experiential account experience at a government general hospital
TRANSCRIPT
OPIOID SUBSTITUTION
THERAPY: POLICY AND PRACTICE
19-04-2015
EXPERIENTIAL ACCOUNT: EXPERIENCE AT A GOVERNMENT GENERAL HOSPITAL
DR. AMIT ARYAASSISTANT PROFESSOR
DEPARTMENT OF PSYCHIATRYKING GEORGE’S MEDICAL UNIVERSITY
LUCKNOWPresented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
OST centre started in May 2013. Slot Allocated- 150 Number of clients registered till date-193 Active clients- 80 Regular clients- 72 Clients who did not receive OST even once during
previous month: 89 Number of clients tested HIV+ : 49 Number of clients receiving ART services: 4
OST CENTRE
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
OST CENTRE
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Staff allotted (as per the contract)
Staff in placeYes/No
Name of the training organization
Assistant Nodal Officer/ Backup Doctor In charge
Yes NDDTC, AIIMS, New Delhi
Doctor In charge Yes NDDTC, AIIMS, New Delhi
Nurse Yes NDDTC, AIIMS, New Delhi
Backup Nurse Yes NDDTC, AIIMS, New Delhi
Counselor Yes NDDTC, AIIMS, New Delhi
Data Manger Yes Training done at RTTC, Lucknow
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
INITIAL HICCUPS IN ESTABLISHING OST Delay in MOU between University authorities
and UPSACS Difficulty in appointment of staff especially
Medical officer Coordination with the TI Unit, UPSACS Difficulty faced in transfer of the fund Delay in release of budget for refurbishment Delay in refurbishment of the allocated
building by UPRNN.
PROBLEMS ENCOUNTERED
1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES Renewal of MOU between University
authorities and UPSACS: Delay at SACS level Delay at University level
CHALLENGES FACED
1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES Human Resource Management: Frequent dropout by the staff Delay in getting new staff member Organizing training for untrained new
personnel No provision of leaves in spite of working in
government setup creates a sense of unrest among staff
Dealing with the psychosocial issues of staff in itself is a challenge
Arrangement of backup staff and ancillary staff
CHALLENGES FACED
1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES Difficulties with the NGO TI Unit: Budget allocation as per lower estimation
leads to poor service delivery High dropout rate of staff Lesser number of ORW Delay in honorarium for PM and PE No kits for STI at TI
CHALLENGES FACED
1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES Erratic supply of funds: Irregular release of funds is a major problem Limited time to utilize the funds, unutilized
funds had to sent back leading to unaccomplished work
Limited contingency head Delay in disbursement due to bureaucratic
hassles
CHALLENGES FACED1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
CHALLENGES FACED
Budget allocated
and released by
NACO
Deposited in the Joint account
Withdrawalrequires
signature of both the
signatories
Unutilizedfunds had to
be sent back
Funds received by
Treasury
Funds released by
UPSACS
1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
FUND SUPPLY CHAIN
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES Problems dealing with difficult clients: They stay in and around campus Limited family involvement by the clients Had opened shops around the centre itself Identified secluded places in the campus for
injecting Some threatens the OST and hospital staff Some are expelled due to serious
misconducts, even then they keeps on coming
Reports of theft and pity crime increasesA lot of time had to be given to deal with such incidences
CHALLENGES FACED
1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
OST ADDED TO THE TEACHING, TRAINING AND RESEARCH ACTIVITIES
Provide us an opportunity to see severe form of addiction which we otherwise did not.
Adds to the teaching of MD students It teaches us to deal with difficult situations in
our clinical field We learn HR management Provides opportunities of learning for students
of various discipline social work, Psychology, clinical psychology and nursing
PG thesis entitled “Psychiatric Comorbidityamong Opioid Dependant Injecting Drug Users” has been done in the department.
Some other research work are in pipeline.
ADVANTAGES AND BENEFITS
1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
OTHER ISSUES WHICH ARE IMPORTANT Change in guidelines and policies leads
to practical difficulties: Field visit by a nurse is not practically possible Counselor will not be paid for field visit Lesser increment in the salary of nurse Backup nurse is not paid for working days Increase in registration fee under CPMS leads
to difficulties in providing hospital services to our clients.
OTHER ISSUES1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
Running a OST centre in a GHPU is a challenging task
It is teaching and learning asset to the department
Issues related to budget and funding needs to be dealt
Guidelines and policies should be implemented effectively
TI Units and Rehabilitation services require more emphasis
CONCLUSIONS
1.INTRODUCTION
2.PROBLEMS
3.CHALLENGES
4.ADVANTAGES AND BENEFITS
5.OTHER ISSUES
6.CONCLUSION
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
OST CENTRE, DEPARTMENT OF PSYCHIATRY KGMU, LUCKNOW
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
THANK YOU
KGMU, LUCKNOW
Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi