Empowerment Experiences During Crisis

1. Empowerment Experiences During Crisis Dr. Jothi Clara J. Micheal, Director – Nursing & Quality (Corporate) Global Hospitals Group (GHG), India (Chennai, Hyderabad, Bangalore & Mumbai)

2. Acknowledgement • THANKS TO GOD ALMIGHTY FOR HIS PROTECTION BESTOWED ON CHENNAI & US • Dr. K. Ravindranath, Chairman & Managing Director, Global Hospitals Group (GHG), India • Dr. Prof. Mohamed Rela, Director and Head of the Institute of Liver diseases and Transplantation, Global Hospitals Group, India  • Dr. IlanKumaran , Consultant, Liver, Anaesthetist ,GHC, Chennai • Ms. LeenaChandrasekaran, CNO, Global Health City (GHC), Chennai • Dr. Sanjay Pandey , HOD- Operations, GHC, Chennai • Ms.Padmavathy & Ms.Gladis, Nursing Officer, GHC, Chennai • Ms.Famila Jane Christiana, Clinical Nurse Coordinator for Education & Quality, GHC, Chennai • Ms.Santhi, Guest Relation Manager, GHC, Chennai • Dr.Lakshmi, HOD, Dietary Department, GHC, Chennai • Mr.Mahadevan, Senior DGM-Operations, GHC, Chennai • Mr.Hariharan, Senior Manager-Operations, GHC, Chennai

3. Thank YouAll NABH Assessors

4. I thank God for • His Purpose in my creation as a Nurse • Turning my professional practice from Academia to Clinical (2009) • Permitting me to be at GHC Chennai though being ND Corporate both during flood disaster. • Giving me the daring thought process to put forth to Top Management We need retain Consultant Experts in good number before the Hospital is Surrounded by 6- 9 feet water (No Exaggeration) Attracting critical care talent pool of Nurses 1:1 Ratio for the 108 patients on that day. Taking a decision that “ I am not leaving the Hospital for the day” predicting by intuition that some thing wrong is going to happen tonight. NO EGO Let us Evacuate I am concerned for the Lives in our hands

5. Global Health City…. • NABH Accredited 300-bedded quaternary care multispecialty hospital, • Pioneer in Multi-Organ Transplantation (Liver, Kidney, Heart & Lung). • Over the years, has nurtured a culture of high quality healthcare and continually improved on its benchmark in areas of patient safety. Experienced important pages of memories in Dec 2015 that requires reflection, sharing and documentation mark events as moments of truth.

6. Introduction • Disaster cannot be prevented but the consequence of disaster could be mitigated with preparedness, prediction and proactive approach. • Preparedness for any kind of disaster management is integral aspect of hospital risk management plan guided by policy; manual and periodic repeat drills. • The recent flood taught several valuable learning for disaster management team, to expand and extend their roles.

7. Empowerment Emerges …… • Great opportunity for Nursing Team at GHC to demonstrate Empowerment • Preparedness using empowerment model and tool reflecting predictive and proactive role of nurses gave us confidence to ensure • Patient safety • Achieving clinical outcomes I am sure most of you present here would have done the same But……

9. GHG Nursing Empowerment Model (2011)

10. MNO P3 CONCEPT Flood disaster related activities gave a great opportunity to the Trio team: Medical- Nursing-Operations to mark health care excellence. Operations PATIENT SAFETY FIRST IN DISASTER Preparedness Prediction Medical Nursing Planning

11. 3 Ps’ Concept P • Patient & Employee safety as central goal. • Integral and systematic process for achieving desired outcome reflects responsibility of top management and commitment of the team. Prediction Planning Preparedness

12. Prior to water entering the hospital 2 - 8 feet After flooding of the ground floor for four feet with specific challenges in planning & implementation applying

13. 10 Empowering Domain the Nurse Leader did to ensure Patient safety! Innovation & Improvisation

14. QA Approach Policy Protocol, Manual, Nurse Patient Ratio, Ventilator Bed Ratio,, Resource planning during shifting. QI Tool triaging & allocation of boats, Patient ID bands with name, consultant name, place of shifting, holding TAT less than 30 minutes, emptying bags, monitoring IO chart, preparing patient file with short discharge note, Monitors, equipment, Oxygen cylinders, securing lines and tubes with water proof wrappers, emergency medicines and kits While evacuating no cardiac arrest, no death, One accidental removal of tubes and drains. FEEDBACK Empowerment & Innovation

15. This was during the Second Flood! There were totally 12 boats which made 65 trips up and down the hospital carrying 6 to 12 members in each trip. Totally 558 members were evacuated safely from Global Health City which includes (108 patients (12 ventilated and 8 pediatric patients), 250 Nurses, doctors and Non medical hospital staff and 200 relatives & visitors.

16. We did not stop…..

17. To Conclude • This lived experience is worth sharing to enable hospitals in handling flood disaster in perspective of patient safety. • It accounts to important pages of memories that requires reflection, sharing and documentation of series of events as moments of truth to mark in the history of Global Health City Chennai.

18. Thanks & Salute……. To the Team(NLT & RNs)