1.introduction - aiims ost cme
OPIOID SUBSTITUTION THERAPY: POLICY AND PRACTICE EXPERIENTIAL ACCOUNT: EXPERIENCE AT A GOVERNMENT GENERAL HOSPITAL DR. AMIT ARYA ASSISTANT PROFESSOR DEPARTMENT OF PSYCHIATRY KING GEORGE’S MEDICAL UNIVERSITY 19-04-2015 LUCKNOW 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 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 Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi OST CENTRE Staff in place Yes/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 5.OTHER ISSUES Backup Nurse Yes NDDTC, AIIMS, New Delhi 6.CONCLUSION Counselor Yes NDDTC, AIIMS, New Delhi Data Manger Yes Training done at RTTC, Lucknow Staff allotted (as per the contract) 2.PROBLEMS 3.CHALLENGES 4.ADVANTAGES AND BENEFITS Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi PROBLEMS ENCOUNTERED 1.INTRODUCTION INITIAL HICCUPS IN ESTABLISHING OST 2.PROBLEMS 3.CHALLENGES 4.ADVANTAGES AND BENEFITS 5.OTHER ISSUES 6.CONCLUSION 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. Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi CHALLENGES FACED 1.INTRODUCTION 2.PROBLEMS CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES 3.CHALLENGES 4.ADVANTAGES AND BENEFITS Renewal of MOU between University authorities and UPSACS: Delay at SACS level Delay at University level 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 1.INTRODUCTION 2.PROBLEMS CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES Human Resource Management: Frequent dropout by the staff 3.CHALLENGES Delay in getting new staff member Organizing training for untrained new 4.ADVANTAGES personnel AND BENEFITS No provision of leaves in spite of working in government setup creates a sense of unrest 5.OTHER ISSUES among staff Dealing with the psychosocial issues of staff in 6.CONCLUSION itself is a challenge Arrangement of backup staff and ancillary Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi staff CHALLENGES FACED 1.INTRODUCTION 2.PROBLEMS CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES 3.CHALLENGES 4.ADVANTAGES AND BENEFITS 5.OTHER ISSUES 6.CONCLUSION 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 Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi CHALLENGES FACED 1.INTRODUCTION 2.PROBLEMS 3.CHALLENGES 4.ADVANTAGES AND BENEFITS CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES 5.OTHER ISSUES 6.CONCLUSION 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 Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi CHALLENGES FACED 1.INTRODUCTION 2.PROBLEMS FUND SUPPLY CHAIN 3.CHALLENGES 4.ADVANTAGES AND BENEFITS 5.OTHER ISSUES Budget allocated and released by NACO Funds received by Treasury Funds released by UPSACS Deposited in the Joint account Withdrawal requires signature of both the signatories Unutilized funds had to be sent back 6.CONCLUSION Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi CHALLENGES FACED 1.INTRODUCTION 2.PROBLEMS CHALLENGES ENCOUNTERED IN DELIVERING OST SERVICES 3.CHALLENGES 4.ADVANTAGES AND BENEFITS 5.OTHER ISSUES 6.CONCLUSION 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 increases Presented at the national on 18th-19th at AIIMS, New Delhi A CME lot of"OST: timePolicy hadand to Practice" be given to dealApril with2015 such incidences ADVANTAGES AND BENEFITS 1.INTRODUCTION 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 3.CHALLENGES It teaches us to deal with difficult situations in our clinical field 4.ADVANTAGES We learn HR management AND BENEFITS Provides opportunities of learning for students of various discipline social work, Psychology, 5.OTHER ISSUES clinical psychology and nursing PG thesis entitled “Psychiatric Comorbidity 6.CONCLUSION among Opioid Dependant Injecting Drug Users” has been done in the department. Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi Some other research work are in pipeline. 2.PROBLEMS OTHER ISSUES 1.INTRODUCTION 2.PROBLEMS OTHER ISSUES WHICH ARE IMPORTANT 3.CHALLENGES 4.ADVANTAGES AND BENEFITS 5.OTHER ISSUES 6.CONCLUSION 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. Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi CONCLUSIONS 1.INTRODUCTION 2.PROBLEMS 3.CHALLENGES 4.ADVANTAGES AND BENEFITS 5.OTHER ISSUES 6.CONCLUSION 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 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 KGMU, LUCKNOW THANK YOU Presented at the national CME "OST: Policy and Practice" on 18th-19th April 2015 at AIIMS, New Delhi
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