| SR NO | SERVICE QUALITY | PROCESS/ FUNCTION/ DEPARTMENT | EXPECTED PERFORMANCE | OCT-15 | NOV-15 | DEC-15 |
|---|---|---|---|---|---|---|
| 1 | Lab Reporting errors | Lab | 5 errors per 1000 tests | 0 | 0 | 0.44 |
| 2 | Radiology reporting errors | Radiology | 5 errors per 1000 tests | 0 | 0 | 6.76 |
| 3 | Adverse drug reactions | Nursing | 0% | 0 | 0 | 0.07 |
| 4 | Unplanned ventillation post anasthesia | OT | 0.25% | 0 | 0 | 0 |
| 5 | Adverse anasthesia events | OT | 0% | 0 | 0.67 | 0 |
| 6 | Compliance with Surgical “Time-out” procedure | OT | 99% | 100 | 100 | 100 |
| 7 | Compliance with Prophylactic antibiotic usage within specified time | OT | 99% | 100 | 97.47 | 100 |
| 8 | Blood transfusion reactions | Blood Storage Unit | 0% | 0 | 3.85 | 0 |
| 9 | Catheter associated UTI (CAUTI) | HIC | 0.0% | 0 | 0 | 0 |
| 10 | VAP | HIC | 0.0% | 0 | 0 | 0 |
| 11 | CLABSI | HIC | 0.0% | 0 | 0 | 0 |
| 12 | SSI | HIC | 0.0% | 0 | 0 | 0 |
| 13 | Return to ICU within 48hrs during same admission | ICU | 1% | 0 | 1.9 | 0 |
| 14 | Return to emergency within 72 hours with similar complaints | Emergency | 1% | 14.29 | 0 | 0 |
| 15 | Number of Re-intubations within 48 Hours of Extubation | Med Admin | 0% | 0 | 0 | 0 |
| 16 | Patient falls | Safety | 0.50% | 0 | 1.32 | 0 |
| 17 | Bed occupancy | Med Admin | 90% | 80.69 | 70.2 | 71.87 |
| 18 | ALOS | Med Admin | 6.20% | 6.09 | 6.67 | 6.92 |
| 19 | OPD patient satisfaction index | OPD | 87.50% | 86.36 | 86.4 | 86.21 |
| 20 | IPD patient satisfaction index | IPD | 87.50% | 79.95 | 91.58 | 85.57 |
