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  • 24
  • Apr'20

RRMCH – COVID19 Preparedness

Aim
1. Continuity of essential services
2. Well Co- ordinate implementation of priority action
3. Prompt internal and external communication
4. Swift adaptation to increased demand of hospital services
5. Effective use of scarce resources

Establish

Incident Management System [IMS] to organise

1. Hospital Emergency response plan for CoViD-19
2. Hospital emergency operation centre – College Board Room / Medical
Superintendents Room ( To be well equipped with audio visual
system with interlink from hospital to Co- ordinate, convene with
emergency response team [TEAR- Team of Emergency Activity &
Response]

3. Designate/ Nominate lead person for ten categories if necessary
4. Second in line in-charge for lead person to be identified if required
5. Ensure effective and efficient hospital management of CoViD-19
outbreak- to follow guidelines of ICMR/MOHFW/WHO or any
other apex body

Incident Management System

Categories
1. Case Management
2. Communication
3. Continuity of essential services & patient care
4. Essential support services
5. Human Resource’s
6. Infection control and prevention
7. Diagnostic/ Laboratory services
8. Logistics & management of supplies
9. Surge capacity
10. Surveillance- early warnings and monitoring

IMS committee

Hospital Administrators– Executive Director, Dean, Principal, Medical Superintendent, Vice – Principal

1. Medical Personnel- HODs – Gen Medicine, Pulmonology,
Anaesthesia, ICU head, HICC head, Epidemiologists/Community
Medicine, Nursing superintendent.
2. Estate Officer, AEO
3. HR manager
4. Security Head
5. Pharmacy Head
6. Bio medical engineering department Head
7. Head of Diagnostic and Laboratory services
8. House keeping in-charge – BVG group
9. Stores head
10. Nutritionist

Continuity of Essential Health Services

1. Emergency and casualty to function as usual [HCWs to strictly follow
safety guidelines]
2. Dialysis [Additional patient consent regarding possible spread of
CoViD19 to be taken]
3. Disaster team / TEAR [Team for Emergency Activity & Response] to
be alerted – As per NABH Disaster Management Committee
4. Resources- HR and Logistics needed to be made available.

Human Resource

1. Updating of all Staff [HCWs] contact details to be done.
2. Policy to monitor and manage staff with suspected/ confirmed CoViD-
19 [Testing, Isolation, quarantine and management of disease to be
ensured]
3. Identify minimum HCWs required for each area of services – MS
Office

4. Distribution of HCW – MS Office / CoViD – 19 Committee
5. Familiarise all staff to work in high intensity areas [CoViD ward/ ICU ,
emergency, etc] – MS, NS and Concerned HoDs
6. Training regarding PPE and Patient management – HICC
7. Travel / Accomodation support for HCWs – Estate Officer
8. Support staff – counsellors from Psychiatry Department – Concerned
HoD

9. To address liability and temporary permission to staff working outside
their area of specialty – HR in coordination with MS / NS office
10. To admit temporary staff from students alumni, volunteers, NGO train
them for the need – Dean/ Principal

Surveillance and Early Warnings

To be done by department of PSM – Systematic collection of data analysis, to monitor progression of CoViD patients to help early management plans and report to Health department.
1. Designate faculty preferably Epidemiologist – HoD – Community
Medicine to designate
2. Check list to be prepared regarding information to be collected & its
necessity – Community Medicine to prepare
3. Formularise data collection and reporting mechanism as per National
health policy and criteria – Community Medicine
4. Ensure testing of persons hospitalised for CoViD 19 is as per standards
[ presently Testing is not done at RRMCH] – If and when it starts,
Dept. Of Microobiology and Pulmonary Medicne to organise
5. Training regarding surveillance to be done- Community Medicine

Case Management

1. Triaging of patients- Early recognition – Isolation- Separation of
Suspect / CoViD/ other patients – Emergency / Pulmonary Medicine/
General Medicine/ Anesthesia – ICU
2. History of Source if any [ Inform PSM Department for surveillance]
3. Triage station to be equipped- area adjacent to Emergency ward
4. Waiting area for patients with respiratory symptoms- designated area
outside casualty – Estate Officer
5. All staff to wear appropriate PPE – To be monitored by HICC
team
6. Standard precautions to be maintained by HCWs for patients and
visitors [ mask , gloves , hand hygiene etc] – To be monitored by
HICC team
7. Display availability of beds under each category – NS Office
8. Routinely monitor availability of drugs , oxygen supply, suction and
other equipment’s – Concerned In charge faculty in coordination
with pharmacy and Assistant Estate Officer

Communication

Prompt communication be done with effective collaboration, Co operation and public awareness

1. Communication through phone , mail , by concerned HCWs to concerned
Faculty and administration
2. Roles and Responsibilities of Hospital staff to be explained and made
aware [to be added under HR]
3. Awareness of hospital policy and guidelines to be ensured regarding
clinical triage/ admissions/ discharge criteria / HICC measures to
relevant staff – MS Office
4. MS / nodal officer to regularly update information to Government Health
Department and communicate the feedback
5. Sign boards / Hoarding with key messages addressing various scenarios
of CoViD 19 for different target audience [patient, visitor, public,
media] – HR and Assistant Estate Officer
6. Principal/ Medical Superintendent/ Vice Principal to be the spokes
persons to Co ordinate communicate with public, media , and health
authorities
7. Regular check up of communication system by EO

Infection, Prevention & Control

1. Respiratory & Hand hygiene awareness and training for all HCWs ,
patients , visitors to be given by HICC. Displays wherever required has
to be put- HR and Assistant Estate Officer
2. Monitor HCWs for following standard precautions to all patients –
HICC
3. Categorise wards & ICU as a. CoViD positive b. CoViD negative c.
CoViD suspect . Distance between beds to be 1 to 1.5 mts – Principal,
MS
4. Recognise shared equipments and train for disinfecting between each
patients – HICC and concerned departments
5. Disinfect all possible surfaces contacts of patients routinely as per
HICC guidelines lines [ copy of guidelines to be made available at all
places ]

6. Ensure and make policy for proper PPE at different levels of HCWs
7. Designate exclusive team of HCWs for CoViD patients to avoid risk of
transmission – MS and NS Office
8. Designate exclusive equipment [ X ray and USG] for CoViD patients [
refer Radiology SOP for CoViD 19 ] – Concerned HoD
9. Maintain records of all persons entering CoViD patients room/ward –
MS/ NS Office
10. Ensure proper BMW guidelines are followed in disposal of PPE and
other contaminated materials [ All contaminated materials are to be
burnt in designated place] – HICC in coordination with Assistant
Estate Officer

Logistics & Supply Management

1. Update inventory of all equipment/ supplies/ pharmaceuticals along
with shortage alert if any – Purchase , Stores and Pharmacy
2. Estimation of essential supplies/ drugs to be done and made available [
weekly requirements for 300 patients] – Purchase, Store, Pharmacy.
List to be taken from Pulmonology, Medicine and Anesthesia
HoDs
3. Keep the Vendors informed regarding sudden requirements [ Recognise
additional supplier]- Purchase
4. Identify space to store additional supplies. – Purchase, Store

Diagnostic and Laboratory Services

1. Exclusive Portable X ray and Sonography unit for CoViD patients-
Concerned HoD – ICU portable X Ray unit and portable Ultra Sound to
be kept in CoViD 19 ward
2. Ensure awareness and train HCWs in appropriate usage of PPE and
equipment safety & disinfectant – HICC and Department SOP
3. Ensure prompt communication of results – Concerned faculty
4. Ensure continued supply / availability of Diagnostic and laboratory
resources – Purchase and Stores
5. Identify backup personnel/ equipment/ laboratory – Concerned HoD
6. To establish referral pathways for identification, confirmation and
monitoring CoViD patients [ all diagnostic and laboratory results to be
sent through online ]
7. Training for concerned staff in packing and transporting of specimens –
HICC

Surge Capacity

Plan for any additional surge of patients above the available capacity
1. Presently old hospital building is recognised for CoViD patients care /
treatment
2. Initially Left Wing to be used for admission later right wing
3. Total of 300 patients[including ICU ] will be treated
4. All faculty, teaching residents , interns and nursing, to be called on
duty
5. All elective surgeries, patient care are cancelled

PPE- Basic guidelines

1. OPD CoViD patients screening – N 95 mask , goggles, water resistant
gown , disposable gloves
2. OPD – sampling / ICU / CoViD wards CoViD patients shifting
ambulance personal – Complete PPE [ for cleaners provide heavy duty
gloves]
3. Other non CoViD areas- Triple layered mask , gloves, hand hygiene,
social distancing
4. Administration- No PPE required other than hand hygiene and
Sanitizers with social distancing.

Reference – RGUHS Webinar Training Program attended by Dr. Pravin

COVID19 Preparedness

Donning and Doffing to be done in Immediate Post Surgical Recovery Room

Fever Clinic Situated in the Main Hospital left Side entrance