Management of COVID-19 Pandemic

What if everything goes in the right direction as per healthcare management during this pandemic?

“It’s time to set aside the business as usual” mindset. Even if a large number of severe cases don’t start appearing for weeks, every moment spend on preparations now will pay off..” ( Vineet Chopra, M.D, M.Sc)

There have been several large outbreaks of infectious diseases, and the loss of life of these diseases is practically identical to the variety of lives lost in the war. There has been a number of enormous pandemics, for example, SARS, H7N9, Zika, Ebola, and now COVID-19. In Nepal, there are more than 15,000 COVID-19 cases with around 35 passing as of the start of April 2020. These numbers continue expanding every day hugely. With the continuous loose modality of lockdown, the cases are expanding step by step. The current battle against the novel coronavirus isn't just a weight trial of Nepal's medical system yet in addition serious difficulties to every public health system across the country. It is where government, associations should consider improving the limit and productivity of control of COVID-19. Hospitals and medical institutions could attempt to strengthen their complete administration capacity including the executives while dealing with patient's needs and safety. For the present and the future, I think the healthcare sector should give specific consideration to the accompanying issues: 

1) Improve management system in Healthcare Institution:

The objective of the management system is to structure and make a quick and adaptable association dependent on its destinations, explain its responsibilities and powers and facilitate inner assets to guarantee operational viability and proficiency. The structure of the administration, as a rule, fuses four key stages: 

a) Risk Assessment: 

A community-oriented group ought to be framed to perform an operational risk assessment. Here, Team ought to detail a contingency plan of action for readiness and reaction, direct standard preparation and activities to strengthen staff adaptability and nature of the procedure and assess process legitimacy of the alternate course of action to make constant improvement. Besides it, the group ought to take part in a joint appraisal with private hospitals and individuals from the same hospital union to recognize the supporting limit of the private hospital services framework. 

b) Incident reaction: 

The organization adapting capacity ought to be evaluated. On the off chance that it is recognized as insufficient, should connect with the private hospital services foundation for coordinating right away. Organizations ought to guarantee an open correspondence channel for all data and reports, urge healthcare professionals to report medicinal services occurrence when it is resolved reportable, and change the inside endorsement process if fundamental. 

c) Capacity recovery: 

When the incident enters a period of noteworthy balance, recovery work ought to be completed like equipment maintenance, staff reorganization, resource allocation, etc. It empowers organizations to recognize and organize essential healthcare assets and administrations to keep up their activity and come back to normal as right on time as could be expected under the circumstances. 

d) Adjustment and improvement: 

With an examination of the reason and an evaluation of its danger level, organizations ought to create and actualize protection quantifies, and build up a relief framework to decrease the likelihood and effect of future emergency. 

2) Upgrade the level of protection for healthcare professional and patients: 

During an outbreak of COVID-19 health, the institution needs to treat patients with additional alerts, particularly patients with additional alerts, particularly understanding with fever.  However, hospital treat fever patients, yet in addition patients with different sickness, which may require emergency services returns to limiting cross-contamination hazard to secure patients, understanding families and medical staff turns into a basic undertaking. Hospitals may take the accompanying measures to evade preventable misfortunes from cross-disease and to secure the health and protection of their patients and staff. 

a) Enhance get to control: 

Hospitals ought to burn through more energy to oversee emergency hospital inhabitance and access ways, limit entry and passage, urge patients to defer non-critical assessment, prohibit unauthorized discharge.

b) Patient Education 

Because of its quick spreading nature (airborne), hospitals need to improve tolerant instruction on the matter. When a specialist takes care of his patient, the individual in question ought to edify the patient regarding the matter. The hospital can likewise choose to hang information realistic banners on the emergency hospital dividers. Another momentous move is to give out enlightening handouts to each patient who strolls into the hospital. 

c) Understanding Care Management 

A few things need to come into place for patients to be thought about with direness and effectiveness. As COVID-19 strikes masses immediately, a hospital can't stand to have fewer doctors. The other perspective is thinking about patients that are in emergency hospitals however without the COVID-19. Individuals are as yet getting unwell from different ailments and conditions. This doesn't imply that they have the right to deteriorate by reaching COVID-19. In this manner, every wellbeing office ought to have a physical framework where COVID-19 patients and different patients don't blend. Another consideration framework is to get each patient 6 feet far from one another. At the point when a patient strolls into a hospital, they ought to be given a mask to cover their nose and mouth and gloves. This implies the individuals who may unconsciously have COVID-19 won't coincidentally contaminate the rest. 

d) Infrastructure Management 

As COVID-19 influences nations continuously, it would be useful if more medical centers are built up in various places. This will make getting to community health understands the sickness side effects. It will diminish the danger of voyaging and contaminating more individuals. In the principle emergency hospitals, there ought to be sufficient wards or rooms that can concede patients. Having a packed ward is an indication of helpless administration. During a crisis, there ought to be medical attendants on backup with hospital beds or wheelchairs to hurriedly get the patient to the emergency room. Emergency rooms ought to be available all through.

e) Upgrade Hospital Infection Control: 

For Hospital infection control, the convention can be made for two areas: work path management and disinfection guidelines. The work way can be managed by giving temperature, observing, mask-wearing necessity, and preliminary pre-assessment for all entrance staff. For high-risk groups, the arrangement of a difference can be made. Notwithstanding the improvement of an exhaustive execution of hand hygiene for medical staff. Additionally strengthening of a high touch contact surfaces ought to be purified according to the cleaning protocol of hospital.

3) Establishing a  sustainable supply chain management:

In the course of outbreak prevention and control, hospitals may confront a lack of earnestly required medical supplies because of deficient early estimates of material demand. To  respond effectively to an outbreak and ensure sustained day today, the hospital should take the following material safety effort : 

a) Establishing inventory warning system: 

Hospitals should arrange an inventory early warning system to which gives full thought to capacity cost, effective administration, deficiency hazard, and different variables. 

b) Establish a joint reserve allocation system:: 

Government or a group of hospitals can do concentrated procurement and establish joint reserves to hold of material to diminish procurement and storage cost. It ought to be guaranteed every time the consignment is received so as to ensure staff safety.

4) Accelerating the improvement of telemedicine and wearables: 

During an outbreak, the hospital ought to advance on overseeing the medical services. Specialists can offer online medical types of assistance to individuals at home and the number of medical attendants can be decreased to the danger of contamination. Telemedicine can improve components for reviewed conclusion and treatment, reinforcing the mix of medical arrangement at all levels and improve the limit of network medicinal services framework. Close to it, the wearable gadget can likewise screen patient heart rate, blood pressure, blood oxygen, ECG information. This information can be shared through the internet s and used to help the re-conclusion of patients with a constant infection, empowering specialists to modify medicine as per changes in the patient’s condition. 

5) Building a national health data platform: 

Building a national health data platform will empower medical specialists to rapidly analyze and make treatment arrangement dependent on case data from the nation over.

Anu Hyanmikha, MHA