management_final project_feasibility report medex hospital-jibran

8/2/2019 Management_final Project_Feasibility Report MEDEX Hospital-jIBRAN

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MEDEXGeneral Hospital


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1-VISION:

a. Way Forward.

We will lead our industry in developing and delivering the next generation of

consumer-driven health care.

b. Superior Quality. We will pursue breakthrough medical advancements and practices todeliver superior clinical outcomes.

c. Personalized Experience. Our care will focus on our patients as individuals. We will

provide every patient an experience customized to their medical, emotional, social, and

spiritual needs.

2-Mission

We provide exemplary physical, emotional and spiritual care for each of our patients

and their families.

We balance the continued commitment to the care of the poor and those most in need

with the provision of highly specialized services to a broader community.

We build a work environment where each person is valued, respected and has an

opportunity for personal and professional growth.

We advance excellence in health services education.

We foster a culture of discovery in all of our activities and supporting exemplary health

sciences research.

We strengthen our relationships with universities, colleges, other hospitals, agencies

and our community. We demonstrate social responsibility through the just use of our resources.

3-Philosophies and Values

Our Values represent the philosophy and beliefs of our organization, guiding all of our

decisions and actions.

a. Human Dignity

We value each person as a unique individual with a right to be respected and accepted.

b. Excellence

We value quality in care, work life, education and research.


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c. Compassion

We value a quality of presence and caring that accepts people as they are and fosters

healing and wholeness.

d. Social Responsibility

We value integrity and the promotion of the just use of resources entrusted to us for

the enhancement of human life.

e. Community of Service

We value a work climate of mutual trust and harmony to enable healing, collaboration

and the fulfillment of human potential.

f. Pride of Achievement

We value our colleagues, our work and our accomplishments and take pride in bringing

our rich tradition of hope and healing to every person in our care.

4-Function of Program

HealthIn Pakistan every ninth child died before his/ her 5th birth day due to Malnutrition

(Imbalanced diet), (WHO survey 2009). During past three years growth rate of diseases

in children is approximately 60% percent due to lack of hygienic factors & polluted

atmosphere. But growth rate in hospital industry is just 15%, the reason is that there is

no technological advancement in hospital industry.

In private or public sector there is no single hospital is situated in Raiwind, match with

our standard & caliber. So, no direct competitor is there but some indirect competitor

have established their clinics and doing practices.


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5-Work Flow

HOSPITAL WORKFLOW AND MATRIX STRUCTURE


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i. Workforce no of persons

Doctors

Physicians 5 Medical officers (M.O) 10

Anesthetic specialist 2

Pharmacists 14

Neurosurgeon 2

Pathologists 2

Psychiatrists 2

Paramedic staff:

Nurses 25

Dispenser 15

Operation thither assistant 8

Laboratory assistant 4

Office Administration:

Administration 10

Accountant 3 Human Resource Personal 3

Procurement 2

Accounts Office:

Accounts Staff 5


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ii. Organizational StructureOrganizational Structure refers to levels of management within a hospital.

Levels allow efficient management of hospital departments.

The structure helps one understand the hospitals chain of command.

Organizational structure varies from hospital to hospital.

Large hospitals have complex organizational structures.

Smaller hospitals tend to have much simpler organizational structures.

Grouping of Hospital Departments within the Structure:

Hospital departments are grouped in order to promote efficiency of facility.

Grouping is generally done according to similarity of duties.

Common Categorical Grouping:

Administrative Services

Informational Services

Therapeutic Services Diagnostic Services

Support Services

Administrative Services

Hospital Administrators

CEO, Vice President(s), Executive Assistants, Department Heads

Business people who run the hospital

Oversee budgeting and finance

Establish hospital policies and procedures

Often perform public relation duties

Informational Services

Document and process information

Includes:

Admissions

Billing & Collection

Medical Records

Computer Information Systems

Health Education

Human Resources Therapeutic Services

Provides treatment to patients


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Includes following departments:

Physical Therapy treatment to improve large muscle mobility

Occupational Therapy treatment goal is to help patient regain fine motor skills

Speech/Language Pathology identify, evaluate, treat speech/language disorders

Respiratory Therapy treat patients with heart & lung disease

5. Medical Psychology concerned with mental well-being of patients

6. Social Services connect patients with community resources (financial aid, etc.)

7. Pharmacy dispense medications

Dietary maintain nutritionally sound

Diets for patients

Sports Medicine provide rehabilitative services to athletes

Nursing provide care for patients

Diagnostic Services

Determines the cause(s) of illness or injury

Includes: Medical Laboratory studies body tissues

Medical Imaging radiology, MRI, CT, Ultra Sound

Emergency Medicine -provides emergency diagnoses & treatment

Support Services

Provides support for entire hospital

Includes:

i. Central Supply orders, receives, stocks & distributes equipment & supplies

ii. Biomedical Technology design, build repair, medical equipment

iii. Housekeeping & Maintenance maintain safe, clean environment


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iii. Organizational Chart

CEO

Physician & surgeon Nutrition

Specialist

Psychiatrist Neurologist

Medical Medical Psychiatrist

Anesthetic

specialist

Anesthetic Medical

Paramedical staffNursesWard Boys

Other Dept.

Admn.

Accounts


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iv. Mechanistic Structures

Mechanistic

Individual specialization:

Employees work separatelyand specialize in one task

Simple integrating mechanisms:

Hierarchy of authority well-defined

Centralization:

Decision-making kept as high as possible.

Most communication is vertical.

Standardization:

Extensive use made of rules & Standard Operating Procedures

Much written communication

Informal status in org based on size of empire

Organization is a network of positions,

corresponding to tasks. Typically each person corresponds to one task


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v. Strategic Plan

1. Goals

To provide immediate attention & medical relief to our patients.

To provide them a favorable health environment.

To accommodate poor and needy free of charge who cannot afford

medical facilities and relief. Set 3 fully functional and equipped Operation theaters for major

surgeries.

Objectives:

To maximize inflow and utilize resources prudently.

To introduce new technologies to make services better than ever before.

To provide incremental value to our patients.

To protect and maintain our resources.

To respond approximately whenever possible to societal expectations

and environmental needs. Maintain a positive and steady growth of 15% each year.

Create awareness programs to sustain better health amongst general

public.

Extend relief programs to people in nearby villages through mobile

hospital facility.

2. Operation strategy

1. Finance

Initial finance needed 46,193,025 (calculated)47,000,000 (Required)

There is no such typical financial plan. As, we are making the feasibility report

therefore; we have decided to include the prices of different equipments and 1st

time salary needed for a hospital.

2. Sources of Funds1. Student Body and personal connections

2. Govt funding institutions and NGOs

3.

External / public awareness through social structure

4. Corporate Involvement

5. Direct Public input through mass media communication


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We have requested for a loan of 20 million from the Punjab Medical

Association (PMA) to be paid in 20 years without interest (Approved). This debt

will cover medical equipment costs, an ambulance and buildings leased cost.

vi. Department, equipments and their prices

Building 40,000,000 First Month salaries 585,000 Operation theater equipment 2,305,000 Laboratory equipment 1,650,000 Office equipment 266,525 Promotion 1,000,000 City Scan Machine Credit Equipment for rooms and wards 121,000

Total 46193025

SalariesDoctors

Physicians 02x30000= 60000

Medical officers (M.O) 04x15000= 60000

Anesthetic specialist 02x15000= 30000

Pharmacists 02x12000= 24000 Neurosurgeon 02x40000= 80000

Pathologists 01x30000= 30000

Psychiatrists 02x20000= 40000

Paramedic staff:

Nurses 10x10000= 100000

Dispenser 03x5000= 15000

Operation thither assistant 04x10000= 40000

Laboratory assistant 02x5000= 10000

Office Administration:

Administration 05x8000= 40000

Human Resource Personal 03x6000= 18000

Procurement 02x5000= 10000


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Accounts Office:

Accounts Officer 01x1000 10000

Accounts Staff 03x6000 18000

Total 585000

a. Operation Theater Equipment:

Operation theater lights 150,000/-

Operation table 300,000/-

Anesthetic machine 80,000/-

B.P monitor 120,000/-

Cardiac monitor 500,000/-

Diathermy 300,000/-

Suction machine 150,000/-

Oxygen cylinder 25,000/-

Nitrous cylinder 30,000/-

Autoclave 150,000/-

Set of surgery instruments 500,000/-

Total 2,305,000/-

b. Equipment for Laboratory:

Colorimeter 200,000/-

Analyzer 500,000/-

Microscope 45,000/-

Centrifuge machine 15,000/-

X-ray machine 800,000/-

Chemicals 50,000/-

Glucose meter 50,000/-

Total 1,650,000

c. Office Equipment:

stethoscope (10)15,000/-

B.P apparatus (5)5,000/-


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Thermometer (10)500/-

Laminator500/-

Otoskop3,000/-

Tongue depressor (10)500/-

Torch (5)1,000/-

Measuring tap25/-

Glucose monitor45,00/-

Stationary1,000/-

Table lamp (5)2,500/-

Office table (5)80,000/-

Office chair (5)+(50)+ (30)103,000/-

Toys for children5,000/-

Weight scale (2)45,00/-

Total266,525/-

After the description of doctors list now we explain some other offices which will becompulsory for further hospital functioning. For this purpose, fist of all we describefinance office

vii. Office Equipment:

Equipment Cost

Computer 70,000/-

Draw 8,000/-

Safe 35,000/-

Table 8,000/-

Total 121,000/-


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viii. Equipment for general ward and other rooms:

Incubator 500,000/-

Nebulizers 10,000/-

Weight machine 5,000/-

ECG machine 200,000/-

Stabilizer 4,000/-

Sucker machine 50,000/-

Oxygen equipment 15,000/-

Pulse oxinator 30,000/-

Wheelchairs(3) 24,000/-

Stature(3) 12,500/-

Total 850,500/-

a. Fund Raising

We segment our market on Income bases:

Amount of finance needed to start. According to our assumptions and the rates of

different things required like machinery, equipment and building for the hospital we

need 50 million approximately. Amount of investments. All of the partners will

provide 30 million to start the new venture.We have requested for a loan of 20 million from the Punjab Medical Association

(PMA) to be paid in 20 years without interest. This debt will cover medical

equipment costs, an ambulance and buildings leased cost.

Statement of confidentiality of report

This report is confidential and is the property of all the four partners. It is intended

only for use by the persons to whom it is transmitted with the consent of all the

partners. Any reproduction or divulgence of any of its contents without the prior

written consent of the company is prohibited. Violation of which may lead to certain

legal action.

b. Budgeting and Allocation

The initial finance required amounting rupees 46, 193, 025 will be allocated as per

detail given below


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c. Development and maintenances of account

Department, equipments and their prices

Building 40,000,000

First Month salaries 585,000

Operation theater equipment 2,305,000

Laboratory equipment 1,650,000 Office equipment 266,525 Promotion 1,000,000 City Scan Machine Credit Equipment for rooms and wards 121,000

Total 46,193,025

Hospital Equipment

When any business is going to be practically implement office equipment is essential for

routine work established discipline and identifications of specific designations.

Similarly, in our hospital three medical departments require some particular officeequipments, which will be helpful in checking of the patients while check by the doctors.

The most interesting thing is that our office equipment is quite different from other

manufacturing organizations. These three departments have three offices and each

office should contain following equipments. All above listed materials should in every

office for checking the patients because without equipment doctor is like the soldier

without the weapon in war. Another thing, which we have in our mind that all the

equipment should be, modernized enough in handily. After the description of doctors

list now we explain some other offices, which will be compulsory for further hospital

functioning. For this purpose, fist of all we describe finance office and the equipmentneeded for this is:

Operation Theater Equipment

Equipment for Laboratory

Equipment for general ward and other rooms

Other equipment includes

Suppliers

6-Marketing

Environmental Scanning

a. Situational Analysis

Our city environment is very much supportive for the hospital industry. Through

environmental analysis we came to know there is no direct competitor here.


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i. Strengths

New idea which will be highly acceptable in the market.

We are the trend setters.

Our relationships with suppliers are strong enough that offer credit

arrangements, flexibility & response to special product requirements.

Employee competency and professionalism, which are the asset of our company.

Our commitment is quality to customers.

We not only satisfy the customers but also build relationship with them in order

to get their loyalty and better future of the company.

Our unique strength is giving all medication services under one roof.

Competitive advantage of first to enter in the market.

ii. Weaknesses

Access to capital.

Cash flow continues to be unpredictable. Lack of awareness to people. They dont have the exact concept of interior

designing.

People living in rural areas difficult to target

All the weaknesses of a company are not the weaknesses; actually they are the

opportunities for improvement in the companys functions. So by properly

arability the opportunities, they would become you strengths.

iii. Opportunities

Growing market with a significant percentage of our target market doesntknow about nutrition and psychiatrist services.

Increase in opportunities beyond the target area of R.Y.K.

By providing ambulance services to rural areas we can capture that market also.

We can expand business by targeting Sukhar to Hyderabab city.


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iv. Threats

New Entrance of competitor

High Import duty on machines can increase the cost and make direct effect on

our services charging from people.

Our first strategy is about the awareness of our hospital to the patients

Informing those not yet aware of what Smile Child Hospital offers.

We will increase the awareness among the customers through properadvertising.

b. IDENTIFICATION OF STAKE HOLDERS:

STAKEHOLDERS INCLUDE GENERAL PUBLIC, STAFF, STUDENT BODY, GOVERNMENT,

DOCTORS, PHARMASUTICAL COMPANIES, ETC EVERYBODY CONCERNED OR BENEFIT

WITH THE HOSPITAL.

Advertising through

1) Local news papers

2) Using cable network

3) www.facebook.com

c. Identification of target community

Our target market is from Raiwind to Kasur, because within this rang there is no

standard hospital giving medication services under one roof.

d. Promotion Strategy:

Marketing Mix

i. Product

Input Sick Patient

Process Treatment of dieses

Output Healthy Patient

ii. Place

We believe that place is not just about distribution it is about convenience too.

If the services are not available where and when people need, it will create a lotof problems for customers.

The physical place which we have chosen of our Hospital is Raiwind Road

because it is a most famous and well known place for all the people. Another

reason for that place so most of people, although, which are not our direct

competitors, are operating in that area and awareness will be created

frequently.
http://www.facebook.com/http://www.facebook.com/http://www.facebook.com/


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iii. Price

Doctors Fee

Consultant physician 500/-

Physician 500/-

Physiotherapist 800/-

Ward and room charges per day

Ward charges 200/-Single non AC room 300/-

Singe AC room 500/-

Double non AC 500/-

Double AC 900/-

ICU (intensive care unit) charges 600/-

ITR (intensive treatment room) charges 800/-

City Scan 4000/-

iv. Promotion

We will promote our Services through different types of promotions like

Advertising Public relations

We need one million (1,000,000) R.s for promotion.

v. Advertising Medias:

We have decided to use almost all types of advertising media because we are the

new entrants in the market. So, we have to aware and educate people to come

to our hospital with their children to get a better treatment with advancedtechnology.

Circulate Hand outs Advertise through Newspapers Through Cable TV because it has made a major source of advertisement

Billboards and banners

Project awareness

Through:

Marketing strategies.

Internet search enginesFace book.

Circulate Hand outs

Advertise through Newspapers

Through Cable TV because it has made a major source of advertisement

Billboards and banners


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7-Administration

a. Setting employee performance slandered

Performance Goals and Objectives:

Statements of results and how to get there. Describes the condition that will exist

when the desired outcome has been achieved.Examples include:

Complete the employee orientation booklet by March 31, incorporating

input from all area supervisors and preparing a content list by February 15

for review by the HR advisory committee.

Learn desktop publishing techniques to produce the departmental

newsletter. Complete training sessions within the next two months and

produce a draft of the spring newsletter by March 1.

Increase number of tests performed daily from 5 to 7. Investigate new

instrumentation to improve the accuracy of testing and make

recommendations to task force to purchase new instrumentation. By July 1, a new file system for survey responses will be developed and all

office staff will be trained to use and understand the system.

Meet with clients monthly, responding to their needs, addressing their

concerns, explaining policies and assisting them with problem solving.

b. Identify measurement criteria

Communicate Responsibilities, Goals and Objectives

By communicating performance standards, you will be able to obtain desired

results/outcomes, improve an employee's performance, and develop new skills.When you do meet to discuss these expectations, standards, and goals, meet in a

quiet place without interruptions and have the job description and objectives in

hand. Be sure to discuss the expectations with the employee and confirm that the

employee understands the tasks and responsibilities of the position.

i. Meet in a quiet place without interruptions

ii. Have the employee's position description as well as unit's business plan

and/or objectives at the meeting

iii. Talk with employee about expectations,

iv. Confirm that employee understands the tasks, responsibilities of the

position

v. Ask the employee for comments, suggestions on performance standardsvi. Finalize performance standards with employee, confirm the employee's

understanding

vii. Define performance standards at each level of performance, e.g., meets

expectations, exceeds expectations.

c. Device controlling tools (feedback)


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d. Reviewing performance

During the annual review phase the staff member and supervisor should meet

to discuss how well the staff member has met their work plan

objectives. This is also an opportunity to consider work priorities, objectives

and development plans for the next work plan.

If regular progress reviews take place throughout the year, the annual review

should contain no surprises for either the staff member or supervisor.

The focus of the annual review meeting should be to:

recognize achievements

confirm what has already been discussed to date

discuss what will be documented in the Performance and Development

Review sections of the work plan (see below)

discuss any outstanding problems

review development activities undertaken

Consider the work plan and development priorities for the next year.

The outcomes of the Annual Performance and Development Review discussion

are recorded in the appropriate sections of the work plan and should include:

comments about how the agreed objectives were met

comments about development and support activities undertaken

an overall comment and rating on performance in relation to the

agreed objectives set out in the work plan

Certifications and space for supervisors to make recommendations

about incremental progression or performance pay where applicable.

e. Time frame: (Example)

In this we have to review that the work in progress is being done according to

the specific time frame already specified in the standard operating procedure.

For and example we would check interval the pace of work and targets being

achieved within time.

f. Responsible person

In this Order responsible person means

a) in relation to a workplace, the employer, if the workplace is to any extent under

his control;

b) in relation to any premises not falling within paragraph (a)--

i. the person who has controlof the premises (as occupier or otherwise) in

connection with the carrying on by him of a trade, business or other

undertaking (for profit or not); or


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28 (Sun) 1st

in service exam (PARP & Pediatric

Radiology)

APRIL 9 to 11 (Fri to Sun) BISP Meeting: Essentials of Breast Imaging

9 to 11 (Fri to Sun) Amorita

Resort, Bohol

PROS Midyear Convention: Quality

Assurance in Radiation Oncology

17 (Sat) 2nd

scientific meeting

Cardio & Pulmo & Pediatric Radio

24 to 25 (Sat to Sun) Trainors Training Workshop

30 (Fri) Cebu Doctors

University Hospital

Scientific Meeting PIMS, Islamabad

Chapter

30 to May 2 CT-MRI Teaching Seminar Summer

Workshop

MAY 3 (Mon) Deadline for submitting requirements for

RTC clearance for PBR 1

18 to 24 PMA Annual Convention

22 (Sat) SLMC PROS scientific meeting

28 (Fri) Consultants Lecture & 2ndQuarterly

Meeting of MEDEX Officers

30 (Sun) 2nd

in-service examination (CVS & Pulmo)

JUNE 21 (Mon) UP-PGH CT-MRI 1st scientific meeting

25 (Fri) Deadline for scientific papers of FPCR

applicants

25 (Fri) Perpetual Succour

Hospital

Residents Journal Report MEDEX Chapter

26 (Sat) 3

rd

Scientific meeting (GUT & WomensImaging & Pediatric Radiology)

No date yet Research Workshop 1

JULY 24 (Sat) JRMMC PROS scientific meeting

25 (Sun) 3rd

in-service examination (GUT &

Womens Imaging)

30 (Fri) Chong Hua Hospital Residents Case Presentation MEDEX

Chapter


AUGUST 14 (Sat) 4th

scientific meeting (GIT & MSK &

Pediatric Radiology)

27 (Fri) Consultants Lecture & 3rd

Quarterly

Meeting of MEDEX Officers


SEPTEMBER 13 (Mon) UP-PGH CT-MRI 2nd

scientific meeting

13 (Mon) Deadline for submitting requirements for

RTC clearance for PBR II & III


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24 (Fri) Residents Research Presentation MEDEX

Chapter

25 (Sat) CSMC PROS scientific meeting

26 (Sun) 4th

in service examination (GIT & MSK

Radiology)


OCTOBER 21 to 23 (Thurs to Sat) CT-MRI-USP Convention

23 (Sat) 5th scientific meeting (ENT & Neuro &

Pediatric Radiology)

29 (Fri) Deadline for submission of all

requirements for FPCR status

29 (Fri) Cebu Doctors

University Hospital

Residents Journal Report MEDEX Chapter


NOVEMBER 21 (Sun) 5th

in service examination (Neuro & H&N

Radiology)

26 (Fri) Consultants Lecture & Last Quarterly

Meeting of MEDEX officers

27 (Sat) MMC PROS scientific meeting


DECEMBER 4 (Sat) Eliminations for Battle of the Brains & RTC

Eid ul Fittar Party

18 (Sat) Eid ul Fittar Party of MEDEX Chapter

j.

Develop policies and proceduresPOLICY

Johns Hopkins Health System Corporation (JHHSC) and The Johns Hopkins Hospital (JHH)

are committed to establishing standards of conduct in the workplace. This policy sets

guidelines and procedures for maintaining these standards of conduct, congenial

working conditions and employee

safety. It is the policy of MEDEX that such standards are enforced in a consistent and

equitable manner to promote operating efficiency and optimum patient care. MEDEX

expects every employee to observe basic rules of good conduct. It is important that

employees understand these standards of conduct and the consequences. Disciplinary

action taken under this Policy is to:

1. Inform employees of behavior or conduct that is considered inappropriate and/or

does not meet departmental standards or expectations.

2. Allow employees to correct such behavior and bring performance to an acceptablelevel.

This policy is a tool for use in managing the behavior of all employees. Standardization

and consistency are necessary, but good judgment and common sense are also vital to


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the success of the program. While the techniques and tools should be consistent, the

treatment of people must continue on an individual basis.

PROGRESSIVE DISCIPLINE STEPS

Pre-disciplinary Counseling:

Pre-disciplinary counseling is a corrective discussion between the employee and thesupervisor regarding the employees failure to meet performance standards, service

standards, and expectations. During this discussion an attempt is made to identify the

cause of the problem and prevent recurrence of the undesirable behavior.

Documentation of counseling permanently becomes part of the employees file.

Written Reprimand:

A written reprimand is a written notice to an employee regarding the employees failure

to meet performance standards, service standards and expectations. It will include a

discussion of the behavior or performance at issue, expectations for improvement, and a

timetable for making corrections. A follow-up date to review the situation will also be

included. An employees failure to comply with the terms of a written reprimand willresult in progressive disciplinary action. A written reprimand remains active for one (1)

year and becomes a permanent part of the employees file.

Written Warning with Decision-Making Leave:

A written warning is notice with one-day suspension. Upon return to duty, management

will meet with the employee to discuss and/or clarify the work plan. A work plan is a

written document (or verbal discussion which is documented) that outlines action steps

an employee will take to address the unacceptable behaviors identified by management.

Management has the responsibility to specify outcomes should the Work Plan not be

followed. A written warning with decision making leave remains active for one (1) year

and becomes a permanent part of the employees file.

Suspension Pending Discharge:

The time period for management to investigate an apparent violation. The outcome of

the investigation will be termination or return to work. If the determination is that no

disciplinary action is required, the employees pay will be restored. Managers should

prepare and review complete documentation with an HR Consultant.

NOTE: An exempt employee will be paid during suspension pending discharge pursuant

to Fair Labor Standards Act.

Discharge (Involuntary Termination)

Discharge is the most serious disciplinary action imposed. It is used for violation of

Critical rules which are considered Critical violations or because of

cumulative/progressive discipline.

CORRECTIVE ACTION RULES FOR MINOR, MAJOR, AND CRITICAL RULES

1. Minor Violations


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Minor Violations normally warrant pre-disciplinary counseling on the first offense.

Listed below are examples (not all inclusive) of minor violations.

Accepting money from patients or family members, or engaging in the unauthorized

sale of services, merchandise, raffle tickets, lotteries, etc

Unauthorized use of nourishments or food intended for patient use

Unauthorized absence from an assigned work area, less than one (1) hour

Failure to complete required time records, or sign in or out of work area where

required

Unauthorized or inappropriate use of the telephone, computer, E-mail, voice mail,

fax or other office/business equipment

Negligent use of property resulting in damage or loss

Failure to follow MEDEX department, division, unit standards, and infectious control

policies covering personal hygiene, grooming standards, and standards regarding the

wearing of uniforms and/or scrubs.

Unsatisfactory job performance, or otherwise not performing to standards

Returning to or remaining on the premises during non-working time, except toconduct business or seek medical care

Unauthorized solicitation or distribution of material on the premises during work

time, or in patient care areas during non-working time

Presence in an unauthorized area

Failure to call in an absence or tardiness according to departmental procedures

Unwelcome, intimidating or harassing comments, remarks, conduct or gestures

creating an unfavorable hostile working environment

Engaging in rude or discourteous behavior

Failure to produce professional license renewal in a timely mane

2. Major ViolationsMajor Violations normally warrant written/decision-making leave on the first offense

Listed below are examples (not all inclusive) of major violations:

Soliciting gifts or money from patients or family members.

Failure or refusal to perform assigned duties or carry out instructions or engaging on

any activity detrimental to the operations of JHHSC/JHH.

Violation of posted safety, security, health, or fire prevention rule, or otherwise

causing a safety hazard or failure to report an unsafe condition existing on the

premises.

Engaging in disruptive, unprofessional or inappropriate behavior while on the

premises, including but not limited to using profane and abusive language, gambling,horseplay, practical joking, name-calling, yelling, arguing loudly in a public area, etc.

Harassment/Discrimination including advances verbal and/or physical conduct, withregard to all applicable laws covering JHHSC/JHHs EEO/AA Policies, when submission

or rejection of such harassment is used as a basis for employment decisions, or

where such harassment has the purpose or effect of interfering with an employees

work performance or creating an intimidating, hostile or offensive work

environment.


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Reporting to work while under the influence of any intoxicant, hallucinogenic, ornarcotic or where the presence of any such agent can be established by a for cause

drug test under the Substance Abuse Policy.

Unauthorized absence from an assigned work area more than one (1) hour

Unauthorized use of property

3. Critical ViolationsCritical Violations normally warrant immediate discharge or suspension pending

discharge on the first offense. Listed below are examples (not all inclusive) of critical

violations.

Deliberate inattention to patient care, or engaging in any conduct detrimental to

patient care, or the safety and security of patients, employees, or visitors.

Unauthorized possession of a deadly weapon on the premises

Smoking in non-designated areas

Theft of property, or willfully causing damage to, waste of, or loss of property

Falsification of records, alterations of documents, and any fraudulent activities

relating to MEDEX business

Fighting, issuing threats or verbal abuse, or other disorderly conduct on the premises,or while otherwise engaged in MEDEX business

Failure to submit to a required fitness for duty examination, including testing for

drugs or alcohol.

Job abandonmentNo longer covered by this policy. Please refer to HR608

Separation.

Violation of Security Access - Patient Information Policy or deliberately releasingconfidential information covering Hopkins business, patient information, employee

information, etc.

Unauthorized possession or use of an intoxicant, hallucinogenic, or narcotic while on

the premises

A criminal complaint, arrest, indictment, or conviction of an employee for alleged

unlawful activity may result in a suspension pending an investigation or discharge,

depending upon, for example, the alleged seriousness of the act, or the job-

relatedness, and the evidence supporting the allegation(s).

Failure to notify management regarding criminal complaint, arrest, or convictions

that

Occur during the course of employment.

Important to Note: HR Consultants will have the responsibility to assist management in

the evaluation of allegations of a criminal complaint, arrest, indictment or conviction

as described above, in partnership with Corporate Security Department, to recommend,

on a case-by-case basis, whether suspension and/or disciplinary action, up to andincluding discharge, should occur.

4. Disruptive Conduct

Conduct by an employee that intimidates others to the extent that quality and safety

could be compromised cannot be accepted or tolerated. Such conduct may be verbal or

nonverbal, may involve the use of rude language, may be threatening, or may involve


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physical contact. Any behavior that interferes with the ability of others to carry out their

duties or that undermine a patients confidence in the organization may be considered

disruptive. Discipline appropriate to the actual conduct or actions will be applied in

accordance with this policy.

Cumulative Violations

Subsequent violations generally will move to the next step in the discipline process (e.g.,

Written Reprimand will be followed by a Written Warning with Decision Making Leave

which will be followed by Discharge if violations continue). Examples of cumulative

actions are as follows:

MINOR VIOLATION ACTION ISSUED DATE

Failure to Follow Dept Rule Pre-disciplinary counseling 12.01.2011

Presence in Unauthorized Area Counseling 15.01.2011

Failure to Follow Dept Rule Written Reprimand 18.02.2011

Unsatisfactory Performance Counseling 07.03.2011

Unsatisfactory Performance Written Warning with

Decision Making Leave

02.04.2011

Presence in Unauthorized Area Suspension Pending Discharge 30.04.2011

Multiple Violations of Minor, Major or Critical Levels

PREVIOUS ACTION + NEXT VIOLATION = OUTCOME

Written Reprimand for a

Minor Rule Violation

+ Written Reprimand for a

Minor Rule Violation (for

which counseling has

been issued)

= Written Warning

with

Decision Making

Leave

Decision Making Leavefor a Major Rule

Violation

+ Written Reprimand for aMinor Rule Violation

= Discharge

Written Reprimand for a

Minor Rule Violation

+ + Critical Rule Violation

(Suspension pending

discharge, if warranted

= Discharge

Decision Making Leave

for a Major Rule

Violation

+ Decision Making Leave

for

a Major Rule Violation

= Discharge

For any combination of violations disciplinary action will be taken in the followingmanner (all actions for minor violations are to be preceded with counseling):

RESPONSIBILITIES

Supervisor:

The supervisor is responsible for the ongoing communications with employees under

their supervision regarding standards of conduct and enforcing MEDEX rules and


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regulations and for the handling of any disciplinary action that may be required. The

supervisor has the responsibility to accurately document and issue discipline in a timely

manner on the proper forms. HR Consultants should be contacted for assistance.

Copies of all disciplinary action that is issued must be sent to the Office of HR Consultants

and Labor Relations and the HR Service Center immediately (within 24 hours of the

issuing of the action).

Employee

The employee is responsible for understanding and following all rules of conduct of

MEDEX which are outlined in this policy. (Also see the Employee Handbook)

PROCEDURES

Please note that completed copies of paperwork should be distributed as follows:

Original - HR Service Center

2nd copy - to the Office of HR Consultants and Labor Relations

3rd copy - Department Head 4th copy Employee

Pre-disciplinarycounseling

Before taking formal disciplinary action for violation of a Minor rule, the employee

should be afford corrective and/or developmental counseling. It is recommended that

employees be provided with a written copy of corrective developmental

recommendations. The counseling should be documented on the Disciplinary ActionTracking Form (See Attachment 1) for departmental uses only. The Disciplinary Action

Report (See Attachment 2) should also be filled out. Employees signature is not

required for counseling.

NOTE: There must be a documented counseling for the initial violation of each Minor

Rule.

Written Reprimand

A written reprimand will remain active for one (1) year; however, the documentation

will not be removed from the employees file.

Written Warning with Decision Making Leave

A Written Warning with Decision Making Leave will remain active for one (1) year;

however,

documentation will not be removed from the employees file. If sufficient improvement

has not occurred at the time of the follow-up meeting, the supervisor can put the

employee in the next step of discipline.


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Suspension Pending Discharge

Before any suspension pending discharge, Office of HR Consulting and Labor Relations is

to review the proposed action.

NOTE: An exempt employee will be paid during suspension pending discharge, pursuant

to the Fair. Labor Standard Act.

Discharge

Before any discharge, the proposed action must have the approval of the Office of

Employee/Labor Relations before it becomes final.

REVIEW CYCLE

3 Years

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