SKIMS has come of age

It is a proud occasion for us to celebrate the 37^th Annual Day of SKIMS-the Sher-I-Kashmir Institute of Medical Sciences. SKIMS has successfully delivered decades of uninterrupted service to the society and SKIMS fraternity needs congratulations for a job well-done. SKIMS Objective was and continues to be that there shall be no need for next patient in need of tertiary-care to go out as SKIMS shall deliver the most sophisticated and modern management (equal or better than available anywhere in the World) to all such patients with complex diseases. Focus has to be on Quality, while maintaining Quantity through state-of-art tertiary care, cutting edge research on diseases prevalent in the region to save lives and generate high quality manpower. Conceptually, SKIMS was built as a as a free-for-service facility and not a pay-for-service facility. I believe SKIMS has fulfilled its objectives, has maintained focus on quality in patientcare, research and teaching and delivered high quality services at a nominal cost to the poor and needy. All this is indeed a remarkable feat accomplished. This could only be achieved by highly committed manpower who have over the years spend their precious moments within the four walls of this sacred place of service.

SKIMS isa national asset and an Institution of great public importance.  Life of everyperson in our society is connected with the optimum delivery of thisinstitution. Medical community of the nation and the whole world is watchingSKIMS for the message it gives about the developments in medical field. Ibelieve we have a huge potential to perform, in view of the large pool ofintelligent manpower available and unexplored diseases in this inbred society.To implement SKIMS concept, hundreds of top medical brains of the country andthe West debated for years and every aspect of the Institute, structure andfunctioning, was drafted. These policies and practices formed the nerve of thisinstitution and SKIMS came with a big bang at National and International arenain its very infancy.

Over the years SKIMS has had many threats to its existence whichincluded:

1. Social transformation inherent in the “Area of Conflict”
2.  Exodusof the medical personal
3.  Inability to attract Men-of-Imminence from outside,
4. Excessive pressure on the existingskeletal staff
5.  Higher incidence of diseases, especiallyrelated to Cancer, Diabetes mellitus, Coronary artery diseases, Liver diseases,Strokes etc.,
6. Changing epidemiology of diseases withtrauma and mental health disorders as front runners.  

However, SKIMS has adapted to all thesechanges and has taken positions on many vital issues. Also, policies andpractices framed and so vital to State-of-Art care have been modifiedaccordingly & optimally. With continuous rapid advances in medicalpractice, SKIMS has kept pace with newer developments by continuouslyintroducing new technology and have employed new faculty of imminence trainedto deliver the best. All this should make SKIMSfraternity feel proud of their achievements under such difficult conditions.

As SKIMS is committed to maintain its heights in areasof patientcare, research and teaching, many doctrines inherent to deliver thebest need to be under focus and constant watch. These include:

1. Always to keep objective of SKIMS in focus &implement/alter policies & practices to achieve it. We need to create andmaintain optimum working environment for public satisfaction, optimumpatientcare and safe practices.
2. To maintain faculty of imminence by continuouslytraining existing faculty in new technologies and employing new faculty who aretrained to deliver the best.
3. Develop/promote excellent hospital services which willhave major impact on public service, patient satisfaction and SKIMS perception.It is worthwhile to have academic review of each service periodically &enforce/change guidelines to maintain quality of services.
4. Maintain high quality of care in consonance with theprimary SKIMS goal. The debate between Quantity vs. Quality is a valid questioneven as of today and what all needs to be done is to maintain Quality carewhile treating numbers.
5. Continue to conduct cutting edge research, whichshould focus on diseases affecting the common man and should be of highstandards and be able to save lives, reduce human suffering and alleviate humananguish and pain.
6. Implement/maintain Primary-Physician Policy by givinglogistic support to faculty on-call team within SKIMS. It will have majorimpact on patientcare, help patient satisfaction & confidence, improvequality of care, enforce safe practices and help resident training.
7. Expand Time-Schedule [8AM to 6PM] by 2-shift systemfor staff in selected areas of service like Theatre, Imaging, laboratory,clinics, etc. This shall enhance productivity, reduce waiting time, improveavailability of services. This has been practiced in the past with excellentresults.   
8. Curb inter-personal faculty conflicts by counselling,interaction and words of wisdom from the seniors.
9. Implement ban on private practice in letter &spirit. This shall have major impact in working atmosphere of SKIMS.  While doing so, maintain dignity and respectof the faculty. Ban can be enforced through step-wise  procedure like counseling/warning and may belimiting facilities, promotions, other benefits, etc.  Suspensions and other harsh measures only tobe implemented under rare of the rare circumstances. Defining privatepractice acriminal act is unfortunate and this order needs to be withdrawn.
10. Continue to maintain Policy Procedure Practice Regulations (IPPR’s)about patientcare; Enforce M & M (Morbidity & Morbidity) to protectpatient’s safety; Implement Material Management Policy as it existed in thepast and maintain administrative hierarchy for personal and policy matters ofSKIMS, which shall improve staff satisfaction and helpmaintain confidentialityof records.

It is a matter of great satisfactionthat, of late, there are concerted efforts to redefine the concepts of thisgreat Institution. SKIMS is being redefined from an administrative departmentto an Institution with high values in Academics, Research, teaching, highquality patientcare and society-friendly measures to help the needy, theoppressed and the poor. SKIMS fraternity and in particular SKIMS faculty is agreat national asset. We should do all that is needed to maintain the SKIMSfraternity in house and satisfied, support them to do the best and make SKIMSenvironment to attract faculty/staff of high calibre. A note should be taken ofthe political and administrative vendetta which SKIMS fraternity/faculty may besubjected to for reasons outside the domain of administrative norms. By theseimportant concepts, SKIMS should be sought for the positionas anAutonomousbaby, which shall be able to take decisions of its own without muchinterferencefrom political and administrative breaks and develop its own checksand balances. SKIMS fraternity will have/need little time to spendapproachingthose in power for getting little benefits and advantages. I am sureall this shall enhance the glory of SKIMS and pave way for counting this pearlin to a national and international monument. I pray that all of us take a newoath to re-explore for a new glorious beginning of SKIMS. God bless…

Prof. Mohammad Sultan Khuroo isformer Director, Professor and Head Gastroenterology, Chairman Dept. Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, India. ( khuroo@yahoo.com )