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Challenges in implementation of
FMS as per NABH stds
Dr. Sidhartha Satpathy
Professor De tt of Hos ital Admn
AIIMS, New Delhi
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Why is safety required?
Stan ar s in FMS
Challenges faced in hospitals
Country specific issues!
Conclusion
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Forms ma or com onent of the structure
criteria defined by Prof. Donabedian. Gets a lot of attention as it is tangible!
Consumes substantial amount of the capital
expenditure in any hospital/project.
A large number of statutory issues have to be co-ordinated with various agencies.
Covers disaster management issues involving thehospital and local agencies.
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Provision of a safe and secure environment for
patients, families, staff & visitors. Conducts regular Facility Inspection rounds, and takes
Provides for safe water, electricity and manifold
system.rogram or c n ca an support serv ce equ pment an
management.
Plans for emer encies within the facilities and the
community.Manages hazardous materials in a safe manner
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Massive fire at AMRI hosp, 90+ persons
lost their lives incl 4 staff
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against hospital TNN Oct 27 2012 04.23AM IST Neonatal Intensive Care Unit| Institute of Medical Sciences
KOLLAM: The parents of a two-day-old baby, who died at the Shanker's Institute of MedicalSciences (SIMS) here on October 19, has alleged negligence on the part of the hospital authoritiesfor the death. Based on a complaint by Shyamkumar, the father of the newborn, Kollam East police
.
Shyamkumar has alleged that the hospital authorities cheated him and his relatives by hushing upthe real reason behind the death of the child. "There was a large burn on the back of the child andwe were not informed about it," he said. It was on October 17 that Shyamkumar's wife, Bismi, wasadmitted to the hospital for her second delivery. She gave birth to a baby girl the next day. The child
. . ,
baby was taken to the Neonatal Intensive Care Unit (NICU) by one of the nurses saying that thechild had developed some complications. Shyamkumar said the child looked healthy then. By nextday morning, he was informed that the baby's condition was serious and it was put on ventilator.But, it was on Sunday last that Shyamkumar got to see the large burn mark on the back of the babyin the photographs taken during the time of preparing the inquest. One of his relatives, a doctor,suggested that the burn might have been caused by the incubator or warmer in the NICU.
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2010, faulty indigenous equipments blamed
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Disaster affected hospital, where 50+ patients died
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..system in place to provide a safe
and secure environment,
implementation, .....
at ent sa ety ev ces are nsta e across t e
organization and inspected periodically.
Facility inspection rounds-Once or twice/year,documented, corr & prev action taken
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FMSFMS..22::The orgns environment andfacilities operate to ensure safety
, ,
visitorsFacilities are appropriate to the scope of services of
the organization.Up-to-date drawings are maintained which detail
the site layout, floor plans and fire escape
.Adequate space, signposting, potable water &electricit , testin , and maintenance lan
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FMSFMS..33 The organization has a
programme for engineering
a) The organization plans for equipment
qu pmen s se ec e , ren e , up a e orupgraded by a collaborative process.
maintained as required.
,documented maintenance plan for elec, HVACwater tanks, DG sets, BMW equipment etc
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First Revision 1983
Second Revision 2005
pages
Published by BIS
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Sin le document in which info from various
Indian Standards is compiled It lays down minimum provisions designed to
protect the safety of the public esp. withregard to
Provisions related to EQ safety
Fire hazards & safet
Health Aspects of buildings
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It also covers aspects related to
administration of regulations development control rules
stipulations regarding construction materials
rules for design of electrical installations, lights, A/c, lifts requ rements o vent at on an accoust es
requirement of plumbing services viz. water supply,drainage and sanitation
measures for safety of public/workers rules erection of signs and outdoor display structures
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Part 1: Definition Part 2: Administration
Part 3: Development Control Rules and GeneralBuilding requirement
Part 4: Fire and Life Safety
Part 5: Building materials ar : ruc ura es gn
Loads, forces and effects
Soils and foundation
Timber and Bamboo
Masonry Concrete (Plain, reinforced, pre-stressed)
Steel
Prefabrication, systems building and mixed/components construction
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safety
Lighting and ventilations
A/c, Heating and mech. Ventilation,
Installation of lifts and escalation
Part 9 : Plumbing services
Part 10: Landscaping, signs and outdoor
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FMSFMS..44 The organization has a
programme for bio-medical
a) The organization plans for bio-med equipment
qu pmen are se ec e , ren e , up a e orupgraded by a collaborative process.
maintained as required.
staff, periodically inspected & calibrated, propermaintenance plan.
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`Medical device'- means any instrument, apparatus,
imp ement, mac ine, app iance, imp ant, in vitro reagent or
calibrator, software, material or other similar or relatedarticle:
a) intended by the manufacturer to be used, alone or in combination, for humanbeings for one or more of the specific purpose(s) of:
-diagnosis, prevention, monitoring, treatment or alleviation of disease,-diagnosis, monitoring, treatment, alleviation of or compensation for an injury,
-investigation, replacement, modification, or support of the anatomy or of aphysiological process,
-supporting or sustaining life,
-control of conception,-disinfection of medical devices,
-providing information for medical or diagnostic purposes by means ofin vitro
b)
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e ca ev ce e n on
which does not achieve its primaryintended action in or on the human body
by pharmacological, immunological ormetabolic means, but which may be
assisted in its intended function by suchmeans.
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,
maintenance, repair, user training and-
by clinical engineering. Medical equipment is
treatment of disease or rehabilitation
.
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injured in adverse events involving medical devicesas er stud in NHS, UK
In a stud ublished in 2004 b Brockton J Hefflin etal in USA, during a one year period, reports of 10,395
medical deviceassociated adverse events were
accumulated using the National Electronic InjurySurveillance System(NEISS)
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database (maintained by the Agence Francaise deSecurite Sanitaire des Produits de Sante), devices for
ventilation and infusion, and monitors of all kinds
accounted for most of the reports, representing 37%,an respec ve y, o a repor s.
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Technology Review(2012) 664 medical equipments at
Beth Israel Med Center were found using outdated
opera ng sys ems w r s o ma ware n ec ons
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FMFM .. Th r niz i n hprogramme for medical gases,
vacuum an compresse air
procurement, handling, storage, distribution,
usage and replenishment of medical gases.b) These are handled, stored, distributed and
used in a safe manner
c) Safety issues, alternate sources, operational& breakdown plan should be available.
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FMSFMS..66 The organization has plans
for fire and non-fire emergencies
w t n t e ac t es
early detection, abatement and containment of
fire and non-fire emer encies.
b) Documented safe exit plans must be available,
c) Mock drills shd be held at least twice in a year,
.
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Table top exercises and mock drills will
not succeed during actual disasters!!
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FMSFMS..77 The or anization lans for
handling community emergencies,
ep em cs an o er sas ers
emergencies.
e organ zat on as a ocumente saster
management plan, tested at least twice/year
c) Prov of medical supplies, eqpt; along withstaff training reg their role.
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FMSFMS..88 The organization has a plan
for management of hazardous
a) Hazardous materials are identified within theorgan za on.
b) The organization implements processes for
transporting and disposal of hazardousmaterial.
c P an or manag ng sp s w t sta e ucat onand training in handling such cases.
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PLEASE
REGISTER
TOCONTINUE
USING THIS
SOFTWARE
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Safety Cultureafety Culture
done around
.
looking!
Stuart Matthews