Report on HIRA in Fortis hospital Amritsar

Students of MBA Hospital and Healthcare management

Course Code: HLTM616 Course Title: DISASTER MANAGEMENT IN HEALTHCARE

Course Instructor: Sunny Kumar

Academic Task No.: 2 Academic Task Title: Assignment 2

Date of submission: 18/12/22

Student’s Roll no: RQ2151A16 Student’s Reg. no: 12101571

Evaluation Parameters:
 PEER RATING

REGISTRATION CLASS ROLL PEER

NO. NO RATING
NAME

UMAR FAROOQ 12101571 16 10

LONE

ANKIT GARG 12112049 9 10

ANKITA 12112100 8 10

PARUL SHARMA 12102067 11 10

RUDHANSHI 12108938 10 10
THAKUR
 INTRODUCTION ABOUT HOSPITAL

Fortis Hospital in Amritsar is one of the leading multispecialty hospitals that offer comprehensive
medical care to every patient. With a pioneering status in the healthcare domain, Fortis hospital,
Amritsar deliver services in a safe and compassionate environment and enhance the well-being of
the patients and their families. Fortis hospital in Amritsar has highly skilled and experienced
doctors and paramedical staff. The specialities of Fortis Amritsar include Anaesthesiology,
Cardiology, Critical Care, Neurosciences, Urology and Kidney Transplant, General and
Laparoscopic Surgery, Gastroenterology and Hepatology, Nephrology, Oncology, Pulmonology,
Internal Medicine, Plastic Surgery, Diabetes and Endocrinology, Gynaecology and Obstetrics,
Paediatrics and Neonatology, Dermatology, Eye, ENT, Dental, Dietetics, Psychology, Psychiatry,
Physiotherapy, Preventive Health Check. Fortis Amritsar has been committed to the delivery of
world-class, holistic healthcare services to each & every patient.

With a special focus on the management of critically ill patients, the hospital boasts
of having 1/3rd of its beds dedicated to critical care and comes well-equipped with
the latest technology and infrastructure. Fortis Escorts Hospital Amritsar is also the
only hospital in the region to have the following accreditations.
- NABH accreditation for the hospital (2011, 2017)
- NABL accredited (2011, 2018)
- NABH accredited for Nursing Excellence (2017)
- NABH Et
1)Hazards
This e-tool is intended for use by people in charge of occupational health and safety
for health workers at the national, subnational and facility levels and for health
workers who want to know what WHO and ILO recommend for the protection of
their health and safety.
1.Occupational infections
1.Needlestick injuries contribute to 39%, 37% and 4.4% of hepatitis C, hepatitis B
and HIV infections respectively
2.The prevalence of acute hepatitis B infection among health workers globally is
5.3%.
3.About 54% of health workers in low- and middle-income countries have latent TB
infection.
2.Unsafe patient handling
1.Up to 72% of nurses are suffering from non-specific chronic low back pain.
2.Low back pain is associated with health workers’ absenteeism, reduced efficiency,
increased economic burden, decreased quality of life, and burnout.
3.Exposure to hazardous chemicals
1.Disinfectants, cleaning products, sterilants, anaesthetic gases, mercury, hazardous
drugs and pesticides used in health-care settings may be harmful to health workers.
2.Cleaning agents and disinfectants have been associated with a 67% increased risk
of new-onset asthma in nurses.
3.Bleach and gluteraldehydes have been associated with double the risk of asthma
in nurses.
4.Exposure to radiation
1.Exposure to ionizing radiation may cause skin and blood damage, cataract,
infertility, birth defects and cancer.
2.The probability of radiation adverse health effects is proportional to the dose
received, but no level of radiation exposure is completely safe.
3.Exposure to ultraviolet (UV) radiation can cause skin cancer, skin burn and
cataract, while lasers can cause tissue burns, eye damage, fire and explosion and
system failures.
5.Occupational stress, burnout and fatigue
Time pressure, lack of control over work tasks, long working hours, shift work, lack
of support and moral injury are important risk factors for occupational stress,
burnout and fatigue among health workers.
1.Intrinsic demands of the job, individual susceptibility, and poor work organization
contributes to increased stress in health workers.
2.Prolonged job stress may cause burnout, chronic fatigue, absenteeism, high staff
turnover, reduced patient satisfaction, and increased diagnosis and treatment errors.

6.Violence and harassment

1.Violence and harassment affect all health worker groups and work settings in the
health sector.
Up to 62% of health workers have experienced workplace violence.
2.Verbal abuse (58%) is the most common form of non-physical violence, followed
by threats (33%) and sexual harassment (12%).
7.Risks in ambient work environment
1.Noise exposure above 85 dB(A) may cause temporary and permanent hearing
damage, while lower noise levels may cause annoyance, lack of sleep, and increased
stress.
2.Heat stress can arise from pronged work in full personal protective equipment
(coveralls, gowns, hoods, googles, boots, respirators). Working outdoors in
situations of extreme cold or heat can cause serious health damage.
3.Poor lighting in work areas can cause injuries, eye strain and loss of vision.
8.Occupational injuries
1.Wet floors, spills, and clutter may cause slips, trips and falls.
2.Poor vehicle maintenance, inadequate operator training and lack of safety restraint
contribute to ambulance crashes.
3.Unsafe electric work practices may cause electric shock, electrocutions, fire and
explosions.
9.Environmental health hazards
Unsafe and insufficient water for drinking and washing, inadequate sanitation and
hygiene, hazardous healthcare waste and climate related risks may cause work-
related diseases and injuries among health workers.
1.One third of health facilities do not have what is needed to clean hands where care
is provided.
2.About 800 million people use health facilities with no toilets.
3.One in four health facilities have no water services
2)Risk Assessment:
The potential areas of risk in the hospitality industry are similar to those in restaurant
and hopita; business settings. However, there are some that are room and guest
specific. A hospitality business, like a hotel, motel, or similar establishment, is a
unique bundle. It contains everything from food and beverage services, to special
event settings, to every nuance involved in the rooms for guests. The effects of
business, even food inflation, come into play as well.
Hospitality risk management is vital to the success of a hospitality business. From
room service to lobby safety to banquet event ideas and planning, there are plenty of
areas with risk potential. One risk area that spans the business is everything to do
with hospital inventory and order management
These six factors of risk in the hospitality industry show the scope of what you have
to be aware of in hospitality risk management. They range across the departments
and different hospitality needs. They also showcase some back of house risks, as the
back of house department of a hospitality business is equally important.

1. Liquor Liabilities
Anywhere liquor is sold, there are liquor liabilities. In a hotel bar, it’s hard to know
where your guests may be headed after they’ve had a drink or two. The best thing
you can do is keep tabs on how many they’ve had with you. You should also keep
an eye on areas like the pool, for safety measures.
2. Hazardous Chemicals
Cleaning is a big part of keeping hotels and hospitality businesses ready for guests.
This is more of an important factor with the COVID-19 pandemic. Of course, this
brings with it the hazard of dangerous chemicals. The best way to avoid risk with
these chemicals is to keep them in the hands of the cleaning crew. That can mean
either on carts or in a locked store room.
3. Common Safety Hazards
Common safety hazards in a hospitality business are slips, trip, and falls. These are
some of the most common issues that show up in hotels regularly. To avoid these
risks, make sure your carpets are well-maintained and keep wet floor signs available.
Additionally, it's a good practice to have stairs and steep areas lit up for visibility at
night.
4. Special Event Management
Special event management, from the hospital server work to the hospital manager
job to hospital server, has a unique set of risk. An event, from a party to a corporate
function, brings together food and beverage risks and general guest satisfaction and
safety risks. A full risk assessment and plan is needed for the event
management department.
5. Property Damage
Property damage is bound to happen from time to time with so many guests moving
through the hospital. Property damage can be as small as a chipped bit of paint on
the wall to as large as a broken nightstand. It can be hard to avoid, as guests are
unpredictable. The best risk management plan is to have a budget set aside for
damages.

6. Food Safety
Food safety is paramount in a hospitality business. From in-house restaurants to
room service to catering, a lot of food moves through a hotel. With all that food,
food safety is a top risk to look out for. The best way to mitigate it is to
have operational efficiency in the kitchen and food storerooms.
7.Lobby Danger Zones
The lobby is a place with many potential risks. From slip and falls near the entrance,
to baggage mishaps, to issues with checking in and out. A mapped out risk
assessment, with procedures in place and necessary equipment–like baggage carts–
will help avoid cluttering up the lobby with risk.
8.Fires
Kitchens pose a greater risk of fire, due to the use of gas, naked flames and other
flammable substances. Ensuring staff understand how fire spreads, how to tackle it
and understanding emergency procedures will help to keep them safe in the event of
a fire. Although most fires are avoidable, so make sure staff are prepared and follow
procedures, which will help prevent a fire in the first place.
9.Mental ill-health
Those who work in hospitality are used to long hours in a fast-paced environment.
The role can often be pressured and stressful, which can contribute to mental ill-
health. You can read more about mental ill-health in hospitality in our blog here. It
is important to recognise mental health on an equal footing with physical
health. Mental health awareness and wellbeing is thankfully being taken more
seriously in the workplace, and businesses are recognising the importance of
supporting employees in this area.
10.Slips, trips & falls
Businesses in the hospitality sector have many operational challenges, especially
when they are at capacity. You will not be surprised to know that slips, trips and falls
are among the most common causes of injury in this industry, particularly among
chefs and waiting staff. Food spillages, wet floors and trip hazards all contribute to
this. Blocked walkways, and waiting staff rushing to serve tables can all act as
hazards. These risks must be managed to help reduce this type of accident. Good
housekeeping, appropriate footwear, cleaning up spills and good lighting are all
practical measures which can be taken to avoid.
Interview questions from the healthcare worker
1Q What is the major risk in hospital?
Ans Infectious agents are organisms that are capable of producing infection or
infectious disease. They include bacteria, fungi, viruses, and parasites. Healthcare
workers have a high risk of contact with infectious agents due to the various types
of activities involved with their jobs and the possibilities of contamination like
Bloodborne Pathogens (BBP): HIV/AIDS, Hepatitis B, Hepatitis C
Influenza (FLU)
Seasonal
Pandemic
Avian
Swine
Ebola
Methicillin-resistant Staphylococcus aureus (MRSA)
Tuberculosis (TB)
Severe Acute Respiratory Syndrome (SARS)
Middle East Respiratory Syndrome (MERS)
2Q what kind of risk are you facing when you do work in your laboratory?
ANS Many hazardous chemicals are present in healthcare settings, which may
pose an exposure risk for healthcare workers, patients, and others. These chemicals
are used to do the following:
• Treat patients (e.g., antineoplastic drugs, aerosolized medications, anesthetic
gases)
• Clean, disinfect and sterilize work surfaces (e.g., phenolics, quaternary
ammonium compounds, bleach) and medical supplies and instruments (e.g.,
ethylene oxide, glutaraldehyde)
• As a fixative for tissue specimens (e.g., xylene, toluene, formaldehyde)
Surgical smoke generated by lasers and electrosurgical devices during surgical
procedures contains many chemical substances, in addition to viruses and bacteria.
3Q What kind of physical hazards are you facing and see around you?
Ans Musculoskeletal disorders are a major concern in occupational healthcare.
Injuries occur frequently and are often due to repeated handling of patients, which
involves heavy manual lifting when transferring or repositioning patients and
working in extremely awkward positions. Lifting becomes more difficult by the
increasing weight of patients to be lifted due to the obesity epidemic in the United
States and an increasing number of elderly people who require assistance with daily
living activities.
NIOSH Hazard Review: Occupational Hazards in Home Healthcare
Workplace Solutions: Preventing Work-Related Musculoskeletal Disorders in
Sonography
Safe Lifting and Movement of Nursing Home Residents
Ergonomics and Musculoskeletal Disorders
Safe Patient Handling
Ergonomics: Guidelines for Nursing Homesexternal icon
4Q Why are health workers more likely to experience mental health problems?
ANS Working conditions have always been challenging for healthcare workers,
even before the pandemic. Work in healthcare often involves:
• Intensely stressful and emotional situations in caring for those who are sick
• Exposure to human suffering and death
• Unique pressures from relationships with the patient, family members, and
employers
• Working conditions with ongoing risk for hazardous exposures such as to
COVID-19, other infectious diseases, hazardous drugs, and more
• Demanding physical work and risk of injuries such as from patient handling
• Long and often unpredictably scheduled hours of work. This is often related
to as-needed scheduling, unexpected double shifts, and unpredictable
intensity of on-call work.
• For many health workers, unstable and unpredictable work lives, and financial
strain
The COVID-19 pandemic has introduced additional elements of fatigue, strain,
stress, loss, and grief for healthcare workers. Many healthcare workers experienced
increased workload in the face of short staffing and shortages in critical personal
protective equipment. This led to increasing anxiety and the risk of personal harm.
Some healthcare workers report symptoms consistent with post-traumatic stress
disorder related to the pandemic. Some also reported residual symptoms due to
personal infection with COVID-19.
Many healthcare workers place the well-being of others before self. On the surface,
this dedication to patients may seem admirable. However, it can ultimately be
harmful if it delays or prevents workers from getting the help that they need for their
own health and well-being.
5Q Do you have any type of preventional control?
ANS Immunization
1.Immunization of Health-Care Personnel: Recommendations of the Advisory
Committee on Immunization Practices (ACIP)
2.Recommended Vaccines for Healthcare Workers
3.State Immunization Laws for Healthcare Workers and Patients
4.Mandatory Vaccination of Health Care Workers – Whose Rights Should Come
First?/ National Institutes of Healthexternal icon
Personal Protective Equipment
1.Respirator Use in Health Care Workplaces: a Toolkit for Respirator Program
Administratorsexternal icon
2.Preventing Transmission of Pandemic Influenza and Other Viral Respiratory
Diseases: Personal Protective Equipment for Healthcare Personnel Update
2010external icon
3.Considerations for Selecting Protective Clothing used in Healthcare for
Protection against Microorganisms in Blood and Body Fluids
4.Eye Protection for Infection Control
5.Ebola
6.NIOSH Research Highlights Importance of Rigorous Standards for Gowns Used
to Protect Healthcare Workers
7.Recommendations for Protecting Laboratory, Field, and Clinical Workers from
West Nile Virus Exposure
8.Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering
Facepiece Respirators in Healthcare Settings
9.Respirator Evaluation in Acute Care Hospitals Study (REACH)
10.Respiratory Protection Program Toolkit
11.Respirator Trusted Source Information
12.Implementing Hospital Respiratory Protection Programs: Strategies from the
Fieldexternal icon
13.Hospital Respiratory Protection Program Toolkit: Resources for Respirator
Program Administrators

Risk Matrix:
The choice of the most appropriate methodological approach to risk
rating estimation is the first organizational decision in risk analysis.
Organizations can choose among quantitative, qualitative and semi-
quantitative methods. Risk levels for patient injury from a particular
medical procedure could be defined through the assessment of the
probability based on the historical frequency or available statistical data
and numerical values expressive of the potential impact ranging from
minor injuries to severe trauma leading to the death.

2.Qualitative Risk:
the qualitative methods do not express the size of likelihood or the consequences
by means of figures . The value of likelihood and impact/consequence levels of a
specific event are given by description using a pre-defined rating scale. This
generally implies an inaccurate determination of risk and it is used in all those
cases in which calculating the numerical value of risks is impossible or
difficult. For example, when numerical data are inadequate or unavailable,
resources are limited (in terms of budget or expertise) and time allowed is scarce, a
single person or team, in these cases, can collect information using structured
interviews/questionnaires (also with experts in the area of interest), specialist and
expert judgments, evaluations using multi-disciplinary groups, and benchmarking
methods.
3. Semi Qualitative Risk:

Semi-quantitative risk assessment represents an intermediary level

between the textual evaluation of qualitative and the numerical
evaluation of quantitative risk assessment, by ranking risks according to
a predefined scoring system , allowing the information to be processed
quantitatively. This approach consents mapping the perceived risks into
categories, establishing a logical and explicit hierarchy between
categories, and reflecting the order that should be followed in reviewing
them. Comparing advantages and disadvantages of the quantitative vs
qualitative methods, the combination of these two models can be a
solution in healthcare. The semi-quantitative method combines specific
advantages of each by decreasing their disadvantages, explaining their
diffusion in the healthcare organization, as suggested by government
guidelines and best non-governmental practices, although they have a
limited ability to correctly reproduce the risk assessments implied by
quantitative models.