January 5th - Projects Begin

Today was the day! With our private investigator magnifying glasses ready, my group was prepared to pick apart Aravind’s Pediatric Department’s anesthesiology protocol and offer recommendations for improvement – our “internal consulting” projects had begun. With a group consisting of a biomedical engineer, an accounting major, a Masters of Health Administration student, and a duel Masters of Health Administration and Masters of Public Health student, the group progressed through the norming and storming development phases astonishingly fast.

Dr. Vayi Laxmi, an opthamologist by training and the department chair of the Pediatric outpatient unit, met us with joy, excitement, and an extensive amount of project deliverables. She was an energetic and ambitious women. Having been at Aravind from its conception over 40 years ago, the fire to excel and provide care was still present. Due to recent occurrences and a newly redefined anesthesia protocol, Dr. Laxmi wanted to ensure not only a fluid process for patients, but a process that would confirm all investigations (procedures) were completed before the patient met with the General Anesthesiologist.

In examining their current process, it proved to be difficult to find initial recommendations. We understood the reason Aravind received the Gate’s Award for Global Health and India’s Most Innovative Hospital Award – they were more advanced in many aspects of infection control, telemedicine, and process flow than first assumptions would have one believe.

Conversations with the surgical counselor, a women similar to our care coordinators, but singularly responsible for coordinating over 3000-5000 patient surgeries per year and a surgical nurse, we were able to understand the process from a patient’s point of view. All patients entered the hospital as walk-in patients and saw an ophthalmologist who determined what the patient needed; returning patients could proceed directly to the unit they were to be seen at. Then, depending upon their diagnosis, they met with the surgical counselor to begin the investigations checklist after a consult from the fitness physician (similar to our primary care providers). With the day ending, the project proved to be more challenging than we originally thought. While my group has developed an initial outline of ideas and recommendations, we will need to consult with more front line with and talk with the General Anesthesiologist to understand the core issue of the project.

As an MHA | MPH student, today solidified my reasoning for coming to India and embarking in a foreign consulting project. I will be relying heavily upon what I have learned in my master’s program to not only enhance Aravind’s anesthesia process at a micro level, but begin to compile a best practice list for myself. It is clear this project will not only push me to draw upon my experiences as a student, my experiences working in the Burn Unit at the University of Iowa Hospitals and Clinics, and my abilities to utilize my team member’s experiences and strengths, but will push me to grow and excel as a person

Aravind cares about and adheres to their mission. Their charity care doesn’t represent numbers of dollars allocated, but the % of their population served in the free clinic. Their commitment proves that – universally – assumptions can make you look foolish. While Aravind and the country still have improvements to be made in terms of processes and public health respectively, my initial thoughts certainly made me look foolish. I have so much more to learn.
      
-Aaron