CHAPTER FIVE – SECONDARY DATA: HOSPITAL PROFILES, CASE STUDIES, MEDICO-LEGAL CASES AND PATIENT GRIEVANCES. ______
5.1 Introduction: The researcher has collected a wide variety of secondary data to study the hospital scene to gain knowledge about the customer relationship management practices in different hospitals. The data has been collected with the help various information on internet websites, newspaper articles, hospital and medical journals, government publications, etc. The data is divided as follows – 1.) Profiles of some selected small, medium and large hospitals including both private and government hospitals. 2.) Case study of a selected best practice. 3.) Medico-legal cases and patients grievances.
5.2 Profiles of select Large Private Hospitals from Pune: 1.) Aditya Birla Memorial Hospital:
Figure 5.1 – Photograph of Aditya Birla Memorial Hospital. History: Aditya Birla Memorial Hospital was established in the year 2006 with the objective to develop world-class level institute for providing quality health care services to
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patients. The vision was to have a world class hospital in India. The mission of the hospital has multiple objectives – To maintain the highest standard of care and respond to the needs of the community in a compassionate manner. To provide state-of-the-art high quality and cost-effective healthcare services and latest information to improve and maintain health for the well-being of the community. To unrelentingly pursue the creation of value for the hospital’s customers, shareholders, employees and society at large. To foster a therapeutic relationship based on compassion that is felt, quality that is measurable and cost that is affordable. To become partners in health promotion with every section of society. Organizational Structure: The Aditya Birla Memorial Hospital is managed by the Aditya Birla Foundation a public charitable trust established in 1995 in memory of the late Mr. Aditya Vikram Birla of the Aditya Birla Group, a US$ 24 billion conglomerate. The trust is chaired by Mrs. Rajashree Birla. Infrastructure: Aditya Birla Memorial Hospital is a 500 bed multispecialty hospital. There are 13 operation theatres and also a 125 ICU bed complex. There are 300 doctors and 1,000 support staff. The OPD facility has 60 consulting rooms, 30 procedure rooms and 150 doctors serving OPD patients. Facilities: The hospital provides treatment in major specialties like cardiology, neurology, orthopedics, trauma care, gynecology, ENT, GI and ophthalmology, Radiography, 64- Slice Spiral CT scan, 1.5T MRI. It also has sub-specialty treatment for all major specialties. Achievements: Emergency and Casualty centre is at par to European and American standards, effective use of telemedicine facility for discussion of challenging cases, distance learning and teaching activities, established Child Development Centre for Neuro
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diseases, was chosen as the primary healthcare provider for Commonwealth Youth Games 2008, attached personnel was speaker at World Congress of Endo-Urology and Shock Wave Lithtotripsy held at Shanghai, have introduced single incision laproscopy. Tie ups: With multiple insurance companies and cashless hospitalization agencies. Education Facilities: The hospital has a number of medical courses – Post Graduate Certificate Course in Emergency Medical Services, Basic Life Support (Training Courses), Basic Trauma Life Support (Training Course), Diploma National Board, CPS (College of Physician & Surgeons) (ENT, DA, DG, DORL). Soft skill training for CRM: Hospital conducts IGNOU affiliated courses for the same. Computerization: The hospital has emphasis to use paperless and filmless technology in its services. The blood bank is only the second of its kind in the country to have fully automatic bar code integrated facility for error free and fast transfusion services. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify highest patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient Registration records, use of other supportive media for the same. Outreach Activities: The hospital conducts health training and awareness workshops in rural communities and has helped to reach out to two million people. Campaigns: Aditya Birla Memorial Hospital has launched responsible citizen campaign, launched Aarogya – Doot - an initiative for health volunteering, launched PCMC Aditya Jyot is the first eye bank in Pimpri-Chinchwad Municipal Corporation area in collaboration with PCMC on 14 November 2010 for collection, preservation and distribution of human eyes or corneas.
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Camps: The hospital organizes mobile clinics, medical camps. In December 2006 the hospital arranged a 6 day yoga camp. In January 2007 the hospital had organized a month long health checkup camp.1
2.) Bharati hospital:
Figure 5.2 – Photograph of Bharati Hospital. History: Bharati hospital was established in 1985 as a medical college attached hospital. Organizational structure: The hospital is a private charitable trust based hospital managed by a managing committee. Infrastructure: It is an 850 bedded tertiary care hospital. Facilities: The hospital has a multidisciplinary OPD and IPD with super specialty services. It has well equipped and modern critical care facilities like ICU, NICU and PICU. It also has a modern state of art operation theatre and all the diagnostic facilities like CT scan, MRI, mammography etc. are available. It has a 24 hours functional blood bank and a pharmacy. Achievements: The hospital has achieved various recognitions and awards for research oriented
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healthcare. Tie ups: The hospital has tie ups with various government and educational organizations. Education Facilities: The hospital has attached educational facilities for M.B.B.S., various M.D. and M.S. post-graduate courses and diploma courses, D.N.B., nursing and para-medical courses. Outreach Activities: The hospital conducts health training and awareness workshops. Campaigns: The hospital supports health and social causes with active participation. Camps: The hospital organizes mobile clinics and medical camps.2
3.) Columbia Asia hospital:
Figure 5.3 – Photograph of Columbia Asia Hospital. History: Columbia Asia commenced operations in 2005 in India and the Pune hospital is its seventh addition in 2013. Columbia Asia hospitals are clean, efficient, affordable and accessible with innovative design having manageable size and advanced technology focused on creating positive experience for patients. The vision of the hospital is to build the best managed healthcare company in Asia.
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The mission of the hospital is to deliver effective and affordable medical services in a clean and caring environment. The motto of the hospital is ‘Customer First’. Organizational structure: Columbia Asia is an international healthcare group operating a chain of modern hospitals across Asia. Columbia Asia Hospitals Pvt. Ltd.is one of the first healthcare companies to enter India through 100% foreign direct investment (FDI) and is owned by more than 150 private equity companies, fund management organizations and individual investors. Infrastructure: Columbia Asia Hospital - Pune, is a 100 bedded multi specialty facility situated close to the IT Parks at Kharadi. The hospital has highly qualified medical personnel and technicians to ensure healthcare delivery of the highest quality. Facilities: The hospital offers a wide range of clinical services such as cardiology, obstetrics and gynecology, minimally invasive surgeries, medical and surgical oncology, pediatrics and neonatology, ophthalmology, urology, gastroenterology, renal transplants, orthopedics, joint replacements, plastic surgery and bariatric surgery, vascular surgery, critical care medicine, orthopedics, oncology and oncosurgeries, etc. Achievements: Since its inception in July 2005, Columbia Asia Hospitals has been committed to providing the highest levels of quality healthcare in a clean and caring environment and to ensure this robust system of policies supported by suitable procedures are implemented including pursuing of NABH accreditation which is a must for all Columbia Asia hospitals. Tie ups: With various insurance and cashless hospitalization companies. Education Facilities: The hospital has recently started certificate courses. Soft skill training for CRM: The personnel and staff are trained for compliance with regulatory and quality
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standards such as statutory requirements, hospital policies and procedures adhering to the current standards. Computerization: Documentation consists of policies and procedures which are implemented by regularly training the personnel and conducting periodic audits to ensure the correct implementation of these policies and procedures through use of digital technology. Questionnaire: Feedback questionnaire is utilized to collect information. Customer Satisfaction Criteria: The collected CRM data is processed to evaluate patient satisfaction built on three principles with a view to achieve medical excellence which includes practice of evidence based medicine, medical audit and patient feedback and continuous professional development. Formal/Informal CRM in hospitals: Monitoring of quality indicators, incident reports, patient feedback and various mock drills for disaster and emergency situations, improvement of infrastructure, processes, and human resources. Outreach Activities: The hospital conducts health training and awareness workshops in various communities. Campaigns: The hospital supports health and social causes with active participation. Camps: The hospital organizes mobile clinics, medical camps.3
4.) Deenanath Mangeshkar Hospital and Research Center: History: Deenanath Mangeshkar Hospital and Research Center was established in 2001. The vision of the hospital is to always strive to meet to best standards of care by constantly upgrading their present skills and knowledge and to make new breakthroughs in managing patients entrusted in their care by contributing in a creative, scientific and ingenious way to the present understanding of medicine.
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Figure 5.4 – Photograph of Deenanath Mangeshkar Hospital and Research Center. The mission of the hospital is to relieve the aggrieved of, their pain, their agony, their ailment, their disease by preventing or curative treatments using state of the art Technology by the expert medicos and allied staff. Organizational structure: The hospital is managed by a joint board of trustees including both Lata Mangeshkar Medical Foundation and Jnana Prabodhini Medical Trust. Infrastructure: Total a 350 bedded hospital including an ICU setup with total 100 beds, Emergency Medical Services Programme as per international standards which includes 2 Wheeler ambulances, a fleet of 5 bus ambulances with all necessary medical equipment, 10 fully equipped operation theatres with all the necessary medical equipment. Facilities: The medical services available at the hospital includes diagnostic services like radiology, pathology, therapeutic services like ayurved, dentistry, dermatology, ENT, obstetrics and gynaecology, medicine, ophthalmology, orthopaedics, pediatric intensive care, psychiatry, surgery, etc. The hospital provides various 24 hour facilities such as Dial 1050 – for heart ailments and trauma, reception, billing, pharmacy, blood bank, coffee shop, ambulance or hospital attendant for going home, mortuary, bank ATM’s – Cosmos Co-Op Bank and State Bank of India. In addition to this time bound services like health checkup, public
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relation department, canteen, laundry, fax, photo-copying, optician shop are also available. Achievements: Received awards for best papers and also for various clinical trials. Tie-ups: Foreign Collaborations like the medical and paramedical staff is trained regularly at Zentral Krankenhousen, a 3000 bedded hospital in Germany. Latest trends in neonatal intensive care are implemented with help from UCLA, USA. New techniques of Laser surgeries by Middles borough, U.K. Rehabilitation Center with help of Philadelphia, USA. Training of Emergency Medical Services staff to handle any type of emergency/trauma with help from USA. Domestic Tie-ups includes Indian Red Cross Society, with multiple insurance companies and cashless hospitalization agencies. Education Facilities: Conducts various post graduate courses. Soft skill training for CRM: Conducts workshops for training of various software utilizations and upgrades like GCP, SPSS, Ayu soft. Computerization: Utilizes paperless and automated processes for information transfer between intra and inter departments. Questionnaire: The hospital uses feedback questionnaire to collect patient information. Customer Satisfaction Criteria: Feedback of patients is processed to evaluate patient satisfaction. Formal/Informal CRM in hospitals: Patient Registration records, use of media and specific process orientations for supporting CRM. Outreach Activities: The hospital conducts health training and awareness workshops for patient education. Campaigns: To care for the psychological and emotional needs of some of these unfortunates
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among us, and their near and dear ones, DMH created a platform as ‘Dinayan Kalaparv’ where many prominent artists perform for the relatives of patients, doctors and hospital staff in the auditorium of the hospital. Camps: The hospital has conducted various camps including dental camp, Rehabilitation camp, Diabetic Foot Care Camp, Cardiac Screening Camp, Voice Disorder camp.4
5.) Inamdar Multispecialty hospital: History:
Figure 5.5 – Photograph of Inamdar Multispecialty Hospital. The hospital is a multi-specialty hospital established in 2010 for providing healthcare to patients at a minimum cost. The vision of the hospital is to become the ideal healthcare provider across the globe. The mission of the hospital is to operate as a world class multispecialty hospital incorporating ethical practices at reasonable costs. Organizational structure: The hospital is managed by trust named as CIMET and is chaired by Mr. P. A. Inamdar. Infrastructure: It is a spacious modern amenities studded 220 bedded hospital with a state of art infrastructure and an eminent panel of doctors.
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Facilities: The hospital provides facilities in accident and emergency, arthroscopy, audiology, cardiac surgery, cardiology, dental, diabetic care, diagnostic radiology, diagnostic pathology, dialysis, dietician, dermatology, E.N.T, endoscopy, gastroenterology, general surgery, ICU services, health checkup, hematology, stem cell therapy, hernia, infertility, laparoscopy, medicine, micro vascular surgery, neurology, nephrology, neurosurgery, obstetrics and gynecology, ophthalmology, oncosurgery, orthopedics, purnopchar holistic therapy, pediatrics, proctology, psychiatrist, physiotherapy, plastic surgery, rheumatology, urology. Achievements: Bilateral knee Arthroscopy Successful Stem Cells Infusion for Multiple Sclerosis. Tie ups: With multiple insurance companies and cashless hospitalization agencies. Education Facilities: The hospital conducts a number of post graduate and diploma courses for medical, para-medical and administrative personnel. Soft skill training for CRM: Conducts workshops for CRM practices and various software utilizations. Computerization: Utilizes paperless and automated processes for information transfer between intra and inter departments. Questionnaire: The hospital uses feedback questionnaire to collect patient information. Customer Satisfaction Criteria: Collected CRM data is processed to evaluate patient satisfaction. Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same. Outreach Activities: Organized Children’s day and Christmas celebrations, the hospital conducts health training and awareness workshops for patient education.
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Campaigns: Supporting Independence Day Helmet Awareness Rally on 15th August 2013, CME on Balloon Sinoplasty, World Global Hand Washing Day, World Kidney Day. Camps: Palki Camp organized at Fatima Nagar by IMH on 3rd July 2013, Cardiac Camp Organized at Dharavi - Mumbai by IMH on 1st Jan 2013, Diabetic checkup, Oral Cancer and dental checkup, BMD screening, RIMS International School Health Camp, KausarBaug senior citizen health checkup, knee replacement camp, blood donation camp, skin checkup camp.5
6.) Jehangir hospital:
Figure 5.6 – Photograph of Jehangir Hospital. History: Jehangir hospital was Pune city’s first private hospital and was founded by Sir Cowasji Jehangir, Lady Hirabai Jehangir and Dr. Eduljee H. Coyaji on the 6th of February 1946. The vision of the hospital is to be the region’s foremost healthcare provider with access to diverse clinical services focusing on consistency in deliver y of quality care and use of best technology. The mission of the hospital is to provide healthcare of international standards through a team of qualified professionals and at a cost affordable to the community while being also committed to maintain clinical excellence by focusing on healthcare academics and use of latest technology.
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Organizational structure: Jehangir hospital is run by a public charitable trust headed by Mr. Jehangir H.C. Jehangir along with trustee board members and is managed in association with the Apollo Hospitals group. Infrastructure: Jehangir hospital is a 325 beds hospital providing tertiary level healthcare services. Facilities: Jehangir hospital has facilities for oncology, cardiology, cardiothoracic surgery, chest and respiratory, pediatric treatment, dentistry, dermatology, multi-specialty diabetes center, endoscopy, foetal medicine and prenatal genetics, ENT, general surgery, haematology, infertility, kidney transplant, laparoscopic surgery, laparoscopic urology, medicine, nephrology, neurosciences, interventional neuroradiology, obesity surgery, obstetrics and gynaecology, pediatric ophthalmology, orthopaedics and traumatology, arthroscopy, spine surgery, joint replacement, hand surgery, pain management, plastic (cosmetic) surgery, geriatric psychiatry, neuro psychiatry, urology, emergency medical services, services for corporate and industrial sector, pathology, laboratory, intensive care,64 slice CT angio, radiology. Achievements: Jehangir Clinical Development Centre (JCDC) is the first and only hospital based research centre which is ISO 9001:2008 certified and the third institute in India and seventh in Asia to receive the AAHRPP Accreditation which is a gold standard for research centres worldwide. The Hirabai Cowasji Jehangir Medical Research Institute (HCJMRI) founded in 1995 has the first cadaveric bone graft bank providing bones for patients requiring bone surgery. Tie ups: The Apollo Group has undertaken to manage the hospital along modern, professional lines since 1998. The hospital also has tie-ups with various insurance and cashless hospitalization companies. Education Facilities: The Hirabai Cowasji Jehangir Medical Research Institute is recognised by the Government of India as one of its scientific and research organizations and conducts
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research in the medical field. The hospital has made an arrangement with the Bharati Vidyapeeth Medical College to provide training to their undergraduate medical students and is now recognised as a teaching Institute for various MD and MS Courses of the Bharati Vidyapeeth Deemed University. Soft skill training for CRM: Hospital conducts courses for the same. Computerization: The hospital has emphasis to use paperless and filmless technology in its services. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same. Outreach Activities: The hospital conducts health training and awareness workshops. Campaigns: The hospital supports various health and social campaigns. Camps: The hospital organizes mobile clinics, medical camps.6
7) K.E.M. (King Edward Memorial) Hospital: History: The K.E.M. Hospital, Pune was established in 1912 by Sardar Srinivas Moodliar as a small charitable dispensary with four maternity beds which has grown to strength of 550 beds in 1999 under Dr. Banoo Coyaji’s leadership. Organizational structure: K.E.M. hospital Pune run is by the K.E.M. Hospital Society, registered under the Societies’ Registration Act 1860 and the Bombay Public Trusts Act 1950.
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Figure 5.7 – Photograph of K.E.M. (King Edward Memorial) Hospital. Infrastructure: The K.E.M. Hospital is a 550 beds tertiary level hospital. Facilities: The hospital has facilities for emergency services, a dedicated PICU, a state of the art NICU, a well-equipped rehabilitation centre, liver and gastroenterology unit, pediatric cardiology, epileptology and clinical genetics, haemato-oncology, orthopedic, neuro, surgical, cardiac, nephrology, obstetrics and gynaecology, pathology, radiology, medicine, academics and research, physiotherapy, etc. Achievements: Availability of low cost heart surgeries, success of ‘aarambh’ programme, opening of TDH centre. Tie ups: With social organizations like the Rotary and the Lions Clubs, charitable trusts, industries, schools, etc. Organizes orientations, visits and work experience for professional social workers and social work students from countries like Sweden, Germany, Finland, Austria, Turkey, Nepal etc. Education Facilities: D.N.B. seats recognized through the B.J. Medical College and Sassoon General Hospitals in subjects like medicine, surgery, anaesthesia, obstetrics and gynaecology, pediatrics, pathology and radiology.
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Direct DNB accreditation is for D.N.B. nephrology, neonatology, general pediatrics, primary DNB Pediatrics (Post MBBS), Post Diploma (D.Ch. from MCI recognized Institute/ University) DNB Pediatrics, IAP Fellowship in Pediatric Critical Care, IAP Fellowship in Neonatology, ISCCM Course - Indian Society of Critical Care Medicine-ICU, a one year comprehensive Post Graduate Course in Emergency Medical Services, the Revised General Nursing and Midwifery Course, The Post Graduate Diploma Course in Hospital Management. Soft skill training for CRM: Hospital conducts IGNOU affiliated courses for the same. Computerization: The K.E.M. Hospital Electronic Data Processing (EDP) Department has a highly sophisticated system consisting of IBM I Series-270 and IBM System I 5, JEEVA customized programme, which is a Hospital Management System (HMS). It has VB 6.0 front end and DB 2 as RD BMS with about 20 integrated modules, which include the accounts, billing, pharmacy, laboratories, blood bank, operation theatre, personnel department, etc. Every area of the hospital has computers linked to the main system, enormously facilitating the functioning of the hospital. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same. Outreach Activities: The hospital conducts health training and awareness workshops. Campaigns: The hospital has conducted a series of workshops on disease awareness, attitudes and bio-safety precautions for the K.E.M. Hospital staff. Camps: The hospital organises mobile clinics, medical camps.7
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8.) Noble Hospital:
Figure 5.8 – Photograph of Noble Hospital. History: Noble Hospital was established on 7th July 2007 and has the distinction of being the first and largest multispecialty, tertiary care hospital in the eastern part of Pune City. The vision of the hospital includes – To achieve standards of excellence which become a benchmark of industry practices. To hold integrity and honesty as most important principals and perform at all times at the highest ethical standards and encourage an environment of respect, trust and openness while applying quality management, leadership principles to foster employee growth and development. The mission of the hospital includes – To provide affordable and superior quality integrated health care for all including the underprivileged with dignity and accountability and to manage illness with skill and compassion. Organizational structure: Noble Hospital is led by managing director Dr. Dileep Mane and managed by a team of specialized doctors who are from different fields of medical science. Infrastructure: Noble hospital is a 250 beds hospital with an aesthetically modern and spacious design with almost 1, 85,000 sq feet of space.
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Facilities: Noble Hospital is a super specialty hospital offering state-of-the- art health care with various departments including general medicine and general surgery, Orthopedics, Dermatology, Ophthalmology, Dental Care, Endocrinology and Diabetes, ENT (Ear, Nose and Throat), Pediatrics, Gynecology, Neurology, Neurosurgery - Brain and Spine, Urology, Lithotripsy, Cardiology, Plastic Surgery and Psychiatry. The hospital also has facilities for Cathlab for Angiography, Angioplasty and Interventional Neurology, Haemodialysis, a modern laboratory and the latest Radiology Services. The hospital has an in-house Drug Store and 24-hour Emergency and Trauma Care Unit. Achievements: 120 bedded hospital coming soon in visionary of Noble Hospital with exclusive burn ICU.A trauma centre on Pune-Sholapur highway with a diagnostic centre. Tie ups: With various insurance and cashless hospitalization companies. Education Facilities: Courses conducted include – PGDEMS - Post Graduate Diploma in Emergency Medical Services. PGDHHCM - Post Graduate Diploma in Hospital and Healthcare Management. Soft Skill Training for CRM: The hospital has set up excellence standards and adheres to the highest possible levels for all that they do, and recognize that attracting and retaining superior and dedicated staff at every level of the hospital while providing training for collaboration between individuals, departments and institutions for better patient service. Computerization: The hospital has emphasis to use paperless and filmless technology in its services. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient Registration records, use of other supportive media for the same.
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Outreach Activities: The hospital conducts health training and awareness workshops in different communities. Campaigns: The hospital has various social and health awareness campaigns. Camps: The hospital organizes mobile clinics, medical camps.8
9.) Poona hospital and Research Centre:
Figure 5.9 – Photograph of Poona Hospital and Research Centre. History: Poona Hospital and Research Centre was established in 1985 entirely through donations from local citizens, with the aim of providing quality medical care at a reasonable cost to the public. Organizational structure: The hospital is managed by the Rajasthani and Gujarati Charitable Foundation, a registered Public Charitable Trust. Infrastructure: The hospital presently has 250 beds with state-of-the-art medical facilities, an ICU unit, operation theatre complex, OPD complex. Facilities: The hospital provides services for Cardiology, Neurology, Diagnostic Services like
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Radioimaging, Spiral CT Scan, MRI (Omega), Pathology, Medical Intensive Care Unit, Cardiac Intensive Care Unit, Neuro Intensive Care Unit, Operation Theatres, Cashless Facility, Emergency and Trauma Centre, OPD Services. Achievements: The hospital is engaged in preventive health programmes, medical education and clinical research and has received various awards for the same. The Flexavision FD - has been installed in the department of Radiology, is a compact radiographic fluoroscopy and digital imaging system which can be used for a variety of examinations. Tie ups: With various insurance and cashless hospitalization companies. Education Facilities: Poona Hospital and Research centre is accredited by the national board of examination for DNB in Medicine, General Surgery, Orthopedics, Cardiology, Neurology, Anesthesiology. The hospital also conducts Certificate course in respiratory therapy, Diploma course in General nursing and Midwifery recognized by Maharashtra Nursing Council and the Indian nursing Council. Soft skill training for CRM: Hospital conducts in house courses for the same. Computerization: The hospital has emphasis to use paperless and filmless technology in its services. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient Registration records, use of other supportive media for the same. Outreach Activities: The hospital conducts health training and awareness. In the memory of Late Shri.Navalmalji Firodia the 'Firodia Trust' donated Cardiac Ambulances to Poona Hospital and Research Centre on 28th July 2012.
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Campaigns: Cardiac rehabilitation programme based on lifestyle management principles with meditation, exercise, diet counseling and stress management is being conducted on a regular basis. Since 2002, Smile Train is an unique program, conducted in association with ‘smile train’ U.S.A., an international charitable organization providing free corrective surgery for children with cleft lip and palate with over 2000 procedures performed successfully in 6 years. Camps: A total of 13 blood donation camps were arranged during the months of July - October 2012 at various places like Kothrud, Bibwewadi, Pimpri, Hadapsar etc. The 25th blood donation amp held in memory of Late Shri. Rakesh D. Jain was organized in Poona Hospital and Research Centre on 15th July 2012 in collaboration with Jin Kushal Seva Mandal to mark the occasion of his 6th Death Anniversary.9
10.) Ratna Memorial hospital:
Figure 5.10 – Photograph of Ratna Memorial Hospital. History: Ratna Memorial Hospital was established in the year 1991 by Maharashtra Medical Foundation in memory of Late. Ratnabai Tulshyan wife of Mr. Shankerlal Tulshyan who donated the initial infrastructure while the land was donated by Mr. Kanitkar. Organizational structure: Ratna Memorial Hospital is managed by Maharashtra Medical Foundation a Public Charitable Trust instituted in the year 1978 by seven medical consultants.
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Infrastructure: Ratna Memorial Hospital is a 100 bedded multispeciality hospital. Facilities: The hospital provides facilities in General surgery, General medicine & cardiology, Eye clinic, Ent clinic, Nephrology, Orthopaedics, Neonatology, NICU, Well women's clinic, Obstetrics and gynaecology, Urology, Dermato cosmetology, Dental clinic, Diagnostic services like Multislice CT scan, Pathology laboratory, Cashless Facility, Blood Storage Centre, Food and Beverage Services, Emergency Services, Ambulance Services, Physiotherapy Services, Value Added Services like Drug Store, etc. Achievements: The hospital has started a nursing school. Tie ups: With Government sector entities like CGHS, Bharat Sanchar Nigam, Film and Television Institute, BalBharati, M.S.F.C., NCRE, NCCS, etc. With Corporate sector entities like TELCO, Cummins India Ltd., Kirloskar Brothers Ltd., Persistent Systems Pvt. Ltd., etc. With various insurance and cashless hospitalization companies. Education Facilities: DNB – medicine, anaesthesia, urology, obstetrics and gynecology, MRCOG revision course, CGO course, post graduate certificate course in emergency medical services, basic trauma life support (training courses), CPS (Collage of Physician and Surgeons - ENT, DA, DG, DORL). Soft Skill Training for CRM: Hospital conducts training programs for the same. Computerization: The hospital has digitized daily routine procedures to improve efficiency. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same.
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Outreach Activities: The hospital conducts health training and awareness workshops. Campaigns: The hospital supports health and social causes with active participation. Camps: The hospital organises mobile clinics and medical camps.10
11.) Ruby Hall Clinic:
Figure 5.11 – Photograph of Ruby Hall Clinic. History: Established in 1959 by Dr. K B Grant, Ruby Hall Clinic started modestly but has now grown to a mammoth facility establishing itself as one of India’s most advanced hospitals comparable to the best in the world. The vision of Ruby Hall Clinic is to enhance individual patient care through timely and relevant healthcare and to meet the healthcare needs of the needy patients in and around Pune. The mission of Ruby Hall Clinic is in keeping with the social commitment to render free and concessional treatment to the less privileged. Organizational structure: It is a Public Charitable Trust managed by the Grant Medical Foundation of which Dr. Purvez Keki Grant is the Chairman and Managing Trustee and is supported by well known dignitaries as members of the trust body.
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Infrastructure: Ruby Hall Clinic is a 560-bed hospital facility with a staff of 150 consultants, 500 panel doctors and 1400 paramedical staff. Facilities: Ruby Hall Clinic has state of the art facilities in Cardiology, Cardiac Surgery, Neurology, Nuclear Science Center, Diagnostic Center, Intensive Care Units, a Blood Bank and Cancer Unit. Achievements: Ruby Hall Clinic is Pune’s first nationally accredited hospital. The first Implantable Cardioverter Defibrillator (ICD) Implant (Medtronic Microjewel II) was performed in Ruby Hall Clinic on 15th January, 1998.The National PTCA Registry Records of India show that Ruby Hall Clinic comes first in Western India in Angiographies and Angioplasties and is classified as a high volume Institution in Cardiology. The Kidney Transplantations and Renal Dialysis Unit at Ruby Hall Clinic performed the first cadaver transplant in the state of Maharashtra, outside Mumbai. It is Pune's No.1 Hospital as per the survey done by ‘The Week’ Magazine on 1/3/2007. Set up the first MRI with IQ in 28/4/2007.India's Ex-President Dr. A P J Abdul Kalam’s visited to Ruby Hall Clinic's Cancer Center On 16/12/2007. A new hospital is being setup at Wanowrie as per information released on 18/8/2008. Chaney Architects of Pune has won the architect of the year award 2008 commendation for healthcare project “Ruby Hall Cancer Centre”. Ruby Hall Clinic was awarded 1st prize for Energy Saving by Maharashtra Energy Development Agency in Maharashtra in 2008 – 2009.Department of Pathology for Medical Testing, Ruby Hall Clinic has been awarded Certificate of Accreditation from National Board for Testing and Calibration Laboratories Department of Science and Technology, India in 2009. The Economic times named Ruby Hall Clinic the best hospital in India to work for in 2009. Dr. Keki Byram Grant won the distinction of being the oldest practicing physician in India in 2009 by Limca Book of Records. Tie ups: International Tie-ups with the University of Seychelles, American Institute of Medicine (USAIM) for undergraduate program in Medicine, collaboration with University of Illinois, Chicago for post graduate studies in Nursing, association with West midlands Ambulance Services of Birmingham, UK for Diploma in Emergency
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Medical Services (DEMS), till now 2000 students have passed out. Recognition from Siemens, Germany for adapting cutting edge technology at the fastest possible time. Asia’s first Beta site. Collaboration with Sydney IVF Centre for treatment of Infertility. Most preferred site for Clinical Research as acknowledged by Quintiles, United States. Domestic Tie-ups with both the Central and State Governments and also by most of the major Government undertakings and large industries for treatment of their employees and families. With various insurance and cashless hospitalization companies. Education Facilities: Ruby Hall Clinic is recognized by the University of Poona as a teaching institution for post graduate medical courses and is also recognized for DGO, DCH and DA courses by the College of Physicians and Surgeons, Bombay. It has also been recognized from time to time by the Indian Council of Medical Research for important research projects. Ruby Hall clinic imparts training for Diplomat of National Board of Examinations for Broad Specialty and Superspecialty degrees and Postdoctoral Fellowships in sub specialties like FNB (Fellowship in National Board), FICC (Fellowship in Indian Critical Care.), IDCC (Indian Diploma Critical Care.),new registers induction and orientation programme, nurses induction programme with help from Tehmi Grant Institute of Nursing Education. Soft skill training for CRM: Hospital conducts in house courses for the same. Computerization: I.T. Department is functional since 1990, and is continuously upgraded in Networking, Hardware and Software with setup including staff strength of 4 utilizing IBM I5 series AS/400 eServer, 9406-520 ( V5R4), IMAGE Server COMPAQ Proline 350, with storage capacity of 1.4 TB, Internal Mail Server HP Prolient 110, Software : JEEVA Online HealthCare System integrated with more than 30 modules. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria.
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Formal/Informal CRM in hospitals: Patient Registration records, use of other supportive media for the same. Outreach Activities: The hospital conducts health training and awareness workshops, uses patient information brochures. Campaigns: The hospital conducts free camps in the far-flung areas of Maharashtra in order to benefit the rural population and spends around Rs.6 crores in free treatment in a single financial year. Camps: The hospital organizes mobile clinics, medical camps.11
12.) Sahyadri Hospital-Deccan Gymkhana:
Figure 5.12 – Photograph of Sahyadri Hospital – Deccan Gymkhana. History: Sahyadri hospitals was established in 2004 and today it is one of the largest chain of hospitals in Maharashtra. Organizational structure: Sahyadri hospitals is managed by an executive committee as in a corporate organization with Dr. Charudutt Apte as its chairman and managing director.
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Infrastructure: Sahyadri specialty Hospital – Karve Road is a 180 bed, super specialty tertiary care hospital with all the latest modern technology and amenities. Facilities: Sahyadri specialty Hospital, Karve Road provides the following services – Behavioural Sciences and Mental Health, Cardiology, Dermatology, Diabetology, Emergency Medicine, Endocrinology, Gatroenterology, Haematology, Hepatology, Internal Medicine, Nephrology, Neurology, Non Invasive Cardiology, Nutritional Therapy, Obsteterics, Oncology, Ophthalmology, Pediatrics and Neonatal Medicine, Pathology, Pulmonology, Radiology, Rehabilitation, Rheumatology, Transfusion Medicine and Blood Bank, Preventive Health, Pharmacy, Cardiac Surgery, General and Laparoscopic Surgery, GI Surgery, Gynaecology, Neuro Surgery, Orthopaedics, Surgical Oncology, Thoracic Surgery, Urology, Vascular Surgery, Joint Replacement, ENT. Achievements: Sahyadri’s has established Centre for Excellence for Diabetes for consultation and treatment of diabetic patients and also to improve awareness among the people about the disease. Sahyadri Hospitals - Pune is the first to receive the Neuro Logica Cere Tom, Intra-operative CT scanner system which helps to transform the way Neuro- surgeries are done. Sahyadri hospital has achieved easy accessibility status with a Sahyadri hospital available within 15 minutes of reach in Pune. Tie ups: With various insurance and cashless hospitalization companies. Education Facilities: Sahyadri Clinical Research and Development Center (SCRDC) was developed to push forward the research for future clinical trial developments. Sahyadri Hospital Ltd is pursuing international accreditation from Association for accreditation of Human Research Protection Program. The hospital has DNB, IDCCM and paramedical courses. Soft skill training for CRM: Hospital conducts in house courses for the same.
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Computerization: The hospital has emphasis to use paperless and filmless technology in its services. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient Registration records, use of other supportive media for the same. Outreach Activities: The hospital conducts health training and awareness workshops in various communities. Campaigns: The hospital supports health and social causes with active participation. Camps: The hospital organizes mobile clinics, medical camps.12
5.3 Profiles of select Large Government Hospitals from Pune. 1.) Sardar Vallabhbhai Patel Cantonment General hospital:
Figure 5.13 – Photograph of Sardar Vallabbhai Patel Cantonment General Hospital. History: Sardar Vallabbhai Patel Cantonment General hospital was established in 1928 for
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providing medical services in OPD building donated by Maneckji Mehta. The present new hospital building was constructed in 1987 and ancillary facilities were added in 1999. Organizational structure: The hospital is run and managed by Pune Cantonment Board which is a government body. Infrastructure: The hospital has a 100 beds capacity. Facilities: The hospital has facilities like Medicine, Surgery, Orthopedic, Eye, ENT, Ayurveda, Homeopathy, Lab facilities, X-Ray, ECG, Sonography, etc. Achievements: The hospital has provided medical treatment to cantonment residents since 1928. Tie ups: The hospital has a tie up with NGO - Care India for providing free screening facilities for cancer detection in women and carry out necessary tests. Education Facilities: The hospital has training courses for its personnel. Outreach Activities: The hospital organizes various social and health awareness activities for patients. Campaigns: The indoor medical services are supported by the various national health programs including family welfare and immunization programs. Camps: The hospital organizes mobile clinics and medical camps.13
2.) Command hospital: History: The hospital was established in 1869 as one of three military hospitals established at and around Poona in the same year. It was initially the British Military Hospital, Wanowrie to cater to the British troops of the garrison as part of the station hospital
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Figure 5.14 – Photograph of Command Hospital. system. The two other hospitals established nearby were at Dinkirk Lines (now Kirkee) and Ghorpadi Lines. On 01 Dec 1947, the three hospitals were amalgamated into a single hospital. The new hospital was designated Military Hospital, Poona on 01 Jan 1948. The hospital was re-designated as Command Hospital (Southern Command) on 08 April 1967. Organizational structure: The hospital is run by the government under the defence ministry. Infrastructure: The hospital is a 300 bedded hospital spread over 105 acres of land. Facilities: The hospital has facilities for neurosurgery, urology, medical and surgical oncology, laproscopy, plastic surgery, nuclear medicine, cardiology and cardiac surgery, craniofacial reconstruction surgeries, stem cell therapy, etc. Achievements: The hospital has distinction of treating 868 casualties during ‘Operation Pawan’ in Srilanka. The hospital has provided medical aid during natural calamities such as the earthquakes at Bhuj and Latur, floods at Sangli and the Tsunami in Southern India. Tie ups: The hospital has tie ups with government defence establishments. Education Facilities: The hospital has facilities for Under graduate, Post graduate and super specialty medical courses.
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Outreach Activities: The hospital conducts health training and awareness workshops. Campaigns: The hospital supports health and social causes with active participation. Camps: The hospital organizes mobile clinics and medical camps.14
3.) Sassoon General hospital:
Figure 5.15 – Photograph of Sassoon General Hospital. History: Sassoon General hospital was established with the help of a generous contribution from Sassoon- a Jewish merchant family in the form of the David Sassoon hospital (Old Sassoon Building) serving the poor and needy from 1867, and the Jacob Sassoon hospital constructed by his nephew in 1905-06 to relieve the congestion on the David Sassoon hospital. Organizational structure: Sassoon General hospital is a large state-run hospital. Infrastructure: Sasoon hospital is a in Pune, India with 1296 bedded structures. Facilities: The hospital has facilities for different medical disciplines some of which include Behavioural Sciences and Mental Health, Cardiology, Dermatology, Diabetology,
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Ophthalmology, Pediatrics and Neonatal Medicine, Pathology, Pulmonology, Radiology, Rehabilitation, Rheumatology, Transfusion Medicine and Blood Bank, Preventive Health, Pharmacy, Cardiac Surgery, General and Laparoscopic Surgery, GI Surgery, Gynaecology, Neuro Surgery, Orthopaedics, Surgical Oncology, Thoracic Surgery, Urology, Vascular Surgery, Joint Replacement, ENT, CT scan, Nuclear Medicine Department, Cardiac Catheterisation Lab, Cardiovascular Thoracic Surgery Unit, super specialty services, diagnostics for diseases like leptospirosis. Achievements: The hospital has served people of Pune for almost 150 years. Avtar Meher Baba was born in the old maternity ward in the hospital, and the father of the nation, Mahatma Gandhi was operated upon for emergency appendectomy in 1924. The hospital fought the outbreak of 2009 H1N1 (Swine flu) in Maharashtra. In February 2010, BJMC and Sassoon General Hospital promptly handled the casualties of German Bakery bomb blast. The Maharashtra Institute of Mental Health - an apex training and research institute was set up in 1991. Tie ups: Johns Hopkins University (JHU), USA. National Institute of Health (NIH) USA, Vanderbilt University USA-NARI-BJMC collaborative project on Cancer Cervix Screening in HIV, WHO Cardiovascular Disease surveillance project, International Clinical Epidemiology Network project for MDR TB surveillance, IDSP Training and pilot center, NACO Training Center for MOs, Technicians and Counselors, etc. Collaborative research through funding agencies like the ICMR and DST. Tribal Research Programme was initiated by the Government of Maharashtra with Sassoon hospital. Education Facilities: The hospital is affiliated to the B. J. Medical College and a Nurses training School offering courses such as MBBS, MD, MS, PhD, Diplomas, MCh (CVTS), MSc, GNM, BSc Nursing, DMLT, PGDMCH, and PGDGM. Outreach Activities: The hospital conducts outreach services in mental health, preventive medicine, human reproduction research, tribal research, through national agencies like ICMR, and international agencies like WHO and UNICEF. The hospital has formed an Institutional Ethics Committee and also publishes quarterly Drug Bulletins – ‘Drugs
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News and Views’ from 1993 and has been conducting CMES for general practitioner. The Microbiology Department has started surveillance services for communicable diseases. Campaigns: In year 2005, through National AIDS Control Organization (NACO) HIV treatment center (ART) was started giving treatment free of charge. Various national health programs including family welfare and immunization programs are organized. Camps: The hospital organizes mobile clinics and medical camps.15
5.4 Profiles of select Small and Medium Private Hospitals from Pune. 1.)Ace Multispecialty hospital and Research Centre:
Figure 5.16– Photograph of Ace Multispecialty Hospital and Research Centre. History: The hospital was established in 1983 as Dr. Patankar Day Care Centre which was later established as Institute of Urology which amalgamated with Arogyaseva Medical Academy of India (AMAI) a Public Charitable Trust and formed in to the ACE Multispecialty Hospital and Research Centre in 2009. The hospital has evolved around the concept that – “Coming together is beginning. Keeping together is Progress. Working together is Success” and the motto ‘Service- Duty-Sacrifice’. The hospital works on the objective to provide ultra-modern, cost effective and better medical treatment to patients suffering from urological and other diseases and also
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implement special programmes, carry on research and to development activities and research for use of herbal medicines, alternate medical treatment. Organizational structure: The hospital is managed by Arogyaseva Medical Academy of India (AMAI). Infrastructure: ACE is a 80 bedded multi-specialty hospital, well equipped with ultra modern diagnostic and curative equipments. Facilities: The hospital has facilities for urology, urosurgery, medical and surgical oncology, laproscopy, plastic surgery, kidney transplant operations, etc. Achievements: N. L. Abhyankar Award given by NRI Parents Organization, Pune for outstanding work in field of medicine -2013, Chandigarh Best video prize of All India, Urological Society of India – 2007, Doctor Of The Millenium Award in 2005, Prestigious Patwardhan Puraskar for Research in Ayurveda – 2001. Doctors’ of the institute have held various important positions in medical fraternity. Tie ups: The hospital has tie up with corporates such as Alfa Laval India Ltd., TATA Motors, Thyssenkrupp Industries India Ltd., NABARD. The hospital has tie up with government entities such as Maharashtra State Electricity Distribution Corporation Limited, Pune Mahanagar Parivahan Limited, Pune Municipal Corporation, With various insurance and cashless hospitalization companies. Education Facilities: The hospital is a research and development institute recognized by Department of Science and Technology, Government of India. The hospital is an educational institute recognized for conducting DNB courses in Urology, Ph.D. by University of Pune and Maharashtra University of Health Sciences to conduct research in Urology as a research place. Soft skill training for CRM: The hospital has established training centres, diagnostic centres to provide education in medical field to doctors, nurses, para-medical staff about running and administration of hospitals.
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Computerization: Utilizes paperless and automated processes for information transfer between intra and inter departments. Questionnaire: The hospital uses feedback questionnaire to collect patient information. Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same. Customer Satisfaction Criteria: Feedback of patients is processed to evaluate patient satisfaction. Outreach Activities: To create awareness among masses the hospital conducts free medical check up camps, organizes lectures, creates awareness through talks and articles etc. Campaigns: The hospital organizes seminars and conferences for medical practitioners to create about health and health related problems thus helping a change in general health awareness for masses. Camps: The hospital organizes mobile clinics and medical camps particularly for benefit of rural and poor needy masses.16
2.)Bora hospital:
Figure 5.17– Photograph of Bora Hospital.
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History: The hospital was established with the vision to be among the leading in health industry, delivering quality healthcare, ensuring equity and compassion for persons of all social and economic strata on a sustainable model. The mission of the hospital is to provide world-class healthcare in key specialties, engaging in state-of-the-art technologies with medical and managerial aspects. The value statement of the hospital constantly endeavours it to remove barriers of accessibility and affordability especially of those who are socially and economically deprived and offer quality healthcare of international standards at a reasonable cost combining efficiency and effectiveness, care with a human touch in the noblest ideals of concern and compassion. The hospital also thrives to maintain mutually beneficial relationships with governmental and non-governmental organizations involved in healthcare and related areas and support healthcare education and research of the highest quality. Organizational structure: The hospital is managed by a managing committee. Infrastructure: The hospital is a 25 bedded state of the art structure. Facilities: The hospital has facilities like Medicine, Surgery, Orthopedic, Eye, ENT, Ayurveda, Homeopathy, Lab facilities, X-Ray, ECG, Sonography, etc. Achievements: The hospital has been providing medical and surgical treatment for many years and have received many awards and recognition for the same. Tie ups: With various insurance and cashless hospitalization companies. Education Facilities: The hospital has post-doctoral study courses. Soft skill training for CRM: Hospital conducts courses for the same. Computerization: The hospital has emphasis to use paperless and filmless technology in its services.
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Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same. Outreach Activities: The hospital conducts health training and awareness workshops. Campaigns: The hospital supports various health and social campaigns. Camps: The hospital organizes mobile clinics, medical camps.17
3.) Chaitanya hospital:
Figure 5.18 – Photograph of Chaitanya Hospital. History: Chaitanya Hospital is a multi-specialty hospital started in 2002 by Dr.Sushil Kulkarni and Dr. Deepa Kulkarni with an aim of ‘Quality, Service and Satisfaction’ for providing the best possible care and services to their patients. Chaitanya Hospital came into being modestly but it is now one of the best medical services providers, keeping in mind the patient and their needs.
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Organizational structure: The hospital is managed by a management committee. Infrastructure: Chaitanya Hospital is 40 Beds Hospital housed in a spacious three-storied building with 5700 sq. ft. built-up area and 2000 sq. ft. open area, complete with Intensive Care Unit, Two Operation Theatres, High Dependency Unit, 24 hours Emergency Services, 24 hrs X – Ray and Lab. Facility, Pharmacy, Physiotherapy, a prompt Ambulance service equipped with life saving equipments meeting International standards etc. Chaitanya Hospital also has a 24 hours generator backup and stretcher lift as well. Facilities: The hospital has multispecialty services like advance Fracture Management, Spine and Brain Surgery, Oncosurgery and General Surgery, Trauma, Head Injury, Accident Care and care for other medical Emergencies, etc. Achievements: The hospital has received many awards for its services. Tie ups: Chaitanya Hospital provides health services to all P.C.M.C. employees under Dhanwantari Yojana Cashless Hospitalization scheme. The hospital has been serving many companies in P.C.M.C. area, Chakan and Pune. The hospital has tie up with various insurance and cashless hospitalization companies. Education Facilities: The hospital has post-doctoral study courses. Soft Skill Training for CRM: Hospital conducts courses for the same. Computerization: The hospital has emphasis to use paperless and filmless technology in its services. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria.
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Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same. Outreach Activities: The hospital conducts health training and awareness workshops. Campaigns: The hospital supports various health and social campaigns. Camps: The hospital organizes mobile clinics, medical camps.18
4.) Mai Mangeshkar hospital:
Figure 5.19 – Photograph of Mai Mangeshkar Hospital. History: Mai Mangeshkar hospital was inaugurated on 16th March 2010. It is commemorated to the memory of MAI, beloved mother of ‘Mangeshkar Family’ and is situated at Warje, Pune. The hospital strives to serve the surrounding community with the purest goals of providing rational practice of medicine and ethical care being imparted at affordable costs. The hospital has a vision of being a true caring friend to the community and tries to make our mark as a hospital by being humane, devoted, polite, soft-speaking, and well mannered care-givers. Organizational structure: The hospital is run as a joint venture of Jnana Prabodhini Medical Trust and Lata
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Mangeshkar Medical Foundation. Infrastructure: Mai Mangeshkar Hospital is a 60 bedded full-fledged community hospital with all basic amenities. Facilities: The medical services available at the hospital includes diagnostic services like radiology, pathology, therapeutic services, dermatology, ENT, obstetrics and gynaecology, medicine, ophthalmology, orthopaedics, pediatric intensive care, psychiatry, surgery, etc. Achievements: Received awards and recognition for its service to the community. Tie-ups: The hospital has tie up with multiple insurance companies and cashless hospitalization agencies. Education Facilities: The hospital has association with Deenath Mangeshkar hospital for post-doctoral studies. Soft skill training for CRM: “Pravarutti Vikasan Ani Sanvaad Kaushalya Shibhir” camp is conducted where employees are taught on a day-to-day basis the value of gentleness, compassion and understanding in this special situation. Computerization: The hospital has emphasis to use paperless and filmless technology in its services. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same. Outreach Activities : A team of doctors is sent in the community on two Sundays each month to conduct a
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3-hour Community Outreach Program. The team visits societies, hutments, settlements covering all socioeconomic classes in an effort to build a bridge with the community that is to be served with help of interaction and discuss with the people on a range of issues. The hospital issues free coupons for a few tests and consultations irrespective of any socioeconomic considerations to the patients during such visits. Campaigns: The hospital has a campaign called ‘SUHRUD’ which involves ‘Rational and Ethical Practice’ along with ‘Personal Touch’. Every day between 6.30 to 8.30 pm, a well- qualified family doctor looks after OPD patients at a minimal charge of Rs.10 paid by the patient for consultation and 3 days worth of generic medicine. The hospital also runs a OPD schedule on Sunday and attends to patients without emergency charges during daytime. The hospital caters to the large middle-class population in Warje and with this view the packages are priced 20% lesser than prevalent market prices. Camps: The hospital organizes mobile clinics, medical camps.19
5.) Shree Shakti hospital:
Figure 5.20 – Photograph of Shree Shakti Hospital. History: Shree Shakti hospital was established to provide patients with latest technology, multi-disciplinary capability, state of the art facilities and excellent patient care ambience and processes all at a single location. Shree Shakti hospital aims to become the most advanced and progressive healthcare institution in the country for which it
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has initiated various preventive healthcare packages that would aid citizens over varying age brackets. Organizational structure: The hospital is managed by a management panel headed by Dr. Mahendra Gulati. Infrastructure: The hospital is a 25 bedded hospital with state of the art equipment. Facilities: The hospital has facilities for critical care and emergency care, heart care, minimal access surgery, general surgery, bone and joint surgery, spine and brain care, urology and nephrology, medical and surgical oncology, gynecology, Pediatrics and pediatrics surgery, psychiatry, dermatology, radiology and imaging, physiotherapy, etc. Achievements: The hospital has gained recognition as a centre for excellence in healthcare provision. Tie ups: The hospital has tie up with corporate and government organizations. The hospital also has tie up with various insurance companies and cashless hospitalization services. Education Facilities: The hospital conducts CME programs to improve knowledge and skills of its staff. Soft skill training for CRM: Shree Shakti Hospital follows process driven quality systems and adheres to international standards of clinical care, safe environment and medication safety and implements training programmes for the same. Computerization: The hospital has digitized daily routine procedures to improve efficiency. Questionnaire: The hospital utilizes feedback questionnaires to collect CRM based information. Customer Satisfaction Criteria: Uses CRM data to identify patient satisfaction criteria. Formal/Informal CRM in hospitals: Patient registration records, use of other supportive media for the same.
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Outreach Activities : The hospital has a Senior citizen card to provide health package for the senior citizens including regular monthly health checkups and other facilities. The hospital also provides Family health card and Vibgyor card for provision of health services at discounted rates. Campaigns: The hospital has established a Diabetic club through which it tries to spread awareness about the disease. Similarly it issues a Womens’ health card for discounted check up to create awareness for womens’ health and well being. Camps: The hospital organizes mobile clinics and medical camps.20
5.5 Observations from profiles of hospitals : The following differentiation was observed in the profiles of the Large Private hospitals, Small - Medium Private hospitals and Large Government hospitals as given in the following table –
S. Private Evaluated profile Government No Large Small-Medium
1.) Organizational Private trusts, Private trusts and Directly under Structure : Public trusts, individual or health ministry or Corporate group ownerships. run by a entities. government body.
2.) Infrastructure : Bed Capacity – 100 and above. Upto 25 beds for Mostly large small hospitals capacity from100 and upto 99 beds beds and above. for medium
hospitals.
Equipment may Equipment - Well equipped Less advanced be advanced. equipment. state of the art. Inadequate Inadequate Availability of Adequate
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number of numbers. numbers. numbers. equipment units -
3.) Facilities : Multiple and Fewer facilities Multiple facilities latest facilities are present. present but latest present with facilities may not separate be present. departments.
4.) Achievements : Many Recognitions and Recognition and recognitions awards are limited awards received and awards for to individuals for humanitarian example rather than the and social causes Jehangir hospital for for example staff hospital example doctor of of Command received the millennium hospital was AAHRPP award given to honoured for accreditation. Dr. Patankar of treating casualties Ace hospital. of ‘Operation Pawan’.
5.) Tie-ups : With With a selected With government Corporates, few TPA’s, and NGO’s, Insurance sometimes with C.G.H.S., E.S.S. companies and government cashless service schemes such as providers, C.G.H.S., E.S.S. TPA’s, rarely associated with government schemes.
6.) Educational Both Some diploma Government Facilities : government and certificate affiliated super approved and training programs specialization and
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private post which are mostly specialization post graduate private. graduate degree, diploma, diploma, degree, certificate certificate programs, nursing programs, and para medical nursing training, staff training newer technique programs. and medical continuing education training.
Customer Relationship Management Practices :
7.) Soft skill training Training of Few hospitals Absence of for CRM : personnel for conduct training training programs. various patient programs while support most use oral or software and print instructions regulatory and for the same. quality standards such as statutory requirements, hospital policies and procedures.
8.) Computerization: Use of Basic Paper records and specialized Computerization limited CRM software, with inter computerization. emphasis on department complete network. automation and use of paperless and filmless
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technology.
9.) Feedback from Almost all Some hospitals Absence of patients : hospitals use feedback feedback feedback questionnaires. questionnaire questionnaires system although to collect CRM some do use a based drop box for information. complaints.
10.) Customer Most of the Some of the Almost negligible Satisfaction hospitals CRM hospitals CRM attempt for Criteria : data to identify data to identify identifying patient patient patient satisfaction satisfaction satisfaction criteria. criteria. criteria.
11.) Formal/Informal Most of the Some hospitals No utilization of CRM practices in hospitals use utilize patient patient records hospital: patient records and other and absence of registration supportive media. supportive media. records and other supportive media for the same.
12.) Outreach Most hospitals Some hospitals Absence of such Activities : conduct training conduct training activities. and awareness and awareness workshops for workshops. the same.
13.) Campaigns : Most hospitals Some hospitals Mostly support support health support a few government and social campaigns. campaigns. campaigns.
14.) Camps : Most of the Few hospitals Organization of
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hospitals organize camps. camps with help organize camps Receive few of government and many are sponsorships. initiatives and sponsored by NGO’s. Some corporates. times may receive corporate sponsorships.
Table 5.1 – Observations from profiles of hospitals.
5.6 Conclusion from profiles of hospitals: Although most of the large private hospitals have entered late in the healthcare scene in Pune, they have started utilizing CRM practices to improve patient satisfaction levels. Few of the small-medium private hospitals have started utilizing CRM practices for improving patient satisfaction levels. Government hospitals are not utilizing CRM practices for improving patient satisfaction levels.
5.7 Case Study of Narayana Health formerly known as Narayana Hrudayalaya Heart hospital: a.) Introduction : Health of the citizens is one of the important factors needing attention in developing nations. In India, the large population along with economic difficulties results in a difficult scenario for healthcare service provision. The WHO data of 2009 indicates that India spends 4.2 percent on national health system which is low compared to the western world.21 The majority of health spending in India is through patient’s private sources. In India about 80 percent of healthcare services are available in urban areas although population distribution is around 70 percent in rural areas.22 This disparity in the healthcare sector has necessitated the private healthcare sector to provide cost
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Figure 5.21 – Narayan Health : Case Study. effective and modern treatment facilities in both urban and rural areas to satisfy their treatment needs and also providing to them a patient friendly environment. b.) The Hospital: ‘Narayana Health’ formerly known as ‘Narayana Hrudayalaya’ is one of the first healthcare service providers to pioneer in providing cheap yet world class health services in India. Narayana Health has established itself as a hospital which has been successful in achieving patient satisfaction while serving a very heterogeneous and broad mix of population. Narayana Health is a benchmark in the healthcare service providers as it has successfully proved that a corporate organization can provide the best medical services available without compromising on ethical and human values. NH while implementing innovative strategies has managed to create a balance between provision of charitable healthcare services versus stable profit margins, use of conventional technique versus the latest in healthcare technology, lower asset investment versus high volume of treated patients, without neglecting patient needs and their satisfaction. Thus NH has set an example for being a socially aware successful corporate group in the healthcare sector as well as the corporate world. c.)Vision: The hospital was started with the vision of providing affordable quality healthcare to the masses worldwide.
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Figure 5.22 – Photograph of a group hospital of Narayana Health. d.)Mission: The hospital’s mission was to fulfill a dream of making quality healthcare available to the masses worldwide while being committed to becoming a tertiary care referral centre for complex medical and surgical problems, developing a health city model to be replicated nationally and internationally and also excelling in education, training and research center in medical, paramedical and allied specialties.23 The hospital started with a humble beginning with 300 beds in 2001 as Narayana Hrudayalaya Heart hospital. In 2013, the hospital has transformed to be Narayana Health a multi-specialty healthcare conglomerate with 6000 beds present within 17 hospitals present in 13 locations across the country which includes Bangalore, Kolkata, Ahmedabad, Hyderabad, Jaipur, Raipur, Jamshedpur, Guwahati, Mysore, Dharwad, Kolar, Shimoga and Davangere. The Bangalore hospital performs 120 major surgeries every day and attends 80,000 OPD patients per month while offering super-specialty tertiary care facilities in multiple disciplines of medicine. Presently, the hospital is equipped with all super-specialty and tertiary care facilities and is now a one-stop destination for any healthcare requirement a common man needs. The hospital has been receiving accolades and awards, NH has been the recipient of “Financial Times Arcelor Boldness in Business Awards” in 2013 for its various innovative strategies to treat and satisfy its patients and this case study tries to enlighten on this aspect of the hospital.24
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e.) How Customer Relationship management is utilized: Narayana Health has been successful in satisfying patients through use of different innovations and strategies as follows –
1.) Cost Reduction:
Figure 5.23 – Comparision of cost and volume of surgeries between Narayana Health and other hospitals. It has been reported by researchers such as Gaziano (2007), of presence of millions of people being affected by heart disease globally with Indians’ accounting for 45 percent of heart patients.25 In India patients are not able to avail satisfactory treatment due to cost affordability. These proportion discrepancies lead to the idea of establishment of ‘Narayana Hrudayalaya’ now known as ‘Narayana Health’, by Dr. Devi Shetty while implementing the ‘Wal-Mart’ strategy. The primary focus was to increase the volume of patients’ that are being treated and thus reduce costs to make the treatment affordable. The hospital performs eight times more procedures per day than other Indian hospitals thus reducing the cost per surgery for individual patients. NH uses a strategy of keeping an asset light model by working to keep low operating costs by investing in green field projects where land and buildings belong to Narayana Health. NH has also had tie ups and partnerships with existing hospitals wherein they run the specialty department of hospitals which own the land and building but the entire facility with equipment, manpower belong to Narayana Health. The hospital has reduced capital expenditure by keeping the number of beds and hospital sizes
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manageable through innovative planning and construction as per the requirement of a particular demographic and geographical location. The hospital has managed to reduce costs of procedural infrastructure such as machines by leasing them at competitive rates from suppliers rather than purchasing, and also arranging for maintenance contracts at reasonable rates. The hospital also purchases consumable reagents for these machines and other needs on a short term supply basis as the large volume helps them to negotiate for low buying prices and avoiding supplier monopoly. The hospital has achieved further reduction in prices by using cheaper alternatives without compromising on quality like use of digital radiography as compared to conventional film, reduction in price by procuring drugs directly from pharmaceutical companies by means of tie-ups, reduction in spending on staff salary by increasing the working hours of staff without reducing pay scale. These cost reduction measures have helped ensure that patients are offered world class services at low prices and satisfaction levels are high for patients as regards the value for money at the hospital.26
2.) Treatment satisfaction for all:
Figure 5.24 – Narayana Health: providing satisfactory treatment for all socio- economic groups of patients. The hospital offers ‘Karuna Hrudaya’ scheme that allows financially constrained patients to pay Rs. 65,000/- for open heart surgery while the rest of the costs are borne by the hospital. For patients who cannot afford the above scheme the hospital helps to arrange funds in form of donations from a list of individuals and organizations such as
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‘Children’s Heart Link’ foundation in Minnesota (USA) who sponsored free heart valves to 50 underprivileged patients. The hospital offers senior citizens membership for a nominal Rs. 300/- which can avail them free registration and consultation, discounts up to 25% on diagnostics, and free sessions on yoga, meditation etc. The hospital tries to balance between paying and non-paying patients while trying to provide treatment to all patients through implementation of a daily accounting system that accounts for all revenue and costs for the day, including prorated salaries and medical supplies. This daily financial information is provided to scheduling doctors who are then able to assess how many surgeries can be performed at a subsidized cost on that particular day. Thus in this manner no patient is turned away from the hospital without satisfaction for their treatment needs.27
3.) Insurance:
Figure 5.25 – ‘Yeshasvini’ Insurance – A ‘Narayana Health’ initiative for farmers. (Source: The Indian Express26). The hospital has created an insurance program called ‘Yeshasvini’ to help the low income patient group in Karnataka like farmers by them paying just Rs 5/- per month to avail of free treatment for any procedure costing upto Rs. 2,00,000 at 150 hospital in 29 districts across Karnataka .This patient friendly insurance facilities has now
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been extended to other groups like teachers etc.28 has thus ensured the hospital of a more satisfied low income patients’ group.
4.) Telemedicine:
Figure 5.26 – Narayana Health uses Telemedicine technology to provide medical assistance in distant places. The hospital uses telemedicine facilities for patients benefit through three different pathways. Firstly, NH uses telemedicine in partnership with state governments and the central Indian Satellite Research Organization (ISRO) using modern telecommunication technology to reach-out to India’s rural poor by establishing 38 remote coronary care units (CCUs) across India that are linked to either Narayan Health (NH) or the Rabindranath Tagore Institute in Calcutta (RTI) which are fully equipped with beds, medication, computers, ECG machines, video-conferencing capabilities, and technical staff. The staff at the CCU’s performs routine checkups and administers treatment under the guidance of NH or RTI and only in case of surgical emergencies is a physical transfer allowed to either NH or RTI. Tele-networking has also been useful to NH to keep a daily check on equipment and necessary supplies, in addition to this the hospital and CCU’s staff has been trained to provide prompt replies within a stipulated time period of 24 hours to patient’s emails about treatment and other enquiries.29 The second pathway used by NH is a tele-medicine project launched in partnership with the Karnataka State Government known as ‘Karnataka Integrated Tele-medicine and Tele-health Project’ (KITTH) which provides a tele-link between NH and the
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district hospital in Chamarajnagar for serving tribal people at affordable rates providing specialist tele-cardiology services. The success of this set up led to an establishment of tele-links with 37 district headquarter remotely based town hospitals which has helped training local doctors in cardiac screening. This enabled the local doctors to screen patients under tele guidance from the NH staff and set up a tele consultation with NH specialists who would study the case and suggest the necessary treatment protocol. The only difference being that these centres were not equipped with the diagnostic facilities available at CCUs but could enable patients to get timely help through NH. Thirdly, the hospital has established a Family Physicians Network of TTECGs (Electro Cardio Grams that were transmitted online) through which private independent general practitioners use an ECG device given by NH for a nominal fee along with free computer software received from NH to transmit ECG data to NH via regular internet services. The cardiologists at NH provide an ECG report within 10 minutes of receiving the data absolutely free of cost. The patient is referred to NH for surgical procedures if there is a requirement for the same. The telemedicine network of NH also includes other hospitals and clinics both in India and overseas including a clinic in Kuala Lumpur, Malaysia, a children’s cardiac facility in Mauritius, and also to a medical school in Germany.30 Thus the use of telemedicine by NH has opened a whole new dimension in treatment and provision of medical services to patients. This technology has helped a lot of patients while saving their time and money and making it affordable thus helping in satisfying patients’ treatment needs.
5.) Accessibility of Information: The need for availability of patient data as well as other managerial information is essential for the smooth and efficient functioning of the hospital. NH is the first one in India to use an ERP system deployed on Cloud that integrates all the units of Narayana Health allowing real time access to data across its different departments and hospitals.
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Figure 5.27 – Narayana Health: Improved functioning with Cloud Computing. The advantage of this system is that it is based on pay per use concept resulting in no investment and maintenance costs, thus making the entire hospital management system efficient and helping staff while providing services to patients. This innovative use of resources helps in the convenience of patients and further satisfying their treatment and other needs efficiently.
6.) Medical Tourism:
Figure 5.28 – Narayana Health is one of the preferred medical tourism destinations for patients.
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The hospital helps international patients visiting for medical treatment by providing assistance in arranging medical visa, visa registration/ extension, assistance in registration process at the FRRO (Foreign Regional Registration office) which is compulsory for all the foreign nationals. In addition the hospital also extends its assistance in booking of a good and economically suitable accommodation available in vicinity of the hospital. The hospital provides a large number of services to their international patients to make their stay comfortable. International in -patients are provided with international television channel for their entertainment. The hospital provides assistance to patients to avail an Indian phone number so as to help save communication costs with family members at home in the patient’s native country. NH offers free dental consultations to both patients and their attendants of all international patients. Availability of interpreters for international languages (like - French, Arabic, Burmese, etc.) facilitates smooth communication between doctors and staff. There is a complimentary airport pick up and drop for international patients. The hospital has appointed relationship managers for convenience of international patients at every point of the treatment process from their arrival to airport till their discharge from the hospital. NH has a dedicated travel desk which takes care of in house FOREX services, vehicle arrangement for local travel, assistance in arrangement of tickets, assistance in fulfilling the formalities before travel, resolving all travel enquiries of international patient travelling back to their country. Thus the hospital is promoting itself as foreign patient friendly destination for provision of medical treatment.31
7.) Improving the staff quality: The hospital believes that the key to improving the health and healthcare delivery is dependent on skilled staff and hence it sees staff development as an investment. Thus the hospital has established “Training and Organizational Development Department” (TODD) - this covers education, training and development and lifelong learning, under which it has introduced its own post graduation and specialization medical programs to train physicians and ensure for availability of quality doctors to treat patients satisfactorily. These programs also include courses on patient relationship management so as to improve doctor relationship skills with patients.
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Figure 5.29 – Narayana Health: Training and development programs. The nurses and other para-medical staff knowledge and efficiencies are evaluated on periodic intervals to enable provision of quality services to patients and achieve satisfaction while maintaining high patient volumes.
8.) Feedback system:
Figure 5.30 – Narayana Health: Online Feedback Form.
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The hospital has established PEARLS - Patient and Employee Resolution and Learning System, a unique initiative that is a customer friendly complaint redressal recourse. The primary features of PEARLS are that employees and patients need to dial a single number where an executive logs the complaint and sends request to the concerned department for addressing the issue which by default has to respond within 24 hours of receiving the complaint. Each department is expected to attend to the problem and update the status on the system. There has to be a favorable resolution to the problem failing which if the complainant is not satisfied then the executive will refuse closure and resend the complaint to the concerned service department. This system has till date been able to satisfactorily resolve 99% of registered complaints in Narayan Health. The presence of an effective and efficient feedback and complaint redressal system in NH has helped in satisfying patients and also the hospital employees.
9.) Outreach camps:
Figure 5.31 – Narayana Health: organization of camps and health awareness projects. The hospital along with NGO’s organizes outreach camps that focus on cardiac diagnosis and care. The hospital also conducts heart camps in rural areas through mobile diagnostic labs. Patients who require further investigations are transported to the hospital. Patients who are diagnosed with cardiac problems are treated at the hospital free of cost or at concessional rates. The hospital has collaboration with NGO’s for providing clinical consultation and for training health staff, not only in
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India but in countries like Malaysia, Mauritius, Bangladesh, Tanzania and South Africa.32 f.) Observations: 1.) Narayana Health has been able to create a balance of providing world class treatment at affordable rates with the use of high volume low cost concept benefitting patients. 2.) Various beneficial schemes and low cost insurance has helped provide treatment to non-affording patients. 3.) The use of technology such as telemedicine has helped in providing medical care in remote locations. 4.) Information accessibility has improved with help of information technology such as cloud computing. This has also helped in processing patient queries and complaints faster within a stipulated time. 5.) Narayana Health has been successful in increasing medical tourism and earning valuable foreign currency. 5.) The training of staff has helped in improving the quality of services provided by them and thus improving the level of patient satisfaction.
5.8 Medico-Legal and patient complaints: A couple of selected cases from newspaper excerpts and few complaints by patients on blog – websites are given below to help in understanding of patient grievances against hospitals in Pune. A.) Medico-Legal cases: The following are two selected legal cases as published in the newspaper - Case 1: Case against Ruby Hall Clinic Mr. Ashutosh Srivastava a city based Supreme Court lawyer-advocate alleged his mother died due to negligence of hospital and filed a complaint under offence of murder. According to Mr. Srivastava the patient was completely active when brought to the hospital. The attending doctor Dr. Rahul Patil conducted preliminary tests on her and diagnosed that she had suffered a heart attack, so an angioplasty was
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performed on her. The doctor demanded that the relatives make an immediate payment of Rs 40,000 in cash, despite knowing that the patient had mediclaim insurance policy of Rs 6 lakh, with cashless facility. Post the angioplasty, as per the doctor’s advice the patient was shifted to the CCU and later she was shifted to a private room. Mr. Srivastava allegation against the hospitals cardiologist is that of medical negligence, The patient was discharged by Dr. Rahul Patil stating that patient was better and only needed rest at home but the patient developed respiratory problems within 6 days of being discharged for which the doctor was contacted but he asked them to come at his private clinic, the doctor was requested to come to Ruby Hall Clinic’s Wanworie branch but the doctor did not turn up. The hospital arranged for another cardiologist, but before the new cardiologist could understand the medical history, the patient expired within a week of being discharged.33
Case 2: Case against Poona Hospital Mrs. Vaishali Sandeepkumar Kothari the wife of a utensils dealer and a resident of Karmala in Solapur had complained to a consumer forum against Poona hospital and Dr. Sachin Gandhi - a neurosurgeon attached to the hospital. The complainant had met with an accident in 2005 after which she started facing a problem maintaining physical balance in day-to-day functioning. She was admitted in Poona Hospital in April 2007 under Dr. Sachin Gandhi to get treated for the same. In her claim, Mrs. Kothari alleges that the surgery for which she paid Rs 1.1 lakh gave her no relief and returned to Dr. Sachin Gandhi at Poona Hospital in May 2008 only to Dr. Gandhi admitting that the previous treatment was incorrect. Kothari later that year got admitted at Sahyadri Hospital, Kothrud to have a successful surgery for which she paid Rs 1.57 lakh, where the concerned surgeon elaborated on the “negligence” in the earlier surgery. The complainant filed a complaint with the consumer forum in 2009, demanding compensation for the mental agony and financial losses caused. Dr. Gandhi , not only argued that the case was a medically complicated one but also emphasized that no expert report had been submitted to provide evidence of medical negligence, he even denied having received payment of Rs.1.1 lakh from complainant.
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The Pune District Consumer Disputes Redressal Forum judge V P Utpat and expert members Kshitija Kulkarni and Mohan Patankar in their order observed that Kothari be awarded Rs 5.50 lakh for medical treatment expenses, mental agony and physical suffering, directing the doctor and hospital to jointly pay compensation to her within six weeks of receiving the order.34
B.) Patient complaints: The few of the selected patient’s complaints and grievances against hospitals in Pune on website – blogs are given below –
Figure 5.32 - Online Internet Website – Blog mouthshut.com about patient complaints regarding hospital services in Pune.35 Observations: 1.) It is observed that patients have realized their rights as consumers of hospital services and do not hesitate to voice their complaints and grievances. 2.) The print media, electronic media and online internet services have helped patients provide an effective platform for publicizing their complaints and grievances against hospitals.
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3.) The patients in case of doubt about a particular treatment protocol given by a particular doctor or hospital are aware of their right to take a second opinion from another doctor or hospital. 4.) The Consumer Protection Act along with the formation of the Consumer Disputes Redressal Forum has helped in resolving patients grievances against hospitals. 5.) Complaints relate to behaviour of staff and services.
Conclusion: Hospitals need to realize the importance of utilizing CRM practices in resolving patient complaints and grievances within stipulated time which would prevent further need of action from higher authorities like Consumer Disputes Redressal Forum preventing economic loss in legal procedures. The timely resolving of grievances will also prevent negative publicity which tarnishes the image of the hospital involved in the legal dispute while also undermining the loyal patient base.
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References: 1.) Retrieved on 02/02/2010 at 12.08 a.m. from http://www.adityabirlahospital.com/Hospital/default.aspx. 2.) Retrieved on 10/08/2010 at 12.44 a.m. from http://www.bharatividyapeeth.edu/Experience+Campus+Life/Pune/Medical- College-Pune/default.aspx. 3.) Retrieved on 13/07/2014 at 1.29 p.m. from http://www.india.columbiaasia.com/hospitals/pune. 4.) Retrieved on 02/02/2010 at 12.43 a.m. from http://www.dmhospital.org/. 5.) Retrieved on 15/10/2013 at 2.49 p.m. from http://www.inamdarhospital.com/. 6.) Retrieved on 31/01/2010 at 4.06 p.m. from http://www.jehangirhospital.com/. 7.) Retrieved on 24/01/2010 at 4.03 p.m. from http://www.kemhospital.org/index.html. 8.) Retrieved on 11/05/2010 at 1.00 a.m. from http://www.noblehospitalspune.com/. 9.) Retrieved on 22/07/2011 at 8.12 p.m. from http://www.poonahospital.org/. 10.) Retrieved on 16/08/2010 at 12.17 a.m. from http://www.mmfhospitals.in/ratna- hospital/index.html. 11.) Retrieved on 19/01/2010 at 6.36 p.m. from http://www.rubyhall.com/. 12.) Retrieved on 16/08/2010 at 1.17 a.m. from http://sahyadrihospital.com/sahyadri- specialty-hospital-deccan-gymkhana-pune/. 13.) Retrieved on 13/07/2014 at 7.48 p.m. from http://www.punecantonmentboard.org/Html1/HOSPITALS.HTM. 14.) Retrieved on 13/07/2014 at 7.52 p.m. from http://afmc.nic.in/Departments/Hospitals/chsc.html. 15.) Retrieved on 13/07/2014 at 7.59 p.m. from http://www.bjmcpune.org/hospital.htm. 16.) Retrieved on 13/07/2014 at 8.02 p.m. from http://www.acehospitals.in/. 17.) Retrieved on 13/07/2014 at 8.06 p.m. from http://www.borahospital.com/index.php. 18.) Retrieved on 13/07/2014 at 8.11 p.m. from http://www.chaitanyahospital.in/. 19.) Retrieved on 13/07/2014 at 8.33 p.m. from http://mmhospital.in/. 20.) Retrieved on 13/07/2014 at 8.55 p.m. from http://www.shreeshaktihospital.com/index.html. 21.) Industry Report, Healthcare: India, The Economist Intelligence Unit, July 2014 22.) Retrieved from https://www.kpmg.de/docs/Healthcare_in_India.pdf. 23.) Kothandaraman, P. &Mookerjee, S. (2007). Healthcare for All: Narayana Hrudayalaya.Growing Inclusive Markets.Bangalore:United Nations Development Programme. 24.) Retrieved on 10/03/2014 at 7.02 pm from http://www.narayanahealth.org/about-us.
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25.) Gaziano, T. A. (2007). Reducing the growing burden of cardiovascular disease in the developing world. Health Affairs.26(1) pp. 13–24. doi: 10.1377/hlthaff.26.1.13 26 & 27.) .) Kothandaraman, P. &Mookerjee, S. (2007). Healthcare for All: Narayana Hrudayalaya.Growing Inclusive Markets.Bangalore:United Nations Development Programme. 28.) Retrieved on 20/08/2014 at 8.00 p.m. from http://www.newindianexpress.com/states/karnataka/Govt-Insurance-Schemes-a-Bonanza-for Cardiac-Hospitals/2014/02/22/article2070915.ece. 29 & 30.) Kothandaraman, P. &Mookerjee, S. (2007). Healthcare for All: Narayana Hrudayalaya.Growing Inclusive Markets.Bangalore:United Nations Development Programme. 31 & 32.) Retrieved on 10/03/2014 at 7.02 pm from http://www.narayanahealth.org/about-us. 33.) Retrieved from http://indianexpress.com/article/cities/pune/case-against-ruby-hall- lawyer-alleges-his-mother-died-due-to-negligence-of-hospital/. 34.) Retrieved from http://www.punemirror.in/pune/cover-story/City-consumer-forum- orders-Poona-Hospital-doctor-to-pay-Rs-5-5-lakh-in-damages-to- woman/articleshow/50841193.cms. 35.) Retrieved from http://www.mouthshut.com/category/Pune-Hospitals_reviews- 925041002.html.
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