A project report on

Management practices at Hospitals

Submitted by:

Kunal Bharat Mehta

Roll no 21

University of Mumbai

Third Year

Bachelor of Management Studies

Ramniranjan Jhunjhunwala College

Ghatkopar (West)

Mumbai-400086

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Declaration

I Kunal Bharat Mehta of Ramniranjan Jhunjhunwala

College of TYBMS hereby declare that I have

completed my project on “Management practices

at hospitals” in the academic year of 2005-06.

I also declare that the information given in this

project is true and original and to best of my

knowledge.

-------------------------

Signature of student

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Certificate

I, the Principal of Ramniranjan Jhunjhunwala

hereby certify that Kunal Bharat Mehta, student of

Third year Bachelor of Management studies has

completed his project on “Management practices

at hospitals” in the academic year 2005-2006. The

information submitted is true and original to best

of my knowledge

______ _______

Signature of Signature of

Project guide Principal

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Acknowledgement

I would like to express my gratitude to those who

have helped me to turn this project into reality.

Firstly I would thank Prof. J. C. Saboo who

supported me in each and every aspect related to

the project.

I would also thank Wockhardt Hospital, Mulund for

giving me summer placement and opportunity to

get close to Hospital management. I also thank Mr.

Mallikarjun (Executive officer) at Wockhardt

Hospitals, Mulund, The administrative staff at

Bombay Hospital, Marine Lines and at ESIC

Hospital, Mulund

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Kunal Mehta

Executive summary

The job of medical care, today, is no more a one man show.

Modern hospital organization involves heterogeneous group of

specialized personnel. It is teamwork and successful operation of any

hospital organization depends on the services of a large number of

personnel specialized in different areas of medical science and

management.

Thus this calls for an effective and perfect management of

hospitals. There is no room for a single mistake in case of hospitals as it

can cause a death of the patient and a challenge for existence of the

hospital.

This project deals with different aspects of management practices

followed at hospitals. Firstly the project deals with the hospitals statistics

and the importance of hospitals in India. Today Indian hospitals are

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thriving to provide world class facilities to Indian residents as well as

foreigners at best quality standards and prices.

Next the project consists of classification of hospitals and the

activities at hospitals. This helps the management to form out efficient

strategies to make the administration flow smoothly. For this the

information was collected from each type of hospitals one is private, one

government and one trust run hospital.

Details regarding the sources of the information in the project

Summer placement at Wockhardt Hospital, Mulund

Personal visits to ESIC and Bombay Hospital

Internet

Magazines and bulletins

The project also covers some informative inserts from Dr. Agarwal, Dr.

Kamle, it also has interview of Mr. Vishal Bali, President (Operations-

Wockhardt).

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Management practices at Hospitals

Contents

1. Business Of Caring

a. Hospitals- The Concept…………………………………. 10

b. Statistics Of Hospital Industry…………………………... 12

c. Indian stand……………………………………………… 14

2. Classification of Hospitals 16

a. On basis of objectives…………………………………… 16

b. On basis of ownership…………………………………… 17

c. On basis of medicine…………………………………….. 18

d. On basis of size………………………………………….. 18

3. Identification Of Activities At Hospitals 19

Medical services…………………………………………. 19

Customer care Department………………………………. 20

Nursing Services………………………………………….21

Central sterile supply Department……………………….. 22

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Dietics Department……………………………………….22

Pharmacy………………………………………………… 22

Pathology…………………………………………………23

Radio imaging…………………………………………….23

House keeping services………………………………….. 24

Out patients Department………………………………….25

Engineering ………………………………………………25

Ward services……………………………………………..26

Fire, security and safety…………………………………..26

4. Visit To Hospitals

a. Private (Wockhardt Healthcare Centre, Mulund)………. 27

i. Achievements and features……………………….. 28

ii. Wockhardt – Harvard medical alliance……………30

iii. Technology and key expertise……………………..32

iv. Quality management……………………………… 36

b. Government (E.S.I.C Hospital, Mulund)………………..37

i. Introduction ………………………………………. 38

ii. Statistics…………………………………………... 40

iii. Model hospitals………………………………….... 42

c. Trust Run Hospital (Bombay Hospital, Marine lines)….45

i. Introduction……………………………………….. 46

ii. Services…………………………………………… 48

iii. Specialties and supportive services………………..49

5. Next Big Business 50

a. Interview of Vishal Bali…………………………………. 51

b. Right investment decisions……………………………….53

c. Future Prospective………………………………………..57

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d. Eight steps in building a world class facility hospital…… 59

6. Conclusion……………………………………………………... 63

7. Bibliography……………………………………………………64

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Hospital – The Concept

Caring for the sick and infirm and nursing them back to health is not

something that one likes to associate with making money. That someone

could be profiting from another person’s ill health does indeed, sound

rather insensitive. But, then, do emotions really have a place in the world

of business? Not quite. The fact is that healthcare is, today, the world’s

largest industry. And this industry, comprising pharmaceuticals,

hospitals, nursing homes, laboratories, day care centers and others, is

slated to become one of the most promising businesses for India riding on

the wave of a growing middle class and changing disease patterns.

With the passage of time, it is natural that a change in perception is

visible. Yesterday, the hospitals were considered as almshouses. They

were set up as a charity institution to take care of the sick and poor.

Today, it is a place for the diagnosis and treatment of human ills, for the

education, training and research, promoting health care activities and to

some extent a center helping bio-social research.

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The document of World Health Organization (WHO) makes a

clear-cut exposition of the conceptual aspect. It is stated in the document

that the hospital is an integral part of a social and medical organization,

the function of which is to provide for the population complete health

care both curative and preventive and whose out-patient services reach

out to the family in its home environment; the hospital is also a center for

the training of the health workers and for bio-social research.

The viewpoints expressed in the WHO document have enlarged the

functional areas of modern hospitals. It is against this background that the

hospitals rekindle new hopes and aspirations to the people of the society.

The WHO documents further consider hospital a complex organization. It

is complex in the sense that multi-faceted developments in the society

have made the people of the society more conscious of their rights.

Today, they demand modern and the best possible means of

medical care and health education. They want everything not only within

the 4 walls of the hospital but also at their doorstep or in the vicinity of

living places. This has made a hospital a complex organization.

Of late, a hospital is also considered a major social institution for

delivering of health care, offering considerable advantages to both patient

and society. It is considered to be the place for the diagnosis and

treatment of human ills and restoration of health and well being of those

temporarily deprived of.

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Dose of Healthcare Statistics

Healthcare is one of the most essential services in any growing society.

Propelled by an affluent and health conscious growing middleclass, the

healthcare industry in India grew by more than 13 per cent per annum

in the last decade.

Market

India’s healthcare industry is estimated at Rs 1,500 billion or USD 34

billion. This works out to USD 34 per capita which is 6 per cent of GDP.

Of this 15 per cent is publicly financed, four per cent is from social

insurance, one per cent private insurance and the remaining 80 per cent

being out of pocket as user fees (80 per cent of which goes to the private

sector). Two thirds of the users are purely out-of pocket users and 90 per

cent of them are from the poorest section.

Healthcare statistics

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India has 5,03,900 doctors, 7,37,000 nurses, 162 medical colleges, 143

pharmacy colleges and 3,50,000 chemists. There are 15,097 hospitals

accounting for 8,70,161 hospital beds in India. There is an extensive

three-tiered government healthcare infrastructure comprising 23,000

Primary Health Centers (PHC) and 1,37,000 sub-centers serving the

semi-urban and rural areas and 3000 (CHC) Community Health Centers

A Healthy Business

Traditionally healthcare has been one of the crucial sectors for any

economy. For most of the developed countries, healthcare spending

accounts for more than seven percent of GDP. Today, healthcare is the

largest industry in the world with revenues of$2.8 trillion. In the US,

healthcare is a $1.4 trillion industry, accounting for 13.7 percent of GDP

and is estimated to expand to a size of $2.2 trillion by 2008.

In India, the industry is worth about Rs.100, 000 crore and

accounts for nearly five percent of GDP. Amit Bagaria, CEO of Asian

Health Services says, “Not many people realize that it is close to Rs

100,000 crore industry and employs 60 lakh people directly and 20 lakh

indirectly. Compare this with the Information technology, which is Rs

40,000 crore and employs only three lakh people. Another important

finding is that in the development cycle of an economy, for the last 25

years before a nation reaches developed status, healthcare is the fastest

growing industry.” The industry is expected to register a 17 per cent

growth and reach a size of more than Rs 2,25,000 crore by 2005-06”

Healthcare industry growth

(‘000 Rs crores)

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Indian Stand

India’s health expenditure is 5.6 per cent of GDP, whereas most

established market economies spend 7-10 per cent of GDP on

health. USA spends over 14 per cent.

US has 2,340 doctors as compared to India’s 143 doctors for very

10,000 people

On an average, 80 out of every 1,000 children die. This figure is

just 9 in the US and 30 for every 1,000 in Thailand.

Life Expectancy in India is amongst the lowest at 55.5 years

compared to US at 75.5 years and 66.5 years for Thailand.

Compared to Brazil’s 4300 beds, India has only 1,600 beds.

Potential

The potential of health services sector is immense in India as there are

more than 140 million upper and middle class, growing at over four per

cent per annum with combined annual income of over Rs 820,000 crore.

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These people have confidence in healthcare products and services offered

by private hospitals. The quality of healthcare has improved considerably

with the availability of world class high-tech medical equipment and

information technology. However, the low penetration of health insurance

is limiting the growth of these world-class services.

Privatization of insurance sector has led to spurt in health care services.

Less than 10 per cent of the Indian population is covered by some form of

health insurance. Insurance is expected to be the main driver for raising

quality consciousness and increased demand for better standards, hospital

accreditation and Patient / Management Information Systems.

The voluntary health insurance market estimated at Rs 4 billion is

expected to be Rs 130 billion by 2005.The healthcare business for IT

services comprises of players like government, insurance companies,

consumer and corporate hospitals is about Rs 500 crore which is a

pittance compared to the contribution of healthcare industry to national

GDP which is growing at a rate of about 10-15 percent annually.

The MBPO (medical business process outsourcing) will be the next boom

the Indian knowledge economy will witness as it has massive potential

for outsourcing within the US healthcare industry. This time outsourcing

won’t be the once fashionable and now dead medical transcription, but

would be more for processes like medical billing, claim processing,

disease coding and forms processing which easily gives returns of USD

16-18 per person per hour, much higher than the billing rates in other

BPO verticals.

According to a Frost and Sullivan Study, the Indian medical hardware

market (equipment and devices) is estimated at Rs 65.32 billion in 2001,

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growing at 12 per cent per annum, which is almost double the market size

in 1993.

With India becoming a healthcare destination, Health Tourism Industry,

stands at Rs 1200-1500 crores, and growing at a rate of 30 per cent

annually is bound to grow at a faster rate.

Lower production costs and skilled workforce has attracted multinationals

to set up R & D and production centres in India. In the long run these

R&D centres will help develop low-cost medicines for the Indian market.

Hospital – The Classification

There are different types of hospitals serving the multi-faceted

needs of the society. There is distinction in their structure, function and

performance. This variation is due to their distinct nature and form.

Classification of hospitals help the management to manage in a better

manner as there are many specialties of each type of hospital.

CLASSIFICATION ON THE BASIS OF OBJECTIVES

The first criterion for the classification is objective. Here the main

objective of establishing a hospital is taken into consideration. Some

hospitals are set up with the motto of imparting medical education,

training and research facilities whereas in some other hospitals, the prime

attention is on health care.

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1. Teaching-cum-Research Hospitals

These hospitals are teaching based. They are found engaged in

advancing knowledge, promoting the research activities and

training the medicos. As for example, All-India Medical Institute,

New Delhi, Post-Graduate Medical Education and Research

Institute, Chandigarh, etc…

2. General Hospitals

The general hospitals also offer teaching and research facilities but

these objectives are secondary. The main objective in the general

hospitals is to provide medical care. As for example, different

medical colleges and district and sub divisional hospitals.

3. Special Hospitals

The main objective of special hospital is to provide specialized

medical services. These hospitals concentrate on a particular organ

of the body or a particular disease. These are multispeciality /

superspeciality / criticare type of hospitals.

Hospital

Teaching cum research

General Hospital

Special Hospital

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CLASSIFICATION ON THE BASIS OF OWNERSHIP

1. Government hospital

The government hospitals are owned, managed and controlled by

the government whereas the semi-government hospitals are found

acting as an autonomous body.

2. Private hospital

These types of hospitals are owned privately and have no

government interference. They provide quality service to there

customers. These hospitals are internally managed.

3. Trust run hospitals

These types of hospitals are under control of the trust and all the

decisions related hospitals are taken by trustees of the hospital

CLASSIFICATION ON THE BASIS OF MEDICINE

1. Allopathic

2. Ayurvedic

3. Homeopathic

4. Others

Hospital

Government Hospital

PrivateHospital

Trust run Hospital

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CLASSIFICATION ON THE BASIS OF SIZE

On this basis, there are variations in the size of the hospitals. As

such, the teaching hospitals generally have 500 beds, which can be

increased according to the number of students. The district hospitals

generally have 200 beds, which can be raised to 300 depending on

population. The teshil / taluka / sub-divisional hospitals generally have 50

beds that can be raised to 100 depending on population. The primary

health centers generally have 6 beds that can be raised to 10 beds.

Hospital

TeachingHospital

District Hospital

Tehsil/Talukasubdiv

isionalHospital

Primary Health Centres

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Identification of Activities at Hospitals

While designing the organisation structure, management must

identify the various activities to be performed in order to achieve the

organizational objectives. The major objective of hospital organisation is

“care of sick” for which it requires some basic activities on its medical as

well as no medical (managerial) side.

On medical side it requires clinical activities, general surgical and

specialized surgical activities, anaesthesiological activities, maternity

activity, nursing activity, pathology and other laboratory activities,

radiology activities, pharmaceutical, dental, dietary and house keeping

activities are:

Medical care is the major function of hospital organisation. Some of

the major medical activities are:

MEDICAL SERVICES:

The medical staff doctors are the

back bone of hospital organisation.

Doctors may be classified under three

categories:

Highly professional - specialized

doctors, Honorary specialized doctors

and General Doctors) with some / no experience and no specialization

in any branch of medical science).

Highly professional, well trained and experienced doctors are the real

asset of hospital organisation general duties of doctors include

diagnosis of illness or state of illness, instruction to patients,

instruction to nurses or the matron about the patients needs by way of

medicines and other facilities, consulting the medical record of

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patients, consulting the other doctor or doctors regarding the patients

and all the activities which are deemed to be an element of medical

care.

The head of the institutions is also a doctor having specialization in

one of the medical areas. But a man may be a first class surgeon or

physician, but that does not necessarily make him a first class

administrator. His duties as doctor itself are very hard and tiring both,

physically and mentally.

A apart from this, the head of the institution has to look after so many

other things such as supervision and control over personal, purchasing,

storekeeping, kitchen, laundry, toilet, maintenance of equipment and

instrument etc,. Hospital abroad now has a cadre of hospital

administrators who combine some knowledge of medical system with

sound management principles.

CUSTOMER CARE DEPARTMENT

This is the department which

has direct interface with the

customers either physically or over

the phone. This department acts as a

single source for a customer in the

hospital and is the basic entry and

exit point for anybody who visits the

hospital for any service. The customer care department functions as a

centralized information, registration and billing area. Thus patients and

relatives know that they have to visit just one place for all their queries

for any of the services available in the hospital.

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The core functions of the department are:

Providing information on the hospital, the services offered, doctors,

package charges, etc. to the patient and relatives

Telephone operating, organizing OPD appointments for all in-house

and visiting doctors, handling admissions, cath labs, report dispatch

etc.

NURSING DEPARTMENT

Nursing services form an integral

part of any hospital. Nursing is

both art and science and it’s a

profession that calls for commitment,

maturity (emotional) and an ability to access and

synthesize information quickly and correctly. The nursing staff acts

as abridge between doctor and patient.

Nursing department works through nursing staff that is competent

and humane in its functioning. The staff provides assistance to doctors to

carry out treatments efficiently. The nursing staff works in operation

theatre, intensive care unit, surgical intensive care unit, intensive cardiac

care unit and out patient wards and rooms.

Normally nurse patient ratio is maintained at 1:1 in ICU, ICCU and

SICU while in other clinical wards it is headed with one head nurse with

30-35 nurses.

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CENTRAL STERILE SUPPLY DEPARTMENT (C.S.S.D.)

Infection control is the major activity in the hospitals. CSSD works

towards infection control by ensuring medical or surgical supplies and

equipment that are cleaned, sterilized, stored and issued for patient care.

CSSD uses auto clave machines for steam sterilization, E.T.O (ethylene

oxide) sterilizer for cleaning and disinfecting.

CSSD provides sterile instruments, linen and dressing materials for the

various invasive and non invasive procedures to be carried out during

treatment of patients.

DIETETICS DEPARTMENT

The meal for a patient has an important role in treatment plan. The

dietetics department prescribes and provides well planned meals to

patient in accordance with there therapeutic needs. Dietetics department

also does counseling of patients to adapt and incorporate dietary

modification in their daily routine to promote better health status.

Dietetics department acts as a link between the dietary prescriptions given

by the doctors and the likes and dislikes of the patients. It monitors and

executes the therapeutic diet orders through Foods and Beverages

services.

PHARMACY DEPARTMENT

It is the area of increasing

importance. This department is often

combined with central sterilization and

stores. The staff has to be well trained

and has to be looked after properly at all

levels by the pharmacists.

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The role of hospital pharmacy in ensuring proper care in

preparation, labeling, storage and distribution of drugs and sterilized

material is of prime significance. Avoidance of any kind of error is the

most important here. A hospital in modern era cannot do without good

and qualified a pharmacist, who has to supervise, guide and control the

performance of its subordinates.

Quality control is and important need in this area and hospital structure

should encourage and provide all the facilities to the pharmacists in

organizing it

PATHOLOGY DEPARTMENT

The pathology department provides valuable services in the

diagnostic areas through various tests.

The department has various sections such as Biochemistry, Hematology,

Serology and Microbiology.

The pathology department conducts following tests:

Routine and special tests in Hemet

Routine and special tests in biochemistry

Hormone Assays

Drug levels

Infection Serology markers

DEPARTMENT OF RADIO-IMAGING

Radio imaging department plays a vital role in diagnostic work-up

of every patient. The department has all advanced modalities/machines

available to perform the Radio imaging for diagnostic purposes.

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The modalities which should be available with the department are as

follows:

Conventional Radiography

Sonography

CT

MRI

Mammography

HOUSE KEEPING DEPARTMENT

Their major focus is house keeping i.e. to maintain high level of

cleanliness and hygiene conditions in such a way only essential things are

kept and its easiest and fastest accessibility is ensured. It is a systematic

for better work place. It assigns a place for everything and ensures

everything in its place it is a starting point for every improvement

activity.

The benefits received by house keeping: -

Person feels happy while working in clean place

Searching of matter is not required

Less rework in the work is resulted

More productive space available

Anything abnormal is seen immediately

Productivity improvement takes place

Avoids accident prone environment

OUTPATIENTS SERVICES

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Out patients services constitute one of the important functions

which most hospitals under in their areas encompassing attention to those

patients who may not require use of a bed. Generally hospital beds are not

available in sufficient numbers, nor are they indicated for all those who

need diagnostic services. Beds are costly to build and maintain, and it is

often economic waste to utilize inpatients cure when out patients services

would serve the purpose.

The emergency clinic is major unit of the out patient department. Here

the attention to the patients needs must be available around the clock,

every day of the year.

ENGINEERING SERVICES

A hospital is described by some administrators as a ship at high

seas. Almost all kinds of emergencies that arise in a ship are required to

be attended to in a hospital. Sudden failure in some of the installations in

operation theatre I.C.C.U, Kidney units etc. can seriously jeopardize the

life of patients. Here some hospitals administrative have advised

experience marine engineers in hospitals. These engineers possess the

know-how to deal with sudden situations that arise and have to be dealt

with without outside help.

WARD SERVICES

Ward is the heart of the hospital where the patients are kept. The

major objective of the hospital is to take care of the sick and injured.

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Other purposes are research in medical field, training and teaching of

medical nursing and many other personnel. All these functions are carried

out mostly in ward or depend on those personnel who spent most of their

time in wards.

FIREFIGHTING, SECURITY AND SAFETY

Hospital can be victim of fires, theft and accidents. While the first

can be dreadful situation for the sick and other relatives, the second and

third would result in indiscipline, dissatisfaction and poor and bad image

of the hospital. In order to solve these problems it is advised to have a

separate section for this as the training, duties and requirements of the

staff in emergencies are quite different from other personnel. They are

like the ‘armed forces’ having special and important role to play.

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Wockhardt’s

achievements

24th largest wealth creator

Ranked amongst the 50 most valuable companies in India

Rated among the Top 10 emerging Corporate in India (Economic

Times, 1999)

Wockhardt employs 2700 people of which more than 1300 constitute

the field force covering 1, 50,000 Doctors

35% of total sales come from International Business

Listed on Bombay Stock Exchange, National Stock Exchange and on

Luxembourg Stock Exchange

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R&D programme rated among the top 3 in the country with R&D

spend of 7% of sales - one of the highest in the country.

Managed by the "Best" Board of Directors in the pharmaceutical

industry (Source: Business Today, May, 1997 survey.)

"Pursuit of growth with excellence in the field of pharmaceuticals and

healthcare" Profitability through:

Quality of products and services

Increasing investment in R & D

Competent scientific and managerial manpower

Salient features

A very spacious hospital with carpet area per bed of around 1100 sq.ft.

A 222 bedded hospital, which includes 100 Intensive Care beds, with

all its services.

Highest Nurse: Patient Ratio of 1:5 due to which they are better

equipped to handle patient's complex health conditions. This is one of

the highest nurse patient ratios in India.

The management comprises of highly qualified professionals, who

have brought with them rich experience which enables the hospital to

be run on truly professional lines.

Central Music System.

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Central Paging System.

Central Fire Detection with interlined Central Sprinkler System.

Well controlled & safe climate with soothing ambience are special

features of the hospital.

100% standby power backup for the hospital with critical areas like

Operation theatres and ICU further backed up with UPS.

Linen and Laundry Services

A high class Cafeteria on Level 3

A well setup Chemist Shop.

Ambulance services.

Fully computerized system with high end Application Servers &

Backup Servers.

Wockhardt-Harvard Medical Alliance

In pursuance of its vision to establish state of the art medical facilities in

India with high degree of clinical excellence Wockhardt Hospitals has

entered into an alliance with Harvard Medical International (HMI).

Harvard Medical International is a self-supporting subsidiary of Harvard

Medical School, which is developing a Wockhardt Healthcare System

that sets its own unique standards in patient care in this part of the world.

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Harvard Medical International (HMI) “a non-profit organization” was

established to extend Harvard Medical School’s tradition of improving

the quality of health care through excellence in clinical medicine, medical

education and biomedical research. Adhering to the standards that have

made Harvard one of the most respected academic medical institutions in

the world, HMI utilizes the talents of the Faculty of Medicine, its

affiliated institutions and selected strategic partners. It has an extensive

knowledge base in clinical and biomedical research.

Drawing upon the resources of Harvard Medical School and its affiliated

institutions, HMI is creating unique programs for Wockhardt hospitals

committed to high quality healthcare. The guiding principles used by

HMI in this relationship are to maintain medical integrity, objectivity and

academic independence.

Harvard Medical International will associate with Wockhardt Hospitals in

improving patient-centered quality care particularly in the areas of:

Facility development

Leadership development

Nursing excellence

Clinical education and clinical investigator training

Quality management

Adapting to managed care environment

Organizational strategic planning and development

IT strategies and provider network development

Faculty development and leadership programs

Quality management and accreditation of systems

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Research program development

Joint National symposia on topical issues

Another significant endorsement for Wockhardt Hospitals is its tie up

with many global health insurance giants. Wockhardt Hospital is the first

recognized hospital in South Asia on the worldwide panel of Blue Cross

Blue Shield, the largest provider of health insurance in USA. The list of

tie ups includes:

Blue Cross Blue Shield Association, USA

Bupa, UK

AEA International Inc., Singapore

Global Emergency Services Inc., USA

Medex Inc., USA

Global Medical Management Inc.,USA

Assist America Inc, USA

Gesa Assistance, Singapore

Technology

The Wockhardt Hospital provides you with the new generation cutting

edge medical technology and the world-class quality treatment with

care. We possess advanced state-of-the-art

facilities and infrastructure benchmarked with

the best hospitals in the world.

Cutting edge technologies include:

New generation Cardiac Cathlabs with Electrophysiology Labs

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Operation Theaters designed to global standards

Sensation 10 CT Scanner

Functional MRI with Spectroscopy

OPMI MultiVision, a new generation microscope used for Neuro

navigation.

Suite of Endoscopes for Minimal Access Surgery and Arthroscopy

Lithotripsy

Modern Kidney Transplant Units

Intravascular Ultrasound

High Technology Dialysis Units

Cutting-edge technology for Anterior and Posterior segment

Ophthalmic surgery

Key Expertise

Wockhardt Hospitals has conceptualized unique facilities and services,

some of which are pioneering global achievements in hospital services:

1. Virtual Family Visit

2. Life Link

3. Health Angel

4. Monitor Your Patients Live

5. Wockhardt Cardiac Line

6. Touch - Screen - Kiosks

7. Specialized Services In Urology, Gastro-Entrology and

Ophthalmology

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8. Laboratory and Imaging services

9. Intra-ocular lens implant and phaco-surgery for Cataracts

10.A state-of-the-art Dental Department

11.Annual and pre-employment check-ups

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Wockhardt hospitals prospective employee should have

exposure in different facets of HR, viz

Competency based recruitment and selection

Competency based training and development

Competencies and performance management system

Creating a culture of competence

Industrial Relations

HR Processes

IT & HR integration

Organization Development

Being a service sector there is no particular product but for them their

service is the product for marketing. They strive to create a culture that

supports empowerment, continuous improvement and customer

satisfaction. There is no such thing as a quality problem but it has

opportunities to improve.

For the quality improvement they have some measures such as customer

feedback forms (taken from patients) on which they work upon for

further improvements.

Some principles followed by Wockhardt Hospital for betterment of total

quality management: -

Customer is the ultimate determinant of quality. Services and

programs are designed with the need of the customer in mind.

Quality is build into the process from the beginning, and not

simply derived from customer complaints. All level of an

organization is involved in producing the quality product and not

just tries to modify it before delivery.

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When customers are assessing quality, they are not simply

comparing us to our performance last year, but to every other

organization that is serving their needs.

Since improved quality comes from improvement during the

processes leading up to the delivery of the service, all levels and

divisions of the organization is involved in developing quality.

Quality Management of Wockhardt

Hospital

Customer focused organization: - It depends on their customers, and

therefore need to identify and understand their present and future

needs in order to be able to meet requirements of customers and strive

to exceed them.

Leadership: - Management is not an administration activity; leadership

is needed to provide unity of purpose and direction, and to create

environment in which people in an organization become fully

involved in achieving the organization’s objectives.

Documentation and Record Keeping: - Important papers related to the

service are maintained with care and their records are kept

systematically.

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Involvement of People: - People’s co-operation and involvement

allows their abilities to be fully and effectively used towards benefit of

an organization.

Systematic approach to management: - Identifying, understanding and

managing a system of interrelated processes for achieving objectives

contribute to effectiveness and efficiency of an organization.

Improvement as a regular practice: - It is a permanent objective of an

organization.

Factual Approach to Decision Making: - Effective decision is based

on the logical and intuitive analysis of data and qualitative

information.

Supplier Relationship: - Relationship between the organization and its

suppliers has to be mutually beneficial that will enhance the ability of

both organizations to add value.

37

Introduction

The Employees' State Insurance Corporation (ESIC) of India is one of the

largest social security organizations providing medical insurance cover

and delivering of medical care to 35 million beneficiaries through 140

hospitals and 1500 dispensaries. The objectives of this study are to

understand the costing of medical care at ESI hospitals and suggest

systems for e-governance to facilitate the coordination between ESIC,

ESIS and the beneficiaries. Towards this, selected a large ESI hospital,

namely, the ESI General Hospital at Bapunagar, Ahmedabad and gained

very useful insights about the systems currently in practice for offering

medical benefits to the insured persons and their beneficiaries. This

working paper brings out our detailed analysis of the working of ESI

hospital, Bapunagar in delivering medical care under the ESI scheme.

38

On papers, the ESI Corporation appears gigantic with 140 hospitals

spread all over the country; boasting a capacity of 26,000 beds and

employing 14,000 doctors and 45,000 paramedics. More than 3.5 crore

people are covered under the ESI scheme with annual revenue of a

whopping Rs 1,510 crore. Despite this, the scheme has been largely

unable to provide quality healthcare services due to poor infrastructure,

cumbersome procedures and lack of professionalism.

Though a massive premium is collected under the scheme, hardly 16-18

per cent (around Rs 244 crore) of the revenue is spent on the

beneficiaries. Three TPAs Chennai-based Apollo Hospitals, Mumbai-

based Sedgwick Parekh Health Management Services and Pune-based

ICAN Medicare Pvt. Ltd have made a bid for the scheme, it is learnt.

Each TPA is said to have presented a different model which the

Corporation is looking into. ‘‘It is definitely a positive sign that at least

our proposals are being considered,’’ says George Mathew M, managing

director, ICAN Medicare.

The Labour Ministry has directed the Employees State Insurance

Corporation, ESIC to set up a model Hospital with modern computerized

facilities and services in each state. He said that ESIC is going to make

ten of its hospitals totally computerized in the near future. The

Corporation would also establish two to three hospital of specialized

nature for treating Cancer, Kidney and Coronary diseases. Shri Yadav

said that he would have no objection to open 50% of occupancy of such

hospitals to general public on payment basis in order to run these

hospitals efficiently. The Labour Minister also disclosed that his Ministry

is making a proposal to take back such ESIC hospitals which are not

reportedly run by the State Governments properly. ESIC is at present

39

managing 9 of 140 hospitals directly. Shri Yadav said that the coverage

of the ESIC is not enough and should be extended to bring in more

workers within its ambit.

    Expressing concern over the lack of social security to a majority of

workers in the unorganized sector, Shri Yadav said that we will have to

look for necessary umbrella security cover to them. He said "the umbrella

legislation will aim at providing protection to agricultural workers,

construction workers, home-based workers, beedi workers, self

employed, artisans and craftsmen. Shri Yadav said that 92% of the 40

crore workers are in the unorganized sector and the Labour Ministry has a

tremendous responsibility in looking after the interest of the workers who

constitute 40% of the country’s population

ESIC India 2004-2005

Number of state covered 25

No of implemented center 687

Employers 2.54 lakhs

Insured person 79.10 lakhs

Insured women 13.40 lakhs

Beneficiaries 307 lakhs

Regional/ Sub Regional offices 38

Branch/pay offices 808

ESI hospitals 143

ESI annexure 43

ESI Beds 27099

40

Specialists 322

ESI Dispensaries 1452

Insurance Medical Officers 7100

Insurance Medical Practicener 2511

Out patient attendance 8 Crores

Inpatients 4.5 lakh

Income for 2003-04 1,97,564.00 lakhs

Expenditure for 2003-2004 1,17,048.00 lakhs

41

Model Hospitals

42

To ensure that there are proper secondary care facilities for the

beneficiaries, the E.S.I.C has decided to set up one Model Hospital in

each State. The proposed Model Hospitals are being identified out of the

existing Hospitals to provide all modern infrastructure facilities, staff and

equipments as per E.S.I. norms and to act as referral hospitals for the

entire State to provide state of art secondary care services.

The Model Hospital will have all general specialties along with support

services of Radiology, Laboratory, Store and Pharmacy, Operation

Theatres, Medical Records, Dietary services, Laundry, CSSD,

Engineering services, Ambulance services, Telephone, house keeping,

horticultural development works, waste management systems, facility for

training, Library etc. To facilitate community services, staff

accommodation, cafeteria, parking areas, recreation facilities etc., shall

also be provided. To start with, staff to manage these hospitals will be

made available on deputation from the State Government for an initial

period of 3 years. The details of the Model Hospitals have been circulated

to all the State Governments for accord of consent for specific hospitals

to be developed as Model Hospital based on accessibility for beneficiaries

and availability of staff. The State Governments of A.P., Bihar, Orissa,

Tamil Nadu, U.P., H.P., Punjab, Kerala, Rajasthan and Gujarat have sent

their consent. To ensure proper functioning, quality assurance programme

will be instituted to monitor the functioning of various activities of the

Model Hospitals.

Recruitment and selection

43

Recruitment and selection were as per the guidelines for Central

Health Services. Being an autonomous body, the process of

recruitment and selection was conducted by the organization, and not

through the Union Public Service Commission. An average

recruitment cycle for the recruitment of medical officers took one and

a half to two years to complete with no certainty of the successful

candidates joining the organization. The respondents (doctors) felt

that this could be shortened by adhering strictly to the established

protocols for speeding up the process.

Performance appraisals

The performance appraisal was done on the basis of annual

confidential reports (ACRs). Nearly half of Insurance Medical

Officers (IMOs) and specialists felt that the reporting and the

reviewing officers usually did a “generalized/subjective” reporting

than a “customized/objective” appraisal and reporting in the absence

of output indicators. The role of the reviewing officer was unclear,

since he/she was too far away and not really associated with the

manner of working of the individual being reported upon. It was felt

that this mechanism sometimes results to identical appraisal between a

non-optimal and an optimally performing worker. This was a major

concern for the respondents. Also identified gaps were practically not

followed up for remedial action. These perceptions have the risk of

transforming as demoralizing and de-motivating factors for an

efficient employee.

44

Training process at ESIC hospitals

Induction training– The Regional Office of the ESI Corporation

conducted this training. Content areas were informally

communicated by headquarter.

Promotional training– No formal promotional training was

conducted for doctors. The respondents felt that unlike the

induction training program where a reasonably accurate figure was

not available regarding the training load, for promotional training,

the same could be calculated on a yearly basis and an appropriate

calendar for formal training could be drawn up.

Orientation training– Requests for such trainings were processed

as per the guidelines of the existing training ‘policy’ document.

Regarding other trainings deemed appropriate by the authorities,

information regarding the personnel to be sent, the timing of the

training was communicated to the individual through his/her

immediate superior for compliance.

45

46

Introduction

Bombay Hospital and Medical Research Centre

- an institution in itself

Mumbai, the centre for quality medical care not only across India,

but also the South Asia. A city that has a rich medical history. Situated in

South Mumbai is the Bombay Hospital and Medical Research Centre, the

medical hub of India's biggest metropolis.

Established over five decades ago, in 1952, The Bombay Hospital

was the result of the enormous philanthropy displayed by Shri

Rameshwardas Birla, Founder Chairman of the Bombay Hospital Trust. It

began as a 440 bed hospital whose objective was, in its founder’s words,

“to render the same level of service to the poor that the rich would get in

a good hospital.”

Today, the hospital has grown to house over 830 beds, some of the

country’s most advanced diagnostic & surgical equipment, and offers a

comprehensive range of specialized medical services. The objective

however, remains unchanged. This is why 33% of the patients treated are

in the general ward and pay only for their medicines and consumables.

The free OPD at the hospital successfully treats in excess of 1,00,000

patients each year.

Ever since it was established in 1952, the Bombay Hospital has

instilled in its patients a sense of genuine trust. Trust that has been built

by combining superior medical treatment with a caringly humane attitude.

Which is why, in excess of two lakh people confidently walk through its

hallowed doors every year, year after year.

47

It is on this sound foundation that the hospital has based its pursuit of

excellence in every field of medical specialization. This has seen fruition

in the form of the Medical Research Centre now known as the M P Birla

Medical Centre.

The Bombay Hospital presently ranks among the finest multi-

specialty tertiary level medical centers in the country. The internationally

renowned panels of doctors and consultants in every field of

specialization have, at their disposal, cutting-edge equipment. Supported

by a highly trained and professional nursing staff. Little wonder then, that

the Bombay Hospital attracts patients from every strata of society. Be it a

factory worker from rural India, a high-flying executive from a multi-

national company or the likes of former Prime Minister and Governor of

Maharashtra.

The Bombay Hospital has 830 beds, of which 300 beds are free

and another 200 beds are heavily subsidized. About 60% of the

operations performed by our surgeons are free or against very nominal

charges.

On this bedrock of charity relentlessly building the bedrock of

excellence in the Hospital by continuously refurbishing its spaces,

installing the most modern medical equipment and injecting

professionalism and dedication in management team, so that world class

doctors can discharge their duties and responsibilities in an academically

stimulating and hassle-free environment.

48

A patient being treated in one of the many

Deluxe Rooms of the hospital

A quick glance at Bombay Hospital and Medical Research Centre

4 buildings with 5,00,000 sq. ft.built up area

Total number of beds: 830

Critical care and recovery area: 110 beds

22 operation theatres

3200 full-time employees

240 eminent consultants

200 skilled resident doctors

R D Birla International Cardiac Centre

The country's latest Coronary Artery Bypass Grafting Complex

35 recovery rooms

4 dedicated operation theatres

Two cath labs & angiographies

1800 surgeries and 4000 angioplasties & angiographies conducted

every year

Department of Neurosurgery and Neurology

Capable of treating all types of brain tumors and spinal surgeries

4 dedicated operation theatres

18 post-operative beds in the recovery room

Equipped with operating microscopes, CUSA

49

Department of Orthopedics

Complete hip/knee/shoulder/elbow replacements done

5 dedicated operation theatres

Spinal corrective surgeries performed

Trauma care centre

Department of Cancer

Surgical treatment

Radiation therapy

Chemotherapy

Comprehensive cancer care

Other areas of specialization

Plastic Surgery

Pediatrics

Medical oncology

Ophthalmology

Dental Care

General Medicine

Supportive Facilities

M P Birla Library

Museum

S P Jain Auditorium

Birla Matushree Sabhaghar

Nurses Training Institute

Pharmacy

Executive Health Scheme

50

51

Vishal Bali (Vice President-Operations Wockhardt Hospitals)

How do you assess the impact of corporate hospitals on healthcare

sector?

There has been a sea change in accountability and today’s managers

realize that it is equally important for their institutions to excel both in

clinical arena as well as delivering consistently on patient service

expectations.

How different is running a corporate hospital from a trust hospital?

The style of management will always be different primarily because the

methodology for both is different. While the decision making in a trust

hospital takes into interest the divergent opinions of various trustees, the

corporate hospital will have a faster decision making process for it gives

higher accountability to the operating team.

How different is Indian pattern of hospital administration as

compared to the west?

The administration systems of corporate hospitals in India compare

favorably to those of the hospitals abroad primarily because the hospitals

here have adopted a leaning system from the West and have a constant

exposure to those facilities.

We need to basically improve and make a differentiation that

administration is not the same as managing the hospital. Our systems

need more and more managers rather than administrators.

52

How has hospital administration in the corporate sector changed?

There has been a sea change in the accountability and today’s managers

realize that it is equally important for their institutions to excel in the

clinical arena and delivering consistently on patient service expectations.

As enterprise expands what will become critical is that the healthcare

system speaks a common language irrespective of the specialties.

What is the pattern of administration for Wockhardt?

All our hospitals are professionally managed by group of professionals

who are both by education and by experience experts in the field of

hospital management.

Wockhardt is associated with Harvard Medical International (HMI).

Do you in some ways follow the administrative pattern of HMI?

Wockhardt’s association with HMI has benefited us immensely in setting

systems in the clinical and administration which conforms to the standard

followed by Harvard Medical School. What has emerged is a focus on

training and education on an ongoing basis within our healthcare system.

53

How to make THE RIGHT INVESTMENT DECISIONS while

planning a hospital project?

Making right investment decisions while planning a hospital project is

crucial to its long-term sustainability. This is because; project costs

directly influence the pricing strategy of services. There have been

numerous instances of budgeting going haywire leaving the poor patients

(who often have no choice) to foot the bill, say consultants. To steer clear

of a negative balance sheet, budgeting time and money right at the

conceptual stage of building a hospital is essential, feel experts.

Hospitals are in red because their investment plans are not based on

budgetary allocations for different infrastructural areas, says Dr C P

Kamle, an international associate of American Institute of Medicine

and Hans Finne International. A botched hospital project may have

several reasons for failure.

Broadly, project costs can be split in the ratio of 60:40 for construction of

the building and capital expenditure towards equipments respectively.

Alternatively, it could be 40 per cent for building; 40 per cent towards

equipments; 10 per cent towards operational expenses; and the rest for

human resources. This later model was followed in the case of Apollo

Indraprastha hospital in Delhi.

Project analysis

Dr Kamle says 3-4 percent of the total budget should be allocated for pre-

project analysis. “It is necessary to spend on preparing a good techno-

feasibility report, which will also have competitor’s structure, disease

pattern, and SWOT analysis of hospital”. Experts say a sound project

analysis can facilitate acquisition of finances on softer terms. “I have

54

come across cases where promoters have copied reports from other

hospitals. The result is that banker is reluctant to fund as there is a

question mark on project feasibility. This delays the project further and

also increases the costs,” explains Dr Kamle. Concurs Dr Kothari,

“Financial feasibility report must work like a bible and project finances

must be tied up accordingly. Project management is all about completing

with quality and containing cost.” What is also essential is frequent

project assessment, he adds.

Infrastructure

Dr B V Venkatesh, administrator, HOSMAT hospital, Bangalore says the

process of budget allocation for hospital infrastructure is two fold. A

hospital has to allocate 70 per cent of its budget for good quality

infrastructure. Quality infrastructure will definitely reduce the

maintenance cost in the long run.

Land cost

According to Dr Kamle, land should not be bought anywhere simply

because it is cheap. Water availability, soil, air direction, natural sunlight,

etc, have to be taken into consideration, he says. “For example, if ample

sunlight is not available, one has to go for artificial illumination, which in

turn increases initial plus recurring costs, not to mention that natural light

aids speedy recuperation.” Land cost should come within the five per cent

limit of the total investment, says Dr Praneet Kumar, head, strategic

planning, Fortis Heart Institute. “In Mohali, Fortis spent eight to nine per

cent of the investment (Rs 13.5 crore) on land acquisition. This high price

would also affect the pricing of services.

55

Medical equipment

Allocation for medical equipment generally accounts for 30-40 per cent

of the total cost. Experts say it is very important to stick to the allocated

figure. However, this is hardly the case. “Not more than 10 per cent of

people think of budgetary allocation while shopping for equipments.

Most buy them because it is a fad to install sophisticated equipments.

This is also true for implementing process management tools,” says Dr

Kamle. Having said that it is important to realize that at these competitive

times, it always pays to acquire cutting-edge technologies. Apollo Delhi

ploughs back 80 per cent of its revenue every year in to technology up

gradation, according to managing director Dr Yogi Mehrotra. Similarly,

Wockhardt Hospitals, Bangalore spends around Rs 1.5 crore every year.

Says Dr M E Yeolekar, dean, Lokmanya Tilak Municipal General

Hospital, “In up gradation of equipments, departments like cardiology,

orthopedics, obstetrics, gynecology, radiology and diagnostic are given

priority since there is a high turnover of patients here. Hospitals tend to

discourage purchase of expensive equipment with limited utility.

Equipments for rare disorders always take a backseat. Funds are

canalized in buying equipments, which serve multiple departments and

for diverse ailments. For instance, a C-Arm serves the departments of

surgery, orthopedics and different other sub-specialties.”

56

Human resources

Human resources form a most important link in hospital management.

This function accounts for 12-18 per cent of the project cost. Here again,

hospital adopt different strategies. The popular one is to lure specialists

from other competing hospitals. This, feel experts, could be detrimental

in the long run since the sense of ownership is lost in financial

bargaining. Dr Kamle feels that hospitals should employ full-time

specialists and encouraging them by providing remuneration along with

perks and foreign trips proportionate to the work generated for the

hospital. This, say others, will instill a sense of ownership in their minds

resulting in overall growth in business prospects.

Operations

While running a hospital, methodological calculation of economics must

be the norm. “Profit centre mechanics demands that each department be

converted into a profit centre. Profit does not mean commercialism. The

money has to be ploughed back in so many ways like salaries, up

gradation, maintenance etc. Even a front office or house keeping gives

profits, though intangible,” explains Dr Kamle. “For instance, in case of a

department like radiology, depending on investment, costing is done,

revenues are calculated and budget is allocated on the basis of this

projected revenue. The head of department must be then entrusted with

the budget and is responsible to run it profitably,” he elucidates.

Lokmanya Tilak Municipal General Hospital, with 1400-odd beds spends

around Rs 3.5 to 4 crore annually on its infrastructure maintenance.

Dr C P Kamle,

57

Future prospective

In order to capitalize on all these opportunities, we have to create a

conducive environment by:

Attracting investment

Granting infrastructure status to the healthcare sector.

Create fiscal policies, like providing low interest rate loans,

introducing tax holidays for investment in low per capita income

states, reducing import/excise duty for medical equipment, et

cetera, to promote investment in healthcare services.

Facilitating various clearances and certification like medical

registration number, building number, anti-pollution certificate etc.

Changing the legislation

Mandating the employers to buy group or individual medical

insurance for their employees to ensure a certain minimum

financial coverage.

Mandating the private sector units, that takes advantage of

improved fiscal policies, to commit resources to remote rural/under

developed sectors.

Create an autonomous body to standardize on medical messaging,

codes and vocabulary, content and format, identification standards

and security.

Mandate the healthcare service providers to transmit selected

patient data to the government for analysis. This data will be

analyzed to identify trends and evolve policies.

58

Create a national database of health care providers, their facilities

and services. This will create awareness among the population

towards quality health care.

Streamline the process of handling patient grievances.

Create a nation-wide agency to deal with patient requests like

ambulance hotline, emergency/first-aid consultation, trauma help-

line etc.

IT initiatives

Sharing of patient information between providers, with patient and

payers.

Security and privacy services.

Need for standards for messaging, codes and vocabulary (CPT,

ICD), content and format standards (MR, lab report)

To witness a successful revolution in healthcare, we need to bring these

arrays of activities together. If this works for India over the next decade,

the vast population living in rural and urban areas will bear the fruit of

success

59

Eight steps towards building a world class facility

hospital

Hospital management is totally different from managing any other

property. Be it hotels or corporate buildings the plan and purpose of their

infrastructure is totally different from that of a hospital. The following are

some of the tips that hospitals must keep in mind to erect a hospital with

an effective infrastructure.

Location

Building a hospital is not an easy job. If there is one thing that the

industry agrees on, it is the fact that clients or ‘patients’ who come to the

hospital are not there out of choice. They visit a hospital because they are

forced to do so. In this scenario the first thing that I would look at before

setting up an infrastructure is the location of the hospital. The property

must be accessible to people from all walks of life. Unlike certain

industries that cater to the rich who can afford their own mode of

transportation, hospitals must be accessible to everyone. This location

should be one that can be permanent since people associate a hospital

with a location.

Vehicle Parking

The second thing that I would look at is the space for vehicle parking.

Though most of our hospitals are in the main road we try to set up our

property where we are also connected to a small lane wherein people can

park their vehicle. Setting up our properties in L-roads reduces the trouble

for the patients to search for vehicle parking.

60

Building

Building is another major area that one needs to look at carefully before

setting up a hospital. The facility for outpatients must be different from

those of the in-patients. Outpatients might bring in infections with them,

which might spread to the inpatient that has undergone an operation.

Hence an inpatient area must be accessible only to the inpatients.

Construct the hospital in a way that the two need not any time have to use

the same area.

Operation theatre

Gone are the days when loved ones of the patients waited outside eagerly

to know how an operation went on. All our operation theatres have an

observation gallery from where attendants can watch and see how the

operation proceeds. This way they would know exactly what was

happening in the room, which increases the awareness of operations

amongst the general public. At present this is being implemented in a few

hospitals but as awareness increases patients would look for a hospital

that is transparent. So while building a new hospital it is best to build it

according to the latest standards and guidelines though you might spend a

little more. Another facility that could be included is to be able to talk to

those in the observation gallery right from the operation theatre. This

further reduces their fear and assuring that the doctor is in touch with

them.

61

Equipment

Remember that a hospital is not a five star hotel. We need 5-star doctors

with good surgical skills. People do not come to the hospital for its

ambience. They come because of the efficient staff and the equipment

handled by them. While it is very important that your hospital is hygienic,

clean and comfortable it would be foolish to make it look like a 5-star

hotel and hike the prices.

Monitoring activity

Monitor every activity that happens at the hospital. In our hospital we

have cameras in the operation theatres and I an able to see what happens

in all the four operating theatres. A television is kept in the outpatient

area where they can also get a feel of what happens at the hospital. This

kind of a transparent atmosphere eases any fear.

Train your staff

The patient comes to the hospital as a last resort. When he comes in he

does not want to feel dejected further by the attitude of the staff. Hence

the staff needs to be trained to be courteous to people. Have a counselor

at the hospital that would be there for the patient both during pre and post

operation period. Our post operation counselor at the hospital dials all the

patients who have undergone the operation that particular day to ask them

how they feel etc.

62

Maintenance

Building a hospital is not over with developing infrastructure and starting

operations. The success of the property depends on constantly

maintaining and updating the facilities. Employ an effective

housekeeping department that can constantly maintain the hospital.

Appoint microbiologists to test the sterilization levels. Manage your

waste effectively. Don’t just burn them or dispose them, as they would

only pollute the surrounding areas.

The Indian healthcare industry is keeping up or even moving ahead of the

developed world. With a steady increase in population India needs more

hospitals. With increase in awareness amongst people these hospitals

need to be of world class standards to survive in the industry. What better

way to do it than to start efficiently and keep up the standards year in and

year out!

Dr Amar Agarwal

63

Conclusion

The success of hospital is usually attributed to the skills of its

doctors and nurses, but there is a club of behind the scene personnel, who

are always on toes to keep the wheels of any healthcare facility smoothly

turning. Hospital administration is all about weaving the different units of

a hospital together into a cohesive whole. Management tools play

important role in the day to day functioning of a hospital.

A few hospitals have training programmes for their staff and use

incentives to ensure that their employees function in a competent and

professional manner. There must be coordination and understanding

between various departments and this can only be achieved if the

administrative and the medical staff have tolerance and respect for each

other.

Nowadays hospitals have to be hi-tech to be efficient in their

operations. Using HIPePS (Hospital information resource planning

system) makes the hospital keep all the patient records and all

government related information under password system. Wockhardt

Hospital uses Wipro’s HIPePS. This project work has made me

understand the management of hospitals from in depth.

Before selecting this topic as my final year project I was just

having the basic idea and I wanted to get more information on this topic.

The ECONOMIC TIMES has stated the hospitals to be the next big

business and good forex earner for the country so let us wait and see the

dream and statistics come true.

64

Bibliography

www.wockhardthospitals.com

www.bombayhospital.com

www.esic.nic.in

www.healthcaremanagement.com

Healthcare issue 2003-04 (Economic Times Group)

Modern healthcare magazine

Wockhardt induction guide

Human resource development in a government health

organization: views of doctors Vivek Handa, A.K. Sood &

Rajni Bagga

Annual Report of ESIC New Delhi (1995-96 & 2002-2003)

Inserts from

Dr. Agarwal (Dr.Agarwal’s eye hospital)

Dr. C.P. Kamle (An international associate of American

Institute of Medicine and Hans Finne International.)

65