PROJECT REPORT ON TIME AND MOTION STUDY

ORGANIGATION NAME: GOMA BAI NETRALAYA (EYE HOSPITAL) COURSE NAME UNIVERSITY NAME UNIVERSITY, SUBMITTED TO:
Mr. M.L. TRIVEDI HOSPITAL SUPDNT. GOMA BAI NETRALAYA NEEMUCH (M.P.)

: M.B.A. (H.A.) 2011-2013 : NIMS JAIPUR (Raj) SUBMITTED BY:

RAMESHWAR PATIDAR

INDEX

TITLE OF PROJECT. ACKNOWLEDGMENT. CERTIFICATE. HOSPITAL PROFILE. HISTORY OF GBN. LOCATION OF GBN. STATISTICAL DATA OF GBN. FOUNDER OF GBN. MILESTONES OF GBN. DEPARTMENT OF GBN. FACILITIES OF GBN. OBJECTIVE OF STUDY. SCOPE AND RATIONALE OF THE STUDY. INTRODUCTION OF THE TOPIC. SAMPLING / OBSERVATION. FINDINGS. SUGGESTION. CONCLUSIONS. BIBLIOGRAPHY.

ACKNOWLEDGMENT
It is my pleasure to be indebted to various people, who directly or indirectly contributed in the development of this work and who influenced my thinking, behavior and acts during the course of study.

I am thankful to Mr. Sandesh Sharma for his support, cooperation, and motivation provided to me during the training for constant inspiration, presence and blessings. I would also thanks to Mr. M.L. Trivedi (Hospital Supdnt.) for allowing me this summer tranning in this hospital. I also extend my sincere appreciation to Mr. vinod vyas(Hospital Manager) and hospital staff, who Provided his valuable suggestion and precious time accomplishing my project report. Lastly, I would like to thank the almighty god and my parents for their moral support and my friends with whom I had shared my day to day experience and received lot of suggestions that improved my quality of work.

CERTIFICATE
Date: This is to certify that Mr. Rameshwar Patidar of M.B.A.(H.A.)Final Year has successfully completed Summer Training Programme for a period of 45 days with GOMA BAI NETRALAYA (EYE HOSPITAL). As per our measurements and reporting structure he is hard working and has been excellent during the training programme. We wish him all the success for his future.

Signature Designation

DECLARATION
I Student of MBA (Hospital Administration), National Institute of Management and Science NIMS University, Jaipur Raj, hereby declare that this project work has been completed by me as a part of my summer training. This report has not been submitted anywhere else to the best of my knowledge.

DATE:

RAMESHWAR PATIDAR

ABOUT GOMA BAI NETRALAYA (EYE HOSPITAL)

Gomabai Netralaya was set up in
1992, under the leadership of Mr. G.D.Agrawal at Nimach in Madhya Pradesh. It is named after shri G. D. Agarwals mother.
It has now become one of the leading ophthalmic centres in (North and Central) India. Patients are provided state-of-art services at affordable rates. Annually the Netralaya performs nearly 10,000 surgeries and has an OPD of over 100,000 patient. Since the major thrust of the institution is on community ophthalmology, 55% of surgeries are done on a totally free of patient basis. Nimach is located on the border of M. P. with Rajasthan & Gujarat states. Therefore, tribal and rural poor from these states constitute 70% of Gomabai Netralayas patients The Netralaya is playing vital role in community ophthalmology by conducting comprehensive screening camp in far flung places in Nimach, Mandsaur and Ratlam districts of M. P. and Chittorgarh, Pratapgarh, Bhilwara, Kota and Bundi districts of Rajasthan. It has tied up with National and International organization like Helpage India, International Eye Foundation of USA, Sightsavers International (U.K.) and also with the District Blindness Control Societies (DBCS) of above district in M.P. and Rajasthan to carry out these screening camps. Gomabai Netralaya has played a key role in Nimach becoming the eye donation capital of India. Nimach has the distinction of having the highest per capita rate of eye donation in the Nation, excellent facilities provided by the institute for performing Penetrating Keratoplasty, (PK) have gone a long way in reducing Corneal Blindness in the region.(As of September 2011, over Corneal Transplant have been successfully carried out in patient regarding in the age from 18 month to 90 years.) The National Board, New Delhi, has authorized Gomabai Netralaya to enroll Doctors to impart training towards DNB (Ophthalmology) course and

Foundation of Ophthalmic and Optometry Research Education Centre, New Delhi (FOOREC) has authorized to conduct Optometry Courses as well. Gomabai Netralaya is also involved in a continuous process of educating staff and conducting innovative research into the cause and cure of blinding eye diseases. A paper on Viral retinitis-role of Intravitreal Ganciclovier + Intravitreal Steroids by Dr. Sumi Gupta has been accepted at International Ocular inflammation Society Conference Scheduled in Nov. 2011 and a paper on Evaluation of Macular thickness for Glaucoma detection using "OCT was presented by Dr. Amit Solanki at Ophthalmology Tomorrow conference at Indore and was awarded as best paper in Glaucoma. Gomabai Netralaya is also conducting retrospective and prospective, clinical & community based research in the field of Cornea, Cataract, Glaucoma, and Diabetic Retinopathy.

LOCATION:

Madhya Pradesh is a fascinating amalgam of scenic beauty, history and modern urban planning. Madhya Pradesh is famous for its legendary tourist destinations such as the temples of Khajuraho, the majestic forts of Gwalior, Buddhist stupas of Sanchi, Pashupatinathe Temple at Mandsaur and the various wildlife sanctuaries that Madhya Pradesh is peppered with. Neemuch lies between the parallels of latitude 240.15 240.35 North, and between the meridians of longitude 740 45 - 750 37 East. During British rule, an army cantonment was established here. After independence, this cantonments have been converted into cantonments of paramilitary forces by the Govt. of India. Presently it is known as CRPF(Central Reserve Police Force). Neemuch is also known as birth place of CRPF.

STATISTICAL DATA:

1012358 Patients till date. 84838 Cataract surgery. 6230 Penetration keratoplastic surgery. 9500 Vitreo retinal surgery. 38122 Camp surgery.

FOUNDER:
GOMABAI NETRALAYA was established in 1992 by a great visionary Mr. Gheesa Lal Darbarilal Agrawal.Mr. G.D.Agrawal's Meteoric rise to fame and fortune had a humble beginning. He was born in a middle class family from Neemuch. A man whose youth and ideals were shaped by the freedom movement. He was an active participant of 'Quit India Movement' under Gandhiji. He made a transition to Mumbai in 1944. Starting with a few tuitions in Andheri, he laid the foundation stone of Agrawal classes in 1953, and thus he set himself upon the path that would make him an educationist of national repute; a man whose teachings have shaped the minds of an entire generation of intellectuals and professionals.Mere material success did not appeal to Mr. G.D.Agrawal

and with a true philanthropist's view of channeling back into the society the rewards he had reaped from it, he established a trust after his parents name "Smt. Gomabai Darbarilal Agrawal Charity Trust" with the motto to serve the poor in the field of education and health. Several deserving students have been provided scholarships for higher education through this trust.Since Neemuch is the native place of Mr.G. D. Agrawal, he had a strong feeling to do something for his native place. This gave him an idea of starting a hospital in Neemuch. During those days Neemuch was a fast growing centre for eye donations but the facility for cornea transplantation was not possible in Neemuch.

Our vision is to light a lamp in the darkness. We are a response to the silent calls of thousands for whom the world is just of one colour.black ! We are committed to bring all the colours of this beautiful world of God to them.

VISION:
Total eye care for all. To deliver global excellence I total eye care for all. Develop as a tranning and Research Institute. Provide comprehensive Quality eye care.

MISSION:
We will deliver total eye care to delight all establish world class facilities and harmess the benefits of technology for informed patient care. Provide manful patient education for preventive and creative therapy. Become the most sought after institution in the society we operate.

MILESTONES:
1992 : Inauguration of Gomabai Netralaya. 1994 : Eye Bank Established. 1997 : Started Free Surgical Rural Camps. 2001 : Started Laser Surgeries. 2001 : Diploma in Ophthalmic Techniques Started. 2001 : Inauguration of Pathology Laboratory. 2002 : Construction of One more floor. 2003 : Association with International Eye Foundation of USA. 2004 : Association with Sight Savers International of UK. 2005 : Constructed independent free patient ward. 2006: Started separate Low Vision Department.

2008: Accreditation granted by National Board of Examination, New Delhi for training of D.N.B. 2008: 100,000 Consultation and 10,000 Surgeries Performed up to 2008.

DEPARTMENTS:

CATARACT AND GENERAL OPHTHALMOLOGY . CORNEA SERVICE. VITREORETINAL SURGERY. GLAUCOMA DEPARTMENT. PEDIATRIC OPHTHALMOLOGY. OCULOPLASTY.

LOW VISION AID CLINIC. CONTACT LENS CLINIC. REFRACTION AND PRELIMINARY EXAM.

ON CALL ANAESTHETIST. PATHOLOGICAL LABORATORY. FULL TIME PHYSICIAN. FULLY EQUIPPED EYE BANK.

INFORMATION & TECHNOLOGY DEPARTMENT (IT). COMMUNICATION DEPARTMENT. HOUSE KEEPING DEPARTMENT. MAINTENANCE DEPARTMENT. MEDICAL RECORDS DEPARTMENT. COUNSELLING DEAPRTMENT. NURSING DEPARTMENT.

 OPTICAL SHOP. RECEPTION.

FACILITIES:
Gomabai Netralaya has a campus area of 9037 sq.mts with double storied hospital building with a total built up area of 2266 sq.mts. Ground floor is situated for OPD purpose. Apart from OPD, Optical shop, Medical shop, Administrative offices, Laboratory, Counselor office and Operation Theatre is also on the ground floor. Neatly maintained spacious cafeteria is also there on the ground floor, just adjacent to the Netralaya building. Well equipped Eye Bank, recognised by All India Eye Bank Association is also functioning on the ground floor. Three Operation Theaters of international standards are also situated on the ground floor equipped with all necessary equipments including operating microscopes Leica, Takagi & Carl Zeiss Visu-210 operating microscopes. Out of three, one theatre is kept reserved for free patients and one for infacted patients. First floor of the Netralaya building is utilized as ward with total 81 bed capacity.

Types of Ward Male Genral ward Female Genral ward Infected ward Private ward VIP ward

No. of Badded 25 25 15 14 02
Time and Motion study helps management

ABOUT THE PROJECT TOPIC:

determine how much is produced by workers in a specific period of time, therefore making it easier to predict work schedules and output. Motion and Time Study is a scientific method designed by two different people for the same purpose, to increase productivity and reduce unit cost. The two methods evaluate work and try to find ways to improve processes. Frank B. Gilbreth invented motion study designed to determine the best way to complete a job. Frederick W. Taylor designed Time Study; it measures how long it takes a worker to complete a task. Time and Motion Study has become a necessary tool for businesses to be successful today. Time and Motion Study is very important in production control. Time and Motion Study were used separately in the past, but with time have come to be used hand in hand because the two areas are interrelated. This is a presentation about Motion and Time Study, a method used to increase productivity, implemented by many companies around the world today. Frank and Lillian Gilbreth used cameras to look at how body motions were used in the process of completing a job. This helped them to improve the processes and rearrange setups.

Time studies were once used to establish performance-based wage rates. Users of Time Study have to establish standards, this works in the service industry, if you work in a car shop and someone brings a car you need to give him an estimate of how long it is going to take you to fix the car. After working in many cars you will have come up with a standard time that takes you fix certain problems with cars. Jobs are also standardized so that workers will not feel pressured to finish a job and work too fast that they will do careless job. Time and motion study is a work measurementtechnique for recording the times ofperforming a certain specific job or itselements carried out under specifiedconditions. For analyzing the data so as to obtain the time necessary for an operator to carry it out at a defined rate of performance.

DEFINITION:
Time and Motion study is the systematic study of work systems with the purposes of developing the preferred system and method usually the one with the lowest cost; time standardization ; method determining the time required by a qualified and properly trained person working at a normal place to do a specific task or operation assisting in training the worker in the preferred method.

Procedure of Time and Motion Study

Secure and record information about the operation and operator being studied. Select operators Divide the operation into elements and record a complete description of the method. (Before you start study) Assign particular work to operators Observe operators performing task: record time taken for each element. Rate the operators performance. ADVANTAGES OF THE STUDY:
It helps the hospital management to fix the standard time for the work for example a technician can perform how many test in a specified time (standard time). The salary / wages / incentives can be fixed based on the outcome of time and motion study. It helps the management of understanding the wastage of time, resources. The management can take necessary steps to control the cost or cost reduction by techniques.It aids the management to identify the training need for the employees. Time-Motion Study include, study of the motion followed by each procedure and time taken in performing them. For this methodology includes collection of both primary and secondary data.

AIM & OBJECTIVES AIM- To measure the time and movement of patients in OPD

OBJECTIVES-

To find out average time period of patient in OPD. To provide valuable suggestions in order to improve the quality of service. To determine a normal or average time for a particular work. To find out causes of delay.

OPD:
The outpatient department is one of the most important area in hospital, as the most important area in hospital, as the first impression of the hospital is formed first impression of the hospital is formed from OPD and this is the area frequented from OPD and this is the area frequented by a majority of patients .by a majority of patients.The OPD should be located on the ground floor, preferably with the separate entrance. Preferably with the separate entrance The diagnostic services should be easily The diagnostic services should be easily approachable from here. approachable from here. Reception, waiting area, Doctors chamber, Reception, waiting area, Doctors chamber ,examination room ,minor O.T. and medical examination room, minor O.T. and medical record Dept. should be easily accessible .record Dept. should be easily accessible.

OPD AT GBN:

Ground floor is situated for OPD purpose. Apart from OPD, Optical shop, Medical shop, Administrative offices, Laboratory, Counselor office and Operation Theatre is also on the ground floor. Neatly maintained spacious cafeteria is also there on the ground floor, just adjacent to the Netralaya building. MOBILE OPD VAN: The Netralaya has a unique mobile OPD van built on a TATA - 1109 chassis with a view to extend our services to remote areas. Through this van screening of the patients possible at their door steps. After screening, t he patients are transported to the Netralaya for surgery and back to their destination after surgery.

FLOW CHART OF PATIENTS IN OPD :

RECEPTION

BELOW 40 AGE

40 YEAR & ABOVE

OPTOMETRIST OPHTHALMOLOGISTS

PATHOLOGY OPTOMRTRIST OPHTHALMOLOGISTS

MEDICAL

OPTICAL

COUNSELOR ADMIT IN WARD EXITMEDICAL EXIT OPTICAL COUNSELOR

EXIT METHODOLOGY:

Methodology can properly refer to ADMIT the theoretical analysis of the methods appropriate to a field of study or to the body of methods and principles particular to IN WARD a branch of knowledge. In this sense, one may speak of objections to the methodology of a geographic survey (that is, objections dealing with the appropriateness of the methods used) or of the methodology of modern cognitive psychology (that is, the principles and practices that underlie research in the field). In recent years, however, methodology has been increasingly used as a pretentious substitute for method in scientific and technical contexts, as in The oil company has not yet decided on a methodology for restoring the beaches. People may have taken to this practice by influence of the adjective methodological to mean "pertaining to method

The following methodology was adopted:

Time consumed (waiting time, service time) to be demarcated. Flow of time - patient - movement. Sample size was 45 patients.

COLLECTION OF DATA:
In this Methodology collection of data are two types, these are following below: Primary Data. Secondary Data.

Primary Data:-

Primary Data are which data, these are collected through Primary levels, and Data which are originally collected by the investigators are called primary data, while the secondary data are collected through some other sources. For example, information collected by an investigator from a. student regarding his class, caste, family background, etc., is called primary data. METHOD OF PRIMARY DATA COLLECTION Observation method. Interview method.

Secondary Data:Secondary data is the data that have been already collected by and readily from other sources. Such data are cheaper and more quickly than the primary data and also may be available when primary data can not be obtained at all. Internet. Articles. Hospital Administration Books(Principle of Hospital Administration and planning ) Other sources.

OBSERVATIONS:

Weekly Data of Fitness Patient: 1st week

2nd Week

Reg./ M.R No. of Patient

Counselor

FITNESS PATIENT TIME ANALYSIS

Pathology 9:22-9:31 9 Mint. 11:19-11:25 6 Mint. 11:20-11:25 5 Mint. 2:15-2:22 7 Mint. 3:51-3:55 6 Mint. E.C.G 9:34:9:41 5 Mint. 11:30-11:37 7 Mint. 11:37:11:45 8 Mint. 2:25-2:32 8 Mint. 3:59-4:07 8 Mint. Optometrist 10:00-10:15 15 Mint. 11:38-11:46 8 Mint. 11:48-12:03 18 Mint. 2:45-2:50 5 Mint. 4:15-4:23 8 Mint. Physician 11:46-11-52 7 Mint. 1:35-1:47 11 Mint. 1:45-1:55 10 Mint. 4:03-4:13 10Mint. 5:20-5:34 13 Mint.

499668 496746 496552 7540 496887

9:04-9:18 15 Mint. 10:45-11:05 20 Mint. 11:03-11:16 13 Mint. 1:45-1:58 14 Mint. 3:31-3:40 9 Mint.

Reg./ M.R No. of Patient

Counselor

FITNESS PATIENT TIME ANALYSIS

Pathology 2:30-2:38 8 Mint. 4:50-4:57 7 Mint. 10:45-11:03 18 Mint. 9:35-9:40 5 Mint. 10:30-10:37 7 Mint. E.C.G --4:59-5:03 5 Mint. 9:46-9:50 4 Mint. 9:45-9:55 5 Mint. 10:38-10:44 12 Mint. Optometrist 2:40-2:45 5 Mint. 5:05-5:20 15 mint. 9:50-10:06 11 Mint. 10:03-10:10 10 Mint. 10:45-11:02 18 Mint. Physician 4:05-4:15 10 Mint. 5:45-6:02 15 Mint. 1:05-1:10 5 Mint. 11:40:11:48 8 MINT. 12:30-12:42 12 Mint.

7769 496818 24700 4373 07824

2:05-2:15 10 Mint. 4:30-4:45 15 Mint. 9:25-9:35 10 Mint. 9:20-9:33 13 Mint. 10:15-10-25 10 mint.

3rd week

Reg./ M.R No. of Patient

Counselor

FITNESS PATIENT TIME ANALYSIS

Pathology 4:25-4:35 10 Mint. 9:17-9:22 5 Mint. 9:17-9:22 5 Mint. 10:10-10:15 5 MINT. 11:25-11:33 9 Mint. 11:45-11:50 E.C.G 4:50:5:00 9 Mint. 9:25-9:30 5 Mint. 9:20-9:25 5 Mint. 10:16-10:30 8 Mint. 11:35-11:42 7 Mint. 12:03-12:07 Optometrist 5:05-5:15 15 Mint. 9:32-9:45 13 Mint. 9:26-9:45 20 Mint. 10:40-10:55 15 Mint. 11:45-12:10 25 Mint. 12:08-12:35 Physician 5:45-5:57 12 Mint. 12:05-12:15 10 Mint. 1:06-1:19 12 Mint. 12:35-12:45 10 Mint. 1:15-1:33 18 Mint. 3:30-3:45

7584 7620 5407 Premlata Bheru ji Unkarlal ji

4:08-4:16 8 Mint. 9:00-9:15 15 Mint. 9:03-9:16 13 Mint. 10:02-10:10 9 Mint. 11:02-11:12 10 Mint. 11:15-11:20

4th week
Reg./ M.R No. of Patient
Counselor

FITNESS PATIENT TIME ANALYSIS

Pathology 3:35-3:42 8 MINT. 9:57-10:05 8 Mint. E.C.G 3:50-4:00 11 Mnt. 10:06-10:15 11 Mint. Optometrist 4:15-4:35 20 Mint. 10:17-10:30 15 Mint. Physician 4:35-4:45 10 Mint. 3:20-3:28 8 Mint.

497144 461682

3:20-3:30 10 Mint. 9:45-9:55 10 Mint.

FITNESS PATIENT FLOW CHART

COUNSELOR PATHOLOGY E. C. G.
MINUTES)
Electrocardiogram

(10 to 15 MINUTES) (10 to 15 MINUTES)

(5 to 8

IOP
Intraocular pressure

(5 to 9 MINUTES)

PHYSICIAN COUNSELOR

(15 to 17 MINUTES) (2 to 5 MINTUES)

ADMIT IN WARD EXIT

NORMAL PATIENT TIME PERIOD:

Reg./ M.R No. of Patient NORMAL PATIENT TIME ANALYSIS (Below 40 age)
Reception Optometrist 9:37-9:44 9:46-9:59 Ophtholog. 9:45-9:57 10:02-10:10 Medical / Optical/Counselor Optical Optical

500935 500939

9:30-9:35 9:40-9:45

Reg./ M.R No. of Patient

NORMAL PATIENT TIME ANALYSIS (Above 40 age)

Reception Pathology 11:24-11:30 6 Mint. 12:12-12:16 4 Mint. Optometrist 11:40-12:05 30 Mint. 12:20-12:27 7 Mint. Ophtholog. 12:40-1:15 35 Mint. 12:40-12:47 8 Mint. Medical / Optical --------

496367 496495

11:19-11:23 5 Mint. 12:07-12:10 3 Mint.

NORMAL PATIENT FLOW CHAT

REGISTRATION (3 to 7MINTUES)

BELO 45 AGE

ABOVE 45 AGE

OPTOMRTRIST OPHTHALMOLOGISTS MEDICAL/ OPTICAL OPHTHALMOLOGISTS(10M.) / COUNSELOR

PATHOLOGY (4 -5 M.) OPTOMRTRIST (7M.)

MEDICAL / OPTICAL/ COUNSELOR

1.

REGISTRATION (5 to 7 M.) BELOW 40 AGE

1) 2) 3) 4) 5)

Patient inter in the hospital. Fill the voucher: name, age, address, mobile no. etc. Receptionist make a Patient file. (Patient Profile) Then give Registration no. and M.R. no. to patient. Then, send the file to optometrist.

2.

BELOW 40 AGE OPTOMRTRIST

1) 2) 3) 4) 5)

(6 to 10 M.)

File comes to optometrist system.(computer) Then optometrist read the patient summary. Optometrist give the vision and spectacle no. to the patients. Optometrist fill the data in patient file. Then send the file to ophthalmologists. OPHTHALMOLOGISTS (10 to 13M.) MEDICAL 1) File comes to the ophthalmologist system. 2) Ophthalmologist read the patient summary. 3) Then ophthalmologist cheek the patients. 4) Then ophthalmologist give the prescription to patient. 5) Then file is send to counselor.

3.

ABOVE 40 AGE YEAR PATIENT:

1. ABOVE 45 AGE PATHOLOGY (10to16M.)
1)

Above 40 year age patient are sent to Pathology.

2) 3) 2.

Pathologist are cheek the patient sugar and blood pressure, blood and urine test. Then go to optometrist.
OPTOMRTRIST (5 to 16M.)

OPHTHALMOLOGISTS 1) File comes to optometrist system. 2) Then optometrist read the patient summary. 3) Optometrist give the vision and spectacle no. to the patients. 4) Optometrist fill the data in patient file. 5) Then send the file to ophthalmologists .
3.

OPHTHALMOLOGISTS (6 to 10M.)

MEDICAL / OPTICAL

COUNSELOR

1) File comes to the ophthalmologist system. 2) Ophthalmologist read the patient summary. 3) Then ophthalmologist cheek the patients. 4) Then ophthalmologist give the perception to patient. 5) And ophthalmologist suggests for spectacles or medicine / surgery. 6) Then file send to counselor for operation.

Interview method:
In interview method data collected from the following below:-

Hospital staff. Patients.

FINDINGS:

SUGGESTIONS :

CONCLUSION:

To maintain the quality and brand image the hospital is required to streaming some of its process and standardized services in the central india. Today Gomabai Netralaya has developed as one of the best eye care providers in Central India serving all sections of the society with equity since last 20 years. Gomabai Netralaya has played a key role in Nimach becoming the Eye Donation Capital of India from population proportion point of view. Excellent facilities provided by the institute for Penetrating Keratoplasty have gone a long way in reducing Corneal Blindness in the region. This Netralaya has performed as many as 844 Keratoplasty surgeries till May 2012. This Netralaya not only created awareness in its service area but also illuminated the lives of hundreds of people. This Netralaya is now providing tertiary level care to the patients in a cost effective way. This Netralaya has enormous potential to grow & to serve the community