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Infection control is emerging as a biggest challenge to health services around the world. All hospitals knowingly or unknowingly admit patients with communicable diseases. In recent years, emerging infectious diseases represent an ongoing threat to the health and livelihoods of people everywhere. Over the last few decades, there have been several emerging infectious diseases (EIDs) that have taken the global community by surprise and drawn new attention to EIDs, including HIV, SARS, H1N1, Ebola, Encephalitis (NIPAH Virus), and Now COVID-19 . For over a century, it has been recommended that patients with infectious diseases should be placed in segregated facilities to prevent the spread of infection. Hospital’s isolation precautions must fulfill following objective: Types of Isolation Rooms There are two types of isolation rooms: (1) airborne infection isolation (AII) rooms and (2) protective environ- ment (PE) rooms. isolation refers to the isolation of patients infected with organisms spread via airborne droplet nuclei <5 μm in diameter. These include patients suffering form measles, chickenpox and tuberculosis. Location The isolation rooms should be located at one end of medical and surgical wards/critical care units/pediatric care units/newborn intensive care units/emergency service areas/also other areas, such as dialysis. Isolation wards for infectious cases to be kept out of routine circulation. The location of the proposed isolation room, such as those near elevator or doorways should be avoided if possible. Number of beds for isolation beds About 2.5% of the beds of a large hospital in a special unit would probably be adequate except during periods of unusually high demand. Space An isolation room has to provide sufficient space around the bed for equipment and the increased number of personnel involved in emergency care. A room area of about 22 m2 is adequate within an isolation unit. Bed Management General Planning Considerations       Ventilation HVAC air flow arrangement for class N rooms. An anteroom designed to provide an ‘air-lock’ (no mix of air) between the infectious patient and the common space is placed adjacent to the patient room. The air would flow from the anteroom to the isolation room. Recirculation of exhausted air is discouraged. The exhaust air should be directed to outside, away from air-intakes and populated areas. However, where recirculation may be deemed acceptable, HEPA filters (99.97% @ 0.3 μm DOP) capable of removing airborne contaminants on the supply side must be incorporated. The supply air should be located such that clean air is first passed over the staff/other occupants and then to the patient. In Class P rooms can be either 100% fresh air or can use re-circulated air usually a 60/40 mix of outdoor air/ re-circulated air. The supply air should be located such that clean air is first flows across the patient bed and exits from the opposite side of the room. Air distribution should reduce the patient’s exposure to potential airborne droplet nuclei from occupants. Positive pressure rooms may share common supply air systems   Emergency Rooms and Reception Areas The likelihood of airborne contaminants leaving these rooms is reduced by keeping these rooms under negative pressure, relative to surrounding areas. Air is exhausted from these rooms either directly to the outside or through high efficiency particulate air (HEPA) filters. Anterooms If space and budget permit, an anteroom should be pro- vided between the negative/positive pressure isolation room and the corridor It is always recommended for both positive and negative isolation rooms for three main reasons: Fire Plan

Healthcare patients have more options than ever before. With so much information available online, these patients no longer feel the need to visit the closest hospital, a medical practice closest to their location, or even healthcare practices with multiple locations in the community. That’s why it’s so important to have a planned, budgeted healthcare marketing plan to reach new and returning patients in your area at the best moment. Healthcare Marketing, even if you’re happy with your current patient volumes, can’t happen without a planned medical marketing strategy to keep your healthcare brand at the forefront of people’s minds. Think of all the reasons someone might decide to switch healthcare providers: changes in the type of healthcare insurance, relocation, dissatisfaction with wait times, or just one negative experience. You are not guaranteed to keep up your patient volumes forever. Planning Your Healthcare Marketing Strategies Doctors tell patients all the time that prevention is better than cure. It’s better to have a marketing strategy in place now than to wait until you find out your patient marketing CRM (Customer Relationship Management) database is nearly empty. A Healthcare marketing strategy is an investment for doctors, healthcare networks, and healthcare marketing professionals. You may have to hire outside help and plan for a larger budget than you have in the past. But in the end, it’s worth it for that peace of mind–and to see your patient volume grow faster than ever before! To help you along, we provided our top 15 items to include with any well-planned healthcare marketing strategy. 1. Use consistent healthcare branding You might feel confident your expertise sets you apart from other healthcare providers, doctor practices or hospitals. But let’s face it–to a patient, one white coat looks just like the next. You need to figure out what your brand is all about. What’s unique about your healthcare network, hospital or medical practice? Is it the way you treat patients? Your family-friendly office? There is at least one thing that makes your medical teams unique, and that’s what helps patients remember your healthcare organization’s name. It may take time to figure out what works for your brand. But eventually, your healthcare marketing strategy comes together smoothly because you learn how best to represent your brand with any marketing materials. 2. Evaluate the online patient experience A decade ago, simply having a website was enough to impress prospective patients and help them find your healthcare brand identity. But now, a website is healthcare’s new front door. It’s the first thing patients often see, and if it’s not optimized for user experience, it may also be the last time a person considers your hospital or practice. Put yourself in a patient’s shoes. If someone were to land on any page of your site, would they know your location, or your medical practices ‘multiple locations, and primary services in about 5-10 seconds? Would they be able to contact the right person quickly? Do the imagery and wording represent your healthcare clinic’s, or practice’s average patient? User experience is an important consideration in website design. But sometimes, designers are so focused on making the website look good, they forget to focus on the patient experience. We often find that websites need to be completely redone. However, it might help to make small changes, like positioning the “Contact Us” form higher up on the page. 3. Build a responsive healthcare website A responsive website is one that automatically adjusts to the size of a screen, so the experience is the same whether the site is accessed on a computer, tablet, your phone, or any mobile device. Google cares about the user experience, and it will prioritize competitors who have a site optimized for mobile. In general, responsive sites work best for the mobile digital healthcare experience. But even if you currently have a responsive site, you should check that the content and imagery continues to load properly on mobile devices. 4. Test site speeds Marketers who study user behaviors online have proven that patients today are less willing to put up with slow loading times than ever before. It only takes 5 seconds to lose a prospective patient who decides to navigate elsewhere thanks to your slow site. In fact, it’s another user experience issue that may cause your medical or healthcare website to fall in the search engine results. You can test your site speed at Google’s PageSpeed Insights here. If load times are slow, speak to your web developer about ways to speed it up. And, another healthcare marketing tip, to remember — check the site speeds of your competitors, within your “healthcare neighborhood”, or within you medical services niche.  5. Optimize for prospective patients search engine results Search engine optimization is a powerful tool for getting your medical practice or hospital network to the top of the search engines. However, it’s a lot more complex than most marketing professionals realize. You cannot simply use the term “healthcare practice” 100 times throughout your website and hope to rank #1 on Google among doctors providing healthcare services in your area. A large part of SEO involves using the right optimal phrases and keywords so that Google can understand your healthcare organization websites and be sure you rank for the proper, relevant and pertinent healthcare-related search terms (e.g., medical conditions, healthcare professional treatment of any type). But it also means using those terms naturally throughout your content, as Google cares about readability first and foremost. And this is only the beginning of healthcare marketing best practices for SEO, which also include: 6. Utilize PPC and display ads for Healthcare Marketing Pay-per-click advertisements appear first in search results. Search engine optimization is an organic way to make a practice or hospital more visible online. However, even if your site ranks number one for a search term like “dentist in Tulsa,” there are still 3 or 4 paid advertisements above that number one search that people will see first. These are pay-per-click advertisements, paid advertisements that are laser-targeted to appear first for a set of search terms. With pay-per-click advertising (also known as PPC or paid search), you can manage your budget and decide what you’d be willing to spend to keep your site visible at the top of the search engines. Your return on investment is clear and defined with both PPC ads and display ads that appear on the sidebar or top of other websites. 7. Leverage social media (the right way) Too

Medical equipment procurement is a critical factor in ensuring that the process of opening, moving, or even upgrading a medical facility is handled in a manner that both lets the doors open when planned, and delivers the level of service promised right from the start. Purchasing managers and facility equipment administrators across the country are becoming increasingly aware of the vital importance of bringing efficiency to this fairly complex undertaking as the healthcare marketplace continues to dictate the need to both cut costs and increase quality performance. One of the best ways to effectively streamline the overall process, of going from an empty facility to one which is fully equipped and ready to go, is to evaluate getting from point A to Z in systematically achievable steps.  With that in mind, let’s take a look at 5 Ways to Improve Medical Equipment Procurement Efficiency. That is the bottom line in the medical equipment procurement processes from the point of view of the purchasing manager, the medical professional and the client at the service end of the operation. These five ways to improve medical equipment procurement efficiency essentially simplify what has historically been complex series of separate transactions and arrangements.   Keeping up with the advancements of the healthcare industry can be an expensive and time-consuming endeavor. When addressing medical equipment procurement, whether for new facility construction, building expansion or for an update to an existing one, having an efficient and cost conscious process is critical. The four things to look for in the procurement provider should be: What are some operational challenges that health systems are having with their supply chain? The big one is product standardization. Your health system is in a growth mode. You’re adding hospitals, ambulatory surgery centers, physician practices, urgent-care centers, retail clinics and home care. When you do that, you’re adding sites of care that probably aren’t using the same medical supplies and equipment as you. And you’re probably not ordering all of your medical supplies and equipment the same way. With the right supply chain partner, you can start tracking all that and identify opportunities to standardize products and product ordering across all your care delivery sites. According to a recent survey of 100 hospital supply chain leaders, nearly half of respondents still use a somewhat manual process such as Excel spreadsheets and other less sophisticated/outdated tools to manage inventory, supply expenses and other supply chain activities. What other operational challenges do health systems face in supply chain management? Your challenge as a health system is how to get the right products to the right places in the right quantity at the right time. That’s why your health system needs a customized supply chain that extends into each and every corner of your operation that provides care to patients. How have new market entrants influenced how health systems think about their supply chain? It’s exciting to think that you could order a box of surgical gloves over a voice assistant and have it delivered in two hours. But the excitement doesn’t always match the reality of what you need. And what you need is consistency. You want consistency of price, right? You don’t want the price changing all the time, and you don’t have the time to comparison shop for the best price every time you need something. You also want consistent availability. You never want the things that your patients need to be unavailable or out of stock. What about delivery time from new market entrants? What do health systems say about that? A lot of people that we talk to think that if you can get books the same or next day, you can get medical supplies the same or next day. There certainly are items that you can get the same or next day. But, those are general items for general use. When you dig deeper, you realize that your health system uses a lot of obscure items. One-time items. And our industry has a lot of obscure products that patients need. Getting that item from a new market entrant may take a week, two weeks or even three weeks. That just doesn’t work in healthcare. You need what you need in two days or less. Those are just table stakes for the healthcare supply chain. What about the security of the supply chain? Should health systems be concerned about safety? That’s always a challenge no matter who you buy from. You should know where your items are coming from. If you buy from a legacy distributor, you’re buying the original products from the original manufacturers who sell directly to the distributor. If you buy from a new market entrant, that line may not be so straight. The sellers may not be authorized distributors for the product. You don’t know where they got the product from. You don’t know who shipped and stored that product. If we’re talking about cold storage of drugs, that can be a real issue from a patient safety standpoint. You need to ask those questions of any of your supply chain partners. Security is a hallmark of effective supply chain management. So is standardization. Yet new products come into the market all the time. How can a health system access those items with its supply chain? There is a lot of innovation happening right now. A lot of those vendors and suppliers are trying to sell into your health system. That’s a good problem to have, and your supply chain needs to be flexible enough to accommodate new things that can help you deliver the best care to patients. But, at the same time, you can’t be flexible in the quality and cost criteria that you use to determine whether you should buy an item or not. At most of the health systems we work with, a new product needs to run through quite a gauntlet to get on to the menu of things you can buy. Supply chain leaders are under a lot of pressure. But they are the

Vital Elements to consider while planning for new hospital New hospital construction projects involve highly specialized, complex, and expensive endeavors.  The construction of new hospital buildings requires significant oversight because of patient safety and health requirements, strict regulations and advanced technology that need to be accommodated. Hospital decision makers face mounting pressures to do more with less while delivering quality patient care. Consequently, hospital construction projects must contain costs and extract maximum value for each capital rupee invested. Here Are Six Vital Elements For Delivering A Facility That Will Meet Your Needs: 1. Include all stakeholders When assembling the project team, make sure membership includes hospital board members, administrators, physicians and nurses. Do not exclude from the process x-ray, and rehab, respiratory therapy, and other staff that will need to buy into the project. Team members must undergo a rigorous review process to ensure they have experience with the type of construction project. They should also have familiarity with the requirements for hospital architecture as well as pertinent local and national regulations. 2. Hire experts to assist the process We recommend that hospital decision-makers should higher/employ highly qualified consultants, architects, engineers, and construction managers that have experience with your model. The integrated project delivery method recommends that you establish partnerships with all of the key players in the project “on day one.” The collaboration process includes working with project design, costs and scheduling. Team members should also provide input on how things can be done more efficiently and cost-effectively. 3. Integrated design method Many decision makers embrace the “integrated design” method to ensure the construction of a high-performance hospital facility at a reduced cost and with less risk. Integrated design produces energy, economic and environmental benefits for patients, staff and hospital administrators. The process results in a dynamic, energy-efficient facility that is comfortable and adds to the organization’s bottom line. For example, utilizing the integrated design method to reduce loads and right-size or do away with equipment can result in lower mechanical, electrical and plumbing costs. 4. Make sure the project is feasible It is very important to ensure that the construction project is financially and physically feasible. This requires an alignment of the budget with the project’s scope. Start by evaluating the physical constraint of project and any environmental challenges. You should also conduct a careful evaluation of any potential risks prior to starting the project.   Prepare a detailed business plan that includes the following items: 5. Integrated risk management for your project Integrated risk management refers to a process that identifies, evaluates, manages, and monitors the risks associated with a construction of a new hospital building.  Risks may include budget and cost overruns, scheduling delays, financing and credit risks, regulatory compliance, and operational impact. Create a comprehensive plan that allocate resources, minimizes exposures and reduces the cost of risks. 6. Integrated project delivery Integrated project delivery denotes the process of bringing together the project architects, engineers construction managers to work together to in a collaborative effort, which can reduce costs and speed up the project’s completion.   About FCHC:  First Choice Healthcare Consultancy is specialised in consulting the health care business: assisting hospitals, clinics, laboratories, research centres, diagnostic centres and rehabilitation centres in managing the planning (architectural & financial), design and construction and operating of facility projects to support their healthcare mission and sustain their improvements. As a full-service healthcare Planning & designing firm, we work with provider practices, medical groups and hospitals to bring these elements into a custom Planning. Please write us at info.fich1@gmail.com Make your Dream Project successful.

National Accreditation Board for Hospitals and Healthcare Providers (NABH) is a constituent board of Quality Council of India, set up to establish and operation accreditation program for healthcare organizations. NABH is structured to cater too much desired needs of the consumers and to set benchmarks for progress of health industry. NABH is Public Recognition of achievement of accreditation standard by a healthcare Organization, Demonstrated through an independent external peer assessment of that organizations level of performance in relation to the NABH standards. Though NABH is integral part of Healthcare service providers as it’s pre-requisite to get empanelled for various government facilities and insurance facility, as it provides access to reliable and certified information on facility. The Insurance Regulatory and Development Authority of India (IRDA) have directed healthcare providers offering cashless services for allopathic treatment to meet National Accreditation Board for Hospitals (NABH)’s pre-accreditation entry level standards. NABH Accreditation benefits all stake holders, Patients are the biggest beneficiary, it ensures high quality of care, along with that it also emphasize over safety of caregivers. It stimulates continuous quality improvement to a health care organization.  With all that safety measures NABH also be helpful in competitive advantage. NABH and QCI jointly released Pre-accreditation Entry Level Certification Standards after healthcare organization, especially small hospitals, as they found full Accreditation standards highly challenging to start with in both way financially and space constraints. It standards has lesser requirements in comparison to full accreditation. Upcoming hospitals and healthcare organization need to develop hospital in such a way that are compliant with the NABH standards, though infrastructure wise But NABH Complies with the laws of land. Usually Indian Hospital designer follows the NBC (National Building Code of India) It serves as a Model Code for adoption by all agencies involved in building construction works. The Code mainly contains administrative regulations, development control rules and general building requirements; fire safety requirements; stipulations regarding materials, structural design and construction (including safety); building and plumbing services; approach to sustainability; and asset and facility management. Apart from that Operation theatre and CSSD must have Suitable location and layout which leads unidirectional flow and zoning. Sufficient space need to plan to ensure that the activities can be performed properly. HISI (Hospital Infection Society India) and HTM Guidelines are usefull. stp For Existing hospitals it is quite challenging to meet with all standers especially in structural requirements stipulated by NABH in their running set up. Existing hospital may required some design changes to fulfill minimum requirement in order to provide quality healthcare services for both patient as well as staff. Most of the old hospitals get non compliances in total floor area per bad requirement, Clean & dirty doors separation.  Realizing that smaller players find it tough to stick some of its size norms, NABH has eased its stipulation for OT rooms. “In all fairness, not all surgeries really called for the erstwhile minimum 400 sq ft. However, they still insist on engineering standards for OTs that often doesn’t add up” NABH not only focuses setting up quality in healthcare setups but also in operational way too. Imaging services shall have adequate space and equipment to meet its defined scope of services which shall include Physical space, MEP requirements.  AERB guidelines could be used as a reference document for radiation based imaging.       Timely repair of civil structure like walls, servicing of furniture must be carried out. For Medical Gases it is advised to refer HTM 02-01 or NFPA’s Medical Gas and Vaccum system installation Handbook. Appropriate safety measures like alarm unit valve boxes at various location and 24×7 monitoring of plant alarm unit to control gas pressure. Standby equipment and supplies facilities must be available in all critical areas. Alternative source for electricity and water are provided as backup for any failure/shortage. It is preferable that separate Civil, Electrical, Plumbing HVAC, and piped medical gas drawings are maintained. Equipments are inventoried and proper logs must be maintained. Accreditation totally depends on compliances with set standards by NABH, though it focuses more over operational compliances a new hospital can apply after 6 month of its operation, after that all its depend over organizational compliances with the stands, but generally it takes 6 to 8 month to get acreditated. Compliances probability can be increase by following standards from starting of hospital with staff training. The main challenge in our industry is getting and retaining medical expertise.  India has a scarcity of specialized and super-specialized doctors. New hospitals coming up make retaining doctors more difficult as they offer attractive packages due to which doctors switch hospitals once in every 2 to 3 years. While in case of nursing and paramedical staff their attrition rate is very high, due to which during whole training module staff remains changing. New staff who haven’t attended previous module need to get trained again,  in this situation for a consultant continuous online trainings may helpful and same time here responsibility of HR department increases in both way to retain trained staff as well as to scheduling properly. As large number of hospitals face challenges and difficulties in implementing all the Accreditation Standards, NABH developed pre-accreditation entry level certification standards, in consultation with various stake holders in the country, as a stepping stone for enhancing the quality of patient care and safety. The aim is to introduce quality and accreditation to the hospitals as their first step towards awareness and capacity building. Once pre accreditation entry level certification is achieved, the hospitals can then prepare and move to the next stage – progressive level and finally to full accreditation status. This methodology provides a step by step and staged approach, which is practical for the hospitals.