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Home » Professional » Hygiene in Healthcare – A Diagnosis

Hygiene in Healthcare – A Diagnosis

Rajiv Gandhi Government Women & Children Hospital, Puducherry

Setting professional cleaning standards

Be it a private or government hospital, everyone, rich or poor, wants a clean ambience, as the very sight of a clean surrounding heals away half the ailments. “At Rajiv Gandhi Government WCH, Puducherry we have made such clean and modern facilities to give every expecting woman, the feel of a mother’s home,” says Dr Dilip Kumar Baliga, Director of Health & Family Welfare Services, Government of Puducherry.

Lack of basic facilities, unclean surroundings… added to the money demanded by hospital attendants from patients, wipes out smiles from expecting mothers. It is this smile that the Government of Puducherry has attempted to restore by giving an ambience that makes one happy. More than Rs.47 crores has been invested in the making of this WCH.

This 700-bed hospital standing on 300,000sqft area is well-equipped with all modern facilities for safe delivery, peadiatric care including neo-natal care. It has everything and every look of a private hospital with a five-star ambience. To complete it all, the entire hospital support services has been outsourced to a professional service provider, Faber Sindoori.

Emphasising on the need for professional cleaning services, which may not be possible in the existing government hospitals, Dr Baliga says, “If you see, in any government hospital the safaiwalas or sanitary workers are in their 50s and have been a part of the organisation for many decades now. They are habituated to cleaning with a broom and a cloth mop or at the most a stick mop. This has become a way of their life. Expecting them to change with changing hospital cleaning needs and cleaning tools is difficult. “We understand that it will not be possible to maintain the new ambience and standards required of the modern hospital by employing our own people. Hence, we took a conscious decision to outsource professional housekeeping services for the new project.”

At the General Hospital located at the heart of the city, more than 6000 patients along with relatives turn up as outpatients every day. People from nearby Tamil Nadu too visit this hospital. The maternity wing with 330 beds has now been shifted into the new hospital. A major issue of the maternity wing was the toilets. De-clogging of sewer lines had to be resorted to every other day. It was very difficult to get people not to throw things into the toilets and drains. The new facility has 380 toilets with facilities to ensure that clogs do not occur.

“Maintaining a hospital is much different than maintaining an airport or hotel as it also involves sound public relations in handling & being courteous to patients, disposing-off bio-medical & hazardous waste, educating people, cleaning toilets at least four times a day & on demand and other aspects. Therefore, the pre-bid meet with the bidders discussed these aspects.

“To qualify for the bid, standard marks on aspects like 10 points for the size of the company with documents, 10 points for three years constant turnover and 10 points for work experience and field of operations. The more the hospital experience the more points were given. The bidders were ranked out of the 100 marks and those below 50 marks were rejected. The ratio of bid was 60:40 of the technical bid and the financial bid.” Faber Sindoori with over three years experience in maintaining leading Healthcare and Non-healthcare institutions in India was awarded the contract for Facility Management Services. Seven support services have been outsourced to a single vendor. “This way I would have to deal with just one person, which makes things easier in coordination and implementation.”

The standard operational procedures followed in this hospital for all services are at par with any international hospital standards and the performance of each service is closely monitored by the administrators in the hospital. To ensure uncompromised quality standards are maintained for patient safety.

Maintenance includes servicing of fans, ACs, maintaining the generator, ensuring medical gas supplies, landscape maintenance, catering & diet supplies and security. The in-house staff is directly involved in pharmacy, labs, including diet, etc. “We have built a nice kitchen with all modern facilities to ensure that the quality of the food supplies are of good standards. The hospital will procure the raw materials and the outsourced kitchen staff will prepare food as per the menu specified. The food has to be brought in a trolley to the respective patient’s bed and served only after the duty nurse has approved it. Other services include collection of tray and plates and washed thoroughly in the dishwasher provided by the hospital,” adds Dr Baliga. One of the major advantages of employing outsourced staff is that we can monitor the consistency in performance and advice them to improve the services as and when needed. Such practices will not be effective with the Government employed staff. Besides, in keeping with the Faber Sindoori’s International benchmarking services to healthcare institutions, the staff is rotated between hospitals every three months as an effective cross training approach. This also enhances the workers’ experience to work under various circumstances towards patient safety.

Faber Sindoori took up the job from the time OPD services began in mid-January 2011. “We realised a lot of education is required to make patients coming from rural areas to adapt to the corporate surrounding. Faber Sindoori staff has been guided to effectively take care of the operational situations and handle the patients politely. A nice pantry provision has been provided for the visitors’/patients’ use.”

Supervision

In order to ensure an effective operational work process, the hospital has facilitated the service provider with adequate office space in their administrative wing. All service requests received by the hospital administrator are passed on to the Maintenance manager to complete the work within the stipulated time. Besides, the maintenance on each floor is handled by the Floor Manager. Round the clock monitoring is practiced, to ensure prompt and timely completion of all requests from the user department.

Waste Management

As a common practice, all clinical waste from the hospital is sent to the government incinerator in a packed container and other general waste is disposed off as municipal waste. Under Puducherry Pollution Control Board authority, a new common bio-medical waste management plant has been set up with modern facilities to handle the workload. The waste engineer attached to this plant along with trained waste lifters visit the WCH every day to collect the waste bags at a scheduled time. Strict operational measures are adopted in the hospital to avoid any irregularities in waste management.

To ensure that the waste is disposed off in the respective bags by the hospital staff, the head nurse of each ward has been made in charge. Any discrepancy the head nurse will be penalized.

Cleaning at International Standards

At WCH, we have been trained to perform the proven International benchmarking maintenance standards required of a healthcare facility,” says Ezra Alexander, Facility Manager from Faber Sindoori stationed in the hospital to handle the support service functions.

“While cleaning requirements is critical in any hospital, the challenge in the Government hospital is to deal with the people coming from rural background who are not exposed to the ideal usage of modern facilities in a hospital. The education of the new patient begins as soon as he or she enters the hospital while meeting our Front office executives.

“We provide them with pamphlets on various quality standards to be practiced in the hospital. The team is available at each floor to educate new patients getting admitted each day in the hospital.

“The initial period of operations were most challenging. Being a Government hospital, people followed the same old practices of littering wherever they pleased. But today, after six months of operations, with our constant education, people have changed their mindset and have started throwing waste into the bins. Lately, the patients walking in are more cooperative and are helping us to maintain the place clean. This is a dramatic change.” The trainers also impart education and training to the housekeeping staff. At present 267 staff are employed in this premise to facilitate all seven support services.

“With all the amenities like gardens, personal care, cleanliness and proper healthcare facilities, the women walking out of this hospital with their new born child have often said with their smiling face,  ‘it’s like leaving from the mother’s house’,” says Ezra.

Hygiene in Healthcare - A Diagnosis Walk down the narrow lanes of some of the government-run hospitals and it would be bustling with activity. Right from fruits to full fledged lunch plate would all be available at the doorstep of the hospital. “Don’t quote me,” said a government official, while discussing about the illegal food stalls mushrooming outside government hospitals in Mumbai. “All these hospitals run on charity and the poor people coming from far off places get to buy food at affordable rates from these food stalls. They practically live out of the footpath. It’s disheartening and not so…

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