Punjab is banking heavily on private players for tertiary care treatment of Covid-19 patients and the state recently carried out an exercise assessing around 220 private hospitals as potential “Level 3 centres” for critical patients in case of a spike.
Sources told The Indian Express that 44 health officials fanned across the state in past days to assess the private health facilities on 76 parameters.
At least 92 private hospitals, which account for less than 42 per cent of the facilities assessed, said a source, were found to be “up to the mark” and 79 out of them “voluntarily” agreed to provide tertiary care for Covid-19 patients in case there was a surge.
The assessment checklist included 16 counts of private hospitals’ preparedness to manage epidemics and pandemics, 27 counts of isolation facility, five counts of environmental cleaning, three counts of bio-medical waste management, nine counts of intensive care unit facilities and five counts of other essential services.
The checklist also included details of total staff strength, including MBBS and Ayush doctors, microbiologists, intensivists, pulmonologists, clinical specialists other than intensivists/pulmonologists, non-clinical specialists other than microbiologists, interns, nurses, laboratory technicians, pharmacists, cleaning staff and ambulance drivers.
The parameters under “preparedness to manage epidemics and pandemics” included whether the facility has a process to conduct symptom and temperature checks prior to the start of duty shift for health care personnel; has patient waiting area with cross ventilation; and does the facility have non-contact infra-red thermometers available near the registration desk.
The details checked under “Isolation Facility” head included: “Is the isolation facility near outpatient patient department (OPD), inpatient department (IPD) or other crowded area, if there is separate entry and exit in isolation area; whether one toilet was available for twenty persons, whether distance between two beds in isolation wards/rooms was more than one metre, do the staff transporting the patients wear personal protective equipments, whether there were specific routes to minimise contact with other patients and staff while transporting patients, any provision for food in the isolation area, any ICU facility attached to isolation area, availability of any designated area for sample collection and following standard precautions and PPE while taking samples and availability of protocol for limiting the entry of visitors at isolation area”.
The parameters under “ICU Facility” included whether there were any beds dedicated for Covid-19 patients; if distance between beds was more than one metre; was the oxygen supply by cylinder or central connection. It also took into account number of ventilators and whether ICU staff received training in donning and doffing of PPEs.
The parameters in “Environmental Cleaning” included frequency of high touch areas, bed rails, tables, chairs, keyboards etc. Further, it took into account whether staff is trained in housekeeping and infection control practices; and types of linen used.
The parameters in “Biomedical Waste Management” checked availability of standard operating procedure for biomedical waste management and whether protocol of colour code bins was being followed.
The “Other Essential Services” head assessed if there was designated ambulance facility for transporting patients from isolation area; whether ambulance staff was trained in wearing PPEs and other infection control practices; whether there was standard operating procedure for disinfecting ambulance after transporting confirmed case/dead body. Enough availability of body bags was also taken into account.
The source told The Indian Express that out of 25,000 ICU beds assessed in private facilities, 565 beds were available and out of 700 ventilators, 135 ventilators could be used to begin with.
A Health Department official said there were 1,100 ICU beds and 115 ventilators available in government facilities in the state.
According to the source, Punjab was also mulling to come up with a command centre to take a call on shifting “moderate” patients from Level 2 facility to Level 3 facilities in private hospitals in case of a surge in Covid-19 patients as part of the exercise.
“The private facilities would be simultaneously used when 70 per cent of the government facilities would be full,” said the source.
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