Overview (1).pptx

its about overviewing the entertainment .

1. Overview

2. National Quality Assurance Standards (Areas of Concern) Service Provision Inputs Support Services Clinical Care Infection Control Quality Management Outcome Patient Rights

3. 2 nd October 2014 Launch of Swachh Bharat Abhiyaan “ A clean India would be the best tribute India could pay to Mahatma Gandhi on his 150 birth anniversary in 2019.” 15th May 2015 Launch of ‘Kayakalp’ as an adaptation and Extension of ‘ Swachh Bharat Abhiyaan ’. To encourage and incentivize Public Health Facilities (PHFs) in the country to demonstrate high levels of cleanliness, hygiene and infection control practices. Rejuvenating Public Healthcare Facilities

4. Swachhta: A Mission for All

5. Objectives of KAYAKALP Promotion of Swachhta Enhancement of Quality of Care Internalisation of Quality Culture & On-going Assessment Incentivisation & Recognition of ‘Exemplary Performances’ Improve patients satisfaction Rejuvenating Public Healthcare Facilities

6. Institutional Arrangement

7. Institutional Framework-KAYAKALP State Level Award Committee District level Award Nomination Committee Hospital Cleanliness & Infection Control Committee Chairperson: MD/Health Secretary. Members: Senior officers from Health Directorate, SQAC, Development Partners, Medical Colleges, NGOs, Public Health Engineering department, Pollution Control Board, Water and Sanitation department. Chairperson: DM/CMO Members: Zilla Panchayat Health committee, DQAC, Civil society representatives, RKS members Medical Superintendent, Matron, Hospital Manager, Pathologist/ Microbiologist , Departmental In charges Dissemination, Assessors Team constitution, Trainings, coordinate &validate Assessment, finalize winners & award, conflict resolution Dissemination, internal & peer assessment, Trainings, monitoring, nomination for awards. Internal Assessment, Action Planning , Gap Closure, Hands on Training , Monitoring of cleanliness

8. Hospital upkeep (100 Marks) Sanitation & Hygiene (100 Marks) Support Services (50 Marks) Waste Management (100 Marks) Infection Control (100 Marks) Hygiene promotion (Marks 50) 8 Thematic Areas for the Assessment Beyond Hospital Boundary(100 Marks) ECO Friendly (100 Marks)

9. 3-Step Assessment Internal Assessment Peer Assessment External Assessment

10. External Assessment A Three-member team (Minimum) Trained – Internal Assessors under NQAS, Ext. Assessors & Kayakalp Ext. Assessors As least one member should be from Non-Government Sector

11. Assessment and Improvement Cycle Assessment & Scoring Gap Analysis Root Cause Analysis Action Planning Prioritizing Actions Gap closure

12. Trainings Trainings Location Target Audience Awareness Training State Capitals Half Day sensitization workshop at State level for Key officials from ,State Health Directorate, State Health Society ,Members of State level award Committee Representatives of NGOs & Development Partners working in state External Assessors Training State Capitals / NHSRC One day Master Training of State level external assessors for using the assessment tool At least One officials should be nominated from every district who can work as master trainer for district level workshop. Awareness cum Internal Assessors Workshop At all district headquarters 4 Hour sensitization workshop at District Level on the ‘’ Swacchh Bharat Abhiyan ’’ and how to use assessment tool targeted for Service Providers Facility In charges Doctors, Nurses, Hospital Managers, DPM , Members of District Quality Assurance Committees, representatives of Development partners & NGOs working at District Level.

13. Cash Awards: DH Category No. of DHs Assessment Score Amount (Rs. in Lakhs) I. Category A 10-25 Highest (Best) Rs. 50.00 II. Category B 26 - 50 Highest (Best) Rs. 50.00 Ist Runner-up Rs. 20.00 II. Category C More than 50 Highest (Best) Rs. 50.00 Ist Runner-up Rs. 20.00 IInd Runner-up Rs. 10.00 Commendation & Cash Award All States DH More than 70% Score Rs. 3.00

14. Cash Awards Category Type of Facility Assessment Score Amount (Rs. in Lakhs) I. Large States SDH/ CHC Highest (Best) Rs 15.00 Runner-up Rs. 10.00 PHC One in each District Rs. 2.00 II. Small States (Less than 10 districts) SDH/ CHC Highest (Best) Rs. 15.00 PHC One in each District Rs. 2.00 Commendation & Cash Award All States More than 70% Score SDH/CHC Rs. 1.00 PHC Rs 0.50

15. S.No . No. of Health Facilities No. of Awards Award (In Lakh Rs.) Unit of Allocation UCHCs 1 10-25 One Winner 15.00 I per state and each of the 7 metros 2 25 or more One Winner 15.00 I per state and each of the 7 metros One Runner 10.00 3 U-CHCs with > 70% in external assessment Commendation Awards 1.00 All Eligible facilities

16. S.No No. of Health Facilities No. of Awards Award Amount (In Lakh Rs .) Unit of Allocation UPHCs with & without beds 4 10 – 20 One Winner 2.00 For each cluster* at state/metro as the case may be 5 20 - 50 One Winner 2.00 I per district / zone or region of 7 metro 1 st Runner up 1.50 6 50 & above One Winner 1 st Runner Up 2 nd Runner Up 2.00 I per district / zone or region of 7 metro 1.50 1.0 1.0 7 All U-PHCs scoring 70% or more in External Assessment Commendation Awards 0.50 All eligible facilities

17. Seven Metro Cities would form a separate Group ( Ahmedabad, Bangalore, Chennai, Delhi, Hyderabad, Kolkata, Mumbai-Further divided into zones/ regions/ districts ) Kayakalp Awards will depend on Number of functional UCHCs and UPHCs in state/UT.

18. KAYAKALP: Measuring & improving Swachhata . If you can’t measure something, you can’t understand it. If you can’t understand it, you can’t control it. If you can’t control it, you can’t improve it.”

19. KAYAKALP Measurement System Thematic areas Broad areas or themes for assessing different aspects of “Cleanliness” like Hospital/ Facility upkeep, Sanitation & Hygiene, waste Management, Infection Control, Support services and Hygiene promotion. Components 8 Statement of requirement for particular aspect of Cleanliness 50 Checkpoint Tangible measurable checkpoints are those, which can be objectively observed and scored. 250/150/100

20. Hospital upkeep (100 Marks) Sanitation & Hygiene (100 Marks) Support Services (50 Marks) Waste Management (100 Marks) Infection Control (100 Marks) Hygiene promotion (Marks 50) 8 Thematic Areas for the Assessment Total Score - 700 Marks Beyond Hospital Boundary(100 Marks) ECO Friendly (100 Marks)

21. Hospital upkeep Sanitation & Hygiene Support Services. Waste Management Infection Control Hygiene promotions Criteria for Assessment Section B: PHC with Beds 300 60 60 60 60 30 30

22. Hospital upkeep Sanitation & Hygiene Support Services. Waste Management Infection Control Hygiene promotions Criteria for Assessment Section C: PHC without Beds 200 40 40 40 40 40 20

23. Theme D: Infection Control D1 D2 D3 D4 D5 D6 D7 D8 D9 D 10

24. Hand Hygiene Personal Protective Equipments Personal Protective Practices Disinfection & Cleaning Spill Management Infection Control Program Infection Surveillance Isolation & Barrier Nursing Environmental Control Infection Control Theme D D Autoclaving & Sterilization 15-09-2022 QI-NHSRC

25. D2: Personal Protective Equipment Use of gloves during procedures and examination Use of Masks and Head caps Use of Heavy duty gloves and gum boots by waste handlers use of Aprons by clinical staff. Adequate supply of PPEs

26. Thematic Area Checkpoint Compliance Reference No. Assessment Method Means of Verification KAYAKALP—Anatomy of Score Card Page-14, Kayakalp

27. Assessment Method OBSERVATION ( OB ) STAFF INTERVIEW ( SI ) RECORD REVIEW ( RR ) PATIENT INTERVIEW ( PI )

28. Observation (OB) Compliance to many of the checkpoints can be assessed by directly observing the articles, processes and surrounding environment. Few examples are given below a)  Enumeration of articles like house keeping equipment, colour coded bins, drugs, etc b)  Displays of signages , work instructions, important information c)  Facilities – layout, zoning of OT, patient amenities, ramps, complaint-box, etc. d)  Environment – cleanliness, loose-wires, seepage, overcrowding, temperature control, drains, etc e)  Procedures like mopping, segregation of biomedical waste, etc.

29. Staff interview (SI) Interaction with the staff helps in assessing the knowledge and skill level, required for performing job functions. Examples – Competency testing – Quizzing the staff on knowledge related to their job Demonstration – Asking staff to demonstrate certain activities like hand-washing technique, use of PPEs, etc. Awareness - Asking staff about awareness of Antibiotic Policy, disinfection, sterilization, autoclaving etc. Feedback about adequacy of supplies, problems in performing work, safety issues, etc.

30. Record Review (RR) It may not be possible to observe all procedures. Records also generate objective evidences, which need to be triangulated with finding of the observation. For example on the day of assessment, every colour coded bins might be having liners, but if review of the liners supply and usage register reveals poor supply pattern of liners, then more enquiries would be required to ascertain on the adherence to biomedical waste management protocols. Examples of the record review are given below – Review of sterilization records – Autoclaving Register, Review of department registers like BMW Register, Linen Register, Kitchen Register, expenditure registers, Needle stick injury Register etc. Review of licenses, formats for legal compliances like Authorization for BMW, Incident reporting, etc. Review of SOPs of BMW management and Infection control for adequacy of process Review of monitoring records –culture surveillance report, calibration records, etc.

31. Patient Interview (PI) Interaction with patients/attendants/visitors may be useful in getting information about cleanliness and their experience in the hospital. It gives us users’ perspective. It should include – Feedback on staff behavior, food quality, Linen, waiting times, etc. Their experiences during hospitalization/visit. Communication about personal cleanliness, hygiene promotion

32. Compliance & Scoring Rules Full Compliance Partial Compliance Non Compliance 2 1 All Requirements in Checkpoint are Meeting All Tracers given in Means of verification are available Intent of check point is meeting Some of the requirements in checkpoints are meeting All Least 50% of tracers in Means of verification are available Intent of check point is partially meeting Most of the requirements are not meeting Less than 50% of tracers in Means of verification are available Intent of Check point is not meeting

33. Level wise Measurement System Level of facility DH/SDH/CHC PHC (with Beds) PHC (without Beds) Theme 8 6 6 Component 6 50 50 Checkpoint 300 150 100 Marks 8 00 300 200

34. Prepare well before Assessment

35. PAGE 77 Two sub-categories: Best ‘eco-friendly’ District Hospital: - In all States/UTs, the top ranked DH will get best ‘eco-friendly’ award in the District Hospital category. Best ‘eco-friendly’ CHC/SDH Award: - In all States/UTs, the top ranked CHC/SDH will receive an ‘eco-friendly’ award in CHC/SDH category. PAGE 76 Kayakalp overall score card

36. PAGE 79 Two sub-categories: Best ‘eco-friendly’ District Hospital: - In all States/UTs, the top ranked DH will get best ‘eco-friendly’ award in the District Hospital category. Best ‘eco-friendly’ CHC/SDH Award: - In all States/UTs, the top ranked CHC/SDH will receive an ‘eco-friendly’ award in CHC/SDH category. B. Eligibility criteria: at least 70% ‘’eco-friendly’’ score under the Kayakalp during external assessment . PAGE 78 Kayakalp overall score card

37. Swachhta / Kayakalp Fortnight

38. Swachhta Fortnight MoHFW in partnership with state health departments & public health institutions across states & UTs celebrate Swachhta Pakhwada (Cleanliness Fortnight) as part of Swachha Bharat Bahiyan . During fortnight health facilities act as catalyst for visible changes all around. Health departments/Hospitals take up focused cleanliness drive to make hospital premises & it surrounding neat &clean. During fortnight health facility collaborate with schools, local civil bodies, PWD, Private hospitals & NGOs etc. to promote these activities

39. Swachhta Fortnight 15 days event planned around themes such as Awareness drive, cleanliness drive & sustenance During fortnight suggested following activities are done: Inauguration of Swachhata Pakhwada by facility incharge , administration of Swachhta Pledge, Display of IEC regarding cleanliness, distribution of Pamphlets, booklets, regarding hand hygiene, promotion for use of toilet, water & hygiene, distribution of T short, badges, having logo of SBA, drawing competition on cleanliness, awareness about cleanliness through posters, videos, sorting of condemn material at facility,

40. Swachhta Fortnight removal of old posters, outdated IEC material, removal of garbage, overgrown grass, repair & replacement of pipes, removal of stray animals, plantation of trees, improvement in landscaping, training of housekeeping staff

41. Swachh Swasth Sarvatra A Joint Initiative of MoHFW & MDWS

42. Swachh Swasth Sarvatra Death due to diarroheal diseases is 5 th most common cause in India across all age groups Unsafe water, inadequate sanitation & poor hand hygiene practices contribute 5% DALY (Disability adjusted life year) Unsafe water & inadequate sanitation impacts the poor section of society Under SBA, MDWS has two main objectives (1) Construction of toilets (2) Enabling behavior changes

43. Swachh Swasth Sarvatra Goal: Make India Open Defection free (ODF) by 2 nd Oct, 2019. To complement this effort MoHFW join hands with MDWS & launch Swachh Swasth Sarvatra . SSS was launched Union Health Minister J P Nadda and Union HRD Minister Prakash Javadekar on occasion of Good Governance Day (29 December 2016)

44. Objective of SSS The objective of this initiative is aimed at strengthening community health centres in 708 ODF blocks across the country to enable them to achieve higher levels of cleanliness and hygiene

45. Key Feature of Program Achieve better health outcomes through improved sanitation and increase awareness on healthy lifestyles. Its objective is to build on and leverage achievements of two complementary programmes – Swachh Bharat Mission (SBM) and Kayakalp . Under it, financial assistance of 10 lakh rupees will be given to the community health centres so that they can be strengthened to meet the standards of sanitation, hygiene and infection control.

46. Overview of Activity

47. Scope & strategy

48. At PHC Level

49. At CHC

50. Thank you THANK YOU