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We thank you very much for your constant encouragement and support offered. Today this website is being accessed by 1400 users from 113 countries all over the world. We are working our best to make this website become the website for management resources in eye care.
As we are bringing out each issue of SiteNews featuring a specific eye disease, we take you to a detailed exploration on the various resources available on the topic featured from our website. All these resources make you clearer on the managing issues of the particular topic.
The theme for this issue is Start Up Eye Hospital
We look forward to your continuous support of our website as well as recommendation of materials that we can add to this storehouse of management resources in eye care. With your support this resource site will continue to grow and be of relevance!
Wish you a productive reading!

Happy reading!
Regards,
Vision 2020 e-resource team
The Issue Features...
Start Up Eye Hospital
Vol. 2 No. 8 August 2005
•   Feasibility planning
•   Requirements
•   Service delivery strategies
•   Departments
•   Complementary Resources

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Estimating the potential for eye care service:
Today there are about 50 million blind people in the world and 135 million more suffering from low vision. The numbers are staggering, and so is the fact that more than 80% of this blindness is needless- which means it can be prevented or cured. This is a huge problem- yes. But it is also a problem that we can and must do something to fix.

Before the actual starting up of an eye hospital we need to estimate the magnitude of blindness in the service area population. This will help to calculate annual incidence of blindness and the surgery market for the given service area population. It helps us to plan our service so that we can serve the patients effectively.

  • MAGNITUDE OF CATARACT BLINDNESS ESTIMATION

    Abstract:
    This tool will help you to find the magnitude of blindness in the given service area Population and also estimate the Incidence of blindness in the given service area population. The Users of this tool are any new Eye Hospitals before its set up, already existing Hospitals and Consultants or Private practitioners.
    Source:
    Mr. S. Saravanan - Aravind Eye Care System

  • ESTIMATION OF REFRACTIVE ERROR SERVICE FOR THE SERVICE AREA POPULATION

    Abstract:
    This tool will help to estimate the Refractive Error Services in the service area.
    Source:
    Mr. S. Saravanan - Aravind Eye Care System.

Tool for Three year Business Plan regarding viability of Starting an eye Hospital:
Currently there are no sufficient planning resources available for starting an eye hospital. Many hospitals are started without adequate planning and after execution end up under utilizing resources like manpower, equipment, etc and having to remodel their building design. This can be avoided by assessing the magnitude of blindness, estimating the workload, planning the manpower, estimating the income & expenditure, cost recovery and determining the price for services during the initial stage. We have provided you resource for effective planning.

  • ASSESSING NEEDS FOR STARTING A NEW EYE HOSPITAL

    Abstract:
    A tool has be developed to estimate the magnitude of blindness for the service area and based on the current performance - assess the gap which can be the basis for estimating the potential workload for the hospital. Several templates of building plans can be created so that the hospital can make modifications based on the available land area and the workload. Project management templates with various tasks for starting an eye hospital can be created with duration and person responsible. This will help the hospital to estimate the time duration required for completing the construction and setting up the hospital before the hospital can be opened to the public. The earlier tool on workload estimation &s financial projections can be used along with this tool.
    Source:
    Mr. S. Saravanan - Aravind Eye Care System.

  • EQUITY IN EYE CARE SERVICES

    Abstract:
    The articles provides the importance of reducing health inequalities and pinpoints the need for the pro-equitable programme in designing the national programme for eye care delivery.
    Source:
    Mr. R. Muralikrishnan, Mr. Keerti Bhushan Pradhan - Aravind Eye Care System.


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Land and site:
The site selected for hospital should be large enough for future expansion. It should be suitable for building construction and it should not be water logged area and should be easily accessible from any direction. It should have transportation facilities and should be on the main road. The availability of water supply should be considered and also the disposal of waste should be taken care of. If the water table is very high then the disposal of sewage will be of a problem. Water also should be potable so that the equipment and pipeline will not be corroded due to salts. The soil condition of the site should be studied so that the foundation for the building can be designed economically. Some times, if the soil is clay then the foundation cost will be very high. In some places, we find that even if we put bore well up to 400 to 500 ft, there will not be any water, which will increase the recurring cost for supply of water. Also we should see whether the corporation/Panchayat could supply enough quantity of water since consumability of water in the hospital per bed per day will be very expensive. Also we should see that electrical power supply (3 phase) of industrial supply would be available in that locality. Other facilities like telephone, roads central sewage should be considered before selecting the site.

  • QUALITY CATARACT SERIES - ARCHITECTURAL DESIGN MODULE

    Abstract:
    Architectural Design consists of examples and models, design principles such as hygiene, technology, function, community design, beauty, economic issues, and development process. This module is useful for several different architectural projects such as building anew facility on a new site, adding another building to the current site , acquiring an existing building and renovating it, renting an existing building and negotiating with the landlord to make changes to and redesigning and renovating the current building.
    Source:
    Ms. Christie Johnson Coffin, M. Arch., NCARB - Aravind Eye Care System.

  • HOSPITAL PLANNING

    Abstract:
    This article focuses on Feasibility study for the hospital to be located in a particular area and the Actual planning of the buildings, equipments etc.,
    Source:
    Mr. G. Srinivasan - Aravind Eye care system.

  • Building and Infrastructure

Equipments and Instruments Planning:
Most of the interventions in eye care require a secondary level setting. The secondary level eye care includes cataract, refraction, and other diagnostic procedures which forms the backbone of eye care services. With the rapid and continuous development of technology the delivery of eye care services are becoming increasingly sophisticated and expensive. While equipping an eye hospital one has to keep in mind the scope of clinical services and anticipated patient flow. One also needs to be clear about the investment to be made and the equipment to be procured at different stages of developing an Eye Care System.

  • INVESTMENT ANALYSIS FOR GENERAL EQUIPMENTS

    Abstract:
    With the advent of modern technology, in order to provide quality eye care the hospitals are forced to purchase several equipments. Purchasing of equipments not only involves capital cost of the equipment but also the cost for supporting facilities like air-conditioning, special foundations and construction. It also involves some recurring costs like salaries to technicians, annual service contract charges, cost of spares, consumables, interest and depreciation charges. Due to all these costs many of the charity hospitals find it difficult to invest in new technology. In this context, the hospitals face a situation as to how to mobilize resources (money) to procure the necessary equipments and also whether to charge patients and if so what would be the amount they would charge?
    Source:
    Mr. S. Saravanan - Aravind Eye Care System.

  • STERILIZATION FOR INSTRUMENTS

    Abstract:
    This protocol deals with how to sterilize the equipments and instruments to avoid infections or anyother problems during treatment with these instruments. Sterilizing the equipments and instruments is very difficult job to maintain. It invlolves how to sterilize the instruments during surgery, how to sharpen them etc.
    Source:
    Aravind Eye Care System.

  • SLIT LAMP - SOME ASPECTS OF USE IN CLINICAL EXAMINATION

    Abstract:
    This article deals with the relationship between the numerical aperture of the objective lens and the various aspects of the image formed in a slit lamp microscope like magnification and field of view, resolution and contrast, brightness, depth of field and stereopsis is described. The effect on quality of the image due to change in the magnification of the eyepiece, without changing the total magnification of the microscope is pointed out.
    Source:
    Prof. V. Srinivasan - Aravind Eye Care System.

  • MAKING THE EQUIPMENT LAST LONGER AND FUNCTION BETTER - NEED FOR IN-HOUSE MAINTENANCE

    Abstract:
    This articles deals with the procedures to be followed in maintaining the ophthalmic equipment and provides some tips in maintaining them.
    Source:
    Mr. A. Manikanda Selvan, Ms. A.S. Meenachi, Prof. V. Srinivasan, Mr. R.D. Thulasiraj and Dr. P. BalaKrishnan - Aravind Eye Care System.

  • OPHTHALMIC INSTRUMENT AND EQUIPMENT - A HANDBOOK ON CARE AND MAINTENANCE

    Abstract:
    This manual provides information on the general maintenance of the ophthalmic instruments and equipments, its management, maintenance protocol with some simple electrical calculations.
    Source:
    Prof. V. Srinivsan, Mr. R.D. Thulasiraj - Aravind Eye Care System.

  • Equipments and Instruments Planning


    Human Resources Requirement:
    Human Resource Management is concerned with the people who work in the organisation to achieve the objectives of the organisation. It concerns with acquisition of appropriate human resources, developing their skills and competencies, motivating them for best performance and ensuring their continued commitment to the organization to achieve organizational objectives. Human Resource Management refers to activities and functions designed and implemented to maximize organizational as well as employees effectiveness. All major activities in the working life of the employee from the time of his entry into the organization until he leaves or retires come under the purview of Human Resource management.

    Pricing of services:
    Pricing of the health services is one of the very difficult decisions health care providers face while starting any hospital.

    Although there are no readymade answers on what price to fix for each services, there are some generic ways which can be thought of.

    Pricing decisions for the services like OPD and Surgeries in eye care can be decided based on the actual cost per service which can be calculated in a simple way taking in to consideration the usage of the manpower, materials and associated resources and the prevailing market rates in the region and off course the economic status of the people of the service population/catchment population.

    The pricing has to be certainly above the cost of the service. But what percentage above the cost of the services can be decided based on the two other factors. that is: prevailing market rate and the socio-economic status of the service population.

    If the hospital has different type of room facilities for stay, then another way of looking at it is the salary/income per month of a category of population can be a determinant for fixing the price. Example is suppose the service population has four socio-economic strata in the population like Rich, Middle, Lower Middle and Poor, then one can take the average monthly income for each category and fix the price accordingly for cataract surgery.

    For OPD charges, normally there is a fixed one charge in most of the eye hospitals. But one may think of having differential OPD fees like Rs.20/Rs.50 as the normal OPD fees and Rs.100/Rs.150 as a special category where the local rich people can have a faster and quicker OPD service.

    It is always better to have fixed onetime package pricing for the services in an eye hospital to reduce cumbersome procedure at billing counters and provide transparency and also comfort to the patient and attendants.




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    Getting patients:
    • ARAVIND MODEL OF COMMUNITY OUTREACH

      Abstract:
      This article briefs you about the model of outreach program Aravind is following.
      Source:
      R. Meenakshi Sundaram Manager - Eye camp and Outreach - Aravind Eye Care System.

    Quality service delivery:
    • QUALITY CATARACT SERIES INTRODUCTION

      Abstract:
      Introduction consists of cataract The big picture, cataract and vision 2020-The Right to Sight, about the entire series, the Aravind model etc.
      Source:
      Aravind Eye Care System, Aravind Communications.

    • QUALITY CATARACT SERIES - MANAGEMENT PRINCIPLES AND PRACTICES

      Abstract:
      Management Principles and Practices consists of management framework, contributing factors, leadership and attitude, manpower and human resources, building and infrastructure, instruments and equipments, policies and systems etc.
      Source:
      Mr. R.D. Thulasiraj - Aravind Eye Care System.

    • QUALITY CATARACT SERIES - CLINICAL STRATEGIES

      Abstract:
      Clinical Strategies deals with benchmarks from monitoring quality volume and sustainability, evolution of cataract surgical techniques, clinical strategies, IOL microsurgery training course, and Manual Phacoextraction training course. Apart from this there are appendices on preoperative evaluation, preoperative preparation and anesthesia, intraoperative considerations, postoperative management and pediatric cataract.
      Source:
      Source:Dr. G. Natchiar,M.S.,Dr. N.V. Prajna,Dr. B. Sirisha,Dr. R. Kim,Dr. Sonia Modi,Dr. Sangeetha Mewara,Dr. Koshy R. Zachariah,Dr. Seema Vishnu,Dr. M. Srinivasan,Dr. Jaya Chandra Reddy,Dr. P. Vijayalakshmi,Dr. Sumitha Agarkar - Aravind Eye Care System.

    • DEMAND GENERATION STRATEGY WORKSHEET AND CHECKLIST

      Abstract:
      This consists of the worksheet for designing the action plan and also a checklist for guiding the action plan design. This worksheet shows how to generate demand for services offered.
      Source:
      Aravind Eye Care System.

    • STRATEGY WORKSHEET FOR CONTINUALLY IMPROVING QUALITY OF SERVICES AND CHECKLIST

      Abstract:
      This consists of the worksheet for designing the action plan and also a checklist for guiding the action plan design. They direct you how to achieve quality service delivery on a sustainable basis.
      Source:
      Aravind Eye Care System.

    Financial sustainability and cost recovery:
    Investment is an attempt to carefully plan, evaluate and allocate funds in various investments which offer safety of principal, moderate and continuous return and long term commitment.

    The investor to be certain of safety of principal should carefully review the eye care trends before choosing to invest. The success of investment in eye care has become increasingly important in recent times.

    Making sound investment decision require both knowledge and skill. Skill is needed to evaluate risk and return associated with an investment decision. We have provided you with some resoruces which will give you an idea for investing in eye care sectors.

    • COST EFFECTIVENESS STRATEGY WORKSHEET AND CHECKLIST

      Abstract:
      This is a work sheet for providing services on a sustainable basis. This consists of the worksheet for designing the action plan and also a checklist for guiding the action plan design. It directs you to deliver services on a financially viable basis.
      Source:
      Aravind Eye Care System.

    • QUALITY CATARACT SERIES - FINANCIAL SUSTAINABILITY

      Abstract:
      Financial Sustainability consists of examples and models, cost recovery issues, and cost recovery principles such as pricing, accountability etc. and also a cost recovery exercise to record lessons learned in the achievement of cost recovery in eye care programmes, to describe the factors and principles to consider when implementing cost recovery measures for financial sustainability, and to remind those responsible for economic development, costing decisions and financial decisions to ask the right questions to the right people at the right time in the planning process.
      Source:
      Mr. David Green - Aravind Eye Care System.

    Community outreach as a service marketing:
    Community eye care and universal coverage can only be ensured through a community based eye care services. We need to lay greater emphasis on preventive and promotive strategies, case finding and referral rather than solely depending on hospital based curative services.

    The essential features of Community eye care include:

    1. Delivery of eye care services to all individuals who are at risk of developing blindness or suffering from low vision, irrespective of their ability to pay for such services.
    2. Social development that promotes eye health through changes in behaviour, environment, adequate food, safe water supply and adequate sewage disposal.
    3. Provision of essential drugs for eye problems is an extremely important component of the primary eye care approach.

    • QUALITY CATARACT SERIES - COMMUNITY OUTREACH

      Abstract:
      Community Outreach Initiatives consists of purposes of community outreach, community outreach activities in various fields and more challenges in community outreach and how to overcome it for improving patient awareness and increasing the uptake of cataract services.
      Source:
      Mr.R. Meenakshi Sundaram,Dr. C. A. K. Shanmugham,Mr. V. Vijayakumar,Mr. V. Rajendran - Aravind Eye Care System.


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    Clinical - MRD, OPD, Ward, OT:
    • MEDICAL RECORDS - ITS IMPORTANT AND THE RELEVANT LAW
      Abstract:
      This article explains importance of medical records in a hospital, the medical ethics, legal aspect, the period of maintaining a medical record etc. in a detailed way.
      Source:
      Dr. Jitendra Jethani - Aravind Eye Care System.

    • INTEGRATED HOSPITAL MANAGEMENT SYSTEM
      Abstract:
      This software helps to maintain the valuable patient data for providing better information system. Also it insists on standardizing the workflow, patient flow and various activities, which enhance overall performance of the organization.
      Source:
      Aravind Eye Care System.

    • OUT PATIENT EXAMINATION, REFRACTION AND GLASS PRESCRIPTION PROCEDURE
      Abstract:
      This protocol introduces the standard procedure for Refraction, history taking, guidelines for prescription, Slitlamp Biomicroscopy etc. as a complete tool to follow.

    Administrative Personnel (Job description), Accounts, Housekeeping and Maintenance, stores:
    Job Description:

    Many hospitals lack in clear job description for the staff stating the responsibility, accountability, and activities to be performed on the job. A job description for each person is essential to avoid duplication of tasks. Once the job descriptions are clear, then it can be compared with all the tasks that need to be performed for increased effectiveness of the eye unit. To facilitate this job description templates is provided for each of the categories in an eye hospital.

    • JOB DESCRIPTION FOR GENERAL OPHTHALMOLOGISTS
      Abstract:
      This is a model job description for the Medical Officers in an Eye Hospital. It clearly focuses the duties of the Medical Officers, and how to manage the duties in an organized way.
      Source:
      Aravind Eye Care System.

    • JOB DESCRIPTION FOR COUNSELLORS
      Abstract:
      This is a model job description for the Counsellors in an Eye Hospital. It clearly focuses the duties of the Counsellors, and how to manage the duties in an organized way.
      Source:
      Aravind Eye Care System.

    • JOB DESCRIPTION FOR THEATRE PARAMEDICS
      Abstract:
      This is a model job description for the Operation theatre nurses in an Eye Hospital. It clearly focuses the duties of the paramedics, and how to manage the duties in an organized way.
      Source:
      Aravind Eye Care System.

    • JOB DESCRIPTION FOR CAMP ORGANISORS
      Abstract:
      This is a model job description for the Camp Organisors. It clearly focuses the duties of the Camp Organisor, and how to manage the duties in an organized way.
      Source:
      Aravind Eye Care System.

    • JOB DESCRIPTION FOR GENERAL OPHTHALMOLOGISTS
      Abstract:
      This is a model job description for the Medical Officers in an Eye Hospital. It clearly focuses the duties of the Medical Officers, and how to manage the duties in an organized way.
      Source:
      Aravind Eye Care System.

    • JOB DESCRIPTION FOR OUTPATIENT PARAMEDICAL
      Abstract:
      This is a model job description for the Out Patient Paramedicals in an Eye Hospital. It clearly focuses the duties of the Out-patient nurses, and how to manage the duties in an organized way.
      Source:
      Aravind Eye Care System.

    • HOUSEKEEPING JOB DESCRIPTION
      Abstract:
      This is a model job description for the House keepers in an Eye Hospital. It clearly focuses the duties of the House keeping staffs, and how to manage the duties in an organized way.
      Source:
      Aravind Eye Care System.

    • JOB DESCRIPTION FOR UNIT HEAD
      Abstract:
      This is a model job description for the Unit head in an Eye Hospital. It clearly focuses the duties of the unit head, and how to manage the duties in an organized way.
      Source:
      Aravind Eye Care System.

    • PRODUCTIVITY AND STRESS
      Abstract:
      This article deals with the effect of stress on the productivity of any organization, its sources and managing.
      Source:
      Ms. S. Santha Subbulaxmi - Aravind Eye Care System.

    • HOUSEKEEPING IN EYE HOSPITALS
      Abstract:
      This article provides information on the functions of a housekeeping department in an eye hospital, the procedures involved in selection, orientation, work description, and coordination with other departments.
      Source:
      Ms. Anoopama - Aravind Eye Care System.

    • LAUNDRY AND LINEN SERVICES IN HOSPITALS
      Abstract:
      This article provides information on the responsibilities and function of a laundry department in an eye hospital with details on the facilities and space requirements, human resource needed etc.
      Source:
      Mrs. Krishna Veni, Laico - Aravind Eye Care System.

    Support services Optical shop, pharmacy, canteen:
    Submit Products


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    We are very much charmed to team up with other Eye Care websites and Resource Centres to reach out more people and develop useful resources. This month we are featuring CBM International as our collaborating partner.

    About CBM:

    Christian Blind Mission Australia (CBMI) is an independent Christian development organisation dedicated to preventing and curing blindness. And also to the education and rehabilitation of people who are blind or have other disabilities.

    CBMI began work in Australia in 1978, but Christian Blind Mission International began internationally in 1908.

    The work of CBMI centres around medical care - preventing and curing blindness - as well as the rehabilitation, training and integration into society of people who are blind or have other disabilities.

    This is achieved in partnership with national churches, other mission organisations, and national self-help groups. This work is only possible through the generous support of caring Australians.

    With more than 1000 ongoing projects in 108 countries, CBMI provides funds and personnel to help our partners meet the tremendous needs.

    Website : www.cbmi.org.au