Safety of patients in Hospitals

During the workshop of CMD's at Staff College Vadodara from 19-23 Dec-2011, a brain storming session was held to formulate a policy for implementation in all hospitals of Indian Railways for safety of patients. DGRHS nominated a committee of 3 CMD's including CMD-ER, CMD-ECR & CMD-WCR to formulate such policy. All Medical officers are invited to express their views on the subject

Relaxation to A1 category Diabetics on Metformin

Wednesday, May 25, 2011
Periodic Medical examination relaxation for Loco Pilots declared with type II Diabetes - Amendment to Annexure-III

GOVERNMENT OF INDIA
MINISTRY OF RAILWAYS
(RAILWAY BOARD)

N0.2008/H/5/18 New Delhi, dated20.5.2011

The General Managers,
All Indian Railways,
(Including PUs).

CORRIGENDUM

Sub:- Periodic Medical examination relaxation for Loco Pilots declared with type II Diabetes - Amendment to Annexure-III (Para 509, 512) — 12.7.2 of IRMM- 2000.

Pursuant to the demand raised by Staff Side as DC/JCM item, the issue of relaxing the medical standards of Loco Pilots suffering from Diabetes Mellitus have been considered by the Board and the following has been decided

Employees in A-one category who are suffering from Diabetes Mellitus can be declared fit for the respective categories if Diabetes is controlled on diet aud/or on Tab. Metformin (oral hypoglycemic drug) upto 2gm/day only.

Periodic medical examination of such cmployee is to be conducted every year in addition to regular follow up as per the advice of the treating physician.

The in-service employee of A-one category who had been declared unfit due to Diabetes Mellitus prior to issue of this Board’s letter will not be considered for re-medical examination.

This issues in consultation with Safety, Mechanical, Electrical & Establishment Dtes. of Board’s office

Accordingly an ACS to Annex III (Para 509, 512)- 12.7.2 of IRMM-2000 is enclosed

Hindi version will follow.

This supersedes the instructions contained in Board’s letter of even number dated 03.05.11.

sd/-
(Dr. D.P. Pande)
Executivc Director Health(Plg.)
Railway Board

MODULAR OT-BRSH-SEALDAH

Operation theatre-Div Hospital-Ahmedabad

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PHARMACEUTICAL FIRMS PROVISIONALLY REGISTERED BY RLY.BOARD

S.N. NAME OF FIRMS
1 Abbot India Ltd.
2 Ahlcon Parenterals Ltd.
3 Ajanta Pharma Ltd.
4 Albert David Ltd.
5 Alchem Pharmaceuticals
6 Alembic Ltd,.
7 Alkem Laboratories Ltd.
8 Allergen India Private Limited
9 Anglo French Drugs and Industries Ltd.
10 Aristo Pharmaceuticals Pvt., Ltd.
11 Astra Zeneca Pharma India Ltd.
12 Aurobindo Pharma Ltd.
13 Aventis Pharmaceuticals
14 Bal Pharma,Ltd.
15 Baxer (India) Pvt.Ltd.
16 Bayer Health Care Pharma
17 Becton & Dickinson India Pvt.Ltd.
18 Bengal chemicals & Pharmaceuticals Ltd.
19 Bharat Serum & Vaccines Ltd.
20 Biochem Pharmaceutical Industries Ltd.
21 Biocon Limited
22 Biological E.Ltd
23 Blue Cross Lab.Ltd.
24 Boerhringer Ingelheim
25 Brawn Laboratories Ltd.
26 Cadila Health Care (Zydus)
27 CFL Pharmaceuticals Ltd.
28 Cipla Ltd.
29 Claries Life Sciences Ltd.
30 Concept Pharmaceutical Ltd.
31 Dabur Pharma Ltd.
32 Dr.Reddy Laboratories Ltd.
33 East India Pharamaceuticals Works Pvt.Ltd.
34 Elder Pharmaceutical Ltd.
35 Elililly & Co.(India) Pvt.,Ltd.
36 Emcure Pharmaceuticals Ltd.
37 FDC Limited
38 Finecure
39 Franco Indian Pharmaceuticals Ltd.
40 Fresenius Kabi India Pvt.,Ltd.
41 Fulford India Ltd.
42 German Remedies Division Cadila Health care Ltd.,
43 Gland Pharma
44 Glaxo SmithKline Pharma Ltd.
45 Glenmark Pharmaceuticals Ltd.
46 Himalaya Drug co.
47 Hindustan Antibiotics, Pune
48 Hindustan Latex Ltd.
49 Hindustan Syringes & Medicals Devices Ltd.
50 Indian Drugs & Pharmaceuticals Ltd
51 Indian Immunological Ltd.
52 Indoco Remedies Limited
53 Ind-Swift Ltd.
54 Intas Pharmaceutical Ltd.
55 IPCA Lab. Ltd.
56 J.B.Chemicals & Pharmaceuticals Ltd.
57 Jagsonpal Pharmaceuticals Ltd.
58 JB Chemicals & Pharmaceuticals
59 Jenburkt Ltd.
60 Jhindal Photo Ltd.
61 Johnson & Johnson
62 Karnataka Antibiotics & Pharmaceuticals Ltd.
63 Khandelwal Laboratories Ltd.
64 L.G.Life Science India Pvt.Ltd.
65 lpca Laboratories Ltd.
66 Lupin Laboratories Ltd.
67 Lyka Labs Limited
68 M.J. Biopharma Pvt.Ltd.,
69 Macleods Pharmaceuticals Ltd.
70 Medley Pharmaceutical Limited
71 Merck Limited
72 Micro Labs. Ltd.
73 Midas-Care Pharmaceuticals Pvt.,Ltd.
74 Morepan Laboratories Ltd.
75 Natco Pharma Limited.
76 Novartis India Ltd.
77 Neon Laboratories Ltd.
78 Nicholas Piramal Pharmaceuticals Ltd.
79 Nova Nordisk India Pvt.Ltd.
80 Orchid Health Care
81 Panacea Biotech Ltd
82 Parenteral Drugs India Ltd.
83 Pfizer Limited84 Pharma Link (India)
85 Piramal Helathcare Ltd
86 Ranbaxy Laboratories Ltd.
87 Raptokas Brett & Co.Ltd.
88 Reckitt Benckiser (India) Ltd.
89 RPG Life Science Ltd.
90 Sandoz Pvt. Ltd.
91 Sanofi Pasteur India Pvt.Ltd.
92 Serdia Pharamaceuticals (India) ltd.
93 Serum Institute of India Ltd.
94 Shantha Biotechnics Ltd.
95 Shreya Life Science Pvt. Ltd.
96 Southern Petro-chemical Industries Corporation Ltd.
97 Span Diagnostics Ltd.
98 Systopic Lab Pvt. Ltd.
99 T.T.K. Healthcare Ltd.
100 Tablet (India) Ltd.
101 Taksal Pharma Pvt. Ltd.
102 Themis Medicare Ltd.
103 Torrent Pharmaceuticals Ltd.
104 Transasia Bio-medicals Ltd.
105 Troika Pharmaceuticals Ltd.
106 U.S.V. Limited
107 Unichem Laboratories Ltd.
108 United Biotech (P) Ltd.
109 VHB Life Science Ltd.
110 Wallace Pharamaceuticals Pvt. Ltd.
111 Win Medicare Pvt. Ltd.
112 Wockhardt Ltd.
113 Wyeth Ltd

ACTION PLAN MEDICAL DEPT- ER FOR 2011-12

SUB: TARGETS & ACTION PLAN FOR THE YEAR 2011-12
All Divisional/Workshop hospital in charges including MD-BRSH-SDAH should plan to achieve the following targets during the year Jan-Dec-2011 by proper planning & distribution of the duties among concerned Medical Officers & other group B officers. The action plan should be discussed with all concerned before implementation
1. Total number of employees under RMC on any particular day Not more than 2% of the employees registered in the hospital/HU.
2. Total number of man days lost on RMC & IOD Average man days lost should not exceed 7 days per certificate & average % Man days lost per month should not be more than 1.5% of total Man days available
MDL = No. of man days lost in a month X 100
No. of employees x days in a month
3. BOR (Bed occupancy ratio)BOR in hospitals should be near 80%

BOR= No. of IPD bed days X 100
------------------------------
No. of beds x days in month
4. ALS (Average Length of Stay) for Indoor patients-Between 5-7 days.
(ALS= Total IPD bed days in month
------------------------------------
No. of IPD admissions
5. PME of employees & candidates 90% of the cases should be disposed off within 2 days and remaining 10% should be disposed off in 3- 5 days (except those which are to be examined by Medical Board or need any intervention).
6. Medical Audit 2% of the Indoor cases and 1% of the outdoor cases should be audited by a team of Sr doctors by rotation and a register should be maintained for the same during inspection. The findings should be discussed during Administrative meetings with Med. Officers
7. Local purchase Local purpose should not be more than 10% of the budget spent on Annual indent of medicines (excluding the amount spent on bulk purchase of medicines which are returned by HQ to be purchased by divisions/workshop hospitals. )
8. Non-Railway Earnings Should be 5% more as compared to last year.
9. Drug analysis Minimum 4 samples of medicines per month
10 Renewal of contracts Proposal for renewal of various contracts should be moved 3 months prior to the expiry.
a) Renewal of CMPs, PT Dental Surgeons
b) Renewal of HVS.
c) Renewal of Recognised hospitals
d) Renewal of Ambulance hiring
e) CAMC/AMC of Med. equipments
11. Upkeep of Assets All medical equipments should be in working order and all M&P items should be under CAMC/AMC For old equipments regular servicing contracts should be planned. All Anaesthesia machines must be under regular servicing contract (under Warranty equipments to be counted as under CAMC/AMC). No equipment should be out of order for >3 months
12. Public complaints and Grievances All complaints should be registered immediately and should be disposed off within 15 days. A register should be maintained for this.
13. Disposal of employees on long sickness (RMC & IOD)
a) > 3 months

b) >6 months

c) Total no. of employees on RMC/HOD for > 1 year
a) A Committee of 2 Sr.doctors with CMS as Chairman should examine and review all such cases that are in sick list for more than 3 months (with opinion of concerned Specialist). A register should be maintained for this. Cases required to be decatagorised should be examined by Sr DMO-Adm after opinion of the concerned Specialist & disposed off with the approval of MD/CHD/CMS (for RPF & RPSF, a Medical board is required for decatagorisation)
b) Cases under RMC for >6months should be examined by Standing Med. Board & sent to CMD for acceptance if invalidation is involved & decided by MD/CHD/CMS if decatagorisation is involved

c) Should be < 4 in each division any time
14. Percentage of low birth weight babies(less than 2.5 kg) out of total number of deliveries in the Hospitals should be < 5% in booked cases ( Proper education to pregnant mothers, dietary supplements & frequent check ups & follow up is required)
15. Deaths taking place following delivery/abortion in Railway Hospitals during the year should be NIL
16. Percentage of money spent on local purchase versus value of bills passed on PO issued from Zonal Headquarter should be <10%
17 Training of paramedical staff both in house Each Divisional/Workshop hospital should organise one day training programme for paramedics as under
a) HA,Aya,Disp.peon -MLDT
b) Dressers/OTA -KPA
c) S.wala (medical) -LLH
d) Sanitary Jamadar -ASN
e) Ministerial staff -JMP
f) Nurses & Mid wives -BRSH
g) Health inspectors -SDAH
h) Pharmacists -CLW
i) Physiotherapists - HWH
18. No. of samples of medicines sent for analysis should be minimum 4 per month per division/workshop hospital
19 New patient friendly technologies All Divisional/workshop hospitals should make efforts to introduce new patient friendly technologies to improve patient satisfaction during year
20 Scientific papers published All Specialists/Super specialists should make efforts to get their Scientific papers published in journals of International/ National/ Local level & submit a list to HQ every month with MCDO
21 Organising Scientific/ Management conference Each Divisional/workshop hospital should organise at least one Scientific/Management conference in a year with the approval of DRM/CWM/CMD

B) HEALTH & FAMILY WELFARE AFFAIRS:

1. Multipurpose Health checkup camps Health check up camps on way side stations should be held at least once in 2 months. More emphasis should be given to diseases related to life style changes of Hypertension, diabetes etc. Proper record keeping and follow up of the detected cases should be done.
2. Health Education Lectures. 2 Health Education lectures & 2 exhibitions should be organized on different preventable diseases by each H.Unit & hospital and detailed report should be sent to CMD from time to time.
3. Examination of Water samples for
Bacteriological examination.
a)From each large station and major colony
b)From each small station and minor colony

Residual chlorine
a) From each large station & major colony,school,hospital/HU

b) From small stations & minor colonies

1 sample per station & per colony every month.

1 sample per station & per colony in 2 months.

Minimum 4 samples per day (one from each station,colony,school & hospital/H.Unit)

1 sample per station & per colony in 2 months

A register should be maintained and if any sample is found unfit, repeat sample should be taken and concerned Engg. Officers should be informed. All stations in the division should be covered in a quarter.
A register should be opened at each station in which HI will make entries of water samples examined & it will be countersigned by SM/SS
4. Examination of food samples under
a) PFA b)QC
a)Minimum 2 samples/month per FI
b) Minimum 2 samples per H&MI per month
Each vendor should have a diary (apart from PFA license book) in which entries of food samples taken & result of reports will be entered by HI/FI every month.
5. Health Awareness programme for Para Medical Staff. Health Awareness Programme should be held on HIV, TB, Smoking & Tobacco Chewing etc. once in a year in each hospital/H.unit
6. Immunization (children in Rly.colony) 100% of the children living in the railway Colony should be immunized.
7. School Health check up 100% of students & staff of Railway Schools must be examined in the month of August.
8. Training of Vendors in food hygiene
Training of Vendors should be held once in a year in each division
9. Joint training of HI's & IOW's in colony sanitation, water supply, disposal of night soil etc Once in a year in each division involving Civil health officers & Malaria Medical Officers etc
10 Colony Sanitation Survey A sample survey of major colonies should be done once in 6 months by getting feed back forms filled by residents and report sent to Dy.CMD-H&FW in the format supplied
11. Other items:
a)RTI cases
b) Audit Para's
c) CA-III references.
d) Parliamentary questions.
e) Union items
a) RTI cases should be disposed off within the stipulated time.
b) Audit Para's should be disposed of promptly.
c) CA-III cases should be disposed off promptly.
d) Parliamentary questions are replied promptly.
e) Union items should be disposed off promptly.


(Dr.S.S. Rathaur)
CMD-ER