We have of around 1.12 crore OPDs and 72 lakh Hospital Inpatient Department (IPD) load on MCGM-run hospitals…We aim to decongest the crowd, reducing patient load from major hospitals, says I A Kundan, Additional Municipal Commissioner, Western Suburbs, Municipal Corporation of Greater Mumbai, in conversation with Harshal Yashwant Desai of Elets News Network (ENN).
Q: The Municipal Corporation of Greater Mumbai (MCGM) has a huge responsibility to cater to people with comprehensive healthcare facility. How do you look at MGGM’s health department significance?
The Mumbai Municipal Corporation runs four major medical colleges and hospitals, five speciality hospitals, 16 peripheral hospitals, 28 maternity homes, 175 dispensaries, and 208 health posts. We have more than 17,000 employees working in our health department.
Out of 40,000 hospitals beds in Mumbai, MCGM hospitals provide about 12,000. MCGM’s share is 30 percent of the total bed strength of the city with a population of over 12 million. We aim to decongest the crowd or reduce patient load from major hospitals. The corporation has taken a slew of measures to improve healthcare deliverables across peripheral and primary hospitals.
So, the Health Department of the MCGM not only provides basic health care facilities to citizens but also focuses on other aspects related to preventive care.
Q: What interventions have been made by the MCGM of late to improve healthcare infrastructure in the city?
The total Hospital Outpatient care (OPD) load on major MCGM-run hospitals on annual basis is 57 lakh. OPD load on peripheral hospitals is 60 lakhs. We have a total of around 1.12 crore OPD and 72 lakh Hospital Inpatient care (IPD) load on MCGM run hospitals.
Taking into account patients’ loads on major hospitals and burden of communicable and non-communicable diseases, MCGM has huge responsibility and accountability to cater people with quality patient care.
Our primary focus is not just to reduce the load from the hospitals but to strengthen the healthcare delivery system in the manner where primary, secondary and tertiary health centres will be robust enough to provide accessible, quality healthcare facility to residents of the city in their vicinity
Q: What initiatives have been undertaken with regard to biomedical equipment management?
Medical equipment are critical to save a person’s life or perform any procedure. And, the use of medical devices is an increasingly important element of a healthcare professional’s role.
An agency was allotted to map and maintain the biomedical equipment available at all MCGM hospitals including medical colleges, peripheral hospitals and maternity homes. The service agency is responsible to analyze and report medical equipment inventory and map the entire equipment inventory in all health facilities.
Q: Please brief us on how operations at primary hospitals have been streamlined.
We have started various diagnostics centres, and also set up diagnostics in dispensaries. It is game-changing initiatives as poor people will now get the facility of around 101 basic investigations and 38 advanced investigation free of cost at these dispensaries. People above the Below Poverty Line (BPL) line can avail the facility at minimum cost.
This will lead to not just reduction in out-of-pocket expenditure, better care, but also decongest secondary and tertiary hospitals by at least 35-40 percent.
We went ahead with development of hospitals with three-pronged strategy where we emphasized on services, infrastructure and Human Resource (HR) aspect. We at MCGM have looked into very holistic manner of strengthening of healthcare delivery mechanism. Not even a single peripheral hospital remained untouched from infrastructural development i.e., renovation and restoration. Major hospitals have undergone lots of infrastructural strengthening and we have developed a concept of hub system whereby most of the peripheral hospitals were linked to certain major hospitals to avoid unnecessary congestion. Also, we developed the super specialization in peripheral hospital in such a way that people living in near vicinity will have access of all kinds of specialization and super specialization facility and they don’t need to travel far off places.
In terms of HR, we have made lots of efforts to fill in vacant posts i.e., post of nurses were filled up which improved patient to nurse ratio to ideal level.
Q: You have also undertaken innovations in Facility Management. Please elaborate.
We believe it is of utmost priorities to maintain clean environment in all areas of the hospital, and to ensure this we need enough manpower – which at times becomes difficult due to growing patient load. In order to address this concern, an innovative contracting mechanism was established wherein instead of outsourcing manpower, actual per square feet area was given for housekeeping services. By doing so, the intervention focused on the ultimate goal of cleanliness instead of getting into the complex mechanism of hiring people for housekeeping.
Q: How is MCGM ensuring digitization of patients’ records?
Soon, we will have, Health Management Information Systems (HMIS), an innovative application which will help store patients’ information in digitised form at one place making patient records, particularly, the patient history, easily and readily available at all levels. Some of the major features of HMIS in process include patient management, data generation and a special feature to convert speech to text for data entry into OPD sheets.
Q: MCGM has done remarkable work by implementing Public Private Partnership model. Isn’t it?
Yes. We have collaborated a lot with private players to improve healthcare delivery. For an example, in peripheral hospitals, 171 ICU beds were not functioning optimally.
With private participation, we outsourced those beds at a certain fix nominal rate which not only improved condition of these beds but referrals to other major hospitals also came down.
To make maternity hospitals fully functional, we made empanelment of private practitioners, anaesthetists, paediatricians, and also created 33 additional posts of post-graduate medical officers which included 20 obstetricians and gynaecologists. We have also empanelled neonatologists so as to ensure better services in maternity homes. With this, urban poor will have very close access to these basic requirements. We provide free drug, diagnostics and treatment facility for non-communicable diseases including cancer at MCGMrun hospitals.