Overburdened tertiary care hospitals: DHSK cautions against unnecessary referrals

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As the two tertiary care hospitals in Kashmir – SKIMS, SMHS – are running out of beds to admit Covid-19 patients, the directorate of Health Services Kashmir has directed all the Chief Medical Officers and Medical Superintendents to ensure that no unnecessary referrals are made from districts to SKIMS Soura or GMC Srinagar.

SKIMS Soura has designated 278 beds for COVID patients, all beds are occupied, in SMHS hospital Srinagar 203 beds have been earmarked for COVID of which 171 are occupied, Chest Diseases Hospital has 94 beds, 85 are occupied.

“In view of these tertiary hospitals grappling for space to admit COVID patients, the authorities have discouraged the practice of referring patients, who can be treated at districts, to these hospitals. It will reduce the burden on tertiary care hospitals where only patients requiring specialized treatment can be referred if deemed necessary by the doctors,” said a senior health department official adding that the government has designated 1718 beds for COVID patients in different hospitals out of which 810 are occupied in Kashmir, which implies that the situation is not so bad but only thing is that our main hospitals are overburdened. The Directorate of Health Services Kashmir (DHSK) has cautioned Chief Medical Officers and Medical Superintendents to ensure that no unnecessary referrals are made from districts to SKIMS Soura or GMC Srinagar, citing that ‘the two tertiary care hospitals are already overburdened with the load of COVID patients.’

An order issued by DHSK states, “It is also imperative that in case any referral is needed for the interest of patient care, the Chief Medical Officer of the district should be informed in advance so that he/she can liaison with hospitals in Srinagar.”

It has been directed to Chief Medical Officers to ensure that no doctors and paramedics leave their respective stations and remain available for patients in this hour of crisis. “Non compliance shall be viewed seriously and action under rules initiated”, it states.

Besides Chief Medical Officers/Block Medical Officers/Medical Superintendents will ensure monitoring of health status on daily basis of all such Covid-19 positive patients, who have been put under home isolation, as per the past practice & standing SOPs/guidelines, the order says.

“The health status should be monitored by the field staff/surveillance teams through personal visits along with a dedicated Call Centre/Control Room to follow up the patients on a daily basis.”

The clinical status of each case shall be recorded by the field staff/call centre viz body temperature, pulse rate and oxygen saturation, it says. The field staff shall also guide patients on measuring these parameters and provide the instructions to the patients & their care givers in light of the guidelines laid down by the Ministry of Health & Family Welfare, Government of India, it further states.