Articles

Evaluating Software-Based Methods for Replacing Manual Collection of Midnight Totals: A Study from Sri Lanka

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The manual collection of midnight totals in hospitals has long been used to calculate key performance indicators such as bed occupancy rates. Despite technological advancements, many hospitals still rely on labour-intensive manual methods prone to inaccuracies at multiple stages. This study introduces and evaluates the Smart Hospital Metrics Calculator, a tool developed to automate the calculation of midnight totals and same-day discharges using patient admission and discharge dates from the electronic Indoor Morbidity and Mortality Return (eIMMR). Both manual and software-based methods exhibited inaccuracies, but errors in software-based calculations were primarily due to issues with entering dates, which can be mitigated by improving workflows and refining the eIMMR system. In contrast, improving manual methods requires addressing challenges across multiple levels. Data from three hospitals were analysed, and while the results do not yet demonstrate these outcomes, it is postulated that with enhanced date entry processes, software-based methods, such as the Smart Hospital Metrics Calculator, could achieve near-zero inaccuracies. These findings suggest that transitioning to this automated approach has the potential to streamline data collection, enable real-time monitoring, and improve hospital data management—without requiring additional workload or significant investment. If successfully implemented, this change could represent a seamless transformation, realizing benefits without disrupting current operations.

Overview of Strategic Supply Management of Oxygen for COVID- 19 Pandemic Patient Care in Sri Lanka

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The immensurable COVID-19 pandemic has a ceaseless destabilizing effects on health systems, economies, and societies around the world. Total number of 671,756 positive cases have been reported in the country and 654,910 of them have recovered from the disease with 16,808 number of deaths out of the population of 21.8 million up to December 2022. Immense burden to the health system and heavy death rate was reported during the 3rd wave for which mainly the delta variant of COVID virus was responsible. Total number of 491,508 patients and 14375 number of deaths as well as nearly 3500 Oxygen dependent patients were managed per day in ICU, HDU, and inward set up using Oxygen concentrator, bi-pap and c -pap machine during 3rd  wave. During this period, Ministry of Health had been urged to reassess its hospital surge capacity in relation to predicted COVID patient load. Based on that, the increasing COVID-19 surge has warranted the rapid hospital facilities expansion in every aspect especially in facilities for Oxygen therapy.

Ministry of Health, Sri Lanka had to develop strategies for Medical Oxygen management to fulfill its rising demand. All those interventions were focused to improve the accessibility and availability of medical oxygen while preventing irrational use and wastage of Oxygen. The ultimate goal of spending such cost was to prevent morbidity and mortality due to poor access of oxygen. To improve the efficiency and effectiveness of medical oxygen gas utilization, it was important to monitor the capacity improvement and supply process.

 

The Forgotten Factors Affecting the Expansion of Medical Laboratory Services to cope up the Rising Health Demands in Sri Lanka

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Introduction: The government of Sri Lanka identifies health laboratory service as an essential component in the health care service and is committed to providing quality essential laboratory services to healthcare seekers. Ministry of Health, Sri Lanka is responsible for the establishment and enactment of relevant legislation, and for providing technical and managerial guidelines for the maintenance of laboratories which comply with nationally and internationally accepted standards. Epidemiological and demographic transitions in Sri Lanka have compelled it to focus its attention to combat noncommunicable diseases, which are accounting for an estimated 80% of the annual deaths in the country. Improvement of diagnostics was identified as a priority in Health Master Plan 2016-2025 and by Primary Health Care System Strengthening Project.

Methodology and results: Qualitative methods such as key informant interviews, attending meetings and desk reviews were used to collect the factors affecting the expansion of laboratory services and the most crucial factors were identified by using the 80:20 rule. Issues related to the implementation of the National Laboratory Policy, laboratory financing, human resource issues, accreditation, and lack of making sense of data were found to be the most crucial factors that need to be addressed strategically to successfully expand laboratory services across healthcare institutions.

Conclusions: It is essential to improve the competencies and capabilities of the Policy Analysis and Development Unit of the Ministry of Health to facilitate policy analysis, reviews, and preparation of groundwork for National Policy enactment. Lack of accredited health laboratories and a plan to accredit may reflect adversely on the technical competence. Widespread unavailability and compartmentalization of information management systems have led to underutilization of laboratory-related data and this has resulted in a lack of a viable plan for evidence-based laboratory finance allocation and human resource development.