ARAVIND EYE HOSPITALAN OPERATIONS PERSPECTIVE Intelligence and capability are not enough.

There must be the joy of doing

something beautiful. Dr. G. VENAKTASWAMY, Founder- Aravind Eye Care Systems

Alike its founder Dr. Venkataswamy, the Aravind Eye Hospital is unique. Not in terms of the services it renders but in terms of its noble aspiration. AEH does not merely to do service to the under privileged but serves them in the real sense. The sole aim of AEH is to eradicate avoidable blindness and it is the passion that drove Dr.Venkataswamy, and now the AEH and its staff to the levels of success that they have attained. And the most laudable aspect of this success is that it has all been achieved without deploying the cut-throat approach towards its patients. Only those who can afford to pay, pay the cost of the treatment. As a result of this, even the poor could now get back the precious gift of vision which they could not afford due to the cost of the treatment and also the other additional and extraneous costs involved. Even after offering services that are either subsidised or free, AEH has managed to successfully achieve full cost recovery and sustainable high quality care. The full cost recovery has been achieved in a system wherein 70% of the patients are treated free of cost. Individuals who come to know about it are startled, to say the least, at this amazing feat. This success could only be achieved by the astuteness of the humanitarian we now know as Dr. V. The cost of the cataract surgery using IOLs was very expensive. Lenses were priced at 80100$. And to add to that these were all imported. As a result, the scope of moderating the prices were dim. Since the lenses were so costly the cost became the central issue at AEH. To overcome this problem Dr. V. set up Aurolabs, the manufacturing facility of AEH for the production of IOL. This did not mean that AEH started using sub-standard lenses to overcome cost. AEHs commitment to quality is undoubted. They acquired the technology from IOL International Florida, USA. AEH not only acquired the technology but also kept in touch with IOL International by giving regular feedbacks which ensured that the quality levels never dipped. The productivity too was enviable as is evident from the fact that Aurolabs produces 600,000 lenses per year in just single shifts. Aurolabs was basically set up with the aim of overcoming the cost of imported IOLs. And Aurolabs was able to achieve it. Not just for themselves but on a larger scale. The cost of the lenses and sutures in Aurolabs was just one-fourth of the standard prices. As a result,

Aurolabs accounted for the reduction of prices of IOLs all over the world. 33% of the lenses produces were exported to 120 countries at adequate prices which helped AEH overcome the cost of treatment in India. Aurolabs was in the process of constant quality upgrades. This is palpable from the fact that a laboratory with plastic lens surfacing and computerized edging facility was estabilished to research and refine the processes. AEH was very particular about the quality of the surgeries done, as revealed by the low complication rates. AEH management kept a very close track of the intra-operative as well as post-operative complication rates. In case of complications, the operation team which dealt with the case of complication is traced and the reasons for the same are identified. Corrective actions like imparting training to those who are in need of it so that the quality levels never decline. The productivity and efficiency at AEH is a feature worth noticing. AEH conducts eye checkup camps on a regular basis for better penetration. AEH used to go fully prepared for the eye camps. Other than the necessary equipments, an optician was also present at the camp with the stock of lenses and spectacles based on their internal forecast which was highly accurate. As the optician was in the team, those who were advised glasses could purchase them on the spot, and the glasses were delivered within an hour or two. Thereby, saving time, money and energy that usually are associated with the procedure. The patients who require surgery are usually advised to come prepared with their relatives so that no time is wasted in moving them to the base hospital for surgery. At AEH, average of about 2600 surgeries per doctor per year is performed. The all India average is about 400 surgeries per year. This speaks volumes of AEHs productivity. The best part is that AEH is ready to impart training to other eye hospitals so that their productivity also comes up. This once again reflects AEHs commitment towards eradicating blindness. The entire AEH system is oriented towards enabling doctors to be at their productive best. The doctors are ably supported by trained paramedical staffs. The paramedical staffs used to carried out the preliminary checks and trained refractionists carried out the refraction tests so that the doctors could concentrate on their job of treatment. During surgeries, one doctor carried out the surgery and would be assisted by four nurses allowing the doctor to carry out work uninterrupted.

AEH is also very proficient in time saving. AEH had its own optical shop within the hospital. The patients requiring specs were asked to wait at the hospital for about three hours to get their specs. They need not come back after few days, saving time for the patients. The patients who were advised surgery were admitted immediately. Time saving was also done in the operation theatre level. The operation theatre had four tables arranged adjacently. Here four patients are operated upon at a time by two doctors attending two patients each simultaneously. Since IOLs are used for the surgeries the post-operative recovery time was very minimal. Apart from the core process of treatment AEH also saved time for patients and for themselves with the aid of proper planning. The patients were always given clear directions as to where to go next. There were paramedical personnel stationed at critical places for directing people to avoid confusion and crowding. This led to a lack of crowding in the waiting hall. AEH was similarly efficient in utilising the available space. The non-paying patients were given wards where they were given mats instead of beds, which is the usual practice. These mats were of different colours to enable colour coding. This colour coding helped to identify Eye camp patients and the non-paying patients. Because of the usage of mats instead of beds the space utilisation was really high. AEH was able accommodate 30 patients in a single room because of this implementation. AEH has managed to embellish its operations at each step in a manner which any corporate giant would crave to emulate. AEHs aim is to eradicate needless blindness which it is progressing towards in leaps and bounds. Not only are the basic operations of treatment being carried out with enviable efficiency, the other operational aspects are also being taken care off in a very competent manner. From an operational point of view, AEH style of operation can be adapted by all organisations to make best use of the available resources. From a humanistic point of view, we would wish to have more organisations like AEH and many more incarnations like Dr.V.