SUPPORT SERVICES
Submitted By:
Sumaira Siddiqui
Sonal Agarwal
Alka Sharma
Dhruv Basu
Vaibhav Agarwal
The Support services are the backbone for the
efficient functioning of the hospital.
The hospital food service department serves
nutritive vegetarian food under the guidance of
trained dieticians. In the quest for total hygiene,
the laundry, house keeping & CSSD play vital
roles so as to minimize risk of infection. An inhouse pharmacy supplies all medicines; medical
& allied appliances to the patients thus ensuring
total control over the quality of drugs
administered to them. A dedicated team of
biomedical engineers provide regular
maintenance, rehabilitation & technical support to
equipment installed in the hospital.
CENTRAL
STERILIZATION AND
SUPPLY DEPARTMENT(CSSD)
PHARMACY
MATERIAL MANAGEMENT
FOOD SERVICE DEPARTMENT
LAUNDRY AND LINEN SERVICE
HOUSEKEEPING
CENTRAL STERALIZATION AND SUPPLY
DEPARTMENT
CSSD deals with the process of cleaning,
disinfecting, packing, sterilizing, storing
and distributing the equipments utilised
in patient care.
FUNCTIONS
RECEIVING AND SORTING
SOILED MATERIALS
DETERMING THE
USAGE OF ITEMS
ASSEMBLING TREATMENT
TRAYS
PACKING MATERIALS
FOR STERALIZING
ISSUING AND
DISTRIBUTING
CARRYING OUT THE
PROCESSOF DISINFECTION
INSPECTING AND TESTING
INSTRUMENTS
LABELING AND DATING
MATERIALS
PACKING MATERIALS
FOR STERALIZING
Pharmacy
It
is one of the most extensively
therapeutic facility of the hospital and on of
the few areas where large amt of money
are spent on purchases on a recurring
basis.
It is also one of the highest revenue
generating centre.
Functions:
Purchase
receive,store
compound,package,label and dispense
pharamaceutical items.
Source of drug information to physician
pharmacist and pateints.
Provide pharmaceutical advice and
consultation regarding drug therapy.
Drug distribution
pharmacy
Nursing unit for floor
stock inventry
inpateints
Material management
It
encompasses, shipping, receiving,
evaluation, warehousing and distribution af
all goods, supply and equipment for an
organization.
functions
Wrinting product specification
Supply through centralised
purchasing
Receving and acounting
for equipments
No over stocking and out
of stock situation
Standardising and evaluating
all products
Controlling unofficial and
unauthorised purchasing
Dietary Department
The Location
The department should be close to the material management
department.
The storage area should be close to the unloading dock.
Easy access to the vertical transportation system serving to
patient care units is important to facilitate delivery of patient
meals and return of used trays and utensils.
The cafeteria and the dinning room(s) should be close to the
food preparation and production area, and within convenient
access to the hospital staff.
Functions of the food department
are as follows:
Provide the best quality food at a cost consistent with the policy of the
hospital.
Buy to specifications, receive supplies, check their quantity and quality, and
store produce portions, assemble and distribute food.
Establish standards for planning menus, preparing and serving food, and
controlling meals. Standards should be established before setting up food
purchase specifications.
Plan and implement patient therapy, educating and counseling; advise
patients and their families on special dietetic problems prior to their discharge
from the hospital or when referred from the outpatient clinics.
Train dietetic interns.
Impart education to the nurses, medical and dental students, interns and
residents about principles of nutrition and diet therapy.
Cooperate with medical staff in planning, preparing and serving experimental
metabolic research diets.
In general layout, the most important factor
to be borne in mind is the logical workflowreceiving supplies, storing and
refrigerating them, preparing and serving
food, returning trays and washing dishes.
Receiving Supplies
Refrigeration
(Meat\ dairy\Fruit-Veg.)
Dry storage
Preparation
Vegetables\Salads
Meats\ baking
Special Diets
Tray Make Up
Serving
Patients
Personals
Dish Washing
Storage and Refrigeration Rooms
It
should be placed adjacent and near to the
receiving area.
Large hospitals have large walk-in coolers
and refrigerators, these refrigerators should
have an alarm system connected to them
Preparation and Production Areas
Pre-production areas have a drainage system
attached to it for washing and cleaning
Special attention should be paid to the size of the
production area. Early in planning stage, it should
be decided whether the hospital will serve the
vegetarian food or non-vegetarian as well. And
whether there should be a separate kitchen for the
latter. Precautions should be taken to handle the
disagreeable odors while preparing the raw foods.
Type of food services
There are at least for systems in the
preparation and delivery of food in hospitals:
conventional, convenience food, cookchill, and the frozen ready (cook- freeze)
system.
The conventional system uses the menu prepared daily from basic
ingredients with preparation, assembly, and finishing, completed on the
premises.
The convenience food system uses menu items that largely have the been
commercially prepared off premises and then have been frozen and/of frozendried in a form that can be easily prepared on site without the need for anything
more complex than simple heating.
The cook-chill system makes use of on-site prepared products that are not
necessarily utilized the day of preparation; they are flash-chilled, stored in the
chill state, reheated immediately before service.
The frozen ready (cook freeze) food primarily uses a menu that is massproduced on site, frozen and stored in a form that requires only thawing and
reheated before service.
A hospital may use more than one system by selecting a combination of these
four systems for its particular production system. Selection among the four
system is left to the dietician, food service manager, and hospital administration.
The costs operating costs per meal and annual cost per meal- may vary. The
food cost in convenience system is apt to be higher, and in conventional system,
lower.
Tray Service
Depending upon the method food production
that the hospital selects, tray service to
patients will vary. Essential, there are two
basic system of tray services: centralized
and decentralized systems.
Centralized Systems
Centralized systems are used by many hospitals
because they provide greater efficiency,
economy and supervision, as well as efficient
utilization of personal time. Patient trays are
centrally prepared and checked under central
supervision along a conveyor belt, somewhat like
an assembly line in the automobile industry.
Decentralized System
The decentralized system is the older method of
serving food. In a decentralized system, food is
prepared and placed on patients trays in
substations of patient care units. This is a less
efficient than the centralized system because each
patient care unit needs a separate kitchen for the
distribution of food, capital costs are increased.
Serving Rooms
The serving rooms are placed where the patient food trays are
assembled or made. It receives prepared food in bulk from the
kitchen and the refrigerators. These trays are then loaded on a
food trolley and sent to the patient floors.
It is important that these areas are close to the elevators.
The equipments and facilities in the service room include
refrigerators, table tops, cupboard for storing trays, dishes, etc.
Here the dietitian inspects the food finally before it is taken to a
particular patient, and also ensures that the food be served
attractively.
Special Diets Kitchen
There is an increase use of special diets for hospital
patients. This has occurred because of advances in the diet
therapy and a greater understanding of nutrition. Special
diets are actually based on physicians therapeutic orders
that are placed in the patients medical records. A
physician, in consultation with the dietician, will recommend
special diets based on a patients condition. Some
examples of special diets are low sodium, low cholesterol, high fiber,
restricted calorie, diabetic, clear fluid, full liquid, and pureed food.
Dishwashing Areas
They
are equipped with modern dishwashing
machines
Drainage and plumbing should be well
engineered, with separate hot and cold water
pipes for dishwashers and sinks.
The pots and others utensils are generally
hand washed in a separate room.
Cafeteria
A customer oriented menu is the key to the successful management of
the hospital cafeteria.
The manner and kind of group to be served,
Whether there should be separate dinning rooms for medical staffs,
VIPs, officials and other staffs.
Types and extent of food,
Type of service-table service or self service,
Size of the dinning room and number of shits,
Method of cleaning tables.
The coffee shop cum snack bar should be preferably away from the
main kitchen and the dinning rooms.
The coffee shops should be easily accessible to the out patients,
particularly to the outpatients, and the Emergency Unit.
A Dietician
Dieticians today usually have earned a
bachelors degree and sometimes a
masters degree and then spend a year in
an internship before earning a registered
dieticians degree.
It is the dieticians responsibility to plan menus for the
patients and staffs. The hospital dieticians must have
sound technical knowledge about the foods as well as
sufficient imagination to group foods attractively for meals.
Dieticians Room
Laundry and linen
Collection
nad receiving of soiled linen.
Processing soiled linen through laundry
equipment.
It include sorting, disinfecting, washing
extracting, conditiong, ironing, pressing
and folding.
Inspection and repair of damaged articles.
Distributing processed linen to the
respective user departments.
Maintenance and control of active and
backup inventories and processed linen.
House keeping
also
called environment services.
Provide safe , clean, pleasant, orderly and
functional environment for both pateint and
hospital personnel.
Moolchand Hospital
Placement of the main kitchen area was much away from the
wards and OT.
Placement of the cafeterias and canteen near the OPD.
Food Trolleys Have to cover a long distance before reaching to
the wards.
The attend of the patients have to cover a long distance for
refreshments and meals
The cafeteria, on the other hand being near to the OPD can be
easily accessed by the outpatients.
Emergency Unit not much far from the cafeteria.
Liquid Oxygen
Generally, there are two type of storages for Oxygen
A 35 lts cylinder, which can be continuously supply
O2 for about 3-4 hrs.
Liquid Oxygen Cylinder of a capacity of around
1000lts
Placement of these Oxygen cylinders are genrally
done in open areas. Generally at the back side of a
hospital.
Gas Supply Pipes
Max Hospital, Noida
Fortis Hospital, Noida
KAMAYANI CANCER
HOSPITAL,AGRA
RECEPTION AREA
WAITING LOBBY
TELECOBALT THERAPY ROOM
TELECOBALT THERAPY ROOM
COBALT ROOM
RECORD ROOM
PHYSICISTS ROOM
BREAKI THERAPY OPERATION THEATRE
BREAKI THERAPY
BREAKI THERAPY
MOULD ROOM
DAY CARE WARD AND O.P.D.
INFERENCES
CSSD
Ideally located in the service core area adjoining the
department from which it receives materials.
Work flow pattern should be such that the personal
traffic and the movement of supplies and equipment
is accomplished in efficient manner.
Separate entrance to receive soil and contaminated
materials from departments and another for issuing
clean and sterile supplies and instruments
Pharmacy
The most suitable location should be according
to the following factors:
Flow of out patient traffic through the hospital
Flow of drugs and other raw materials into the
pharmacy.
Flow of drugs and services from the pharmacy
to the inpatient areas
The pharmacy has four min functional areas
the dispensing areas, the production area,
the administrative area, the storage area.
Material Managements
The major divisions of this unit should be
located in one area of the building.
The purchase office should a have a sub
waiting area with an outside entrance to
avoid routing it through the main lobby.
Central stores should be on the ground floor.
