Objectives

 

  • To be part of essential health care services as per government directives and guidelines
  • To keep our staff and doctors safe from infection while rendering the vital services
  • To take care of vision care emergencies and consultations for preventive care

Policy

We, at Maxivision Eye Care Hospitals Group, have seen over 6 million patients in 25 years across Hyderabad, Warangal, Vijayawada, Vizag and Bhimavaram. And it is our duty and responsibility to be of service to those who need continued eye care and emergency services.

As the majority of our hospitals are in one city, Hyderabad, we are opening only three centres in three different areas of the town, enabling the patients to visit their nearest centre. Other standalone branches in other districts are also being opened.

We can only serve those patients who are calling us for vision care consultation, emergencies, postoperative guidance, eye drops or medicine prescriptions, change of glasses, or repair of glasses, pathological examinations, diagnostics or investigations related to eye problems. Apart from this, we will also serve patients for the continued care of Retina which includes lasers, and other diagnoses, any mature emergency cataracts threatening vision, or any other corneal or glaucoma procedures, which are progressing, or hampering their vision.

All patients will be seen or registered only on strict sterility protocols from the entry levels, and submission of self-declaration on travel history. Staff and Doctors who will be examining the patients will also follow strict guidelines of sterility protocols.

Minimal infrastructure will be used to perform these services to avoid the risk of infections. Patient intake will also be minimal in numbers and hours.

Protocols

Infrastructure Arrangements

  • All hospitals must have only one entry to the premises guarded by security personnel restricting any unauthorized entry
  • Plan OP operations only on one floor, preferably on the ground floor and shift all diagnostic equipment from other floors to the OP operational floor
  • Keep the optical shop entry limited to one customer at one time
  • Keep the pharmacy doors closed and use only the billing counter to facilitate transactions
  • Keep all the doors open with stopper to avoid touching doorknobs
  • Reduce the number of seats and place the waiting chairs with social distancing measures
  • Use armless chairs and steel chairs which are easy to wash and sanitize
  • Mark the entry map with floor markings and place it at the entrance
  • Arrange the Front Desk with one computer and one staff seating
  • Keep a barricade in front of the Desk while registering to maintain social distancing
  • Keep sterilium bottles in the Entry area, Waiting area, Front desk, Consultation rooms, Optometry rooms and Washrooms
  • Demarcate separate washrooms for patients and staff including doctors
  • Restricting the movement of the patients in unauthorized areas by laying out barricades with waiting chair units or temporary partitions
  • Decommission lifts in case of only one floor, and in case of multiple floors keep a lift operator to operate the lift
  • Prepare the staff roaster in 2 or 3 batches with multitasking skill staff so that number of staff can be reduced
  • Every batch should be designed to meet the unexpected absenteeism of any one of the staff member and assign a replacement of that member
  • Batch 3 must act as a backup batch to replace any batch that might get infected and needs to be quarantined
  • These batches can be rotated on alternate days or alternate weeks
  • In case of any infection in one batch, the entire batch must be regrouped, and their duties must be assigned to another batch until the end of their quarantine period
  • Take voluntary undertaking from all staff and doctors who are working in this period
  • Ensure that the staff and doctors are trained on safety and sterility protocols on an everyday basis
  • Staff and Doctors have to be insured for COVID under existing coverage or with a new policy
  • Document the staff and doctors’ addresses, number of family members, their general health conditions etc.
  • Arrange one ambulance/vehicle to pick up and drop the staff
  • The vehicle should be sterilized every day, and the driver should also follow the safety and sterility protocols
  • Give written authorization letters to all staff and doctors as emergency health workers with the hospital address and the hospital working timing

At the Entry

  • All patients must write their name and phone numbers in the register available at the security desk
  • Patients are allowed to enter the hospital with one attendee, if necessary
  • All patients and their attenders must wear a mask. If they do not have a mask, they can purchase the mask from the pharmacy in the hospital premises.
  • On their arrival, the patients and their attendees will get their temperature checked and recorded by a thermal non-contact thermometer. If their temperature is found to be more than 100-degree Fahrenheit, they will not be allowed to register for any checkup and will be advised to consult a physician
  • The temperature will be noted in the entry slip/gate pass which will be handed over to the patient before entering the hospital
  • If the patient is not cooperating, security personnel will retain the patient politely and inform the manager to intervene
  • The patient and attendees will be asked to remove their footwear at the entrance
  • All the patients and their attenders must wash their hands with hand sanitizers before entering the hospital

Guidelines for Security Staff

 

  • Security staff will undergo thermal check and hand sanitization before resuming duty
  • Security will wear the mask, gloves, face shield and maintain social distancing
  • Security staff found to have temperature will be sent back or referred to a physician
  • Security will not misbehave or be rude to any patients or guests
  • Security will ensure all persons who are entering into the hospitals, be it doctors, staff, visitors, patient or patient attenders follow the protocols of removing the footwear, thermal check and hand sanitization
  • Any patient having a high temperature will be informed to the manager immediately

Registration Desk

 

  • Hand sanitizer and paper napkins will be placed on the registration desk
  • The registration desk will be placed away from the entry point and will have markings of the one-meter distance between each patient to maintain a queue for social distancing
  • A barricade must be placed at a 1-meter distance from the Desk to avoid any touching of the Desk by the patient and to maintain social distancing with the staff
  • A pen tied to the Desk will be available for the patient to enter the forms
  • Front office staff will collect the entry slip from the patient in a tray and read the temperature
  • Front office staff will then hand over the Self Declaration Form to the patient and ask them to fill in all fields. They will verbally assist the patient in entering the form or fill the form interviewing the patient and get their signature
  • Ask the patient repeatedly, if necessary, of any history of foreign travel and reconfirm that they have not travelled anywhere out of India, after 31st of January 2020
  • If they report of any foreign travel, ask the patient to wait and inform the manager
  • Insist on wearing the mask throughout the process and offer hand sanitizer on the Desk
  • Register the patient and prepare the case sheet and ask the patient to wait while maintaining social distancing
  • The patient should maintain social distancing in seating even with their attenders
  • Attach the self-declaration forms and temperature screening note in the case sheet
  • Keep the case sheet in a tray available for the next process

Guidelines for Front office staff

 

  • Have only one staff at the Desk
  • Wear masks, gloves and face visor at all times
  • Wipe the Desk and computer keyboard frequently with sterilium
  • Attend the intercom only through speaker mode
  • Request the patient to make card payments only
  • Keep change notes in one box and ask the patient to drop the cash in another box
  • Give the balance amount from the change box
  • While counting or bundling the collected cash wear gloves and pack the cash in envelopes
  • Wipe the card machine with sterilium after every transaction
  • Be polite even if you have to reject a service or instruct the patients

Optometry Room

 

  • Optometrists should come out to the Desk, collect the next case sheet and call the patient
  • Make the patient sit inside the optometry room with social distance
  • Request the patient attender to wait outside
  • While doing refraction maintain maximum distance from the patient’s head
  • Wash your hands with sterilium before and after touching the patient
  • Optometrists must not do NCT, Syringing and Contact lenses trail
  • Regular refraction can be done with AR/ARK
  • Trail sets, Trail frames, AR chin rests, Slit Lamp Chin Rests will be cleaned with sterilium after the examination of every patient
  • Optometrists must take a detailed history, and case sheet must be documented properly
  • Optical prescriptions can be given, and patients are asked to purchase from our optical store
  • In cases of surgical intervention, optometrists must take the patient directly to the doctor and explain the case in detail

Guidelines for Optometrists

 

  • Optometrists must wear masks, gloves, face visor, apron fully buttoned and disposable gown over it
  • Leggings must be worn and disposed of after using the washrooms and also while leaving the hospital
  • Change the gloves after contact with any infectious cases or conjunctivitis cases
  • Optometrists must wash their hands with sterilium after every examination
  • If the patient sneezes or coughs, extra precautions must be taken for sanitizing the room
  • Patient instructions must be explained properly
  • Optometrists working in Conjunctivitis patient station must not enter the main clinical area

Consultant Room

 

  • Consultants must follow the standard protocol on thermal check at the entry point
  • Consultants must change their dress to their regular OT dresses before examining the patients
  • Appointments are given on every half-hour basis to one consultant to avoid crowding and long waiting inside the premises
  • Patients must be examined and interviewed with social distancing
  • Restrict patient attender inside the consultant’s room. In case the consultant needs to talk to the attendee, they must go out of the room to speak to the attendee
  • Slit lamps will have a sterile acrylic shield which must be cleaned after every patient examination
  • Use sterile buds to examine the patient’s eyes instead of touching the eyes
  • Clean the Gonioscopy, lenses, and Applanation tonometer after every patient examination
  • Wash your hands and gloves with sterilium after every patient examination
  • In case of intervention with conjunctivitis patients, discard the gloves after the examination
  • Be extra careful while doing Indirect Ophthalmoscopy or slit lamp examination
  • If dilatation of the eyes is required, advise patient care executive to follow extra precautions not to touch the eyes of the patient while administering the dilating drops
  • If emergency surgery is recommended inform the patient about the protocols and our OT days for surgeries
  • If the patient is given a pharmacy prescription, advise the patient to collect it from our store
  • If the patient requires investigations, inform them about our lab services
  • Give a gap of at least 5 to 10 minutes after every patient examination to prepare the room for the next patient
  • Case sheets will not be given to the patient and must be handed over to your patient care executive
  • The patient may be given a case summary and prescriptions wherever required

Guidelines for Consultants

 

  • Sterilization is essential for the treating doctor so all doctors must follow the sterilization protocol strictly
  • Consultants will wear masks, protective glasses, gowns, face visor, leggings and gloves before treating any patient
  • Keep your door open with stopper and minimize the use of AC inside your room
  • If any staff member or patients are not wearing masks or not sanitizing their hands properly, instruct them to follow the protocol
  • Ensure that the chair unit and the slit lamp and other instruments should be cleaned with sterilium after every patient examination
  • Consultants must bring their water bottles or take water in disposable glasses only
  • Dispose of the gown, leggings, gloves properly while leaving the hospital premises
  • If you are feeling any discomfort in treating any patients, please let the manager know
  • If you are identifying any symptoms of COVID during your diagnosis, please inform the patient politely to have further tests done from a Physician

Optical Store

 

  • There will be only one entry to the store
  • The optical shop must have a thermal check at the entry point for staff and patients
  • Request the patient/customer to come in without attender or maximum of one person
  • Maintain social distance while interacting or helping the customer in sales
  • If a customer tries on a frame or any other products, replace it on the rack only after cleaning it with sterilium
  • Please be polite with all customers and handle them as you handle them regularly, without compromising on sterilization protocol

Guideline to Optical Staff

  • Wear Mask, Gloves and use hand sanitizer after every contact with a patient/customer
  • Have only one desk for sales and cash transactions to reduce contact
  • Request cashless payment modes, or if cash is accepted, please follow the same protocol as suggested in the Front office section
  • Keep the doors open at all times with stoppers
  • Do not do any contact lens trial
  • IPD Marking instruments should be adequately cleaned after every usage
  • Do not group up between colleagues and maintain social distancing between everyone
  • Keep the patient data with complete details in separate registers or sheets
  • Offer home delivery of frames/glasses

Pharmacy

 

  • Close the pharmacy door and do not allow others to enter the pharmacy store
  • Do all the transactions through the glass counter only
  • Follow same protocols of Front office on cash payments
  • Wear gloves and masks at all times
  • Sanitize your hands and gloves with sterilium at all times and after every transaction
  • If a patient is returning any drugs/vials, clean them with sterilium and place them separately

General Rules & Ethics

The above protocols are to keep patients, staff and doctors safe from infections and will be relaxed depending on the pandemic ease and government directives.

As a staff of Maxivision, ensure that you:

  • Do not discriminate any patients or isolate them rudely
  • Handle all patients with extra polite manners as this is a stressful time for everyone
  • Serve beverages or food only in disposable glasses and plates and dispose of them safely
  • Ensure that the entire premises are cleaned and disinfected at the end of the day
  • Allocate separate bathrooms for patients, and staff and doctors
  • Ensure that the frequency of housekeeping cleaning is more in washrooms and on floors
  • Managers should be alert and always on the floor to supervise the operations

 

glucoma-consultant-in-hyderabad-dr-anil-kumar-bathula

A blog Written by
Dr. Anil Kumar
Sr. Glaucoma Consultant