Jagjivan Ram hospital a hope and happiness for Covid patients

Crossed milestone of 1500 discharges since declared as a COVID hospital

Since breakdown of COVID 19 pandemic, Western Railway’s Jagjivan Ram Hospital had become the combat zone after  turned into a full-fledged COVID hospital on 4th April 2020.  In a unique decision Ministry of Railways had declared it a 100% COVID Hospital, being the first over Indian Railways.

On 24th July, 2020, Jagjivan Ram Hospital achieved a milestone of discharging 1,500 patients. It was a moment of pride for JRH and Western Railway as on 25th July, 2020 the hospital discharged its 1000th fully recovered COVID patient and more. JRH also registered a recovery rate of 78% which is highest among all railway hospitals across the country. GM Alok Kansal has appreciated this unique achievement & has congratulated Dr Hafizunnisa- Medical Director of Jagjivan Ram Hospital & her entire team for this commendable performance.

According to a press release issued by WR CPRO Sumit Thakur, swinging into swift action, the management at JRH transformed the hospital under strict lockdown conditions of Mumbai and with severe resource constraints. From being a renowned super specialty hospital specializing in Cardiology, Joint replacement, Gastroenterology along with other major specialties and handling over 360 patients in the wards and another 700 daily at the OPD, into a robust COVID Handling facility. 180 beds were made available for COVID treatment in the very first week itself, the largest number that was in Mumbai area in a single hospital at that time.

Thakur added that in the 111 days of being the COVID Hospital, a total of 1,638 patients have been admitted in JRH. Out of these, 1,253 were admitted as COVID positive patients while the remaining were COVID Suspect Cases. Till now, Jagjivan Ram Hospital has discharged 1,500 patients. Only 9 cases were referred to other hospitals and the rest of 1,629 cases were treated in JRH, out of which 54% of the total patients admitted were above 50 years of age. The total number of deaths has been 118. On an average, the stay of a COVID +ve patient at JRH has been recorded as 9.4 days. Currently, total 141 patients are undergoing treatment, out of which 130 patients are COVID positive and 11 are suspected cases whose test results are yet to come.

Jagjivan Ram Hospital has always approached the method of holistic care for their patients. It is worth mentioning that the essential systems for COVID management were put in place in a matter of few weeks at the initial stage and later developed and augmented its COVID handling capabilities by inducting additional medical and paramedical staff, doubling its oxygen handling systems, modifying ICUs with Negative Pressure Air Conditioning systems and many such advancements to fight the war with Coronavirus effectively. The entire hospital space has been systemically designated into COVID and Non-COVID areas for effective management of incoming patients and of JRH staff. The patient flow, right from the Entry point into the Triage Area are manned by Resident Doctors, Health Attendants, Radiographers & ECG technicians till the treatment in COVID wards, was made seamless and systems put in place.

As per guidelines issued by MoHFW, all Health Care Workers (HCWs) be it Doctors, Paramedics, lab technicians to assistant staff, were trained, equipped, and deployed to treat this deadly virus. Dedicated Committees viz, IEC Committee, HICC & BMW Committee, Sanitation Committee, Food & Accommodation Committee, Treatment Protocol Committee, Procurement committee and others were setup with Nodal Officers to cover and treat all aspects of this so far, intractable virus disease.

All the staff was trained in PPE-Donning & Doffing in groups along with selected few for Ventilator use. All HCWs were advised to take HCQ/Arsenium Albicum as a preventive measure. As per guidelines issued by MCGM and followed at other COVID centers HCWs were deployed in 07 days working and 07 days Rest roaster. Institutional Quarantine of 14 days is strictly followed to contain any chance of spread amongst the HCW and their families. Railway accommodations available near Mumbai Central area was mobilized for HCWs. With the help of internal resources along with IRCTC, NGOs and few  good Samaritans food/snacks/water are being also provided on continuous basis.

In the face of all these seemingly insurmountable hardships, the team of JRH, initiated the multipronged activity of planning preparing, training, procuring materials and medicines to execute the health care delivery for all COVID patients.

● COVID patients brought by Ambulances are screened at Entry by RPF and thereafter HCWs, record all basic details in a database.
● Preliminary tests (ECG & X- ray – Chest) are done and masks & sanitization are provided before moving into the COVID wards.
● COVID wards are adequately sanitized, ventilated, cooled and specifically equipped with COVID medical kits, Oxygen supply etc.
● MICU, SICU, DIALYSIS and Operating Theatre with Negative pressure AC Ventilators are made functional for treating COVID patients infected with other serious diseases.
● Additional infrastructure was developed like capacity enhancement of existing 1000 Liter Liquid Oxygen Tank to 2000 Liter, 500 number of B-type cylinder in place of 60, 100 number of D-type cylinder from existing 20 number, 126 Oxygen outlets in wards from existing points of 26 only, in order to ensure patients in need are treated adequately.
● Special focus was given on sanitization of entire hospital space, housekeeping staff was trained and sensitized about Hypochlorite Spray and 3 Bucket system of Floor and Surface cleaning.
● Special Nursing stations with mobile connectivity were setup at each COVID floor with round- the-clock deployment of HCWs. These Nursing stations ensured all the details pertaining to admission, discharges, medicines prescription, lab reports like X-rays,  ECG are maintained and consultation/opinion with Doctor and its coordination with patients are done in seamless manner.
● Each COVID ward is equipped with adequate number of Oxygen inlets, Hot & Cold Water Dispenser.

Proper medical care in the form of Antiviral drugs, Hydroxy Chloroquine, High Antibiotics, Anticoagulant injection along with Vitamin support is being given for all patients. Patients having lung infection are being given round the clock Oxygen therapy. Invasive and noninvasive ventilator support is being given as required.

● Injection Tocilizumab costing about Rs 30,000 per vial has been given to indicated patient. Till now 50 patients have received this injection, seeing good response the therapy is planned 150 doses more are being procured.
● Anti-virals like Injection Remedesivir have been initiated. Currently, 80 vials have been procured and therapy has been started for 20 patients. Seeing its good response, 500 more doses are being procured.
● JRH has also been approved for PLASMA therapy by ICMR. JRH has in-house facility for plasmapheresis. Donation drive has been started to collect plasma from 17 COVID recovered patients. So far, Plasma therapy has been administered for 16 patients.
● JRH has also gained the approval for Rapid Antigen testing from ICMR. The kits are under procurement and the testing facility is expected to start from 27thJuly 2020.

As a special initiative, JRH has engaged two Clinical Psychologists, to counsel staff as well as patients to overcome any emotional disturbance during this pandemic. These Counsellors visit all wards, interact with the patients and work upon their thought process towards positive mindset. Arrangements for video communication between patients and their family members to strengthen their faith and resilience has also been ensured. These methods help in allaying anxiety and help the patient along with their family members to cope with the illness. Special sessions were also taken for staff and workers to tackle their feelings of fear and anxiety.

The entire JRH team, under able guidance of Shri Alok Kansal – General Manager of Western Railway and Dr. Ghanshyam Sahoo – Principal Chief Medical Director of Western Railway took the challenge with great zeal. Shri GVL Satya Kumar- Divisional Rly Manager of Mumbai Central division of WR and his team had gone extra mile to fulfil all infrastructural augmentation needs of JRH.   The necessary materials especially PPE kits and N95 masks were procured within short span of time. This combined with the motivation and training provided Corona warriors with the moral strength to go beyond their individual self to fight against the disease and save the life of patients.

Efforts of JRH management, Health workers and Railway administration is well appreciated by all, be it discharged patients, media outlets or state government. In true sense, JRH is leading the fight against COVID as far as railway is concern. Untiring efforts and dedication shown by Doctors, Staffs and other associated department at JRH are taking humanitarian facade of Indian Railway many miles ahead and cementing JRH in good books for fight against this deadly global virus.