1. OT Committee Meeting ( 21/9/2012)

2. | Apollo Hospitals, Bhubaneswar Main Agenda 1. To Improve OT utilization 2. To Save precious OT time Study Period -June, July, Aug’12

3. | Apollo Hospitals, Bhubaneswar Last Meeting- June 27 th 2012 IssuesDiscussed & Status 1OT Data Numbers and Procedures are being recorded separately OT timings, delays and TAT are being recorded and analyzed 2Noise in OTAcceptable level 3Surgery recordingOpen surgery recording system to be purchased for OT-1.- Pending 4C-Arm & Lap SetUnder process- C arm has come, Lap set pending 5 Trainee Nurses in OT All Trainee nurses in OT has to be replaced by registered nurses is not yet done (Registered 18 (3 on long leave), Trainee-13 (4 on long leave)] 6C-Sect OT Modifications to be done to separate the toilet area & make provisions for OT pharmacy & OT store is completed 7C-Sect OT Table Some attachments are required. Local fabricator may be explored to provide the same. This is pending 8OT Technicians One or two technicians are weak performer- they are being posted with experienced staff. 3 more OT technicians have to be recruited. 9 Neurosurgery schedulingThree days a week Neurosurgery will get preferential first slot in OT-3. This is not implemented due to lack of consensus, however the posting is being done by mutual adjustments. Use of OT-2 for Neuro/Ortho cases is being done only after permission of Dr R N Mohapatra.

4. | Apollo Hospitals, Bhubaneswar 10Sample receiving in Lab. Provisions are to be made to receive samples in all labs from OT has been made by Dr. Dipika. 11Dining Room in OTDining room is completed & furniture has been placed. 12Outsiders inside OT No outsiders (Doctors/Relatives) related to the surgery being performed is allowed inside the OT. 13 Software for Anaesthesia record keeping We are continuing to work with the old software. No one was sent to Delhi to get the software. 14Instrument PurchasePending instrument replacement from last year is yet to be completed. 15Neuro Instruments Wilsons frame & Codman lumbar Retractor newly purchased are not functioning and needs to be replaced. 16Intubating Naso-LaryngoscopeAs requested by Anaesthesist 6 months ago is still pending. 17OT SecretarySecretarial service in OT is being provided up to 8pm. 18Instrument Trolley11 trolleys have been purchased recently. 19 Nursing deployment in evening hours No shortage of nursing staff but shortage of skilled nursing manpower. 20Need for emergency OTEmergency OT will be developed after NABH inspection 21Overtime issueSame overtime payment among nurses/ technicians `

5. | Apollo Hospitals, Bhubaneswar Total OT Utilization for the month of June, July & Aug'2012

6. | Apollo Hospitals, Bhubaneswar OT WISE UTILISATION(in %) FOR THE MONTH OF JUNE - AUG’2012

7. | Apollo Hospitals, Bhubaneswar Total number of Surgeries & Patients ( June- Aug’12)

8. | Apollo Hospitals, Bhubaneswar Total No. of Surgery Dept.wise for the month of June,July & Aug'2012

9. | Apollo Hospitals, Bhubaneswar Major causes for OT delay  Late arrival of Surgeon & Previous case prolongation is contributing largely as a cause of Delay  Scope of improvement – Minimizing the late arrival of Surgeon, anesthetist and encourage them to give proper estimation of OT duration Others Includes Equipment not available, Incomplete preparation, Financial constraint, Clinically Unfit etc

10. | Apollo Hospitals, Bhubaneswar Percentage Contribution  OT secretary gives reminder call to the patient posted for first case in order to avoid late arrival and therefore causing delay in surgery resulted in lower trend for the month of June

11. | Apollo Hospitals, Bhubaneswar