A SUMMER INTERNSHIP PROJECT REPORT ON

“THE STUDY OF OPERATION THEATRE UTILIZATION AMRI

HOSPITAL BHUBANESWAR”

SUBMITTED
BY: GUIDED BY:
RAKESH KUMAR ACHARJYA MR. NIRMAL CHANDRA BAL

MBA IN (HA) (AGM- OPERATIONS)

REGD NO – MS. DIPANWITA GANGULY

2161302059
(ASSISTANT MANAGER, OT)
INSTITUTE OF BUSINESS AND AMRI HOSPITAL,
COMPUTER STUDIES, BBSR
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BHUBANESWAR
SIKSHA ‘O’ ANUSANDHAN
(DEEMED TO BE UNIVERSITY)
 DECLARATION

I RAKESH KUMAR ACHARJYA, do hereby declare that the summer

internship report entitled, "THE STUDY OF OPERATION THEATRE
UTILIZATION AMRI HOSPITAL BHUBANESWAR" is based on actual in
depth of study, as far as practical undertaken by me in the OPERATION
THEATRE OF AMRI HOSPITAL, BHUBANESWAR and submitted for the
partial fulfilment of summer internship program of MBA(HA) degree in
INSTITUTE OF BUSSINESS AND COMPUTER STUDIES,
BHUBANESWAR.

I also declare that the entire job indulged in completion of this project report is
a profound and honest work of mine under the guidance of MR. NIRMAL
CHANDRA BAL (AGM-OPERARION).

I also declare that this project has not been submitted by me for the award of any
other degree by the university or for publication in any journal, magazine, or
anywhere else. It is the genuine and the fact and finding presented here are true
to my knowledge and belief.

Signature: __________________
NAME: RAKESH KUMAR
ACHARJYA
Duration: - 17 June – 17 August
th th
MBA(HA)
Dept.: - OT REGD. NO:2161302059
BATCH: 2021-2023
INSTITUTE OF BUSNESS AND
COMPUTER STUDIES, BBSR
SIKSHA ‘O’ ANUSANDHAN
(DEEMED TO BE UNIVERSITY)

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 ACKNOWLEDGEMENT

It is really a great pleasure to have this opportunity to describe the feeling of gratitude
imprisoned in the core of my heart. I convey my sincere gratitude to MR. NIRMAL
CHANDRA BAL (AGM - OPERATIONS) for giving me the opportunity to prepare my
project work in Amri Hospital. I express my sincere thanks to all the staff members of
AMRI Hospital.

I am thankful to MS. DIPANWITA GANGULY (Assistant Manager) for her guidance

during my project work and sparing for his valuable time for the same.

I express my sincere obligation and thanks to all the faculties of IBCS DR. LEENA
KAR (MENTOR) for her valuable advice in guiding me at every stage in bringing out
this project

I am also thankful to my family for their kind co-operation which made my take easy.

NAME: RAKESH KUMAR ACHARJYA

REGD NO: 2161302059

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 CERTIFICATE

This is to certify that Mr. RAKESH KUMAR ACHARJYA, a student of

MBA(HA), in INSTITUTE OF BUSINESS AND COMPUTER STUDIES,
BBSR. SIKSHA ‘O” ANUSANDHAN (DEEMED TO BE UNIVERSITY) has
undertaken a project work titled “THE STUDY OF OPERATION THEATER
UTILIZATION IN AMRI HOSPITAL, BBSR” is a bonfire research work done
for partial fulfilment of the summer internship program required for the degree
of MBA(HA) in INSTITUTE OF BUSINESS AND COMPUTER STUDIES,
BHUBANESWAR.

Date:
MS. DIPANWITA GANGULY
Place:
ASSISTANT MANAGER, OT

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 INDEX/CONTENT

SERIAL NO TOPIC

1 HOSPITAL PROFILE

2 INTRODUCTION

3 OBJECTIVE

4 METHODOLOGY

5 FACILITIES

6 FLOOR DIRECTORY

7 VARIOUS DEPARTMET OVERVIEW

8 RECOMMENDATION

9 MAJOR FINDINGS

10
CONCLUSION

11 BIBILIOGRAPHY

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 HOSPITAL PROFILE

BRIEF OF AMRI HOSPITAL

AMRI Hospitals was co-founded by the Emami and Shrachi Groups in 1996.

AMRI Hospitals Ltd is the premier private healthcare provider of Eastern India,
with three super speciality hospitals at Dhakuria, M moukundpur, and Salt Lake,
in Kolkata, a state-of-the-art daycare centre on Southern Avune in Kolkata, and
another super speciality hospital at Bhubaneswar, Odisha.

The Group takes care of around 3.5 lakh patients annually, conducting more than
15,000 successful surgeries, with a roster of more than 5,000 healthcare
professionals. An impressive roster of more than 600 doctors and a well-trained
force of nursing staff works tirelessly across more than 1,000 beds across its four
hospitals, backed by advanced technologies and latest equipment to treat people
and save lives. With major changes and developments on its plate, the AMRI
Group is headed towards a path of steady growth. AMRI Hospitals is all set add
around 700 beds in the near future.

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AMRI HOSPITAL, BHUBANESWAR, ODISHA

AMRI hospitals, Bhubaneswar the largest super-specialty hospital in the city and
the largest inclusion under the renowned brand-AMRI Hospitals Limited, the
fastest growing hospital chain in Eastern India. Representing images of hope and
happiness, this is a 400 bedded multi-specialty hospital is located by the side of
Jaydev Vatika, a green belt on the Khandagiri by pass road next to the Satya Sai
Enclave.

This hospital provides tertiary level clinical care, backed by a multidisciplinary

team of medical fraternity with the finest state of art technologies available in
Eastern India. It has one of the most unified and committed team of doctors,
medical, nursing and paramedical staff, offering services at a competitive and
affordable price. The new management initiative is to ensure co ordination,
transparency and a human face in its administration. The emphasis is on providing
services at true value for money and total patient satisfaction, with the motto of
"GET WELL SOONER". The Hospital's internationally acclaimed consultants
are attached on full time basis and hence the highest standards of clinical service
are always maintained.

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VISION OF AMRI HOSPITAL, BHUBANESWAR:

Be cherished as the best place to come for care and the best place to work.

MISSION OF AMRI HOSPITAL, BHUBANESWAR:

● To provide healthcare services maintaining accountability in a responsible

manner which contribute to the physical, psychological, social and spiritual
well-being of the patients. and community which we serve.
● To participate in the creation of healthier lives within the community
confirming to the requirements of our patient and customers round the
clock and constantly measuring and striving to improve the outcome of our
care and service.
● To create and sustain a work environment in which all participants are
empowered and committed to continual quality improvements confirming
the values of participation, acknowledgement, accountability, teamwork,
integrity and respect.
● Create the national model of care through relentless pursuit of unparalleled
quality and value to the entire satisfaction of patient, customer and staff.
● To carry on educational and research activities related to the provision of
care to the sick and injured or related to the promotion of health and
continually rethink, reshape and redefine solution to healthcare challenges.

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 LOCATION OF AMRI HOSPITAL, BHUBANESWAR:

SERVICES OFFERED:

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INTRODUCTION
The operation theatre complex of a hospital represents an area of considerable
expenditure in a hospital budget and requires maximal utilization to ensure optimum cost-
benefit. Operation room utilization analysis is essential to assess the existing workload as
well as to optimize facility function patient scheduleing for surgical operations. Optimum
utilization of the OT time has always been a priority area for hospital administrators. It
also aids in allocating reserve time for emergency operations, as epsis measures and
procedures, and provides decision making information for augmentation or downsizing of
the facility.
Operating room is one of the key departments of any hospital. Its carries high cost. All the
measures must be taken to make it highly efficient. Multidisciplinary approaches improves
the OR efficiency and reduces the cancellation. Specialty based time distribution and their
underutilization affects and it can be predicted then it also improves the working of the OR.

The operating room, sometimes called the OT or surgery center, is a place where
surgery takes place in a hospital

Structure of the Department

● OT complex in AMRI hospital is situated on the 1" Floor of the building.

● Average Size of OT is 450-500 sq feet

● Operating theatre are modular and are equipped with modern state of the art
facilities

● Sterile supply from CSSD will be stored in sterile room

● Supply will reach to the OTS by means of Pass box present between OT complex
& CSSD

Employee mix for the operation theatre would be

● Doctors

● Nurses

● Technicians

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 ● OT Executive

● Housekeeping staff
Purpose

To provide guideline instructions for Processes Related to OT Suite Functioning with

the aims that

● Needs and expectations of patients are established/fulfilled,

● Patient satisfaction is enhanced on continual basis, and

● Feedback loop is established for continuous improvements.

Scope

It covers the total functioning of the Operation Theatre with relation to the patient and
other OT specific processes.

Responsibility

OT In - charge

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 AIM OF THE STUDY
● To study the physical facilities, staffing and equipment of MODULAR OT IV in
AMRI Hospital
● To study whether the planning of OT is according to the following standard or
not.
● To assess the overall utilization in terms of hours to find out the factor affecting
the utilization.

OBJECTIVE
● To provide skilled and efficient administration of anesthesia for elective &
emergency surgeons throughout the year.

● Training of all Doctors OT Technician & OT Sister.

● Safe & effective sterilization Procedure.

● Improving coordination among the surgeons’ anesthesiologists & the surgical

team
● Having control on the stock available in the OT, by assigning the work to
different people & verifying them in regular intervals.

● Standardization of surgical procedures done in the Operation Theatre; specialty

wise along with the surgery code.

● Streamlining of various processes related to procurement of implants,

consumables, drugs and finally billing.

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 METHODOLOGY
1. Primary data collection
● Direct Observation
● Discussion with junior hospital administration and OT in charge.
2. Secondary data collection
● Data Analysis: Data was analysed with the help of MS-Excel.
OT utilization Formula: - (Actual utilization of OT in hr / Total given working
hr)100

OBSERVATION AND PROCESS

NURSING CALL SYSTEM

There is a two-way voice communication system.

ELECTRICITY
Round the clock electricity with UPS, inverter and standby generator facility
is available.

MEDICATION
All the essential drugs, IV Fluids, gases in sufficient stock are available round
the clock. There is cold storage facility like refrigeration for medicines are
stored in cold temperatures.

STORED AREA
Separate storage area is reserved for storage of linen, housekeeping materials
& other supplies for ward.

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 SCHEDULING OF OT

Prepare list

Discuss with anaesthetist

Full time consultant

Draft list

Ward nursing
Dedicated number (*****) for OT
booking (OT Manager- day) Clearance
(OT Nursing – night)

Final list

Visiting consultant

Update System booking

Inform consultant by sms, phone

Floor coordinator to check

financial clearance

 Inform to patient
 Inform to
consultant
Re-listing by floor coordinator
 Inform to nursing Rescheduling
supervisor
 Inform to ward
nursing

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 1. Full time Consultant / Visiting Consultant will directly or through ward/ICU nursing
staff, intimate on the dedicated number for booking OT cases. This number will be
managed by OT manager from 9am -5 pm and then will be handed over to OT
nursing from 5pm - 9am.

2. Draft OT list to be prepared by OT manager responsible for OT booking.

3. Cut off time for OT booking will be 5.30 pm Post 5.30pm the cases continue to add
as add-on cases and scheduled next to the booked cases.
4. OT schedule to be prepared by OT manager based on the OT list (OT allocation &
time) after discussion & approval of Anesthetist I/C.
5. OT schedule to be sent to financial counselor by OT manager for clearance.
6. After clearance final OT schedule to be updated in system by OT manager by
5:30pm.
7. OT manager informs the consultant & Anesthetist through Call and SMS
8. OT manager also informs the nursing supervisor, ward nursing & floor coordinator.

9. Floor coordinator to recheck the financial clearance of the scheduled cases

10. Re-scheduling of OT cases to be done by the floor coordinator based on the

clearance.

11. Any deviation to be informed to the consultant, patient, OT nursing, nursing

supervisor & ward nursing by the floor coordinator.

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 STRUCTURE PROCESS AN OUTCOME OF STUDY
• Structure
• OT scheduling is performed to have a uniform, timely and streamlined method of
OT allocation and facilitate appropriate OT utilization and patient care is not
affected.
• Among the OT scheduled if cancellations occurs then there is disturbance in the
routine Patients kept on NPO are physically & mentally influenced and leads to
patient dissatisfaction. Patient safety culture in the organization is affected.

• Process
1) The number of cases scheduled are studied along with the cancellation and their
reasons for cancellation also.
2) These all cancellations are categorized under major defined categories based on
the retrospective reasons compiled.
3) Reason wise specifications are analyzed where the cancellations could have
been prevented.
4) Doctor wise cancellations to any specific reasons were also analyzed to work
on such reasons.
5) Reasons specific rescheduling also studied to know how many times the cases
were rescheduled or missed out for administrative workup.

• Outcome
1) Based on the reasons decisions were made to prevent the OT cancellation at
ward level itself.
2) Consultants are encouraged to post the case only after appropriate fitness
3) Anesthetist& Surgeon to be informed of the investigation reports immediately
on receiving in wards.
4) Major critical reports if suspected by consultant during fitness then case to be
scheduled only after reviewing the Reports.
5) Checklist to be prepared and followed in wards for planned surgeries the basic
requirements to prevent OT cancellations

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 FACILITIES

⮚ Total 400 bedded Hospital

● 362 operational beds.
● 138 critical care beds.
⮚ The centre of Excellence provided :
● Institute of Cardiac Sciences
● Institute of Neuro Sciences
● Institute of Oncology and Radiotherapy
● Institute of Urology and Renal Sciences
● Institute of Nuclear Medicine
● Institute of Haemato Oncology and Bone Marrow Transplant
● Institute of ENT and Head Neck surgery
● Institute of Orthopaedic and Joint Replacement
● Institute of Gastro Sciences
● Institute of Woman and Child care
● Institute of Emergency and Critical Care
● Institute of Imaging and Interventional Radiology
● Institute of Diabetes and Hormonal Disorders
● Institute of Dentistry and Maxillo facial surgery

⮚ Scope of special services

● Cardiac CT
● CT/MRI
● Capsule Endoscopy
● ERCP (Endoscopic Retrograde Cholangipancreatography)
● Endoscopy and Colonoscopy
● Manometry and PH study
● Dialysis
● Nasal Endoscopy and FOL
● Diabetic foot scan
● Diabetic Fluroscien Angiography
● Laser Photocoagulation
● Mammography and Bone Density Analysis
● Interventional Radiology
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 ● USG/CT Guided Biopsy
● EEG(Electroencephalogram), EMG(Electromyography), NCV(Nerve Conduction Velocity)
⮚ Services provided AMRI Hospital
● Diagnostics
✔ 1.5 Tesla MRI
✔ 128 Slice CT scan
✔ Digital X-ray
✔ 4D ECHO/TEE/ECHO
✔ EEG+EMG+NCV
✔ USG
✔ Uroflowmetry
✔ Endoscopy
✔ Colonoscopy
✔ ERCP
✔ Mammometry
● 24X7 Services
✔ TRUE SENSE Critical Care with Advanced ITU
✔ Critical Care Ambulance Service
✔ Advanced Dialysis Unit
✔ Latest generation Digital Cath Lab
✔ Microbiology and Pathology Services
✔ Frank Ross Pharmacy
● General
✔ Cardiology and Cardio Thoracic Surgery
✔ Diabetology
✔ ENT and Dentistry
✔ Gastroenterology and GI Surgery
✔ General Medicine
✔ Gynaecology
✔ Hematology and Neonatology
✔ Vascular Surgery
✔ Maxillofascial Surgery
✔ Neurology and Neuro surgery
✔ Nephrology
✔ Oncology and Onco surgery
✔ Opthamology

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 FLOOR DIRECTORY
FLOOR PARTICULARS

BASEMENT Doctors and Staff Parking

LOWER GROUND FLOOR Administration, HR Dept., Finance Dept., Medical

Administration, Medical Records, Central Stores, Conference
Room, Training Rooms, Biomedical Dept., Marketing Dept.,
House Keeping Dept., IT Dept., Blood Centre, Nursing Dept.,
Mortuary, EPABX
GROUND FLOOR May I Help You Desk, Admission & Discharge Desk, OP
Registration & Billing, Corporate & TPA, Financial Counselling,
Pharmacy, Emergency, Day care, Nephrology Dept., Radiology
Dept., OPD Block (A,B & C), Sample Collection, Health Check-
up, Physiotherapy, Cafeteria, VIP Lounge, Waiting Lounge,
Report Dispatch, EYE OT, Prayer Room, Dialysis, Sports
Medicine, Ophthal Shop
FIRST FLOOR Room No.9(1001-1034), OT Complex, Cath Lab, Surgical ICU,
CCU,CTVS ICU, Kidney Transplant Unit, Central Unit, OT
Lounge, OPD, NCV, EEG/EMG, Oncology Waiting Area, CSSD
SECOND FLOOR Room No.(2001-2128), Single Rooms, Deluxe Room, Pediatric
Ward, Oncology Ward, Medical HDU, Cardiac HDU, Neuro
HDU, Pediatric ICU, NNICU, Nursery, Labour Room, OBS
&Gynae OT, Doctor Lounge, Chemo Preparation Room,
OPD,ERCP, Endoscopy, Feeding Room, Sample Collection,
Audiometry, Uroflowmetry, PFT, Dental Dept., Gastro Waiting
Area
THIRD FLOOR Room No. (3001-3048), Room No. (3066-3118), General
Ward, Isolation Room, ICU-1, ICU-2, HDU

FOURTH FLOOR Room No. (4001-4059), Single Room, Double Room, Deluxe
Room, Suite Room, Isolation Room, Discharge Cell, Quality
Cell

FIFTH FLOOR Room No. (5001-5062), Single Room, Double Room, Triple
Room, Semi Private Rooms, Isolation Rooms, Patient Service
& Delight Cell

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 VARIOUS DERPARTMENT OVERVIEW
AMRI HOSPITAL has following various department as follows : -

❖ CARDIAC SCIENCES
🡪 Our well-integrated ‘Cardiac Care Center’ at AMRI Hospitals, offers a comprehensive and multidisciplinary
approach for treating patients suffering from chronic heart diseases. We have a team of highly experienced and
qualified cardiologists, surgeons, paramedics, and dedicated nursing staff, and advanced infrastructure to offer
accurate and precise treatment suitable for patients of all ages.
🡪 Our pioneering contribution for preventing, diagnosing, and treating complex cardiac diseases has led to the
achievement of providing improved quality of life to numerous cardiac patients. At AMRI Hospitals, we are
committed to provide the highest standards of post-surgery care & excellent rehabilitation facilities under the
supervision of the country’s best & leading doctors having international level expertise.
⮚ Available Diagnostic & Therapeutic Services:
● All kinds of Angiography including Cerebral Angiography
● All kinds of Angioplasty
● Balloon Mitral Valvotomy
● Permanent Pacemaker Implantation
● Electrophysiology Study with RF Ablation
● ICD and CRT Implantation Diagnostic (Non-invasive)
● ECG (12-lead, computerized)
● Echocardiography (Colour Doppler, trans-oesophageal and 4D)
● 64 slice Cardiac CT with Cardiac Angio facility
● SPECT CT enabled for Myocardial Perfusion scan
● MR Angio facility with TIM-DOT 1.5 MRI machine
● TMT • Holter Monitor • Stress Echo
● Tilt-table test
● Preventive cardiology (lifestyle modification, control of risk factors) Therapeutic intervention
● Elective Coronary Angioplasty and stent implant
● Primary or emergency Coronary Angioplasty (during early hours of Ml)
● Renal Angioplasty
● Carotid Angioplasty
● Limb artery Angioplasty
● Aorta intervention
● PTSMA
● Balloon Valvuloplasty (Mitral, Aortic, Pulmonary, Tricuspid valve ballooning)
● Device (ASD, VSD, PDA) closure of holes in the heart
● Acute intervention after birth (TGA, PDA opening)
● Closure of abnormal arterial channels in children
● Pericardial fluid aspiration

⮚ Technology
● Congenital heart surgery
● ASD Closure
● VSD Closure
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 ● PDA Ligation
● BT Shunt
● BD Glenn Shunt
● Fontan's Procedure
● TAPVC Repair
● Total Correction of TOF
● Restelli's Procedure
● Senning's Operation
● Arterial Switch for DTGA
● Double Switch for CCTGA
● Norwood Procedure
● Minimally Invasive Cardiac Surgery Surgical intervention CABG
● Off-Pump
● Multi-Vessel Total Arterial Bypass (LIMA-RIMA Y) Valve surgery
● Aortic Valve Replacement/Repair
● Mitral Valve Replacement/Repair
● Double Valve Replacement
● Tricuspid Valve Repair
● Stent-less Aortic Valve Replacement
● Aortic Root Surgery (Bentalls Operation)
● ROSS Procedure Pacing modalities group
● Pacemaker implantation (single/dual chamber, bi-ventricular)
● A Multi-site pacing
❖ ORTHOPEDICS & JOINT REPLACEMENT
🡪 Offering world-class orthopedic care, AMRI Hospitals is renowned for its highly experienced and skilled joint
replacement surgeons, and sport injury specialists who use state of the art technologies and advanced techniques to
deliver reliable and high-quality treatment. Our orthopedic surgeons focus on providing comprehensive and
effective solutions based on observation and precise diagnosis of common orthopedic problems.
🡪 Our dedicated team of best orthopedics specialists usetheir observation, experience, knowledge and realistic
approach for complex procedures. At AMRI, we take pride in the latest Arthroscopic, Reconstructive and
Minimally invasive techniques for treating sports and joint injuries. Our specially designed physiotherapy units
offer excellent rehabilitation and pain management facilities using modern & accessible equipment for speedy
recovery.

⮚ Available Treatment Facilities

● Trauma Surgery
● Joint and Spine Replacement
● Reconstruction Procedures
● Arthroscopy
● Sports Medicine
● Paediatric surgery
● Deformity correction
⮚ Highlights
● High standard implants for improved motion and minimum wear process
● Ensuring short hospital stay and quicker return to normal life
● Excellent multi-disciplinary support of doctors
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❖ NEURO SCIENCES

🡪 The center of Neurosciences, at AMRI Hospitals has a demonstrated track record in providing highest
levels of professional expertise in the varied field of Neuro diagnostics, Neurology, Neuro surgery,
Neuro Anaesthesia and Interventional Neurology.
🡪 We are backed by a team of the country's best neurologists & surgeons who have immense
knowledge and experience in diagnosis, treatment and patient-care management. The
Neurosciences Centre is committed to follow multidisciplinary approach & advanced techniques for
treating life threatening & challenging neurological disorders.
🡪 At AMRI Hospitals we are fully equipped to provide 24*7 comprehensive evaluation and therapeutic
care to a wide range of neurological conditions including stroke, seizures, brain & spine disorders, and
congenital diseases.
⮚ Facilities
Brain tumour surgery with Neuronavigation:

● Micro surgery for spinal tumour

● Minimally invasive disc surgery
● Head & spinal injury services
● Neuro endoscopy & pituitary surgery
● Microvascular surgery for AVM & Brain Aneurysm
24x7 1.5 Tesla Ambient MRI :

● 70cm bore for comfort

● Premium digital imaging
● Reduced noise
● In gantry entertainment 24x7 128 Slice CT Scan :
● Gem stone imaging
● Single pass cerebral DSA
● 60% less radiation
● 230-micron resolution
Neurophysiology :

● Electroencephalogram (EEG)
● electro myelogram (EMG)
● Nerve conduction velocity test (NCV)
● Evoked Potentials (EP)
● Video EEG
● Transcranial Doppler (TCD)

❖ GASTRO SCIENCES

🡪 AMRI Hospitals’ Department of Gastroenterology and Hepatobiliary Sciences is a premier centre in

eastern India with latest technology based high end treatment facilities. The department provides a

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 wide array of multidisciplinary and multi-modality services, all under one roof to manage any kind of
liver and gastro-intestinal disorders and its complications.
🡪 We have a team of eastern regions’ most talented and renowned Gastroenterologists, high precision
instruments along with video navigation tools for minimally invasive as well as robotic surgeries for
accurate diagnosis and perfection and round the clock emergency services to provide comprehensive
care for faster recovery and excellent rehabilitation.
⮚ Spectrum of Services
● Ultrasonography
● Hi-speed CT scan
● Gl Endoscopy
● Gastroscopy
● Colonoscopy
● Sigmoidoscopy
● Double Balloon Enteroscopy
● ERCP (Endoscopic Retrograde Cholangio-pancreatography)
● Bile Duct Stone Extraction
● Esophageal dilation
● Argon plasma Coagulation
● Endoscopic Variceal ligation
● Capsule Endoscopy
● Anorectal Manometry
● Esophageal Manometry
● Esophageal Metal Stenting

❖ ONCO SCIENCES

🡪 The Oncology department of AMRI Hospitals stands at the forefront of excellence in providing
precision cancer care. We understand the significance of personalized care and aim to provide top
notch facilities along with expertise from the best oncologists of Kolkata. At AMRI, our prime focus
is to build a holistic and integrated environment for cancer patients under the supervision of our top
cancer specialists.
🡪 Our team consists of highly experienced and well-trained Radiation Oncologists, Medical Oncologists,
and Surgical Oncologists offering a wide range of treatments and medical procedures including
surgeries, chemotherapies, blood transfusions and transplants considering the patient’s ongoing
condition. We are in the process of establishing the most advanced Haemato-pathology service that
will help in looking after the requirements of the outside world.
🡪 We offer treatments for: Blood Cancers Thalassemia Anaemia including complex causes of aplastic
anaemia & thalassemia Bleeding and clotting disorders Auto-immune disorders Inherited disorders
AMRI promises its’ oncology patients the most advanced and sophisticated cancer treatment. The
presence of the best oncologists and the latest technologies makes it possible.
🡪 Treatment planning is done in the widely accepted Monte Carlo based calculation system. We also
make pre-treatment verification imaging available both in 2D and 3D, that ensures highly efficient
treatment.

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❖ OBSTERICS & GYNAECOLOGY

🡪 AMRI hospitals is the one stop centre for highly extensive gynaecological treatment and services in
Eastern India. We provide comprehensive diagnosis for all the various gynaecology subspecialties.
The various subspecialties include Uro-Gynaecology, Gynae-Oncology, and Laparoscopy
Gynaecology.
🡪 We understand that women across different age groups have different health complications. At
AMRI, a lot of emphasis is laid on providing top notch gynaecological treatment. The Department of
Obstetrics & Gynaecology across all units aim to provide the most comprehensive women’s
healthcare services.
⮚ Available Treatment Facilities
● Providing the best pregnancy care with renowned consultants specialized in dealing with High
risk pregnancies & Medical disorders in pregnancy.
● Combined clinic to deal with Endocrine (Diabetes, Thyroid etc.), Neurology & Haematology
problems in pregnancy
● Electronic Fetal Monitoring in Labour for safety of the baby
● Customized LDRP (Labour, Delivery, Recovery & Postpartum) Suites
● Regular antenatal classes for pregnant lady to care the unborn baby
● Dietary advises for all pregnant & lactating mother
● Painless labour facility for normal delivery
● Gynaecology Subspecialties
● Infertility & IVF with Folliculometry Screening
● Urogynaecology with Urodynamics
● Onco-Gynaecology with Colposcopy Clinic
● Laparoscopy Surgery for Cyst, Lap Hysterectomy etc.
● 24 hrs USG facility for Emergency patients
● 24 hrs facility for antenatal CTG (Cardiotocography) to monitor High risk pregnancies
● 24 hrs CT Scan, X Ray & pathology.
● State of the art NICU to provide support to babies from 26 weeks of gestational and also all
underweight & preterm babies
● Multispecialty support for babies with congenital problems through our Paediatric Surgery,
Orthopaedics, Pulmonologist, Nephrologist etc.
● Stem Cell collection

❖ PAEDIATRICS
🡪 We take great pride in offering comprehensive care facilities for infants and children. Our multi-
disciplinary team of highly experienced paediatricians, neonatologists, surgeons, therapists and
nurses across different specialties ensure that children across various age groups receive the best
possible care and treatment.
🡪 Care is provided in dedicated & fully equipped Neonatal ICU, Paediatric ICU & Paediatric
ward.. Paediatric specialists are available for immediate consultation for problems presented in
our clinic. Each and every child is unique because of their age, physical illness, mental health, or

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 maybe their unique genetics, no two children have the same healthcare needs. It is when you need
a specialist, you want a doctor who knows how to care for children.

⮚ DEPARTMENT HIGHLIGHTS

AMRI Hospitals offer highly specialized Emergency Retrieval service for sick neonates & children.

● Fully dedicated & well equipped PICU

● Non Invasive + Conventional + High Frequency Ventilation
● Continuous End Tidal CO2 Monitoring
● State of the art Blood Gas Machine with Lactate Value
● 24 hrs. Renal Replacement Therapy
● 24 hrs. Ultrasound & Echocardiography
● Ultrasound Guided Vascular Access & Pleural Drain Placement
● Blood Pressure Monitoring facility in Ambulance
● Paediatric ward with 24 beds with additional beds for the accompanying mothers
● Children's play areas both in paediatric ward and outpatient areas
● Paediatric Dialysis Unit
● Paediatric Bronchoscope Unit
● Paediatric Endoscopy Unit

❖ ENT

🡪 The highly trained, board-certified otolaryngologists, along with our licensed audiologists and
speech-language pathologist, use the latest state of art instruments to diagnose and treat the most
complicated Ear, Nose, Throat, Head & Neck, as well as Skull Base problems.
🡪 ENT physicians are doctors who specialize in surgical management and treatment of patients with
problems of the ear, nose, throat, and related structures of the head and neck. The team of ENT
Specialists at AMRI Hospitals is one of the finest in the region with the expertise to handle any kind
of trauma/ emergency.
🡪 The ENT department at Bhubaneswar performs both basic and advanced endoscopic sinus surgeries,
micro ear/micro laryngeal surgeries, Esophageal endoscopes and surgery for deafness. It also offers
solutions in advanced endoscopic, microscopic anterior and lateral skull base surgeries in
collaboration with experienced neurosurgeons.
🡪 The ENT specialty unit in Southern Avenue explores the advanced sub-specialties with deeper
expertise. Our internationally acclaimed medical faculties along with a dedicated tam of over 15 ENT
surgeons ensure that patients are provided with undisrupted medical attention. With over 12 years
of sustainable success rate, AMRI Southern Avenue over the years has established itself as one of the
best centres for ENT treatment in Eastern India.
🡪 From Video Endoscope and Microscope based ENT Treatment to Cochlear implant, our highly skillful
medical team is well equipped to meet the most complex challenges with ease. There are also
numerous dedicated clinics in the unit which include:
● Dedicated Hearing AID Clinic
25 | P a g e
 ● Snoring Clinic with Drug Induced Sleep Endoscopy (DISE)
● Vertigo Clinic - through assessment with investigation & rehabilitation therapy
● Voice Clinic - Voice Correction for the professional voice user with voice therapy, medication &
laser surgery
● Speech Clinic - Providing therapy & counseling to developmental & behavioural speech defect
❖ PULMONOLOGY

🡪 The highly experienced doctors, trained staff and the latest technologies in use is what makes AMRI
one of the best Institute of Chest Medicine not just in Eastern India, but in the country. The effective
diagnosis and treatment of lung diseases can be a complex procedure. Our medical team, having
best pulmonologists in BBSR, understand this fact and undertake all means necessary to make sure
that services of the highest order are provided to all patients who seek help.
🡪 Our Pulmonologists diagnose and treat diseases by collaborating with colleagues in Cardiothoracic
Surgery, Cardiology, Hematology/Oncology, Infectious Diseases, Rheumatology and surgeons in
other specialties to provide comprehensive and effective treatment for patients.

⮚ Highlights
At AMRI we provide comprehensive consultation, evaluation, and treatment of various lung diseases
and conditions which include:

● Asthma.
● Bronchiectasis and Bronchitis.
● Cancer.
● Chronic cough.
● COPD/Emphysema.
● Fungal, Inflammatory and Infectious processes.
● Interstitial Lung Diseases (i.e. pulmonary fibrosis, BOOP)
● Lymphangioleiomyomatosis
● Mycobacterial infections including non-tuberculous mycobacteria as well as tuberculosis.
● Occupational related diseases (i.e. asbestosis).
● Pneumonia.
● Pulmonary hypertension (PH).
● Pulmonary embolisms and effusions.
● Sarcoidosis.

❖ DIABETES &ENDOCRINOLOGY
🡪 As an Advanced Medicare Centre, we provide state-of-the-art technology combined with the latest
research findings in medical treatment to make sure patients receive the best care.
🡪 The department is supported by DEXA scan for bone mineral density, nuclear image for thyroid,
parathyroid and adrenal disorders; and state-of-the-art diagnostic solutions in radiology and
hormone analysis. At AMRI, we provide the best diagnosis and treatment for various conditions like:
● Adrenal Disorders
● Thyroid Disorders
● Bone Disorders
● Pituitary Disorders
● Reproductive Disorders
● Metabolic Disorders
26 | P a g e
🡪 The Department of Endocrinology & Diabetology at AMRI offers comprehensive services in diagnosis, treatment
and management of all hormone related disorders. A dedicated team of Endocrinologists, Bariatric surgeons,
Diabetes educators, Ophthalmologists work together to provide patients with the most advanced therapies in the care
and management of complex endocrine diseases and diabetes.

❖ DENTAL SCIENCE

🡪 AMRI hospitals has acquired great reputation over the years of being experts at handling all kinds
of dental complexities. We are equipped with a highly experienced team of dentists and dental
surgeons who are well-supported by a trained team of staff and associates.
🡪 We offer extensive dental services across our different units which covers all aspects like Oral
&Maxillofacial surgery, Orthodontics, Conservative dentistry & Endodontics, implant dentistry,
Paediatric Dentistry, General Dentistry, etc.
🡪 The AMRI medical centre at Southern Avenue is a centre of excellence in advanced cosmetic and
digital dentistry. This unit is renowned for being equipped with latest generation equipment and
state-of-the-art infrastructure. This unit has provision for numerous specialty clinics like oral
medicine, implant clinic, lock-jaw clinic, gum diseases, screening clinic, pregnancy & diabetic dental
clinic.

❖ MENTAL HEALTH

🡪 We understand that the avenue of psychiatry is a sensitive area and is required to be handled with
enormous amounts of patience. Our doctors, being thorough professionals are committed to provide
highly effective mental health services to the patients, as they deal with the most complex of cases
with a great deal of fortitude and expertise.
🡪 The Department of Psychiatry at AMRI hospitals constitutes of highly experienced doctors providing
the best psychological services to all patients seeking mental and emotional help. Our highly
integrated healthcare system comprising of the best psychiatrists in India thrive on providing
comprehensive clinical evaluation and treatment for a variety of behavioral and emotional disorders.
A lot of our endeavour lies in promoting a high degree of trust among our patients and their families
by creating a highly reliable environment. We take great pride in diagnosing and treating patients
belonging to all ages and backgrounds.
🡪 The psychological services that we provide is widely renowned across the country owing to our high
success rate. Our team, comprising of the best psychiatrists in India, clinical psychologists,
counselling psychologists, and occupational therapists are instrumental in making us one of the
leading centres of psychiatry. Some of the services we provide involve treatment for anger, low
confidence, Schizophrenia, lack of interest, abnormalcy, behavioral disintegration, etc.

❖ OPTHALMOLOGY

🡪 The department at AMRI Salt Lake was initially set up with the primary objective of being able to
cater to the basic and routine needs of a super-specialty hospital. Over the years it has developed
into one of the best hospitals for ophthalmology in the country. The new department at the annex–
I building of AMRI Salt Lake provides all the world-class facilities like:
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 ● Routine eye check-ups
● A complete medical retina clinic with angiography and lasers
● A hi-tech glaucoma clinic with Applanation tonometry, perimetry, and 90 D examination
● A complete end to end solution for cataract treatment
● A one-stop surgical retina treatment center
🡪 AMRI Salt Lake is widely regarded as one of the most advanced eye-treatment centers in Eastern
India. The department in this unit boasts of:

● A Topcon digital fluorescein angiography (latest TRC 50Dx) to deliver crisp clear images of the
retina via the Image net (patented) software, imported from Japan
● A Humphrey auto perimeter which has become the gold standard in diagnosis and follow-up of
glaucoma, from Carl Zeiss, a world leader in this technology.
● A blue-green laser from Ellex corp, Australia complete with an indirect ophthalmoscope delivery
system (first of its kind in eastern India) for highly accurate and effective retinal photocoagulation
● A sonomed biometry machine that gives quick and highly accurate acquisition of data for lens
power calculation in cataract surgery
● The Moller Wedel microscope, imported from Germany is one of a kind in the industry, with no
contemporaries in the stereo base setup.
● A dedicated Fabius Anaesthesia machine capable of handling long-duration surgeries in, backed
by the best monitors and lifesaving equipment.
🡪 The Bhubaneswar unit is another renowned hospital for Ophthalmologythat provides
comprehensive eye care and services for all eye and vision problems under one roof. We have
exclusive clinics for Refractive error and contact lenses, Cataract, Glaucoma, Cornea, Paediatric
Ophthalmology, Vitreo-Retina, Diabetic Retinopathy, ROP, ARMD, Oculoplasty, Ocular Oncology,
Ocular trauma, Uveitis, Neuro-ophthalmology, Computer vision syndrome etc.

❖ UROLOGY

🡪 AMRI hospitals offer a wide range of urological and nephrological ailments across all its’ units. The
units provide some of the best treatment for complications like enlarged prostate, urinary stones,
urinary tract infections & obstructions, urinary incontinences, genitourinary malignancy, etc.
🡪 Complex procedures like kidney transplantation, dialysis, reconstructive urology surgery,
laparoscopic urology, among others are carried out with relative ease and expertise. The highly
advanced medical team comprising of the best urologists in India and skilful nursing team &
technicians also specialize in treating uro-oncology anduro-gynaecological complications.
⮚ Facility
AMRI provides laparoscopic urology services with a great degree of precision and care. Some of the
surgeries include:
● Radical Nephrectomy
● Partial Nephrectomy
● Radical Prostatectomy
● Adrenal Tumours
● Simple Nephrectomy
● Pyeloplasty
● Ureteral Re-implant

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 ● VVF/UVF Repair
● Pyelo/Uretero lithotomy
AMRI also ensures that patients receive the best of treatment facilities backed by the latest technology and equipment,
no matter how complicated the procedure. Here is a detailed view: -
● URINARY STONE MANAGEMENT
● 100 W HOLMIUM LASER
● TREATMENT FOR UROLOGY CANCERS
● FEMALE URINARY INCONTINENCE
● RECONSTRUCTIVE UROLOGY SURGERY

❖ NEPHROLOGY

🡪 Nephrology is a super-specialty of medicine that deals with the diagnosis and management of
diseases of the kidneys.
🡪 The Institute of Nephrology and Kidney transplantation at AMRI Hospitals provides comprehensive
care for kidney ailments in the following manner:

● Endeavors to prevent kidney diseases from developing, where possible by aggressive

management of systemic diseases such as diabetes and hypertension
● Slows down the progression of kidney disease through diet and lifestyle modification that
complement medications
● Offers renal (kidney) replacement therapy in the form of dialysis or kidney transplantation when
the kidney fails
● Plans the treatment process in an organized manner causing minimum discomfort to the patient
or disruption to his/her lifestyle or work schedule
⮚ Facilities
Diagnostic Nephrology Kidney biopsy is performed by a totally safe ultrasound guided technique with an
automated needle. Haemodialysis The dialysis wing has 12 modern computerized.

⮚ Super-specialty Nephrology Services

⮚ Haemodialysis
⮚ Peritoneal Dialysis
⮚ Kidney Transplantation
⮚ Pediatric nephrology
⮚ Interventional Nephrology
o Central Venous Catheterisation
o Tunneled Catheter Insertion
o Kidney Biopsy (Native and Graft)
o Renal angioplasty
⮚ Critical Care Nephrology:
o Slow low efficiency dialysis
o Continuous renal replacement therapy (CRRT)
o Cytosorb/Polymixin B adsorption
o Charcoal Haemoperfusion
o Plasmapheresis
⮚ Vascular Access Creation:

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 o A-V Fistula Creation
o A-V Fistula Angioplasty
o Central Vein Angioplasty
o A-V Graft Insertion(PTFE)

DATA ANALYSIS

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Layout:

Types of OT complexes
In OT Complex at AMRI, there are 10operation theater with a pre operative
& post operative room and manager's room.

The OT Complex is located in the 1st floor.

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OT-1: Urology, Kidney, transplant (donor)
OT-2: Lab Cases, kidney transplant (recipient)
OT-3: Orthopedics.
OT-4: CTVS
OT-5: Neuro Surgery
OT-6: General OT (Infected Care)
OT-7: Eye Related Surgery
OT-8: Gynaecology
OT-9: Cath Lap
OT-10: Minor OT

There are three main categories of operating theatres:

1. The single theatre suite with OT, scrub-up and gowning, anesthesia
room, trolley preparation, utility and exit bay plus staff change and
limited ancillary accommodation.
2. The twin theatre suite with facilities similar to, but with duplicated
ancillary accommodation immediate to each OT, sometimes sharing
a small post anesthesia recovery area.
3. OT complexes of three or more OTs. with ancillary accommodation
including post anesthesia recovery, reception, porter's desk, sterile
store and staff change.
ZONING OF OT
Protective Zone: Areas included in this zone are:
• Reception,
• Waiting area,
• Trolley bay
• changing room
Clean Zone: Areas included in this zone are:
• Pre-op room,
• Recovery room,
• Staff room
• Store
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Sterile Zone: Areas included in this zone are:
Operation theater
• Operating Suite,
• Scrub Room,
• Anesthesia Room,
• Instrument trolley area
Disposal Zone: Areas included in this zone are:
• Dirty Utility
• Disposal corridor

STAFFING OF MODULAR OT

● OT in charge 1
● Nursing staff 14
● Pharmacist in charge 1
● Anesthesiologist Head 1
● Asst Anesthesiologist 9
● Technician 12
● sweeper 3

AREA
OPERATION ROOM =6.5mx6.5mx 3.5m. Glass window should be plan on one side.
Main Door to the OT Complex has to be adequate width 1.2 to 1.5 m
Procedure Room
Anesthesia = 6’x8 ‘work zone
2 area shared between anesthesia staff and circulator patient area
3’x7’ for planning purpose
Clear floor area and clearances
Change room= 6’x7’
Staff Toilet= 4’x6’6”
General Store =7’7”x9’8”
Utility Room =6’x8’9”
PAC ROOM – 11’ X 11’
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PATIENT WAITTING AREA – 15’ X11’

PRE-OPERATIVE ROOM – 35’ X 21’

RECOVERY ROOM – 35’ X 21’

DOCTOR REST ROOM -15’ X 21’

STORE ROOM – 15’ X 21’

OT-I GENERAL SURGERY – 20’ X 19’

● OT-II ONCOSURGERY – 20’ X 19’

● OT-III ORTHOPAEDIC – 31’ X 19’
● OT –IV ORTHPAEDIC – 20’ X 20’
● OT –V GENERAL SURGERY-18’ X 15’

Walls
Laminated polyester or smooth paint provides seamless wall; tiles can break and epoxy
paint can chip out. Collusion corners to be covered with steel or aluminum plates, color
of paint should allow reflection of light and yet soothing to eyes. Light color (light blue
or green) washable paint will be ideal. A semi-matt wall sur-face reflects less light than
a highly gloss finish and is less tiring to the eyes of OT team

Scrub area:
To be planned for at least for 2-3 persons in each OT.
There has to be a preparation room in clean zone
Corridors not less than 2.85 m width for easy movement of men, stretcher & machines
Separate corridors for uses other than going into OT.
Rooms for different persons working in OT & for different purpose (it should be as per
zone & size)
Gas & suction (control, supply & emergency stock) for all OTs & areas where patients
are retained. Oxygen, gas and suction pipe to be connected with central facility and
standby local facility should also be available.
Provision for adequate & continuous water supply:
Besides normal supply of available water at the rate of 400 liters per bed per day, a
separate reserve emergency overhead tank should be provided for operation theatre.
Elbow taps have to be 10 cm. above wash basins.
Proper drainage system.
Pre-operative area with reception with separate designated area for pediatric patients is
desirable.
Adequate illumination with shadow less lamps of 70,000-120,000 Lumens intensity, for
assessing patient color and tissue visibility (discussed under " Lighting").
The safety in working place is essential, and fire extinguishers have to be planned in
34 | P a g e
appropriate zone.
Provision for expansion of the OT complex should be borne in mind during planning
stages itself.

Recommendations on the number of OTs required

It is observed that out of all surgical beds, of the hospital, 50%of patients are expected
to undergo surgery. Thus for 100 beds, with average length of stay of 10 days for each
patient, 10 operations per day can be performed.
In general, multiuse OTs, instead of multiple OTs of-fer advantages of efficient man
power utilization, economical maintenance and better training of supporting staff.
Thus, in a 300 bedded hospital (with 150 surgical beds), one OT complex with 3 OTs
for General Surgery, Gynecology, Orthopedics/ENT, one for Endoscopy and one for
Septic. OT will be required with 8 hours a day working duration.

Ventilation
Ventilation should be on the principle that the direction of air flow is from the operation
theatre towards the main entrance. There should be no interchange air movement
between one OT and another. Efficient ventilation will control temperature and
humidity in OT, dilute the contamination by micro-organisms and anesthetic agents.
There are two types of air conditioning systems: re--circulating and non-re-circulating.
Non re-circulating systems heat / cool the air as de-sired and convey it into the operating
room with ideally 20 air exchange per hour. Air is then exhausted to outside. Anesthetic
agents in the OT air are also automatically removed. These are thus ideal but are
expensive.
The circulating system takes some or all of the air, adjusts the temperature and circulates
air back to the room.

Pendant services
Two ceiling pendants for pipeline services should be designed; one for surgical team and
one for anesthetist. Anesthetic pendant should be retractable and have limited lateral
movement and provide a shelf for monitoring equipment. It should have oxygen, nitrous
oxide, four bar pressure medical compressed air, medical vacuum, scavenging terminal
outlets and at least four electric sockets.

Piped gases in the OT

Automatic / semi-automatic fail-safe manifold room to be designed.
Two outlets for O2 and suction and one for N2 O are a minimum in each OT.
Pipeline supply system should be able to cut off from mainline if the problem occurs
anywhere along the delivery hosing / tubing.

Electrical
All electrical equipment in the OT needs PROPER grounding
35 | P a g e
In the past, isolated power systems were preferred when explosive agents were being
used. They have the advantage of a transformer using grounded electricity and there is
no risk to the patient or machines if a machine gets faulty.
The grounded systems as used at homes offer protection from macro shock but devices
may lose power without warning. Life support systems, if in use could be disturbed.

Following criteria are ideal with respect to electricity in OT complex:

Use of circuit breakers / interrupters is desirable if there is an overload or ground fault.

Power line of 220 Volts. Suspended ceiling outlets should have locking plugs to avoid
accidental disconnection. Insulation around ceiling electrical power sources should
withstand frequent bending and flexing. They should not develop cracks and should not
damage wires. Wires inside rigid or retractable ceiling service column can help to some
extent Wall outlets to be installed 1.5 m above ground (as already mentioned). Use of
explosion proof plugs.
Multiple outlets from different electrical line sources should be available.
Electrical load calculation should be based on, equipment likely to be used and
appropriate current carrying capacity cords to be used.
Emergency power: OT electrical networks need to be connected to the emergency
generators with automatic two-way changeover facility.

About 10-12 inch of focus of light gives adequate illumination both at depth as well as
surface of body.

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 Literature Review
Efficiency in OTs depends upon of good system of planning and scheduling including
emergencies at a reasonable time.
The efficient use of operating theatres is important to ensure optimum cost–benefit for
the hospital and to clear waiting lists. A retrospective audit were performed using data
gathered from the operating theatre database of orthopedic trauma theatre in which they
found End utilization and operating theatre utilization were 78.8 and 81%, against a
standard of 77 and 85–90%, respectively.
Peter, A. (2013) described about the scenario of OT Complex in New South Wales. He
described Utilization indicators as Start time accuracy, case-time effectiveness, Room
utilization, Quality & Safety and last Scheduling.
In a simulation study in USA to define optimum utilization in OR, it was concluded that
achieving utilization of 85% to 90% is highest that can be achieved. Factors which affect
OT utilization are Overutilization/ underutilization, Case duration and variability of
case duration.
Findings:
GENERAL FACILITIES
Table-1
DESCRIPTION PRESENT ABSENT
OT supervisor room ✔
Staff lounge ✔
Operating rooms ✔
Pre-operative preparation areas ✔
Induction room ✔
Anesthetic room ✔
Recovery room ✔
Holding areas ✔
Post anesthetic care unit ✔
Anesthesia work room ✔
Scrub facilities ✔
Knee/elbow operated taps in the scrub room ✔
Electronically controlled activated taps ✔
Clean work room ✔
Clean supply room ✔
Consultation room ✔
Clerical work area ✔
Family waiting rooms outside the operation ✔
theater

STORAGE AREA
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 Table-2
Medical gas storage facilities ✔
Medication storage facilities ✔
Equipment storage room ✔
Portable x-ray equipment ✔
Stretchers ✔
Other equipments and materials ✔
Housekeeping equipments ✔

ENCLOSED SOILED WORK ROOM

Table 3
Clinical sink ✔
Work counter ✔
Waste receptacle ✔
Linen receptacle ✔

STAFF CLOTHING CHANGE AREA

Table 4
Doctors ✔
Nurses ✔
Technicians ✔
Orderlies ✔
Lockers ✔
Toilet ✔

WALLS AND CEILINGS

Table 5
Fire resistance and water resistance ✔
Stain proof ✔
Non reflective ✔
Easy to clean ✔
Non slippery
Ceiling painted with washable paint ✔
Coved corners ✔

POWER BACKUP
Table 6
Generator ✔
Invertor ✔
UPS ✔

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 THE OVERHEAD OPERATING LIGHTS
Table 7
Intense light, within a range of 50,000 to 1,25,000 ✔
lux
Light equipped with intensity control ✔
Shadowless ✔
Freely adjustable ✔
Having vertical and horizontal range of motion ✔
Produce minimum heat ✔

EQUIPMENT
SURGERY OT
a) Anesthesia machine 04
b) Monitor 05
c) Syringe pump 05
d) Infusion pump 04
e) Microscope 04
f) Cautery machine 04
g) Drill machine 04
h) OT table 05
i) Warmer 05
j) Suction machine 05
k) Medtronic drill machine 05

REGISTER
1. Admission Register
2. Discharge Register
3. Handover & takeover Register
4. Stock Register
5. Pharmacy register
6. MRD register
7. Census register
8. Medicine in/out Register
9. Blood transfusion Register
10. Diet Register
11. Trans in & out register
39 | P a g e
 12. Chemo register
13. Mortuary Register
14. Laundry Register
15. Narcotic Register
16. Vulnerable Register
17. Adverse drugs Register
18. High risk medication Register
DATA ANALYSIS AND INTERPRETATION OF OT
UTILIZATION
OT TABLE NO. JUNE JULY AUGUST

OT-1 85% 80% 70%

OT-2 75% 75% 79%
OT-3 72% 82% 81%
OT-4 72% 69% 76%
OT-5 75% 66% 66%
OT-6 68% 70% 75%
OT-8 85% 80% 70%
MEAN 76% 74% 73%

RESCHEDULE
JUNE 37.16%
JULY 29.36%
AUGUST 25%

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 OT UTILIZATION AND RESCHEDULE
80% 76%
74% 73%

70%

60%

50%

40% 37.16%

29.36%
30%
25%

20%

10%

0%
june july august

ot utilization reschedule

TOTAL OT DONE-1710
JUNE-450
JULY-800
AUGUST-460

TOTAL OT DONE

460
2 800
450

0 100 200 300 400 500 600 700 800 900

AUGUST JULY JUNE

41 | P a g e
Reason for most cancellation was
Anesthesiologist unavailable - on leave
PAC Unfit
Patient absent
High blood pressure
HBS Positive
High Fever/nose running
Finance problem
Lack of time due to long cases & delay of OT
unavailability of ICU beds

Late Start
• Late starts and unutilized time between cases is an area where
improvement is possible. This is especially true of starting on time.
Attention to this problem would increase the utilization of available
operating time.
• The OT should adopt flexible scheduling of OT session between
departments.
• The IT system should be used for OT scheduling.
• Surgeons. Anaesthetists and Nurses should work together to set OT lists,
with a view to maximize the utilization of theatre.
• Operating TimeThe elective OT sessions should be reallocated on the basis
on the waiting times and number of urgent cases.
• Up gradation of the minor O.T.'s with respect to infrastructure, staffing and
equipment.
• Number staff be in adequate number during evening shift.
• If too many cases booked. then by using case mix achieve maximum O.T.
utilization.

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Key Messages
• There is marked difference in utilization of operation theatres between the
perception of surgical consultants and reality
• The common reasons for cancellation were due to patient not admitted
• Improper utilization of time between two surgeries and late starting of OT's are
important areas needing attention of Hospital Administrator's to improve
utilization

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 RECOMMENDATION

1. The study shows the utilization level of the major operation theatre complex is much
below its capacity. Most of the OT time remains idle. This study throws light only on
the level of utilization. Basing on this study a future course of action can be taken to
find out what the reason are for its less utilization.

2 The management, doctors and OT personnel can jointly design a strategic plan for
the optimum utilization of the operation theatre. As the study shows it is not just the
better organization of OT activities but the concern of the management should be to
increase the number of cases in order to utilize the OT optimally. In order to increase
the number of surgeries, the following basic issues need to be addressed

• Enhancing the number of out-patients.

• The total number of patients recommended for surgery.

• Out of these, number of surgeries performed by the hospital doctors,

• The patient's preference of the hospital.

• The availability of specialized doctors in the hospital for surgeries

• The efficiency of the doctors to win over the confidence of the patients

• The infrastructure and other facilities provided in the hospital

3. While assuming at the optimum utilization, attention should be given also to the
coordination

44 | P a g e
 CONCLUSION

In any hospital, Operation Theatre is said to be the primary source of revenue

generation with around 50-60 percent of revenue earned just by this area. This is More
important for surgical specialties. The OT complex in a hospital also represents an area
of considerable expenditure in a hospital budget and requires Maximum utilization to
ensure optimum cost-benefit. Low utilization of operating Room has been a problem
in some hospitals and overworks a cause for concern in Others.

From three month of study, it has seen that all the facilities, staffs provided for OT are
adequate for effective functioning of both OTs.

It will be also seen that overall Modular OT is under-utilized but urology and Neuro
surgery OT is properly utilized as compare to pediatric and CTVS OT.

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BIBLIOGRAPHY
 https://www.amrihospital.com/about/
 https://pubmed.ncbi.nlm.nih.gov
 https://www.qualityhealth.in/hospitalsdetail/detail/AMRI_Hospitals_(Bhubaneswar
)/
 https://www.bing.com/images/search?view=detailV2&ccid=AaTB%2fEvH&id=13
90E72804A9F15DC720C29DB8836430590A7B0D&thid=OIP.AaTB_EvHfL1q7
SBABbX9EwHaEk&mediaurl=https%3a%2f%2fwww.drbiswajeet.com%2fwp-
content%2fuploads%2f2020%2f12%2fdr-
biswajeet1.png&exph=357&expw=579&q=OT+IN+AMRI+HOSPITAL&simid=6
08024029319101907&FORM=IRPRST&ck=252AD2C3B212311DA3E96F9B432
417FD&selectedIndex=0&ajaxhist=0&ajaxserp=0
 https://www.slideshare.net/sblueboy/ot-utilization-review-27519788
 https://docshare.tips/ot-utilization_58713662b6d87f97098b4843.html

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