This report on the administration of Yashoda Hospital, Secunderabad is based on primary data which was collected by visiting the various departments and specialties in the hospital. The report describes the functioning of the hospital and the various organizational levels involved. It also talks about the different departments and how they function. This report can act as a window to the students of BITS regarding the working of the hospital.
It can also be useful for students to learn how an organization functions. The recommendations given at the end of the report can be used to improve certain facilities made available at the hospital. Table of Contents AcknowledgementI Abstract SheetII 1. Introduction1 2. Yashoda as an Organization3 3. Specialties Available5 4. Procedure for Patient Admission7 5. Summary of Departments visited9 6. Medical Records Department10 7. Medical Laboratory13 8. Credit and Billing Department15 9. Rajiv Arogyashree Health Insurance Scheme17 10.
Human Resources Department18 11. Conclusions20 12. Recommendations21 INTRODUCTION Hospitals are very important for health care and providing patient treatment by specialized staff and equipment. Hospital Management is an emerging field in the health care industry. It is very necessary to study the functioning of corporate hospitals as they have direct impact on the society. The main purpose of writing a report titled “ A Report on the orientation program at Yashoda Hospital, Secunderabad” is to learn the various aspects of hospital administration.
We have written this report under the guidance of Dr. R Gururaj as a part our evaluative component for Practice School- 1. Our learning process aimed at knowing the facilities, services and equipment available at Yashoda Hospital, Secunderabad. These hospitals are renowned for their medical expertise, excellent nursing care and quality diagnostics. Medical specialists on the hospital’s panel of doctors include some of the most distinguished names in the medical faculty. Yashoda Hospitals has consistently ventured to bring the latest medical systems in the world to its patients.
Yashoda Hospitals is ISO certified, its labs are NABL accredited and all our facilities are completely NABH compliant. Our report includes an overview of the various departments and the administration here at the hospital. The initial stages of our report includes the study of the working of the department Of Credit and Billing, Medical Records, Human Resource Management, Laboratories, Etc. The report includes the orientation program for PS- 1 that went on smoothly for two weeks. This program helped us to get acquainted with the administration of the hospital.
We have done a comprehensive analysis of these departments and are now familiar with the various aspects involved in Hospital Management. We have also included the various specialties that this hospital offers. The report also studies the procedure followed by the inpatients and outpatients in the hospital. Yashoda Hospital is strongly focused on delivering healthcare affordably, to the largest number of people. And the hospitals’ doctors, medical staff and administrative team are strongly aligned with this goal.
A culture of value permeates the organization, with each team member contributing to making our services more affordable to our patients. We interacted with the medical and administrative staff to collect data about the functioning of the various departments that function smoothly at the hospital. We were introduced these departments by the respective department heads who gave us a brief overview of the various aspects involved in Human Resource Management, Hospital Management, Credit And Billing, Medical Records and Laboratories.
Our periodic visits to these departments helped us in having firsthand information about the departments at the hospital. The website of the hospital helped us in gathering useful data about the history of the hospital. We familiarized ourselves with the various specialties and modern equipment available here through this website. The report then concludes with the various observations related to the analysis of our study. We have made efforts to explore the various aspects of the administration, services, facilities and equipment available at Yashoda Hospital, Secunderabad.
We have jotted down the overview of our orientation program which helped us choose our area of interest for the project to be submitted at the end of our learning tenure at the hospital. The report with its conclusions will help us dissect the fundamentals of administration at the hospital. We have used the data to make useful recommendations for upgrading the working of the various departments of the hospital. We have also made an effort to suggest improvement in the existing administrative conditions. Organized and reasonable recommendations are suggested at the end of this report.
Yashoda as an organization Yashoda Hospitals is a full fledged corporate organization in its structure. The hierarchy of the organization is headed by the Management – Dr. G Surender Rao, Dr. G Ravinder Rao and Dr. G Devender Rao. The Board of Directors is directly under the management and is the body in charge of the running of the hospital. The Medical Superintendent or Chief Medical Administrator reports to the Board of Directors and heads the various in-patient and out-patient departmental activities. The Medical Administrator of Yashoda Hospitals, Secunderabad is Dr.
Lingaiah. All the RMOs are under the Medical Superintendent. The major departments that play a vital role in the everyday functioning of the hospital are as follows: Clinical services: • Activities involving doctors and medication Outpatient department: • Deals with patients who consult physicians of the hospital without getting admitted into the hospital. • It involves: o Reception o Admission counter o Diagnostics o Pharmacy Casualty: • Accident emergency service • Ambulance service • Transport wing (for transporting patients within the hospital)
Diagnostics: • Radiographic (X-rays, MRI scans, CT scans etc) • Pathological (blood/urine/sputum tests etc) Pharmacy: • For supply of medicines and drugs to patients • IP and OP pharmacy operate separately Support services: • Non medical activities that support the clinical services • Includes: o Human Resource Management o Billing o Bio medicals o Bio informatics (medical records) o Security o Maintenance o House keeping o Hospital information systems o Security o Laundry o Catering Fig1. Hierarchy in Yashoda Hospitals
VARIOUS SPECIALITIES AVAILABLE AT YASHODA Cardiology Innovative and scientifically based treatments for heart disease have always been the hallmark of Yashoda Cardiology. Yashoda Cardiology is renowned for its expertise in Trans-Radial Procedures. The centre houses a Digital Flat Panel Cardiac Catheterization Lab. It is the first of its kind in Andhra Pradesh and provides new levels of diagnostic accuracy, facilitates life-saving cardiac interventions, minimizes complications, improves patient comfort, reduces hospital stay, and is cost effective. Neurology
The centre for Neurology at Yashoda is committed to provide the highest standards of surgical & non-invasive treatment based on latest technologies and procedures. The centre is headed by world-class neurologists and neurosurgeons and ably supported by a very competent clinical staff. Yashoda is among the first and very few centers in Andhra Pradesh to introduce Intra-arterial Thrombolytic Therapy for Acute Ischemic Stroke. Oncology This branch is subdivided into various other branches some of which include • Radiation Oncology • Medical Oncology • Surgical Oncology
Yashoda Cancer institute, Hyderabad, is an international quality 150 bedded Comprehensive Cancer Center with the ultra modern diagnostic treatment rendering systems, which are truly at par with developed countries. Yashoda Cancer institute is one of the most comprehensive cancers hospitals with facility for advance diagnostics systems including invasive diagnostics, outpatient & inpatient chemotherapy, non-chemotherapy (biologic) drugs, radical / supraradical & minimally invasive cancer surgery, palliative care, and other related cancer care needs Haematology
The department of Hematology at the Yashoda is fully equipped to handle cases relating to all Blood diseases that affect the production of blood and its components, such as blood cells, hemoglobin, blood proteins, the mechanism of coagulation etc. It also has a Day Care Chemo-therapy unit with trained onco nurses. Services: • Chemotherapy • Plastic anaemia • Neutrogena • Orthopedics From complex procedures such as Total Knee Replacement to Total Hip Replacement, fractures to sports medicine, osteoporosis to cervical disc prolepses, ortho surgeons at Yashoda use the latest medical procedures and cutting edge technology to care of the patients.
Yashoda Orthopedics comprises of internationally reputed surgeons with vast experience performing various complex procedures such as Lengthening and shortening of limbs, bone tumors, etc. The Physiotherapy department backs the centre for Orthopedics with highly qualified therapists and specialists Urology The Center of Urology at Yashoda Hospitals, India, provides diagnostic and surgical services for all kinds of illnesses affecting the kidney, bladder, urethra, prostrate and male genitalia in all age groups, independent of origin or cause of the disorder. The center for Urology has one of the highest success rates in kidney transplantations.
It also deals with Male sexual & infertility disorders, apart from endoscopic procedures such as Trans-urethral resection of prostate (TURP), Uretero-renoscopic lithotripy (URSL) and Percutaneous Nephro-lithotomy (PCNL). Nephrology Yashoda Nephrology is equipped with a state-of-the-art harmo dialysis and post-transplantation unit. It also houses a smooth running CAPD program. Facilities include a dedicated twin OT with Laminar Air flow specially designed for Organ Transplant, isolated and specially designed areas with all facilities for strict aseptic precautions for Post Transplant Recovery and a state-of-the-art Dialysis unit
ENT The center for ENT at Yashoda Hospitals has a team of surgeons whose credentials go beyond the ordinary. The team is one of the finest in the region with the expertise to handle any kind of trauma / emergency and also undertakes complex surgeries on a regular basis. World-class equipment such as flexible and rigid endoscopes, high-resolution video camera system and other accessories are used regularly in the treatment of patients. Procedure for patient admission, treatment and discharge The following is the summary of the procedure that a patient goes through when he comes for consultation or admission to Yashoda Hospital. When a patient first comes to the reception at Yashoda Hospital, Secunderabad, the receptionist fills out the personal information of the patient, assigns a unique identification number to him and then sends him to the required consultant in one of the Out Patient Departments. For outpatients, a medical case sheet is maintained which is sent to the consultant along with the patient. Each Out Patient Department has its own counter where further information about the patient is filled up in the outpatient file before his seeing the consultant.
The consultant then orders diagnostic tests to be done on the patient and after taking these tests, the patient returns to the consultant. If the patient can be diagnosed and treated without having to take admission, he is discharged and can buy his medicines from the Outpatient Pharmacy and leave the hospital. > If however, the consultant decides that the patient warrants admission, he is sent to the admission desk with a note from the consultant. At the admission desk, a case record is filled out with the demographic data of the patient, a consent form is signed, and also the details of payment are discussed and an advance is usually paid.
In case of credit patients, the details of insurance or a letter of credit from a company is shown at the admission desk. After the formalities at the admission desk are completed, the patient is shifted to the ward after being assigned a unique identification number called IP number. At the ward, the duty doctor fills up the patient history and other parameters. > After that, the duty doctor calls the consultant who recommended the patient for admission, to come to the ward and examine the patient. The consultant then comes to the ward and evaluates the patient and also calls in other specialists for cross referencing.
The consultant then orders more tests if required and then recommends a course of treatment. If surgery is required, the patient has to sign a surgery consent form. As the treatment continues, the progress of the patient is recorded. The medication given to the patient when he is admitted comes from the Inpatient Pharmacy. After the patient is cured, he is discharged from the ward and can leave the hospital after finalizing the bill for the hospital stay and course of treatment. The patient gets a discharge summary in which the final diagnosis, course of treatment, outcome, doctor’s recommendations etc are written.
If the patient requires any medicines after getting discharged, he can buy them from the Outpatient Pharmacy. EMERGENCY CASES: The above procedure is for non emergency cases. For emergency cases like accidents etc the patient is admitted to the 24 hr casualty ward where the casualty doctor examines the patient and assesses the situation and calls in the required consultants. In the cases where foul play is suspected, the duty officer in the casualty ward has to inform the police about the case and a copy of the FIR is kept in the case sheet. Such cases are medico-legal cases (MLC) with a unique MLC number apart from the IP number.
Once the patient is stabilized he is shifted to a regular ward and the required formalities are completed. [pic] [pic] FIG: Procedure for patient admission, treatment and discharge Summary of Departments Visited During our orientation at Yashoda Hospital, we were taken to various departments like Insurance and Billing, Medical Records, Diagnostic Laboratories and Human Resources. The following is a brief summary of what we learnt in each department. Insurance and Billing: Dr. K. Lilly, the RMO for credit patients of the Insurance and Billing department gave us an introduction to the working of her department.
According to the mode of payment, patients who come to Yashoda Hospital are classified as cash patients and credit patients. Credit patients are those who have health insurance or are employees of companies which have an agreement with Yashoda like BHEL, BSNL etc. The Credit Billing department is responsible for looking at the insurance details and finalizing the total bill of credit patients and sending it to the insurance companies. The work of this department starts from the admission desk itself. This department has both medical and non medical personnel. Medical Records: We were oriented to the Medical Records department by Mr.
Prabhakar, the records manager. He gave us an introduction to the structural and hierarchal divisions of the hospital. Also he told us about the activities of the Records Department. This department is responsible for maintaining the medical records of all the patients admitted to Yashoda Hospital. There are three types of cases: general cases, medico-legal cases, and death cases. The documentation for these is slightly different. Also we were told about the different components of each type of case sheet. Diagnostic Laboratories: We were oriented to this department by Dr. B. Lakshmi, Chief of Diagnostics.
For diagnosing a patient, lab work is crucial to find the biochemical parameters affected by the disease. Also lab results are used to monitor the progress of a disease or treatment. The department is further divided into Clinical Pathology, Histopathology, Serology, Clinical Biochemistry and Microbiology labs. Dr. Lakshmi also told us about the various inventory control and quality control practices adopted at the Yashoda Hospital laboratories. Apart from internal quality control, Yashoda is also a part of the external quality assessment program EQAS conducted by the US based Bio-rad Laboratories. Also, all Yashoda labs are NABL accredited.
Human Resources: We were addressed by Ms. Vasu Shrivastav, manager, Human Resources Department. She told us a bit about the history of Yashoda Hospital and also told us about the various HR activities conducted by her department. HR department is divided into three: general HR which deals with recruitment, employee relations etc , training, and wage and salary. The department is responsible for the 360 degree performance appraisals where all employees are evaluated by themselves, their superior, two of their colleagues and their subordinates. Based on these performance appraisals, various rewards and incentives are given to employees.
Several welfare activities like celebration of birthdays and anniversaries, carrom and chess competitions, picnics for nurses, award functions, Christmas celebrations etc are also conducted by the HR department. Medical Records Department A medical record is a systematic documentation of a patient’s medical history and care. These records which comprises the total of each patient’s health history, intensely personal documents and there are many ethical and legal issues surrounding them such as the degree of third-party access and appropriate storage and disposal.
The information contained in the medical record allows health care providers to provide continuity of care to individual patients. The medical record also serves as a basis for planning patient care, documenting communication between the health care provider and any other health professional contributing to the patient’s care, assisting in protecting the legal interest of the patient and the health care providers responsible for the patient’s care, and documenting the care and services provided to the patient.
In addition, the medical record may serve as a document to educate medical student physicians, to provide data for internal hospital auditing and quality assurance and to provide data for medical research. Functions of the medical records department: 1. To develop and maintain good medical records 2. To generate hospital statistics 3. Reporting to state and health agencies 4. Quality assurance Yashoda‘ s medical records department headed by Mr D Prabhakar, the records manager maintains the best in and out patient records. This department maintains complete, adequate and accurate records of its patients.
The process of medical documentation starts from registration desk. Apart from classifying patients into IP and OP, they are primarily classified into three cases: 1. General cases – normal patients come under this category 2. Medico legal cases – these cases generally include accident and emergency cases which need further legal proceedings, etc 3. Death cases – in case of death of patients Documentation: For every patient either IP/ OP, a unique id number is issued and a case sheet with the same id no. is opened which are further classified based on the type of the case involved.
The medical records primarily contain Case records – this contains the general details of the patient, complete patient history etc. • Consent form of the patient • Infection control • System checkup • Progress reports • Medication chart & diagnosis reports • Activity chart • Doctors’ notes • Nurses’ notes • Discharge summary • Bill sets and insurance/credit details in case of credit patients. Procedure: At first, a document containing the demographic data of the patient is made with the assigned id number followed by the systematic review.
This is common for both ip and op patients. And now if it’s a general op case then they are headed to the concerned consultant doctor and the documentation process continues with the doctors notes followed by the medication chart and finally ends with the bill sets. For a general IP patient after the systematic review they are taken to the ward with the doctor’s consent for admission, where the duty doctors take the patients details. In such cases documentation includes the doctors’ notes, nurses’ notes, medication, dietary charts, diagnosis sheets, bill sets, etc.
