1. Operative Methods:
Operative methods are essentially connected with almost every aspect of the hospital’s operations, including those that are carried out by such workmen as telephone operators, inquiry office personnel and admission office clerks to mention a few. All those coming in contact with patients, as well as those operating behind the screen share the same burden.
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The three fundamental ingredients of a hospital’s operations are: (i) cheerful and courteous behaviour, (ii) prompt and efficient treatment, and (iii) clean surroundings and well-kept appearance of workers. Some of the important aspects are enumerated below.
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i. A high quality of patient care is the sine quo none of good public relations. No amount of smiles and propaganda can compensate for poor professional care.
ii. Adequate physical facilities with a good functional layout. Adequate waiting areas, toilets, drinking water and refreshment facility in the outpatient department and such facilities which take care of the basic creature comforts of the patients and others.
iii. To make others happy, one must be happy himself. Good morale of workers not only increases efficiency, but workers with high morale interact in a positive manner with one another and also with patients and the community.
Frustrated doctors, nurses, technicians and paramedical personnel will bring the working of the hospital into disrepute. The least expensive way to improve public relations is to render the service with a smile and cheerful greeting.
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iv. By placing more emphasis on technology in dealing with the diagnosis and treatment, there must always be a continuous effort not be create other anxieties and concerns, as Florence Nightingale exhorted that the first concern of the hospital is to do patient no harm.
v. Operating efficiency with effective coordination among all clinical departments and other supportive services stems from good administration.
Organizational structure, policies and procedures, authority and accountability should be clearly understood by each worker.
vi. Sensitive areas: Many misunderstandings by patients and public originate in the OPD. Efforts should be made to reduce high waiting time of the patients in OPD. Lindell2 has felt that the nature of the admission process plays a major part in determining the humanity of the hospital.
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The procedure may be an administrative triumph, but if it reduces our patient to a barely insignificant case or number who is an imposition on the high technology medical shrine, the process is a failure.
Delay in receiving specimens at the laboratory counter and delay at the dispensary should be curtailed.
Casualty department must be organised to deal with any type of casualty, at the same time causing least confusion when a number of relations accompany the patient.
Importance of food served hot from the dietary department and of clean and well-pressed linen from the hospital laundry cannot be overemphasized. Other activities: The Hospital premises should be kept clean at all times and not only during the morning working hours.
Hospital visitors should be dealt with courteously their visit to a hospital inpatient is of great emotional value to the patient.
A member of nursing or medical staff should be available in the ward during visiting hours to answer their queries. Availability of medico social workers in a hospital in very beneficial in respect of patients having social problems more than medical problems
Voluntary services by people from the community help to provide emotional support to patients. Such services can run libraries for patients, write letters on behalf of disabled patients and help the nursing staff in carrying out unskilled nursing chores.
Perhaps the greatest benefit is that they soon develop an insight into the limitations of the hospital and, by discussing the same with other members of the community, cause a mutual under-standing and goodwill between the hospital and the community.
2. Communicative Methods:
These methods employ means of communication in all possible forms to enable the hospital to convey its message to the public. Some of these are also intermixed with the intramural functions of the hospital and operative methods. The others deal with the media. Communicative methods may be used in the following ways.
i. Making available appropriate information to the patients, their relatives and visitors at Enquiry and Registration, and also on patients’ discharge regarding his or her health status and follow-up. A discharge interview with the attending physician can serve this purpose well.
ii. An open-house approach to the visitors without interfering in the routine medical care functions. Large number of visitors to patients cannot be avoided in our peculiar socio-cultural ethos.
iii. The queries of the relatives and visitors can be satisfied if a doctor or senior nurse conversant with the ward is made available in the ward during the visiting hours for this purpose.
iv. Administrative rounds by hospital administrators at different levels. However, they should be as informal as possible.
v. A provision to listen to verbal complaints instead of insisting or written ones.
vi. Written communication: prompt replies to questions.
vii. Provision of a Suggestion Box at an appropriate place.
viii. Visual communication film shows, exhibitions, hospital brochure.
ix. Hospital tours by groups such as school teachers and students, housewives and members of women’s organisations, peoples’ representatives, and religious leaders.
x. Holding of an annual “Hospital Day” or open-house day where public can be shown every aspect of the hospital’s operations including some of the highly technical functions.
xi. Advisory committee its role should be to suggest to hospital administration the methods to overcome their shortcomings, and interpreted the functioning of the hospital to the community.
xii. Talks and interviews on radio and television.
In his discussion on the humanisation of the hospital, Lindell has advocated that firstly the misconceptions held by community towards the hospital should be dispelled by breaking down the “trauma”, “crisis” and “high technology” associations and by developing the ‘health maintenance’ and ‘community support images’. Secondly, the physical setting should be modified to respect the “human” in the patient by helping him or her to feel significant.
The hospital will be humanized if the “human” in the patient is understood and respected. On entering hospitals, people do not cease to be individuals with no personalities and needs and do not cease to interact of their own or become merely bodies.