GENERAL ADMINISTRATION

CONTENTS

CERTIFICATE

ACKNOWLEDGEMENT

OVERVIEW HOSPITAL /AIM /OBJECTIVE

REVIEW OF LITERATURE

OBSERVATION

RECOMMEDATIONS

SUGGESTION

GRAPHS

BIBLIOGRAPHY
 GENERAL ADMINISTRATION

AIM

The aim of this project is to study the General Administration of CHL - Apollo
Hospital, Indore.

OBJECTIVE

The objective of this project is to study the basic procedures, facilities provided and
problems encountered at the different departments of the hospital, constituting the
General Administration of the hospital.
 GENERAL ADMINISTRATION

REVIEW

OF

LITERATURE
 GENERAL ADMINISTRATION

I. RECEPTION
For a person entering in the hospital, it is a strange place and he needs reassurance
and guidance. At reception, he found solutions of his various queries about location
of various clinics, registration process and so on. Thus, reception therefore plays a
role of guide for patients by solving their queries.
Reception is placed at the prominent place at the entrance of the hospital. To isolate
reception area from noise, the reception and enquiry should be enclosed in a see-
through cubicle. The reception is staffed during the working hours by experienced
and competent persons. Medical social worker, a senior nurse or a lay administrator is
equally suitable, provided the person should have complete knowledge about the
every single facility and activity if the hospital. The staff members of the reception
should be well-mannered and cool tempered, so that after the hectic activity taking
place at reception, he / she should patiently hear patient’s innumerable queries and
answer them.
Reception and enquiry should have good communication through telephone and
intercom sets with all clinics and whole hospital. A well-illustrated, easily
understandable guide map or sign posts should be present, showing locations of all
clinics and adjacent service units, should be promptly displayed in this location.

I. MEDICLAIM
The mediclaim policy provides reimbursement of hospitalization expenses for
illness / diseases suffered or accidental injuries sustained during the policy period.
Mediclaim insurance policy has been deviced under the policies of the Government of
India. The policy provides the following benefits:

1) Reimbursement of hospitalization expenses, which are reasonably and

necessarily incurred, under the following heads:
 Room, boarding expenses as provided by the hospital / nursing home.
 Nursing expenses
 Fees of surgeon, anaesthetist, medical practitioner, consultant and
specialist.
 GENERAL ADMINISTRATION

 Expenses on account of anaesthesia, blood, oxygen, operation theatre

charges, surgical appliances, medicines and drugs, diagnostic material, X-
ray, dialysis, chemotherapy, radiotherapy, cost of pacemaker, artificial
limbs and cost of organs and similar expenses.
2) Reimbursement of domiciliary hospitalization, for a period exceeding three days,
which would in the normal course require treatment at a hospital, but is actually taken
at home because of the critical condition of the patient or non-availability of bed in a
hospital. Certain diseases are included under this head.

3) Premium paid for the policy towards self, spouse, 2 dependent children and
dependent parents are exempt from Income Tax..
4) Cumulative Bonus-Benefits payable will be increased by 5% for each claim free
year, upto maximum of 50% for continuous policy period.

5) Cost of Health Check Up-Reimbursement of cost of medical check up once at the

end of a block of every four continuous policy years, which are claim free.

Additional expenses:
The other silent features of the policy are:
1) Family Discount- A family discount of 10% in total premium will be allowed
if a person takes cover for himself and any one or more of the following:
 Spouse
 Dependent children
 Dependent parents
2) Age-limit: The insurance is available to the person between the ages of 5
years to 75 years. Children aged between 3 months to 5 years can also be
covered, provided that one or both the parents are covered concurrently.
3) Treatment anywhere in India- The benefit of the policy can be taken
anywhere in India.
4) The sum insured- An insuring person can choose a sum insured between Rs.
15000/- to Rs. 5,00,000/- presently.
5) Pre-Hospitalisation and Post Hospitalization Expenses- Such expenses are
payable upto 30 days prior to hospitalistion and upto 60 days after
hospitalization.
 GENERAL ADMINISTRATION

The insurance policy is available only for allopathy, ayurvedic and unani systems of
medicine. Other alternative systems of me
dicine are not eligible for claims. The mediclaim protection is available for the illness
/ disease contracted anywhere in the world provided the treatment is availed in India.
There are certain diseases and injuries that are not covered by the mediclaim policy.
These fall basically under 3 categories. These are:
 Diseases not covered under 1st year of policy.
 Medical conditions not covered at all under mediclaim.
 Injuries and diseases not covered under certain conditions.
Diseases not covered under 1st year are:
 Cataract
 Benign Prostatic Hypertrophy
 Hysterectomy for menorrhagia or fibromyoma
 Hernia
 Congenital disease
 Piles
 Sinusitis and related disorders .

Medical conditions which are not covered under mediclaim are listed below:
 Dental treatment, unless require hospitalization
 Congenital external diseases
 Venereal diseases
 Conditions related directly or indirectly to AIDS
 Pregnancy
 Cost of spectacles
 Contact lens and hearing aids
 Surgery, unless it require hospitalisation

The diseases which are not covered under certain circumstances are:
 Intentional self-injury
 Use of intoxicating alcohol or drugs
 Diseases / injury arising in the first 30 days from commencement of policy.
 GENERAL ADMINISTRATION

THIRD PARTY ADMINISTRATORS (TPAs)

TPAs are the link present between the health insurance companies and hospital. TPAs
are in the business of processing medical claims. They are interested in processing
medical claims as quickly and efficiently as possible. Hospitals have to deal with
TPAs and not directly with health insurance companies.
Previously the work of TPAs is done by surveyors, inspector, retired insurance
officers and partly by Doctor’s who are hired for medical opinion in insurance
companies. Now these works is handed over to TPAs who have their own medical
boards and inspectors to bring efficiency in the system. A standard agreement format
is present between the General Insurance Company (GIC) and TPAs. The hospital
can sign an agreement with TPAs on standard format. TPAs work on the behalf of
insurance company and the administrative expenditure is borne by an insurance
company.

TPAs need funds to issue I-cards, customer education brochures and to run a call
centre for customer enquiries. Therefore, TPAs as intermediary shares the premium
of mediclaim customer at least by 10-15% to provide better customer care service.
The work of TPAs to process claim is true particularly in the case if TPA has Prompt
Pay Discount agreements with the hospital whose claim it process. Prompt Pay
Discount agreement requires the TPA to pay claim within a brief time period which is
usually 5-10 business days. Discount is given on the Prompt Payment, which usually
goes into TPA revenue stream. The contracts that TPA has with their client almost
never require the TPA to audit hospital bill for overcharges. Auditing hospital bill for
overcharges takes a considerable amount of time.
Development of a good customer care attitude will definitely give a boost to
mediclaim business and provide quick relief to policyholder.

III. OUT PATIENT SERVICES

Out patient department is defined as “A part of hospital with allotted facilities and
medical and other staff in sufficient number, with regular scheduled hours to provide
care for patients who are not registered as inpatients.”
 GENERAL ADMINISTRATION

Patients get their first impression of hospital from the out-patient department. It has
been described as the first point of contact between hospital and community. OPD is
an important department of hospital as:
o OPD is the patient’s first point of contact with hospital.
o It is an inseparable link in hierarchical chain of health care facility.
o It contributes to reduction in morbidity and mortality.
o It helps in reducing the number of admission to inpatient wards and act as a
filter for inpatient admissions.
o It acts as a filter for the inpatient admissions, ensuring that only those patients
are admitted who are most likely to benefit from such care.
o It is the “shop window” of the hospital.

Categories of outpatients:
1. Emergency Outpatients - Person given emergency care as a result of
sudden severe illness or accident.

2. Referred Outpatients - Person referred to the OPD by a private

practioner or other physicians.
3. General Outpatients - Person referred by other physicians, given
diagnostic and/or therapeutic services on an outpatient basis.

OUTPATIENT VISIT:
Outpatient visit is the visit of a person at outpatient department to receive service.
The visit may be:
 New outpatient visit  Outpatient visit by a patient for first time.
 Repeat outpatient visit Outpatient visit by a patient subsequent to initial
outpatient visit.

Sources of Origin of Outpatients

Unreferred Cases

Discharged cases Emergency and

from hospital Accidents
(Follow-up) OPD
 GENERAL ADMINISTRATION

Referred cases from

Private Practioners,
Dispensaries and
Peripheral Hospitals

ORGANIZATION OF OPD
Staff of OPD is made up of four major organizational components:
1. Medical Staff
 Most important and central to the organization.
 It includes the Doctors and Consultants.
2. Nursing Staff
 It includes Registered nurses.
3. Ancillary Staff
 It includes Lab technicians.
4. Clerical Staff
 It includes staff, which carries out Registration, Billing, Cashiering,
Secretarial and Medical Record Functions.
 GENERAL ADMINISTRATION

FLOW PATTERN OF OUT PATIENT DEPARTMENT

OUT PATIENTS

OPD RECEPTION

MEDICAL RECORDS WAITING TOILETS

RECORDS
DEPARTMENT APPOINTMENT

INFORMATION TELEPHONES
SOCIAL
REGISTRATION SERVICES

SUBWAITING SUBWAITING

DOCTORS OFFICES, CONSULTATION,

IPD EXAMINATION, MINOR PROCEDURES,
ADMISSION DENTAL, EYE AND ENT SERVICES.

TREATMENT PHARMACY

DIAGNOSTIC AND THERAPEUTIC SERVICES

(X-RAY LABS, ECG, USG, PATHOLOGY)
 GENERAL ADMINISTRTION

IV. CLINICAL LABORATORIES

Clinical laboratories perform lab tests, which will provide information to clinicians in arriving at
correct diagnosis and in the treatment and prevention of disease.
It plays an important role in the hospital infection control and surveillance program. As the
practice of medicine today, requires the more and more laboratory examinations, pathology plays
a major role in hospital. The basic function of pathology is: -

 To assist doctors to confirm diagnosis and to assist the treatment of follow-up patients.
 Laboratory also works as store house of report for future references.
 A hospital-based laboratory has to carry out urgent test any time, so provide service 24
hours a day.
 The pathology also assists in teaching program for nurses and laboratory technicians.

FUNCTION
With their specialized section, these labs make a complex dept. The functions of its major
sections are:
 Hematology – It performs tests and procedures, which pertain to the examination of
blood and blood forming organs of body.
 Blood Bank – It is involved in the blood donor programs, typing, cross matching,
processing etc.
 Histopathology – It prepares and examines tissues in order to provide data on the cause
and progress of disease.
 Microbiology - It identifies microorganisms found in body fluids. Skin scrapings and
surgical specimen. It tries to identify, grow and perform sensitivity tests of organisms to
different antibiotics.
 Cytology – It examines body cells for diagnosis of malignancy and other disease
conditions, effects of hormones and so on.
 Biochemistry – It performs quantitative and qualitative analysis of body fluids, secretions
and substances found in tissues.
 GENERAL ADMINISTRATION

The pathology room should be located at a suitable place in the outpatient department. This area
should include waiting room for the patients, venepuncture room and specimen toilets separately
for both males and females.

V. RADIOLOGY
Radiological services are to assist the clinicians in the diagnosis and treatment of diseases
through the use of radiography, fluoroscopy, radioisotopes and high voltage acceleration.
The practice of modern medicines cannot be undertaken without proper investigation. Radiology
is an important department of hospital, which directly contributes to the patient care.
Radiological services are integral part of hospital as they give a vital back-up to all specialties
which can not be practiced effectively without it’s support. The term radiology incorporates: -
A. Radio diagnosis
i. Xray ii. MRI
iii. CT scan iv. Sonography
B. Radiotherapy
C. Nuclear medicine
D. Interventional radiology
Some typical radiological examinations are:
1. Routine X-Ray – This involves X-Ray procedure of spine, neck, chest and extremities.
2. CT scan/CAT scan – It’s an X-Ray technique that uses a special scanner and computer to
produce cross-sectional images of the head or parts of body. A 3-D picture of the part is
examined.
3. MRI – It’s based on the phenomenon NMR (Nuclear Magnetic Resonance) and is used
to view the soft tissues without the use of harmful ionizing agent (making use of 2 natural
forces – magnetic field and radio waves). Its used to look through hard bones and
examine soft tissues.
4. Sonography – It makes use of the 4-D Ultrasound Color Doppler. It’s based on the
ultrasound that is, frequency above 20 KHz. Ultrasound of frequency between 1 & 15
Mega Hz is beamed into human body and the returning echoes are detected. A scan head
transducer is placed in contact with the area to be scanned. A layer of aqueous gel is
applied between the skins and scans head to ensure that the sound has an air free path to
 GENERAL ADMINISTRATION

the object of interest. Eg-foetus. It’s also used to asses foetal growth and to detect
abnormalities such as spina bifeida, disorders in abdomen and pelvis.
5. Echocardiography - Cardiac structures and its motions are visualized with
echocardiography. It’s used to study the heart structure and valve conditions.
Other tests:
 Stress
 TEE – Trans Esophageal Echo
 PFT – Pulmonary Function Test
 TMT – Tread Mill Test
 Holter – 24 hrs ECG

BLOOD BANK
The blood bank is involved in blood donor programs, typing, cross matching, processing,
etc.Blood bank performs active service of storing and providing blood and components of blood,
whenever required by the patient.
Blood bank stores blood, plasma, PRP and platelets. Blood is also collected at blood bank. Blood
is collected in a special beg divided into double, single and triple bag. After collection of blood,
blood is tested for HIV, HbSAg testing, Hept. B, Hept. C, malaria and after negative report of
these tests, blood is stored in blood bank.

The machines used for blood storage in a hospital are: -

1. Centrifuge machine
2. Laminar air flow
3. Incubator
4. Refrigerator
5. Cryoprecipitate Bath
6. Platelet Agitator

VI. STORES
 GENERAL ADMINISTRATION

Central store contains various items including linen, drugs, dressings and laboratory supplies.
Hospital store is included in central service as it supplies required materials to all over the
hospital. Stores can be classified into 2 types: -
1) Separate stores and purchase department
2) Integrated stores and purchase department
In integrated store and purchase department, single authority held responsible for availability and
control of machines. Coordination between two functions under one authority leads to better
insights into quality, quantity, variation in demand and standardization. The process involves:-
• Demand forecasting and planning
• Purchasing
• Receipt, inspection and stores
• Inventory control
• Issue and distribution
A forecast is an estimate of demand expected in future. Planning is done according to the
estimated demand in future. Purchasing acquires material as required to meet quality and time
schedules. The fundamental action of purchasing includes selection of acceptable tenders and
negotiation of terms, placing purchase orders considering economic levels and expediting
delivers to meet inventory requirement. Materials are received at a specified receiving area. At
point of delivery, each item is checked physically, counted, undergo through visual inspection
before accepting. If some damage persists, then it is sent back. Entries are done in day book and
inward flow register.

Materials are issued with an authorized requisition, on a periodic basis unless urgently required.
Requisition is processed and items are arranged at order processing counters from where
indenting department collects issued material.

VII. HUMAN RESOURCE (HR)

The term human resources within corporations and business refers to the individual within the
firm and to the portion of the firms organization that deals with hiring, firing, training and other
personal issues. Human resource management serves following functions-:

1. Recruitment
 GENERAL ADMINISTRATION

2. Compensation
3. Evaluation and management of performance
4. Promotions
5. Managing relations
6. Planning
The objective of human resource is “To maximize the return on investment from the
organisation human capital”.
 Hiring employees in the organization is the main function of human resource
management. On the basis of his / her knowledge and skills, if the person is able to meet
the requirement of the respective job, then the person is hired as the organisation’s
employee.
 . The staff of the organization should be made to understand and agree to the objectives
and goals set up by organization. After the setting of goals, performance of employees are
monitored and compared by the standard of organization. If there is decrease in variance,
then the cause is analyzed and corrective measures are implemented.
 Sometimes due to certain reasons, employee is not able to show the highest level of his /
her performance. In this situation, motivation of employee and promotion according to
his / her skills give a boom to employee’s performance.
 The staff of the organization, needs to be motivated to give their best at all time even in
tying situation, as expensive fascilities and equipment do not run hospital, it is the staff
that makes the organization go.
 A new entrant need to be introduced to his colleague and shown the layout of his / her
department, He / she would be benefited from some understanding of how his / her
particular job fits into the pattern of the whole organization.
 There is no job in the hospital for which some sort of training is not beneficial. Their
immediate need will be to learn to adopt their knowledge and skills to specific
requirement of hospital. Many of them at the interval of their professional career needs
refresh training and instruction in special aspects of their work.

VIII. CENTRAL STERILE SUPPY DEPARTMENT

 GENERAL ADMINISTRATION

CSSD is the abbreviation of Central Sterile Supply Department. The objective of establishing
CSSD is to make reliably sterilized articles available at the required time and place for any
agreed purpose in the hospital.
The CSSD in a hospital receives, sterilize, stores, and distribute articles to the entire department,
including wards, OPD and other special units such as OT. Major responsibility of CSSD includes
processing and sterilization of syringes, rubber goods, surgical instruments, treatment trays and
sets, dressing etc.
The main objectives of CSSD are:
• To provide sterilized material from a central department where sterilizing practice is
conducted under conditions.
• To take some of the work of nursing staff, so that they can devote more time to patients.
• To maintain the record of effectiveness of cleaning, disinfection and sterilization process.
• To monitor and enforce controls necessary to prevent cross infection according to
infection control policy.
• To maintain an inventory of supplies and equipment.
• To provide safe environment for patient and staff.

FUNCTIONS
 Receiving and sorting the soiled material.
 Carrying out process of decontamination and disinfection prior to
sterilization.
 Carrying out specialized cleaning of equipments and supplies.
 Inspecting and testing instruments equipments and linen.
 Assembling treatment sets, instruments sets, linen packs etc.
 Packaging all materials for sterilizing
 Labeling and dating materials
 Storing and controlling inventory
 Issuing and Distributing
EQUIPMENT:
 GENERAL ADMINISTRATION

The main item of equipment in CSSD is autoclave. Most modern electric autoclave is designed to
achieve vacuum in the sterilization chamber followed by injection of steam under controlled
pressure to achieve sterilization. Other equipments of CSSD are:
 Dry oven
 Gauze cutter
 Ultrasound washer
 Needle flushing device
 Autoclaves
 Ethylene oxide sterilizer
 High pressure water sets
 Work benches with marble
or stainless steel top
 Storage cup-boards and
racks
 Linen folding table
 Soaking sinks
 GENERAL ADMINISTRTION

The two main processes which take place in CSSD for sterilization are:

Sterilization process

Autoclave Ethylene oxide

Process Process

 AUTOCLAVING:
Use of saturated steam under pressure is safest and dependable method of sterilization. It is
used for destruction of all types of microorganism. The minimum time for sterilization by
autoclave process is 1210c at 15Ibs psi in 15 minutes.

 ETYELENE OXIDE STERLIZER:

In EOS, ethylene oxide gas is used as sterilizing agent for heat sensitive and moisture sensitive
materials like PVC. The type of packing used for instruments should be penetrable by ethylene
oxide. Polyethylene is commonly used upto 12 hours time is required for sterilization.
Sterilization process is done with single use glass ampoule of ethylene oxide, seated inside a gas
release bag. On breaking, liquid ethylene oxide vapors diffuses out of glass-release bag into
larger bag. This bag performs function of diffusion chamber and allows gas to retain for long
time to achieve sterilization.
Concentration of gas:- 450mg/lt

 ULTRASONIC CLEANER:
One of the essential items in CSSD is ultrasound cleaner. Ultra sound cleaner cleans by
bombarding the items with sound waves
Chemical indicators are devices with a sensitive chemical or dye to monitor one or more
parameters of sterilization process. They change color when conditions necessary for
sterilization have been met. These are available as tapes and strips.
The list of items and special trays commonly processes in CSSD are as follows:
 Instruments  Special packs
 Appliances  Gauze and cotton material
 Dressing  Gloves
 Springs  Bowls and trays
 OT linen
Materials sterilized in autoclaving are packed in linen and Kraft paper
having double wrapping. Articles for hot air sterilization can be kept in
suitable stainless steel containers. If the pack is not used during shelf life it
is again sterilized without being open.
 OBSERVATION

I. RECEPTION:
 At reception, people come for enquiry regarding Doctor’s, Inpatient’s,
Admission process, location of OPD clinics, and all other queries related
to hospital.
 At reception, EPBAX intercom set is present which helps in
easy communication between the various departments of hospital,
through extension numbers.
 At reception, firstly it is checked that the patient has come
directly or with any reference.
 If the patient has come directly then he/she is sent to casualty
where a yellow receipt is made and then it is forwarded to admission
department.
 Paging is also done at reception.
 After a particular time billing, OPD, cash receiving all will be
handled at main reception.
 At night cash counter shifts to the main reception.
 When the payment is through the credit card or debit card then
it will be done on main reception and forwarded to cash counter for
receipt.
 If the patient has come with reference then he/she is first sent
to OPD reception.
  Every morning admitted patient list is taken out which gives
information about unoccupied beds in the hospital. This list is forwarded
to chairman and to neurology department.
 Occupancy is the number of beds occupied in the hospital. For
an ideal hospital occupancy should be 85%.
 Occupancy = Occupied bed/Total bed x 100
 Occupancy of CHL-Apollo Hospital is 72%. Above 85% of
occupancy the level of services provided to the patient lowers and below
it, the resources of hospital can not be fully utilized.
 HMS software is used for collection of information of patients.
Certain information such as first name, last name, IPD number,
Registration number etc are feed in system for getting information or
sorting out of patient.
 Working staff: 10 members (at different schedule) Office boy
-1
Documents attached to IPR are:
 Case summary  Clinical chart
 Discharge summary  Daily clinical record
 Progress sheet  Intake-Output chart
 Investigation summary  Billing record.

II. MEDICLAIM
 It is a claim made to the insurance company by an insured person for
the health related expenses borne by him/her.
 Cashless facility is provided when patient is hospitalized.

 Reimbursement is done after discharge.

PROCEDURE
If person has come for mediclaim, policy copy and card is required.
 Pre-authorization form is filled by doctors and then it is faxed to the
company.
  It has to be faxed within 24 hours of hospitalization.
 Follow up is done to confirm and find out why the approval has not
been received?
In the follow up 3conditions can be there:
1. Approval – In case of approval, no charges are deposited for
treatment from the patient except for the security deposit.
2. Denial – In case of denial, patient has to pay cash to the hospital and
reimbursement can be done by him/her afterwards.
3. Additional Information – In this case the extra information asked by
the company is sent by the hospital.
Payment is deposited in advance from patients. When claim application
of patient is approved then cash is refunded back to the patient, but in
case if the claim of patient is not sanctioned money is not given back to
the patient. Finally in case of approval:
• Claim form • All original reports
• Hospital bills • Approval letter
• Medicine bills • Original fax
• Discharge summary • Original pre-authorization
form
All the above documents are sent to TPA for payment.
 Finally, insurance company issues the check.
 Medicine bills are directly reimbursed.
 Patients of suspected case (burnt, poisoning, accident etc.)
comes under Medico Legal Case (MLC).
 In CHL - Apollo Hospital, maximum medically insured patients are
client of Paramount Healthcare.

 TPA’s act as a bridge between the hospital and the insurance

companies.
 Work flow:
 Health Insurance Companies TPAs
Hospital
Name of the TPA which has tie-up with CHL Apollo hospital:
1. Bajaj Allianz. 5. TTK Health Care.
2. E-Meditek. 6. Universal Mediaid
3. MD-India. Services Ltd.
4. Paramount Health 7. Vipul Med Corp.
Service Private Ltd.

III. OUT PATIENT DEPARTMENT (OPD)

 OPD RECEPTION- At OPD reception, when a new
patient arrive a registration form is given to fill up. Then
a new file is made with the reference card and receipt is
given by taking the consultation fee Rs 200.Under 14
days if the patient again comes for the check up to the
same doctor then the consultancy fee will not be taken, if
to the different doctor then consultancy fee will be taken.
After doctor consultation, the patient file is collected back at OPD reception.
Next time when patient comes for consultation, showing his reference card
his file is taken out from record room, and the previous procedure is
followed. All the investigations charges are taken at OPD reception. Reports
of CT scan and MRI are dispatched from here.
Staffing: 2 members, 3 office boys.
 OPD COUNTER – At OPD counter, enquiry regarding
doctor’s information is done. OPD coordinators act as a
link between the doctors and the patients. When patient
file is made at OPD reception, patient is registered at
OPD counter. On the basis of number of patients for
doctors appointment is given. Except CT and MRI all
 investigations reports are dispatched from here. At
present 54 doctors are working here.
LOCATION OF OPD’S
• GROUND FLOOR
Specialties No.
Of Doctors

I. CARDIOLOGY
 Physician and Cardiologist 3
 Cardiac surgeon 2
II. GASTROENTEROLOGY
 Full time Gastroenterologists 2

 Food and Nutrition Dietician 1

III. ORTHOPAEDICS
 Orthopedic Surgeon 3
IV. ENDOCRINOLOGY
 Endocrinologist 1
V. PLASTIC SURGERY
 Cosmetic Dermatologist 2
VI. UROLOGY
 Urologist 1
 Consultant Urologist 1
 Uro-oncosurgeon 1
 Laparoscopic Urology 1

VII. GENERAL PHYSICIAN 3

CHEST PHYSICIAN 1
CANCER PHYSICIAN 1

VIII. GENERAL SURGEON 3

CANCER SURGEON 2
 IX. PSCYCHIATIST 1
PSCYCOLOGY 1
X. SKIN 1
XI. ONCHO HEAMAT 1

• FIRST FLOOR
I. GYNAECOLOGY
 Gynaecologist and Obstetrician 1
 Consultant Gynaecologist 3
II. NEUROLOGY
 Neurophysician 3
 Neurosurgeons 3

III. NEPHROLOGY 2

• SECOND FLOOR
I. DENTAL
 Orthodontist 1
 Oral and Dental Surgeon 1
II. OPHTHALMOLOGY
 Eye specialist and surgeon 2
 Ophthalmologist 1
III. ENT
 ENT Surgeon 2
IV. PAEDIATRICS
 Consultant Pediatrician 2
 Pediatrics Surgeon 3

• FOURTH FLOOR
PHYSIOTHERAPY
 Physiotherapists 2

The OPD of CHL-Apollo hospital is conveniently located in close proximity

to adjunct services such as Registration and Medical Records, Admitting,
Emergency and Social Services. It is easily accessible from the diagnostic
and therapeutic departments, such as, radiology, pathology, pharmacy, etc.
used by patients during every visit.

IV. EXECUTIVE HEALTH CHECK UP

Many groups of people do benefit from regular and complete check-ups.
Some of these people are:
 Smokers and Heavy drinkers.
 Overweight
 Easily and often Breathless
 Suffering from stomach illness
Health check-up dept. of CHL-Apollo Hospital Indore, has designed
different health check-up plans and packages to suit one’s need based on
self-assessment or depending on ones age and need. Executive Health
Check up is specially designed for executives. It is of two types:
1. Pre-employment 2. Pre-policy
 Pre-employment health check up is done for an individual
who is applying for job in a company and company has demanded for a
health check up.
 Pre policy health check up is recommended by insurance
companies for getting health information about an individual before
providing insurance policy.
The various packages and their respective charges are:
1. Comprehensive 3. Cardiac
2. Executive 4. Diabetic
 5. Women
A very few of the renown companies having tie-ups with CHL-Apollo are:
o Apollo Tyres. o HSBC.
o Andhara Bank. o ICICI Bank.
o BPCL. o ICICI Prudential.
o Bank Of India. o IDEA Cellular.
o Cholamandalam. o Indian Airlines.
o Crompton Greaves o Kingfisher.
(Indore & o L & T.
Pithampur). o Nicholas Piramal.
o Eicher Motors. o RANBAXY.
o FHPL. o SRF
o HDFC. o Siemens Ltd..
o Heath India. o Matlani Groups.

And many more……..

 The investigations to be included differ according to
companies’ requirement. Health check up reports of pre-employment
and pre-policy of tie-up companies are confidential. Reports are sent
to the company, sometimes reports are handed to the executive
directly.

GENERAL PROCEDURE
 Investigation time for EHC is from 8.30 to 11.30a.m.
 Appointment should be taken prior 1 day before.
 The executives come with urine and stool taken in a
container.
 Yellow file is made containing the patient’s information.
 At OPD reception the payment is done by the executives
according to the package.
  Then the executive is sent to the pathology for taking the
blood sample and urine sample.
 One by one according to the availability of the department
tests are done.
 Sonography is done empty stomach when the urinary bladder
is full.
 After sonography if the patient is not diabetic then 75gm
glucose & water is given.
 If the patient is diabetic then breakfast to the executive is
provided by the hospital.
 Executive’s reports are dispatched from here.
 Four registers are maintained at EHC.
 Monthly and Daily register has entries of number of check
ups done in one day and in one month.
 Appointment register has information about checkup
appointments.
 Courier register keeps information of reports which has
been couriered and which has to be couriered. Courier
register contains a POD No., which confirms that report has
been couriered.
Working staff:
Executive head 1
Helper 1

V. PATHOLOGY
Its sub divided in different departments:
 Hematology  Microbiology
 Biochemistry  Histopathology
 Immunology  Blood Bank
LOCATION
 Hematology and Biochemistry Dept is located on ground floor.
  The rest of the depts. are located on 1st floor.
1. Clinical pathology - Stool and urine tests are performed at clinical
pathology. These tests are done when 8-10 samples are collected for the test,
unless there is an emergency.
Machines present in clinical pathology are serological water bath, centrifuge
machine, pH meter and microscope. In serological water bath, incubation is
carried out.
Working staff: 1 technician
2. Biochemistry - In Biochemistry quantitative and qualitative analysis of
body fluids takes place.
 Different machines present in Biochemistry are:
o Body Gas Analyzer (Cobar b 121):- This machine is used for the
calculation of the different gases present in the body.
o Blood gas and electrolyte machine:- It is used for Na+ and K+
tests. 2 machines are present in pathology, one of which is on
stand-by mode.
 3 Biochemistry machine are present out of which one is semi-
automatic and one is fully automatic (Daytona)
 Photometer machine is old model Biochemistry machine which is
used for the test of Billirubin and Billiverdin.
 Centrifuge machine is used for conducting the tests related to serum
and plasma.
Working staff: 4 technician
3. Haemotology - All the tests related to blood and its components are
performed in hematology department.
 Beckman coulter machine is used for CBC count. Graphical
representation of the test results can be seen on the system connected
to the machine.
 Coagulometer machine is used for taking out PTA for cardiac
patients, which shows the degree of dilatation of blood.
Working staff: 3 technician
4. Histopathology - Investigations related to tissue and cells are carried out
at Histopathology division.
 As soon as the specimen / tissue is received, it is entered into the
register. Along with the specimen of the hospital, specimens from
peripheral hospital also come at laboratory for investigation.
 In Histopathology staining of tissue is done and in cytology, slides of
body fluids are made
(CSF, Pericardial fluid, Perivascular fluid etc.)
 For preparation of Wax slides, automatic tissue processor is used.
Tissue is kept in processor for overnight and in morning it is fixed
with Formalin, Alcohol and Absolute alcohol. Then it is treated with
Xylene.
 L-mould is used for fixing the cubes of wax containing tissue, and
then it is cut with microtome which has size range of slices from 2-5
micron. Then slices ranging in micron are heated carefully to liquefy
wax. Then it is passed from 3 bottles of xylene to remove extra wax.
After that slides are dehydrated to remove water. Staining of slide is
done by haematoxin and eosin. To remove extra stain, slide is
washed with running water. Haematoxin is used for nuclear staining
and eosin is used for cytoplasm staining. After proper staining of
slides these are observed under microscope.
 These prepared slides and specimens are filed and maintained. Slides
are maintained for upto 5 years and specimens are stored for 15 days.
 Pathological test reports are sent to OPD counter for outpatients and
to floor coordinator in case of inpatients
Working staff: doctors – 2, technician – 2, typist -2.
6. Immunology-Rose diagnostic electrochemical skin method is
used here. Test done here:
 T3, T4,TSH  Cortisol,
 Prolactin , troponia
testosterone  FSH , LH
 Working staff: 1 technician
7. Microbiology- All body fluids and tissues culture, blood culture, acid fast
bacilli , eye conjunctiva, urine culture, CSF culture , stool culture , throat
soft culture, sputum routine & culture, pus culture semen culture etc. are
processed here.
Working staff: 3 technician
NOTE:
 Pathology of hospital remains open for 24 hours a day. The time for collection
of report is from 5.30-7.30 p.m.
 The payment for the investigation to be performed is done first, at OPD
reception by out patients. After that specimens are collected at pathology and
numbering is given to the specimen. The same number is entered in request
register for avoiding confusion and mistake in identifying specimen.
 IPD and OPD register are maintained in pathology department. Initially entries
are done in these registers and afterwards into the register of respective
department.
o Emergency requests are normally accepted at all times.
o Specimens are sent to the labs in properly labeled containers.
o A list of commonly requested investigations with the details of time for taking
specimens (fasting, non-fasting etc) min. vol. Necessary and proper container
are posted and are readily available at Nursing Station.
o Lab staff receives and enters each request in a daily record ledger.
o A colour code system and numbering system is followed to identify
specimens.
o 4 types of tubes called vaccutaner is used for the collection of blood sample.
1. K3EDTA - VIOLET
2. PLAIN – RED
3. HEPARIN VIAL – GREEN
4. SODIUM CITRATE – BLUE
FACILITIES
• Work counters with space for equipment, microscopes, incubators,
centrifuge under the counter and overhead cabinets.
 • Workstations equipped with vacuum gas, electrical services, sinks and
water.
• Specimen collection area for blood, urine and faeces.
• For blood collection area, work counter, space for patients seating and
wash basin for hand washing.
• Storage facilities for reagents, standard supplies and stained specimens,
microscopic slides, refrigerators.
• Culture media preparation area.

LABORATORY PROCEDURES:
The laboratory processing system is manual.
Doctor writes Investigation

Logged in the register

Passed to Technicians

Tests performed

Results recorded in Register and Report Form

Transported to dept. that requested for the Tests

Sent to be filed in patient’s Medical Record

8. BLOOD BANK- Blood bank performs the function of properly storage and
providing blood and its components whenever required by patient. The function of
department is to collect blood from donor and to store it. Blood bank of CHL-Apollo
Hospital is well equipped with advance facilities and machines for collecting, testing,
and storing of blood.

Rooms for functioning:

 Donor room  Medical examination
 Eliser room room

 Component room  Donor refreshment

room.
PROCEDURE IN THE BLEEDING ROOM
 Receives the blood donor with pleasant gesture.
 Inquire about the relevant history and complete all the entries in
donor register.
 Perform medical check up to as certain fitness like BP is
checked, weight is taken and the breakfast must be taken by the
donor.
 Take written consent for donation.
 Ask the donor to lie down on the bleeding couch.
 Complete all the entries on the blood bag and bleed the donor
to collect 350 ml blood.
 During collection rotate the bag properly.
 Collect the donor sample in piolet tube and label the piolet tube
correctly.
 Ask the donor to take rest on bleeding couch.
 When donor feels comfortable shift to refreshment room and
provide refreshment.
 Allow the donor to leave the blood bank.
 In emergency cases, screen the blood from blood bank.
 Requisition form is filled by inpatients.
 Sample is taken and cross matched, if matched then given.
 After this, replac the blood by attendant’s blood.
PROCEDURE IN COMPONENT ROOM
 Component room is used to prepare the components like plasma, platelet
and packed cell.
 Plasma is prepared in heavy duty cooling machine and plasma expresser is
used to separate the components.
 In fresh frozen plasma refrigerator plasma is stored at -30 degree Celsius.
In this plasma is in solid form.
 At the time of transfusion, plasma is kept in cryoprecipitate bath at 30 to
convert that solid plasma into liquid form.
 Components are kept in triple blood bag.
 Plasma expired after 1 year.
 Platelet expired after 5 days.
 Packed cell expired after 42 days.
 Whole blood expired after 35 days.
 In platelet agitator, platelet is kept in vibrating mode to keep them alive
otherwise platelets will die if they are kept in stationary position. PRP is stored in
platelet agitator at 220c.
 Incubator maintains the temperature to 370c, because test of HIV and HEP.
Gives reaction at this temperature only. Time limit differs from 45 min. to 60 min.
 In blood collection bag, anticoagulant CPDA is used. The temperature
required for storage of blood and RBC is 2-40c. Blood collection bag is of single use
only. Expiry date of bag varies from 1-2 year, depending upon the manufacturer
company. The companies supplying blood collection bags to CHL-Apollo Hospital
are:
o Terumo penpal o Baxter
o HL o J.Mitra
Maximum storage capacity of hospital’s blood bank is of 300-400 units (one
collection bag is considered as one unit). A requisition comes to blood bank from
floors, wherever blood is required having details that blood is required or components
of blood. After receiving requisition blood is issued. Requisition also comes from
other hospitals.
VI. RADIOLOGY
Radiology department provides the facility of X– ray, MRI, CT scan and sonography.
In CHL Apollo hospital 2 mobile units of X- ray machine is used.
Functions common to radiology department:
1. Routine X-ray like chest, abdomen, limbs etc.
2. Special procedures like barium studies, myelograms etc.
3. Ultrasound work
Rooms for technical functioning:
1. X-ray room 4. X-ray record room
2. Dark room 5. Film store.
3. Autoprocessing
room

X-Ray - Digital X-Ray is taken on a cassette and processed for getting an image. Big
X-Ray unit of hospital is of 300 mA and mobile X-Ray is of 60 mA. Table top X-Ray
is done for obtaining image of extremities .X-Ray cassette contains a film which
stores image. This cassette is kept in CR500 machine for processing for about 2
minutes. Two computers are attached with machine. The processed image is sent in 1 st
computer by which the patient’s details are written digitally on film. Then it is
processed in 2nd computer in which contrast effects sharpness of the image is decided.
Finally, print of X-Ray is obtained from dry view machine. Master view software is
used for this process of digital X-Ray.
When image is processed from CR500, then the image will automatically deleted
from X-Ray cassette. On an average, one cassette can be used for 4-5 years. Different
size of X-Ray cassette is: 6x8”, 10x12”, and 14x17”.
Working staff: technician - 9, radiologist – 1, typist – 2, ward boy -1
MRI / CT Scan - The hospital provides facility of 64 slice CT scan, which is the
fastest scanner available. Cardiac trigger monitor is attached to machine contrasting
agent is injected for getting better contrasting image. CT scan image is of 512 x 512
pixels. In MRI reconstructed image is obtained, which provides more resolute image.
Patients for radiological investigations are registered at reception counter.
Appointments are also given to patients at reception.
Working staff: technician – 8, doctor – 1, bai – 3, ward boy- 3.
 Ultrasonography - Voluson 730 PRO provides 4D sonographic image. It is the
most advanced sonographic machine which gives colour Doppler Effect. The clear
images of movement of foetus can be obtained. Excellent fetal face & body profile
with real time images are provided on CD. The hospital offers full range of ultrasound
services i.e. transvaginal, transrectal, musculoskeletal pediatrics, USG, and color
Doppler along with routine ultrasound imaging. 2 printers are attached with machine,
one is simple printer used for routine patients in which glossy paper is used other is
color printer for Doppler effect.
Working staff: Technician – 2, sonologist – 1, bai – 1.

VII. MATERIALS MANAGEMET (STORES)

Material management encompasses acquisition, shipping, receiving, evaluation,
warehousing and distributing of all goods, supplies and equipments for organization
INVENTORY CONTROL
Store generally stocks all items that have not been delivered to departments upon
receipt, but have been used for distribution and used at a later date.
Most common materials used are:
• Medical, surgical items • Office supplies
• Dressings • Stationary and forms
• Housekeeping items
DISTRIBUTION SYSTEM
Requisition System – Each user department maintains and keeps track of its
inventories. Periodically (1 month or 1 week) or when inventory levels are low; a
requisition is prepared and sent to stores, which delivers the requisitioned items to the
user department. In this system space utilization and management control are almost
negligible.
LOCATION
It is situated at the ground floor and faraway from the other traffic area. It’s
conveniently accessible to an unloading dock and elevators.
STAFFING
 Store Manager-1
Purchase officer-1
Store Assistants-2
Purchase Assistants-2
FACILITIES
• Manager’s office
• Clerical area
• Central stores

IV. HUMAN RESOURCE (HR)

Human resource management is the process of binding people and organization
together so that the objectives of each are achieved. HR department basically deals
with employees of the hospital.
FUNCTIONS OF HR:
Whenever any new employee has to be appoint the following process are done
by an HR-
1. Recruitment – It is the process of searching for required personnel and
stimulating them to apply for jobs in the hospital.
2. Selection – On the basis of requirement HR select some people, on the
basis of short listing call is done to candidates.
3. Placement – It means the HR assign suitable job to the candidates.
4. Induction /orientation – It involves familiarizing the new employees to
the hospital, the work environment and the existing employees.
 After induction a written report has to be submitted by employee, which
contains the general procedure of hospital, observation, experience, nature of
departmental staff, full information about the department and staff is present.
 After submission of report, he / she is placed at the concern department. Up to
6 months, the employee remain in probation period, means work as a trainee.
After this period if his/her performance is well they are taken as a regular
employee.
 During probation period, employee can leave the organization without notice
and he can also be fired without notice. Facilities like mediclaim, casual
leave, and earned leave are not provided during probation period.
  14 casual leave per annum are given to employees. Even if the employee has
not taken all 14 casual leave, salary percentage of 14 days is not paid to him.
Earned leave are 13 per annum, but alike from casual leave if employee has
not consume full-earned leave, then cash equal to unavailed leave is paid to
employee.
 Attendance of doctors, nurses, administration staff and technical staff is
maintained at HR department. A punching machine is placed near reception,
entry and casualty, which is punched by every employee on arrival and
leaving, the produced over there is directly transmitted to the HR department
system.
 Employee record are also maintained by HR.
 Wage and salary administration is also done in HR department.
 In performance and potential appraisal, systematic evaluation of employees
with respect to their performance on the job is done by HR.

V. CENTRAL STERILE SUPPLY DEPARTMENT (CSSD)

To combat Hospital Acquired Infection, hospitals have a scientific and effective
method of disinfection and sterilization. This process is centralized and takes place in
CSSD. From various parts of hospital like OTs, wards, out patient clinics and other
departments, all soiled items are collected in the CSSD for processing and then
transported back to the end users. In CSSD, the process of cleaning, disinfecting,
inspecting, packing, sterilizing, trained personnel carry out storing and distributing.
This ensures better control and reliable results and consequently reduced risk of
infection. In CSSD two processes are used for sterilization of equipments. These are:
1) Ethylene Oxide Gas Sterilization
2) Autoclaving
Instruments which are received are firstly washed thoroughly to remove blood stains.
a) Washer Disinfector: After washing instruments they are put into washer
disinfector. In this instruments are first treated with cold water and then with hot
water. It has indicators of control on, door precondition, process on end, and
temperature indicator and controller
b) Ultrasonic washer: In ultrasonic washer, items are cleaned by sound waves.
Workload is of 15 minutes. It has 3 working stages: -
 1) Water in time: Time upto which water is to be filled in machine. It is 4 minutes.
2) Ultrasonic timer: Time of ultrasound procedure. It is for 6 minutes
3) Drain: Time for drainage of water from machine. It is for 6 minutes.
c) Drying cabinet: It is used for drying of sterilized material. Its loading time is 15
minute. Temperature on which it is operated is 600c.
d) Autoclave / steam machine: In autoclave machine concentrated steam is used
for sterilization process. Its workload is of 1 hour. All items other than PVC are
sterilized in autoclave. A chemical indicator is used which is originally white but on
getting favorable condition for sterilization it becomes black.
e) Ethylene oxide gas sterilizer: All PVC items which are heat sensitive are
sterilized in ETO sterilizer. Workload of machine is of 12 hours. White indicator
becomes red on sterilization. Items sterilized in ETO remain sterilized for 1 year. A
sealing machine is attached for sealing sterilized items. In one work load one bottle
of ethylene oxide gas is required. The reels used for sealing PVC items is of
measurements of 5mm, 10mm, 15mm, 20mm, 25mm,30mm.
 In one portion of CSSD gauze and dressing pad are made. From one cotton
role 70 dressing pad are made and from one bundle 40 gauze are made. In one
packet 5 dressing pads are provided. Gauze is cut with electronic gauze cuter.
Items which are not used after sterilization and crosses validity period are
sterilized back without open it. Racks are provided for storing items.
 The time for accepting unsterlized materials is from 10 - 11 a.m. and 2 - 3
p.m. Special trays are also made available to hospital by CSSD. Items are
issued to department personnel strictly according to rules and after proper
entry in indent, which is later on transferred to other registers. The different
registers maintained in CSSD are:
 OT register  Ward register
 Instrument register  Stock register
LOCATION
It is located in the 5th floor with accessibility to elevators. The personal traffic and the
movement of supplies and equipment s accomplished in an efficient manner.
VI. FINANCIAL MANAGEMENT UNIT
The main components of Financial Management unit are:
1. Billing Department – It performs the day-to-day billing procedures, primarily,
dealing with the patients’ accounts, accounts payable and payroll.
2. Medical Account Section – It deals with budgeting, auditing and monitoring
functions
FUNCTIONS
 Maintains extensive accounting and statistical records
 Establishes patients’ accounts – A unique IPD or OPD number is assigned and
a file is opened for each patient.
 Posts charges for hospital services to patients’ accounts.
 Compiles all charges, and issues bills; also collects cash and unpaid bills.
 Records all financial transactions, including control of cash and recording of
purchases.
 Assists in preparation of hospital’s budget
 Coordinates with purchasing dept. for the purpose of verifying payments for
the goods and services received.
LOCATION
A front office is provided for billing and cashiering and a back office for work of
Medical Accounts Section demanding concentration and privacy.
ORGANIZATION
 Medical Accounts Section
Accounts Manager –1 Assistant Accounts Manager –5 Office boy –2
 Billing Department
Billing Executive –3 Head of the department -1

VII. NURSING SERVICES UNIT

Nursing services constitute the largest single group of hospital personnel and in
mainstay of the organization are responsible for providing comprehensive and
continuing nursing care to all patients in collaboration with other health care
personnel. Good nursing care results of coordinated administrative.
FUNCTIONS
 Nursing administration is responsible for:
 Maintenance of stable staffing pattern.
 Selecting and assigning nursing personnel
 Maintenance of proper nursing records for clinical and administrative
purpose.
 Coordination of the activities of various nursing units.
 Promotion and maintaining effective and harmonious relationship among
nursing personnel and between the nursing service dept. and medical staff, patients
and public.

HIERARCHY OF NURSING STAFF

Matron

Nursing Floor Supervisor

Nursing Superintendent

Junior Sisters

Nursing Assistants

VIII. INPATIENTS
Inpatients are the patients who require hospitalization and cannot be treated on
outpatient basis. When a patient is admitted in hospital, first of all a yellow slip is
made at casualty, then preceded to admission department, where information is given
regarding unoccupied beds and charges, patient can choose his choice of ward
category. Inpatient file is made and sent to reception where IPD slip is attached to file
and is forwarded to floor coordinator. At floor patient’s data is entered in computer.
Requisition is sent from floors to investigation departments, for inpatients, indent for
required medicine is also sent to medical stores and on discharge of patient spare
medicines are returned to pharmacy. Patient’s medical record is maintained at floors.
To discharge patient, discharge summary is made from summary department. It has 2
copies, original is handed over to patient and duplicate copy is retained in hospital.
This discharge summary is sent to all investigation department and medical stores to
clear all charges. Then it is forwarded to billing department.

DISTRIBUTION OF IPD
FIRST FLOOR
1. INTENSIVE CARE UNIT
ICU is meant for the most critically ill patient, which requires concentrated nursing
care. The unit is designed with this fundamental requirement in view.
No. Of Beds - 25
Nurse: Bed Ratio – 1: 2 & in case of emergency 1: 1
Other departments on this floor – Nephrology, Blood bank, Neurology, cafeteria,
gynecology, labour room.
SECOND FLOOR
This floor mainly consists of the wards, which are classified as
o Semiprivate Rooms 24 beds.
o Cardiac general Wards 5 beds.
o Noncardiac general wards 6 beds.
o Deluxe Room 2 beds.
o Private Room 2 beds.
STAFFING:
Coordinator 1 Floor Supervisor 1
Duty Doctor 2 Ward Boy 4
Nursing Incharge 1 Bai 4
Nurses 8 Sweeper 2

PAEDIATRIC NURSING UNIT

It encompasses the care of children. The pediatric care calls for understanding of
unique needs, fears and behavior of the children. Some cases may require protracted
convalescence ands educational therapy.
ORGANISATION
Discharge summary Room -1
Nurses Bed Ratio: General ward – 1:5 & Pvt. Room – 1:3
No. Of beds: 17
General Ward: 2
Semi- Private Room: 3
Private Room: 5
STAFFING
Coordinator: 1 Duty Doctor: 1
Nurses: 16 Bai: 3
Ward Boy: 1
FACILITIES
• Paediatric Wheel chair: 1 • Trolley: 1
• Adult Wheel chair: 1 • Stretcher: 1

SPECIALITIES
SCBU – Special Care Baby Unit
To provide special care and services to the critically ill Pediatric patients.
It consists of two units:
1. NICU – Neonatal Intensive Care Unit
Here the health care services are provided for the children up to age of 6
months. It has 3 sub-units
a) In Born unit – For the children born in CHL Apollo
b) Out Born unit – For the children not born in CHL Apollo but have
approached for health care services.
c) Septic unit – For the patients who are infected (both in born and out born)
2. PICU – Pediatric Intensive Care Unit
It’s meant for critically ill children aged 6 months to 12 years.
MACHINES
NICU:
 Incubator – 5  Photo therapy machine – 2
 Ventilator – 1
(Machines are shifted in the unit according to need)
PICU:
 Ventilator – 1  Monitors
 Centralized oxygen facility and  Weighing Machines – 2
suction facility  3 beds

STEP DOWN ICU

The patient who needs 24 hrs observations from ICU is shifted to step down ICU and
then shifted to wards.
No. of beds = 12
Staffing
Duty doctor-1 Ward Boy-1
Nursing Incharge- 1 Bai-1
Nursing Assistants- 1
MACHINES REQIRED:
 Monitor  Wall Oxygen
 Wall suction  Syringe pump
Other departments on 2nd floor are Dental, Ophthalmology, ENT.
THIRD FLOOR
Total rooms = 23
This floor comprises of wards, which are classified as follows:
 Private Rooms – 18 beds
 General Ward – 5 beds
 Twin sharing Room -6 beds
 Super deluxe Room -1bed.
ORGANISATION
Discharge Summary Room – 1
PFT (Pulmonary Function Test) room-1
Auditorium - 100 seats
Nurse: Bed ratio
• General Ward – 1 : 5
• Pvt Room – 1 : 3
STAFFING
Duty doctor-2 Coordinator – 1
Nursing Superintendent – 1 Ward Boy– 1
Nurses – 23 Transporter-1
Nursing Assistants-3 Sweeper-1
Floor Supervisor -1 Aya Bai - 3

FOURTH FLOOR
It comprises of:
 Deluxe rooms – 15 beds
 Super Deluxe rooms – 3 beds
 Physiotherapy department – 6 beds
STAFFING
Floor Coordinator – 1 Ward Boys – 3
Duty Dr. -1 Bai -6
Supervisor - 1 Shifting Boy- 1
Nursing Superintendent – 1 Sweeper - 3
Nurses – 14 Nurse/ Bed ratio =1:4
Nursing Assistants- 5

PHYSIOTHERAPY DEPARTMENT
This department provides a specialized rehabilitative service. Therapy is necessitated
as a result of surgery, trauma, stroke and other functional impairments.

STAFFING
Physiotherapist – 2
Nursing Assistants-1
There are two types of therapies provided:
I. Exercise Therapy
 Wrist Roll  Pulley Exerciser
 Shoulder Wheel  Hand Gym Kit
 Pronator & Supenator  Dumbles & Weight
 Foot Exerciser  Quadriceps Chair
 Rowing Machine  Stationary Cycle
Function: Increasing range of motion and flexibility.
 II. Electro Therapy
 Muscle Stimulator  Ultrasound
 Short Wave Diathermy  Interferential Therapy
 Cervical & Lumbar Truxion  Paraffin Wax Therapy

Function: Relief from pain, local tenderness and strengthening of Muscles.

RECOMMENDATIONS/ SUGESTIONS

 A separate fax machine and computer system must be made available to

mediclaim department.
 2 more monitors are required in step down ICU.
 Cash counter must be shifted near to billing department.
 Drinking water must be made available at 3-4 places in hospital, in hygienic
conditions.
 X-ray room should be expanded because the control panel should be far.
 Changing room, barium room and film drying room is required.
 Work area of CT-Scan and MRI should be expanded.
 Number of nurses in ward & staff at billing counter must be slightly
increased.
 OPD counter must be shifted to properly spaced cabin.
 BIBLIOGRAPHY

 Principles of Hospital Administration & Planning: B. M. Sakharkar

 www.chl-apollo.com
 www.erwaxman.com
 www.sify.com
 www.aims.com
 www.managementhelp.org