On Wednesday morning, 21-year-old Vijay Kumar rushed his 15-year-old brother Prashant to the fever ward in Delhi’s All India Institute of Medical Science. He jostled his way through the the hall packed with scores of men, women and children, down with high fever and acute pain in their joints – most of them being tested for chikungunya.
“His (Prashant’s) blood samples have been collected and the doctors suggested a test suspecting chikungunya,” said Kumar. “We are now waiting for a doctor to prescribe medicines for the fever which hasn’t receded for the past three days, the lumps in his body and the severe joint pain.”
In one corner of the room, a security guard curled up in a stretcher was shivering. “I have been deployed in this emergency ward and have been working here for around two years,” said the guard who did not want to be named “I have witnessed thousands of malaria, dengue and chikungunya patients in this fever ward but I was never affected till now.”.
Next to him lay a police constable in uniform receiving a dose of saline. “He has very high fever and severe body ache. He too is being tested for chikungunya,” the guard said.
Twenty eight-year-old Pradeep, a plumber by profession, also awaited his test results. On his bed lay a medical sheet in which the doctor noted that he had fever of 104 degrees Fahrenheit and acute pain on his joints. “I hope it is not chikungunya,” Pradeep said. “I work on a contract and I have to get back to work at the earliest.”.
The four men are among thousands who presently throng the emergency wards of government and private hospitals in the city, down with high fever and being diagnosed for chikungunya. In what can be called a severe public health crisis in the national capital, the Delhi Municipal Corporation has recorded as many as 1,057 chikungunya cases till September 10, reported PTI. This is a 90% rise in just a week.
Even data from the National Vector Borne Disease Control Programme shows that the current outbreak in Delhi is worse than in previous years.
The crisis appears to have worsened with the deaths of 10 people diagnosed with chikungunya reported this week. The Indian Express reported on Wednesday that five deaths occurred at Apollo Hospital and most of the victims were above 80 years of age. The hospital authorities said that the deaths had occurred in the last three weeks.
Union Health Minister JP Nadda, however, maintained that chikungunya cannot be the cause of death even as Delhi government and the civic agencies are trading blame for the crisis. Delhi's Health Minister Satyendra Jain on Tuesday claimed that the national capital did not have an outbreak of chikungunya and blamed the media for creating panic about it. "There has never been any death due to chikungunya in the world. Medically. This is media-created panic," he said, according to a news report by ANI.
Death from chikungunya is not common. However, the disease can contribute to the cause of death especially in older people who already have serious health conditions. There is no cure of chikungunya, only treatment for its symptoms.
Dr Atul Kakar, Senior Consultant and Vice Chairman at the department of internal medicine in Delhi’s Sir Ganga Ram Hospital put it in perspective. “Patients of extreme age and those with co-morbid heart, lung and liver problems or diabetes need to be more careful," Kakar said. "Chikungunya triggers the inflammation of certain cells which may lead to multi-organ failure.”
Referring to the first three deaths which were reported from Sir Ganga Ram Hospital, its spokesperson Ajoy Sehgal said that the three of them were above the age of 60, two of them were diabetic with hypertension and kidney disease and the third had a severe lung ailment. “The vector-borne disease led them to a state of shock, causing death,” said Sehgal.
Meanwhile, Kumar, who watches over Prashant at AIIMS, is worried that his brother, who is in 10th standard now, may not recover before his term examinations next week. “We live here on our own and our family, which is settled in Bihar’s Siwan district, is quite tense,” he said.
What hospitals can do to drive entrepreneurship and enhance patient experience
Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.
At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.
Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.
At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.
Getting the best from collaborations
Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”
Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.
There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.
When intrapreneurship can lead to patient centric innovation
Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.
Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.
Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:
Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
Help for non-English speakers: Iconography cardstohelp non-English speaking patients express themselves and seek help in case of emergencies or other situations.
As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.
According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.
Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.
To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.
This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.