Not All Santa's Wear Red - Some Wear White!

Season's Greetings - A Special Message from Dr. Wasim Ghori

Dr. Waim Ghori, M.D.

Dr. Wasim Ghori is the Medical Director & Consultant Diabetologist, Heart & Diabetes Clinics, Mumbai.

In this article, he takes stock of the current COVID19 situation and how healthcare workers have gone the extra-lengths to highlight the work and efforts to provide care and relief, saving lives at the risk of their own.

 

Nine months may as well be a lifetime!

The COVID-19 pandemic has left its mark on the entire world and will continue to do so well into 2021.

2020 has been a tough year. It will always be remembered as the year a virus brought the world to its knees - locked down, shut away and isolated.

But more than that, it will be remembered as the year the medical community and health workers across different countries, cities and villages stood bravely on the frontlines of a war against COVID-19, in the face of a highly infectious and unknown virus, to save lives – often at the cost of their own.

One of the groups most affected by the outbreak has been those in the hospitals taking care of people infected by the virus. There were doctors, nurses, ward boys, janitors, pharmacists, ambulance drivers, morgue attendants, bio-waste sanitation staff, medical officers, community health workers, ASHA workers, inoculators – too many to count, in hospitals, clinics, isolation facilities, clinical wards, ICUs, health centres, nursing homes across India and across the globe - their valiant effort keeping us safe, looking after infected patients, providing them not only medical aid, but also the emotional support & care they needed in isolation.

The conditions were supremely tough – stigma to begin with, long hours in suffocating hot PPE kits, dehydration, hunger, separation from their own families, the constant threat from the virus. They didn’t back down. They fought valiantly.

In a year defined by what will likely be the biggest health care crisis of our lifetimes, tens of millions of doctors, nurses and caregivers have demonstrated courage, compassion, stamina and selflessness unlike anything we have seen.

These medical bravehearts have bravely gone above and beyond in looking after those affected by the Pandemic. As the COVID-19 virus spreads across the globe and researchers mobilized to develop a safe and effective vaccine, healthcare workers adapted and innovated to serve their communities.

A mere thank you does not begin to convey the gratitude we feel for health care workers. Neither it does bring back the lives we have lost to this virus, nor does it make up for the unrelenting stress caused by isolation from friends and loved ones.

Furthermore, the pandemic has exposed many of healthcare industry’s shortcomings, but it has also highlighted many opportunities to re-imagine the future of care.

Opportunities to simplify access to data-driven insights, to improve the interoperable exchange of critical health data and to address the crisis of healthcare workers' burnout.

As we enter the New Year, I’m optimistic and confident that together we can advance the pace of improvement. We all know health care is too important to stay the same.

As we near the end of a demanding and tumultuous 2020, with the next bringing the promise of a vaccine, I want to express sincere gratitude and appreciation to all my friends, colleagues and frontline health workers around the world who have sacrificed so much in the fight against COVID-19 and helped the world back on its feet.



I take this opportunity once again to let you'll know that I greatly value our friendship and association and wish all of you and your loved ones - Happy Holidays and a Sparkling New Year 2021 - one that's built on Prosperity, Happiness and Strong Foundations.

Here's to Sweet New Beginnings....

Dr. Wasim Ghori
Consultant Diabetologist
Brand Ambassador - Education UK, British Council
Brand Ambassador - Association of Healthcare Management Professionals, AHMP, India
Director - Indian Economic Trade Organization, IETO

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Interview of Ms. Ekta Modi, Chief Operating Officer of Parul Sevashram Hospital, Vadodara, Gujarat

Ms. Ekta Modi (MBA; Healthcare Administration) represents Parul Sevashram Hospital as Chief Operating Officer, is a dynamic person and has a 16 plus years of strong experience in diverse areas of Healthcare; a firm believer of Patient Centricity approach model. She has honour of undergoing the prestigious “Management Development Program” from AIIMS (New Delhi), is a known speaker at many renowned forums for Customer Delight, Human Resource engagement, Networking and Inter=disciplinary approach, Digital Communication & Branding areas.

She is QAI Assessor for QAI Patient Safety Hospital Standards, Certified by NABH for Ethics Committee Standards, Certified as Internal Assessor for NABH (Programme on Implementation – 4th Edition), Certified by NABH for “Continual Quality Improvement, Tools and Techniques” and is also a Certified by NABH as Internal Assessor for “Nursing Excellence”. She was awarded a Gold Medal for a 50 hours course in Total Quality Management (TQM).

Ekta is a strong believer in work ethics, teamwork and Quality is the focus of all her work.
Hello Ekta, First of all, congratulations on your new Role as Chief Operating Officer at Parul Sevashram Hospital (Affiliated to “Parul Institute of Medical Sciences and Research”) Vadodara where it is located, is a place of cultural importance in the glorious history of the State of Gujarat. It’s a pleasure to be connected and interacting with you. Looking forward to some great insights from you on your role and functions of a Hospital.


CC.1    As the head of a Hospital’s Chief Operating Officer, how does your typical day start and what are your top priorities?

EM:     Thank you for letting me to share my experiences on practical Healthcare management. The best thing about working with Parul Sevashram Hospital is you start your day with National anthem. No two Days are the same!  Usually, I start my day with random round from random departments with random floor so it does not become predictable and keeps every on their toes. Making the best use of technology, click few pictures of unusual observations and areas of improvement and send them to required personnel to ensure that things are timely closed with evidence. My only top most priority remains “patient satisfaction” and so I ensure the actual satisfaction in all areas like nurses, doctor, cleanliness, food, etc. during my rounds. The other areas include troubleshooting of routine things! I have trained my eyes to pick and observe the most minutest of things which helps me improve the things around.


CC.2    What is your strategy for managing your human resources – are you a strict disciplinarian or you take people along, building teams?

EM:     I always believe and work on only one principle “Involve and Empower”. Unless I involve my people in the work process and empower them to the responsibilities, the desired outcome will not be achieved.

Conducting daily post lunch meetings helps me to ensure that the follow up mode of task completion is in process. I am a strict disciplinarian for getting things done at right time and ensure that it’s done through Teamwork (Together Everyone Achieves More).


CC.3    Which of the issues are more demanding of a Operation Manager’s time – Consultants, Patients and their grievances, Staff (Nursing, Administrative, support, Recruitment, Attrition, Discipline), infrastructure related issues & breakdowns?

EM:    The issues mostly have the Triangle relationship: Patient’s problems, Staff issues (availability and behavioural issues) and breakdown problems. Communication as a catalyser! I have observed and realized that most of the problems arise due to communication issues. Major challenge includes keeping me and staff up to date on new policies and procedures. This might mean attending offsite conferences and trainings, holding staff meetings, and implementing training programs for individuals at every level of the organization.


CC.4    For a Hospital to function like a well-oiled machine, the working relationship of a COO with the CEO and with the rest of the team below is very crucial. Please narrate some of your personal experiences and your recommendations to streamline them.

EM:     Usually, a big part of our job is behind the scenes!
We may not hold a scalpel, but play a critical role in keeping hospitals on the cutting edge of medicine and healthcare delivery management, budgeting, operations and compliance. This demands an intimate understanding of both the business and healthcare worlds. Every day, we operate with one goal in mind: to keep all the different parts running smoothly, effectively and cohesively to create a well-oiled centre for exceptional patient care. One of the most exciting aspects of this high-level management position is that no two days are alike. In eight (read nine, ten or even twelve at times!!!) business hours I am likely to apply a number of different skill sets to various tasks. It’s like beginning the day in my office reviewing the most recent financial reports and managed care contracts before heading to a meeting or regarding hiring the hospital’s staff.


CC.5    In a crisis situation, what is your mantra for handling them?

EM:     Crises often come without warning. A Hospital comes under dynamic, fast-paced environment that is typically open 24/7, and we should be prepared to answer after-hours calls or address emergencies at a moment’s notice. I may not set foot in an emergency room, but crisis management is an essential skill for someone in this position. It’s like tactfully dealing and understanding how to pivot gracefully without missing a beat. Modification works! Just modify the things as per the priority and usually it serves the purpose. Sometimes, the solution to some major problems is the most simplest and vice-versa. It has to be seen from a different perspective and requires some training, skill and experience.


CC.6    Do you sometimes feel that you do not have enough resources to accomplish the wide range of tasks or to manage a huge organisation like a Hospital or a Medical College?

EM:     Yes, the resources are always in scarcity! It makes me wonder whether it’s a Stopping point or stepping stone. But Practice pays off. The task is to balance Hospital and ambulatory operations, Employment and staffing, Facilities and infrastructure planning, operational excellence, PR/communications. It is similar to Exercising of vision & constantly challenging the status quo. To make it simple, it’s challenging to penetrate the thoughts of an employee’s mindset; the vision of director and trustee here “Quality can be achieved in quantity also”. Change is the only thing that remains constant. Change in culture, working pattern of key departments and enthusiastic staff will help in exercising the vision.


CC.7    Hospitals are blamed for not being patient-centric. Please Comment.

EM:     It is because we aim for person specific approach and not system specific approach! There are many reports and analysis of internal hospital resources stating that patients are not satisfied with their treatment provided in the hospitals. The common reasons of patient's dissatisfaction are overcrowding, long waiting time to meet doctors, short consultation period (average of 2 minutes), absence of a congenial environment, and communication gap. It is a well known fact that there is frustration with systemic problems too. It is evident from management studies that, if we have to give better output without changes in the input level, we have to improve our existing processes. Improvement of any system is possible by proper system analysis, system design and effective implementation.


CC.8    Do you agree that the term “Patient Satisfaction” is relative? How can it be increased and sustained?

EM:     Team-based treatment works. With the inclusion of machines in work processes, brought by the Industrial Revolution, the management of production of goods and services has become a matter of concern among managers of organizations, since quality assessment, which had been based on inspection, is now evaluated on the basis of customers' perceptions, or those who actually "consume" the product. This is now becoming Crucial in Healthcare too. Quality assessment is a cause for concern among health service managers, and for that reason, it is important that its implementation occurs by means of instruments and systematic techniques, so the managerial process achieves a rational and strategic vision of quality, with decision making oriented toward continuous improvement of processes and products, that is, care services.


CC.9    Across the country, Hospitals have been vandalised by relatives of patients, Why is this happening and what solutions would you propose?

EM:     Instances of rude behaviour and vandalism by irate patients’ attendants and damage to hospital property are becoming a common occurrence. Not only has it led to meaningless damage to property and resentment among hospital staff, but also to disruption of patient care activities adversely affecting the treatment of other patients. Often there are situations where the attendants overcharged with emotions and resentment due to negligence/alleged negligence on the part of hospital staff (leading to damage to/death of a patient), start manhandling the staff as well as damaging the hospital property. Education and Awareness is the key to limit this to an extent! Informed Signages, record of proper documentation, audio visual records are some suggestive measures.  Also, such errant behaviour is not a good sign of our times and for the healthcare system. People should try to seek dialogue for their problems and at the same time, the healthcare providers must be as transparent as possible, keep the communication lines open and take the family in confidence in the event of any adverse situations.


CC.10  How does having Quality Management Systems and Accreditations like JCI, NABH different a hospital from the rest of the Hospitals?

EM:     In spite of the barriers related to the organizational culture and staff turnover, accreditation is mentioned by managers as beneficial to the quality of management and care because, through the standardization of processes and user centralization, the provision of care services is focused on quality. Among the benefits of hospital accreditation, which are mentioned by many professionals, there is greater safety in care of patients and in professional activity, standardization of techniques, support on the scientific nature of care, and better working conditions, which tend to be oriented toward excellence in the care of patients.


CC.11  What measures should be taken to ensure that Quality Management systems in a Hospital remain consistent and sustained?

EM:     When you open the discussion about accreditation, you discuss quality management; you focus on the person of interest: the patient or customer. When you put the end-user at the centre of these care processes, everything is solved. But many will agree with me, that major incidents are not reported!
So to know about the lapses, incident reporting and proper corrective & preventive measures are important.


CC.12  Which are some of the most typical and critical areas a Quality Manager must have her/his eye consistently zoomed in where lapses are likely to occur?

EM:     Standardization of Quality Process - Standardization is a difficult and time consuming task, maintaining the Quality Improvement Culture, medical records management, patient satisfaction and infection control. For me, it starts from Patient Identification right from OPD Registration to Patient Satisfaction at time of discharge. Our eyes have to be like CCTV areas to monitor the implementation of SOP and Processes.


CC.13  A common question that I frequently ask is “what must be done to educate citizens about seeking care at Accredited Healthcare organisations”?

EM:     Inform, Involve and Imbibe! Use the available technology to spread the word. For common people, it is virtually impossible to get information of these internal functions of the hospital or to understand how it affects their healthcare. This limitation on part of patient group many time results in selection of hospitals that lack basic quality features necessary for providing medical care to patients. Thankfully, there is a solution to this problem in form of ‘accreditation’, which is a mark of quality in hospitals.


CC.14  A fresher with a Master’s Degree in Hospital Administration finds himself at sea in a Hospital scenario. What were your personal experiences and what change would you like to recommend to Institutes offering such courses?

EM:     While medical graduates generally take care of the more technical aspects of hospital administration, non-medical graduates handle the operational aspects. The tasks would typically involve managing the staff, health services, technology decisions, IT management and working under a given budget. Practical case studies with guided leadership are the need of the hour! They have to come out of the copy-paste era. The Institute should focus on the ground level necessities like managing the task on your toes most of the time & Intense work pressure as a part and parcel of this job profile. This will make the transition smooth.


CC.15  What will be your 5 key recommendations to young professionals seeking to pursue Hospital Management as a career?

EM:     Hospital management and administration is concerned with the organization, coordination, planning, staffing, evaluating and controlling of health services for the masses. The primary objective is to provide quality healthcare to people and that too in a cost-effective manner. Just assure to follow Step by Step Process, Critical & Creative Thinking, Implementing leadership skills, Adaptability, and DOING things rightly at right time!


Ekta, I thank you for taking time from your hectic schedule to share your deep insights which I am sure will be helpful to the readers.

Disclaimer: The thoughts expressed by Ekta here are her personal and do not represent or relate to any person or organization!