of Safe and Sustainable Hospital (SASH 2016) ds mn~?kkvu lekjksg ds k.k

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Denis Ryan
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1 12 uoecj] 2016 dks iq.ks] egkjk"vª esa vk;ksftr fd, tk jgs National Conference of Safe and Sustainable Hospital (SASH 2016) ds mn~?kkvu lekjksg ds volj ij ekuuh; v/;{k क Hkk"k.k k.k fgekpy izns'k ds iwoz jkt;iky tflvl oh-,l,l- dksdts],;j ek'kzy iou diwj] Hkkjrh; fo kihb ds lalfkkid dqyifr MkW- iraxjko dne],;j ek'kzy ZyZy lh-ds ds- jatu] lg~;kfnz vlirky dh v/;{k lg izca/k funs'kd MkW- pk: nrrk vkivs],dsmeh vkwq gkwflivy,mfefulvªs'ku ds v/;{k es-t- vkj-ds ds- xxz ¼vodk'kizkIr½] miflfkr fof'k"v vfrffkx.k] nsfo;ks vksj lttuks! 1- Academy of Hospital Administration (AHA) ds rroko/kku esa vk;ksftr fd, tk jgs ^^National Conference of Safe and Sustainable Hospital (SASH 2016)** esa 'kkfey gksdj eq>s izluurk gks jgh gsa lu~ 1987 esa viuh LFkkiuk ds le; ls gh ;g vdkneh yksxksa dh LokLF; ns[khkky laca/kh lel;kvksa dk lek/kku djds ljdkj ds iz;klksa esa cgqr izhkkoh <ax ls lgk;rk dj jgh gsa tslk fd ge lhkh tkurs gsa fd The first wealth is health vksj ;g Hkh mruk gh lp gs fd Good health is not something we can buy. However, it can be extremely valuable Savings Accounts. blfy, vpns LokLF; ds egro dks ge lhkh tkurs gsa vksj bldh vko';drk,oa tu&tu ij] fo'ks kdj xjhc rcds ds Åij im+us okys izhkkoksa ls ge lhkh vpnh rjg ls ifjfpr gsaa 2- Hkkjr dk gsyfk lsdvj nqfu;k ds lcls cm+s gsyfk ds;j fllvel esa ls,d gsa gekjs gsyfkds;j fllve esa cgqr&lh [kwfc;ka vksj [kkfe;ka Hkh gsaa Hkkjr esa health sector ds nks fglls gsaa,d ifcyd lsdvj vksj nwljk izkbosv lsdvja c<+rh gqbz tula[;k ds lkfk LokLF; dh t:jrksa dh iwfrz ds fy, izkbosv gsyfk lsdvj esa cgqr rsth ls c<+ksrrjh gqbz gsa,d vuqeku ds vuqlkj kgjh {ks=ksa esa yxhkx 70 izfr kr vksj xzkeh.k {ks=ksa esa yxhkx 63 izfr kr yksx viuh LokLF; laca/kh t:jrksa ds fy, izkbosv lsdvj ij fuhkzj gsa vksj ge lhkh tkurs gsa fd ljdkjh {ks= ds vlirkyksa ij viuh {kerk dh rqyuk esa LokLF; lqfo/kk,a

2 2 iznku djus dk ncko gs vksj mugsa fdl izdkj dh lel;kvksa ls tw>uk im+rk gsa Hkkjr esa vkt Hkh esfmdy ba ;ksjsal dk QSyko fo o ds vu; ns kksa dh rqyuk esa cgqr lhfer gsa blfy,] vf/kdrj yksxksa dks bykt ds fy, viuh tsc ls islk [kpz djuk im+rk gs vksj ;g dkqh egaxk gksrk gsa blfy, ljdkjh {ks=ksa ds vlirkyksa ij nckc vksj vf/kd c<+ tkrk gsa dgha&dgha rks flfkfr bruh xahkhj gs fd fnyyh ds dqn vlirkyksa esa diagnostic test vksj surgery ds fy, yxhkx Ms<+&nks lky dh waiting gksrh gsa ogha gekjs izkbosv lsdvj ds dbz vlirky,oa ogka miyc/k lqfo/kk,a fo olrjh; gsa ftlls nqfu;k ds nwljs ns kksa ds yksx Hkh ;gka bykt djkus vkrs gsaa Hkkjr esa LokLF; lsokvksa esa rduhd ds lkfk&lkfk ejht dks HkkoukRed lecy Hkh feyrk gs] Lusg vksj lsok ge Hkkjrh;ksa dh igpku gs vksj fons'kh yksxksa ds fy, Hkkjrh; vlirky,d vpnk,oa u;k vuqhko gksrk gsa Hkkjr nqfu;k esa lcls vf/kd biologically active region esa ls,d gsa vksj ;gka lhkh izdkj ds eksle vksj tyok;q ds dkj.k tks fofo/krkiw.kz vuqhko gekjs fpfdrldksa dks izkir gksrk gs] og vuqhko mugsa dkqh ifjido,oa dq ky cuk nsrk gsa kk;n blhfy, gekjs fpfdrld dq ky ekus tkrs gsaa 3- izkbosv vksj ifcyd lsdvj ds vykok Hkkjr ds fpfdrlk {ks= esa,d vksj divide gs ftugsa ge urban vksj rural divide ds :i esa dg ldrs gsaa gekjh vf/kdrj fpfdrlk lqfo/kk,a kgjh {ks=ksa esa gh miyc/k gsaa gekjs xkaoksa esa tgka fd 68 izfr kr population fuokl djrh gs ogka dsoy 2 izfr kr MkWDVj gsaa bldk dkj.k xkaoksa esa cqfu;knh lqfo/kkvksa ds vhkko esa MkWDVj dke ugha djuk pkgrs gsa vksj blfy, Hkh kgjh {ks=ksa esa izkbosv vksj ifcyd lsdvj nksuksa] vlirkyksa ij dkqh nckc im+rk gsa 4- orzeku esa gekjk gsyfk lsdvj 7]15]000 djksm+ #- ds yxhkx gs ftlds lu~ 2020 rd nqxquk gks tkus dh lahkkouk,a gsaa bu lc ckrksa dh i` BHkwfe esa bl Conference dk egro vksj Hkh c<+ tkrk gsa ;g ns[kdj oklro esa cgqr [kq'kh gqbz gs fd bl izdkj ds jk"vªh; dk;zøe ds vk;kstu ls LokLF; ns[khkky ls tqm+s yksxksa dks,d eap feyk gs vksj Hospital Management vksj Technology ds {ks= esa ftruh rsth ls muukfr gks jgh gs]

3 3 mls ns[krs gq, ;kstuk rs;kj djus vksj O;oLFkk dks le; ij upgrade djus dh vko';drk gsa eqöks fo'okl gs fd bl leesyu ls bl vko';drk dks iwjk djus esa cgqr enn feysxha fo'olrjh; vlirky izca/ku ge rhkh ns ik,axs tc bl fn'kk esa vksj O;kid fopkj foe'kz gks,oa jksfx;ksa ds lkfk&lkfk vlirky ds dkfezdksa dk Hkh [;ky j[kk tk,a 5. Sustainability should be embraced as a core value in every sector. The whole world is talking about Sustainable Development Goals. There are 17 Goals and 169 targets under SDGs. Goal No. 3 talks about ensuring healthy lives and promoting well-being for all at all ages, underpinned by 13 targets that cover a wide spectrum of WHO's work. India's support is in line with Indian Philosophy of returning back more than what one receives. In fact in a prayer we say that oh God! please keep my mental framework such that I always remain committed for giving more than what I receive. 6. The cost of medical education, rapid pace with which the technological advancement is taking place, extremely high land prices in urban areas and increased wages for technical and medical staff makes it obligatory for every hospital administration to keep pace with the medical advancement to achieve financial sustainability and also invest in new technology. It is absolutely essential for a hospital to be safe from clinical, environmental point of view for not only the patients but also its staff, visitors and people in the immediate neighbourhood. Hospitals often experience the opposite pulls and pressure of safe and sustainable hospitals. 7- Although sustainable development is closely interrelated with health and health promotion, in health care systems, these themes are hardly ever discussed and even more rarely implemented in combination. We see opportunities for sustainable development and health promotion, particularly in hospitals, since they

4 4 play a central role in health care systems. Furthermore, hospitals have significant and growing economic, social, and environmental impacts, which in turn cause adverse effects upon health. 8. The health care sector has a large and costly environmental footprint and hospitals are among most energy intensive facilities and the amount of waste generated by them and use of large quantity of various chemicals have major effects on public health. Reducing such pollution and green house gas emission would reduce the incidence of human disease thereby saving money for the health care system and society as a whole. This requires efficient, sustainable hospital buildings and operations. It has been assumed by many that intervention end at sustainability, good cost hospitals more to undertake than any savings that would accrue to them. However, findings in other countries have shown this concern to be misplaced. However, energy use reduction, waste reduction, more efficient purchase of operation use supply can go a long way in tackling these issues through reprocessing and reuse of single use medical devices wherever possible. 9. Hospitals must expand quality criteria in decision making to include sustainability and health gain improvement to improve its future viability and also contribute to global sustainability. So, reduce, reuse and recycle should be the Mantra for all Hospitals. Recycling hospital waste has significant potential and is another area where health professionals can have a positive impact. 10. Medical disposables have increasingly replaced reusables, due to lower perceived costs, infectious risks and personal opinion. The few life cycle analyses of medical products have found that reusable devices are generally both financially and environmentally preferable to single-use comparators.

5 5 11- vlirky izca/ku ds {ks= esa dqn ubz&ubz rduhdsa vkbza gsa ftuls LokLF; lsok,a miyc/k djkuk vklku gq, gsaa tsls] bysdvªkwfud fpi] tks jksx dk irk yxk ldrs gsa] jkscksfvd ulz vfllvsav] jkscksv ds }kjk dei;wvjhd`r ltzjh] d`f=e jsfvuk yxk;k tkuk] d`f=e vax fuekz.k,oa mlds rehabilitation dh rduhd] br;kfn dqn,sls mnkgj.k gsa ftuls LokLF; ns[khkky ds {ks= esa Økafrdkjh ifjorzu yk;k tk ldrk gsa,sls midj.k Hkh vk x, gsa tks jksxh ds 'kjhj dks LdSu djds mldh orzeku,oa lahkkfor LokLF; ds ckjs esa lvhd Hkfo";ok.kh dj ikrs gsa ftuls jksxh dks Qk;nk gks ldrk gsa ;g lc rduhd dk lkfkzd mi;ksx ekuk tk ldrk gsa 12- vkt yksx LokLF; laca/kh lsokvkas ds fy, eyvh Lisf'k;kfyVh ;k lqij Lisf'k;kfyVh vlirky dh vksj :[k djus yxs gsaa yksx,slh txg bykt djkuk pkgrs gsa tgka mugsa ml jksx fo'ks"k dk fof'k"v mipkj feysa is'kk vksj ifjos'k dks /;ku esa j[krs gq, mugsa LokLF; lqfo/kk,a iznku djuk Hkh mudk nkf;ro gsa mnkgj.k ds fy,] iozrh; {ks=ksa esa mapkbz ls lacaf/kr fo'ks"kk dh O;oLFkk gksuh pkfg, rks industry ds {ks= esa vlfkek] Vh-ch-] flyhdksfll br;kfn jksxksa ds fo'ks"kk dh O;oLFkk gksuh pkfg,a {ks= fo'ks"k tsls xksj[kiqj esa tkikuh balsqykbfvl ds bykt gsrq dkjxj izca/ku djuk Hkh LokLF; izca/kdksa dh izkfkfedrk gksuh pkfg,a 13- fe=ks! bl ckr esa dksbz lansg ugha fd vius ns'k ds ukxfjdksa dk LokLF; vksj dy;k.k gekjs fy, lcls egroiw.kz gksuk pkfg,a xahkhj chekfj;ksa lfgr lhkh izdkj dh chekfj;ksa ls vius ukxfjdksa dh lqj{kk vr;ur vko';d gsa bl mìs'; dks izkir djus ds fy, gesa lcds fy, fdqk;rh nj ij csgrj LokLF; lqfo/kk,a iznku djus ij tksj nsuk gksxka ljdkj }kjk LokLF; ns[khkky dks ysdj,d ubz igy ^lsgr ¼Social Endeavour for Health and Telemedicine½* dh 'kq:vkr dh xbz gs ftlls gsyfk ds;j ds {ks= esa vke ukxfjdksa dks tkuus] le>us,oa mi;ksx esa ykus laca/kh tkx:drk c<+sxh vksj ;g fmftvy rduhdksa ds blrseky ds ek/;e ls yksxksa ds fy, leqfpr fodyi cudj mhkjsxka xzkeh.k {ks=ksa esa rks ;g dkqh izhkkoh fl) gks ldrk gsa lhkh yksxksa ds LokLF; laca/kh gsyfk fjdkwmz

6 6 dks dsunzhd`r j[kus dh O;oLFkk gks ldrh gs D;k\ rkfd jksxh dh LokLF; laca/kh gkyr dh leiw.kz tkudkjh vlirky dks miyc/k jgs ftlls u dsoy jksxh dk bykt vklkuh ls gks lds cfyd tkap ij vkus okyk [kpz Hkh de gksa Hkkjr ljdkj us vlirkyksa dks LoPN,oa laøe.kjfgr cukus ds fy, izksrlkfgr djus ds mn~ns'; ls,d ubz Ldhe ^^dk;kdyi** izkjahk dh gs ftlesa bl fn'kk esa myys[kuh; dk;z djus okys vlirkyksa dks iqjldkj fn;k tkrk gsa 14- jksfx;ksa ds fy,,d lcls cm+h lel;k nokbvksa dk vr;f/kd egaxk gksuk gsa Hkkjr tsls ns'k] tks vkffkzd :i ls mrus leiuu ugha gs] ds fy, czkamsm nokvksa dh txg tsufjd nokb;ksa dk ;fn mi;ksx fd;k tk, rks dkqh gn rd fdqk;rh LokLF; lqfo/kk,a miyc/k gks ldsaxha blds fy, ljdkj dh iz/kkuea=h tu vks"kf/k ;kstuk ds rgr ekpz 2017 rd 3000 tu vks"kf/k LVksj [kksyus dh ;kstuk gsa Hkkjr esa ikjeifjd fpfdrlk i)fr;ka tsls vk;qoszfnd] ;qukuh] fl)] ;ksxk vksj uspqjksisfkh br;kfn Hkh lfn;ksa ls dk;zjr gsa ftldks fodflr djus,oa yksdfiz; cukus dh fn'kk esa ljdkj dk iwjk iz;kl gsa blds fy, fo'o LokLF; laxbu ds lkfk Hkh,d le>ksrk fd;k x;k gs rkfd Hkkjrh; fpfdrlk i)fr dh igpku osf'od Lrj ij gksa 15- fe=ks! finys rhu n'kdksa esa Academy us health care management ds fofhkuuk igyqvksa ds {ks= esa viuh Nki NksM+h gsa,slk blls tqm+s lhkh yksxksa }kjk yxu vksj izfrc)rk ls dke djus ls gh lahko gks ldka mugsa c/kkbz nsrs gq, esa vk'kk djrh gwa fd Academy ns'k ds] fo'ks"kdj xzkeh.k vksj nwjnjkt ds bykdksa esa gekjs lekt ds fu/kzu vksj misf{kr oxks± dh lsok ds fy, fd, tk jgs vius ljkguh; iz;klksa dks tkjh j[ksxha eqöks fo'okl gs fd bl leesyu ls LokLF; ns[khkky {ks= esa 'kkfey fofhkuuk {ks=ksa ds izksqs'kuyksa dks,d eap feysxk ftlls bl leesyu dk LokLF; ns[khkky m ksx ds fy, LokLF; ns[khkky izca/k ds {ks= esa u, iz;klksa dh tkudkjh izkir djus ds fy,,d O;oLFkk iznku djus dk y{; izkir gksxka esa bl volj ij Academy vksj lhkh izfrhkkfx;ksa dks 'kqhkdkeuk,a nsrh gwaa esa dkeuk djrh gwa fd vkus okys o"kksza esa bls vksj Hkh egroiw.kz

7 7 lqyrk,a izkir gksa vksj bl izdkj bls mu yksxksa dk leeku izkir gks ftudh lsok djus ds fy, bldh LFkkiuk dh xbz FkhA 16- gekjs vlirky lqjf{kr gksus pkfg,] jksfx;ksa] ifjpkjdksa] LVkWQ vkfn ds fy, lqjf{kr gksus pkfg,a mipkj de ykxr okyh gksuh pkfg, vksj i;kzoj.k dh n`f"v ls Sustainable gksus pkfg,a In the end, I would like to say Make our health Care System healthy and caring. bugha 'kcnksa ds lkfk] esa National Conference of Safe and Sustainable Hospital (SASH 2016) dk lg"kz 'kqhkkjahk djrh gw A /ku;okna &&&&&

CENTRAL COUNCIL OF INDIAN MEDICINE NEW DELHI

CENTRAL COUNCIL OF INDIAN MEDICINE NEW DELHI 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 136y 36. 37. 38. 39. 40.