B.P. Koirala Helth science Institute Dharan

This institute is in Dharan Nepal with the 400 bed teaching hospital this institute is a biggest Health teaching institution in east Nepal.

Reference

www.BPKIHS.edu

Introduction

B.P. Koirala Institute of Health Sciences (BPKIHS), established in 1993, upgraded to a University in 1998, is an autonomous Health Sciences University with a mandate to work towards developing socially responsible and competent health work force. Striving continuously to meet the health needs of the eastern region of Nepal at the primary, secondary and tertiary levels is its primary responsibility.

BPKIHS has been visualized as a self-governing, self-reliant International Health Sciences University attracting students and teachers from all over the world to its constantly innovative educational programmes. BPKIHS is the single largest project implemented through Indo-Nepal co-operation. The University is aptly named after the late Bisheshwar Prasad Koirala, a great nationalist and former Prime Minister of Nepal, who was Nepal’s foremost visionary in social upliftment and firm believer of national reconciliation and national integration.

BPKIHS took over the management of 150-bedded former Eastern Regional Hospital in 1993, With the new hospital complex, the University raised the strength of beds to 700 with added facilities like CCU, ICU, VVIP Critical Care area and Observational beds. Now CT-scan, emergency laboratory, C-arm and mobile x-ray facilities, sterilization section, state-of-the-art Operation Theater with recovery rooms facilities are available in the Hospital.

The medical education at BPKIHS started on October 19, 1994 with the intake of the first batch of MBBS students. Gradully it started B.Sc. Nursing in 1996, BDS, MD/MS, M.Sc. and the CN Programme in 1999, OT and AS in 2000, BMIT in 2001 and B.Sc. MLT in 2005. At present altogether 908 students are studying various programmes. The number of students programme wise is: MD/MS 155, M.Sc. 18, MBBS 264, BDS 160, B.Sc. Nursing 54, B. Sc. MIT 18, Certificate Nursing 120, OT & AS 17, B.Sc MLT 10, MBBS Interns 57 and BDS Interns 35. The Institute is preparing for admission in to MPH programme starting from September 2005. In order to provide students a community oriented medical education and to create a socially accountable health work force in the nation, this Institute has launched the concept of a ‘Teaching District’. Presently Sunsari, Morang Dhankuta, Saptari, Jhapa and Ilam districts are included, but gradually all the districts of the entire eastern region of Nepal (16 districts) will be included in teaching districts.

The MBBS Programme is recognized by the Medical Councils of India and Sri Lanka, in addition to the recognition by the Nepal Medical Council. The world Health Organization has listed this Instiute in the World Directory of Medical Schools, Similarly, the Nepal Nursing council has recognized the B.Sc. Nursing Program. The Institute is processing for obtaining recognition of MD/MS and BDS programmes from the Medical Council of India and Dental Council of India respectively.

BPKIHS gives high priority in research to areas requiring greater attention and the existing and emerging health problems threatening the well being of large population groups using community-oriented, multidisciplinary, integrated and problem solving approach. BPKIHS has its own research committee comprising of researchers from Nepal and abroad. This committee is responsible for approving, monitoring and promoting research activities in the Institute. In this short span of it’s existence more than 100 important research projects including the base line surveys such as ‘Sunsari Health Interview Survey’ and ‘Sunsari Health Examination Survey’ have been completed. Greater emphasis is placed on research, which will lead to application of available knowledge for the benefit of large number of people.

Today, BPKIHS has the highest number of national and expatriate doctors and nurses outside Kathmandu, and BPKIHS is the only Institute in the whole of the Kingdom to be so privileged. The achievements of the last eleven years can be considered as milestones on a road which should lead Dharan to emerging as the ‘Health Capital’ of the country. This road has to be paved with more action, more devotion and absolute commitment to realize this dream. BPKIHS, a fast developing center of excellence, should be prepared to face challenges in its march forward

Hospital Services # Social Health Service

B.P. Koirala Institute of Health Sciences was established by an act of parliament in the year 1993 as an autonomous institute. As per its stated mission, it is recognized as socially accountable medical school and also as centre for research & innovation in service as well as education.

There is a gap in the cost of service & affordability by people. This Program is based on

* Social Solidarity.
* Contribution on ability to pay.
* Non profit concept.
* Compulsory for house holds

It also takes care of international labour standard i.e. Social security (minimum standard) convention 1952 (No. 102) and medical care and sickness benefits convention 1969 (No. 130

Conceptual Background:-People should not remain devoid of health care because of lack of money. BPKIHS is committed to provide research and trial based advised to HMGN for the improvement of Health Sectors. Approximately 35% of patients attending the hospital can not afford the tertiary level treatment needed. It was discovered through focused group discussion in village, that on an average they are spending NRs 1000 /head/year for their health needs. It was also found out through community research that people are spending higher percentage of their income on tobacco and alcohol. Receipt of recommendation letters for free treatment from political parties, NGO, INGO, etc. Keeping all the above mentioned factors in mind, We offered various alternatives/options to the villagers. VDC can deposit certain amount from their health budget to the institute and then recommend patients for free treatment who cannot-afford for their health care. To raise money from NGO/INGO/ local donors and use it on their recommendation. Social Health insurance Scheme.

Philosophy: To have the right to get treatment from the Institute during illness by investing when in good health.Taking into consideration the above policy BPKIHS has developed a group health insurance plan tailor made for community.

Objective: To make the community people aware of health insurance philosophy, take it to the masses and to implement it. To insure health risk by providing costly health care.

Procedure/Publicity:

* To build up Public awareness through brochure.
* Conducting Awareness programme by meeting people of various levels in the community.
* Awareness programme through meeting with Vice-Chancellor, Hospital Director etc. to convince people and make them believe.
* Programme is organized through VDC or NGO, INGO president.
* After convincing VDC/NGO/INGO approaches us.
* Guidelines are given through a nucleus Insurance Section. All the procedure there after is having two parts.

RESPONSIBILITY OF VDC/NGO/INGO

* Identify the interested group and give the family number.
* Identify the marginalized community give the family number.
* Get the photographs of the people (we have given camera also)
Make a list of above with required parameters.
* Get the premium from user and approach Institute.

Premium- Villagers:

* Adult : NRs.25.00/ head / month
* Children : NRs.12.50/ head /month
* Marginalized community as well as handicapped unemployed, older people who have been abandoned by their family.
* 33.33% Institute
* 33.33% VDC
* 33.33% person himself

City People

* Adult : NRs.100/ head / month
* Children : NRs.50/ head /month

Note: Premium should be deposited in advance for the whole year through VDC or NGO/INGO etc. who are involved (Waiting time One month). One individual Independent person can't have access to this scheme. He has to come through VDC or NGO/INGO etc. Total members of the identified household have to be insured compulsory.

Benefits of above scheme Per Head/year (Revised from 2061)

BPKIHS OPD service

* Consultation - Unlimited
* Investigation- Unlimited

In-patient service at BPKIHS

* consultation - Unlimited
* Investigation- Unlimited
* General bed- Unlimited
* Medicine up to Rs. 3000/-
* Surgery up to Rs. 7,000/-

Exception: Only 25% discount provided for CT scan, MRI, TMT, Echo, Haemodialysis etc.

Types of disease covered

* All acute cases.
* TB and Leprosy through National Control Program.
* Normal delivery/ cesarean and assisted (Maternity case).
* All types of surgery available in the Institute.
* Exception: Prosthesis, Implants, etc. that are not available in Hospital are not covered.
* Eye/ ENT
* Cataract without IOLAll other operation available
* Dental: - OPD Card/ X-Ray, zinc oxide filling only.

This medical campus is unique in Nepal because it does not only provide a excellent education but also many different sporting utilities such as a Golf Course, Squash Courts, Tennis Courts, Swimming Pool, Criket Pitch, and three basketball courts. Other than being the biggest medical school in all of east Nepal is also brings along with it a core course curriculim that has been brought over from India. This school also has very good relations with Australia which keeps at least two international doctors there so that they can teach the Nepali doctors international standards of medical research.

Department of Anaesthesiology & Critical Care

Patients Care Activities

• We are providing PAC services daily.
• We are providing daily outdoor based pain clinic for Patients.
• We are providing OT facilities for patients requiring nerve blocks.
• We have significantly improved the efficiency of our emergency operation theatre services.
• We have started painless labour services in cooperation with Dept. of Gynae & Obst.
• Post operative analgesia & acute pain services are being provided at the ward level.
• Anaesthesia services in Radiology department is being provided on biweekly basis
• MECT (Modified Electro Convulsive Therapy) for the psychiatric patients
• Two- bed indoor services for pain and palliative care has been started on a regular basis.
• ICU beds has been increased from 6 to 8

Community services (health camps and health education)

• We have provided anaesthesia services in health camps sponsored by His Majestys Government of Nepal held at Terhathum, Taplejung, Okhaldhunga and Khotang.
• Anaesthesia services at Bhadrapur zonal hospital are being provided on regular basis.
• We plan to provide pain and palliative care services to the patients at their doorstep (including at the district level ).
• We plan to organize General Awareness about the advantages of painless labour – its beneficial effects on the mother and the unborn child through the organizing of lectures and video presentations at the community level. Patients Care Activities
• We are providing PAC services daily.
• We are providing daily outdoor based pain clinic for Patients.
• We are providing OT facilities for patients requiring nerve blocks.
• We have significantly improved the efficiency of our emergency operation theatre services.
• We have started painless labour services in cooperation with Dept. of Gynae & Obst.
• Post operative analgesia & acute pain services are being provided at the ward level.
• Anaesthesia services in Radiology department is being provided on biweekly basis
• MECT (Modified Electro Convulsive Therapy) for the psychiatric patients
• Two- bed indoor services for pain and palliative care has been started on a regular basis.
• ICU beds has been increased from 6 to 8

Community services (health camps and health education)

• We have provided anaesthesia services in health camps sponsored by His Majestys Government of Nepal held at Terhathum, Taplejung, Okhaldhunga and Khotang.
• Anaesthesia services at Bhadrapur zonal hospital are being provided on regular basis.
• We plan to provide pain and palliative care services to the patients at their doorstep (including at the district level ).
• We plan to organize General Awareness about the advantages of painless labour – its beneficial effects on the mother and the unborn child through the organizing of lectures and video presentations at the community level.

New proposals.

• Starting of Advanced Life Support (ACLS) Training for medical and paramedical personnel who have already undergone BLS training.
• Starting Certificate / B. Sc. Nursing Course for Critical Care Nursing.
• OT and Allied Services certificate course to be upgraded to B. Sc. and Allied Services.

Teaching

• We plan to procure and develop teaching models for learning regional block techniques and the technique of fibreoptic laryngoscopy.
• To develop teaching video films and CDs on Percutaneous techniques of Tracheostomy, Central venous line insertion, Nerve blocks, Physiotherapy procedures in the ICU, etc.
• To improve upon the current data entry of the Anaesthesia and critical care patients in the department Database programme.
• Classes for the ICU Nursing Staff for better understanding of management of the critically ill patients.
• To conduct regular CME/ Workshop quarterly

Patient care services

• We will continue to improve the Emergency Operation Theatre services so that there is no delay in providing emergency anaesthesia to patients coming to BPKIHS. Currently, all cases admitted for surgical procedures from Emergency OPD are operated within 24-48 hours.
• We plan to strengthen the "Post operative analgesia services" being provided by us in the wards