CASE STUDY-TO EVALUATE THE HOSPITAL ON THE GROUNDS OF DISABLED FRIENDLINESS

(ACCESSIBILITY) AND TO FIND FURTHER SCOPES OF IMPROVEMENTS

By: Dr. Deepika VermaB.D.S, M.H.A (TISS)

Location: KOKILABEN DHIRUBHAI AMBANI HOSPITAL,MUMBAI

Introduction• Disability is the consequence of an impairment that may be

physical, cognitive, mental, sensory, emotional, developmental, or some combination of these. A disability may be present from birth, or occur during a person's lifetime.

Key facts • Over a billion people, about 15% of the world's population,

have some form of disability. • Rates of disability are increasing due to population ageing and

increases in chronic health conditions, among other causes. • People with disabilities have less access to health care

services and therefore experience unmet health care needs.

Problem

• People with disabilities encounter a range of barriers when they attempt to access health care including the following.

Prohibitive costs

Limited availability of services

Physical barriers

Denial/Negligence

AIM

• To see if the hospital is disabled friendly and cater to their needs in an efficient manner along with analyzing gaps and finding more steps to improve the same

OBJECTIVES: • To audit the hospital on the grounds of disabled friendliness • To check whether the hospital is disabled friendly in aspects of Infrastructure,

Technology, Workflow, Process.• To find out the gaps in different aspects of the hospital unfulfilling the criteria to

give disabled friendly atmosphere to the patients. • To suggest recommendations for improving the infrastructure, technologies,

process and workflow of the hospital to make it disabled friendly hospital.

METHODOLOGY

NCPEDP audit of the hospital covers various aspects of the hospital-parking areas, Ramp , elevators , cafeteria, public telephone, patient examination rooms , staircases, corridors , washrooms, hospital wards, counters and corridors

PRIMARY DATA: observation, interview INTERVIEW of following people were taken: Disabled patients, Relatives of disabled

patients, Porter boys, Receptionists, Rehabilitation therapists, Facility manager Secondary data-architectural guidelines manual, Internet

National Centre for promotion of employment of Disabled patients

NCPEDP AUDIT( BY NATIONAL CENTRE FOR PROMOTION OF EMPLOYMENT OF DISABLED PATIENTS)

• Set of 115 questions

Observations

Number of patients who say they are being provided with special care by the hospital and satisfied with the hospital

Number of patients who said that they faced difficulties in accessing the areas in the hospitals

Yes

No

Number of patients who said further improvements are needed to make this hospital disabled friendly

Number of patients suggesting the most awaited areas of improvement to make the hospital more disabled friendly

Recommendations• The ramp at the entrance of the hospital building has only one hand rail on one side.

There is glass window on the other side of the ramp. As per the architectural guidelines manual there should be two handrails on either side of the ramp.

• When there is rush at the gate , The entrance landing area becomes insufficient. It becomes a hurdle for the patients on wheelchair to cross the area, therefore at that place effective management is required to make the area obstruction free.

• There is no drop off area within 30 meters of area from the entrance. There has to be a drop off area located there with a big signage made on the ground showing the drop off area and disabled patients can land safely.

• Special parking area should be made for disabled , 50 meters away from the main entrance door of the hospital. It should carry a board symbolizing parking for disabled. The parking for them should be free of cost.

• Elevators should have handrails on three sides with a proper contrasting colour. elevators should also be provisioned with audio signals on arrival of respective floors. Elevators must also include instructions in Braille and the buttons in Braille pattern. There are only two elevators with Braille button patterns.

• There should be a menu card available in BRAILLE in the cafeteria so that visually impaired people can access the menu. A notepad should be kept with the staff there so that people who cannot hear and speak can write on it what they want.

• There should be one public telephone provided in the hospital at the ground floor which the disabled people can use in emergency.

• Training and Orientation of staff• Wheelchairs should be kept at every floor. • During fixing of the appointment, the employees should definitely ask the

patients or the relatives fixing the appointment about any special assistance required so that they can be ready with it.

• There should be a generalized system such as a violet tag on the file of the patients with special needs and a violet band tied on their hand, so that where ever they go, they get special care.

• WASHROOMS for disabled don’t have pivoted doors opening on both the sides and they also don’t have provision so that the doors have emergency release system from outside. Such doors should be facilitated. Every washroom should have an emergency nurse call system. The housekeeping staff should be cautious to clean the washrooms of disabled frequently so as to avoid any cases of slipping due to water pilferage.

• The examination tables in the hospital are not disabled friendly. An examination table with adjustable height equipped with padded leg sports. Exam table should have elements to stabilize and support a person- rails, straps, stabilization cushions, wedges or rolled up towels.

• With the upcoming technologies, latest technology weighing machine that can be used by the people on the wheel chair should be provisioned. This machine calculated the weight of both the patient and wheel chair, patient’s weight can be calculated by subtracting the weight of wheelchair. The only hospital that provides it in India is INDIAN SPINAL INJURY CENTRE,NEW DELHI.

• JOSEPH EYE HOSPITAL has come up with a new idea of employing disabled people in tasks in the hospital, there a visually impaired person sells stuff in canteen. Similar notion can be adopted by our hospital.

• MOBILE CARTS can be made available in the hospital which includes three chairs excluding a driver’s seat.

• There should be a facility of pick and drop patients in the hospital for the disabled on call.

• GURU TEG BAHADUR HOSPITAL has created disabled friendly ATMs with a ramp and a landing area so as the patients on wheel chair can access them. Our hospital can do the same.

• Special health check up camps should be conducted by the hospital free of cost on WORLD DISABLED DAY in the hospital for the people with special needs .This would not only be an activity of CSR and attract more disabled patients towards our hospital to seek treatment but also it would be a strategy to enhance the brand of the hospital.

Never ignore somebody with a disability, You don’t realize how much they can inspire you!!