People tree hospitals is 5 years old today. A hospital which was conceptualised by a group of doctors who left their cosy jobs to turn a warehouse into a fully accredited NABH hospital in five years. It provides acute and elective care to patients who come from far and wide. Currently, the hospital treats more than 80,000 patients per year caring for approximately 6000 inpatients and performs around 2400 surgeries in a year. There is a provision of tertiary level service in almost all specialties. One of the most important tenets of the organisation was to develop a culture of patient safety and quality care with affordable cost.
Over the last 50 years healthcare in India has changed dramatically and life expectancy has increased from 30 years to 70 years. This has been possible in India because of advances in medical and surgical care, national policies, rapid strides in healthcare delivery, emphasis on preventive care and adoption of advanced technologies and local innovations. As a result, increasing life expectancy has led to an increase in spending on healthcare. Over the years however, India has experienced a growing trust deficit between doctor and the patient. It is often assumed that the quality medical care is provided but transparency and accountability is not.
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In 2014 the Commonwealth fund named the NHS (National Health Service, UK) the number one healthcare service for safe care. With almost 50% of the doctors at People Tree Hospitals trained in the UK or other parts of the developed world, it was important to let the lessons learnt elsewhere to be ‘put in action’ and ‘create a model’ for safe and quality health care to be delivered to our population. It was also very important for us to constantly improve and find cost effective solutions.
Bringing in openness and transparency in reporting healthcare related adverse events is one of the biggest challenges in a health care organisation. Creating a blame free culture and structuring a safety net for adverse events through education and learning is the key to this success. This will enable us to find the root cause of the problem and find solutions in the Indian milieu.
Setting standards for quality and safety
Working in India is a challenge. There is a evident contrast of highly qualified doctors practicing in a divergent environment where one works in a severely resource constrained environment or with support staff who are inadequately trained. Bringing this together with the aim to provide the best care for the patient is a challenge.
📷 Healthcare guidelines, protocols and practice of evidence base medicine
The development of guidelines based on high quality medical research started almost at the end of the last decade (NICE guidelines). The move towards guideline based and evidence base practice has resulted in standardization of the care provided to the patient across the world. Some of the major changes which we have incorporated from the international recommendations were in the treatment of stroke, (with door to needle time of less than 60 minutes), management of acutely ill trauma patients, patients with cardiac arrest and screening at risk patients for local illness. This has proven to be effective in reducing morbidity and mortality due to illness.
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📷 Developing quality infrastructure and IT based systems
Developing quality infrastructure for rapid diagnosis and adequate treatment is paramount. The hospitals are well equipped with the support system of laboratory medicine and imaging. State of art operation theatres with Intensive Care Unit and recovery room helps us to provide quality care further. Developing robust IT system linking diagnostics with therapeutics had improved turned around time for patients. These are regularly audited to improve patient experience. 📷
📷 Compliance with regulatory body
Once the government standards have been set it is very important for us to adhere to it. There are almost 40 regulatory licences which needs to be complied to run a Hospital. Being open and transparent we have always welcomed any scrutiny. The first milestone which the hospital achieved was to become NABH Safe I (Certification for infection control practices). Our stringent Infectious Disease Control practices like high standards of hand hygiene, minimal catheter associated infections and hospital acquired infection, very low incidence of superbugs and a stringent antibiotic policy resulted in us being awarded NABH safe I within first year of commencement of the hospital.
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📷 Medical and Nonmedical audits
Audit is a quality improvement exercise which People Tree Hospital conducts on a monthly basis. This stringent exercise closely monitors patient safety issues like hospital borne infection, patient experience, patient feedback and drug errors. This has helped us to provide corrective actions and integrate new services and develop a multidisciplinary care model to improve overall patient experience. 📷 📷
📷 Education learning and development
One of the important traits of a good medical organisation is the time given for staff education. This has proven to improve the capability of staff and enhances staff experience. The hospital leads from the front in nursing education in almost all areas of care (Operating room/emergency/ward care and specialist nursing). We conduct regular seminars, work place assessments and certification courses. There is also an opportunity for staff to visit other centres of excellence to enhance skill sets and adapt newer practices to incorporate at People Tree Hospitals. The recruitment of doctors is through a standardized credentialing and privileging platform so as to recruit the best talent and nurture them to become medical leaders. Medical professionals are encouraged to attend regular conferences and workshops in order to maintain and improve their knowledge and skills. In an endeavour to train the next generation of healthcare professionals, People Tree Hospitals has started courses (DNB Orthopaedics, Fellowships in Paediatrics and Registrar positions in many other specialties)
The regular morbidity and mortality meetings are also another source of constant learning and improvement as we seek to identify the root cause of a critical event. 📷
Safety does not happen by accident
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📷 Research and innovation
Although India is a country of 1 billion people, medical research is still in its infancy. Being a doctor driven hospital, we wanted a shift of paradigm from medical care to cost effective care. By partnering with Atria medical research, we hope to bring in medical innovations and cost effective treatment strategies to the Indian population. We are proud to state that we are constantly presenting and publishing our work in medical forums and journals. We are also recruiting patients for more than 12 trials which we hope will benefit the patient population.
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Conclusion
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