Efficient Budgeting for Standardization of Space and Layout in Healthcare Facilities
Explore the essential process and guidelines for budgeting to standardize space and layout in healthcare facilities, focusing on areas like consumables, equipment, human resources, and practices. Learn about key components and methodology for effective budget planning, including major costs involved in standardizing space and layout. Prioritize future requirements while considering past performance to enhance care facilities.
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Process of Budgeting for Standardization of Existing LRs Calculate future requirement Any future increase in delivery load Addition of new technology Deletion of old technology Review Past Performance Delivery load Short supply of any items Non- availability of items or equipment Space or infrastructure requirement for care as per guidelines Prepare Budget Include Past performance and future requirement while finalizing Develop budget worksheet
Guidelines Focus on Five Important Areas Consumables Equipment and accessories Human resource Space and layout Practices and protocol Will discuss in detail on three areas: Space. Equipment and Consumables
Space and Layout: Major Focus areas Lighting & Ventilation Privacy Ambience Adequate labor & delivery facility Better space manageme nt Client facilities
Space and Layout: Components for Conventional Labor Room Complex Waiting/Registration area Triage/Examination room Staff room Labour and delivery area Newborn care area Doctor s duty room Nursing station Store Clean Utility Area Dirty Utility Area
Suggested Methodology for Budgeting for Standardization of Space and Layout Constitute assessment teams comprising of local facility in-charge, available DP reps, and an architect/ civil engineer contracted for this purpose Prepare detailed upgradation/renovation layouts for each facility Add costs for each item and prepare facility- wise cost estimates Prioritize LRs for Standardization
Major costs incurred while standardizing space and layout of LRs Cost of expansion of space (new construction/removal of walls to merge spaces/shifting to new space) Cost of upgradation of ambience: wall tiles, floors, paint, seepage removal, etc. Costs of fixing broken windows, doors, partitions, etc. Costs of upgrading services such as washrooms and utility areas Costs of adding missing structures such as handwashing station, nursing station, storage areas Costs of upgrading lighting and ventilation
Example of costs for civil work (approximate costs) Item Approximate cost Partition 40000 10000 per partition, size 8*6, Made up of aluminium and ACC sheet Shifting of wall to make LR more spacious and convenient for provider 20000 (wall size 10*12, 9 inch thick) Construction of new LR 1,00,000 (for a LR of 10*12) Waiting area with sitting facility 1,00,000 (for a area of 10*12) Building of new toilet in vicinity of LR 45000 (size 4*6, tile upto 6 feet, separate septic tank) Floor of the labor room is constructed of anti-skid vitrified tiles 18000 LR size 10*12, 150 rs per sq feet (150*120=18000) Walls of labor room have wall tiles of white color 40500 Upto 6 feet
Example of costs for civil work (approximate costs) Item Approximate cost Main doors has 2 frames, one large (3/5th of width) & another small (2/5th of the width) 10000 Size 7*4, made with aluminium and glass Windows having outside panel fixed & should have half ground glass & half mesh. The second panel should be moving with frosted glass & a lock Hand washing area A steel sink and Two elbow operated taps with 24*7 running water supply Curtain for privacy 20000 5000 per window 5000 With stainless steel sink 5000 For 6 LT, 3 windows and 1 door
Suggested Budgeting for Ensuring Availability of Essential Equipment and Instruments Step 1 : Calculate the desired number of equipment As per load and level of facility See section equipment & accessories, page 32 Use equipment calculator Step 2: Assess of the number of functional Instrument and equipment in the existing LR Step 3: Calculate the Gaps (2 - 1) Step 3 : Request for unit cost from the State Equipment Management Unit (SEMU)/ other similar body Step 4 : Multiply the gaps with the UNIT cost so as to calculate the total cost estimate
Example: List of equipment-calculated for labor room with approx. 400 deliveries per month Sl No Items Required as per norm Unit Cost Cost Estimated 6 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Number of labor tables Stepping Ladder for Pregnant Women McIntosh or disposible draw sheet Kelly's pad Stainless Steel IV rod Yellow biomedical waste bin Stool for birth companion Curtains in LR Ceiling mounted lights Shadow Less Light Fan Air Condition Refrigerator The facility has power back-up No. of Functional Radiant Warmer Ambu bag for babies(240 ml) with both pre & term mask (size 0,1) Functional oxygen cylinder (with wrench) with new born mask Doppler/fetoscope in labor room / admission area Mucus Extractor (De Lee's) Adult Weighing scale Baby weighing machine Thermometer (Adult) Thermometer (Baby) BP Apparatus Stethoscope Suction device 30000 500 180000 3000 10800 3500 7200 7800 3000 32400 600000 126000 12000 42000 20000 600000 100000 3000 10000 10000 18 7 6 6 6 18 2 6 6 1 1 1 2 2 2 2 14 1 1 2 2 2 2 1 200/meter 500 1200 1300 500 1800 300000 21000 2000 42000 20000 600000 50000 1500 5000 5000 30 420 1500 15000 200 3400 1100 1000 3500 1500 15000 100 1700 550 500 3500
Sl No Items Required as per norm Unit Cost Cost Estimated 2 2 2 2 6 8 1 8 27 28 29 30 31 32 33 34 35 36 37 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 Wall clock with seconds hand Examination table with step Examination tray Measuring tape Delivery trolley Delivery tray Emergency drug tray Sterile scissors Artery forceps Sponge holding forceps Sims Speculum Episiotomy scissor Allis forceps Toothed forceps Needle holder Needle (round body and cutting) Thumb forceps Anterior vaginal wall retractor Posterior Vaginal wall retractor MVA syringe and cannulas MTP cannulas PPIUCD Insertion Forceps Autoclave Protocol posters Wheelchair and/or stretcher Table & chair for Service provider Communication Washbasin Total Estimated cost 500 4000 1200 100 8000 2000 50000 500 500 800 1000 1000 700 800 3000 1000 8000 2400 200 48000 16000 50000 4000 8000 12800 8000 8000 5600 6400 24000 400 4000 2000 2000 6000 200 4000 30000 16000 6000 10000 24000 10000 16 16 8 8 8 8 8 8 8 2 2 2 2 2 1 16 1 1 1 2 50 500 1000 1000 3000 100 2000 30000 1000 6000 10000 24000 5000 2115020
Budgeting for Consumables Usually non Budgetary Items Forecast demand for the year and for various months based upon historical trends Use LR supply calculator Ensure planning of quantities based upon the perishable nature of the supplies Budget for supplies based upon the forecasts Facility to have contingency funds for ensuring 24 X 7 - in case of inadequate supply
Example: List of essential Supplies-calculated for labor room with approx. 400 deliveries per month Required as per norm Cost Sl No Items Unit Cost Estimated 158400 103320 59400 79200 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Gloves Cotton rolls Gauze (10 Meter) Sanitary napkins Sterile pads Apron Thread Towels for receiving new borns Chromic Catgut "0" IV Fluids IV drip sets Foleys Catheters Cord clamp Disposable Syringes (2 and 5 ml) Disposable Syringes 10ml Delivery kit for HIV positive women Povidone Iodine (500 ml) Magnesium Sulphate Antibiotics for mother Antibiotics for baby 1320 42 33 660 13 334 33 660 165 330 330 33 330 330 33 10 205 150 10 0 50 10 140 200400 3960 1108800 0 20 50 125 10 10 79200 198000 49500 39600 39600 2772 7 4 0 33 476 40 80 65 6 200 500 25740 34272 96000 480000
Required as per norm Cost Sl No Items Unit Cost Estimated 21 Oxytocin (5/10 IU per ml) 1320 10 158400 22 Vitamin K (1mg/ml or 1 mg/0.5 ml) 330 0 23 24 25 26 Antiretrovirals Tab Misoprostol Nevirapine Syp and Tab. Inj Dexamethasone 1 0 495 6 35640 1 7 0 5 420 27 Uristix for Protienuria and Glucose 420 127 640080 28 29 30 31 32 Glucometer Family Planning options Soap and Running water Washbasin Utility Gloves 2 2000 48000 0 0 0 2000 50 120 72000 33 Bleaching Powder/Sodium Hypochlorite solution 350 50 210000 34 Plastic tubs for 0.5% Chlorine solution 6 500 3000 35 36 37 38 39 40 41 Coloured bins Hub cutter Puncture proof container MCP Card Safe Motherhood Booklet Partograph IUCD client card Total Estimated cost 9 1 3 500 150 500 10 20 4500 150 1500 39600 79200 3960 19800 4074414 330 330 330 330 1 5
