The realization that it is not a matter of ‘if’ but ‘when’, the pandemic was going to hit the country, compelled us to think long and hard, requiring activation of a disaster like situation, with hospitals getting very little time to prepare. Sarvodaya Hospital & Research Centre in Faridabad, was one such corporate hospital which was at the forefront in Delhi-NCR region, in terms of its preparation to deal with the current crisis.
It all started with creation of a Covid Core Committee comprising of experts from all clinical & non clinical fields to brainstorm on the way forward including laying down the policy, resource management and delegation of work.
The 1st step was creation of a Flu Corner outside the 2 main entrances of the hospital for thermal screening of patients & their relatives. Patients presenting to the Emergency department were then triaged again, using a specially created visual triage checklist, based on their symptoms at a triaging desk manned by a trained emergency physician. A separate isolation area was created within the Emergency, with a dedicated nurse and separate portable Xray, ECG and Sonography machine. Standard treatment sheet for Out patient & In patient management of suspected patients was created, so that patients could be treated based on whether their symptoms were mild, moderate or severe. At the same time, patients who were advised home isolation were handed over specially designed patient education & awareness brochures from the Emergency & the OPDs. A specially designed sample collection booth was also made, to collect the swab samples of patients, thereby ensuring zero contact with aerosols & minimizing risk to the nurse collecting the samples.
A separate Isolation ward was created, and the High Dependency Unit (HDU) was converted into the Corona Care Unit for admitting suspected cases. Patients were transferred from the Emergency Isolation room to the respective IP areas directly through designated lifts. Patient wards which were not needed were also closed, to provide a backup reservoir if there were too many cases.
Since the OPDs were closed initially and all non essential services had to be stopped, the hospital made arrangements of video consultation and tele-consultation for the patients with their primary physicians. Once the OPDs were permitted for few hours a day, the hospital made all arrangements to restrict the number of visitors with the patients, introduced a token system to meet the doctor and also the waiting area seats were numbered to follow social distancing norms. Similar process was followed at the other support service areas like the pharmacy, laboratory & the radiology departments. The security department in the hospital was proactive to make sure that there was a smooth movement of patients and that they were guided properly. The Consultants were also provided Level 2 PPEs and maintained social distancing while attending to OPD patients.
To keep the hospital machinery functional, similar arrangements were made for the Operation theatres, Endoscopies, Labor room where doctors & nurses were provided with complete protective equipment. Patients were counseled & screened for COVID before undergoing any procedures.
Under the watchful eyes of the Microbiologists and the infection control nurses, a detailed COVID infection control policy was also made which was regularly updated as per the dynamic government guidelines. The department was also responsible for training and monitoring of all hospital staff for compliance of the policy. Their other responsibility was tracing of all reports, everyday, from the government approved laboratories that the hospital had tied up with for COVID sampling. The patients whose test came positives were immediately referred to the ESI hospital & Medical College as per the guidelines of the state government, in the hospital ambulance, where even the driver and support staffs were provided with Full PPE hazmat suits.
The hospital was very prompt in its actions and was successful in the mammoth task of procuring the recommended N 95 masks, 3 ply masks, PPE kits; even to the extent of procuring raw materials and having in house tailors stitch protective gear, round the clock. Thankfully, there has been no dearth of any protective equipment to any of the hospital staff. A lot of credit should be given to the purchase department which went out of the way to procure things, day in and day out, since the supply chain of the hospital was broken due to the lockdown.
All hospital staff was also allotted duties on a rotational basis so that a backup team was always ready, if an entire team on a shift needed to be quarantined. The hospital also made all arrangements to quarantine the doctors and nurses in isolation rooms within the hospital premises and the hostels.
Regular patient education and awareness information, training videos were created for the patients and widely shared on the hospital’s social media platforms as well.
Understanding the importance of mental health, the hospital has continued regular counseling of all the frontline staff, conducting stress management activities to keep the morale high of all its employees in such testing times.
Though it is sad that it took a pandemic to lay bare our vulnerabilities and forced us to radically revamp the way healthcare is delivered, but we must look towards the future. We, at Sarvodaya Hospital & Research Centre, Faridabad, are fully prepared and committed to providing the best care to all our patients in times of this pandemic. We sincerely hope that our collective efforts shall not go in vain and the lessons learnt from this pandemic will eventually make our systems more resilient in its aftermath. Hopefully soon.
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