Model of Care
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Model of Care
Quality Care at TMH
1. Before meeting the doctor, the patient’s vitals are checked and entered in the case record. The care providers evaluate patients thoroughly with proper history taking and previous medical records available. A detailed assessment of the patient’s current condition is done at the consultation time. The required investigations are ordered and carried out. If the doctor needs to verify his/her findings, then he/she consults a senior colleague. Once the diagnosis is made, both the patient and his/her family attender are educated on the disease, course and duration of treatment.
2. The health records are documented and shared with the patients. This also creates a rigorous process of documenting the report and helps crystalize the problem. We believe that the patient is entitled to his/her own health information. Transparency is key. At TMH, all records and data are kept on the central computer server, called the Electronic Medial Records. With this, the doctors all have access to any medical report generated. Each doctor has his/her own folder on the server where they keep patient records. This makes it easy to follow up on patients and keep records updated. Interdepartmental coordination for care also becomes easier and efficient.
3. Choose the medical investigation carefully. We don’t want people to pay for procedures or tests they don’t need.
4. We ensure that the lab employs very good quality methods to provide accurate results. We have an external quality assessment system with Christian Medical College that once a month tests our ability to ensure trustworthy results.
5. Make sure that treatment protocols are implemented. We have a check-list by which doctors are audited to ensure consistency.
6. Where the concerned doctor feels the need to refer the patient to another colleague, he/does that immediately. When there is a referral needed to another hospital or practitioner, that is enabled by a referral letter and a telephone call from the hospital. The patient is given a medical report including all the reports of investigations carried out for such a referral. The hospital ambulance service comes to the aid of the patient if he/she is in a critical condition or if he requires such support.
7. Our pharmacy stocks quality medicines and we don’t overprescribe!
8. Each aspect of patient care and admin areas is driven by standard operating procedures. Every new entrant is oriented to the system of care and is trained in his/her functions.
9. We adopt an internal management system with a few committees for the overall administration. The committee members are drawn from the staff and medical team members. Key Performance Indicators for each of the committees are assessed and reviewed at these meetings. Suitable modifications and corrections are made.
10. All our staff are encouraged to participate in external training that would add value to their work. Internal training programmes are held on a periodic basis and are mandatory for the concerned departmental staff. We believe that training is the key to improve and ensure quality.
11. Academic sessions at TMH enable learning from each other.
12. We have our patient relations executives going around waiting areas to ensure nobody misses out the consultation and gets unduly delayed. A systematic collection of feedback is in place for outpatients and we also collect feedback from the patients after they are discharged.
The TCT Model of Integrated Health
We adopt a closed-loop model where primary healthcare and secondary healthcare are implemented in an integrated approach. Before embarking on steps to improve health care in the rural community, common health problems need to be identified and their prevalence assessed. Health care models should be developed based on the needs of the community and the predominant health problems. Our field staff are trained to implement basic primary care in the village. If the patient needs further care, they are given a referral to the hospital. Our field staff then does a house visit with the patient to ensure they meet their appointments, getting the required medicines, and are getting the right counseling. Lastly, to close the loop, they continue to monitor the patient and encourage follow-ups if required. This shared responsibility helps the doctors keep track of their patients.