ABOUT THE NURSING HOME

What? A 13 bedded nursing home in Delhi, providing primary & secondary care. When? 23rd Aug, 1992 By whom? Dr. Ashwani & Gurbeen Malhotra (Family Physicians) Why? To provide cost effective, friendly medical care U.S.P? Personal touch and patient friendly environment.

STRENGTHS VS WEAKNESS ANALYSIS

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RESEARCH & ANALYSIS PHASE

The phase focused on understanding of strengths & weaknesses concerning each area of the system through interviews, questionnaires, and observation. This was followed by prioritizing areas for need for intervention. POSITIVES

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POSITIVES
-Personal Touch -Convenience

RESEARCH METHODOLOGY

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POSITIVES
-Reputation of owners -Commitment of Staff

POSITIVES
- Reasonable prices - Finance not the driving force= TRUST

POSITIVES
-Goodwill of owners -Homely Environment -Trust in advice

- Transparent billing procedure - Key medicines & labs available - Cashless Facility

1
Interviews

NEGATIVES
- Inadequate expansion - Lack of facilities like ultrasound, digital Xray - Not truly a 24 hr hospital - Reliability of Lab - Lack of facilities in deluxe rooms

NEGATIVES
- No supervision, incentivization/ punishment -Retention & training of staff - Idea & Vision of Swasthik not shared

NEGATIVES
- Lack of focus on finances - No fixed charges-led to mistrust

NEGATIVES
- Visually unappealing faade - No promotion - Difficulty in locating Swasthik - Quality of healthcare not associated with Swasthik

NEGATIVES - Housekeeping & admin. processes not streamlined - Lack of dedication & focus of consultants - Low average occupancy rate - Delay in emergency services - Flawed billing system - Vacant rooms were misused

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

2 3

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PATIENT EXPERIENCE

Questionnaires - Observing it in action - Taking a visual tour Observation - Competition study - Anonymous Opinions & suggestions

FRAMEWORK

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SERVICES OFFERED
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Suggestion Box

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THE FINANCIAL PERSPECTIVE

SOURCES OF INCOME:
36% Room Rent 29% Lab Procedure 13% Day care/ emergency 10% 4% Labour Room 4% X Ray 2% Physiotherapy 1% Gym 1% ECG

KEY SUGGESTIONS & IMPROVEMENTS

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Simplified Financial Recording System

Room Re Categorization
- Max. utilization of existing resources - Simplification - Demand oriented categorization

Retention & Recruitment Logo & tagline Tools - Redesigned the identity of
- Nurse of the Month: monetary prize & recognition - Inpatient Feedback form: gives feedback on staff - Attachment with training institutes the centre: gave it a more organic, softer touch, retaining the original elements

Maternity & Childcare

- Directed focus on this through investments in the labour room & medical infrastructure - Catering to the demand for deliveries in nursing homes - Increase no. of gynaecologists - Developed road map from 6 months to 5 years

COSTS:
63% 10% 9% 8% 6% 4% Salaries Basic Infra Bills Lab Referring doctors Payment to Govt. Canteen

- Easy Analysis - Info about utilization of rooms can be easily deduced - Info about how many patients under which doctor is easy to find The Hub - Comparing revenues across - Polyclinic Concept months is an easy task - Way to advertise to doctors - One stop for diverse specialities - Increasing Footfalls A new Financial Model - A regular system of filling 1 page every month, that gives the idea of how much revenue is generated from each service. - Also, became possible to compute monthly profit & loss easily.

Facade
- Redesigned the boards to clearly define & communicate the centres USP and updated the consultants list.

Training Methods
- Developed a training module based on ideal patient experience - Library - Environment of learning - Regular training sessions - Training manual - Special Workshops

Lab Service
- Accessibility: Home service, 365 days facility - Reliability: computerization, skilled staff - Marketing: Building brand, getting consultants to invest

May I Help You Desk

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

Promotion & Ads

- Designed a campaign containing a series of 10 posters, with each one specifying a service and focussing on the USP, i.e. personal touch.

KEY ISSUES
- No current profits for reinvestment - Need to focus on areas of quick returns, so as to earn the money for long term investments - Huge scope in maternity & childcare dept.

Feedback tools
- Inpatient feedback form - Suggestion box for anonymous comments and suggestions from staff, patients and doctors.

Motivational tools
- Posters in work area - Motivational meetings - Target setting - Assigning leadership at all levels

Family Wellness Card

- A novel idea of primary & secondary health insurance - Objective: to increase footfalls & bank on the strength - Offering a family package, which would cover consultation & provide discounts on services.

SUGGESTION & IMPLEMENTATION PHASE

SWASTHIK
MEDICAL CENTRE

Patients First

Duration of Project: 2 Months Aim: System Design

Summer Internship
Duration of Project: 2 Months Aim: Design Audit, System Intervention

CONTEXT

A
Bigger Hospitals eating up the business of smaller nursinghomes Commercialization of healthcare; trust linked to money Challenge to attract the doctors to smaller nursing homes

ABOUT THE NURSING HOME

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

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SERVICES OFFERED

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RESEARCH & ANALYSIS PHASE

RESEARCH METHODOLOGY
KNOW SWASTHIK

1
Interviews

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

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

2
Questionnaires

- Anonymous Opinions & suggestions

Suggestion Box

SUGGESTION &IMPLEMENTATION PHASE

IMPROVE SWASTHIK

FRAMEWORK
People

Financ

es
PATIENT EXPERIENCE

Service
&F
acilitie

Fin

ances

RESEARCH & ANALYSIS

SOURCES OF INCOME:
36% Room Rent 29% Lab Procedure 13% Day care/ emergency 10% 4% Labour Room 4% X Ray 2% Physiotherapy 1% Gym 1% ECG

PROBLEMS
- No current profits for reinvestment - Need to focus on areas of quick returns - Very tough to analyze finances - No fixed charges-lead to mistrust

COSTS:
63% 10% 9% 8% 6% 4% Salaries Basic Infra Bills Lab Referring doctors Payment to Govt. Canteen

Fin

ances

KEY IMPROVEMENTS
Simplified Financial Recording System
- Easy Analysis of profit from each area - Info about utilization of rooms easily deduced A new Financial Model - Comparing revenues across months is easy - Regular system of filling 1 Pg/month, to give an idea of how much revenueis generated from each service. - Also, became possible to compute monthly profit & loss easily.

KEY IMPROVEMENTS
Room Re Categorization
- Max. utilization of existing resources - Simplification - Demand oriented categorization

May I Help You Desk

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

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

Feedback tools
- Inpatient feedback form - Suggestion box .

The Hub

Inpatient Form

May I Help You Desk

People

KEY IMPROVEMENTS
Retention & Recruitment Tools
- Nurse of the Month: monetary prize & recognition - Inpatient Feedback form: gives feedback on staff - Attachment with training institutes

Training Methods
- Developed a training module based on ideal patient experience - Library - Environment of learning - Regular training sessions - Training manual - Special Workshops

Motivational tools
- Posters in work area - Motivational meetings - Target setting - Assigning leadership at all levels

People

KEY IMPROVEMENTS

Retention & Recruitment Tools

- Nurse of the Month: monetary prize & recognition - Inpatient Feedback form: gives feedback on staff - Attachment with training institutes

People

KEY IMPROVEMENTS

Training Methods
- Developed a training module based on ideal patient experience

People

KEY IMPROVEMENTS
Motivational Tools
Posters in the work area Motivational Meetings Ingraining the idea of SMC to each & every staff Target setting Objective ways to measure & reward performance Assigning leadership at all levels of work

& Brand A l
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KEY IMPROVEMENTS

Patients First

& Brand A l
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KEY IMPROVEMENTS

& Brand A l
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Visu

KEY IMPROVEMENTS

Promotion & Advertisements Advertisements in the nearby locality, eg. Near chemists shops SMS updates- awareness

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KEY IMPROVEMENTS

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Maternity & Childcare Services

- Investment in Labour Room, Nursery, Doctors - Developed a road map for 6 months to 2 years - Increasing no. of gynaecologists

Lab services
Accessibility: Home Service. 365 days facility Reliability: Skilled staff, computerization Decrease time taken Marketing: Building a brand

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A NEW STRATEGY

Idea: A novel concept of primary & secondary health insurance. Objective: To increase footfalls & bank on SMCs strength

THANK YOU

THANK YOU