Our Work

Critical care equipment

We provide critical care equipment and set up critical care facilities for hospitals that can cater to the burgeoning rural and urban population of India.

Best possible care

What We Do

We work with partners in India to tackle the shortage of critical care facilities.

We identify hospitals that are in need of critical care facilities and undertake a comprehensive process of due diligence. The hospital's legal position, auditory compliance, standards, capabilities, and conformity to our values are just a few of the things we thoroughly investigate with the help of our partners.

If a hospital fulfills our compliances, we determine the level of ICU care required and select the equipment that can fulfill that level of care. Our fundraising initiatives are geared towards meeting each project’s requirements. These funds are distributed to our NGO partner so they can purchase the required equipment. The hospital receives this equipment to set up and begin using it. Throughout the entire process, there is no disbursement of funds to any recipient directly; instead, we only provide the critical care equipment required to set up the ICU facilities. This helps ensure control over the fund utilization and keeps it a transparent and traceable effort. Kindly note, we often purchase maintenance of care for 3 to 5 years for the equipment since most of them last 15 plus years.

We prioritize recognised standards for ICU facilities while working to ensure that as many individuals as possible have access to critical care facilities. To ensure that everyone who needs assistance not only receives it but also receives the best possible care, we continue to monitor impact analysis on a regular basis.

Standards established by the Intensivists Association of India for the planning and design of ICU’s are enclosed below for reference. Though all of them cannot be followed in every single project because of multiple challenges, they are useful yardsticks to emulate.

6-8 beds
Should be able to perform cardiopulmonary resuscitation including intubation, short-term cardiorespiratory support including, non-invasive ventilation, and defibrillation
Provision for short-term mechanical ventilation (desirable)
Have syringe pumps/infusion pumps
Have multipara monitors with SPO2, HR and ECG, NIBP, temperature facility
Access to ABG facility
Access to ultrasound, X-ray and basic clinical lab (CBC, blood sugar, electrolytes, LFT and RFT).
Desirable to have access to CT scan and microbiology
Access to ambulance (ACLS desirable) and trained manpower for safe transport of the patients to higher level centers
Doctors should be encouraged to participate in short-term training courses/workshops like FCCS/4C /ACLS/mechanical ventilation, etc.
Access to 24 × 7 blood bank/pharmacy/nutrition (desirable)
Provision for telemedicine consultations
At least one book and one journal of critical care medicine should be available as ready reckoner
General infection control and, patients and staff safety measures should be observed

In addition to all the recommendations from Level I, Level II has the following requirements:

8 to 12 beds
HOD/Director/In-charge of the ICU should be an intensivist and be qualified/trained/certified in critical care
Facility for multisystem organ support.
Central nursing station (CNS)/central monitoring facility
Provision of both invasive and non-invasive ventilation (preferably up to half to two-thirds of bed strength)
Access to renal replacement therapy (RRT)
Transcutaneous pacing facility
Microbiology support with facility for fungal identification (desirable)
Nurses and duty doctors are trained/certified in critical care
Should have ABG, bedside X-ray and ultrasound 24 × 7
Access to CT and MRI
Protocols and policies for ICUs must be there and are observed
Research should be encouraged
Should have access to super-specialties of medicine and surgery
High dependency unit (HDU) facility and telemedicine are desirable
Should have access to e-journals, databases and books

Level III is further divided into A and B based on the provision of extreme care services. In addition to the recommendation from Level IIIA, Level IIIB provides extracorporeal therapies.

Level IIIA:

Critical care unit should preferably be a closed ICU
Protocols and policies are defined
Must have provision of advanced cardiorespiratory monitoring—both invasive and non-invasive
Intra- and inter-hospital transport facilities available
Multisystem care and referral available round the clock
Should become lead center for teaching and training in critical care
Ultrasound and echocardiography in the ICU 24 × 7
In-house blood bank, pharmacy and canteen services 24 × 7
In-house CT scan and MRI facilities strongly recommended
Bedside flexible bronchoscopy facility is desirable
Bedside renal replacement therapy (RRT)
Continuous renal replacement therapy (CRRT) and plasma exchange facility are recommended
Optimum patient/nurse ratio (1:1 on patients on organ support e.g. mechanical ventilation, RRT, multiple inotropes; and 1:2 at least when patient is on non-invasive ventilation and/or requires less intense monitoring)
Should follow guidelines of a professional body of critical care (ISCCM) or equivalent in terms of ICU structure
Should act as a center for research, training and teaching, including tele-consultations and telemedicine center
Should be equipped for both long-term acute care and palliative care
Team should be well versed with transplant critical care

Level IIIB:

In addition to all the requirements of IIIIA, this level includes ECMO-, ECCO2R- and LV-assist devices.

Compassion, Integrity, Diligence, and Sustainability

How We Do It

We are committed to a Radical transparency in all our operations.

Cpr stands on four pillars: Compassion, Integrity, Diligence, and Sustainability.

Compassion means providing life saving interventions to anyone who needs it, even if they can’t afford to pay for it. For us the Compassion of our partners carries the maximum weightage in identifying a project.

Our second pillar is Integrity. At cpr, we are brutally transparent in the utilization of funds. No matter the challenges, we don’t compromise Integrity for any reason whether it be financial, cultural, social or political. We have a thorough vetting process to identify health care projects that are aligned with our level of integrity.

Our third pillar is Diligence. Over the course of 18 months with cpr and the decades of experience our founders have in the healthcare industry, we have understood the dire need of diligence in critical care delivery. From choosing the right paint for the ICU walls to identifying world class pediatric ventilators, we are extremely diligent and thoroughly meticulous in the entire process of setting up life saving centers. Our executing partners are given thorough guidance for the diligent identification of a project and the process is continued till execution.

Our fourth and last pillar is that of Sustainability. To ensure that our partners are able to provide life saving interventions even to those who can’t afford to pay for it, they have to be financially and operationally sustainable. We work in collaboration with the brightest minds to fine tune models that can enable operational sustainability. We held a symposium at the highly reputable institute, IIIT, Hyderabad to understand this challenge and published a white paper to that end.

As a NGO based in the USA that provides critical care equipment in India, there are a number of challenges that we face in ensuring that the right equipment gets to the right hospitals and through the right people. We seek partners who are tenacious and passionate about helping those less fortunate.

To this end, we have partnered with Spherule, an Indian NGO that is committed to bringing sustainable grass roots change in the lives of the poor. With their ethos revolving around equality, justice, and sustainability, they are a perfect partner in our quest to offer compassion and integrity with diligence.

Due Diligence

We undertake a rigorous process of due diligence to ensure that the hospitals we equip with critical care facilities can cater to the underprivileged and will also provide any service required to save lives even if the patient can’t afford to pay. We work with partners who are just as passionate as we are and who conduct site visits, audit financial reports, determine operational capacity, and undertake a geographical assessment among other parameters before we take on a project.

Each project is scored on 4 major parameters to determine whether the project falls in line with our values and whether it can deliver the impact we seek:

Parameter	Factors Considered
Patient	ICU beds to Total Patients Ratio
Due Diligence	Valid Licenses and Adherence to Government regulations Audited Financial Records & Current Assets Price chart for treatments for hospital and nearby hospitals Number of verified patients Attitude of doctors towards patients History of founders and doctors
Expected Impact Score	Expected % increase of patients in ICU pm after donation % increase of patients at full cost % increase of patients at affordable cost % increase of patients of free treatments Expected % occupancy of the ICU
Project Sustainability Score	Years of Operation Cash Flow Statements for Preceding 3 Years Total Medical & Support Staff & their Experience Population of Area to Number of Hospitals Ratio Ability to raise funds through donations, loans, etc.

Hub & Spoke Model

Providing access to life saving interventions in rural and semi-urban India is a formidable challenge.
The prohibitive cost of setting up full-fledged ICUs and the desperate shortage of intensive care specialists are just some of the challenges that we have to contend with. Even with the funds required to set up facilities, there aren’t enough skilled personnel to ensure an acceptable level of care for patients in those facilities.

To overcome this challenge, we are in the process of developing a hub and spoke model that can effectively address these complexities while preventing loss of life. We conducted a symposium in IIIT, Hyderabad to understand this model and we are actively looking into how to implement it in the near future based on our growth and resources.

Be sure to keep an eye out for updates to this section. We will be publishing details of this model once we have finalized the detailed minutiae needed for this complex endeavor.

Feedback & Monitoring

We are very grateful for the trust our donors and partners place in us and our work. We don’t take that for granted and we don’t ever want our donors to wonder where their donation goes and whether they are making an impact with their dollars. To that end, we are diligent with providing feedback to our donors as well as monitoring the facilities that our donors have funded.

Throughout the process of identifying and setting up facilities, we stay engaged with our donors and partners. We document our journey with stories and pictures of the facilities and the people in them. In collaboration with our partners, we continue to maintain contact with the hospital administration and medical staff to track the number of patients treated and the cost of the treatment subsidies.

We believe in more than just stats. Human lives are more than just a number. We delve into the true accounts of the real life interventions that brought vulnerable people back from the brink of death. Sign up for your newsletter here(link to newsletter sign up) to stay up to date with our progress and to see the lives that you have saved through your donations.