how to prepare project report for new hospital

INTRODUCTION TO HEALH CARE

Health care means a wide and intensive form of services, which will be related to well

being of human beings. Health Care is a social sector. Health Care services are

provided at state level with the help of central government.

Health care is a wide and intensive industry, which covers Hospitals, Health

Insurances, Medical software, Health- equipments and Pharmacy in it.

Major inputs of health care industry

The major inputs of health care industries are as listed below:

I. Hospitals

II Medical insurance

III. Medical software

IV. Health equipments

Overview of health care sector in India:

India’s healthcare sector has made impressive strides in recent years. It has

transformed to a US$ 17 billion industry and is surging ahead with an annual growth

rate of 13% a year. The healthcare industry in India expected to grow in size to Rs

270,000 core by 2012. The healthcare industry employs over four million people,

which makes it one of the largest service sectors in the economy of our country.

Healthcare is dependent on the people served; India’s huge population of a billion

people represents a big opportunity. People are spending more on healthcare. The rise

in literacy rate; the higher levels of income; and an increased awareness through the

deep penetration of media, has constituted to greater attention being paid to health.

India has a very low density of doctors. Infant mortality is amongst the highest in

India.

SERVICE SECTOR MANAGEMENT 1

Hospitals in India are running at 80-90% occupancy. Major corporations like the

Tatas, Apollo Group, Fortis, Max, Wockhardt, Piramal, Duncan, Ispat, Escorts

have made significant investments in setting up state-of–the-art private hospitals in

cities like Mumbai, New Delhi, Chennai and Hyderabad.

Good Healthcare in India is in extreme short supply and it is this gap that Corporate

are looking to plug. Most users of healthcare prefer private services to government

ones. The private Healthcare segment has grown into a formidable industry estimated

to be Rs.8,00,000 crores. Using the latest technical equipment and the services of

highly skilled medical personnel these hospitals are in a position to provide a variety

of general as well as specialists’ services.

“India is well positioned to tap the top end of the $3 trillion global healthcare

industry because of the facilities and services it offers, and by leveraging the brand

equity of Indian healthcare professionals across the globe”, said Vinod Khanna,

Union Minister of State for External Affairs.

The Government of India places top priority to healthcare in the national agenda. It

is very serious about encouraging indigenous R&D and creation of human capital.

This would improve the quality of life of our people, leading to greater socio-

economic progress of the country.

As medical costs sky rocket in the developed world, countries like India have

immense potential for what is called "Medical Tourism", highlighted Harpal Singh,

Conference Chairman, in his theme address. “India, with outstanding human resource

talent and the setting up of world class medical facilities, was now poised to take

leadership in the fast emerging arena of healthcare management which is witnessing

the first signs of globalization”.


MARKET ANALYSIS

Market Overview

India has a fairly comprehensive healthcare system comprising of government and

private service providers. However, the system reaches barely fifty percent of the

population – mainly on account of general infrastructure bottlenecks. The country

lags behind international standards on basic healthcare infrastructure and facilities.

India has 94 beds per 100,000 population as compared to the WHO norm of 333

beds per 100,000. The density of doctors is also low. There are only 43 doctors

for a population of 10,000.

Size of Market

India's healthcare industry is estimated at Rs 1000 billion. Of this, pharmaceuticals

account for Rs 200 billion. As per some estimates, Rs 185 billion is spent on

healthcare annually. On average, Indian families spend 600 per month on healthcare

which is 11% of the household income, showing that they are willing to spend

provided the service they get is of high standard. According to The World Health

Report 2000, India's health expenditure is 5.2% of its GDP. Public and private

health expenditure is 13% and 87% respectively.

CII-McKinsey Study

A joint study "Healthcare in India: The Road Ahead" done by the Confederation of

Indian Industry and McKinsey & Company in 2002 mentions that India has 1.5 beds

per 1000 people while China, Brazil & Thailand have an average of 4.3 beds. The

study projects that changing demographic and disease profiles and rising

treatment costs will result in healthcare spending more than doubling over the

next 10 years. Private healthcare will be the largest component of this spending

in 2012, rising to Rs 1560 billion from the current level of Rs 690 billion. In

addition, public spending could double from Rs 170 billion if the Government

reaches its target spending level of 2% of the GDP, up from 0.9% today.


PEST ANALYSIS

Political factors

Most of the healthy nations are also wealthy nations. In India even after 53 years of

independence we all have to accept that government has failed to provide basic

healthcare. Healthcare is the neglected field, only meant for slogans by our

politicians.

To improve healthcare facilities we have to provide special assistance to private

healthcare sector. The reality in private healthcare sector is that as an industry it has

long gestation period and so most of the bigger projects fail.

Government has to give certain concessions to private health sector. It can be in the

form of free land for small hospitals at district levels or concession in power tariff.

Government later on gets back revenue in the form of tax when these institutions start

making profits. Concessions can be limited to first five years or so.

Maharashtra government is playing an important role in the development of the

hospital sector.

Economic factors

The Indian healthcare is the next boom in the country after the IT euphoria.

Setting up hospitals is not an easy task.

The amount of hospitals in India is very less when compared to the other developed

countries. Even the urban areas do not have enough medical facilities. In the rural

areas one village has only one doctor, who may not be very well qualified.

The other governments of other states should take up a cue from the Maharashtra

government, in setting up similar Joint ventures all over the state with the assistance


of World Bank. The World Bank can make available funds of around Rs 700

crore for state health systems and development projects.

The people in India do not avail of the hospital facilities very soon. This is because of

the high cost related to it. However this may all change because of the increasing

deployment of third party payment either in the form of Medical and Allied

Insurance, or in the form of reimbursements from the State. This in turn will increase

the employment opportunities to many people.

Social Factors

1. Certain percentages of beds have to be kept for poor people. E.g. in Bombay

20% of beds has to be kept reserved for poor people.

2. Look after the needs of local poor people.

3. Open counseling and relief centers.

4. Teach hygiene, sanitation among the poor masses.

5. Safe disposal of hospitals wastes like used injection needles, waste blood etc.

and taking due care of environment.

6. Spreading awareness about various diseases through campaigns and free

medical check ups.

7. In brief the social aspect of hospitals industry is to see that latest treatment and

medicines are available to people at large at concessional rates or free of cost

and that its activities are not only restricted to rich people.

Technological Factors

We are witnessing Information technologies transforming the way health care shall be

delivered. Innovations such as computer based hospital information systems, medical

records; decision support systems, health information networks, telemedicine, real

time image transfers and newer ways of distributing health information to consumers

are beginning to affect the cost, quality, and accessibility of health care.

The technologies today can support vast databases, network communications, quick

distribution and reliable image transfers.


INTRODUCTION TO HOSPITALS

Until the early 1980s, Government-run hospitals and those operated by charitable

organizations. The last two decades have seen the mushrooming of corporate and

privately run hospitals. Most large trust and corporate hospitals have invested in

modern equipment and focus on super-specialties.

The private sector accounts for 70% of primary medical care and 40% of all

hospital care in India. They employ 80% of the country’s medical personnel.

The corporate hospital sector is most evolved in the south while charitable/trust

hospitals proliferate in the west. However, the north and east are also showing a

growing trend in private hospital expansion. Key therapeutic areas are cardiology,

nephrology, oncology, orthopaedics, geriatrics, maternity and trauma/critical care.

Hospitals are not for profit making, they are social institution to make available to

society the required Medicare services. However this may not be true for private

hospitals. Today hospitals are a place of diagnosis and treatment of human ills, for the

training research, promoting health care activities and to some extent a center helping

biosocial research. WHO states that hospitals are socio-medical organization whose

functions are: Curative, preventive, patient services and training of health workers in

biosocial research.

With time the classes and quality of hospitals have changed a lot today. Most

hospitals today are trying to provide all ultra facilities and are in the process of

making state of the art hospitals. Hospitals provide the infrastructure facility to

healthcare.


CLASSIFICATION OF HOSPITALS

The classification of Hospitals on the basis of objective, ownership, path and size.

1. On the basis of the OBJECTIVE there are three types:

Teaching cum research for developing medicines and promoting research to

improve the quality of medical aid.

General hospital for treating general ailments.

Special hospitals for specialized services in one or few selected areas.

2. On the basis of the OWNERSHIP , there are four types:

Government hospital, which is owned, managed and controlled by

government

Semi-government hospital, which is partially shared by the government.

Voluntary organisations also run hospitals.

Charitable trusts also runs hospitals.

3. On the basis of PATH OF TREATMENT , there are:

Allopath which is the system promoted under the English system.

Ayurved, which is based on the Indian system where herbals are used for

preparing medicines.

Unani

Homeopath

Others


4. On the basis of the SIZE, there are:

Teaching hospitals – generally have 500 beds, which can be adjusted in tune

with number of students.

District hospital – generally have 200 beds, which can be raised to 300 in

contingencies.

Taluka hospital – generally have 50 beds that can be raised to 100 depending

on the requirement.

Primary health centres – generally have 6 beds, which can be raised to 10.


I’S OF HOSPITAL INDUSTRY

Intangibility

Intangibility indicates that the service has no physical attributes and as a result,

impossible for customer to taste, hears, feel or smell before they actually use it.

Hospital industry is where the customers (patients) get treated for physical problems

they have. The customers can’t really realize the service provided until they get well.

For this they have to provide good supplementary services.The only way they can

provide tangible clues to make the service provided a success. For e.g. the hospitals

provide extra facilities like television, or then friendly personnel’s can make a

difference.

Inconsistency

It’s also referred to as heterogeneity or variability. The inconsistency occurs largely

because of

Different service providers perform differently on different occasions.

Interaction between customer and provider may vary from customer to

customer.

Standardization is hard to maintain. Every doctor is not the same and may not give

the same diagnosis. Also a patient may not each diagnosis in a different way. Also

since the quality of work done can be determined only after the service is performed

the providers have to be well trained in case of performing the service process.

Inseparability

Inseparability means that the service can not be separated from the creator-seller of

the service. Infact there are many services which are created, delivered and consumed

simultaneously through interaction between customer and service producers.

Here too the customer, i.e. the patient has to come upto the hospital to get the

treatment. The customer has to be present when the service is performed. Infact in


case of hospitals the service is created and delivered simultaneously. The type of

service to be provided depends on the customer.

Inventory

Services can not be easily saved, stored or inventoried. This is all due to the

perishable nature of the services. Also there’s cost also associated with the carrying of

inventory. Here the costs are more subjective and are related to capacity utilisation for

e.g. if a doctor is available but there’s no patient during that period, the fixed cost of

the idle physicians salary is a high inventory carrying cost.

Also due to demand fluctuations the services can not be stored. E.g. there’s a lot of

rush at the dentists clinic in December and January as that’s the time when there are

lots of tourist visiting India.


INTRODUCTION TO DIABETES

"Diabetes" is a Greek word meaning "a passer through; a siphon". "Mellitus" comes

from the Greek word "sweet". Apparently, the Greeks named it thus because the

excessive amounts of urine diabetics produce (when blood glucose is too high)

attracted flies and bees because of the glucose content. Diabetes is the common term

for several metabolic disorders in which the body no longer produces insulin or uses

the insulin it produces effectively.

In 2004, according to the World Health Organization, more than 150 million

people worldwide suffer from diabetes. Its incidence is increasing rapidly, and it

is estimated that by the year 2025 this number will double. Diabetes is in the top

5, of the most significant diseases in the developed world, and is gaining in

significance. It’s almost hit the world like an epidemic.

What is diabetes?

It is a common condition and is characterized by abnormally high blood sugar levels.

Diabetes is a number of diseases that involve problems with the hormone insulin.

Normally, the pancreas (an organ behind the stomach) releases insulin to help the body

store and use the sugar and fat from the food we eat.

Diabetes occurs:

When the pancreas does not produce any insulin, or

When the pancreas produces very little insulin, or

When the body does not respond appropriately to insulin, a condition called "insulin

resistance."


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Diabetes is a lifelong disease. As yet, there is no cure. People with diabetes need to

manage their disease to stay healthy.

India has currently the world's largest population of diabetics, with an estimated

30 million people suffering from the disease. According to the World Health

Organization (WHO), India is expected to encompass 57 million people, ailing

from diabetes by 2025 and this would become 80 million in by 2030.

Diabetes is characterized by a partial or complete lack of insulin production by the

body. the classification of diabetes mellitus include five clinical classes. Type 1,

type2, other specific types of diabetes, gestational diabetes, and pre-diabetes. Type1

diabetes is characterized by absolute insulin deficiency. Type2 diabetes which has

relative insulin deficiency combined with defects in insulin action account for 95-

97% of adult population suffering from the disease. One specific to our country is

malnutrition related diabetes mellitus and fibro calcus pancreatic diabetes. Gestational

diabetes is described as diabetes related to pregnancy. Pre-diabetes is a tern coined for

people who have only fasting high blood sugar and have no other sign and/or

symptomsofdiabetes.

The persistent rise of blood glucose levels in diabetes can lead to long term

complications (if not treated properly) involving important organs like: eyes, kidneys,

nerves, heart, blood vessels.


Who is at risk?

People who are:

In children with unexplained weight loss, fever, nausea and vomiting.

Obese

Aged 40 years above

Having family history of diabetes (any body in the family affected by

diabetes),

who have sedentary lifestyle (not exercising) and

Unhealthy dietary habits are at risk of developing diabetes.

Women who have suffered from Gestational diabetes (diabetes you have

during your pregnancy) or have given birth to a baby who weighs more than 9

pounds may also have increased risk of developing diabetes.

Consequences of Uncontrolled Diabetes:

When diabetes isn't well controlled, a number of serious or life-threatening problems

may develop, including:

Retinopathy. This eye problem occurs in 75% to 95% of adults who have had

diabetes for more than 15 years. Diabetic retinopathy diabetes is extremely

rare before puberty no matter how long they have had the disease. Medical

conditions such as good control of sugars, management of hypertension and

regulation of blood lipids are important to prevent retinopathy. Fortunately,

the vision loss isn't significant in most people with the condition.

Kidney damage. About 35% to 45% of people with diabetes develop kidney

damage, a condition called nephropathy. The risk for kidney disease increases

over time and becomes evident 15 to 25 years after the onset of the disease.

This complication carries significant risk of serious illness -- such as kidney

failure and heart disease.


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Poor blood circulation. Damage to nerves and hardening of the arteries leads

to decreased sensation and poor blood circulation in the feet. This can lead to

increased risk of injury and decreased ability to heal open sores and wounds,

which in turn significantly raises the risk of amputation. Damage to nerves

may also lead to digestive problems such as nausea, vomiting and diarrhea.



INTRODUCTION TO EMERALD DIABETES

HOSPITAL

Diabetic Association of India was formed in 1955. The association was formed to

educate and disseminate information concerning diabetes to the public, it soon

became the apparent that members of the medical profession also need to be

educated, trained and upgraded in these fields as per recent innovations due to

progress of research and development. To accomplish this goal, the All India

Institute Of Diabetes was established under the aegis of the diabetic association of

India in 1974. Diabetes as an ailment found new combatants as the institute educated

and trained a whole new generation of doctors, nurses and the required medical staff

in the field of diabetology.

It was then that S.L. Raheja hospital at Mahim was set up as a specialty hospital in

diabetes. Now they too have moved on, and have expanded their services for curing

ailments such as cancer and have become a multispecialist hospital.

It is finally now, EMERALD DIABETES HOSPITAL. It is situated at Worli, with a

view facing the sea, a very accessible location, the hospital promises to provide

quality diabetic care to patients.

Also helps in prevention of the disease, as it is not curable. It super specializes in

juvenile diabetes. Our aim is to specialize in one area and then move on to another.

Our services are the core specialties that provide comprehensive and affordable care

to patients suffering from various diabetes related ailments. The bed capacity of our

hospital is 50 beds, which will be increased in near future. EMERALD will be a

renowned name in the field of medicine. At EMERALD we are aware of are social

responsibilities, for which we run various health care camps and sessions that educate

the general public about common health problems, their prevention and cure.

The hospital has been designed as per the norms and the rules laid down by the All

India Association Of Hospitals. Also the technology and the equipments are as per


international standards. It is started to set a benchmark in quality care, ethical

practice, appropriate cost and training for those in the profession.

OUR VISION

“To be a leader in health care services”

OUR MISSION

“To provide quality care in key specialities, exploiting the full potential of

technology, with medical and managerial expertise”

A PIECE OF WORD FROM THE MANAGEMENT

“We at EMERALD DIABETES HOSPITAL believe in our motto- let the sweetness

remain. For this end we attempt to provide more than just the best possible medical

treatment to our patients. Our faith lies in the miraculous power of human touch. In

keeping with this faith, our patients are treated with personal care and medical

expertise. We strive continuously to invest in technology and healing techniques. Our

aim is to combine expertise, state-of-art-equipment and care- to control the spread of

diabetes and manage the lives of diabetic individuals”.

Why EMERALD?

VALUE STATEMENT

Offer international standard of quality at reasonable cost.

Care with human touch.

Maintain a high standard of awareness towards social issues, environment and

ecology and contribute towards quality of life of the present as well as the

future generations.

Maintain mutually beneficial relationships with other agencies involved in

healthcare and related areas, both governmental and non-governmental.


Support healthcare research.

ORGANIZATIONAL STRUCTURE


MEDICAL DIRECTOR

CHIEF EXECUTIVE

CONULTANTDIABETOLOGIST

DIRECTOR OF NURSING

CLINICAL NURSE MANAGERS

STAFF NURSES

NURSE ASST.

ACCOUNTANT

DEVELOPMENT OFFICER

ADMINISTRATION

CATERING

ESTATES

LAUNDARY

MARKET ANALYSIS

STP For Our Hospital

We have done the STP i.e. Segmenting, Targeting and Positioning to help us carry the

research forward;

SEGMENTING

Segmenting variables such as geographic, demographic, Psychographic and

behavioral segmentation helps in knowing consumer wants needs and responses of

various services and products. It is very essential to know which segment would be

right for setting up our hospital as only after studying the diseases and the people who

are diseased or at high risk of getting those diseases form our segment.

Geographic Segment: It calls for dividing the market into different geographical

units such as nations, states, regions, countries, cities or neighborhood. One can

operate in few geographic areas, or operate in all but pay attention to local variations.

After doing research we decided on setting a specialized Hospital which would target

all sections of people, by and large the entire mass by delivering varied services to a

specific disease. The location for our hospital is Mumbai having population of around

13343 thousand people. Apart from being one of the most populous city’s it is also a

metropolitan and the financial capital of India. In Mumbai there are thousands of

people being diseased everyday with hardly any medical centers or Hospitals to treat

them. In Mumbai there are lot of people who have Diabetes, some of them don’t even

know that they have the disease.

Demographic Segment: the market is divided into groups on the basis of variable

such as age, family size, family lifecycle, gender, income, occupation, education,

religion, race, generation, nationality and social class. With these variables of

segmentation we get to know the preferences and the usage rates associated with


different consumers. After doing a research on the following variable sour result

showed that Diabetes can be either be inherited or caused due to lifestyle disorders

such as wrong eating habits. However Diabetes can happen at any age. Our Hospital

would target Section A and Section B people. However people who are from low

income groups also form our segment because EMERALD is the only hospital

specializing in Diabetes with super specialization in Juvenile Diabetes thereby

providing best services required to treat these ailments.

Psychographic Segment: As per this segmentation we have divided the patients into

categories such as children below 20 who have Juvenile Diabetes and the others who

inherit or get Diabetes because of incorrect lifestyles such as wrong eating habits. As

told to us by diabetologist at S L Raheja hospital that most people who have greater

purchasing power and are relatively rich are the ones who suffer from Diabetes.

Behavioral Segmentation: In this the segmentation is done as per the following

variables i.e. knowledge of, attitude towards, use of, or response to a product or a

service. These behavioral variables – occasions, benefits, user status, user rate, loyalty

status, buyer readiness stage and attitude- are the best starting points for constructing

market segments. As per research and analysis any person having diabetes would

come to our hospital after knowing the facilities that we offer and the care, comfort

we provide. They would slowly develop trust in us. This would help in creating loyal

patients and create goodwill for our hospital.


TARGETING

The entire population is our target audience because a lot of people already have the

disease but don’t know about it and the others can anytime fall prey to the disease.

EMERALD in this case, would study the different regions in the city of Mumbai

inspect those areas, initially carry on free checkups to do this and draw inferences

from those check ups that which people have diabetes and in which area mostly are

there diabetic people. These would be the case histories and be helpful in forming our

data base. Since EMERALD is a specialty hospital for Diabetes at present its target

audience is diabetic people and people who are at high risk. However it has future

plans of becoming a multi specialist hospital and then would expand its services. This

is called segment by segment invasion.

POSITIONING

EMERALD Diabetes Hospital has been set up after proper research and study

conducted on different needs of customers and varied groups in the market place.

Also specific targeting of those needs and groups are done to understand which

services would be superior and entice patients towards our hospital. Being a new

hospital it is very important for us to convey our services and offer facilities which

would help in generating a favorable word of mouth and thereby creating the much

needed trust factor amongst the masses. The end result of our positioning has led to

successful creation of a patient focused value proposition and why diabetic people

should come to EMERALD.


DIFFERENTIATION

Juvenile diabetes

In house pharmacy

Chemist in the hospital premises used by outsiders also

Diet food with a sugar free department: health and grocery store accessed by

outsiders also.

Differentiation is like oxygen in Todays competitive environment to survive. It is

very difficult for an organisation to survive without differentiation. EMERALD

specializes in diabetes with super specialization in JUVELINE DIABETES. This will

be the first hospital to specialize in JUVELINE diabetes in Mumbai. Thus, we have

gone one step further by not only differentiating our service but introducing

something for the first time in mumbai. Also the service delivery will be our

differentiating factor will be explained further.


OUR VALUE OFFERINGS

Specialities

Medical speciality

Diabetology (All the below in the connection to diabetes)

Ophthalmology

Dentistry

Gastroenterology

Dermatology

Nephrology

General medicine

Neurology

Paediatrics

Psychiatry

Rheumatology

Gynecology and obstetrics.

Surgical speciality

Ophthalmology

E.N.T

Pediatric surgery

Dental

General surgery

Orthopedic surgery

Urology

Nuero-surgery

Health check-ups

Basic, Executive and Comprehensive packages.

Well woman (basic and special packages).

Sweet package (Diabetes).


Nana-Nani package (senior citizen).

Pre-employment package.

FACILITIES/SERVICES OFFERED AT

EMERALD…

Highly qualified doctors and paramedical, friendly nurses and ward boys.

I.C.U. and Operation theaters with latest technology.

Blood banks.

State of art laboratory.

Casualty ward. Tie ups with Jaslok and Breach Candy hospital.

24hours chemist shop.

Availability of stretchers and wheel chairs easily.

Lobby on every floor with proper sleeping and sitting facilities.

Good infrastructure facilities.

Coffee/tea/juice vending machines on every floor.

Dieticians and consultation.

Library.

Prayer room.

Phone booth center.

Cyber café.

Ambulance.

6 lifts and 3 exits.

Diet store.

Cafeteria with clean and hygienic food.

Good sanitation conditions.

Gift shop.

24hours ATM facility.

Dust bins at short distances.

Signage.


Medical tourism can be broadly defined as provision of ‘cost effective’ private

medical care in collaboration with the tourism industry for patients needing surgical

and other forms of specialized treatment. This process is being facilitated by the

corporate sector involved in medical care as well as the tourism industry - both

private and public.

THE most recent trend in privatisation of health services is medical tourism, which is

gaining prominence in developing countries. Corporate run institutions are seized

with the necessity to maximise profits and expand their coverage. In this background,

corporate interests in the Medical Care sector are looking for opportunities that go

beyond the limited domestic “market” for high cost medical care. This is the genesis

of the “medical tourism” industry.

The rendering of such services on payment in foreign exchange will be treated as

‘deemed exports’ and will be made eligible for all fiscal incentives extended to export

earnings”.

.

According to a study by McKinsey and the Confederation of Indian Industry, medical

tourism in India could become a $1 billion business by 2012. The report predicts that:

“By 2012, if medical tourism were to reach 25 per cent of revenues of private up-

market players, up to Rs 10,000 crore will be added to the revenues of these players”.


CHRONOLOGICAL SCHEDULE OF

ACTIVITIES

A standard schedule of the day is described below.

TIME OF DAY ACTIVITY

05.30 a.m. Wake Up and cleaning

06.00 a.m. – 7.00 a.m. Sponge/bath

07.30 a.m. –8..30 a.m. Breakfast

08.30 a.m. – 09.00 a.m. Organizing the patients charts

09.00 a.m. – 10.00 a.m. Doctors routine check-up

10.00 a.m. – 11.00 a.m. Medication and rest time

11.00 a.m. – 12.00 p.m. Visiting hours

12.00 p.m. – 01.00 p.m. Lunch time

01.00 p.m. – 04.00 p.m. Medication and rest hours

04.00 p.m. – 04.30 p.m. Tea/Snacks time

04.30 p.m. – 05.00 p.m. Freshing up and Doctors routine check-up

05.00 p.m. – 07.00 p.m. Visiting hours

07.00 p.m. – 07.30 p.m. Dinner

07.30 p.m. – 08.00 p.m. Medication

08.00 p.m. sleep


S.W.O.T ANALYSIS

Strength

Quality of the doctors, nurse and staff

Medical facilities and equipment and infrastructure (room is a/c, phone

lines….)

Ambience and the general atmosphere of the hospital

Attitude of the staff, even the menials (human touch)

Specialization

Pricing is reasonable.

Weaknesses

The patients are completely at the mercy of the doctors.

Not a general hospital.

The Doctor: Patient ratio is low.

Opportunities

More training to the staff for improving their behavior and medical knowledge

To increase the facilities they provide.

To become more specialized in various fields.

Threats

The government is reducing the grants given to hospitals, thus making it

impossible to cater to the poor people.


Competitions.

Unawareness among public.

The unions of the menials and even doctors: they can go on a strike,

disrupting the functioning of the entire health care unit.

8 P’S OF HOSPITALS

1.PRODUCT

Phillip Kotler says a product is anything that can be offered to a market to satisfy a

want or a need. Products that are marketed include physical goods, services,

experiences, events, persons, places, properties, organisations, information and ideas.

The product of a hospital can be any of the following:

Medical Services

Medical Training

Medical Education

Medical Research

AT EMERALD we believe that the ultimate aim is to make available the best

possible medical services and to prepare and train the best medics. Thus, it is very

essential for our service providers to be aware of the nature, behavior, requirements

and status of the users. This helps them in planning and development of the services

in the background of users’ changing needs and requirements. The product should be

developed keeping in mind the users’ psychology.


THE PRODUCT MIX

Levels of service:

Level 1. Core / generic product:

This is the basic service product. In hospitals, health or well being by way of the

treatment provided by the doctor to deal with the ailment of the patients is the core

product or service.

Level 2. Expected product:

This is the basic product and minimum purchase conditions that must be met. In

hospitals, in addition to the core product, all other supplementary services like a bed,

waiting area, availability of medicines and drugs, meals, hygiene etc.

Level 3. Augmented product:

In this, along with the basic and minimum offering, there is something different

which enables the product or service to be differentiated from that of the competitors.

Hi-tech equipments, good infrastructure, personalized assistance, prayer room, cell

charging facilities, gift shop, ambulances, a terrace garden for patients to walk,

exercise all form a part of the augmented product.

Level 4. Potential product:


The potential product contains potentially feasible features and benefits that play a

significant role in holding and attracting the customer. These features and benefits

are useful or likely to be useful to the buyers. For example, in EMERALD beds are

provided for ICU attendants free of charge along with other communication facilities

like internet.

SUPPLEMENTARY SERVICES: SERVICE

FLOWER

Information

In a hospital, providing information refers to making the patients or the general public

aware of the services and facilities offered by the hospital.

At EMERALD, this is done in a number of ways.

Information to the general public: The hospital has its own website at

www.emerald.com, containing details about the location, services, etc.

New customers or patients in general: A ‘patient guide’ is made available in each

room. This guide provides various points for the patient’s knowledge and

information, right from booking and cancellation procedures, admission rules and

procedures, visiting hours, meals, and facilities for relatives and discharge

procedures, to procedure for payment of bills.

During the patients stay in the hospital: Information regarding services, facilities or

various procedures is also provided by the employees as and when the required or on

the patient’s request. For example, at the time of discharge, the ward sister gives the

patient a summary as to the formalities like processing papers with insurance

company etc.

Consultation


In any hospital, treatment is provided only after a preliminary check-up and/or

various tests. Preventive healthcare facilities at EMERALD include a range of

sophisticated tests and consultations.. The hospital has 24 hour diagnostic services

and state-of-the-art laboratories that help the medical team (doctors and surgeons)

diagnose the patient’s problem and suggest treatments.

Order taking

In a hospital, this is usually in the form of admitting or registering the patient. The

process of admission in any hospital should be simple, easy to understand, fast and

accurate. Means of quick registration must also be provided for in the case of

emergencies. At EMERALD the registration and necessary formalities are done

immediately.

Hospitality

This is becoming increasingly important in the healthcare sector, particularly in

hospitals as the expectations of people towards medical care are ever increasing. No

longer are they limited to only the clinical outcomes but also involve the delivery

process, margin of safety and behavior of personnel.

The EMERALD provides a host of conveniences to patients and their relatives.

Service to patients:

A choice of packages from twin sharing, single room and deluxe suites are

available to patients.

A lot of care has been taken to ensure that the patient does not feel walled in.

For example, all rooms have natural and indirect lighting with huge windows

and in some cases, terrace gardens. A number of facilities are provided to the

patient such as a television, in-house meals etc. So as to make the room


aesthetically pleasing and improve patient mentality (they are usually

depressed), all medical sockets, instruments or attachments are hidden from

view, behind a panel beside the bed.

Service to relatives:

The EMERALD hospital in Mumbai provides a separate family waiting area for

relatives of patients in ICU. Each cubicle in the waiting area has provisions for

sleeping such as a bed, pillows, blankets etc. The reason for such an arrangement is

that, in the ICU cases, one person should be present in the hospital 24 hours so that he

is available to sign the consent form. Patient number is allotted to the relatives bed

and in the case of an emergency; the relative is immediately called by the secretary in

charge.

Relatives also enjoy facilities like internet connection, a hygenic cafeteria, prayer

rooms, library, public call booths, coffee machines, a gift shop etc.

Safety /Caretaking

Safety and hygiene is of utmost importance in any hospital. On the safety front, the

EMERALD measures up to the highest international standards, including

major/minor operation theaters, keeps a dust free environment, special peat filters for

maintaining air quality and highest degree of sterility etc.

Bills/Billing

Hospitals should ensure that billing and payment procedures are quick so as to enable

the patient to return home soon after discharge.

At EMERALD, two types of bills are generated i.e. Interim bills and Final bill. The

interim bills are generated to give on a bi-weekly basis. They give the patient an idea

about the charge payable for the specified period. It helps is avoiding any confusion


at the time of generating the final bill. The final bill is generated at the time of

discharge. This considers all the interim bills and the advance deposit paid.

Payment

There is a separate business centre for payment of bills. An approximate bill amount

is collected as deposit before discharge, which is considered at the time of final bill.

Exceptions

These usually occur in the form of emergencies. Hospitals must be well prepared to

face any kind of unexpected emergency. For example, EMERALD has special

procedures for emergency cases.

Quality dimensions

The rapidly expanding scope of healthcare has led to increasing complexity in its

delivery. Patient satisfaction is increasingly taken as an important measure of quality.

There is increasing willingness to provide protection against illnesses by way of

healthcare insurance. This has made it pertinent that management of quality is done

on a wider basis than mere medical audits.

Implementing quality system controls the cost by:

a. Reducing unnecessary interventions.

b. Getting it right first time of repeat surgery.

c. Avoidable complications e.g. post-operative infections.

d. Imbalances of resources: Lack of theatre time or lack of access to diagnostic

facilities leading to increased length of stay.

e. Employee turnover and consequent training costs.

RATER


Reliability - Reliability refers to the ability to perform the service promised,

dependability and accurately.

Assurance - Assurance refers to freedom from danger, risk or doubt. It

includes creditability, competence, security and courtesy. EMERALD is high

in assurance. The hospital also has a world-class team of doctors and

surgeons.

Tangibility - Tangibility refers to the appearance of physical facilities,

equipment, personnel and communication material.

Empathy - This includes access, communication and understanding of the

consumers.

Responsiveness - EMERALD is also high in responsive i.e. the willingness to

help the customer and provide prompt service. It has special procedure in

place for emergencies and quick complaint handling procedures. The

employee also goes out of their way to help both the patients as well as their

relatives.

The main products of hospitals are medical services. In addition to medical care,

EMERALD DIABETES HOSPITAL also imparts education, training and research

facilities and also educates and train paramedical officers, nurses and other technical

staff. With the changes in environmental conditions, the staff at emerald has put in

tremendous amount of efforts for acquiring sophisticated equipment and appliances,

put in process the state-of–art-technology, aquired various quality certifications and

also ventured into strategic tie-ups with renowned research and development

companies.

Medical Care


At EMERALDthe most important functions are to give care to the sick, to render

services to the injured and restore the health of diseased persons. We believe in

controlling and managing the entire life of a diabetic patient. All the services like

line, staff and auxiliary divert a close attention.

LINE SERVICES

At EMERALD the line services can further be classified as follows:

Emergency Services

The casualty services are made available round the clock. This department is

specially meant for patients having illnesses of grave nature requiring immediate

treatment. It is also meant for injured persons. The casualty department needs to

apply more precautions especially in cases of poisoning and accidents.

This department takes added responsibility of removing emotional strain, suspense

and anxiety of attendants by rendering the best treatment made available to patients.

To attend quickly and effectively, we have the necessary set up, co-ordination with

other departments, well-defined procedures and work distribution.

Casualty Dept

Reception &

Enquiry

SERVICE SECTOR MANAGEMENT

Registration

Examination

Observation

34

Normal Health Death

Out Patient Services

In our out patient department (OPD) all patients are examined irrespective of the

degree of illness, whether minor or serious, acute or chronic. Accordingly the OPD

renders diagnostic, curative, preventive and rehabilitative services. The examination

or investigation of diseases is the most significant aspect of services rendered by the

OPD.

Our OPD is well connected with the X-ray Department, laboratories and other

facilitative services.

The doctors, para-medical officers and nurses should be well trained so that

customers never feel dissatisfied. Writing prescriptions, dressing and treatment

and further admission of patients to in-patient ward need time-honored

arrangements.

We have an extensive appointment and scheduling system that reduces the

waiting time and offer a comfortable and timely visit to the consultants.

Our panel, consisting of doctors from various specialties, offers consultations on

diabetes related problems.

The presence of support services in close proximity reduces time consumption

and offers better and quicker services.


Admission Dressing

Discharge

35

In Patient Services

After the examination of patients in OPD, the patients are advised admission to

inpatient wards, if necessary. The patients are required to make decisions regarding

their admission to a particular ward, whether private or general. Each ward has a

doctor’s duty room, dressing room, nursing staff station, and other facilities required

for patient care.

Intensive Care Unit

The ICU is considered to be the heart of the hospital. It is for those patients

demanding acute, multidisciplinary and special treatment.

The staffing pattern of our ICU is planned in a scientific way so that related

patients get proper medical aid without a break or gap.

Our 10-bedded ICU is equipped with life saving and support systems handles

medical as well as surgical emergencies.

Round the clock monitoring by nursing staff ensures efficient patient care.

There is one nurse per patient; to give the much needed care and attention.

Wards

Centrally air-conditioned wards provide accommodation and services to patients.


Least expensive are the general wards where there are10 beds.

The deluxe ward has 20 beds.

The super deluxe wards include a drawing room, a kitchen, a T.V and exclusive

facility. We have20beds.

Day Care Service Unit

Our day care services cater to those patients who require a single day stay at our

hospital. Uniquely designed unit offers a comprehensive package of services

offered globally.

Equipped with sophisticated, state-of-the-art technology, it combines care with

medical expertise to tender complete treatment.

It’s on the same floor of the OT, which helps us to provide both pre-op and post-

op care in the same department.

Artificial kidney dialysis unit

Our 24- hour Dialysis unit is a haemodialysis one.

Open round the clock, it is extremely feasible for office goers who can make use

of this facility and then return to work

The unit exploits the expertise of renowned specialist and the advantages of recent

technology to formulate a complete treatment plan.

SURGICAL SUITE AND QUALITY CONTROL

Operation Theatres


AT EMERALD OT comprise of 6 highly sterilized operating rooms, including one

septic and one minor operation room.

The management has made available technologically advanced and sophisticated

equipment and appliances to facilitate surgeries such as diabetic foot, general

surgeries, Nuerosurgeries, orthopedics, ENT, ophthalmology and non-invasive

surgeries.

The sterilized environment ensures minimal infection while trained nurse and

aseptic techniques assure best care and treatment.

Our OT also incorporates digital recording and audio-visual connectivity with the

auditorium that assist information sharing with the experts during clinical

meetings.

Professionals designing it take important factors such as stand-by power

arrangements, proper ventilation into consideration.

Efficient doctors, paramedical staff and nurses are there in the OT.

Our OT has a pre-anesthesia room and a sterilization room. There is a scrub room

for nurses and doctors. The OT is in close integration with the blood bank.

CSSD

CSSD uses autoclave for steel, ETO sterilization to sterilize heat sensitive

reusable items and ultrasonic and water disinfector for cleaning and disinfecting

used items.

This ensures that all surgical and other reusable equipments used in the

hospital remain infection free

Department process issues and control all professional supplies used by various

medical and surgical units of the hospital to ensure our patients safety.

Quality Assurance And Infection Control Committee

It ensures good quality patient care by reducing hospitals acquired infection.

It informs the hospital authorities about communicable/ infectious diseases

Holds regular audits and imparts CME to staff members


The department is also responsible for internal and external quality control

procedures.

DIAGNOSTIC SERVICES

Laboratory Services

Radiology

We have multi slice Spiral CT scan

Mammography (DMR plus) with stereo tactic

X RAY with image intensifier

Ultra sonography and color Doppler

Per procedural counseling by well known radiologist

Laboratory medicine

Fully automated laboratory offers services in the fields of bio chemistry, clinical

pathology, hematology, histopathology, immunology and sito genetics.

Technologies like florescence and Karyotyping ensure instant and accurate

results.

Blood Bank

Our blood bank is capable of providing whole blood as well as blood components.

All prescribed tests are performed before issuing blood to patients

Endosonography

Our endoscopy department is one of the only few hospitals in Mumbai that has digital

Video Sono Endoscope facilities. The Facility enjoys unmatched expertise and

supervision by renowned consultants.

REHABILITATIVE AND SUPPORTIVE UNITS

Physiotherapy


It uses a combination of state – of - the –art equipment and medical expertise to

provide our patients with the best possible treatment

Our treatment plan is divided into

Exercise therapy- That includes Connective Tissue Mobilization Techniques,

exercises with different gadgets that aids movement

Electrotherapy that includes ultra sound, infrared, wax bath, stimulation,

Traction.

Diet And Nutrition

Our Dieticians and other experts provide individual diet counseling to patients

Diet consultation is available for all major and minor ailments like diabetes and

other related complications

Our cafeteria, open to all, includes an in staff dietician who keeps a check on the

nutrition value of the food served

They also provides diets for weight gain or weight loss and create awareness

about importance of diet

Nursing

Our nursing services are benchmarked and the best in the industry. The care and the

attention provided by our nurses is so comforting that patients feel that they are

recuperating at home.

24 Hour Pharmacy

We have two pharmacies One in-house and one in the premise. Open round the cock

our pharmacies offer invaluable services to the IP, OP, and Day Care and Emergency

departments. It also ensures that medicines are purchased from authorized sources

and thus guarantees the authencity of all medical supplies.


THE STAFF / SUPPORTIVE SERVICES

Certain supportive services are important e.g. sterilisation, supply and maintenance of

instruments, materials and garments etc. At emerald these are the support services:

The catering department comprises the kitchen, bulk food stores and dining rooms

and supplies meals in the hospital. Heated trolleys have to be used to transport meals

to patients. Pharmaceutical services play an important role. An official laundry

provides bacteria free garments and clothes. The patients are provided with

disinfected and clean linen. The laboratories are properly manned and proper

diagnosis is given by them to enable right medical prescription. The establishment of

laboratories should be between the OPD and indoors so that both areas are covered

without delay or disruption. Clinical pathology, blood bank and pathological anatomy

are important areas to streamline functional management of hospital laboratories. The

radiology department should have hi-tech facilities. Currently ultrasound scanning

and CAT scanning have been found significant in improving services of the radiology

department. A matron who is assisted by a sister-in –charge, manages the Nursing

services. The norms accepted by the Indian Nursing Council should be followed. An

ideal nurse-patient ratio is 1:5, however at EMERALD we ensure 2:5.


THE AUXILIARY SERVICES

Auxiliary services consist of registration and indoor case records, stores management,

transportation management, dietary services, engineering and maintenance service

etc. At EMERALD these services are maintained properly which govern the

successful operation of a particular department. The security arrangements, supplies,

transport facilities etc are not ignored.

The central stores department issues bulk items. There are different types of stores

like pharmacy stores, chemical stores, linen stores, glassware stores, surgical stores

etc. For carriage of supplies and patients, trolleys, wheelchairs and stretchers are

used. The dietics department plays a vital role as it provides menu to meet the needs

of patients. The services of well-qualified and trained dieticians help in providing

nutritious diets. The engineering and maintenance services are concerned with

hospital building, furniture and other equipment. Awe have a security force to provide

protection to the hospital property. Personnel related with defence or police are given

preference while appointing the security force.


2.PRICING

In the words of Philip Kotler, one should try to “Sell value, not price”. Price is a

major determinant of a buyer’s choice, as a person must have the need, willingness

and ability or financial backing to buy the product. At EMERALD services involve

the use of expensive and complex machinery, which involve huge investments. Apart

from that, the cost of maintaining them and cost of running the hospital is in no terms

cheap. We have experienced doctors and also specialist who come from abroad

whose salaries along with those of the skilled nurses and helpers constitute a great

part of the cost.

Sophistication can’t be possible unless we change our pricing strategies. The main

thing in the pricing strategy is to link it with the paying capacity of the users so that

all the classes get medical aids without any discrimination.

There are 4 types of costing: Free, subsidized, cost based subsidy and cost plus

subsidy.

EMERALD follows Cost plus Subsidy

This strategy allows charging more than the costs involved on the services, but only

from the better-off sections of society. The transfer of these surpluses to the account

of subsidy for compensating the losses on account of providing free or subsidized

services to the weaker sections and low-income group users is also necessary.

On one hand, it is judicious that no discrimination is found in respect of making

available the medical aids, but on the other hand, we can’t adopt uniform policy while


making available to the users and their attendants other facilities like standard of

room, indoor facilities and other non medical amenities. This is justified on the

ground that all groups are not paying equal fees for availing their services. Moreover

when no income group has been availing the services without paying any fee, their

expectations would not be more than the proper medical aids.

It is difficult to offer free or subsidized services to the masses. On the other hand,

the technological sophistication has raised the cost of services, as the inputs used in

making available the medical services are found costly.

How should prices be communicated to the target market?

Patients must be made aware of the prices of different treatments/ services as well as

how, where and when that price is payable. This must be done in an intelligible and

unambiguous way. In hospitals, generally, customer’s service representatives give

responses to customer queries about pricing, payment and credit.

Hospital bills sometimes run to several pages and contain dozens of items. Thus the

hospital must ensure that such an itemized bills are accurate and intelligible.

At EMERALD, the ‘patient guide’ in each patient’s room provides information with

regard to billing and payment procedures. Patients can also contact the billing

department for any clarification.

For the patient’s convenience, the hospital generates an ‘interim bill’s a bi-weekly

basis. This gives the patient an idea about a charge payable for the specified period

and avoids confusion at the time of generating final bills.


3. PLACE

Place refers to the contact point between the service provider and the customer. Two

main issues considered regarding the decision of the place are accessibility and

availability of the service to the customer. EMERALD is easily accessible, that is, it

is not located in a heavy traffic zone as this would prove detrimental to the very

existence of the hospital. Areas around hospital are silent zones i.e. EMERALD is

located near Worli sea face and is near a prominent road so that it can be reached

easily. Having in house ambulance services to pick up patients on the other hand

increases accessibility to EMERALD. We also have contracts with ambulance

services to bring our patients from whichever location to the hospital.

4. PROMOTION

EMERALD relies on favorable word of mouth and not on aggressive promotion.

We conduct camps in rural areas to give medical check ups at reasonable prices; we

sponsor visits to old age homes and donate them a good amount of food and

medicines. We continuously introduce different health services and we generally

advertise in health and fitness magazines and also conduct free check ups.

EMERALD holds seminars and conferences relating to Diabetes and latest


technology, where we involve the doctors from all around the country, for detailed

discussion.

PROMOTIONAL MIX

Personal communication

1) Personal selling:

This involves an immediate and interactive relationship between two or more persons.

We at EMERALD usually resort to personal selling for business-to-business

marketing. Both in the case of corporate tie-ups and approaching doctors for patient

referrals, it is our marketing executive who personally approaches the corporate or the

doctor so as to pitch and finalize the deal.

2) Customer service and training:

In EMERALD, almost all the services are delivered in the customer’s presence.

Front-line personnel are directly involved in the process of offering the services, due

to which they are efficiently informed, trained and supported. For instance, if nurses

neglect patients, receptionists misbehave and doctors do not show a human approach,

the hospital will fail in delivering good service to the society in spite of the

availability of most sophisticated equipments and technologies, efficient doctors and

nurses and most comfortable buildings and infrastructure facilities.


Thus, we invest a lot in internal marketing by way of training so as to ensure that the

employees are at their best of behavior with the patients and well informed about the

various activities of the hospital, including free check-up camps and talks. An

important way of internal marketing is analyzing feedback from regular customer

satisfaction surveys and improves service delivery so that the way of service delivery

itself is the marketing of the service.

As mentioned before under service recovery, one way in which EMERALD ensures

good customer service is by holding training programs for nurses every 15days,

enlighting them about how to handle various patients etc.

3) Word of mouth:

In Medicare services, word of mouth plays a very important role, as people are more

likely to trust a hospital if they have heard about its success in treatments or quality

care from a patient. Thus, by ensuring good customer service, we also get a lot of

promotion by way of word of mouth.

Advertising

They are not used frequently in hospital marketing. Hospitals can focus on the quality

of their services, their contribution to the social transformation process, but they

cannot advertise for generating profits. Mostly, advertising through mass

communication media like TV, print media etc. is only used in social marketing

where the objective is to pass on a social message like family planning, child

immunization, health and family welfare etc.

Sales promotion

In EMERALD, sales promotion takes place usually by way of

Sign up rebates or discounts


Gift premiums, for ex. Doctors are offered various gifts and benefits in return

for patient referrals.

Instructional materials

Although service personnel plays an important role in educating the customers about

the service they may not always be available to help in the locations where or when

the customers need them. EMERALD, thus uses traditional approaches like printed

materials, ranging from brochers and instruction manuals.

As mentioned earlier, EMERALD has a ‘patient guide’ in every patients room which

gives patient valuable information regarding booking, cancellations, various facilities

available, what to expect during the stay, discharge procedure, billing and payment

procedures etc.

We also have a patient education service, wherein brochers regarding Diabetes, what

the various Diabetes symptoms are, what the various treatments are involved, how

diabetes can be avoided by way of healthy eating and exercise etc.Along with this we

even have a website with necessary information for the patients.


5. PEOPLE

Service personnel play an important role in an organization. For satisfying the users, it is

only not essential that they are made available the best possible medical aids. In addition

to the medical aids, the behavioral aspect is also found impact generating, especially

when we consider marketing a customer satisfaction-engineering tool. It is natural that

the expectations of all groups can’t be uniform. In a hospital the behavior and attitude of

the personnel providing services is very important as far as the customers overall

perception of the service is concerned. It is necessary that the staff in a hospital is trained

to provide quality patient care using state of the art technology. The objective of

EMERALD is providing quality service to patients and this can be achieved by:

1. Motivating employees to be efficient, dedicated and loyal to the organization.

2. Providing regular on-the-job training of employees to ensure continuous

improvement in health care

3. Utilizing services of professionally competent medical consultants.

4. Use of the latest technology.

Motivation is not necessarily by giving high salaries. There are many other ways to

motivate employees – concessions should be given to the employee’s near ones and there

should be active participation of the employees in the activities of the hospital.


6. PROCESS:

Process is a set of activities that take an input, convert it and add value to the input and

finally, create an output. Blueprints design processes, which sets a standard for action to

take place and to implement the service. A process is divided into the following phases in

a hospital. At EMERALD the patient has to go through the following phases:

1. The joining phase – which includes

The arrival of the patient

Registration – where a patient has to make an initial deposit at the inpatient

billing counter after which a file is opened in the patient’s name to know the

patient’s medical history.

2. Intensive consumption phase – which includes

Diagnosis – where the consultant diagnoses the illness by making the patient

undergo various tests

Treatment – where the illness is treated with proper medication or surgery

Information about further actions – the consultant will instruct the patient

regarding the diet to be followed, the medication to be taken etc.

3. Detachment phase – which includes

Discharge of the patient

Payment – after the patient is discharged, the bill will be paid at the billing

counter.

4. Feedback – at this stage, the patient is requested to fill an evaluation form, which

helps the hospital authorities to know the level of satisfaction derived by the

patient. Patient’s suggestions are always considered for improving the hospital

services.


7. PHYSICAL EVIDENCE:

Physical evidence makes a huge impact on the customer. Physical evidence provides

customers means of evaluating the service. Corporate image plays an important role in

terms of physical evidence. The physical evidence has a good and favorable influence on

the mindsets of the patients and their relatives who visit the hospital. This helps patients

to come again to our hospitals and also do favourable publicity by the most effective

weapon the “word of mouth”.

We have the following aspects which help in enhancing physical evidence there by

creating good first impressions.

The hospital is structured as per the hospital planning decided by the

Bombay hospital association.

Emerald Hospitals has a good ambience. This ambience plays an

important role because when a patient walks into a hospital, he

immediately forms an opinion about the hospital.

The staff follows a dress code to show professionalism and maintain discipline.

The staff is trained to understand; be warm and comforting because the patients

that goes to the hospital is usually disturbed or unhappy.

The hospital is centrally air – conditioned.

The signage is put at regular intervals so that people can have easy

accessibility.

The reception and help desk are on the ground floor, for easy access to

information and other departments.

Our hospital is well organized and segregated into different departments.

The departments are well planned and equipped with the state-of-the-art

technology.

All the doctors are provided with a well – equipped cabin.


Professional hospital interior designers plan the operation theater; also the blood

bank and the intensive care units are on the same floor in proper spacing and

alignment of the OT.

There is wooden flooring in the hospital and in the wards, it is marble

Good lighting and ventilation is taken care of.

There are different bathrooms for women and men, two on every floor.

There are six lifts in total: two for patients, one for doctors only, one for staff, two

for visitors which is used only from 10am -11am in the morning and 4pm to 6pm

in the evening. The rest of the times one remains for visitors the other are for the

catering department, which has to serve meals.

The kitchen is extremely hygienic and the food prepared as per required. Also the

kitchen has a glass door so that the process of cooking is visible. The cooks are

well trained and use sterilized crockery. Also they have were gloves, masks, lab

coats and no footwear allowed.

Water coolers are placed at regular intervals having hot and cold drinking water

facility.

There phone booths in the visiting lounge.

There are two cyber cafes: one for the doctors and staff and one for visitors in the

visiting lounge.

Special care is taken to maintain hygiene; cleanliness and the whole hospital is

well – lit. This is generally taken care of by the housekeeping department.

Keeping the hospital clean and dirt free is every ones responsibility and because

of which the dustbins are kept at regular intervals.

The hospital is kept odor free by spraying air fresheners and neutralizers.

Our hospital has kept in mind both the aspects of physical evidence that is

essential and peripheral evidence. Physical evidence plays an important role in a

hospital where the patients are already depressed or traumatized and a good

atmosphere could make all the difference.

Every aspect of our hospitals has to meet the hygiene and cleanliness standards set by the

board. We ensure care, convenience and comfort at all times.


8. PRODUCTIVITY AND QUALITY:

Productivity in services is how we transform the inputs into outputs, which are valued by

the customer. Quality is the degree to which the service satisfies a customer by meeting

their wants and expectations.

INNOVATION

Hospitals will soon go hi-tech, not so much in terms of sophisticated medical equipment,

but in that a patient’s kith and kin can virtually visit him/her from any part of the world

and the patient too can communicate with them and relieve their undue anxiety.

Bangalore has emerged as a pioneer in the design of an interactive website used in

making virtual visits to hospitals, thus introducing a human element hitherto, unthought

of. This breakthrough in the usage of information technology for patients was achieved

by the Bangalore based ‘Think Ahead Incorporated’, in designing he website for a

hospital.

The primary advantage of this technology is the mitigation of undue anxiety of relatives

particularly, sons and daughters, children of patients who are settled abroad – who cannot

be at the bedside of the patient undergoing treatment for a heart ailment or a major

surgery. The ‘Virtual Family Visit’ allows relatives to see real time images of patients

through audio – visual files which can be downloaded on their computer by entering the

hospital website through the Internet. These files of the patient are shot by the hospital

using a webcam to show the convalescing patient and his message for his family

members. The files are then uploaded in the hospital website. The family members can

also communicate with the patient by way of sending online get well card to patients.

Besides, they can also get reports of the patient’ condition from the doctor in-charge, if

the relatives so desire.


Wockhardt Hospital, where the virtual family visit is in use, the relatives are physically

able to see their near and dear ones recuperating from the treatment which avoid

emotional trauma. This facility in hospitals is particularly useful when a relative is unable

to rush to the hospital to be physically present due to various reasons. Besides, the patient

himself is to be on the road to faster recovery when he communicates with his loved

ones.


THE SERVICE MARKETING TRIANGLE

– BY GRONROSS

The triangle comprises of the company i.e. the hospital, employees i.e. the doctors, nurses

and the customer or in this case, the patient

The company here is the hospital which dreams up the idea of a service offering

by way of treatment, which will satisfy the customers i.e. patient’s expectations of

getting cured.

The patient who seeks to get cured is the customer for the hospital as he is the one

who avails of the service and pays for it.


Internal MarketingEnabling the Promises

External MarketingMaking the Promises

Company –EMERALD DIABETES HOSPITAL CENTER

Employees – doctors, nurses, etc.

Customers - Patients

Interactive MarketingKeeping the Promises

55

The employees comprise of all the people who are involved in providing the

service, namely doctors, nurses, technicians, attendants, administrative personnel

etc.

From the triangle we see that three kinds of marketing activities take place in a hospital.

EXTERNAL MARKETING

The hospital undertakes external marketing as to promote the service i.e. treatments and

facilities to the patients. This has been explained in detail under the promotion mix and

the hospital marketing.

INTERACTIVE MARKETING

Secondly interactive marketing takes place between the employees and the patients.

Interactive marketing describes the employees’ skill in serving the client/patient. We

know the customer of the hospital is the patient who is in some degree of discomfort or

suffering when he is admitted/comes in.

From the time he enters to the time of discharge, the patient has to continuously interact

with the hospital’s employees by way of talking to the nurses, attendants.

Thus in his vulnerable state of suffering or sickness the patient expects quality care along

with empathy and consideration of his every need by the hospital staff.

Thus the selection, motivation, training of the hospital staff makes huge difference in the

well-being and recovery of the patient.


INTERNAL MARKETING

Good and effective interactive marketing is made possible only through efficient internal

marketing. Hospitals undertake internal marketing to train employees and motivate them

to serve customers well. Such training will help improve employee competence and

improve employee responsiveness, problem solving ability as well as their attitude,

goodwill towards patients, all of which in turn will result on patient well being and

recovery or customer satisfaction.

Thus internal marketing ensures that the employees are at their best behavior with the

patients and well informed about the various activities of the hospital. An important way

of internal marketing is analyzing feedback from regular customers satisfaction surveys

and improving service delivery so that the way of service delivery itself becomes the

marketing of the service

INTERNAL MARKETING AT EMERALD

Continuous medical education programs are held periodically so as to make

doctors aware of how new/rare diseases, latest technology etc.

Training programmes are held every fifteen days for nurses who come into most

direst and frequent contact with patients, so as to educate them on how to handle

various temperaments/patients.

They also collect feedback from customers which will help them continuously in

improving the service delivery.


CRITICAL INCIDENTS

Here, critical incidents are the period prior and during the procedure, discharge and

billing. During and prior the procedure, the relatives of the patients are likely to be most

vulnerable. That is, they are worried about the well-being of the patient and as a result are

likely to be less tolerant of mishaps.

EMERALD handles this by ensuring that the relatives receive a host of conveniences at

the time. For instance,

A counselor gives frequent updates to relatives during the procedure. In the case

of ICU patients, the counselor also arranges meetings between the ICU doctor and

the relatives once a day.

Relatives are provided with comfortable cubicles with communication facilities in

the waiting lounge.

Prayer rooms are also provided for the relatives. This is where they can pray

while the patient is in surgery or ICU.

Sometimes there may be more than one consent form for a procedure. This may

prove a complication that the patient/relatives don’t need at the time. Thus, the

hospital ensures that the patient’s consultant or his assistant explain the details of

the procedure to the patient/relatives.

All measures are also taken by the hospital to ensure that the patient receives the best

care, a number of formalities have to be completed by the patient at the time of discharge.

As this may prove confusing to the patients, the ward sister gives the patient a discharge

summary at the time of discharge.

After the procedure and recovery the patients are usually eager to get home. Therefore,

they will not appreciate lengthy or complicated billing procedures. The hospital has a

separate business centre for the efficient and quick processing and payment of bills. So as


to avoid any inconvenience to the patient, the final refund is made by cheque, and sent to

the patient by courier

COMPLAINT MANAGEMENT/SERVICE

RECOVERY

Service recovery is an aspect of the total customer service strategy that is often

overlooked by hospitals and health care workers. Service recovery provides the tools

employees need to help customers “recover” from negative perceptions, thus becoming

satisfied patients.

EMERALD has a distinct Customer Care department. It is the duty of this

department to sort out problems associated with customer satisfaction, complaints

etc.

The department takes a round of the hospital everyday between 9-12 every

morning, collecting feedback and checking on the service that the patients and

visitors receive.

Feedback forms are provided by the ward sister to the patient at the time of

discharge. The patient is asked to fill it and put it in the suggestion boxes before

leaving. The patient is assured of his/her identity being kept secret from the

hospital staff.

Suggestion boxes are placed at the nurse’s station in each wing.

The department acts any problems discovered on. For example, if a patient

complains that a particular doctor doesn’t arrive on time etc., the doctor is made

aware of the situation/ discomfort caused due to his late arrival and asked to

correct his behavior.

In the event that the patient leaves the hospital with a bad impression, a letter is

seen to the patient, apologizing for the inconvenience and an assurance that it will

be looked into and prevented from happening again.

The use of web technology for virtual hospital visit is said to be the first of its kind in the

world. The claim may be true considering that family bonds in the country are very

strong and even extends to close relatives. It may also be one of the reasons why such a


facility had not been thought of in other parts of the world. Besides, scaled – down joint

families are still prevalent where this technology would come in handy. The success of

this facility is revealed by the fact that there were as many as 8,000 hits within two

months after its introduction.

MEDIA PLAN

All media promotions will begin six months before the commencement of the hospital in

order to create some awareness before be become completely functional. The Ad spend

will be maximum in the first year, as this will be when we are creating awareness about

diabetes and also building a name in society among our target audience.

Our plan will consist of the following activities along the various lines,

Personal Selling:

It involves sending personnel out to schools, pharmacist, doctors and other hospitals etc.

to talk to prospective customers (patients), especially parents of these children. So that

nobody is ignorant about the seriousness of the disease. We will also have walk in

seminars to achieve the same end.

Public Relation:

Direct contact program:

Nurse’s day celebration on 12th may every year.

Children’s day celebration on 14th November every year.

Celebration of Independence and Republic day in order to shape the young minds

as they will be molding the future.

Education/Awareness:

Magazines newsletter where children will share their experience.

Sponsorship incase of school sports day.

Pharmacist and doctors.


Corporate Social Responsibility:

Free check-ups done at school and other places.

Diabetic week

Beautification of the surrounding

Out reach camps incase of epidemics, communicable diseases

Provide medicines to orphanages and old age homes.

Internal assessment:

Seminars held on a monthly basis for doctors in the auditorium.

Get together and informal meetings for staff.

Continuous training provided to staff on different issues such as behavior,

personality, etc.

CMEs (continuous Medical educational Programmes)

Committees for grievances and accepting constructive criticism.

.

Advertising:

Television commercial media plan

Channels Program Days Total Budget

Mon, Tue, Wed, Thur Fri, Sat,Sun ####(Rs.) week

Star plus Kaun Banega Crorepati 2 1 1 1 1 3 39,00,000Kyunki saas bhi kabhi bahu thi 1 1 2 17,00,000Kasautii zindagii kay 1 1 2 12,00,000

Sony C.I.D. 1 1 12,00,000

Aaj Tak News around the clock 1 1 2 39,000

CNBC Health and Fitness 1 1 12,000

History Biography 1 1 9,000

Star world Opra Winfrey Show 1 1 25,000

Zee Café Full House 1 1 5,000

Total 2 2 2 2 2 2 2 14 80,90,000


The total budget for the TVC for the week is Rs. 80,90,000 and hence for the month Rs. 32,360,000 and the difference in the rate is due to the various categories.

News paper media plan

Name Of The Paper No. Of times in a week Weekly Budget (Rs.)

Times of India + Wellness 3 6,00,000

Hindu 2 1,00,000

Economic Times 3 3,00,000

Dainik Bhaskar(Regional paper) 2 2,50,000

Gujrat Samachar(Regional paper) 1 50,000

TOTAL 11 13,00,000

Magazine:

Name of the magazine Weekly Budget

Health and Nutrition 67,500

Health Screen 55,000

Reader’s Digest 2,50,000

India Today 4,00,000

TOTAL 7,72,500

The print budget for the month is Rs.82,90,000

Outdoor:

Place Weekly Budget

Worli 3,50,000

Mahim (Bombay Scottish) 1,00,000

Juhu ( Maneckji cooper school) 1,00,000

Bandra ( A.V.M. school) 3,00,000

TOTAL 8,50,000


The monthly budget for outdoor advertisements is 34, 00,000

Direct Marketing:

As for direct marketing, we will be sending out brochures/pamphlets on a selective basis

to doctors, hospitals and schools. They can even visit our website for the same. We also

have customer service departments, which will be entertaining all the calls and queries of

the customers.


THE ROAD AHEAD…

It is very important to have a clear cut vision of what the organization wants to achieve in

the following years as competition gets intense and delighting customers gets difficult.

Hence we at EDH have set a benchmark for ourselves regarding the future perspective

and we will achieve this within five years from now.

The list on our agenda includes:

We plan to open a medical institution (diabetes education) in our campus which

would help the young minds get first hand information with practical exposure.

We would have our own Research and Development facilities.

Continuous improvement in Human Resource.

We plan to expand ourselves into a multi-specialized hospital.

Open branches in metropolitans.

Emerging as one of the main market players in the field of health care.

Finding new ways to delight our patients and help them to stay fit for a better

tomorrow.

Air ambulance facility will be provided in near future.

‘The diet store’ which is one of a kind now, will have franchising given to

different places and cities.


AIR AMBULANCE CONCEPT

Transfer from military evacuation to today’s sophisticated EMS (Emergency Medical

Services) programs for all concerned did not occur overnight. Australia, a land of vast

distances and scattered population, probably deserves the credit for being the leader in

integrating the airplane into the health care delivery system. “Get the patient to the best

medical care available as rapidly and as safely as possible, a rewarding goal with proven

medicalbenefits.”

In India this service was only available in the military, but none in civil due to lack of

finances and non-availability of suitable aircrafts. With the onset of liberalisation in our

country during the early years of the last decade, it became possible to commence a

dedicated Air Ambulance Service, leading to reduced morbidity and mortality during

evacuation.

An air ambulance is specifically designed to accommodate the aero medical needs of

person’s who are ill, wounded, injured or otherwise mentally or physically incapacitated

or helpless, who may require emergency medical care in-flight, and who, in a physician’s

opinion, cannot be safely transported on a standard commercial flight.


BIBILOGRAPHY

1) S. L. Raheja Hospital Name of fellow

A) Books

Philip kotler……..Marketing Management

Christopher Lovelock…….Service sector Management

Understanding diabetes

(Simple guide for patients)….Anil Kapur, Kamla Kapur

B) Magazines / Brochures

Health screen….. Volume 2, No.7, July 2005(diabetes clinical management ……cover story pg 10 – 17)

Granosinithline ( nd, sheetal booklet)

S. L. Raheja pampletes

Healthcare

Websites

C) websites

D)Nespaper

Bombay times…….30th August , 2005

Mumbai Mirror ……29th August, 2005


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