Forbes Concept:Fortifying Perfection at Fortis Healthcare

Fortis Healthcare is a fast growing chain of hospitals in India. By adopting a “Total Patient Centric Approach”, the teams of doctors & medical staff and management professionals meet international protocols.

The food service at Fortis Mohali is managed by Forbes Concept Hospitality Services Pvt Ltd. A total of nine services are provided to patients at the hospital throughout the day. Forbes Concept follows a stringent policy of food safety and adheres to all the procedures and norms as per HACCP guidelines right from receiving of the materials to serving of the food to the patients. All the temperature controls, hygiene standards, sanitization and standard cleaning procedures are taken into consideration.

Apart from serving food to the patients, Forbes Concept also successfully handles the smooth operations of the Jam Ja Jee cafeteria for the staff which starts with breakfast at 7am and ends with dinner at 10pm. The operation capacity of Forbes Concept doesn’t end here; Café 24, 24-hour restaurant of the hospital, serves food to visitors which include all the services along with a la carte menu. Another eatery, Hot Shop, situated in the campus of the hospital, to provide immediate snacks to the visitors is also successfully managed by Forbes Concept.

In order to ensure smooth functioning, the entire operation is handled by a highly qualified, motivated and experienced team which consists of operations manager, assistant manager, supervisors, experienced chefs, well-trained cooks, well-mannered service staff and the utility staff. The team is interactive and has a structured client feedback and complaint management system to deliver its best.

The entire quality procedure is strictly scrutinised by a Quality Assurance manager who conducts regular audits and gives training to the staff along with the F&B head and his team at the hospital. Around 97 professionals of Forbes Concept are engaged in the catering services at Fortis Mohali. In the kitchen area alone, 18 staff members work in shifts.

Protocols and standard service

“With various national and international accreditations in place, Fortis Mohali adheres to laid out standard procedures which are being executed by Forbes Concept diligently,” said Sunil Ganjoo, DGM – Facilities, Fortis Healthcare, Mohali.

“We follow the standards to the smallest details. Refrigerators are checked for the temperature levels every hour. Each food item is checked on the prescribed temperature. For example, the ice cream cabinet has to be under -28oC. Every area of the kitchen has to meet the protocol.” There is a sequence of operations on managing the kitchen. Procedures begin right from the time the vegetables are received. All vegetables are thoroughly washed, disinfected in Suma tablets and kept in the sterile area which is a separate corridor before being stocked into the walk-in cooler. Every item received is tagged date-wise.

Vegetables are pre-soaked in a quality disinfectant solution. Dieticians are deputed at hospitals to counsel patients and prescribe the menu. Each person’s ‘therapeutic menu’, as they call it, is fed into the computer which gives a chart of the calorific value of the meal. The diet software generates service charts to track the diet for every patient according to the rooms they occupy.

Similarly, groceries received are first removed from the cartons at the entrance before being brought in, as there are always chances of spread of contamination through the cartons. Fortis stocks only branded items. Storage too is subjected to simple protocols like nothing should be stocked above three feet from the ground; everything has to be kept clean and all food areas have to be washed and cleaned regularly.

“Anytime, anyone enters the kitchen, it is always clean. We have an auto scrubber drier running exclusively for floor cleaning. Normal wipes dipped in Suma tablet solution are used for the work area. At all times, headgears are a must for anyone in the kitchen. We have soap dispenser and tissue paper at strategic locations in the kitchen area besides special eye washers, in case anything splashes into the eye while cooking.”

Hygiene is given prime importance. Kitchen staff handling raw vegetables has to wear gloves and cutting tools have to be disinfected. Regular checks by the supervisor and auditing staff ensure all rules are adhered to. “As a routine, there are teams of doctors who do cross-auditing of departments.”

While the food prepared is as per the dietician’s chart, meals cooked are checked thoroughly before being served to the patients. Food is carried in special trolleys – heated trolley to carry cooked food and non-heated or plain trolley to take back used plates. “Again, there are separate lifts for taking the fresh food up and bringing down the soiled / used plates, etc. There is clear segregation.”

The use of dishwasher to clean the used containers using Diversey chemicals does away with the need to wipe them, as they come out dry. Besides, the kitchen is fumigated fortnightly and the floors are swabbed with R2 everyday.

The staff has to undergo medical check-ups. “We have staff hygiene cards monitored by the Supervisor and anyone not meeting the standards is asked to go. These include rules like well-cut nails, groomed hair, etc. To ensure that there is no non-adherence, there is a briefing before every shift. Forbes Facility staff has been trained to meet the standards and they have responded well. We have also given them three other sites to handle besides Mohali.”

On Housekeeping

Sunil Ganjoo lists down some of the housekeeping practices adhered to at the hospital:

Housekeeping is an integral part of any type of hospitality and hospital operation. It is the most-in-demand field in the service industry as every building needs looking after. People in this profession need to be qualified and have skills such as eye for detail, organising and problem solving abilities etc. A very important trait is to be able to handle people and lead from the front.

The housekeeping department work has advanced rapidly and requires not only knowledge of technical skills but also good management practices such as planning, organising, coordinating, acting and monitoring all the activities in hand for effective utilisation of resources. A very important factor is the training and grooming of manpower, making them aware of the latest systems and tools and effective and economic usage of consumables.

As per the hospital infection control committee guidelines the areas are broadly categorised into the high risk, medium risk and low risk areas.

The High Risk Areas include Operation Theatres, Intensive Care Units, Cardiac Catheterisation, Neonatal ICU and Renal Transplant ICU.

Guidelines:

1. Hands should be washed; protective clothing such as masks, shoe covers, caps and scrub suit should be changed into.
2. When the garbage bags are 3/4th full they should be secured, labelled with area, date and time and sent to the holding room in enclosed garbage trollies.
3. The soiled linen from OTs, Isolations and ICU’s is placed in special pink bags. When filled, they are properly secured before transporting to the laundry in enclosed trolleys and treated separately.
4. In the ICUs partition curtains are changed after every discharge.
5. In the OTs, after every surgery fumigation and carbolisation is done by the paramedical staff

The Medium Risk Areas include Examination rooms, Procedure rooms, Consultant rooms and In-patient rooms.

Guidelines:

1. The same procedure as in the high risk areas is followed along with the general guidelines for cleaning.
2. In the patient rooms, cleaning is done and services are provided twice a day and on request.
3. Beds in the occupied rooms are made by the nurses and the vacant rooms are prepared by Housekeeping.
4. For every vacant room, housekeeping maintains a check list of all the amenities, fixtures, fittings and other furniture, etc. which has to be complete in all respects before releasing the room. If there is a maintenance job with short turnaround time, then the engineering rectifies it immediately. In case, it is a major job, then the room is taken out of order.

The Low Risk Areas include Public areas, Waiting areas, Corridors, Basement, Staircases and Elevators.

Guidelines:

1. Auto scrubbing machines are used for scrubbing the floors in lobbies and corridors. Crystallisation is done regularly for the proper upkeep of the floor and maintaining its shine.
2. In public areas thorough washing is done at night and during the day only dry mops are used.
3. The garbage disposal is done thrice a day and also, as and when required.
4. In the ICU waiting areas, it is the responsibility of housekeeping to provide shoe covers and gowns for the attendants.
5. A schedule is followed for the cleaning of window panes on all the three floors and we have installed uplift Delta machine to facilitate easy cleaning from outside. A low cleaning solution, often containing a little ammonia, is prepared with cold or warm water (never hot).
6. For cleaning of elevators, stainless steel cleaners are used on the walls and rinsed thoroughly with warm water. A thin coat of baby oil is applied and buffed in. Stainless steel is the preferred metal for equipment and elevators, especially in a hospital, as it is easy to maintain and is not prone to chips or peeling.

General Cleaning Guidelines

• Washing of hands before and after contact with patients is the most important item to remember to protect the personnel and patients.
• All equipment in the area should be kept aside before starting the cleaning.
• Soiled linen and garbage should be removed and kept in the designated colour coded bags. Fresh garbage bags should be placed in the dust bins.
• Damp dusting is recommended in the hospital to avoid any kind of allergy or infection due to scattering of dust particles in the air. Damp dusting of all surfaces, lockers, bed, bed table, lamp, chairs, fixtures and fittings shall be done with Bacillocid Solution.
• Floor to be scrubbed with auto scrubbing machines using disinfecting solutions. Or it can be mopped using the designated coloured mops (meant for ICUs. Thereafter, the mop head to be sent to the laundry for disinfection in pink bags.)
• Put proper signages for different works in progress e.g. wet surface, etc. and cordon the injury prone areas. Mops should be wringed properly and should not be too wet, otherwise they increase the risk of a fall.
• Change cleaning solutions and mop heads frequently for best results. As a general rule, change after every three patient rooms.
• Carbonisation of beds and other equipment to be done after every discharge.
• Liquid soap units and paper towels should always be available next to the hand washing areas.
• Separate trolleys to be used for transportation of soiled and clean linen.
• Maintenance jobs to be informed to the engineering and follow up should be done.
• Spring cleaning of the rooms should be done once a week.