No. HFW-14015(11)/2/2019-SPSRC SEC-Dept. of H&FW/PPP/1173 Sub: Government of West Bengal Department of Health & Family Welfare PPP Cell ‘Swasthya Bhawan, Sector ~ V, Salt Lake Kolkata — 700 091 NOTICE Amendment/ Corrigendum in relation to pre bid query for tender for Service Providers for Date: 01/10/2019 Establishment, Operation, Maintenance and Management of Mechanized Laundry Facilities at nine different Government Hospitals (Centralized units) in West Bengal on Public Private Partnerships (PPP) mode Ref: Tender Reference Number- PPP/NIT/4/2019 and Tender 1d-2019_HFW_244634_1 Sirf Madam, References above please note that the amendment will be as follows:- [s. ata a 5 ae Queries raised by the prospective bidders Clarifications proposed Related to service rates © Flat rate for 10 yrs with differential escalation for (Power & Water) Revision of rate every three years based on last 3 years, Consumer Price Index (CPI) | As per clause no 7.2.1 of the Draft Concession ‘Agreement- Land will be handed over to the Concessionaire on lease basis at nominal lease value of Re 1. Separate land lease agreement (s) shall be executed between the Authority and the Concessionaire at the time signing of this Agreement The Authority shall provide encumbrance-free, directly accessible, suitable land/space of approximately 5000- 6000 sq ft of land free of cost in or near the hospital premises for 10 years for the project (the “Project Site”). to offer in some cluster what will be tender clause in such case. Also Bid security is single ie. 2 Lacs for all the 9 3)__| What will be the Protocol for Linen Changing? Bidder should follow the Protocols as per Annexure-A L | (enclosed) 4) [Are there any standard guidelines with respect to | Bidder should follow the Protocols as per Annexure-A washing procedures to be followed, quality procedures | (enclosed) to be followed and frequency/intervals of washing linen based on the type of linens? 3) _ | What will be the mode of collection and distribution of | Guidelines will be published by State. Bidder should linens? follow the Protocols as per Annexure-A (enclosed) 6) | Generic specification or standards for the equipments to | Relevant standards as per machine manufacturing be used. country (USFDA, ISI, CE , ISO, etc) to be followed. However, in case of reusable equipments/machinery it should not be older than 3 years. 7) _ | Ifa bidders are selected at multiple cluster and refuses | In any such multiple bids, bidder will be allowed to work on the desired clusters even if he refuses to accept some. Bid security will be forfeited and for the clusters not clusters even for multiple bids then how will the | considered by the bidder the same will be provided to authority seize bid security in case of default and what | H2 bidder based on negotiations (as per clause 2.26.2 of is the way out for bidders in this case. | the RFP document) or authority will go for retender forsuch clusters, 5) There is no exit clause for the bidders in the bid document. Bidders can exit from the contract anytime by giving 6 month prior notice to the authority or in liew by providing amount equivalent to 6 months bill to the authority and in addition to that the performance security will also be forfeited. %” Document states that Steam Boiler will be (Diesel) Variety ‘Steam Boiler may be of Electrical variety 10) For big units with more number of beds eg. one at mayo or Vidyasagar with about 10000 attached beds will possibly generate 15000 kg linens per day and space needs may be increased against standard of 6000 sqft. No change, Space to be provided as per the Bid document, However as represented by Bidders, for units at Mayo Hospital under Kolkata MCH and Vidyasagar SGH where about 10000 beds will be tagged, additional space of 1500-2000 sq ft over the proposed 6000 sq ft ( Total 7500-8000 Sq Ft ) may be allowed subjected to availability of space. i) The number of beds tagged to Mayo hospital facility is 13105 and Vidyasagar is 8476 both comes under Kolkata region, as the load in Mayo Hospital cluster is ‘more so clubbing pattern can be changed to redistribute load. NRS MCH (2000 beds ) may be tagged to Vidyasagar SGH instead of Mayo Clinic which will balance the beds. 12) Location/distance tagging with centralized units may be provided. Hospital location tagging and distance (approximate kilometers) is enclosed as Annexure-B No, HFW-14015(11)/2/2019-SPSRC SEC-Dept. of H&FW/PPP/1173 Ce Ses aweyne ‘+ Last date of submission of query by bidders may be extended to 5" October, 2019. ‘Bid Submission online date and other dates in fact sheet to remain the same. This has approval of higher authorities of the department. ‘opy forwarded for information and necessary action to: Director of Health Service, DoHFW, GoWB. Director of Medical Education, DoHFW, GoWB. Secretary PPP, DoHFW, GoWB. MD NHM, DoHFW, GoWB MD, WBMSCL, DoHFW, GoWB. ‘Commissioner MS, DoHFW, GoWB. Additional Secretary DE, DoHFW, GoWB. District Magistrate-ALL. Additional DHS AAS&V, DoH&FW, GoWB 10. Financial Advisor of the Department. 1. Additional DHS, HA Yours faithfully, hh PPP CELL Health & Family Welfare Deptt. Govt. of West Bengal. Date: 01/10/201912, 13, 14, 15, 16, 17. 18, 19, 20, 21 22, 23, Special Secretary ME. Joint secretary MS Joint DHS Accounts. Joint DHS-HA Joint DHS P&D Principal ~All Medical Colleges. MSVP - All Medical Colleges. CMOHS- All districts including Health districts Deputy CMOH-I & District Nodal Officers for PPP-All Districts. ‘Superintendent -Alll concemed DH/SSH/SDH/SGH/other Hospitals. Co-ordinator IT cell with a request for web posting. Guard File/Office copy TO. he PPP CELL Health & Family Welfare Deptt. Govt. of West Bengal.Annexure-A: Protocol to he followed HOSPITAL SUPPORT SERVICES Support services inthe hospital play a major role in ensuring that they provide the defined services in an efficient manner and also enable the other staff ofthe hospital to carry on the activities which are required for patient care delivery. An engaged and integrated support service team has significant effect com hospital services which allows patient to heal quicker. promotes a safer environment, and improves the satisfaction of staf, patients. and families. The contributions made by support service personnel in today’s hospitals have become 2 erucial component to the organisation's success. Support service departments ensure thatthe hospital is clean, limiting the risk for infections: patient rooms are ready and available, improving throughput: foodis nourishing and deicious.improving healing and wellbeing: linens are fresh instilling trust and comfort: equipments work. improving clinical diagnostics and outcomes. ‘The major support services areas covered under these guidelines include: ‘+ Laundry Services & Linen Management © Water Sanitation + Kitchen Services ‘+ Security Services ‘+ Outsourced Services Management LAUNDRY SERVICES AND LINEN MANAGEMENT ‘The provision of clean linen is a fundamental requirement for patient care, Incorrect procedures for handling or processing of linen ean present an infection risk both to staff and patients who subsequently seit. Hence correct linen managements important to prevent HAL and ensure a better hygienic hospital cnvironment. ‘The term ‘hospital linen’ includes all textiles used in the hospital including mattresses, pillow covers, blankets, bed sheets, towels, screens, curtains, doctors coats, theatre clothes and tableclothes. Thehospital receives all these materials from different areas like OT, wards, outpatient departments and office areas. ESTIMATION OF STOCK OF LINEN NEEDED BY THE HOSPITAL Hospitals need to ensure that they have enough stock of linen (including reserve) readily available fr all theareas of the hospital Different types of linen needed in the hospital include ‘+ General Purpose Linen: This includes linen which is not used for patient care like curtains, drapes. table clothes and similar items commonly used in all parts ofthe hospital ‘+ Patient Linen: This consists of patient clothing such as pajamas, shirts, gowns, coats ete. worn by Patients. ‘+ Bed Linen: This consists of bed clothing such as bed sheets, pillow covers, blankets used by the Patient cx+ OT, Labour Room, Procedure Room Linen: This includes items such as pajamas, kurtas, gowns, coats, shirts etc. worn by surgeons, anaesthetists, OT personnel and also surgical gowns, caps, masks, trolley covers, OT towels etc: required in OT labour room and procedure room. Number of Linen Sets Moats eed! to ensure that they have atleast fur sets of nen per day eventhough sc sets are preferable. Classification of six sets of linen needed in hospitals is a8 follows: ‘© Onealreadyin use (on bed) © One ready to use (in sub store) ‘+ One in transit-oute to laundry or tothe ward © One in washing cyelein laundry ‘+ Twoin stock (in central store) ‘Thus, in an ideal situation. for'a 100-bedded hospital, 600 bed sheets are needed. Hospitals need to maintain the linen stock register for available linen in the central store or with laundry Inccharge of the hospital GENERAL INSTRUCTIONS FOR LAUNDRY MANAGEMENT LINEN ‘The basic principles of linen management are as follows: ‘+ Place used linen in appropriate bage atthe point of generation, ‘Contain linen soiled with body substances or other fluids within suitable impermeable bags and close the bags securely for transportation te avoid any spills or drips ofblood, body fluids secretions or excretions ‘© Donot rinse or sort linen inpatient care areas (sort in appropriate areas) ‘+ Handle al linen with minimum agitation to avoid aerosolisation of pathogenic micro-organisms ‘© Separate dean from soiled linen and transport/store separately ‘+ Wash used linen (sheets, cotton blankets) in hot water (70°C to 80°C) and detergent, rinse and dry preferably ina dryerorinthe sun ‘+ Autoclave linen before being supplied tothe operating rooms/theatres ‘+ Wash woollen blankets in warm water and dry inthe sun,in dryers at cooltemperatures or dry-clea, BEDDING ‘+ Mattresses and pillows with plastic covers should be wiped over with a neutral detergent ‘+ Mattresses without plastic covers should be steam cleaned if they have been contaminated with body fluids If this isnot pessible, contaminations should be removed by manual washing, ensuring adequate personnel and environmental protection ‘© Wash pillows either by using the standard laundering procedure described above, or dry clean if contaminated with body fluids CLASSIFICATION OF LINEN Forlaundry purposes linen in the hospital is clasified into two categories ee Pe fluids or contaminated nen from apatient whois known or clinically suspected, tobe infected with diseases like salmonella, Hepatitis , B or C, open pulmonary tuberculosis, HiVete.es | bidyinen Soiled/Infected Linen <> r - ‘Figure 44: FLOW CHART OF LINEN MANAGEMENT i Cites oc platin OF KAYARALP" ivePROCESS OF LINEN MANAGEMENT IN THE HOSPITAL LABELING OF LINEN Alinen being used in hospitals needs to be labelled for identification and traceability. Proper labelling of the linen also helps in proper inventory management, The label of the linen includes the following ‘minimum details: + Name ofthe hospital (XYZ) + Name ofthe Department or Number of ward (ICU/OBS/WARD) ‘+ Type oflinen like Bed Sheets (BS), Patient Gown (PG), Pillow Cover (PC) + Number of linen ie. 1,2,3. * Doctors coat labelled with Doctor's name For example, bed sheets used in ICU of hospital can be labelled as: XYZ/ICU/BS/1, similarly bed sheet in general ward 1 can be labelled as: XYZ/GW1/BS/06 LINEN COLLECTION AND SEGREGATION + The hospital should have fixed schedule for the collection of linen from different areas of the hospital + _Allthe patientlinen including bed sheets, patient gowns needs to be changed daily + Allthe linen of critical areas like OT and ICU etc. need to be changed daily + The stafflinen needs to be changed on weekly basis + tis strongly recommended to change all the linen used in the hospital when visibly dirty or are soiled + While collecting linen, care should be taken to ensure all sharps or patient equipment is removed + Staff should wear appropriate PPE like heavy duty gloves, apron and mask during linen handling. ‘Any skin lesions on hands should be covered + Hand hygiene should be practiced after linen handling + Linen needs to be collected in bags and trolleys and should not be placed on the floor or any other surfaces + Allthe linen generated from patient care areas should be segregated into dirty and infected linen, Linen generated from different areas ofthe hospital needs to he collected in diferent colour coded trolleys + Dirty linen needs to be collected in a green coloured trolley and soiled linen in yellow coloured trolley. The aundry management protocol ofthe hospital needs to include segregation guidelines for allthe stafTof the hospital + Tominimise aerosolisation of any organisms contaminating linen linen should not be rinsed, shaken orsorted in the clinical area. The personnel should keep his/her hands away from face while handling linen ‘+ Thecollected linen needs to be stored ata designated place ie. in dirty utility ofthe area of generation. ‘© The attendant/sister in-charge of the area needs to update the daily transaction register every time linen is collected from the area. The transaction register should include the details of the number of different types of linen items collected from the particular area. A separate register has to be ‘maintained in different areas for the same.a Colour coded bags for segregation of linen at the source Figure 23: Colour coded bags for segregation of linen ‘TRANSPORTATION OF LINEN ‘© Linen collected from different areas of the hospital needs to be transported in the covered trolleys tothe laundry + Dirty and soiled linen needs to be transported in separate trolleys * Adedicated trolley for transportation of linen needs to be used and trolleys used for waste collection ‘or any other purpose should not be used for transportation of linen + During transportation itis tobe ensured thatthe bags used for collection of inen are properly tied ‘+ Incase of any spillage of the soiled linen during transport, the linen needs to be securely placed in the transportation trolley and cleaning of the surface is undertaken as per the spill management protocol ofthe hospital. RECEIVING IN THE LAUNDRY The person responsible for receiving linen in the laundry needs to enter the details ofthe linen in the receiving and distribution register atthe laundry. The details include type and quantity of linen received, the department from where linen is received, time and date of receiving. Records are necessary to ensure quality assurance of linen and laundry management inthe hospital DISINFECTION AND SLUICING ‘The first step of processing of the soiled linen is disinfection and sluicing of the linen. All infected linen needs to be soaked in 0.5% bleaching solution for 30 minutes, then thoroughly rinsing ofthe linen is carried out with plain water to remove the bleach. The linen is then handed over for washing. Ifthe laundry services are outsourced, i is the responsibility ofthe hospital to disinfect and sluice the soiled linen within the facility itself before handing over the same to the outsourced agency or personnel for further processing. ‘ietines For inplemention OF-KAVAKALP” nativeWASHING + Washing by Hand STEP 1: Wash heavily soiled/infected linen separately from non soiled linen STEP 2: Wash the entre item in water with liquid soap to remove all silage, even if not visible REMEMBER: Pre-soakiin soap, water and bleach ONLY iflinn is soled © Use warm water ifavailable © Add bleach (for example, 30-60 mi [about 2-3 tablespoons}, of a S¥ichlorine solution) to aid cleaning and bactericidal action © Add sour (a mild acid agent) to prevent yellowing of linen, if desirable STEP 3: Check the item for cleanliness, Rewash tisdirty or stained STEP 4: Rinse the item with clean water: + Machine Washing ‘STEP 1: Wash heavily soiled linen separately from non-soiled linen STEP 2: Adjust the temperature and time cycle of the machine according to manufacturer's instructions and the type of soap or other washing product being used. STEP 3: When the wash cycle is complete, check the linen for cleanliness. Rewash iftis dirty or stained, (Heavily soiled linen may require two wash cycles) Dirty Linen: Dirty linen (non-infected linen) is tobe washed in the first batch, with plain water and detergent, Use of hot water with temperature > 71°C is recommended. Soiled & Infected Linen: Infected linen is defined as linen derived from known infectious patients, neluding those with HIV, Hepatitis B, Cand other infectious agents After shuicing the infected linen is treated with hot water and detergent having temperature of more than 71°C with a minimum wash cycle for 25 minutes, HYDRO EXTRACTING AND DRYING ‘+ Washed linen is put in the mechanised hydro-extractor for extraction of water from the processed linen. If hospital does not have the facility of hydro extracting the linen can be put toairdry indirect sunlight ‘+ During the process of drying ofthe linen itis tobe ensured thatthe linen is kept off the ground and away from dust exposure. REPAIR OF LINEN (IF NECESSARY) + Allthe linen is checked for any damage, wear and tear * Incase of any damage ike minor hole or tear observed it should be sent for repair and mending ‘+ Ifthe linenis severely damaged and cannot be repaired, the same can be discarded or condemned as per the hospital condemnation policy. by the laundry supervisor, ‘CALENDERING AND IRONING ‘+ Bed sheets and other heavy linen needs to be calendered with mechanised calendering machines installed atthe hospital ‘reins For nplemezation Of KAVAKALP" Initiative+ Ifthe hospital does not have the facility of calendering machines, the linen needs to be ironed using flat work iron andis folded properly. DELIVERY OF CLEAN LINEN ‘+The processed linen i transported in clean covered trolley to the central store. + Itistobe ensured thatthe storage of clean linen before distribution is separate from dirty linen © From the central store the clean linen is issued to respective departments hased on the indent generated from the departments ‘© From the central store the linen is distributed to respective departments in the clean trolleys ‘+ Record ofissued linen needs tobe updatedin the central store room while the respective departments need to update the transaction register withthe details of inn received in the department. BEDDING ‘© Mattresses and pillows with plastic covers should be wiped over with disinfectant such a8 70% alcohol or 1% chlorine solutions. ‘+ Mattresses and pillow cover without plastic covers should be washed with water and detergent and left forair drying after discharge of every patient. or on weekly basis if occupied by same patient ‘+ Blankets may be dry cleaned orhand washed. Itcan be done by soaking for 15 minutes in lukewarm ‘water: Then soap suds are squeezed through the blanket and then rinsed in cold water at least twice ‘The blanket should not be twisted or wrung, It should be dried by spreading on clean surface. RESPONSIBILITY OF LINEN MANAGEMENT + Change of Linen Staff Nurse/Ward Attendant + Sorting and Storing of used Linen - Ward Attendant/Housekeeping Staff + Disinfection of Soiled/Infected Linen - Housekeeping/Laundry Staff + Collection of Used Soiled Linen - Laundry staff + Counting of Collected Linen - Laundry Staff/Nursing In-charge © Transporting Dirty Linen - Laundry Staff © Washing, Drying and troning - Laundry Staff + Receipt of Washed Linen in Departments -Nursngn-charge + storage and ese of Washed Linen Narechange + Table 28:Do's and don's for Linen Management Dos r {Arson epg uadand end) toee nen sould] Carry edinen desta the ‘be available close to the point of use ee Sharp tobe removed from te linen oplinn on oor ‘Appropriate tagging and labelling oflinen bags | Shaking linen as thi wil result in the dispersal of potentially pathogenic micro-organisms ‘Decontamirating hands immediately following re | Overling of used linen bags ‘moval of PPE after handling used linen and before handing dean linen ' disposable plastic apron should always be worn | Linen bags containing wed linen stored in corridors ‘when tandling used linen and disposable gloves (should be keep in aseparate designated area) ‘Should be wom where linen soiled fou ‘Storing lean and used linen inthe same area, seins For Inplementition Of-KAVAKALP IitiiveAnnexure-B: Approximate Distance between the Tagged locations North 5 ( Coochbehar Coochbehar DH. Bengal MCH | Coochbehar, Dinhata SDH 171 Jalpaiguri, MathaBhanga SDH 1s (Siliguri) | Alipurduar, Mekhliganj SDH 85 Darjeeling ‘Tufangang SDH 179 and Jalpaiguri Jalpaiguri DH 48 Kalimpong ) Jalpaiguri SSH (TB Hospital) B Mal SSH 60 Alipurduar Alipurduar DA 137 Falakata SSH 102 Birpara SGH 123 Darjeeling NBMCH 0 Darjeeling DH 70 Siliguri DH 7 Kurseong SDH a Kalimpong Kalimpong DIT 2 Malda MCH [3 (Maida, | Malda Malda MCH 0 Uttar ‘Chanchol SDH with SSH 58 Dinajpur and | Uttar Dinajpur Raigunj DH (with SSH) 8 Dakhin Islampur SDH (with SSH) 167 Dinajpur ) Kaliagunj SGH 92 Dakhin Dinajpur | Balurghat DH (with SSH) 102 ‘Gangarampur SDH (with SSH) 76 Murshidabad | 2 Murshidabad Murshidabad MCH 0 old District | (Murshidabad Domkol SDH with SSH 35 Hospital and Nadia ‘Jangipur SDH with SSH 35 ‘Campus part ) Kandi SDH BS Lalbag SDH 3 Behrampur Mental Hospital 3 Sagardighi SSH 31 Nadia ‘Nadia DH 38 Tehatta SDH 61 Shantipur SGH 105 Nabadwip SGH 100 ‘Ashoknagar [2(North24 | North 24 Parganas | Barasat DH 2 sGH Parganas and ‘COM Sagar DUTTA 45 Nadia part ) Basirhat DH with SSH 44 Barrackpore SDH 37 Bangaon SDH wih SSH 35 Salt Lake SDH 45‘Ashokenagar SGH Bhatpara SGH Naihati SGH Panihati SGH Habra SGH Bhatpara SGH Balaram Seva Sadan Khardah 39 Nadia ‘COM INM Kalyani 31 Ranaghat SDH 5 Gandhi Memorial 30 (Chakdah SGH 35 Vidyasagar | 2(South 24 | South 24 parganas | MR Bangur DH with SSH 5 sGH parganas and Canning SDH 33 Diamond Baruipur SDH with SSH 27 Harbour HD ) Gardenreach SDH with SSH i Vidyasagar SGH 0 Bagha Jatin SGH 10 joygarh SGH 8 Calcutta National MC&H 12 Pavlov Hospital 12 SSKM Hospital 8 BIN 8 SN pandit Hospital 9 Diamondharbour MCH 0 Kakdwip SDH with SSH 76 Mayo Clinic [4 (Kolkata, | Kotkata Kolkata MCH 4 second North 24 NRS MCH 3 campus of | Parganas, RGK MCH 7 Kolkata Howrah and IDBG 7 mer Bocaire Dr B.C Roy PGIPS 6 ) ‘School of Tropical Medicine 4 casi Chittaranjan Seva Sadan 9 ies R Ahmed Dental College 3 eet, Lumbini Mental Hospital 10 Beniatola, Lady Dufferin Hospital 4 Kolkata. North 24 Parganas | Baranagar SGH 7 Howrah Howrah DH 4 Located on Uluberia SDH with SSH a1 Strand Road) TL Jaiswal SGH 7 Gabberia SGH 33 Belur SGH ul Udaynaraypur SGH 47 Fort Gloster SGH 28‘Souith Howrah SGH Hooghly Hooghly DHT 3 CChandannagar SDF a7 ‘Srirampur SDH with SSH 25 Uttarpara SGH 4 Bankura [5 (Bankura, | Bankura Bankura MCH 0 MCH Bishnupur Khatra SDH a HD, Purulia , Borjora SSH 39 Pashim (Onda SSH 25 Borage ae Chatna SSH 4 dapohivioast Bishnupur DH 39 ) Purulia DA #2 Purulia - Hatuara SSH 80 Raghunathpur SDH (with SSH) 56 Pashim Burdwan | Asansol DH with SSH 2 Durgapur SDH 33 Hooghly ‘Arambag DH B Kharagpur [4 (Paschim | Paschim Midnapur_| Midnapur MCH 16 SDH, Midnapur , Kharagpur SD 0 Paschim Jhargram, Ghatal SDH with SSH 7 medinipur | Purba Belda SSH 37 ae Debra SSH 33 and Thargram ‘Nayagram SSH a | Thargram DH (with SSH) 5 Shalboni SSH 40 Gopiballavpur SSH 39 Purba Medinipur | Tamluk DH 8 Egra SDH with SSH 70 Haldia SDH 122 Contai SDH 99 Nandigram DH with SSH 101 Panskura SSH 3 Digha SGH 105 Bolpur 3 (Birbhum , | Birbhum Suri DH with SSH a SDH, Rampurhat Bolpur SDH with SSH 0 Birbhum HD and Rampurhat HD ‘Rampurhat DH_with SSH 65 Purba Purba Burdwan | Burdwan MCH 38 Burdwan ) Katwa SDA Gl Kalna SDH with SSH 105 ‘Note: The distances mentioned here may vary during actual travel.