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When?

23rd Aug, 1992

By whom?Dr. Ashwani & Gurbeen Malhotra(Family Physicians)

Why?

To provide cost effective, friendly medicalcare

U.S.P?

Personal touch and patient friendlyenvironment.

What?

A 13 bedded nursing home in Delhi, providingprimary & secondary care.

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Servr ie ch etsO

SERVICES OFFERED

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FPATIENT

EXPERIENCE

- Inadequateexpansion

- Lack of facilitieslike ultrasound,digital Xray- Not truly a 24 hrhospital- Reliability of Lab- Lack of facilitiesin deluxe rooms

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-Personal Touch-Convenience

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-Reputation ofowners-Commitment ofStaff

- No supervision,incentivization/punishment-Retention &training of staff

- Idea & Vision ofSwasthik notshared

- Reasonable

prices- Finance not thedriving force=TRUST

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- Lack of focuson finances- No fixed

charges-led tomistrust

-Goodwill of

owners-HomelyEnvironment-Trust in advice

- Visually

unappealingfaade- No promotion- Difficulty inlocating Swasthik

- Quality ofhealthcare notassociated with

Swasthik

- Transparent billingprocedure- Key medicines & labs

available- Cashless Facility

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- Housekeeping &admin. processes notstreamlined- Lack of dedication &focus of consultants- Low average

occupancy rate- Delay in emergencyservices- Flawed billing system- Vacant rooms weremisused

FRAMEWO

RK

POSITIVES

NEGATIVES

ABOUT THE NURSING HOME

NEGATIVES NEGATIVES NEGATIVES NEGATIVES

POSITIVES POSITIVES POSITIVES POSITIVES

RESEARCH &

ANALYSIS PHSTRENGTHS VS WEAKNESS

ANALYSIS

Interviews

RES

EARCHMETHODOLOGY - Directors

- Administrators- Paramedic Sta- Patients- Potential patie

1

2

Questionnaires

- Consultants- Ex Consultants

3

Observation

- Observing it in - Taking a visual

- Competition st

The phase focused on understandinstrengths & weaknesses concerning of the system through interviews,questionnaires, and observation. Thisfollowed by prioritizing areas for neeintervention.

4

Suggestion Box

- Anonymous Opsuggestions

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THE FINANCIAL

PERSPECTIVESOURCES OF INCOME:

Room Rent

LabProcedure

Day care/ emergencyLabour Room

X RayPhysiotherapyGymECG

36%

29%13%10%4%

4%2%

1%1%

COSTS:

Salaries

Basic Infra BillsLab

Referring doctorsPayment to Govt.

Canteen

63%

10%9%8%6%

4%

- No current profits for reinvestment- Need to focus on areas of quick returns, soas to earn the money for long terminvestments- Huge scope in maternity & childcare dept.

KEY ISSUES

KEY SUGGESTIONS & IMPROVEMENTS

Simplified Financial

Recording System

- Easy Analysis- Info about utilization of rooms

can be easily deduced- Info about how many patientsunder which doctor is easy tofind- Comparing revenues acrossmonths is an easy task

A new Financial Model- A regular system of filling 1page every month, that givesthe idea of how much revenueis generated from each service.- Also, became possible tocompute monthly profit & losseasily.

May I Help You Desk

- No confusion in billing- Some one to guide the patient

na ceni sF

Room Re Categorization

- Max. utilization of existingresources- Simplification- Demand orientedcategorization

The Hub

- Polyclinic Concept- Way to advertise to doctors- One stop for diverse specialities- Increasing Footfalls

Feedback tools

- Inpatient feedback form- Suggestion box for anonymouscomments and suggestions fromstaff, patients and doctors.

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Motivational tools

- Posters in work area- Motivational meetings- Target setting- Assigning leadership at alllevels

Retention & Recruitment

Tools

- Nurse of the Month: monetaryprize & recognition

- Inpatient Feedback form:gives feedback on staff- Attachment with traininginstitutes

Training Methods

- Developed a training modulebased on ideal patientexperience- Library- Environment of learning- Regular training sessions- Training manual- Special Workshops

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Promotion & Ads

- Designed a campaigncontaining a series of 10posters, with each onespecifying a service andfocussing on the USP, i.e.personal touch.

Logo & tagline

- Redesigned the identity ofthe centre: gave it a moreorganic, softer touch,retaining the original elements

Facade

- Redesigned the boards toclearly define & communicatethe centres USP and updatedthe consultants list.

Family Wellness C

- A novel idea of prima

secondary health insu- Objective: to increas& bank on the strengt- Offering a family pacwhich would cover co& provide discounts o

Maternity & Childc

- Directed focus on thisinvestments in the labomedical infrastructure- Catering to the demdeliveries in nursing ho- Increase no. of gyna- Developed road mapmonths to 5 years

Lab Service

- Accessibility: Home sedays facility- Reliability: computeriskilled staff- Marketing: Building bgetting consultants to

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ce&Faci

SWASTHIKMEDICAL CENTRE

Patients First

SUGGESTION &

IMPLEMENTATION PHASE

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Summer Internship

Duration of Project: 2 MonthsAim: System Design

Duration of Project: 2 Months

Aim: Design Audit, System Intervention

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CONTEXT

Bigger Hospitalseating up the

business ofsmaller nursinghomesACommercializationof healthcare;trust linked to money Challenge toattract the docto smaller nursin

homes

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SMC, a 13 bedded hospital was started on 23rd August, 1992.Theobjective was and is to provide cost effective, friendly medicalcare to the neighbourhood people.

ABOUT THE NURSING HOME

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SERVICES OFFER

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RESEARCH & ANALYSIS PHASEKNOW SWASTHIK

Interviews

RESEARCHMETHODOLOGY

- Directors- Administrators- Paramedic Staff- Patients- Potential patients

1

2

Questionnaires

- Consultants- Ex Consultants

3

Observation

- Observing it in action- Taking a visual tour- Competition study

4

Suggestion Box

- Anonymous Opinions &suggestions

SUGGESTION &IMPLEMENTATION PHASEIMPROVE SWASTHIK

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PATIENTEXPERIENCE

FRAMEWORK

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SOURCES OF INCOME:

Room Rent

LabProcedure

Day care/ emergencyLabour Room

X RayPhysiotherapyGymECG

36%

29%13%10%

4%

4%2%

1%1%

COSTS:Salaries

Basic Infra Bills

LabReferring doctors

Payment to Govt.

Canteen

63%

10%

9%8%6%4%

RESEARCH & ANALYSIS

- No current profits forreinvestment- Need to focus on areas ofquick returns- Very tough to analyze finances- No fixed charges-lead tomistrust

PROBLEMS

nca eni sF

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Simplified FinancialRecording System

- Easy Analysis of profit fromeach area- Info about utilization ofrooms easily deduced

- Comparing revenuesacross months is easy

A new Financial Model- Regular system of filling 1Pg/month, to give an ideaof how much revenueisgenerated from eachservice.- Also, became possible tocompute monthly profit &loss easily.

nca eni sF

KEY IMPROVEMENTS

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KEY IMPROVEMENTS

May I Help You Desk

- No confusion in billing- Some one to guidethe patient

Room Re Categorization

- Max. utilization of existingresources- Simplification

- Demand orientedcategorization

The Hub

- Polyclinic Concept- Way to advertise to doctors

- One stop for diverse specialities- Increasing Footfalls

Feedback tools

- Inpatient feedback form- Suggestion box .

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Inpatient Form

The Hub

May I Help YouDesk

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KEY IMPROVEMENTS

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Motivational tools

- Posters in work area

- Motivational meetings- Target setting- Assigning leadership at all levels

Retention & Recruitment Tools

- Nurse of the Month: monetaryprize & recognition- Inpatient Feedback form:

gives feedback on staff- Attachment with traininginstitutes

Training Methods

- Developed a training modulebased on ideal patientexperience

- Library- Environment of learning- Regular training sessions- Training manual- Special Workshops

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Retention & Recruitment To

- Nurse of the Month: monetaprize & recognition- Inpatient Feedback form:

gives feedback on staff- Attachment with traininginstitutes

KEY IMPROVEMENTS

poe leP

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KEY IMPROVEMENTS

poe leP

Training Methods

- Developed a training modulebased on ideal patientexperience

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KEY IMPROVEMENTS

poe leP

Posters in the work area

Motivational MeetingsIngraining the idea of SMC to

each & every staff

Target settingObjective ways to measure &reward performance

Assigning leadership at all

levels of work

Motivational Tools

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KEY IMPROVEMENTS

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Patients First

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KEY IMPROVEMENTS

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KEY IMPROVEMENTS

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Promotion & AdvertisementsAdvertisements in the

nearby locality, eg. Nearchemists shopsSMS updates- awareness

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Maternity & Childcare Services

- Investment in Labour Room,Nursery, Doctors

- Developed a road map for 6months to 2 years- Increasing no. of gynaecologists

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i

S

ce&Facilitie

s

KEY IMPROVEMENTS

Chil& dy Sti en rr ve icteasM

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Lab services

Accessibility: Home Service.365 days facility

Reliability: Skilled staff,computerizationDecrease time taken

Marketing: Building a brand

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A NEW STRATEGY

Idea: A novel conceptof primary & secondaryhealth insurance.

Objective: To increasefootfalls & bank onSMCs strength

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THANK YO

THANK YOU