Executive Summary
Department of business administration demands every student of BBA program to go a process of 6 weeks internship program and to submit the report based on the observations and work done during the training process. It is actually the review of any organization currently running its business, having its competitors .The study of the functions of the human resources department is the main purpose of this internship. It is also meant for finding the weaknesses and shortcomings and then giving the suggestions for improvement.
I have completed my bachelor¶s degree in Business Administration from Kinnaird College for Women Lahore, and internship is compulsory for this degree because College has recommended the internship.
Internship helps us to get the practical knowledge of the field and we get a chance to implement our knowledge which we have gotten from our sixteen years of education. We become aware from the field and its requirements that which types of abilities we should have so that we can perform well in the field.
I did Six weeks internship in Shalamar Hospital in Human Resource Department. I have gained a lot of information and understanding of how an organization runs & how its tasks are performed.
Shalamar Hospital is fulfilling all the new requirements which are put on it by the emergence of consumer-directed health plans, the growth of health consumerism, the chronic shortage of nurses, and escalating competition among providers. The hospital places great emphasis on quality care, providing comfortable, and infection free environment and a range of clinical services which are tailored to meet the needs of individual patients.
The hospital has a Chief Executive and highly qualified and experienced professionals. Like all hospitals Shalamar Hospital also have defined their visions and missions, it has its values and objectives which the company has to achieve. It is
Page | 1
situated in a very large area and has a large number of departments. The offices for the management are separately situated in separate building.
In Chapter 1 an introduction of Shalamar Hospital is given and in Chapter 2 a description of Shalamar hospital departments are given.
In Chapter 3, I gave a detail of patient care services and Chapter 4, is all about major projects of Shalamar Hospital.
In Chapter number 5, I did the different analysis of the Hospital like the SWOT analysis and PEST analysis. In SWOT analysis I have analyzed that how the weaknesses of the Shalamar Hospital can be overcome by using the strengths of the Hospital. And how hospital can save itself from available opportunities. I also did the PEST analysis which is political, economic, social and technological analysis.
In Chapter 6, I have discussed complete analysis of human resource department and also did financial analysis. As I have done internship in HR department but still to make any conclusion about shalamar hospital it was important to do financial analysis.
Then in the Chapter 7, of my internship report, I have discussed my observations about the dilemmas faced by shalamar hospital during my internship.
In Chapter 8, I included my internship experience. I did the internship in the HR department and got a lot of knowledge from my managers.
In Chapter 9 of this report, I gave some recommendations to shalamar hospital. After following on them may be shalamar hospital will face fewer problems.
In the last chapter of report Chapter 10, I give the conclusion about this report and my internship in Shalamar Hospital. What are the things which I learned from this internship report and what are the skills and strategies which I should implement in my life and personality so that I can achieve my goals and objectives.
Page | 2
. CHAPTER NUMBER 1
Introduction
Shalamar Hospital was founded in 1982, built by generous contributions by its founders- Chaudhry Nazar Mohammad, Chaudhry Mohammad Hussain and Syed Babar Ali.
The Businessmen Hospital Trust established Shalamar Hospital to cater the needs of patients belonging to the lower income population of Lahore, a historic city with over 7 million populations. With the sustained efforts of the Board of Trust and the Management of Hospital,
Shalamar Hospital has grown to 10,000 beds and is now amongst major health care providers in Lahore. The hospital has been recognized by Pakistan Medical and Dental Council and College of Physicians and Surgeons Pakistan for the training of fellowship and diploma in different faculties.
The hospital is located in the northern part of Lahore, cosmopolitan capital of the Punjab Province. The services provided at the hospital have moved with the times and provides high quality multidisciplinary services. From six specialties originally, now the hospital provides a comprehensive range of consultation, diagnosis and treatment services for almost all medical and surgical specialties through its hospital based clinical services and community based outreach programme.
Shalamar Hospital has achieved recognition for:
Excellence in health care
Exemplary patient care
Out standing education and research.
To provide affordable healthcare facilities and extending it to all.
Page | 3
1.2- History
1.2.1- The Genesis
During the 1970's, many business concerns, educational entities, banks and other industrial units were nationalised by the then government of Prime Minister (late) Zulfiqar Ali Bhutto which jolted the confidence of the big business families of the country. One of the accusations was that the business sector was not undertaking public welfare activities and money was being accumulated in the hands of a few families. These businesses understood that to an extent the perceptions were correct, since giving by this sector during those days was sporadic and more personalised which could not be seen by the general public. At the same time they also realised that a concentrated and collective effort was required by them to invest monetarily into welfare projects for the deserving citizens of the country.
The initiative to undertake a collective welfare project, with the assistance of the business community primarily with the Lahore Chamber of Commerce, was the brain child of two very close friends Ch. Nazar Muhammad and Ch. Muhammad Hussain (also co-founders of the Services Industries). A team of 10 members from the Chamber of Commerce and Industries, including the two friends, successfully contributed Rs. 5 million as seed money for the construction and operation of a hospital.
1.2.2- Businessmen Hospital Trust (BHT) : Shalamar Hospital
The Hospital
The first challenge was to find a suitable place for the hospital. During the survey an 18-acre public land owned by Pakistan Railways near Mughalpura, Lahore was found best considering the community's requirement as well as location. After hectic efforts and persuasion the land was donated in the name of the hospital by the Ministry of Railways. The hospital was named the Businessmen Hospital Trust which was later changed (as it was giving an impression of a hospital only for the business
Page | 4
community), to Shalamar Hospital for being in the vicinity of the historical Shalamar Gardens constructed by Mughal Emperor Shah Jahan in 1642.
Designed by a team of experienced Australian architects, it is a reflection of the 70s, with a squarish and rectangular design. The interior has a uniqueness not seen in many buildings. The wide corridors have windows on both sides so that air can ventilate naturally throughout the hospital, which reduces odour and provides sufficient natural light inside the hospital.
1.2.3- Services
Shalamar Hospital formally started operations in 1982 as a not-for-profit hospital to cater to the needs of patients belonging to the lower income population of Lahore and its surroundings. With the sustained efforts of the Board of Trustees and the management of the hospital, it has grown to a 350-bed general hospital and is amongst the prominent health care providers in Lahore. It is among the first public welfare initiatives taken collectively by the business community of Pakistan, which set an example of Corporate Social Responsibility (CSR), perhaps even before the term was coined.
The hospital is equipped with modern equipment and has 7 medical, 9 surgical and 17 other related departments which are complemented by 7 operation theatres used for both minor and major surgeries. One important feature is that 5 departments offer fellowship programmes accredited by College of Physicians and Surgeons of Pakistan (CPSP). Some of the city's best qualified doctors are engaged by the hospital. The departments and various rooms and wards are donated by generous philanthropists and named after them.
1.2.4- Feather in the Cap - College of Nursing
On the initiative of Syed Babar Ali, an illustrious businessman and founder of Lahore University of Management Sciences (LUMS), Shalamar Hospital ± College of Nursing was established and is the first private health care institute in Lahore to offer
Page | 5
Bachelor of Science in Nursing with a mission ³to provide dynamic and innovative nursing education and continuing staff development for professional nurses´.
The college offers a Bachelor of Science in Nursing (BSc. N) a four year generic BSc.N degree and Post Registered Nurses (RN) BSc.N and a two-year BSc.N degree for nurses who have completed their Diploma in Nursing. Staffed by skilled professionals, amongst others the college offers the following facilities: a modern auditorium, classrooms, chemistry and computer laboratory, and a hostel for female students.
The main objective of the founders was to establish a not ± for ± profit hospital, which would provide health care services to patients from all income groups, especially to lower and middle social classes. Hospital is owned and managed by the Businessman Hospital Trust.
The hospital is easily accessible to patients from other cities. Today, we are a modern well- equipped 350 bedded hospital providing elective medical and surgical services. In recent years the hospital has increasingly been able to provide services for patients who are non- affording.
The hospital places great emphasis on quality care, providing comfortable, and infection free environment and a range of clinical services which are tailored to meet the needs of individual patients. The hospital has a Chief Executive and highly qualified and experienced professionals.
The hospital has been recognized by Pakistan Medical and Dental Council and College of Physicians and Surgeons Pakistan for the training of fellowship and diploma in different faculties.
The outpatient department (OPD) provides consultation to about 1000 patients in Walk in and Private Clinics during day time and at evening. The number of patients coming for consultation and diagnosis makes it one of the busiest hospitals amongst the private sector health care institutes. The out reach program (ORP) caters to the needs of people living in the outskirts of Lahore on alternate days.
Page | 6
The hospital is equipped with 9 most modern theatres to provide surgical facilities to patients of general surgery, gynaecological procedures and emergency trauma cases. Almost all types of diagnostic and surgical procedures are performed.
Page | 7
1.3 Information about the Shalimar Hospital
Every successful hospital and organization defines its visions and mission and makes the strategies and rules to achieve these missions and visions. To achieve these visions and missions hospital have to fulfil the objectives so that the long term visions and missions can be achieved. Same like that Shalamar Hospital also have defined its vision and mission which are quoted here.
1.3.1 Vision
³To provide quality services without discrimination to patients from all walks of life .´
Shalamar Hospital foremost aim is to think big, be the pace setter and modernizer. It is the VISION that every employee of the organization is clear about.
Page | 8
1.3.1.2 Mission
³To distinguish as a not- for- profit health care leader and to provide advanced medical treatment through hospital based clinical services, to enhance health care and well being of all patients, regardless of their social classes and to set highest standards of personalized specialized accessible cost-effective medical care.´
Shalamar Hospital uses the best prevalent clinical services and tools to win and maintain the satisfaction trust and loyalty of its valued customers. To enhance health care of all patients is its main aim and commitment so shalamar hospital works hard to achieve it. Continuous struggle with commitment is technique to accomplish this MISSION.
Page | 9
1.3.1.3 Core values
The intrinsic values, which are corner stones of Shalamar Hospital, are:
Commitment Integrity Fairness Team-work Service
1.3.1.4 Objective
The main objective of the founders was:
y To establish a not ± for ± profit hospital, which would provide health care services to patients from all income groups, especially to lower and middle social classes.
y To place great emphasis on quality care, providing comfortable, and infection free environment.
y To provide a range of clinical services which are tailored to meet the needs of individual patients.
y Excellence in health care.
y Exemplary patient care
y Out standing education and research.
1.3.1.5 How challenge be delivered
These objectives and guiding mission will be achieved through
Focused objective
Winning as a team
Excellence in health care
Relentless quality
Upward rising sale
Page | 10
1.3.1.6 Achievements
Shalamar hospital has achieved so much after its foundation. Some of its major achievements are:
30 children with burns sent to USA for free plastic surgery.
200 free surgeries performed in earthquake affected areas.
Approximately Rs. 24 million spent on free treatment each year (2002-2005).
Accident and emergency ward ISO 9002 accredited.
Outreach programme through the mobile dispensary serve patients within 50 km radius of Lahore 3 times a week providing free treatment & medicine.
Incinerator (funded by Government of Netherlands) disposes off 1550Kg of waste per day, thus protecting the environment and against contagious diseases like typhoid, hepatitis B and HIV etc.
100 hospitals and 10 pharmaceutical companies avail waste disposal facility
OBJECTIVES OF STUDYING THE ORGNIZATION:
1. To review the human resources department. 2. Analysis of the functionalities of human resources department. 3. To do a comparative analysis of the organization with the other in the same business and capacity . 4. Finding out the weaknesses, short comings, strengths and beauties of the human resource department. 5. To put some suggestions & recommendations for the development and polishing of the human resource department.
Page | 11
1.3.2- Board of Trustees
The Board of Trust comprises of 7 members who had been putting efforts in this joint endeavour to bring it at par with the international standards in health care sector. The Board of Trustees consist of eminent Industrialists, Businessmen and experts. They include the following:
1) Ch. Ahmad Saeed Chairman B.H.T. Servis Industries Ltd. Servis House, 2-Main Gulberg, Lahore.
2) Syed Babar Ali Advisor Packages Limited, Shahrah-e-Roomi, Chungi Amer Sidhu, Lahore.
3) Mr. Shahbaz-ud-Din Chaudhry Managing Director Sunrise Textile Ltd, 67-E-1, Hali Road, Gulberg-III, Lahore.
4) Mr.Ibrar A Mumtaz Director Fazal Din Pharma Plus, Mall Mansions,30-The Mall, Lahore.
5) Mr.Shahid Hussain Chief Executive Servis Industries Limited,Servis House,2-Main Gulberg,Lahore.
6) Mr. Muhammad Munir Chaudhry Chief Executive Technical Associates Pakistan (Pvt.) Ltd. 5-Bawa Park, Upper Mall,Lahore.
7) Mr.Altaf M Saleem Chief Adviser Shakargang Mill Ltd , 10 th Floor, Crescent Standard Tower,Gulberg-III, Lahore.
Page | 12
1.3.3- Organizational Structure
Shalamar hospital is market leader in providing advanced medical treatment through hospital based clinical services, to all patients, regardless of their social classes. We stand for as top five in hospital industry in Pakistan. Shalamar Hospital Spans following divisions:
Shalamar Hospital Organogram
Chief Executive Board of directors
Chief Information Managing Director Officer
Director Accounts Director Marketing Director HR Director Procurement
General Manager General Manager General Manager General Manager
Page | 13
1.3.4- Management of Shalimar Hospital
Management of the hospital includes:
1-Dr. Rashid Ahmed Chief Executive
2-Ms.Mahnoor Masood Manager Administration
3-Mr. Muhammad Akbar Ashraf Chief Information Officer
4-Mr. Muhammad Riaz Chohan Manager Accounts
5-Lt.Col. (R) Dr.Asghar Ali Chaudhry Manager Procurement
6-Dr. Muhammad Khalil Deputy Administrator
7-Dr. Rashid Hussain Deputy Administrator
8- Maj. (R) Dr. Muhammad Arjumand Assistant Deputy Administrator
9- Ms. Safia Nazir HR Manager
Page | 14
CHAPTER NUMBER 2:
Departments Description
There are many types of departments in Shalamar Hospital. All are given below:
2.1-Accounting/ Finance Department
Traditionally, the accounting department has played a significant role in monitoring and improving the efficiency of Shalamar Hospital . In recent years, however, most organizations found it necessary to broaden their emphasis from an efficiency-only based orientation to an orientation which integrates efficiency and quality to achieve organizational effectiveness.
Importance of Accounting Department
The accounts are an essential element of the management information system. They tell management, in financial terms, what the hospital has done, but, more importantly, the accounts provide a basis for decision making. Although hospital is also dependent on external factors for survival, careful management of resources (by means of accounting information) can help to mitigate losses, but also must be used facilitate the identification and exploitation of opportunities.
The accounts can provide various measures of efficiency and effectiveness, from identifying co-relationships between marketing activity and sales, to staff and asset performance. Good accounting can be used in a predictive way, and as a basis for rewarding those within the company/organisation who contributed to past success. Accounts can be an incentive to better business. Good budgeting therefore plays a part, all part of a good accounting system. The essence of good accounts includes accuracy, timeliness and clarity and simplicity of format, so that all users can make informed decisions.
The Accounting Section in Shalamar hospital handles invoicing for medical treatment costs and such related to inpatient and outpatient care, expenditures related to the
Page | 15
procurement and such of supplies, management of facilities and equipment including Monitoring Room and Disaster Prevention Centre, and accounting work for budget requests and the like.
In Shalamar Hospital accounts department has following sections:
Accounti
¡ epartment
Financial Internal Accounts Payments Company Inspection Section Billing Section Statement Audit Section Section Section
Indoor Patient Out door P P Refunding FAX Billing rotocol atient P Patient Billing Billing Section ayment Section Section Section Section
2.1.1-Acti ities & Functions of Each Section
Payments Section
All physical movement of cash is made through the payment department. Normally payment department performs following functions:
Receipt Payments Act according to any standing instructions Transfer of funds from one bank to another
Handling of donation amounts Verification of signatures
Page | 16
Posting Handling of invoices
The payments section is involved in receiving donations from domestic or international level. It also deals with vendors, making their cheques and also cheques of employees who have yet not opened accounts in banks. Bank position report is made on daily basis in order to see opening and ended accounts.
Company Billing Section
Company Billing Division deals with sending total bills to companies that provide free health services to their own employees. Company billing division has sub- divisions. They are as following:
1) OPD( Out Patient Department) Billing Section 2) Indoor Patient Billing Section 3) Protocol Patients Billing Section 4) Refunding Payment Section 5) FAX Section
Financial Statement Section
Financial statement section includes a process of bookkeeping that is involved in making the financial records of business transactions. These Bookkeeping methods are also used in preparation of statements concerning the assets, liabilities and operating results of hospital. It is a very important process for shalamar hospital.
The information derived from the accounting processes gives complete financial information about the hospital and conveys its financial standing to the owners and employees of the hospital. It also shows which products or assets of the hospital are most profitable and those which are weak. Day to day bookkeeping on the accounting principles helps in keeping record of daily transactions and also helps in preventing any frauds.
Page | 17
Internal Audit Section
The audit division reports directly to the board through the executive committee, which is also the audit committee. The audit division is completely independent of the management and is responsible for checking and reporting on the management compliance with the board¶s policies and directives.
However their role is not intended to just that of fault finding; but also guiding and assisting hospital in improving their operations. The division is responsible for evaluating every aspect of the hospital operations with the goal of improving the effectiveness of risk management and internal control. The audit section is of more quality assurance rather than strictly audit. The internal audit reports to the accounts manager, and assist them in ensuring that there is proper compliance with all the relative banks, and also that customer service standards are maintained and improved. The system of internal audit has been introduced since 1999 for effective supervision and control of operations. The scope of the system also spans the development and management of hospital operations and activities.
Accounts Inspection Section
Accounts inspection section tracts the assets, liabilities, owner¶s equity, revenue and expenses of hospital. It provides not only current operating information for management but also track the historical transactions of the entity.
It encompasses not only cash earned by the hospital but also the investment activities, financing activities, lending activities, non-cash charges and recognition of and expiation of the useful life of assets used in the operating of the entity. It also encompasses intangible recording and recognition of items that may have a value yet are not specific in nature such as organizational cost, patents, copyrights and trademarks. I will reflect monies owed, accruals of interest on those monies and also the amounts of excess over operating expenditures that have not been distributed. It is the basis of calculating taxes owed and due as well as a parameter as to the health of the entity and is essential for owners and managers in calculating and projecting operational problems, budgets and compensation. With out accounting no entity could
Page | 18
survive. It is the essential information needed to not only run but also perpetuate a continued enterprise.
2.2-Department of Marketing
With the realisation of importance of hospital marketing, the presence of a full- fledged marketing department has also been acknowledged. ³The marketing department is said to be the voice of hospital where the brand is fashioned and communicated, internally as well as to the community at large,´ says managing director.
According to senior manager, marketing, ³Since a hospital makes a lot of investments in setting up the infrastructure and offering its services, selling the services of a hospital needs a proper system. Therefore, the role of the marketing department in our hospital is of paramount importance. Apart from helping to create a brand image for the healthcare institution, the department acts as an interface between the doctor and the public.´
Marketing Strategies
Though there are no specific strategies for hospital marketing, a systematic approach to marketing has evolved over the past few years. ³Unlike earlier, now the corporate prefer a long-term association with the healthcare institution by signing a memorandum of understanding (MoU),´ says Miliya Nadeem, marketing executive. Marketing experts believe that a sound Client Relationship Management (CRM) forms the basis for soliciting corporate tie-ups, today.
Events, both indoor and out-reach programmes, play a significant role in marketing of healthcare institutions. Continuous medical education, awareness sessions for general public, check-up camps for public, organising events on various health days, conducting interviews of specialists on visual media, informative and interactive website, printing and making readily available various emergency or appointment numbers are the commonest marketing tools.
According to medical director, Shalamar hospital, with the surge in concern in health check ups, hospitals have fashioned various types of special health check up packages
Page | 19
catering to executives, pregnant women, servants, shop keepers to slum dwellers.³Recently, we celebrated Liver Day at Apollo, which was aimed at educating and creating awareness amongst children and parents, so we organised a fashion show and health quiz, which generated a lot of interest.
Though hospitals are publicising through advertisements, Shalamar hospitals should create goodwill for themselves and will not completely rely on advertisements. As patients are the best ambassadors, it is important to take care of their needs and provide them with best possible care. Their apprehensions should be addressed so that they have the courage to come back to the same facility.
Promotion strategies
y Website Shalamar hospital has made its own official website i.e. www.shalamarhospital.org.pk. This website helps patients and other individuals to gain information about shalamar hospital. y Newspapers Local Urdu & English Newspapers are used for promotion of shalamar hospital. y Television Television is also used for promotion. It is very helpful in gaining donations and blood for needy people.
Page | 20
2.2.1-Activities and Functions
The marketing department is said to be the voice of hospital where the brand is fashioned and communicated, internally as well as to the community at large. These following are the main activities of marketing department in shalamar hospital. Each section of marketing Department performs their respective functions:
Find Outside Vendors. Create New Ideas of facilitating patients for the problems they face Communicate internally new policies. Manage a Budget. Designs ads to promote hospital To do Strategic Marketing, which includes handling CRM, Research etc To do Publicity of shalamar hospital and establishing PR for hospital To do research and find new ways of treatment of any disease Buying new equipment, machines and stationary for shalamar hospital and for nursing college. To differentiate your hospital from your competitors is through exceptional customer service. Organizing Events, both indoor and out-reach programmes, Continuous medical education, awareness sessions for general public, check-up camps for public, organising events on various health days, conducting interviews of specialists on visual media, informative and interactive website is main function of marketing department.
2.3-Department of Administration
The department of Administration of Shalamar Hospital is closely associated with the provision of administrative support to various departments for delivery of patient care and control of costs in the hospital services. The faculty in the department, worked actively under the supervision of Manager Administration. The department is also entrusted with the responsibility for co-ordinating VVIP medical care.
Page | 21
Important tasks of this department involve developing and implementing good routines for hospital management and personnel administration, in addition to managing the premises, the IT systems and general administrative routines.
2.3.1Activities and Functions
The activities/ tasks of administration department are:
Supervise and manage all day-to-day office administrative activities. Fully Handling Setting up new Office & Office Shifting in new location. Vendor Management & Office Administration (Adequacy of Stationary / Provisions / Refreshments / adequacy of Sub Staff) Courier & Dispatch (Inward / Outward / Outstation) / also making record of local maintaining. Co-ordination and maintenance of systems related to Housekeeping. Managing vendors and keeping track of cycle of all maintenance contracts. Keeping records of Visiting Cards, Utility Payments, Printing of Stationary. Maintaining record of AMC (Computers, AC, Cars, Pest Control, Insurance, Etc) & taking care of departments. Updating Assets List of the company. Handling complete Facilities and infra structure of office and liaising with contractors and interiors for the same. Canteen maintenance Building maintained Cleaning Legal issues Area maintained
Page | 22
2.4-Human Resource Department
Strategically, perhaps the most important department at Shalamar Hospital is HR department. It is responsible for human resource management, including recruitment staff training and evaluation. The division also handles matters relating to administration.
This department operates on future oriented strategy focusing on employee¶s personal and professional growth. Staff development activities are geared to enhance their capabilities for applying the knowledge and facts towards development of practical situations. Under our human resource management policy, we develop and groom our management personal for positions of greater responsibilities analytical, interpersonal, conceptualized and specialized skills to enable them understand cause-and-effect relationships and to think logically.
A human resources (HR) department develops, advises on and implements policies relating to the effective use of personnel within hospital. HR/personnel work comprises a number of different but related policies, all of which are required by hospital that employ people, whatever the size or type of business. These cover areas such as working practices, recruitment, pay, conditions of employment and diversity.
HR department ensures that the hospital employs the right balance of staff in terms of skills and experience, and that training and development opportunities are available to employees to enhance their performance in order to achieve the hospital's objectives.
Staff & doctors are given on the-the -job as off-site training in diverse areas of medical and management. Shalamar hospital hiring philosophy is based upon meritocracy and selecting the right person for the right job. They lay greater emphasis on employee¶s honesty and integrity besides technical competence. Candidates are selected through well defined and systematic selection procedure.
Page | 23
Human resource department of Shalamar hospital has following sections:
Human Resource Department
Recruitment/ Leave Record Promotion Payroll Section Record keeping Section section Section
2.4.1-Acti ities and functions of HRD
Each section of Human Resources Department performs their respective functions:
y Creates and implements an orientation program that eases the adaptation of new employees to their jobs and to the company. y Determines the requirements for in- and out-house training that will accelerate the worker's technical and personal development and actuali es these training programs. y Prepares procedures and forms related to Human Resources to ensure that employees are made aware of hospital practices and processes. y Prepares job descriptions for every task included within the Performance Management System (PMS). y Supports PMS implementations. y Counsels hospital employees. y Offers support to promote implementation of the suggestion award system. y Prepares payrolls and manages insurance procedures. y Organi es motivational activities and events. y Carries out various HR projects.
Page | 24
y Monthly updating of the Leave records of all the Employees on the Biometric System. & following up for the Leave applications with the Employees. y Query and grievances handling of the Employees. y Issuing Offer Letters, Appointment Letters, Transfer Letters & Confirmation Letters.
2.5- Accident & Emergency Department
The Department of Accident and Emergency was upgraded in 2000 with the help of Qarshi Foundation and the trustees of Shalamar Hospital. This department has ISO 9002 certification.
The department comprises of 40- beds including 10- bedded male ward, 18- bedded female, 8-bedded paediatrics ward, 4- bedded Intensive Care Unit, Emergency operation theatre with a recovery room and a Treatment room. Central Oxygen points, wall mounted blood pressure apparatuses, suction machines and crash trolleys along with all necessary equipments and accessories are available in the wards for patient care. The Intensive Care Unit is equipped with Ventilator, ECG monitor, defibrillators and Pulse- Oximeters. The department is fully air conditioned and has a comfortable waiting area for attendants in the reception area.
We receive and treat on an average above 400 causalities in 24 hours which include major road traffic accident, stab wounds, gun shot, poisoning, abdominal pain, chest pain, Obstetric problems etc. Non- affording patients are provided free treatment which is paid from the generous donations raised by the trustees and philanthropists.
2.6- Department of Anaesthesia
The Department of Anaesthesia started working in 1982 and grew to meet the demands of the surgical and medical departments. At present the department comprises of 12 Consultants, 10 Specialists, 02 Senior Registrars, 13 Medical Officers, 02 Senior House Officers and 01 House Officer.
The department has been recognised for the post graduate training programme by the College of Physicians and Surgeons of Pakistan since 1998. We are running four
Page | 25
years structured Residency Programme for FCPS trainees in Anaesthesia. The teaching module is devised according to the protocol set by the accrediting body. The training programme has been modified with a view to impart better knowledge and would incorporate rotation of the Residents to the Shaukat Khanum Cancer Hospital and Research Centre, Lahore. This would help them in gaining exposure in the field of oncology.
Apart from the regular teaching programme we have first time in Lahore started conducting training workshops like Basic Life Support & Advance Cardiac Life Support for doctors and paramedics on monthly basis. The department believes in meticulous work with emphasis on patient¶s safety and care.
2.7- Department of Audiology
Audiology Department was established in 1996. This department is currently serving not only the population of Northern Lahore but is one of the few tertiary referral centres for whole of Punjab. It is serving both the adults and paediatric population suffering with congenital and acquired hearing problems. Besides making hearing assessment, advice regarding different types of hearing aids is also provided.
The department is equipped with latest machinery and expertise. The services are not only provided at the base institution, but trips have been arranged at the Basic Health Units to provide free hearing tests to the needy.
Uptill now approximately Fifteen thousand patients have been examined. Following services are currently available at the Shalamar Hospital.
1. Audiometery (Paediatric and Adult)
2. Tympanometery
3. Speech Audiometery
4. Vertigo test
5. Hearing Aid Advice
Page | 26
It is planned to up- grade the unit with the addition of Evoked Response Audiometery and Otoacustic Emission tests. Currently a study being conducted on Childhood deafness program.
2.8-Department of Cardiology
The Department of Cardiology was setup in 1994. The department comprises of 02 Consultant cardiologists including an Interventional cardiologist, 01 Senior Registrar and 07 Medical Officers. The 8 bedded CCU has all the state of the art equipment necessary for managing all sorts of cardiovascular emergencies. Facilities include ECG, EchoCardiography, Exercise Tolerance Test, Halter Monitoring and Temporary pace maker insertion
Training programs are offered on regular intervals for the medical doctors and nurses. The intended research program is on permanent pace maker implantation.
2.9- Department of Dentistry
The Department of Dentistry was established in July 1986. The department is equipped with state of the art equipment ³PROGEA´ by Belmont Japan. It is a multi discipline clinic run by a full time Consultant and one Senior Registrar.
It has the facility of providing a wide range of patient services ranging from simple fillings to the extensive surgical procedures. The commonly treated problems include Periodontal Problems (Gum disease), Conservative Problems (Caries, Fillings etc.), Surgical Problems (Extraction, Impaction etc.), Trauma, Prosthetic Problem (Dentures, Bridges etc.) and Ortho Dontic Problems (Prominent teeth). Sterilization is ensured strictly.
Services offered are:
y Cosmetic Dentistry y Restorative Dentistry y Periodontal Services y Management of Trauma y Surgical Rehabilitation y Prosthodontic Services
Page | 27
For the last few years the department is also providing services to the patients in the evening as well. Keeping in mind the heavy influx of patients, extension of department has been planned to incorporate another surgery.
2.10-Department of Dermatologist
The department was set up in 1988 and is being run by three full time Consultant and five full time Specialists. The department provides consultation in the Out Patient and offers electro- cautry services for various minor dermato surgical problems.
Facility for the cautry of viral warts is available on the latest state of art Italian cautry machine- Epilodine. On an average 130- 150 patients get consultation in the morning and 20- 30 in the evening. The Head of the Department is research- oriented and the department is collecting data for an on- going study.
The department plans to extend its services for patients by starting Cryo- surgery technique and Laser hair- removal technique.
2.11-Department Of Otolaryngology (ENT) & Head & Neck Surgery
The department was set up in 1982 and has 03 full time Consultants, 02 visiting Consultants and 03 Medical Officers.
The out patient clinics are run daily, morning and evening for the convenience of the patients. The variety of patients is wide ranging from children to adults.
Endoscopic Sinus Surgery is being done regularly in this department including Endoscopic Pituitary removal, Optic Nerve Decompression and Orbital decompression. Endoscopic Dacrocystorhinostomy (EDCR) is carried out with the assistance of a qualified Ophthalmologist. Surgeries such as Parotidectomies, Laryngectomies and other head and neck surgery are also being carried out here. Carbon Dioxide Laser is regularly used in Rhinology and head and neck procedures. The first Pakistani Isshiki Thyroplasty was also carried out in this department.
Page | 28
The department intends to start a Voice Clinic for the patients coming with voice disorder. There are several research studies going on in the department.
2.12- Medicine Department
The Medical unit of Shalamar Hospital was established in 1984. Now it is a multi speciality unit and comprises of Divisions of Gastroenterology, Pulmonology, Diabetes and Endocrinology.
We have three full time Consultants, two visiting Consultants, one Senior Registrar and 12 Medical Officers. The department has been recognized by the College of Physicians and Surgeons of Pakistan for Fellowship training. All together we have six training posts. The teaching program includes lectures, teaching rounds in the wards, Clinico Pathological Conference on weekly basis, Journal Club meetings.
The Division of Gastroenterology has a state of the art Endoscopic unit which was established in 1990 and upgraded in August 2001. This unit provides both, diagnostic and therapeutic services like Gastroscopy, Colonoscopy, Stricture Dilation, band ligation, injection Scierotherapy and foreign body removal.
The Division of Pulmonology includes Bronchoscopy and the latest electronic Pulmonary Function Test machine. These tests are carried out by a qualified pulmonologist.
The Diabetic Clinic forms an integral part of the department and caters to the needs of diabetic patients of the northern Lahore. A trained doctor and a nurse provide consultation to the patients regarding their compliance with the medicines, diet, self monitoring of Glucose level and other preventive measures.
The Division of Endocrinology treats numerous illnesses related to the malfunctioning of the glands that produce and secrete hormones into the blood or lymph systems. The Diabetic Clinic is run as its allied unit.
Keeping in mind patients, the extension plan of the department includes procuring two more Gastroscopes and a Colonoscope to perform ERCP. The upcoming
Page | 29
Research work targets The Treatment And Outcome Of Hepatitis C In Compensated Cirrhosis, Upper GI Bleed.
2.13-Department of Ophthalmology (EYE)
The Department of Ophthalmology consists of four full time Consultants, seven visiting Consultants and five Medical Officers.
The Department is well equipped with latest diagnostic and operative equipment. On an average 100 patients are provided consultation and treatment everyday. The most prevalent ophthalmic diseases are refractive errors, cataract, glaucoma, diabetic retinopathy and minor eye disease. Treatment provided on the Out Patient basis includes complete eye examination, Argon Laser Treatment and Yag Laser Treatment. The anterior and posterior segment eye problems are treated with Yag laser and laser photo coagulator.
The operation theatre offers state of the art facilities. Phacoemulsification is the latest procedure for patients suffering from cataract. We are also implanting foldable lenses without applying corneal suture. Because of these modern methods visual rehabilitation is very quick.
Patients suffering from complicated vitreo- retinal problems are also treated. Shalamar Hospital offers highly specialized vitreo- retinal surgery which is very rare in this country. We have all the latest microsurgical instruments for this complicated surgery. Recently we have acquired a laser for endophotocoagulation during vitreo- retinal surgery. All these latest and highly specialised procedures are performed without any surgeon¶s operating fee for poor and deserving patients.
The upcoming project of the department includes buyingB-Scan Fundus Camera and Field Analyzer. The extension plan includes introduction of two new clinical services for patients, i.e.; Ultrasonography and Fluorescent Angiography. The Head of the Department aims at launching a Glaucoma Clinic. The department intends to conduct a research program on The Role Of Early Vitrectomy In PDR.
This department is helping a large number of patient populations suffering from eye problems from all over Punjab.
Page | 30
2.14- Department Of Orthopaedic Surgery
The department of Orthopaedic Surgery started functioning in September 1992. We have 03 Consultants, one Senior Registrar and 06 Medical Officers. The department has been recognised by the College of Physicians and Surgeons of Pakistan for the training of Fellowship in Orthopaedic Surgery.
The training focuses the management of patients. Residents are encouraged to present cases in the Out Patient clinics and during the ward rounds. They are also encouraged to learn operating skills. Academic sessions are conducted twice weekly. Interesting cases are presented in Clinico-Pathological Conference.
All the emergency cases are discussed in departmental meeting. Lectures are given on the management of routine orthopaedic emergencies. The library offers a wide range of reference books and orthopaedic journals. The consultants represent the hospital in the international orthopaedic conferences in Pakistan as well as abroad where they present papers and share their experience with the delegates from different countries.
We have a separate operating room fully equipped with Orthopaedic Traction Table, Image Intensifier, Arthroscopic equipment, pneumatic drill system, instruments for spinal and routine orthopaedic surgery. These facilities are at par with any such facilities all over the world. We regularly perform all routine orthopaedic operations including Arthroscopic (endoscopic) surgery, joint replacement surgery, spinal surgery, trauma surgery, surgery for the polio patients and those with congenital deformities.
2.15- Department of Paediatrics
The Department of Paediatrics was established in 1982 and since that time it is serving the people of Lahore. The department has three full time Consultants, one visiting Consultant, 2 paediatric trained Senior Registrars, 1 Registrar, 9 Medical Officers, 4 Senior House Officers and paediatric trained nursing staff. They provide 24 hours emergency coverage and also examine all the newborn babies delivered in the hospital. Shalamar Hospital is a baby friendly hospital.
Page | 31
The department consists of following sections:
1. Alam Buksh Neonatal Nursery (new most modern, purpose- built neonatal nursery)
2. Children Ward (Air Conditioned)
3. General and private out patient departments
4. Vaccination Centre
5. Well- Baby Clinic
6. Breast Feeding promotion Centre
7. Paediatric Intensive Care
8. Play Area for children
The department is well equipped with modern equipment such as ventilators, incubators, phototherapy units, resuscitation trolleys, radiant warmer, cardiac monitor, Apnoea alarms, oxygen saturation monitor etc.
2.16- Department Of Pathology
The department of Pathology was instituted in 1985 and is being run by seven full time and five visiting Consultant.
Pathology Department
The new Pathology Department is now comprised of seven sections including Haematology, Immunology, Chemical Pathology, Histo/Cytopathology, Microbiology, Molecular biology and Transfusion Medicine. All these sections are fully functional and equipped with modern and state of the art equipment. The senior clinical staffs (consultant/specialist) are well trained and the paramedical staffs are also well qualified.
Page | 32
Haematology and Transfusion Medicine
This section is well equipped, including autoanalyzer to perform routine as well as specialised investigations ranging from routine blood counts, optimal Malaria test, clotting screen, coagulation factor assays, thrombophilia screening, bone marrow aspiration and trephine, cytochemical stains, Hb and protein electrophoresis with these diagnostic facilities.
Chemical Pathology Section
The chemical pathology section of Shalamar Hospital Laboratory is providing services to inpatients, outpatients and emergency departments of Shalamar Hospital. The chemical pathology section is rendering a comprehensive and quality diagnostic services which is innovative, efficient, cost-effective and timely. We are committed to work together as a team of professionals to deliver an efficient, reliable and quality services towards achieving excellence in patient health care in a caring and friendly environment.
Chemical Pathology section is equipped with state of the art instruments and the tests are carried out by properly trained professionals. The diagnostic laboratory is extensively automated to facilitate requesting of investigations and reporting of results. This section performs approximately more than 1200 tests daily from in- and out- patients and provides routine and 24-hours emergency services. Qualified and experienced medical technologists and technicians work in chemical pathology and have the vast experience on handling the automated analysers.
Quality Assurance Programme
To provide accurate, precise and highest standard of test the internal quality control program is monitored regularly and section participates in external quality assurance program by having collaboration with Randox External Quality Assurance Program (REQAS) London and National External Quality Assurance Program (NEQAP) monitored by Armed Forces Institute of pathology Rawalpindi ( AFIP). Our turnaround time generally range from 30 minutes to 4 hours from receipt of samples to reporting, depending on the test.
Page | 33
Immunology Section
The immunology section of Shalamar Hospital Laboratory is providing services to inpatient and outpatient departments of Shalamar Hospital. The immunology section is providing a comprehensive, specialized and quality diagnostic service. The section is performing specialized test by agglutination, ELISA and Chemiluminescence¶s Techniques on fully automated state of the art equipment. Qualified and experienced medical technologists and technicians work in immunology section that have the vast experience of handling the automated analysers installed in this section. Immunology section is equipped with
Automatic ELISA Plate Reader Automatic Incubator and Washer Random Access Hormone Analyser (IMMULITE)
Histopathology & Cytology Section
The Histopathology section at the Shalamar Hospital, Lahore is functioning for last over15 years. Presently the section is handling over 3000 surgical specimen and over 1000 Cytology specimens annually under supervision of UK trained histopathologist.Section is equipped with automatic tissue processor (Sakura), Microtome, Electronic balance. In addition to Haematoxylin & Eosin staining other Histochemical stains like Giemsa, Z-N, Congo red, Reticulin and Oil red are also available.
Immunohistochemistry with panel of antibodies for diagnosis and classification of tumors and receptor assay analysis for breast cancer is also performed. Cytology section is also provided with the room for Fine Needle Aspiration Cytology, which is now regularly performed.
Histopathalogy section also looks after the museum which has more than 300 Surgical specimens for FCPS students training.
Page | 34
Microbiology Section
The section is fully equipped to perform all types of bacterial culture and sensitivity testing, fungus culture as well as parasitological examination facilities. Importance of the culture and sensitivity of blood
in cases of septicemia and disseminated infections can not be over-emphasized. The section is using one of the latest systems to diagnose such infections.
Culture and sensitivity of cerebrospinal fluid (CSF) for diagnosis of meningitis, and other body fluids (synovial, pleural, and peritoneal) for infections of these organ systems as well as culture of urine for the diagnosis of urinary tract infections (UTIs) is done using the state of the art facilities.
Culture and sensitivity of pus or swab from any part of the body is the cornerstone for the diagnosis of infections in that part of the body and this test can be done round the clock in the section. Culture of fecal specimens for the diagnosis of Typhoid fever and food poisoning is also done. Anaerobic infections are increasing in importance especially in the obstetric and gynecology patients, ENT patients and in surgical and penetrating wounds infections. The microbiology section is performing such cultures with very good results. The section is also performing as American Thoracic Society (ATS) Level-I Mycobacteriology Laboratory for the diagnosis of TB. Future plans include raising the standard to level-II.
In addition, the section performs routine urine and stool examination, and all biological fluid analysis including Gram and ZN staining. Skin scrapping examination for direct microscopy and fungal culture tests are also done. Recently the section in collaboration with Gynaecology and obstetrics department has started sperm preparation for IUI (intra-uterine insemination). Special sperm preparation media are used for this purpose. Strict sterilized environment is maintained for this procedure.
The section is being supervised by a trained medical microbiologist who is a Diplomate American Board of Medical Microbiology {D(ABMM)} and Fellow of Canadian College of Microbiology (FCCM). Properly trained and qualified medical technologists work in the microbiology section.
Page | 35
Molecular Biology Section
The Molecular Biology section is a new addition for the people of Northern Lahore. This section is well equipped and supervised by a qualified Specialist Molecular Biologist. PCR technique is available for the detection of HCV, HBV, MTB, and bcr- abl gene in CML patients. We are performing both qualitative and quantitative tests including HCV genotyping by PCR technique. All the quantitative assays are carried out by fluorescence technique. In near future, we shall be commencing Cytogenetic studies and Thalasaemia screening on Molecular level.
2.17-Department of Psychology
The Department of Psychology started in 2000 to provide psychotherapeutic intervention to children, adolescents and adults with psychological symptoms and/ or psychosocial, emotional, behavioural and interpersonal problems. Counselling room is equipped with diagnostics tests. Clinical Psychologist suggests psychotherapeutic intervention to both- the patients coming to the Out Patient Department and to hospitalised ones.
Formal psychological assessment and evaluation is made to form the diagnosis. Standardized psychological tests are administered. Besides treating psychological disorders, Psychology Department also provides specialized services for children with Pervasive Developmental Disorders and Learning Disabilities. Psychologist provides a remedial plan focusing behavioural management programme and skill development for home and school settings for the child cases. Mentally retarded children are referred to special education institutes after making assessment.
Family Therapy and group therapy sessions are also conducted. There are several researches being conducted in the department.
Page | 36
2.18-Department of Psychiatry
Shalamar Hospital started providing Psychiatric care to patients in November 1996. The present team of Mental Health professionals comprise of a Psychiatrist, a Clinical Psychologist and a Medical Officer. They provide consultancy on the out patient basis only. Psychiatric patients are admitted in Female Medical Ward and Male Medical Ward. Violent patients are not admitted rather they are managed on out patient basis or are referred to Government Hospital for Psychiatric diseases.
The Department of Psychiatry provides psychotherapeutic intervention to people with psychosocial, emotional, behavioural and interpersonal problems. Counselling room is equipped with diagnostics tests. The Psychologist suggests psychotherapeutic intervention to both- the patients coming to the Out patient and hospitalised ones. Family Therapy sessions and group discussions of patients are also conducted. The psychologist provides a behavioural management programme for home and school settings for the child cases. Mentally retarded children are referred to special education institutes after making assessment. The heavy flow of patients during the daytime led to the opening of psychiatry department in the evening Out Patient since October 2001. There are several researches being conducted in the department.
2.19-Department of Radiology
The Department of Radiology is functioning since the start of this institution. X-ray is the busiest department of the hospital after clinical laboratory. We are equipped with three X-ray units; that is, two 500 ma units and 600 ma unit with fluoroscopy and image intensifier and monitor for routine radiography. The department also have one mobile (500 ma unit) and another portable unit for bedside radiography. The Ultrasound section has one multi purpose Ultra Sound unit and one mobile unit for bedside sonography. The department functions round the clock and is supervised by three full time and one visiting Consultant.
Contrast related procedures like myelography, arthrography, sialography, venography and many other procedures are performed in the department. Sonouamography and almost all ultrasound guided procedures are also performed in the ultrasound Department.
Page | 37
2.20- Department of Speech Therapy
The Department of Speech therapy started working in November 2000. The Speech therapist employs two different modes of intervention- Direct Speech Therapy sessions, Indirect through home based therapy. These services are provided in collaboration with the Department of Psychiatry. Training workshops for parents are run on regular intervals with a view to train them to run therapy successfully at home.
The department has planned a study regarding the Collection Of Data On Developmental Phonological Processes Between Age 1 To 7 Years.
2.21-Department of Surgery
The Department of Surgery at Shalamar Teaching Hospital was set up in 1982. It has two surgical units¶ that has provision following surgical procedures General Surgery, Laparoscopic Surgery, Cancer Surgery and vascular Surgery. The department has two full time Consultants, two visiting Consultants, 02 Senior Registrars and 06 Medical Officers.
The department offers a fellowship programme in surgery accredited by College of Physicians and Surgeons of Pakistan. The teaching module includes Lectures, Ward Rounds, Clinico Pathological Conference, Journal Club, Short Case Presentation, Lectures by Guest Speakers and OPD Teaching. Three departments that work in collaboration with the department of Surgery are Plastic Surgery, Neuro surgery and Paeds Surgery.
The hospital theatres are fully equipped and all kinds of major surgical procedure which are done in tertiary referral centres in Europe and America are being successfully undertaken at the Shalamar Hospital such as Parotidectomies, Thyroidectomies, Gastrooesophageal surgery, whipples procedure for pancreatic cancer, Hepaticojejunostomies, Liver surgery, low anterior resection and abdominoperineal excision for colorectal cancer.
The Department of surgery at Shalamar Hospital has the honour of performing the world¶s first ever removal of biggest vascular tumour from the face of a fourteen year old boy successfully. This surgery was performed with the help of a visiting plastic
Page | 38
surgeon. The extension of the department includes building up of more Operation Theatres to perform more Laparoscopic Surgery for Inguinal Hernia and Lapcholecystectomy. This would improve clinical services for the patients.
2.22-Department of Urology
The Department of Urology in Shalamar Hospital is one of the few tertiary referral centres for the whole of Punjab and Pakistan where, we are performing highly specialized procedures for the management of Urethral & Ureteric Strictures, and in the field of Endoscopic Stone Surgery. It was started in September 1991. The staff of the department comprises of two full time Consultant, one visiting Consultants and three Medical Officers.
We are pioneers in the world for doing Free Graft Endoscopic Urethroplasty and allied procedures. We are specially dealing with V.V.F repair, Gynaecologyo- Urological Procedures, male reproductive health and renal transplant surgery. The department is equipped with state of the art equipment for endoscopic management of ureteric and urethral strictures and stones.
2.23 -Department of Transportation
Purpose Purpose of shalamar hospital ambulance is: ³To ensure safe and coordinated medical service activity in support of the hospital ambulance service requirements. The policy and procedure serves as a general guideline for management of patient transfer cases.´ Policy Ambulance services and functions are approved by one of the following individuals. Hospital Director or his appointed designee. Medical Director or his appointed designee. Hospital Administrator or his appointed designee. Nursing Supervisor. Ambulance will be physically located in the parking area of the Emergency Room.
Page | 39
³Emergency Call´ for dispatch of the ambulance shall receive immediate priority of action and should be dispatched by the Nursing Supervisor or Head Nurse. Emergency dispatch of ambulance should always include a nurse and possibly a doctor in attendance whenever deemed necessary. The choice of a Resident or doctor, in general, will be determined by the mature/type of emergency or the service required. The nurse accompanying emergency ambulance dispatch will ensure that the emergency medicine box is carried within the ambulance. Safety custody of this box will be the nurse¶s responsibility.
2.24 -Department of Physiotherapy
Physiotherapy is essentially one of the healing sciences which pertains to treatment of disorders of muscles, bones and joints by means of physical agents i.e. heat, light, water, magnet, manual and electronic massage and exercises. It aims at restoration of physical function & performance, promotes healing, prevent deformity and rehabilitation of impairment by disease or trauma.
Shalamar Hospital has a state of the art department of physiotherapy Since its establishment in 1988, it is being continuously upgraded and equipped with latest machines, which improve patient care and quality of services. We work in isolation as well as in collaboration with the departments of Orthopaedics, Medicine, Neurology and Chest Medicine etc.
2.25-Department of Nephrology
Nephrology is a branch of internal medicine dealing with the study of the function and disease of the kidney. A nephrologists is a specialist who treats diseases of kidney including care for: Dialysis Patient, Peritoneal dialysis Patient, All forms of kidney disease, Kidney transplant patients, Electrolyte problems, Kidney stones, Congenital Kidney disease, Metabolic kidney disease
The department of Nephrology provides a comprehensive clinical and referral services for the patients with renal disease and end-stage renal failure, a renal transplant service, day ward and out-patient clinics.
Page | 40
The dialysis unit named Mian Jhangir Hemodialysis Ward has been established with the support of Main M. Latif(Late) in the memory of his beloved son Main M. Jehangir(Late).Hemodialysis unit comprises of 9 machines offering 1200 dialysis sessions per month. The medical equipment is continually updated and purchased according to the latest therapies available which results in a non-stop improvement of center¶s facilities.
Page | 41
CHAPTER NUMBER 3: Patient Care Services
3.1-FREE TREATMENT
Hospital provided subsidized and free treatment worth Rs. 46.49 million during the period July 2007 to June 2008 to the non affording patients belonging to poor families. The detail is given bellow:
Department No. of Amount in Description Patients Rs.
Indoor 14572 33,612,008 y No fee for visit of Consultants y No fee for Surgery and Anesthesia y Subsidized bed Charges y Subsidized and free treatment of Zakat Patients y Consultants Salary paid by Hospital.
y No Registration Fee charges from poor patients Outdoor 279,740 12,532,714 y Top Consultation attended 279,740 patient in OPD y No Consultation fee charged from General patient
Mobile 15,089 350,145 Free Medicines Dispensary
Immunization 18,849 Free Vaccination
Page | 42
3.2- BLOOD BANK
The mission of Blood Bank Shalamar Hospital is to serve humanity by providing the safest blood and its products at subsidized rates for transfusion to the patients in need. Shalamar Hospital Blood Bank is equipped with state of the art equipment.
Utmost care is taken in the selection of healthy donor, meticulous screening regarding Hepatitis B & C (HbsAg, Anti HCV antibodies) Syphilis (VDRL), AIDS ( Anti HIV Antibodies) and Malaria Test.
Processing of the collected blood is carried out by trained staff under the supervision of haematologist. FFP (Fresh Frozen Plasma) are preserved at Minus 50 °C to make it usable during one year period.
This blood bank has the honour to supply whole blood and red cell concentrate (RCC), as much as can be spared from our hospital needs, to Fatimid Foundation and Punjab Red Crescent Society for the care of thalassemia patients. Transfusion of one unit of Platelet Concentrate prepared by cell separator (Single Donor) provides an increment of 80 X 10 3 / ul in patient¶s platelet count instead of about 7 X 10 3 / u/l by manual method (Random Donor).
Page | 43
3.3-DONATIONS
For the better utility of amounts received through donations, it is allocated only to those services/ departments where influx of non-affording patients is the most. Distribution is as follows:
SERVICES / DEPARTMENT PERCENTAGE (%) Poor patients in general ward 33 Lab Investigations 22 Free Surgical Procedures 18 Free Consultation in OPD 07 Free Radiological Services 06 Patients in CCU 05 Patients in ICU 05 Patients in Dialysis Ward 02 Diet for poor Patients 02
Shalamar hospital appreciates financial support that will be used to continue mission of Shalamar Hospital. Donors can send their donations/ Zakat/ Sadqa for any of the following:
1. Donate Medical Equipment 2. Donate Rs. 100,000/- for treatment of Zakat deserving/ poor patients. 3. Donate Rs. 50,000/- for one bed in General Ward for one year dedicated to the memory of your loved ones or free treatment of patients in villages served by our mobile dispensary. 4. Donate any amount to support our efforts to provide relief to non affording patients.
Donations to Shalamar Hospital are exempt from income tax. In Pakistan under SRO. 300(1)75, Section 60(sub-section 1).
Page | 44
3.31- Overseas support
Since 1997 Shalamar Hospital has international liaison with the House of Charity, USA with regard to free surgical treatment of burnt and congenitally abnormal children from around the country. We have been sending children with deformities to USA for free surgical treatment. These children either could not be treated in Pakistan or the treatment was so expensive that the child¶s family could not afford it.
Teams of House of Charity comprising of American Plastic Surgeons, Doctors, Nurses and Operation Theatre Assistants have examined innumerable children from all over Pakistan and operated upon hundreds of children totally free of cost in collaboration with Shalamar.
All the responsibility of these children in USA is of HOC, whereas return air tickets, visa fee and examination fee is taken care of by the donors.In their last visits in May 2008. they operated 140 children with congenital abnormalities in Shalamar Hospital totally free of cost. 6 burnt and congenitally abnormal children were selected for free surgical treatment in USA. Approximately 200 children are still waiting for the treatment. The waiting list of deformed children increases every week.
Page | 45
CHAPTER NUMBER 4:
Projects of Shalimar Hospital
Shalamar Hospital has two major projects. These both projects are near to be completed. Its first project is recycling of hospital waste products and other is establishing college of nursing.
4.1- Hospital Waste Management
Hospital Waste Management is a project started with the sole objective of stopping recycling and reuse of clinical waste such as syringes and other disposables.
The recycling of clinical waste results in spread of typhoid, Hepatitis B, C, HIV and epidemics. In addition to this, many health care providers and diagnostic centres throw contagious waste on the roadside or in municipality containers.
To overcome the above mentioned menace of hospital waste disposal in Lahore, a non- Profit Company was registered in June 2000 for the proper handling of the Hospital Waste. Shalamar Hospital has the honour of executing this project- first ever in Pakistan.
Under its supervision two incinerators each having the capacity of 1600 Kgs/Shift have been installed at the two hospitals i.e. Shalamar and United Christian Hospital. These incinerators were donated by the Government of Netherlands and inaugurated by the then Minister for Environment, Government of the Punjab on the 19 th of June 2000.
Custom made collection vehicles have also been provided to collect the bio medical waste from the health care providers and pharmaceutical companies who have been registered as members of the user club.
A nominal fee is charged to all the members to cover the cost of the collection and incineration of the Bio Medical Waste. Currently, 170 Hospitals, Labs and
Page | 46
Pharmaceuticals companies including 10 Government Hospitals are using this facility. The company has successfully completed five years of Bio Medical Waste disposal services.
The incineration plant is working under capacity and is burning average 1,500/- Kgs bio medical waste per day.
The main aims of the Hospital Waste Management Company are to:
1. Reduce the recyclable infectious clinical waste and 2. Educate medical and non- medical professionals in proper biomedical waste management.
About 200 Training Workshops and Lectures have been delivered to develop understanding on the hazards of hospital waste in approximately 15,000 health related professionals. Following areas are focused while conducting such courses.
1. Reduction in the spread of infectious diseases mainly contributing to the reduction of mortality. 2. Almost no reuse of medical disposal. 3. Collection of waste and disposal service at the doorstep of registered members. 4. Positive projection of hospital through our newsletters, posters and other activities. 5. Conducting refresher courses. 6. Assisting all members in working as environment friendly.
Page | 47
4.2- College Of Nursing
The Mission: Learn and Serve
Shalamar Hospital College of Nursing set its mission to provide dynamic and innovative nursing education and continuing staff development for professional nurses.
The Vision:
Shalamar Hospital College of Nursing is committed to provide services for patients requiring highly competent nurses, environment of professional growth and provision of dynamic and innovative clinical experience which is internationally acceptable standard of health care education.
Faculty:
The College Administration recruited highly skilled professionals to provide a good and strong foundation of learning. We have foreign qualified and experienced faculty.
Courses Offered:
The following courses are offered:
y Bachelor of Science in Nursing (BSc. N) ± A four year generic BSc.N degree
y Post Registered Nurses (RN) BSc.N ± A two year BSc.N degree for nurses who have completed their Diploma in Nursing.
Teaching Equipment:
The Teaching methodology includes of multi-media, projectors, CD and many others. The library carry¶s maximum number of text use of reference books including some of the very special and rare editions. For better teaching and learning purposes, research work is encouraged.
Page | 48
Facilities:
The College of Nursing is equipped with skilled professionals. Amongst others the college offers the following facilities: a modern auditorium, classrooms, chemistry and computer laboratory, and a hostel for female students.
Clinical and community based facilities:
The students will be utilizing the facilities of Shalamar Hospital during their clinical practicum. It has also on-going community outreach programme that will enable students to learn and contribute to the versatility of nurses at Shalamar Hospital.
Bachelor of Science in Nursing is a newly emerged concept in nursing education in Pakistan. Shalamar Hospital College of Nursing is the first private health care institute in Lahore to offer such a degree.
Results of Professional Exam
1. First Professional Exam conducted by the University of Health Sciences. Shagafta Rehman-Third place
2. Second Professional Exam conducted by the University of Health Sciences Ms.Qandeel Farooq-First place
Page | 49
4.3 - Educational Services
Shalamar Hospital ever since its establishment has a mission to educate, train and inspire young people in the science of healing and the art of communication. Using modern information technology and conventional approaches, we aim to produce internationally acceptable professionals. Together with our alumni, we shall strive make Pakistan a healthier and happier place.
Shalamar Hospital is providing following educational services:
y Medicine and Dental Education ± College of Medicine and Dentistry y Nursing - College of Nursing y Allied Health Sciences - Institute of Allid Health Sciences y Post graduate Sciences - Centre for Postgraduate Training y SH Center for Health Research
4.31-Student Leadership Programme (established in 1995)
Since 1995, Shalamar Hospital has been playing host to students from educational institutions from Lahore and around the world as part of its Student Leadership Program.
Every summer, a number of A-Level & Bachelors students from different educational institutions apply and are selected to join the Student Leadership Program at the Shalamar Hospital system. This program has been labeled as a Role Model for Internships in Pakistan and its popularity can be assessed by the growing number of applicants who apply for this program both locally and from overseas. In 2007 alone over 400 applicants registered for the program.
Page | 50
CHAPTER NUMBER 5: Company Analysis
In chapter number fifth of my report of internship I have done the analysis of Shalamar Hospital. Here I did two type of analysis; first one is SWOT analysis in which I examined the strengths, weakness, opportunities and threats faced by Shalamar Hospital. And second analysis in this chapter is PEST analysis which is about politics, economic, social and technological changes. First I did first SWOT analysis and then PEST analysis.
5.1- SWOT ANALYSIS
SWOT stands for strengths, weaknesses, opportunities and threats. This is the analysis related to the strengths which Shalamar Hospital proudly have, weakness of Shalamar Hospital, opportunities which Shalamar Hospital can avail to prevent from the threats faced to the company and the weaknesses of the hospital. The reason to do this analysis is to find out that, what are the strengths of the hospital which can overcome the weaknesses of it and to determine the opportunities which can hospital avail to prevent the threats to the hospital. I will individually examine the strengths, weaknesses, opportunities and the threats faced by Shalamar Hospital here.
Strengths
The hospital has built up goodwill in the hospital industry of Pakistan, from a very long time. Shalamar Hospital caters the needs of patients belonging to the lower income population of Pakistan. It receives large amount of donation from overseas & domestic level. The hospital has the largest market share throughout the country in the latest clinical equipments.
Page | 51
Name of Shalamar Hospital is known to almost every person in the country and is very famous in providing high quality multidisciplinary services. Shalamar Hospital has recognition for Excellence in health care. Major strength of it is that it has completed its project on waste management. The hospital is having a number of old doctors & employees who are committed and loyal with the hospital. The hospital has won the Merit Trophy 2004-2005 of Federation of Pakistan Chamber of Commerce & Industry presented by General Peres Musharraf to the Chief Executive of shalamar hospital.
Weaknesses
By keeping the inflation in mind Salaries of employees are not very sufficient. They are not very satisfied from the pay rate and they have negative views about the management of hospital. The advertisement budget of Shalamar Hospital is very short comparatively other hospitals in the market. Most of the security & sweeper staff is not well educated. The complaints department does not provide the proper services to the patients and employees of hospital. Vendors are not very satisfied because of delay payments. Over work Load on nurses Employees, nurses are not very much Motivated. The hospital has been discussing possibilities of embarking on income generating activities, however, the poor prevailing economic situation makes such ventures risky
Page | 52
Opportunities
Due to the strong financial position of the company, the management can use the latest technology & equipments in treatments. The hospital continues to excel in its various endeavors because of committed staff and a supportive working environment. These factors offer opportunities for expansion of hospital services especially in Primary Health Care department.
The hospital with financial, material and human resources available would go a long way in strengthening community-based interventions.
They can use the brand name in the international market to increase their donations. By increasing name in international market patients with burns and other problems can be sent for free surgery.
Threats
The increasing introduction of highly sophisticated diagnostic and treatment technology is the very big threat to Shalimar Hospital. Emergence of palliative care as a specialty in many major medical centres. Need to balance increasing attention to building security with openness to patients and visitors. The decreasing numbers of general practitioners along with the increased use of emergency facilities for primary care Preventative care versus sickness care; designing hospitals as all-inclusive "wellness centres" Other competitors of Shalimar hospital are offering the same treatments at relatively lower prices.
Current Power & Electricity crises are very big hurdle for the hospital.
A growing interest in more holistic, patient-cantered treatment and environments. This might include providing mini-medical libraries and computer terminals so patients can research their conditions and treatments, and locating kitchens and dining areas on inpatient units so family members can prepare food for patients and families to eat together
Page | 53
5.2- PEST ANAL SIS
A scan of the external macro environment in which the hospital operates can be expressed in the following factors;
1.Political 2.Economic 3.Social 4.Technological
PEST analysis is used to describe a framework for the analysis of these macro environment factors. A PEST analysis fits into an overall environment scan as shown in following diagram
Environmental Scan
Macro Micro Environment Environment
Pest
Analysis
Page | 54
Political Factors
Pakistani government is somehow stable in these days and focusing on the foreign aid. Shalamar Hospital is taking advantage of this move by government and is trying to increase their overseas donations.
Government is providing opportunities to the companies to provide benefits like old-age benefits, disability benefits, pension, etc. These benefits are to be provided by every hospital under the supervision of Social Security Ordinance. Shalamar Hospital is also providing its employees the benefits of social security.
The hospital has a trade mark and a trade name that gives the Hospital an exclusive right by the government policies to use it and enter into contracts and dealings through its registered trade name.
The Hospital is bound to follow the workers safety regulations as laid down by the workers safety act.
All the tax related policies are being followed by Shalamar Hospital.
Economic Factors
Shalamar hospital plays an important role for economic growth by contributing to the economy of the country by investing on education seminars and events.
The hospital provides health care services to patients from all income groups, especially to lower and middle social classes.
Hospitals avail waste disposal facility.
Page | 55
Social Factors
The salaries and wages of the workers and management are not satisfactory so the income distribution factor is not satisfactory.
Shalamar hospital is funding in the college of nursing.
Shalamar hospital has the honour of being the first hospital to sponsor TB day
symposium and exhibition 2008.
The hospital is providing various types of free treatment which are helping poor families.
Many children with burns sent to USA for free plastic surgery.
Technological Factors
Due to technological improvements many treatments are available at lower prices.
The Shalamar hospital is also thinking of introducing a new swap machine that would note the attendance of each employee when one will swap his card into it. This machine will also provide the management with the statements showing the late minutes of each employee and the leaves in the month.
The company has provided the computers to the staff members to eliminate the cost of stationery and to save the time.
Different software are being used in every department for advertisement, employee data base, payroll and for the maintenance of accounts.
Page | 56
CHAPTER NUMBER 6: Human Resources Department
Introduction and Overview of the Department
The Human Resources Department provides expert advice and support to management and staff in all aspects of Human Resources Management and plays a key role in strategic planning for Shalimar Hospital . The Department is staffed by skilled HR professionals and, through best practice HR polices, promotes a working environment which is conducive to positive employee relations and promotes the personal and professional development of employees. The HR Department strives to meet the needs of a dynamic and constantly changing HR and healthcare environment, including the challenges arising from new services, legislation and the developing information and communication management agenda. Responsibilities of the HR Department y Resourcing and Retention y HR Services y Employee Relations y Learning and Development y Medical HR 1. Resourcing and Retention:
Resourcing and Retention of staff involves the recruitment and selection of staff in the organisation (except Nursing Staff). In the case of Nursing staff the recruitment and selection process is managed directly by the Nursing HR Department. It is the aim of the Human Resources Department at St. Michael's Hospital to source and retain high caliber staff for the organisation who will add value to the Hospital in the future. We strive to recruit develop and retain a skilled, positive and highly motivated staff which will improve the quality of patient care.
Page | 57
2. HR Services:
The HR Department is responsible for the implementation of Hospital policy on terms and conditions of employment e.g. employee remuneration, leave arrangements including sick leave, maternity leave etc. We also provide an advisory and support service to department heads, line managers and staff regarding polices, practice procedures and terms and conditions of employment. The HR Department is also responsible for the maintenance of individual employee files and personnel administration records, both manually and electronically using the Wiztec HR Management Information System. 3. Employee Relations:
The HR Department is responsible for providing advice, support and representation to service delivery managers throughout the hospital and for ensuring compliance with national and local agreements in relations to Employee Relations matters. It also has responsibility for developing a robust ER/IR architecture and best practice policies designed to create a positive ER climate and enhance communication. St. Michael's Hospital places a strong emphasis on the use of effective use of partnership between line managers and staff. 4. Learning and Development:
The HR Department assists in the continued learning and personal development of managers and staff within guidelines of best practice, developments in employee enrichment and organisational objectives. An objective of the HR Department is to develop a learning culture through the promotion of continuous learning and development and to encourage a working environment where learning is shared, applied and evaluated. The HR Department undertakes to ensure that the Hospital delivers quality training to staff and keeps abreast of current developments in the fields of learning, personal & professional and organisational development which contributes to enhanced service delivery.
The Department co-ordinates Induction for new staff, supports Management and Staff Development programmes, which are offered on a regular basis, and continuously reviews them for their effectiveness. The roll out of Performance
Page | 58
Management Systems is facilitated by the Department, which supports and develops line management and staff and is designed to achieve sustainable improvements in organisational performance. 5. Medical HR:
The Human Resources Department is responsible for the recruitment and administration of the hospital¶s medical staff. It provides advice and support to management and medical staff in all aspects of Medical Human Resources Management.
6.1 HUMAN RESOURCE ANALYSIS
Currently there are over 2200 doctors, nurses working in shalamar hospital. On the entry level the HR Department is mostly taking MBA graduates for working in administration, finance and HR departments. According to shalamar hospital belief is that "Their people aretheir greatest asset´. The HR team takes great pride in acknowledging the contribution of each employee. Shalamar focuses a lot on HR development and for that the HR managers ensures: Staff, doctors and nurses of this hospital consists of world¶s top class specialists and experts and shalamar also ensures that the right systems are in place to encourage people to develop to their full potential.
Collaborative and mutually supportive work environment is created that encourages employees, staff and doctors to grow. Performance management and reward systems are developed. A clearly defined recruitment & selection policy is defined in which need for training & development of employees, doctors, staff members is assessed and compensation & benefit plan is developed which ensures that employees are motivated.
Shalamar hospital is basically equal employment opportunity organization. It provides equal opportunites to male and female staff. The job description of each and every employee, staff member is predefined. Performance appraisal is done on annual basis. Average Salary is almost 12000 for an employee, doctor, nurses of hospital.
Page | 59
6.1.1Management
In shalamar hospital the hierarchy is very lean, in general the whole setup is centralized. All the matters are to be reported to the CEO and manager of administration and all the policies and targets are approved at the higher level. And all the decisions are made at a single point in the hospital. As hospital is centralized but it has wide span of control.
6.1.2 -Personnel
There are about 550 employees who are working in the shalamar hospital administration, HR, marketing, finance, procurement departments. and 2200 doctors, specialists, nurses working in shalamar hospital. All of them are very devoted as they are given a wonderful learning environment to work, pay offered to them is also very attractive and ample chance of progress motivates them to work more. The job analysis is done on targets assigned and daily routines. The employees are indeed very satisfied and motivated.
6.1.3-Recruitment & Selection
Recruitment is the process of gathering a pool of candidates for an organizational vacancy. Selection is the process of short listing only the qualified candidates who are fit for the job. In terms of recruitment and selection it is important to consider carrying out a thorough job analysis to determine the level of skills/technical abilities, competencies, flexibility of the employee required etc. And HR at shalamar hospital follows these criteria.
Shalamr hospitals policy of recruitment is very simple, if at any time there is a vacancy, due to retirement, resignation, if employees opted for the golden handshake or the death of an employee/ doctor, the management will inform the managing director or the concerned department about the vacancy. Then HR department will
Page | 60
place an advertisement in all major newspaper with the all necessary information required to be furnished by the applicant.
Usually final selection and hiring takes place through the takes place after the candidate has been interviewed by the Manager of the department who requires the new employee and then the HR Manager and manager of administration. On the joining day, the employee has to fulfil theses following documents from the HR Department: Joining Report Copies of educational and professional degrees/certificates Reference Letter Three copies of recent passport size photographs
6.1.4-Training & Development
Training & Development involves improving the knowledge, skills and abilities of the individuals. A continuous training is conducted inside shalamar hospital to improve the performance of the employee, doctors and all other staff members.
6.1.5 Pay packages
The packages are also determined by the Human Resources Department. These are determined on the basis of performance, ACR, qualification and seniority. It has comparatively low pay packages yet good ones. The promotions are on the seniority cum fitness basis .So the qualified and the efficient workers are supposed to come up to the top.
6.1.6 Retention and firing
Human Resource Department also deals with the retention and firing of the employees .According to qualification and skills it ensures the employee benefits. More over the Human Resource Department also cares for the old age benefits
Page | 61
of the employees .It is obvious that the Human resources Department is of key importance and is playing a complementary role in the development and promotion of the hospital..
6.1.7-Compensation & Benefits A very effective way to retain an employee is to give him compensation and benefits. At shalamar hospital following benefits are given:
Medical Facility to employee and his/her parents Paid Vacations Retirement benefits
6.1.8-Pension and Life Assurance
After three months' service, every employee has the option to join the company's group personal pension scheme, or to take a cash alternative. All employees are covered under Life Assurance from their first day with shalamr hospital. The hospital contributes to the scheme and reviews its contributions on a periodic basis, to ensure that these remain suitable, attractive and fair.
6.1.9-Orientation
A newly hired employee is oriented so that he can get an idea about the hospital setup so that he/she may feel at home. At shalamr hospital orientation plan covers the following points:
Visits to different department of the hospital Hospital ¶s Policies, Rules and Regulations
Page | 62
6.1.10 Information System
At shalamar hospital first all the data relating to employees and patients was kept manually but now patient related data is saved in a data base. But still profiles of all the employees, doctors and nurses containing data relating their payroll, leaves, benefits etc is not saved in a database. And this is biggest drawback of HR department.
6.1.11 Holidays/ leave Policy
Each employee is entitled to a basic 23 days holiday per year. However, for some people this amount is either too much or not enough. For this reason, all their employees have the flexibility to trade salary and holiday. Each employee is entitled to receive 15 annual leaves, 10 causal leaves and 8 sick leave. An employee who took more than this then his/ her pay will be deducted.
6.1.12-Promotion
One of the most important and difficult tasks the HR Management department is charged with is rewarding the employees, staffs, nurses and doctors and deciding appraisals. Rewarding them properly for their hard work and effort is essential in maintain employee satisfaction and keeping them motivated. HR manager and concerned department heads always make sure that the appraisals that are handed out to the employees are fair and correspond with the level of input and output of each employee. A form of appraisal is handed over to all departments head for their comments about their employees, workers, nurses and doctors and then according to their comments appraisals are given.
Page | 63
6.2Human resource Requirement at Shalimar hospital
6.2.1-Supervising the implementation of Policies, Goals and Strategies:
* Supervising the implementation of the department¶s plans, as well as ensuring their compliance with company¶s rules and policies * Developing department¶s work plan; assigning work activities, projects and programs, monitoring work flow, reviewing and evaluating work methods and procedures, and directing such activities to serve department¶s goals and plans * Proposing plans and programs that boost the effectiveness of the department * Ensuring that instructions, circulars and organizational and technical decisions are followed and applied * Ensuring that work activities are carried out according to the pre-set performance goals, and suggesting any necessary actions to the Human Resources Director. * Conducting periodic meetings with subordinates to follow up smooth running of activities and keeping abreast with latest business-related practices
6.2.2Executive and Technical Duties:
* Implementing the Human Resources systems, procedures, and forms in addition to formulating and recommending policies, regulations and practices for conducting human resources programs * Communicating Human Resources-related policies and procedures to all company¶s employees and responding to inquiries regarding them * Preparing manpower forecasts to project employment needs and efficient manpower planning, succession planning and career path development * Ensuring the application of equal opportunity principle through the formulation of recruitment, testing and selection policies and programs * Managing and supervising the implementation of training policies and programs through conducting needs analysis studies and conferring with direct supervisors to determine training needs of employees * Administering the implementation of the performance appraisal process for the company¶s employees to ensure its effectiveness and the fair and equal treatment of all employees
Page | 64
* Developing and managing recognition and incentive programs for high potential employees, and developing and monitoring processes to upraise poor performance
6.2.3 General Administrative Duties:
* Preparing periodic reports with respect to the department¶s activities and achievements to be submitted to the Human Resources Director. * Specifying manpower requirements for the department according to the recruitment and selection and human resources planning practices. * Recommending training needs of subordinates and evaluating the outcomes of training courses * Following-up on employee administrative affairs such as: vacations, leaves ¦etc. * Conducting performance appraisals for subordinates according to scheduled plans and recommending necessary actions as per the applied practices. * Nominating a deputy to carry out the responsibilities of the position whenever the need arises. * Performing other duties related to the job as assigned by the Human Resources Director.
6.2.4 Professional Knowledge:
* Professional knowledge in Human resources systems such as performance Appraisal, Recruitment & Selection, Compensation & benefits etc. * Knowledge in Administrative and Supervisory concepts.
Page | 65
6.3 -Short-falls/Weaknesses of the HR Department
6.3.1 Planning
At shalamr hospital during my internship I observed that very small importance is given to planning. Upper level management like CEO and Director give low attention to this department. CEO and Administration department does not search for and does not know whether there is need of new employee at same job or not. They only know who is going out and there is a vacancy at the place of outgoing employee. I have examples for such employees who are doing work of two or three men. There should be better planning for that in order to achieve organizational goal. If the goal is to minimize the expenses it is not proper way to control and is not legally and ethical acceptable.
6.3.2 Recruitment
In Shalamar hospital recruitment is done internally as well externally. Recruiting is to attract qualified people to apply for positions with an organization. Shlamar hospitals do advertise their job in newspaper but not that often. And they let the people be informed by existing employees. Most of new employees are hired on reference basis. This is the biggest weakness of shalamr hospital.
6.3.3 Training & Development
At shalamr hospital every new employee trains himself at his own because training is not given properly by the hospital. Employee¶s new colleagues teach him manners of his job.
6.3.4 Compensation Plans
As shalamar hospital is an industry of conservative type therefore compensation and reward system is not very much impressive. Compensation level of shalamar hospital is low that is way qualified and talented people hesitating to join shalamar hospital. There are low basic pays offered. One good thing is that including allowances, pays
Page | 66
become double of the basic. But gross pay remains at the low level as compared to the other hospitals. Various allowances are given to employees like medical allowances etc.
As compensation level is low therefore employees are not very much motivated. Motivation level and morale of employees are low which affects the periodicity of the hospital. It is fact that shalamar hospital is well reputed hospital in mughalpura and covering productivity requirement but if morale and motivation levels are brought high the productivity could increase. Anyhow Pakistani work force are scared and compelled to take whatever any body gives because of unemployment. Some think is better than nothing.
6.3.5 Evaluation
Shalimar hospital performance of the employees is evaluated on the basis of what has been expected from them. The upper level management evaluates performance. Upper level management sees how an employee is performing on his assigned position. Sometimes if employee is unable to perform one given task and rest he fulfilled tasks on time than he wouldn¶t get any promotion. This is an unbiased decision. And is a big drawback of HR department.
Page | 67
CHAPTER NUMBER 7:
Dilemma Faced By Hospital
There are many problems faced by patients, doctors and administration of hospitals and a successful administration is which implement¶s effective measures to prevent from those problems. Directors or the managers of hospital must have quick decision making power in order to respond to the current dilemma faced by hospital.
During my internship shalamar hospital faced lot of dilemma¶s in Human Resource departments and other departments. Some of dilemmas are given below:
7.1Protection from Suicide bombing
When I was working in shalamar hospital the main and shocking dilemma faced by hospital was the security. In all cities of Pakistan suicide bombing were done frequently, they were occurring since last decade and our government was and is still helpless in this matter, they have no idea how to manage the country or how to save people from these incidents, no place in country was safe. Neither schools nor hospitals. 0n 20th June 2009 in Quetta a suicide bomber blew himself up inside a hospital.
This horrifying news made the directors and administration of shalamar hospital to make decisions regarding the security of hospital. For this purpose they installed cameras in all areas such as parking, emergency department, waiting areas, out-door patient department area, Indoor Patient department area etc and they also installed scanners on the entry gate. And checked cars, other vehicles before entering in hospital.
Human resource department was given notice of hiring educated five security guards and three persons for monitoring those cameras within one week. So HR manager Mr. Asif gave an advertisement in newspaper and started search of security guards and
Page | 68
employees for monitoring camera and after selection five guards and three employees were hired within one week.
7.2 Impact of Economic Recession
Shalamar hospital provide life-saving care to anyone needing it, despite their ability to pay for the health care services received. During my internship shalamar hospital provided more than Rs. 11.3 lac of uncompensated care. Shalamar hospital is not unique to the negative impacts of the current economic recession.
Shalamar Hospital is struggling with deteriorating revenues and increases in bad debt and charity care. As a result, hospital is having to make very difficult choices to reduce services, make staff reductions, or close services altogether.
7.3Emergency department in stress
Mughalpura has only one proper equipped emergency department hospital, which is shalamar hospital. As our population continues to grow and age, emergency room of hospital is under ever increasing pressure trying to care for all patients who enter their doors. Shalamar hospital¶s emergency room is "operating at or over capacity" with an increasing number of patients seeking care. Every four seconds, someone enters an emergency room in shalamar hospital. The average wait time now is about 4 hours and getting longer. And this was a bad and critical situation for shalamar hospital. So the administration decided to expand its emergency department. And now emergency department is out of stress. Because hospital has hired well-experienced staff, nurses and doctors and increased number of beds.
Page | 69
CHAPTER NUMBER 8:
Purpose &Expectations from HR internees
The practice of Human Resources is a distinctive approach to employment management which seeks to achieve competitive advantage through the combination of implementing an integrated array of personal, cultural and structural techniques.
If you plan to pursue a career in the field of Human Resources (HR) an internship will allow you to acquire the necessary skills and essential working knowledge in how to build and coordinate a good relationships with staff and learn how to communicate with people all over the world.
An internship in Shalimar hospital Human Resources department is a challenging, yet highly rewarding role, as it will prepare you for the job market afterwards. Working in Human Resources (HR) comprises a number of related activities, all of which are integrated into the overall ethos of this company. These areas cover, working practices, working conditions, conditions of employment, diversity and equal opportunities at work.
8.1 The Objectives of Shalimar HR Department are:
To provide assistance and support to our staff
To maximize the potential from our students at Internship and provide training to interns
To design and develop policies relating to the effective use of personnel within the hospital.
To follow-up applications and evaluate potential interns
Page | 70
It is the responsibility of Human Resources team to conduct all of the above activities and procedures in an effective, responsible and friendly way.
During internship in Human Resources you will have the opportunity to learn how to devise and implement policy changes that affect your surrounding working environment. To build and retain excellent communication and inter personal skills, and understand the intricate and multi-facet world of business practice and culture.
This work experience will provide you with a distinctive edge that is required to gain success in a future HR career. As an intern you will be working in our multi- cultural team, gaining hands on practical knowledge, learning how manage effective communication between staff and management. Interns in Human Resources need to ensure that the organization employs the right balance of staff in terms of skills and experience. In addition to provide adequate training and development opportunities to others to enhance overall performance and job satisfaction in the office.
8.2 Essential for the success of Human Resources department,
Essential for the success of Human Resources department, interns should be able to have a grasp of organisational legislation and working practices and have a clear understanding of business objectives, direction and procedures.
One of the benefits of internship program is that HR interns have the opportunity to gain hands on work experience in Human Resources. Therefore, for our HR department to operate effectively we expect our Human Resource Interns to have capable office skills as well as excellent interpersonal skills as you will be working both in a team and individually.
Supplementary to improving communication skills, this highly challenging internship placement will demonstrate how to effectively optimise an office environment and utilise a range of HR techniques.
Work closely with all departments, in a consultancy role
Prepare reports for management
Page | 71
Provide assistance for staff and advice (to help implement polices and changes in the workforce)
Ensure there is equality and diversity in the culture of the organisation
To devise and implement policies which select, develop and train staff
Establish and implement adequate training and induction programs for new staff
Develop HR planning strategies with managers, to consider the short and long term staff requirements / the allocation of resources and the direction of the company
Develop policies that affect working conditions, equal opportunities, disciplinary procedures and absence management
Interpret employment legislation
Work with a wide range of organisational procedures including health & Safety / office rules / welfare and living arrangements for other interns
Manage the work-life balance concerns of your staff and colleagues
Page | 72
CHAPTER NUMBER 9:
Internship Experience
I worked in Shalamar Hospital as an internee for six weeks in Human Resource department.The reason for choosing this organization for internship experience was that it is one of the biggest Hospital in our city. Although other companies and banks also offer the facility of internship for BBA students but I decided to work in Shalamar Hospital for its reputation and its friendly environment. Although an internee is not a permanent employee of the company but can get a lot of knowledge and skills in this very short period and so did I.
I took it as opportunity for me and my career and tried to acquire as many skills as I could. The management and other staff of departments have been very cooperative and guided me throughout my internship period.
They treated me like the employee of the hospital and took my full time to work in the hospital for me to get used to of working in an organization. It was for the first time in my life when I felt that there are some practical and reasonable assignments in front of me and I tried to accomplish each and every task with full of my responsibilities and capabilities
9.1- Concerned Department Information:
I did BBA and we studied all subjects in it but I had more interest in human resource subject so I decided to gain an experience and to see practical implementation of bookish knowledge of human resource subject. I worked six weeks in human resource department.
In this hospital each department is governed by director, so managing director was the head of the all the departments. Under director are the managers who manage their concerned departments.
Page | 73
Dr. Rashid Ahmed chief executive of the hospital has played a leading role in the all aspects of the hospital, he is fully aware of the international modern trends and treatments.
9.2-Human Resource Department
Ms. Safia Nazir is the Manager of HR department. Ms. Amber Hameed is assistant manager of Human Resource and Mr. Naeem is the manager of payroll.
There is a team of HR professionals who perform their separate duties and responsibilities. HR department is concerned with recruitment, staff training and evaluation. This department operates on future oriented strategy focusing on employee¶s and doctors personal and professional growth.
Ms. Sumaira had duty of recording leaves and marking attendances of all the employees, workers and doctors working in hospital. And Mr. Asif was responsible of issuing promotion, recruitment, warning etc letters to employees & doctors. And to keep all the record of employees, workers, doctors and nurses was the responsibility of Mr. Abdulla. Records of employees, doctors everyone was kept manually. There wasn¶t any computerized system of keeping record.
HR Manager Ms. Safia
Assistant HR Manager Ms. Amber
Promotion/ Leave Record Record Payroll recruitme section section keeping section Section Mr.Asif Ms.Sumaira Mr.Abdulla Mr. Naeem
Page | 74
HR department have a lot of responsibilities and functions to perform as it basically falls onto mangers shoulders to make sure that the hospital functions smoothly and effectively. If the HR Manager of a hospital fails to perform his duties effectively, the entire working system of the hospital is affected badly. Some of the key responsibilities of an HR department include:
9.2.1-Leave Record Section
Ms sumaira is responsible for recording leaves of all the workers, nurses, doctors and other employees working in hospital. She keeps a record of leaves manually and also on a computerized software i.e. solo-smart system. She also tells new employees about the leave policies. And informs them if their leaves are exceeding their policies. And she also prepares ID cards and job description of employees, doctors and nurses.
9.2.2-Payroll Section
Payroll section is concerned with the determination of monthly salary rates for workers, nurses, doctors etc and it vary according to occupation and level of experience. This section is operated by Mr. Naeem. A very effective way to retain an employee is to give him compensation and benefits. At shalamar hospitals following benefits are given: Medical Facility to employee and his/her parents and paid
Vacations, Gratuity, Provident fund etc.
9.2.3-Promotion/ recruitment section
Recruitment of employees, staff, doctors and nurses is one of the most important tasks of an HR Manager. Receiving cv¶s from employees and passing on to the concerned department head and then setting time foe interview with the prospective candidate and making sure that hiring him will be in the best interest of the hospital is the duty of a HR Manager. Moreover negotiating the salary and other job related clauses with the candidate is the duty of Mr. Asif.
One of the most important and difficult tasks the HR Management department is charged with is rewarding the employees, staffs, nurses and doctors and deciding appraisals. Rewarding them properly for their hard work and effort is essential in
Page | 75
maintain employee satisfaction and keeping them motivated. Ms Safia and Mr. Asif always make sure that the appraisals that are handed out to the employees are fair and correspond with the level of input and output of each employee. A form of appraisal is handed over to all departments head for their comments about their employees, workers, nurses and doctors and then according to their comments appraisals are given.
9.2.4-Record Keeping Section
This section of department is concerned with keeping the records of each and every individual working in hospital. It keeps record manually. There isn¶t any data base or any software used for record keeping. Records all doctors, nurses and other staff is kept in files and are given serial numbers for convenience to spot any file.
Page | 76
9.2- Work done by Internee (Duties/ Responsibilities)
During the internship in Shalamar Hospital some duties, responsibilities & tasks were assigned to me and I have to complete these tasks with my full attention and responsibilities.
Here I have given some little bit detail of these duties and responsibilities which were given to me in human resource department:
Human Resource Department
In HR department these responsibilities were given to me:
Preparing office order letters, contract letters, bank letters, appreciation letters, warning/fine letters, appointment letters and various other letters and issue them to employees.
Maintaining leave, attendance and absenteeism records relating to staff manually and on the solo smart system.
Checking and completing forms and required documents after selection of candidates.
Developing job description for the employees, workers, supervisors and doctors.
Preparing Roasters for doctors & nurses.
Undertaking regular salary review
Preparing different types of advertisements such as hiring nurses, doctors, chefs, sweepers etc.
Advising on pay and other remuneration issues, including promotion and benefits.
Page | 77
Communicating, dealing and solving problems of doctors, nurses or staff members and all other people who walk into HR department.
Prepared ID cards of all the employees working in hospital. Including doctors, nurses, security guards etc.
Carried out troubleshooting duties as required.
Assigned, directed, and managed the work activity of clerical staff.
Performs other reasonably related duties as assigned.
9.3- Learning/ Achievements
The main purpose of internship is to get a practical experience and to get some practical knowledge. Usually the period of internship is short but we can learn a lot from this period.
This was first time in my life when I was doing some reasonable and practical tasks. A lot of learning and achievements I have gotten from the hospital staff like:
First thing I learnt from this short period of job is punctuality. I learnt from this how to be in time in the hospital.
The second thing is dressing, professional dressing matters a lot. By seeing my seniors and colleagues I start to copy them in dressing. It was a big achievement for me, that I learn how to do the work in team and group of people. Working in the team should be learnt. Communication with the patients & vendors and to get their minds is very difficult task, but in Shalamar hospital I learnt it very well. How to sit in professional people, how to look, how to talk and how to work is also learning for me. I learnt from the Shalamar Hospital that how to accomplish the tasks and the assignments which were assigned to me.
Page | 78
It was first time in my life to work whole day in the hospital with full responsibility, to go in time and to off in time. I learnt how to implement my BBA knowledge. I learnt what the practical implementation of the book knowledge is.
Page | 79
CHAPTER NUMBER 10:
Recommendations
I have realized that Shalamar Hospital is performing very well since its inception. It is quite difficult to give suggestion to improve the working conditions of Shalimar Hospital . As we know that nothing is perfect, there is always a room for improvement, so I have found some recommendations during my internship which can be taken into account. The following suggestions are:
The hospital is also in process of computerizing its records which is good sign but it is going on with small progress. Computerization must be done on early basis. This will help in increasing efficiency of work done.
Shalimar hospital uses manual system of record keeping, it must move towards a computerized system for record keeping of employees, doctors, nurses and all other employees working in hospital.
Shalimar Hospital deals with thousands of vendors but during my internship period I came to know that there are a lot of complaints the company is facing from vendors. They have a biggest complaint towards delay in payments. So the hospital must improve the accounts department in order to maintain its goodwill.
In past Shalimar Hospital has always being suffered from bad Government policies. Government should minimize duties on imported machineries.
Employees and Doctors Training programme must be introduced on continuous basis so that Employees and Doctors have understanding with the latest developments especially with the customers and patients.
Shalimar Hospital should introduce incentive plans for employees on regular basis so that if employees may work whole heartedly for the welfare of
Page | 80
hospital. While giving incentives qualification, work, experience, hard work and such other factors must be considered.
Mismanagement of resources must be avoided as much as possible as it decreases profit but also discourage hard worker and honest employees.
Fresh graduates must be recruited. As the combination of Experienced and fresh can produce better results and it will improve the efficiency of management.
Management by objectives needs to be introduced immediately. It will help improve the functioning of the hospital and will lead to greater participation and the workers and subordinates will be encouraged.
In this fast moving world if Shalimar hospital wants to compete with our competitors and gain competitive advantage then it must use new equipments for treatments, give superior quality of care in low price & should do continuous researches on medicine.
The hospital should be adopting flexible policies, especially in the areas of the recruitment, promotions, evaluation of the employees otherwise the high turnover observed in the hospital will continue to create problems for the hospital now and in the future.
The higher authorities should form team-based management rather than centralized management. It would result in improvement in uplifting the morale of the employees. They will be more motivated and involved in all their operations resulting in overall effectiveness of the organization.
Should give recruitment packages, higher wages, etc., for nurses and other personnel in short supply. By providing these things hospital will face less workforce shortages. And should use concerted efforts to improve workplace climate, especially nurse doctor relations.
Page | 81
CHAPTER NUMBER 11:
Conclusion
Organizations exist when two or more people work towards achieving common goals. A hospital can never be better than the people it hires. Hence we have to get the best to be the best because the performance of the employees, doctors reflects the hospital¶s image and standing in the market.
Out of the three M¶s i.e. Man, Money & Machine, probably the human dimension is of the utmost importance. Hiring employees is not the sole objective rather the primary goal is to devise a tool that can help the hospital attract, maintain, retain and motivate them enough to give their best to the organization. Training and development is therefore the first step towards success. Better the quality of the employees, doctors better the performance of the Hospital. With better quality people executing the hospital¶s operations the Human Resource department can create a competitive advantage for the hospital.
By improving quality of care, using new effective & expensive technology, by increasing health care expenditures and insurance costs for employee¶s, doctors and nurses, shalamar hospital can gain competitive edge over competitors and can create barriers for new hospitals to entry into the market.
One main reason for better performance and recognition of this hospital in market is that shalamar hospital puts greater emphases on patient safety by regulatory agencies, and it uses all the safety measures to protect hospital infrastructure, doctors, patients and all other staff members from bomb blasts and other incidents.
If I have to express my experience of internship in shalamar hospital I would briefly say: ³ Shalamar hospital is a good Organization in the way that anybody can join it for his/ her long-term career. Overall working environment is comfortable. Management of hospital cares a lot of its employees, doctors, all other staff members
Page | 82
and considers them as the Asset of hospital. Behaviour of senior managers of hospital is very polite and they are caring about the individual¶s career and their growth.
However management is very demanding about the targets but good reward at the achievement of assigned targets is awarded.
Employees in each department are quite efficient. They work more than their working hours sometimes to accomplish goals and it is all according to their will. It also shows their loyalty, commitment to hospital. Employees are given the benefits like bonus, gratuity funds, loans, increments, and free medical.
Shalamar hospital is now moving towards computerized systems. All work is done on computers. All the entries, bio data of patients, doctors, nurses and other employees are kept in computer.This increases efficiency of the hospital.
I found my internship training at shalamar hospital to be a very rewarding experience. The training was beneficial because it helpful me to aware a real life working environment.
So far my learning is concerned; all the employees at HR department were quite cooperative. They helped me to understand the activities of a HR department to possible extent. Their good attitude gave me more confidence to learn more and to ask if I have any query in my mind. Besides their ever going activities they never get irritant by my questioning. I had made an honest efferent to present the working & operation of hospital in simplest way.
I feel pleasure that I have really gained a lot during 6 weeks & enjoyed working with experienced cooperative & intelligent staff.
Here in the end I want to sum up my report of internship in Shalamar Hospital in few words. Again I would like to say thanks to Shalamar Hospital and to all of its employees for providing such supportive environment of learning. I must say that my six weeks internship experience in Shalamar Hospital was a great learning time and I believe that it will be very helpful for me in future career.
Page | 83
During my internship in Shalamar Hospital I had chance to practically use my knowledge and skills which I have gained during my study as well as I gained and experienced different new skills on the job. It also helped to learn about the medical sector of Pakistan, its budget, equipments and services.
In the report I have tried my best to give very informative and useful details regarding my internship in Shalamar Hospital and I believe that by reading this one would agree with me that gaining practical experience of what we learn in books is as important and useful as any other thing. I was fortunate enough to secure a position as an internee here and thereby able to do an in depth analysis of the working environment of this hospital from the inside and of the external environment.
Page | 84
References
Websites
http://www.shalamarhospital.org.pk Google website methods of preparing report Retrieved on December 30,2008, www.projects.ex.ac.uk/RDavies/arian/ http://www.quickmba.com http://www.netmba.com
Book Reference
Management by Mar Coulter Principles of Marketing, by Philip
Managers Guidance:
Mr. Asif Ijaz (office Asstt HRD)
Page | 85
Annexure
Page | 86