. The situation also demands a rethinking of the healthcare system. Overall, there was an increase in BMW generation, and municipal waste had increased globally. Pandemic preparedness requires a global public health strategy and long-term investments. This will be vital for making a robust community capable enough to fight against any public health pressures in the future, as well as the pandemic tremors. Systematized efforts from all stakeholders, at all levels, not only refines epidemic preparation but also helps to attain a sustainable development of health for a healthier future.
International Journal Of Community Medicine And Public Health, 2021
Background: Healthcare expenditure is becoming a point of discussion in the recent past. Cardiac ... more Background: Healthcare expenditure is becoming a point of discussion in the recent past. Cardiac problems are the major non-communicable disease burden in the society. Health insurance play a major role to share individual health risks and there by provide better access to health care. In this study an attempt was made to find out the level of awareness of health insurance policies among cardiac patients in a tertiary care hospital.Methods: One hundred and twenty patients were surveyed using a pretested questionnaire comprising of thirty different questions related to health insurance. Simple statistical test and Chi square test was used to assess the association between the variables.Results: Only 41% were aware of health insurance among non-insured patients (n=100). It was found that only 16.7% (N=20) had chosen insurance policy and reason for having taken insurance was to cater to the huge medical expenses (14.2%). 45% patients were opted Insurance due to low premium and good rep...
International journal of scientific research, 2020
Aim: To determine the service quality as per the standard quality indicators of OPDs and to find ... more Aim: To determine the service quality as per the standard quality indicators of OPDs and to find out the satisfaction level of the patients attending the OPDs, AIIMS, Bhubaneswar. Methods: A Cross sectional descriptive study was carried out for a period of 3 months. Cleanliness, Doctor's behaviour, Staff behaviour, Public utility services and Waiting time has been analysed in the Outpatient department. Results: Out of total patients, 64% are males and 36% are females. 77% patients had come for revisit and 50% of patients have utilized the hospital services for more than 5 times, 84% of patients are satisfied with the cleanliness facility of the AIIMS Hospital while 93% are satisfied with consultant's behaviour at the time of consultation in OPD. 80% of the patients are satisfied with the public utility services. 70% patients has spent more than 2 hours waiting for registration and 8.7% suggested that improvement of staff behaviour is needed to some extent. Recommendations: B...
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, 2021
Background: Outsourcing is one of the business strategies by which a organization's functions... more Background: Outsourcing is one of the business strategies by which a organization's functions, processes, activities and decision responsibilities shifted to an outdoor provider. Cleanliness of hospital is directly linked to infection control, patient comfort and satisfaction. This study evaluates this shift in service delivery system. Its main objectives are to get a feedback of quality of services rendered by hired housekeeping staff and service of the contracting agency. Method:Two separate sets of pre-tested structured Questionnaire and interview method were used for two group of respondents. One set contained 25 questions and the second set 20 questions. First group consist of nurses, technical staff etc. and second group consist of department head, division manager, supervisors etc. Using judgement sampling method, for rst group 52 response and for second group 43 responses were received Result: In Group I, 52 respondents were there of young age (µ= 37.65 and σ =10.019) a...
journal of Medical Science And clinical Research, 2019
Activity-based costing (ABC) is a costing model that identifies activities in an organization and... more Activity-based costing (ABC) is a costing model that identifies activities in an organization and assigns the cost of each activity resource to all products and services according to the actual consumption of each. The study, Costing of Neurosurgical procedures was an observational study which was carried out in SCTIMST (Sree Chitra Tirunal Institute of Medical Sciences & Technology) Thiruvananthapuram during 2009-2010.Objectives of the study were to study the charging system at SCTIMST, to analyze the various elements of cost involved in the neuro-surgical procedure craniotomy, to calculate expenses for selected cases of craniotomy, to ascertain average cost per case by preparing a cost sheet based on elements of cost. An activity based costing method was used for calculation of the cost. Ten cases of major Neurosurgery were studied. The cost included manpower, consumables, overheads etc. The cost was calculated to be Rs 77914/as against the hospital charge of Rs 36000/- .
Internet Journal of Medical Update - EJOURNAL, 2007
Aim: To determine the service quality as per the standard quality indicators of OPDs and to find ... more Aim: To determine the service quality as per the standard quality indicators of OPDs and to find out the satisfaction level of the patients attending the OPDs, AIIMS, Bhubaneswar. Methods: A Cross sectional descriptive study was carried out for a period of 3 months. Cleanliness, Doctor's behaviour, Staff behaviour, Public utility services and Waiting time has been analysed in the Outpatient department. Results: Out of total patients, 64% are males and 36% are females. 77% patients had come for revisit and 50% of patients have utilized the hospital services for more than 5 times, 84% of patients are satisfied with the cleanliness facility of the AIIMS Hospital while 93% are satisfied with consultant's behaviour at the time of consultation in OPD. 80% of the patients are satisfied with the public utility services. 70% patients has spent more than 2 hours waiting for registration and 9% suggested that improvement of staff behaviour is needed to some extent. Recommendations: Behaviour of staff and delay in waiting for registration and patient feedback system need to be improved. Conclusion: Overall the patients are satisfied with OPD services obtained at AIIMS, Bhubaneswar. The study found that patients are satisfied with Doctor's behaviour, Public utility services and Cleanliness.
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Papers by Dr. Jawahar S K Pillai