Observation on Free Hospital

To eliminate needless blindness Aravind Eye Care System VISION To eliminate needless blindness MISSION To eliminate needless blindness by providing high quality, affordable, compassionate eye care to all

Medical Record Department Free Hospital Medical Record Department Counselling Ward Refraction Outpatient Operation Theatre

Scope of Services & Function Surgery for Cataract Refractive Error General Eye Problem Special surgery for Glaucoma, Retina & Cornea Time: 7.00AM to 5.00PM We provide the EYE care service to all people

Infrastructure Total land area is 12000 sq.ft ; Building area 7000 sq.ft Pharmacy Optical Operation Theatre Canteen

Process flow of Free Hospital In our Free section we follow the Route card system for guiding the patient 1.New Registration When the patient enter into the hospital we provide the ID card for availing treatment. Registration and investigation record all kept in EMR 2.Vision Test This is measure the actual vision of the patient (Snellen Chart)

3.Primilnary Investigation Based on the vision test Doctors collect the Health History of the patient and slit lamp verification; they suggest for DUCT, Refraction. Those who are above 40 years they also suggest for Duct. 4.Refraction If patient have refractive error problem, the Dr. suggest to refraction test. In this section they were using the different type of instrument for correct the refractive error.

Refraction Instruments. Auto Refraction - its help to find the actual power of eyes Trial Set – Lens Box ( Concave & Convex Lens) Cylinder lens – one side movement Medox rod lens – Squint Measure Occutor – Blocking lens Pin Hole & Multiple Hole Lens Steno pix lid – Cylinder & Axis Measure IPD – Inter Pupillary distance Retino Scope

5.DUCT RAF - Royal Air Force Its help to find out eyes accommodation & eyes muscular balance Prism bar – It helps to find the weakness of the eye. Snellen Chart Near Vision Chart 5.DUCT It is an investigation of find the water blocks in the eye; mostly the test suggest for those who above 40 years & Cataract persons

Medicine for DUCT Aurolig - Pain killer Aurocol – Antibiotic Auto rub – Hand wash if the patient have free in puctum they allow for surgery. If the patient have not free in puctum they refer to orbit clinic in pay section. In orbit section they conduct the some investigation like lacrimal duct & Dr. Diagnosing based on the advise the allow minor surgery DCT & DCR If patient not affordable they charge only Rs.500/- for Blood test.After surgery they allowed for Cataract surgery.

6.IOP & BP 7.Dialatation 8.Final Examination Intra Ocular Pressure to find the pressure of the eye - Normal 12.2 to 20.6 Blood pressure 120 mg – 150 mg 7.Dialatation Dilatation is a process of expansion of pupils in eye; we used the auromide drop for this process. 8.Final Examination After dilatation the patient move to final examination for Dr. Diagnosis. In this examination patient know the result of the eye problem

Dr. suggest for Counselling, Optical, Pharmacy or special Clinic 9.Lab If the patient suggest for 10 counter, the dept of counselling refer to the Lab for Blood test for surgery purpose. 10 & 11.Counselling In this department tells about the surgery details like cost, admission procedure & formalities. If the patient have affordable condition they refer to pay section.

20.Review Enquiry 12.Payment 13.Glaucoma 14.Pharmacy 15.Counselling – Patient Care 16.Optical 20.Review Enquiry Old patient & Surgery Review patient all are approach for registering.

WARD Ward department daily function is Pre OP & Post OP procedure Pre OP Procedure On the same day surgery patient were admitted into hospital; ward sister verify the MR No, IP Admin slip & Consent Form From the night & morning the attender give the drops; the ward sister also ensure this before surgery.

Post OP Vision Test & Dr.Exam IP Pre OP procedure for IP Immediate post OP for IP Post OP Vision for IP

Counselling After the all investigation the patient direct into Counselling department for getting the surgery details. Rs.850/- Cot in the ward Rs.600/- Mat in the ward Rs.810/- DC/DA Counselling the department prepare the list day care and day admit patient for surgery

Admission IP Counselling Post OP Counselling DC Post OP Counselling IP & DA Operational Information for IP IP moving into OA

Manpower Department Senior Junior Total Counselling 6 4 10 Refraction Doctors   CMO MO PG  Total New 1 4 5 10 Review - 3 6 Department Senior Junior Total Counselling 6 4 10 Refraction 8 16 Out patient 5 9 Ward 7 13 MRD Admin 1 2 3

Equipment Particulars New Review Total Direct Ophthalmic scope 4 Slit Lamp 9 5 14 NCT 2 1 3 Trail set 8 Snellen Chart 7 11 Auto Refraction A-Scan

Performance of the week Date OP Review Total Surgery operated 09-05-2016 483 266 749 200 10-05-2016 368 327 695 155 11-05-2016 380 289 669 170 12-05-2016 333 270 603 135 13-05-2016 230 243 473 91 14-05-2016 137 174 311 12 Advised upto 12.30

Quality ensuring For quality ensuring the each department conduct the weekly meeting; and the discuss about the weekly performance. Department Day Time Councelling Friday 4.00 PM Ward 3.00 PM MRD Saturday Refraction Tuesday 4.oo PM OT - Complications meeting Tu/Saturday Out Patient

Thank you

My recommends Preparation of OT in time Day Care room (209) more crowd because DA,IP & DC all patient dialatate in same room. My recommendation: when the day care/day admit people before reach the theatre; they are all meet the counseling's department, in this time we post one OP sister in counseling department for dilating and verification process. It reduce the crowd in the room. If more patient in ward counseling the sister shift the room into Optometric room; that they used the ramp way, at the same time post op vision test in occur in the 3 floor; its create the some confusion. My recommendation: use the review section stairs