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Organisational Study At Muthoot Hospital, Kozhencherry

Executive Summary Health care sector is one of the fastest growing sectors in India. Also hospital is one of the most complex structured organizations amongst all industries at present because of IT revolution, consumerism and specialization in different fields, hospital as an organization got new dimension. Earlier it was easy to manage a health care set up with so called most experienced and bureaucratic medical professional. But this trend has become back dated now. Such a situation calls for a study of the organization to know the working department and various other complexities of hospital. The study helps in understanding the various dynamics of MGM Muthoot Medical Centre, Kozhencherry. . The health care industry, or medical industry, is a sector within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, palliative, or, at times, unnecessary care. The modern health care sector is divided into many sub-sectors, and depends on interdisciplinary teams of trained professionals and paraprofessionals to meet health needs of individuals and populations. The health care industry is one of the world's largest and fastest-growing industries. Consuming over 10 percent of gross domestic product (GDP) of most developed nations, health care can form an enormous part of a country's economy. For purposes of finance and management, the health care industry is typically divided into several areas. As a basic framework for defining the sector, the United Nations International Standard Industrial Classification (ISIC) categorizes the health care industry as generally consisting of: 1. 2. 3. hospital activities medical and dental practice activities Other human health activities This third class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, or other allied health professions, e.g. in the field of optometry, hydrotherapy, medical


Organisational Study At Muthoot Hospital, Kozhencherry

massage, yoga therapy, music therapy, occupational therapy, speech therapy, chiropody, homeopathy, chiropractics, acupuncture, etc. The Global Industry Classification Standard and the Industry Classification Benchmark further distinguish the industry as two main groups: 1. 2. Health care equipment and services; and Pharmaceuticals, biotechnology and related life sciences. Health care equipment and services comprise companies and entities that provide medical equipment, medical supplies, and health care services, such as hospitals, home health care providers, and nursing homes. The second industry group comprises sectors companies that produce biotechnology, pharmaceuticals, and miscellaneous scientific services. Other approaches to defining the scope of the health care industry tend to adopt a broader definition, also including other key actions related to health, such as education and training of health professionals, regulation and management of health services delivery, provision of traditional and complementary medicines, and administration of health insurance.

The study focuses on the organizational structures and the departmental functions. In a hospital there are two types of departments i.e. administrative and medicinal departments. As part of our management studies, the role played by administrative departments is a major area of research. The study gives the overall idea of the health care industry, organization and the role played by each department in the hospital. The organization is examined by SWOT analyses. The main objective is to get a real life exposure and practical experience regarding the organizational functions and various processes carried out by the hospital.

Training and learning in a class room will make an individual knowledgeable in theory of the various functions of a company. But a person comes out from class room and visits various industries, in this situation he can learn more from them. In such a situation real experience in the practical functioning and operations of a company can of very much use to the students of management studies.


Organisational Study At Muthoot Hospital, Kozhencherry



Organisational Study At Muthoot Hospital, Kozhencherry

1.1 Introduction Organization is a social unit of people, systematically arranged and managed to meet a need or to pursue collective goals on continuing basis. All organization has management structures that determine the relationship between different functions and positions and delegate roles, responsibilities and authority to carry out defined task. It is often said that good people can make organization pattern work the better the organization the fuller would be the achievement of the objective. An organization study will help in having a better idea about the functions of each department in detail and the duties and responsibilities of each and every personnel in a particular department. It will also provide better picture about the organization structure and the hierarchy of various position in the organization. The study also gives a better understanding about the history of the company and its different phases of development since its inception. It also helps in identifying and studying the various policies, procedures and programs adopted by the company. It also gives an opportunity to interact with the people working in the organization. The study also throws light into the future plans of the company. The organization study at MGM Muthoot Medical Centre is conducted for understanding more about the structure and functioning of various departments in the organization. In the fast moving world illness is increasing day by day. So health care has a vital role in modern society. The maxim that health is wealth highlights the increasing importance of health. Good health is an integral part of social development and hence it creates wealth considering its importance all over the world, April 6th is celebrated as world health day. The world health organization (WHO) has defined the highest possible level of health as physical, mental and social well being and not merely the absence of disease or infirmity [biswanath, 2001] The components of good health care are: 1. Nutritious diet 2. Hygienic condition of living 3. Safe drinking water 4. Information about good health care 5. Existence of good health facilities like hospital and medical treatment facilities


Organisational Study At Muthoot Hospital, Kozhencherry

1.2 Objective of the Study MAIN OBJECTIVE: To make an organizational study at Muthoot Hospital in Kozhencherry

SUB OBJECTIVES : To acquire knowledge about the functions and managerial aspects of the organization To study the functions of each departments and the role played by each To understand relationship between each department Examine the organization using SWOT analysis. To get a real life exposure and practical experience regarding the organizational functions and various processes carried out by the company

1.3 Scope of the Study

Health services research is the multidisciplinary field of scientific investigation that studies how social structure, financing system, organizational structure and process, health technologies and personal behavior affect access to health care, the quality and cost of health care and ultimately our health and well being. Its research domains are individuals, family, organizations, institutions, communities and population. The provision of high quality, affordable, health care services is an increasingly physical challenge. Due to the complicity heath care services and system, investigating and interpreting the use, cost, quality, accessibility, organization, financing and outcomes of health care services is to informing of the government officials, insures, provided, consumers and others making decision about health related issues. This study focuses on the organizational structure, the departments and overall analysis of the organization.


Organisational Study At Muthoot Hospital, Kozhencherry

1.4 Research Methodology INTRODUCTION: Research in common refers to a search of knowledge. It is scientific and systematic research for pertinent information on a specific topic. In fact, research is an art of scientific investigation. The Advanced Learners Dictionary of current English lays down the meaning of research is a careful investigation or inquiry especially through search for new fact in any branch of knowledge. In short, the search for knowledge through objective and systematic method of finding solutions to a problem in research RESEARCH DESIGN: A research design is the arrangement of conditions for collections and analysis of data in a manner that aims to combine relevance to the research purpose with economy in procedure. In fact, the research design is the conceptual structure within which research is conducted; it constituted the blue print for the collection, measurement and analysis of data.

1.5 Sources of Data Datas for the research are collected mainly from two sources Primary data Secondary data

Primary data It refers to the first hand data (information) which is original in character that an investigator himself collects from the respondents.

Primary data required for this study were generated from the employees and also from discussion made with the authorities of the organization.

Secondary data It is the information collected from those data which have already obtained by some other researcher or they are already been existed in records. Secondary data for this study were collected from the books, magazines, websites, newspapers etc. 6

Organisational Study At Muthoot Hospital, Kozhencherry

1.6 Data Collection and Instruments observation

Personal interview There is a face-to-face contact between the investigator and informants. The investigator asks them questions pertaining to the study and collects the desired information.

1.7 Limitations of the Study Since the limitations of the study have been a major threat to the researcher during the study, the following limitations were found: It is a time consuming process The busy schedule of the personnel made it difficult to conduct a proper interview with all of them. In spite of all these limitations, adequate care has been taken to derive at more reliable conclusion


Organisational Study At Muthoot Hospital, Kozhencherry



Organisational Study At Muthoot Hospital, Kozhencherry

2.1 INDUSTRY PROFILE Hospitals are organized institution for the care of the sick and injured. The word hospital comes from the word hospes which means the host. In older days the hospital were guest house the for the shelter of the homeless and for the treatment of travelers. In the modern times, however the chief function of the hospital has been the care and the treatment of the sick. According to WHO a hospital is an integral part of social and medical organization, the function of which is to provide for the population the complete health care, both curative and preventive and whose outpatient services reach out to the family and its home environment the hospital is also centre for training of the health workers and for bio-social research The functions of the hospital are: 1) Cares of the sick and injured 2) Prevention of disease and promotion of health 3) Diagnosis and treatment of disease 4) Rehabilitation and vocational training 5) Medical education 6) Research The health care industry is considered as an industry or profession which includes people s exercise of skill or providing of the service released to the preservation or improvement of the health of individuals or the treatment of the care of individuals who are injurselik, disabled or infirm. The delivery on an expanding group of trained professionals coming together as an inter disciplinary team The health care industry is one of the worlds largest and fastest growing industries. . The hospital services market represents one of the most lucrative segments of the Indian healthcare industry. Various factors such as increasing prevalence of diseases, improving affordability and rising penetration of health insurance continue to fuel growth in the Indian hospital industry.


Organisational Study At Muthoot Hospital, Kozhencherry

Healthcare Industry in India Healthcare is one of Indias largest sectors, in terms of revenue and employment, and the sector is expanding rapidly. During the 1990s, Indian healthcare grew at a compound annual rate of 16%. Today the total value of the sector is more than $34 billion. This translates to $34 per capita, or roughly 6% of GDP. By 2013, Indias healthcare sector is projected to grow to nearly $40 billion. The private sector accounts for more than 80% of total healthcare spending in India. Unless there is a decline in the combined federal and state government deficit, which currently stands at roughly 9%, the opportunity for significantly higher public health spending will be limited. Growing population and economy one driver of growth in the healthcare sector is Indias booming population, currently 1.1 billion and increasing at a 2% annual rate. By 2030, India is expected to surpass China as the worlds most populous nation. By 2050, the population is projected to reach 1.6 billion. This population increase is due in part to a decline in infant mortality, the result of better healthcare facilities and the governments emphasis on eradicating diseases such as hepatitis and polio among infants. In addition, life expectancy is rapidly approaching the levels of the western world. By 2025, an estimated 189 million Indians will be at least 60 years of agetriple the number in 2004, thanks to greater affluence and better hygiene. The growing elderly population will place an enormous burden on Indias healthcare infrastructure. The Indian economy, estimated at roughly $1 trillion, is growing in tandem with the population. Goldman Sachs predicts that the Indian economy will expand by at least 5% annually for the next 45 years (see chart), and that it will be the only emerging economy to maintain such a robust pace of growth. The healthcare division When it comes to healthcare, there are two Indias: the country with that provides highquality medical care to middle-class Indians and medical tourists, and the India in which the majority of the population livesa country whose residents have limited or no access to quality care. Today only 25% of the Indian population has access to Western (allopathic) medicine, which is practiced mainly in urban areas, where two-thirds of Indias hospitals and health centers are located. Many of the rural poor must rely on alternative forms of treatment, such as ayurvedic 10

Organisational Study At Muthoot Hospital, Kozhencherry

medicine, unani and acupuncture. The federal government has begun taking steps to improve rural healthcare. Among other things, the government launched the National Rural Health Mission 2005-2012 in April 2005. The aim of the Mission is to provide effective healthcare to Indias rural population, with a focus on 18 states that have low public health indicators and/or inadequate infrastructure. These include Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand, Jammu & Kashmir, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar Pradesh. Through the Mission, the government is working to increase the capabilities of primary medical facilities in rural areas, and ease the burden on to tertiary care centers in the cities, by providing equipment and training primary care physicians in how to perform basic surgeries, such as cataract surgery. While the rural poor are underserved, at least they can access the limited number of government-support medical facilities that are available to them. The urban poor fare even worse, because they cannot afford to visit the private facilities that thrive in Indias cities. Medical tourism on the rise Medical tourism is one of the major external drivers of growth of the Indian healthcare sector. A Google search of India medical tourism turns up more than two million results. The emergence of India as a destination for medical tourism leverages the countrys well educated, English-speaking medical staff, state-of-theart private hospitals and diagnostic facilities, and relatively low cost to address the spiralling healthcare costs of the western world. India provides best-in-class treatment, in some cases at less than one-tenth the cost incurred in the US (see chart). Indias private hospitals excel in fields such as cardiology, joint replacement, orthopaedic surgery, gastroenterology, ophthalmology, transplants and urology.


Organisational Study At Muthoot Hospital, Kozhencherry

According to a joint study by the Confederation of Indian Industry and McKinsey, Indian medical tourism was estimated at $350 million in 2006 and has the potential to grow into a $2 billion industry by 2012.4 An estimated 180,000 medical tourists were treated at Indian facilities in 2004 (up from 10,000 just five years earlier), and the number has been growing at 25-30% annually. India has the potential to attract one million medical tourists each year, which could contribute $5 billion to the economy, according to the Confederation of Indian Industries. In addition to receiving traditional medical treatments, a growing number of western tourists are traveling to India to pursue alternate medicines such as ayurveda, which has blossomed in the state of Kerala, in southwestern India. The number of medical tourists visiting Kerala was close to 15,000 in 2006 and is expected to reach 100,000 by 2015 To capitalize on medical tourism and build a sustained public-private partnership in the hospital industry, the Indian government is supporting an initiative by well known heart surgeon Dr. Naresh Trehan to build a Medi City in Gurgaon, on the outskirts of Delhi. The compound will include a 900-bed hospital that supports 17 super specialties, a medical college and paramedical college. The project, on 43 acres of land, will cost an estimated $493 million. The Medi City will integrate allopathic care with alternative treatments, including unani, ayurvedic and homeopathic medicine, and it will provide telemedicine services as well. To encourage the growth of medical tourism, the government also is providing a variety of incentives, including lower import duties and higher depreciation rates on medical equipment, as well as expedited visas for overseas patients seeking medical care in India. Healthcare infrastructure expansion


Organisational Study At Muthoot Hospital, Kozhencherry

An enormous amount of private capital will be required in the coming years to enhance and expand Indias healthcare infrastructure to meet the needs of a growing population and an influx of medical tourists. Currently India has approximately 860 beds per million populations. This is only one-fifth of the world average, which is 3,960, according to the World Health Organization. It is estimated that 450,000 additional hospital beds will be required by 2010an investment estimated at $25.7 billion. The government is expected to contribute only 15-20% of the total, providing an enormous opportunity for private players to fill the gap. Recently we have seen many new investments in healthcare infrastructure facilities in India. For instance, ICICI Venture, the countrys largest private equity fund, has invested $8.6 million in a chain of diagnostics facilities, along with Metropolis Health Services Ltd. And in 2006, General Electric announced a $250 million investment in infrastructure and healthcare projects in India. With the advent of private insurance and the emergence of India as a medical tourism destination, there also has been a surge of growth in so-called super specialty hospitals, which have teams of specialists, sophisticated equipment, links to other medical centers, and the ability to treat a broad range of ailments.


Organisational Study At Muthoot Hospital, Kozhencherry

Some of these new facilities, such as the Rajiv Gandhi Super Specialty Hospital are publicprivate partnerships. Government fiscal constraints are driving the growth of PPPs to help meet Indias growing demand for healthcare infrastructure. Such partnerships have gained legitimacy worldwide in recent years as a major strategy for health sector development. In addition to participating in infrastructure PPPs, opportunities are emerging for foreign companies to create super-specialty hospitals in collaboration with Indian corporations. For instance, Wockhardt Hospitals Group has partnered with Harvard Medical International to create a chain of super specialty hospitals in India. Two hospitals, in Mumbai and Bangalore, are attracting large volumes of medical tourists from the UK and US. There also is strong demand for tertiary care hospitals, which emphasize the treatment of lifestyle diseases, focusing on specialties such as neurology, cardiology, oncology and orthopedics. Tertiary hospitals are projected to grow faster than the overall healthcare sector, in response to the growing incidence of lifestyle disease and the accelerating growth of medical tourism.7 In addition to a deteriorating physical infrastructure, India faces a huge shortage of trained medical personnel, including doctors, nurses and especially paramedics, who may be more willing than doctors to live in rural areas where access to care is limited. There is an immediate need for medical education and training, which could provide additional opportunities for private sector providers or public-private partnerships. The communications technology that enables telemedicine could also be used to deliver training courses. Health industry in Kerala The health ministry of Kerala has played a pioneering role towards the betterment of the healthcare sector in Kerala. It is striving towards the development of better diagnosis facilitating healthcare equipments, like PCR tests, that can arrest the growth of genetically transmitted maladies like cancer and diabetes. Life saving vaccination is also in the pipeline. The ministry of health also plans to erect diagnosis outfits across districts in Kerala. These centers will cater to pulmonic and stomach disorders, HIV, AIDS and a host of other health problems. Sree Chitra Thirunal Institute of Medical Sciences and Technology and Rajiv Gandhi Centre for Biotechnology is famed for their ground breaking research in cancer, HIV, AIDS, Hepatitis, offering a host of medical tests for patients.

Biotechnology has also forayed in to the world of medical science. Tissue engineering 14

Organisational Study At Muthoot Hospital, Kozhencherry

has been growing in leaps and bounds which will chart the path for successful transplantations of heart, liver and bone. Polymer studies and bio ceramics of Sree Chitra Thirunal Institute of Medical Sciences is playing a pioneering role in this direction.

Kerala is a favored restorative destination for many because of the age-old healing science of Ayurveda. Besides, holistic healing facilities available at spas, resorts and hotels of the state, The Ayurvedic Medicine Manufacture's Association is to be credited for sending the cash registers ringing. Kerala boasts of about seven hundred and sixty Ayurveda centers that rakes in a huge money (Rs.750 crores in 20001-02 that billowed to Rs.5000 crores by 2005).


The Muthoot Group is a 125-year-old business house based in India. It has interests in Financial Services, InformationTechnology, Media, Healthcare, Education, PowerGeneration, Infrastructur e, Plantations, Precious Metals and Hospitality. The Muthoot Group operates in 23 states in India, and has a customer base of over 25 million. It is wholly owned and managed by the Muthoot Family. The Group takes its name from the Muthoot Family based in Kerala. The Company was set up by Muthoot Ninan Mathai in 1887 at Kozhencherry, a small town in the erstwhile Kingdom of Travancore (Kerala). It was then later taken over by his son M George Muthoot who incorporated the Finance division of the group which was until then primarily involved in wholesale of grains and timber. The company is now managed by the third and fourth generation of its family members. The group is headquartered in Kochi, Kerala Finance The origins of Muthoot Finance can be traced back to 1939 when [M.George Muthoot] ventured into financial services through a partnership firm under the name of Muthoot M. George & Brothers (MMG). MMG was a Chit Fund based out of Kozhencherry. In 1971, the firm was renamed as Muthoot Bankers, and had begun to finance loans using gold jewellery as collateral. The operations of Muthoot Bankers was then renamed and incorporated as Muthoot Finance in 2001. Muthoot Finance falls under the category of Systematically Important Non 15

Organisational Study At Muthoot Hospital, Kozhencherry

Banking Financial Company (NBFCs) of the RBI guidelines. The company has more than 3,510 branches spread across 23 states of the country and is the largest gold loan company in India. Muthoot Finance, according to the IMaCS Research & Analytics Industry Reports [Gold Loans Market in India, 2009 (IMaCS Industry Report 2009) and the 2010 update to the IMaCS IndustryReport 2009 (IMaCS Industry Report (2010 Update))], is the largest Gold Loan NBFC and has the largest network of branches for a Gold Loan NBFC in India. Muthoot Finance is also the highest credit rated Gold Loan Company in India. Muthoot Gold Power is the lifestyle product of Muthoot Finance aimed at mobilizing the Household gold in India which is estimated to be more than 15000 tonnes. Muthoot Finance according to its company website has "the largest gold loan portfolio in the country". Muthoot also provides various financial services such as Insurance distribution, Wealth Management, Foreign Exchange, Money Transfer and Vehicle & Asset Finance. Muthoot Finance was selected as one of the Top 10 Finance companies to work for in India by Muthoot Finance privately placed 4% of its paid up capital to Private Equity players - Barings India and Matrix Partners India for Rs.1.57 billion, hence valuing the earlier privately held company at over $1 billion. In terms of market capitalization, Muthoot Finance is the second largest company in Kerala, first being Federal Bank. Information technology Emsyne, the information technology wing of the group develops products for the service, education and healthcare industry. Emsyne offers on site and offshore services, whether projectbased outsourcing / assignments, or based on time and materials. The Core Products of Emsyne are Edge - Educational Institutions Management System Finex - Innovative Banking Automation System Precious Metals Muthoot Precious Metals Corporation (MPMC) is one of the Group companies of Muthoot Group, selling Coins & Bars of 999 Pure 24 Carat gold and silver across India through the outlets of Muthoot Finance. MPMC is importing gold bullions from Switzerland and converts them into gold coins of smaller denominations so as to suit the investment requirements of people from different income groups. The coins are sold through more than 3400 outlets of Muthoot Finance Ltd. MPMC is one of the leading sellers of Gold Coins in retail market. Gold Coins/Bars are sold in 16

Organisational Study At Muthoot Hospital, Kozhencherry

denominations of 0.5, 1, 2, 4, 8, 10, 20 and 50grams denominations. MPMC has silver coins in 20, 50 & 100grams denominations. Coins are marketed in attractive blister packings with Muthoots certificate of Purity and MPMCight. MPMC has the gold & silver coins imprinted with the images of deities and monuments such as Goddess lakshmi, Lord Ganesha, Lord Ayyappa, Lord Sri Venkateswara (Balaji), Our lady of Velankanni, St. Alphonsa, St. Gregorious, Lord Sri Padmanabha, Golden Temple, Chatrapathy Sivaji, Mary Matha, St.George and Normal Coins etc.. From January 2012 MPMC is expanding its horizons, from a Trading company to a gold Investment Company.

Media Chennai Live 104.8 is India's first talk radio FM station. The station would be focusing on knowledge centric and local content and will be targeting the information and entertainment needs of Chennai's intelligent community. Healthcare The Group operates several Diagnostic & Scan centers throughout Kerala and 2 multispecialty hospitals in Kozhencherry and Pathanamthitta. Hotels & hospitality Muthoot Hotels operates a 4 star resort in Thekkady (Kerala) and also operates 12 houseboats in the backwaters of Kerala under the brand Muthoot River Escapes.

Kaapi Club is a chain of South Indian coffee outlets managed by Muthoot Hotels. Muthoot Hotels is in the process of constructing a 5 star luxury hotel in the city of Kochi and 5 star beach resort in Mararikulam. Housing & infrastructure The projects of Muthoot Builders are primarily situated in central and south Kerala, Muthoot has a track record of more than 30 completed projects including commercial and residential spaces. Other divisions Muthoot has interests in Power Generation through windmill farms in the state of Tamil Nadu. The group also manages a school in New Delhi and 2 Nursing Colleges in Kerala. In the


Organisational Study At Muthoot Hospital, Kozhencherry

year 2008 the group re-entered the plantation business, the group has acquired 1000 acres of land in Sawantvadi, Maharashtra as a pilot planting of rubber.

Philanthropy Muthoot M George Charity Foundation Set up in memory of the Late M. George Muthoot, the Foundation has been extending financial aid for its employees as part of the Staff Welfare measures. Every branch of The Muthoot Group is actively involved in Community Development and Social Welfare. The Muthoot Foundation frequently grants medical and financial aid to deserving individuals through its welfare programs. Community support is a corporate responsibility. The Muthoot Group maintains its position as a valued and responsible corporate citizen by enhancing the quality of life in the communities where they do business. It is very important for a corporate to support the community in which it operates. The Muthoot M. George Charitable Foundation is approached by numerous organizations and individuals requesting financial and medical assistance.

Muthoot Medical Centers at Kozhencherry and Pathanamthitta are super specialty hospitals set up in the rural areas of Kozhencherry and Pathanamthitta. They are both organizations established in 1989. Environment research foundation The Periyar Foundation set up by Muthoot Hotels is based in the town of Thekkady, near the Periyar National Park has undertaken several projects for the conservation of the national park including 'vasantha sena' and a research study along with the National Institute of Advance Studies for the conservation of 'Nocturnal Flying Squirrels

Tucked away amidst sylvan surroundings and picturesque Kozhencherry, Kerala, nestles Mar Gregarious Memorial Muthoot Medical Centre. MGM Muthoot medical centre is a multispecialty hospital founded in 1988. The Muthoot Group is a well known business group in India spread over 16 diversified areas. MGM Muthoot Medical Centre is a division of Muthoot Health Care. Housed in a cluster of majestic buildings of architectural excellence and surrounded by the scenic enchanting hillocks, Mar Gregorious Memorial Muthoot Medical Centre has a host of unique features as a 407 bedded multi specialty hospital. 18

Organisational Study At Muthoot Hospital, Kozhencherry

Founded under the aegis of the Muthoot Group, this Medical Centre has been in the continuous pursuits of excellence. Situated in the heart of Pathanamthitta, which is in the blossom of the Holy Sabarimala this eco-friendly and insurance-friendly hospital offers state-of-the-art therapeutic service in all established genres both clinical and non-clinical. This 407 bedded ISO certified hospital with a credo of, pursuit of excellence delivers state of the art professional care coupled with efficient and empathetic nursing care. Muthoot medical centre was founded with a vision of bringing all available modern facilities of the different specialties of medical sciences within the reach of the common man. It now caters to the, medical needs of a population well, beyond the limits of central Travancore and its surroundings and offers therapeutic modes in all established clinical specialties. It has already earned a reputation of being the best staffed, best equipped and the fastest growing medical centre in Kerala. MGM Muthoot was founded by Late.Dr.George Kurien MRCP. MGM Muthoot Medical Centre was founded with the venerable vision of bringing the best available health care to Kozhencherry, where the Muthoot Medical Centre grew remarkably adding value and care for patients well beyond the precincts of Kozhencherry. As of now, MGM Muthoot Medical centre offers state of the art therapeutic modes in all established genres, clinic, para clinic and ayurvedic. Today this multispecialty hospital offering 15 specialty and 9 super specialty hospitals. Muthoot groups health care division owns a sister concern at Pathanamthitta , a multispecialty modern hospital ,5 MRI scanners and 12 CT machines in different location , many one in remote rural area. Set in tandom with this is state of the art clinic, pathology diagnostic centers, catering to a large population. The health care division is running through its motto pursuit of excellence.


Organisational Study At Muthoot Hospital, Kozhencherry

MISSION MGM Muthoot Medical Centre is a medical institution dedicated to providing quality patient care with attention to clinical excellence; passion and commitment to assure the very best healthcare, to a rural community in a financially responsible manner; serving all with a spirit of equality regardless of religion, caste, creed, age, gender or social standing, which contribute to the physical, psychological, social and spiritual well being of the patients and community VISION To be a prominent community member known for meeting the healthcare needs of the entire community through incomparable patient care and wellness programs. To be the hospital of choice for patients, physicians and employees in Central Travancore because of our patients pre eminent patient care Integrity is everything we do, we believe in being honest and genuine Accessible to our patients We are committed to service excellence and continuous performance improvement. As a community healthcare services provider, we remain attentive to the health and well being of those we serve through education, outreach and other innovative services. Maintain high standards by recruiting and retaining excellent staff, physicians, dentists and specialists.


COMPETITORS Poyanni hospital, Kozhencherry Century hospital, Chengannur Pushpagiri hospital, Triruvalla


Organisational Study At Muthoot Hospital, Kozhencherry

BOARD OF DIRECTORS Dr. George Mathew Muthoot ------------Chief Medical Director Mr. M.G. George Muthoot -------------Chairman Mr. George Alexander Muthoot---------Managing Director Mr. George Thomas Muthoot-------------Joint Managing Director Mr. George Jacob Muthoot----------- Joint Managing Director Mrs. Valsa Kurien Muthoot-------------Director Mr. Georgi Kurien Muthoot---------- Executive Director

There are 4 blocks : a) M.G Block b) A.G block c) G.K block d) Centinary block a) THE MG BLOCK This block consists of five floors The ground floor Reception , casualty, X- ray, ECG , radiation, Minor Operation Theatre , Divisional Managers room, medical out patients department, injection room, pharmacy, cash counter, dieticians room. The first floor

Department of cardiology, neurology, nephrology. There are also wards for patients shifted from the ICU, Electrophysiology lab. ICU , ICCU , Echocardiography , Spirometry , Dialysis unit, computerized stress lab, and bronchospirometry( PET ), Color Doppler echo lab, consulting room of nephrologists, cardiologist. The second floor

Surgical ward, conference hall, nursing station. The third floor

Medical ward, nursing station The fourth floor

Orthopedic room 21

Organisational Study At Muthoot Hospital, Kozhencherry

The fifth floor

Pediatrics, nursing station, executive rooms

b) THE AG BLOCK This block consists of 4 floors: Canteen The ground floor

The first floor

Consulting rooms of skin specialists, ENT, dental , pediatrician, ophthalmology , psychiatry. The second floor

Nursing student hostel The third floor

Surgical and ortho ward, nursing station The fourth floor

Department of physiotherapy, physiotherapy class room, rehabilitation centre c) THE GK BLOCK This block consists of 3 floors The ground floor Consulting room of gynecologist, CT scan, store, diabetic resource centre, accounts , the rooms of chairman , director , medical superintendent, administrator , board room, hr departments, quality assurance department. The first floor

Gynecology ward, labor room, nursery, chapel The second floor

Department of anesthesiology, Operation theatre, anesthesiology, recovery room, endoscopic department, CSSD The third floor

Inpatient medical records, housekeeping section


Organisational Study At Muthoot Hospital, Kozhencherry

d) THE CENTENARY BLOCK Physiotherapy, lab, OT, blood bank


Dedicated team of Doctors Nurses Paramedical Auxiliary staff State-of-the-art equipments

Accidents and emergency care 24 hours accidents and emergency units ICCU OR IMCU , surgical ICU facilities with ventilations and modern operational theaters 24 hours blood bank facility Ambulance service on call

Supporting services Front office Administration Public relation House keeping Medical records Finance Human resource management Central stores Security services

Pharmacy 24 hours -7 days a week


Organisational Study At Muthoot Hospital, Kozhencherry

All the essential drugs are available IP pharmacy for admitted patient

OPERATION THEATRE Description The OT of the hospital undertakes the operations in the following specialties: Ophthalmic and ENT surgery General surgery and pediatric surgery Orthopedic surgery Maxillofacial surgery Gynaec and obstetrics

The OT is classified into 5 types. They are

1) Ortho, eye 2) Vascular, ENT 3) Gynaec and obstetrics surgery 4) Small procedures 5) Septic cases Laboratory Micro biological department Reception Bio-chemistry department Hematology department Facilities are available to the public without consultation Major test are authorized to Muthoot MRI Trivandrum Urology Blood bank


Organisational Study At Muthoot Hospital, Kozhencherry

Community health program Domiciliary medical assistance for bedridden patients Free medical camps in remote villages Concessional treatment for auto rickshaw drivers as patients

Insurance friendly hospital Cashless inpatients treatment for health card holders Tie up with major insurance companies

Academics DNB family medicine General nursing and mid-wifery course Bsc nursing DMLT( CMAI) CCU training OT Technician course

LEAVE DETAILS Casual leave 1 year 12 days casual leave i.e.; monthly one causal leave Sick leave- 10 days in 1 year Annual leave after completion of 12 months eligible for 20 days and not allow less than 4 days in one time Maternity leave- 30 days after 12 months service completion and 60 days after 24 months. This type of leave only taken by once in two years Working off- 1 day and not allow more than 2 days together

STAFF BENEFITS Free consultation 20% discount for medicine, 50% lab and procedures for OP visit Subsidized medical coverage for staff and department 25

Organisational Study At Muthoot Hospital, Kozhencherry

ENQUIRY Attending phone calls Giving relevant information to the individuals visiting the hospital Booking facility

WORKING TIME The period and hours of work for all classes of employees in each shift, shall be communicated through notice or register of communication or exhibited in the notice board provided that if any particular employee is required for a different period he shall be notified to that effect in advance. The employee shall also attend the work anytime outside the regular hours of work if in the opinion of the employees superior officer or any of them, such attendance or presence is necessary for the efficient running of the hospital or establishment. Each employee should work minimum of 8 hours duty per day and 6 days per week .there will be a shift for administrative staff and 2, 3 shifts for auxillary and nursing staff respectively. STAFF RATIO 1) Nursing category Critical areas (all ICU, dialysis, post OP) Day time a) 1:1 (for ventilator and highly critical areas ) b) 1:1 (for other ICU cases) 26 Total no of employees 615 Doctors- 52 Nurses- 270 Administration- 83 Maintenance and civil- 38 Others- 37 Education- 73 Paramedical- 62

Organisational Study At Muthoot Hospital, Kozhencherry

Night time a) 1: 1 ( for ventilator and highly critical areas ) b) 1:3 (for other ICU cases) 2) Rooms Daytime a) 1:6 (1 staff nurse for 6 patients) Night time a) 1:10 3) Wards Daytime a) 1:18-10 b) 1: 10 12

Working hours for administrative category 8.00am 5.00pm (8 hours duty with 1 hour lunch break) 8.00am 5.00pm 5.00pm 8.00am (8 hours duty with resting time) 7.30am 4.00pm 7.30am 6.00pm (7 hours duty with a break of 3 hours from 1.00pm 4.00pm) 6.00pm - 7.30am (7 hours duty with resting time)

Working hours for auxiliary category

Working hours for nursing category


Organisational Study At Muthoot Hospital, Kozhencherry



Organisational Study At Muthoot Hospital, Kozhencherry

3.1 Organizational Chart


Organisational Study At Muthoot Hospital, Kozhencherry

3.2 Functional Area Analysis

3.2.1 HUMAN RESOURCE DEPARTMENT In the hospital HRD mainly deals with the matters related to the employees such as receiving application from the candidates, conduct interviews, give effective training to the new staffs etc. The main function of HR is welfare of the employees. Details pertaining to vacancies are displayed on the notice board and advertised in papers ( Malayala Manorama on Wednesday employment opportunities section) The applicants send in their bio-data and a date is fixed for a walk-in-register Transfers to its sister-concern in Pathanamthitta are possible. Promotions are encouraged on the basis of experienced. Salary is given on the 6th of every month. Under the human resource department comes the issuance if ID card and recording of punching machine entries. Suggestion boxes are hung in each floor of the blocks. Financial aid are extended to MGM medical centres employees as part of the staff welfare measures within a years time, more than 70 employees have received help from the charity foundation set up in memory of the founder chairman Late Shri m George Muthoot. Also there is a Bru coffee counter at the entrance and 1/5th of the income goes to the staff welfare fund.

The aid includes: 1) Support in basic educational expenditure of the dependent children 2) For the medical treatment of their dependents 3) For the marriage of their dependent children 4) For the funeral of their dependents 5) In times of accidents and emergencies Other features Every month, the staff welfare committee meets at the corporate office and decision is taken case to case.


Organisational Study At Muthoot Hospital, Kozhencherry

No deserving case are declined or kept in abeyance. Mediclaim coverage for the employees, spouse and two children covering up to an amount of rs 1 lakh. Exit interviews are conducted for the quitting employees and for the inpatients at the time of discharge. Casual leave is given once a month. After 3 months, up to 10 days sick leave can be taken after the completion of one year, up to 20 days annual leave can be taken.

REGISTERS KEPT IN HRD 1) LEAVE REGISTER In the leave register the details about the leaves taken by the employees and the number of balance of leave is shown. It also gives details of the type of leave being taken by the staff i.e.; whether it is a sick leave or casual leave or annual leave 2) APPRASIAL REGISTER The performance of staff is evaluated in every 6 months. On the basis of this evaluation promotion or increase in salary is done

3) TRAINING REGISTER This register includes the details about training and orientation given to the new employees

4) INTERVEIW REGISTER This register include the details about the interviews conducted by the hospital authorities

5) APPLICATION RECEIVE REGISTER The register gives the details of the applications received from the applicant

6) HOLIDAY REGISTER This register includes the number of holidays that employees can take. 7) CERTIFICATE ISSUE REGISTER It gives details of the certificates that are being issued from the HR department.


Organisational Study At Muthoot Hospital, Kozhencherry

8) ATTENDANCE REGISTER It gives the attendance of the staffs. Employees are supposed to put signature in the register before they start working

9) MOVEMENT REGISTER Each employee should write in the movement register , when they are moving out during the working time.


MAIN FUNCTION OF HR Performance appraisal Induction programmed Training Promotion and increment Leave absence recording Recruitment Conduct interviews

VARIOUS FORMS ISSUED FROM HR DEPARTMENT Induction form Performance appraisal form Clearance form Man power requisition form Interview assessment form Application form Leave form


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.2 FRONT OFFICE Front office is the main centre for the customer relationship. A medical receptionist is a broader categorization for all type of receptionist working in the industry. In this section, there is a front office manager who has the overall control and regulates the front office activities. There is a total of 18 front office staff out of which there are two for transferring the patients file to the respective doctor. Fully computerized with real-time connections to the administration and accounts departments. Connected indirectly to all the medical departments through initiating files. The front office manager manages the hospital vehicles and ensures that the rooms are neat. In addition to the above, the front office manager handles communications with the police concerning the MLC (medico legal cases). Internal auditing conducted three days in a week. There are four counters: 1. NEW REGISTRATION COUNTER The new registrants are given a form to be filled and the data is fed into the computer. A print-out is taken, neatly folded to fit into a plastic cover and the OP card is ready to be handed over to the patient. OP consultation fee

2. REPEAT REGISTER COUNTER The OP card is instructed to be put in a slot at the counter from where one of the staff takes them to the adjacent room where the OP files are kept. Once the OP files are identified, they are brought into the counter. They are asked for the doctors name and if the doctor is available, after the payment of consultation fees they are given the taken. Merging of files is possible




Organisational Study At Muthoot Hospital, Kozhencherry

ADVANCE BOOKINGS AND ARRANGE FOR STORE ORDERS THROUGH TELEPHONE The features are: There are 7 lines with call waiting and call transfers options with all the extension numbers right on the computer screen facilitating a better and prompt service The screen also retrieves the residence number as well as the mobile numbers of the doctors If an extension number is disabled, it is engaged Doctors appointment books are maintained where advance booking arrangements are encouraged and this can be done in two ways At the counter make the advance booking along with the payment and the patient receives a booking receipt along with the token number for the scheduled day so that the patient could just drop in on time It is possible to phone up for an appointment Separate books are maintained for each doctor

DUTIES AND RESPONSIBILITIES OF FRONT DESK Provide information service Receiving and processing reservation or appointment Communication and coordination with other departments Meeting , greeting and welcoming visitors Entering visitors details into visit log book Taking incoming telephone calls, dealing with such calls promptly in a professional manner and re-directing appropriate calls to other individuals or departments within and outside environment.


Organisational Study At Muthoot Hospital, Kozhencherry


1) IP registers 2) OP registers 3) OP movement registers 4) IP movement registers 5) Repeat IP register 6) Accident information registers 7) Key register 8) Birth and patients register 9) Referred patients register 10) OP registers new patient record

3.2.3 SYSTEM DEPARTMENT Hierarchy of the department

The services are exclusively housed in a spacious AC room. Specific software has been developed in association with the InfoTech for the accounts, pharmacy, store, scan centre , laboratory and front office sections Full back-up conducted on a daily basis 35

Organisational Study At Muthoot Hospital, Kozhencherry

The files are compressed with WinZip Annual maintenance contract with magna systems Future plans involve web and on-line marketing measures which would eventually lead to a close collaboration with the marketing department The human resource department is also linked in such a way that the employee details regarding the payroll are fed into the computer

DUTIES Hospital system administration and control Installation of new system and softwares Data record maintenance Training Maintenance of computer systems



Organisational Study At Muthoot Hospital, Kozhencherry

The medical records todays are a complication of pertinent facts including patients lift and health history , including past and present illness and treatment written by professionals is dependable for patient care. The MRD is responsible for keeping the medical records of patient. Previous days IP and OP records are brought to MRD from respective wards details in viewed are verified with details of discharged patients are entered in discharge register, coding disease and surgical procedure according to international classification of disease and procedure is done and entered into the computer files are arranged in assembling records files are arranged chronologically.



Organisational Study At Muthoot Hospital, Kozhencherry

This register include the details of patient, IP and OP number, treating physician name, date of admission and date of reference and reason.

2) DISCHARGE REGISTER This register includes IP and OP number of the patients under which department he/she was treated, date of admission, disease code and date of discharge.

3) OP Movement registers This register includes OP number of the patient and patient name.

4) IP movement registers It include details , to which department files are going to, patients name and IP number should be written.

5) CODING REGISTER In this register IP number of the patient and disease code are depicted. Disease code are followed according to ICD-10

6) COMMUNICABLE DISEASE REGISTER This register includes patients details, date and disease of new and old cases. This register is used for entering only the communicable disease.

7) OP DISCARDING REGISTER This register includes patient name, OP number, patients first visit and patients last visit.

8) MORTALITY REGISTER This register include IP number , patients name, date of admission, date of death, cause of death, disease etc. should be recorded


Organisational Study At Muthoot Hospital, Kozhencherry

FUNCTIONS OF MEDICAL RECORD DEPARTMENT They should write the daily census They should receive the discharge files By analyzing the discharge summary they should enter the date of discharge diagnosis and other details in IP files The files arranging should be in the assembling order The files should keep OP and IP register They should conduct daily chart meeting. They should keep the incomplete files to the corresponding doctors OP/IP for completing the files They should write daily discharge list in discharge register They should tick the required IP files on discharge list They should conduct deficiency checking Disease codes are followed according to ICD-10th revision

3.2.5 PUBLIC RELATION DEPARTMENT Hierarchy of the department


Organisational Study At Muthoot Hospital, Kozhencherry

The public relation department is one of the main departments of the hospital. Individuals who specialize in health care public relation are in charge of handling the internal and external communication for health care facility. They interact with physicians, nurses, managers, administers and patients and therefore must have excellent communication skills. Some of their responsibilities include writing for internal, publication as newsletter handling calls from the media, as well as writing and creating various materials that promote the services officials at the facility. Public relation specialists may also be called upon to prepare a maritime plan that highlights various aspects of the organization DUTIES All type of public problems is handled by the public relation office. Even the patients problems are handled by them. The insurance companies that deals with ;

1) ICCI prudential life insurance 2) Life Insurance Corporation of India In the hospital there are four schemes. The schemes are taicored to meet the needs of the executives and their family. 1. Standard health check up 2. Diabetic health check up 3. Master health check up 4. Ladies health check up

Encourage the specialists and other service group on the hospital and provide the PRO and logistic support for such meeting Any other work or duty assigned by medical superintend or administration etc. Help to arrange blood donors in case of emergencies

Major highlights The third party medical insurance claim facility from 15 major companies Approval by ECHS for cashless treatment for ex-service man 40

Organisational Study At Muthoot Hospital, Kozhencherry

Approval hospital by BSNL for cashless treatment for their employees Several packages schemes in Muthoot hospital Privilege card are given to the persons who have RS50000 around in their banks. With their privilege card is renewed by divisional manager of the hospital for outpatient service

The health check up scheme of the hospital offers a non-stop comprehensive screening service

Three types of health check up packages 1) Standard Health Check up package which charges Rs- 1100 2) Diabetic Health Check up scheme for RS- 2500 3) Master Heath Check up scheme charging RS- 3000 4) Ladies health check up scheme charging RS- 1500


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.6 LAB Hierarchy of the department

A laboratory is a facility that provides countersued condition in which scientific research experiment measurements may be performed. GENERAL LABORATORY PROCEDURE Maintain the necessary records on investigation and submit the reports to the MO, PHC etc. Ensure that equipments are kept clean Prepare monthly report regarding work Handle and maintain microscope Sterilize the equipments as required Indent for supplies for the laboratory through the MO, PHC and ensure the safe storage at materials received


Organisational Study At Muthoot Hospital, Kozhencherry

REGISTERS Packaged register ECHS register OP register Outside register Endoscopy and biopsy register Widal register AFB register Microbiology lab register

MICROBIOLOGY LAB Microbiology lab is a lab where perform test to elected the presence or absence of micromere. It should be placed which should be kept under very sterile condition the people who work in the lab should be very careful while performing the test. Inoculation and culture should be performed under sterile condition in the laminar test should wash their hands before and after every experiments

BIOCHEMISTRY LAB Biochemistry lab is a lab where we perform experiments based on enzyme kinetics, 3-D problem structure interaction with enzyme and purification of enzymes. To study these protisiticated bioanalytical techniques, such as NMR or mass and fluorescence spectroscopy are used. While doing tests instruments should be sterile and after doing experiments. It should be cleaned well.

BLOOD BANK Blood bank is bank for blood or blood components gathered at the result of blood donation start and reserved for later use in blood transaction. The infrastructure facilities of blood bank are according to the criteria given by Drug Controller of India. The blood bank consists of five major functional areas: 1) Donor complex 43

Organisational Study At Muthoot Hospital, Kozhencherry

2) Storage room 3) Component preparation room 4) Serology lab 5) TTD lab

Many hospital blood banks perform the testing to determine the blood type of patient and identify compellable blood product for blood transfusion. This could also be done by a contracted laboratory. Blood components are separated by configuring and either separated as blood plasma or different blood components. Functions of blood bank Donor recruitment Blood collection Testing of blood Component preparation and supply Teaching Research

Registers Donor records Record of results and laboratory Patient records Equipment checking registers Reagent expense register Purchase requisition register etc.


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.7 CASUALTY Hierarchy of the department

Casualty provides hospital care outside the normal working hours for risk patient mainly surgical and medical emergencies and trauma. Accident and emergency services offers 24 hours of service. It is also called as accident and emergency department.


Organisational Study At Muthoot Hospital, Kozhencherry

The word casualty means, an accident causing an injury or death. In the hospital casualty is department to manage the patient requiring emergency drugs. In the casualty emergency drugs are kept in a trolley. Other equipments seen in casualty are ventilators, oxygen cylinder, ambiances, catheter, drip set and ECG medicine and enatrchial tube. If a patient is too serious and entered in the casualty, the patient will get admitted; at that time his files will move from casualty to ward.

Registers 1. Trauma register It used to register the trauma patients details. Date, serial number, time, age, sex, op number, duty no, senior consultants, treatment, remark are entered

2. MLC register It is used for accident cases. In the register the details regarding accident cases such as SL NO, OP NO, name and address, age, sex, date and time of incident, date and time of examination, alleged cause, details of injuries, MLC charges, police intimation number are entered, name and signature of the consultant CMO etc

3. Vaccination register Used to register the patients who have taken vaccines. In this register sl no, name, age, sex, vaccination given.

4. Stock register Used to register the stock items. Sl no, surgical, intend quantity, issued quantity, balance are catered

5. Replacement register Used to register the replacement details of medicines, sl no, equipments, intend quantity, issued quantity, balance are entered


Organisational Study At Muthoot Hospital, Kozhencherry

6. ETCU register Used to register the all details of the patient in ETCU sl no, population no, name, address, age, sex, OP, IP no, ETCU or unit, room no, ward, place, trinage, admission no, complaints etc are catered

3.2.8 WARD The term ward means division of hospital or a separate room. In ward primary purpose of the nursing service is to provide comprehensive, safe effective and well organized nursing care. Through the personal of department other personal who function in the nursing service department may include the auxiuary personnel-nurse aids and domestic who handle the nonnursing service. The nursing education section has the responsibility of preparing nursing students to become professional nurses. WARD MANAGEMENT The ward management is the responsibility of the head nurse and her nursing team. The ward management includes 1) Management of patient care 2) Management of personnel 3) Management of supplies and equipment 4) Management of environment

IMPORTANT REGISTERS 1) Admissions and discharge register 2) Day and night report register 3) Meeting book 4) Rounds book 5) Sending and borrowing register 6) PRO visit book 7) Dobby registers 8) TRP book 9) Injection book 47

Organisational Study At Muthoot Hospital, Kozhencherry

10) Duty list book Duties and responsibilities 1) Make sure that care given to the patient 2) Alert at every time 3) Good contact patient with the patient 4) Information passing to the patient and it receive at right time 5) If any problem created in the ward, report it to the higher authorities 6) Discharge summary given to the patient and another copy kept in the file

3.2.9 RIADIOLOGY DEPARTMENT Hierarchy of the department

Radiology is the scientific study of x-rays and other high energy radiation, especially as used in medicine. Radiology direct and array of imaging technologies, such as ultra sound, computed eomography, nucleus medicine, MRI co diagnose and trust disease radiology that


Organisational Study At Muthoot Hospital, Kozhencherry

involves the use of x-ray is known as roentgenology. But the modern days radiological imaging with high frequency sound waves, magnetic field and radiology. Procedure done when a patient arrives on radiology department When a patient arrives on the hospital with any disease; if he is subjected to undergo CT scan; his medical record will record will come to that department. All the investigation forms and files will add to that patient record. The register include all the information about patient and the procedure done after scanning his records will go to other department if any procedures have to be done. Some registers keeping in the radiology department they are: X-ray register ECG register CT register USG register

Importance of x-ray diagnosis X-ray and radiology service are very important diagnostic and therapeutic department they help in: Diagnosis of the disease in pneumonia , lung abscess Treatment ( in therapeutic procedure) Prognosis It is vital the functioning of the department be efficient in orders to have rapid service and quick diagnosis Some of the x-ray equipments are generator, x-ray tube and control unit.


Organisational Study At Muthoot Hospital, Kozhencherry










superintendent, administrative assistants and PRO heads of the administrative department. It is one of the important departments in the hospital as well as all other department come under this. The services are: Administration of other departments Maintain attendance register Interviewing prospective employees Recruitment and selection Sending acknowledgements Maintenance of leave books Approval and payment of salary and other benefits to employee

Procedure Hospital organization a) Proper planning is required to locate, layout and set up facilities for establishing the hospital as organization b) The total activities to be established at present, near future and for long term are to be thoroughly conceptualized, executed and monitored and improved upon c) The infrastructural facilities, environmental requirements and resources to be made available including trained and skilled man power are to be planned and made available. d) In strategic planning, the objectives of the hospital including purpose, kind of service, etc are to be translated into the operations to achieve the goal

Hospital administration a) Hospital administration shall be carried out through various functions like administrative, clinical and financial b) In order that the administration is more effective, there shall be proper and effective information system, to be aware and take effective and timely actions required. The communication facility shall be properly established


Organisational Study At Muthoot Hospital, Kozhencherry

c) From the administration to down the line, proper delegation of tasks shall be carried out and activities monitored so that the delegated activities are executed responsible and authority d) Regular review meetings are to be conducted and progress of activities entrusted with different agencies are monitored effectively e) Personal required for different department shall be made available through recruitment and training. Their performance shall be monitored and effectively controlled. f) Taking into consideration, the importance of all the paramedical staff, their recruitment, posting, extent of controls on activities etc shall be managed g) The procurement of medicines, other materials shall be planned and executed as per standards procedures h) To meet and foster good relations with government authorities and the general public i) All the front office staff, especially those who directly face the patients shall be more effective, which shall be ensured j) Patient feedback and general quality implementation process shall be properly adhered to and remedial or preventive actions are to be taken


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.11 PHARMACY Hierarchy of the department

The hospital has 24 hours working pharmacy. Disbursal of the medicine to the IP and OP patients and different departments and nursing stations are monitored through the module. The department has three counters with 27 employees The duties: Producing purchasing order Placing orders of medicine and other surgical items Ensuring minimum level of stock Distribution of medicine to patients at market price


Organisational Study At Muthoot Hospital, Kozhencherry

Discount schemes Sales price correction

Procedure The pharmacy staff shall be qualified and trained personnel having necessary skill, knowledge and experience in the pharmacy function The pharmacy staff shall have the information about latest medicine, its approved alternatives, relevant rules and regulations, maintenance of required registers or files etc Pharmacy and store shall have sufficient racks or shelf suitably identified for storage of medicine and other related items Doctors samples shall not kept in the pharmacy Records including those to satisfy statutory rules and regulations shall be maintained Stock position shall be updated after each receipt and issue in relevant registers or computer files


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.12 PURCHASE DEPARTMENT Hierarchy of the department

The purchasing department has the responsibility to all suppliers and equipment for the hospital. After getting the purchase order from the pharmacy the purchase in charge make the arrangement for purchasing the medicine required. On receipt of purchase order the purchase in charge will make necessary steps for purchasing medicine that has been mentioned in the purchase order. Plans are made by the purchase department about what to purchase, how to purchase, when to purchase and so on. Purchase in charge invites quotation for the supply of medicine from different department. Purchase order of heavy equipments is issued from administrative departmentPROCEDURE

Purchasing process-equipment In case of equipment or machinery purchase, the concerned lab in charge shall forward requisition to the HOD purchase along with the detailed specification of the equipment. The HOD purchase shall forward the same with his recommendation to the medical superindent for getting approval for purchase 54

Organisational Study At Muthoot Hospital, Kozhencherry

Medical superintend shall either select the supplier as per the conditions or shall instruct the administrator or concerned department in charge to arrange for the technical or commercial discussion with the selected supplier The administrator or department in charge shall arrange for the technical or commercial discussion on a date convenient to all members. The members who attend the discussion shall be: 1) Medical superintendent 2) Administrator 3) Doctor 4) Concerned dept-in charge 5) Nursing superintendent 6) Supplier representatives The final decision on the selection of supplier shall be taken after negotiating or considering on aspects like warranty, guarantee, discount offered, detailed product specifications, delivery date, payment terms, installation, availability of service, salient features of the equipment etc.


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.13 DIETARY Hierarchy of the department

Description 1) Quality assurance of food preparation The head cook or dietician or other hospital staff shall taste the food prepared for the patients and ensure the quality of the food being served to the patients The supply of food to the patients shall not commence without approval of the manager. 2) Feedback about food service The food service feedback sheet shall be provided to each patient before their discharge from the hospital for their feedback about the food services The same shall be collected by the dietician or food service supervisors and be analyzed for improvements. 3) Solving the issues Dieticians shall meet patients in random everyday to get a direct feedback about the food served. All problems arising will be raised and discussed at the regular dietary meetings held on 2nd Saturday of every month


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.14 ACCOUNTS DEPARTMENT There is one finance manager, one accountant, 5 assistant accounts and one cashier Revenue is from the inpatient bills, lab investigations ,scanning and pharmacy Payment is made through monthly settlements, general purchase items, medicines and petty expenses Salary is given through union bank of India The finance activities include preparation of final bill ,journal entries, maintaining ledger and cash books This department deals with foreign currency transactions as well as issuance of travelers cheques. These transactions are dealt with on behave of their sister concern banks The finance department can make purchases up to an amount of RS 5000, if it goes above 5000 it requires the purchase committees approval; the purchase committee informs the manufacturing companies and a quotation is invited A cash-credit account is being maintained and a check of up to rupees one lakh can be issued by the department The finance department is linked with the pharmacy, the front office, the lab, the human resource, the systems and the marketing department Weekly audit is being conducted by a representative of the Muthoot group

The accounts department consists of seven employees who are in charge of the accounts department. Main duties of accounts department Salary and wage administration Retirement Gratuity and other personal departments Verifying stock statements Attending legal and departmental proceedings Verifying of purchase bill Expense bill Renewal of various licenses 57

Organisational Study At Muthoot Hospital, Kozhencherry

3.2.15 PHYSIOTHERAPY Hierarchy of the department

Rehabilitation after injury, operation and illness from an integral part of health service. The aim is to prevent loss of muscle tone and to restore full function to the limbs and body. Duties Rehabilitation of patients Providing exercise for patients Re-education in movement of body after injury, operation and illness

Procedure In-patients 1) Consultants refer patients for various rehabilitation services 2) Consultants brief physiotherapist provides treatment accordingly. It includes instructions for practices at home. Patients are also overseen by the consultant physiatrist who makes occasional changes in the treatment plan 58

Organisational Study At Muthoot Hospital, Kozhencherry

3) Physiotherapists accompany the consultants medical officers during their rounds and check the improvements of the patients on a daily basis and the progress is watched

Out-patients Consultants refers the patients to the physical medicine department and patients sent from the OP counter Physiatrist examines the patient and prescribes based on the prescription from the physiatrist, the treatment is provided and instruction or advices are also given as required The patient are advised to pay the required charges at the payment counters and secretary will cross check the bill with the amount given by the therapist The patient, who are coming directly for the physical medicine consultation takes the OP ticket and consultation and necessary treatment or exercise advice of the physiatrist.


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.16 GENERAL MAINTEANANCE DEPARTMENT Hierarchy of the department

DESCRIPTION The maintenance supervisor shall respect the areas for any defects. This shall be entered in the maintenance register ( carpenter, welding , upholstery and painting) Procedure 1) Equipment management All the bio-medical equipment of the hospital shall be controlled using a unique identification number issued by BMF department. This number shall be visibly labeled on all the biomedical equipment for easy identification. 2) Preventive maintenance planning and execution The BMF department shall plan the preventive maintenance activities through annual preventive maintenance activities through an annual preventive maintenance plan


Organisational Study At Muthoot Hospital, Kozhencherry

based on the annual preventive maintenance plan the internal preventive maintenance activites and AMC visits of the service providers shall be planned and executed on a monthly basis the details of the preventive maintenance or service done for each equipment shall be recorded in the equipment history register 3) Breakdown maintenance The user departments shall intimate the BME on the breakdowns or complaints using the breakdown requisition note on the receipt on the breakdown requisition note the BME shall analyze the nature of the breakdown or complaint. In case an outside service agency is to be engaged for the repair or servicing activity, the bio-medical engineering staff shall raise a work order detailing the nature and cost of work. On management approval a copy of the work order shall be forwarded to the finance and accounts department the details of the repairs or service done shall be recorded in the equipment history registers

3.2.17 STORES Hierarchy of the department


Organisational Study At Muthoot Hospital, Kozhencherry

The main function of store department is to purchase, store and issue the hospital need. The objective of this department is to plan for, acquire, store, move and control materials to optimize the usage of facilities to provide customer service in accordance with organizational goals. The department is fully computerized. The hospital equipment, surgical equipment and general items are issued by the stores department. The department works under FIFO method. Apart from the main store department, there are sub stores working under other departments. The two main function of store department are Purchase function Stores function Duties and responsibilities Maintain evaluate general stores items as per hospital needs Maintain stock, suppliers and inventories Receive goods ordered Check the received goods against invoiced price, quantity and quality Store the goods Issue item to various departments in response to their requisition Keep reports about all issues Given information about its activities to finance department Training & education Maintain store documents and confidential files

Procedure 1) A preliminary quality checking like item, number of packages or items, condition of packaging, external appearance etc shall be carried out by the stores in charge before acceptance 2) The details of the receipt like suppliers name, name of the item, quality, date of supply, invoice or bill or delivery chellan number, value, relevant purchase order number etc are entered in the relevant computers


Organisational Study At Muthoot Hospital, Kozhencherry

3) In the case when approved samples are available, inspections shall be carried out comparing the received items with the approved samples. The approved samples shall be identified and stored till the supply is completed 4) Items pending inspection shall be stored in the designated areas. The store-in-charge shall ensure that only accepted items or materials are issued for use 5) On receipt of store indent from the user department, duly signed by the authorized person material or items shall be issued 6) Stock position shall be updated after each receipt and issue of the items or materials 7) The items having limited shelf-life shall be inspected once in six months either by the stores-in-charge or by the user department, the inspection status and date of inspection shall be displayed in the stage bin 8) stores-in-charge shall ensure that the regular or fast moving items have adequate stock always, so that the emergency local purchase can be avoided 9) All stores related records shall be up to date and verification of stores shall be conducted once in a year, suitable corrective actions taken if deviations are detected. Important register Stock purchase register Stock issue register Stock ledger Stock transfer register


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.18 QUALITY ASSURANCE DEPARTMENT Hierarchy of the department

The goal of the Quality Assurance Department at MGM Muthoot Medical Centre is that the patients must receive the best care possible. They have taken a "patient-centered" approach to healthcare while at the same time using the most up-to-date medical evidence and the best in technology. They intend to continue our tradition of providing high quality care in a caring, compassionate environment. In order to maintain high standards, the Quality Assurance Department at MGM Muthoot Medical Centre focuses on patient safety, healthcare quality, and having open lines of communication within the hospital community


Organisational Study At Muthoot Hospital, Kozhencherry

Quality improvement program consist of evaluating Indicators from various departments Performance standards Actions against noscominal infections Time delay studies Incident report analysis Various other audit reports Customer feedback Adverse drug reaction Training conducted Research availability Risk management Implementation of corrective action Quality assurance program in radiology, lab, OT, ICCU

The quality assurance department has quality indicator registers of each department.

3.2.19 MARKETING DEPARTMENT Hierarchy of the department


Organisational Study At Muthoot Hospital, Kozhencherry

The duty of marketing department is to attract maximum customers to hospital, by conducting medical camps; field work etc. in this hospital MD is integrated to PRD formation technology in MIS. The primary step is in categorizing customers: the influencers whose opinions matter (suppliers or distributors, media and politicians) and the customers (the patients and bystanders) ensuring everyones satisfaction is crucial and projecting a positive image is what marketing is all about The functions are: The marketing department has taken the initiative to set up public relations a counter The idea of exit interviews were introduced by the marketing department The latest marketing strategy is the introduction of insurance schemes exclusively targeted at the less fortunate sections of the society Promotes awareness on the latest facilities , equipments as well as the doctors There are also commendable internal marketing measures and that is targeted at the employees. Therefore, cluster groups are formed among the employees to nurture healthy interpersonal relations as well as in promoting awareness about the various benefits, schemes, doctors, equipments and so on. They are also encouraged to freely speak out their problems, issues and satisfaction levels Facilitate doctor to doctor interaction under the banner of the Indian medical association through doctors programmes and seminars Internal public relations activities for better patient relations and supplement awareness through brochures External marketing activities in 4 ways:

Doctors of other hospitals through communication, handing over brochures, intimating medical developments, informing about the new doctors taking charge and referring patients In case, of referred patients, the referred doctor is promptly informed of the condition of the patient and the medical assistance provided. The doctor is frequently updated with the condition of the patient The marketing department attempts to build up a confidence in the referred doctor that the patients return to the original doctor and at the same time attempts to create a good image in the patients regarding the hospital and their treatment


Organisational Study At Muthoot Hospital, Kozhencherry

Other hospitals- promote good relations with their management, administration and the deciding staff The additional facilities offered by the hospital are elaborately expressed and the other hospital is welcomed to utilized its resource Organizations- it involves building up relations with factories, offices, banks and schools by providing health check-up packages. The organizations usually go for pre-employment health check-up, post-employment health check-up and annual health check-up This hospital has a tie-up with SBI for emergency treatment on credit and the payment need be gradually made within 30 days The NGOs- in collaboration with the charity organizations like lions club and rotorary club, this hospital conducts medical camps, seminars and awareness programmes for the general public Other indirect marketing efforts include health articles in newspapers, health, magazines and Vanitha and through Media-talk programs on TV This department keeps in touch with the front office for details of patients, their condition and the room where they are in so that the public relations officers can meet them


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.20 HOUSE-KEEPING DEPARTMENT Hierarchy of the department

Scrupulous cleanliness and aseptic techniques are essential for the maintenance of health, prevention of infection and curing of disease. The hospital is particular in keeping the hospital as well as the surroundings clean as possible. The wastes are managed in an efficient manner LINEN AND LAUNDRY Procedure Method of washing 1) Soiled linen Will undergo the usual process of washing, conditioning 68

Organisational Study At Muthoot Hospital, Kozhencherry

2) Infected linen To be collected in bags handled carefully, it will be processed through sluicing and subjected to soakage in disinfectant solution prior to normal process of washing, conditioning 3) Washing arrangements The washing of hospital linen is being done by machine very dirty and soiled linen obtained from OT ,acute surgical wards , labour room should usually be prewashed by the cleaning staff before being sent to the final washing. Issue of washing material 1) The issue of washing material like soap and soda etc will be done by the general stores 2) Frequency of change of linen 3) The bed linen will be changed daily and also changed when a new patient is admitted after discharge of the old patient

3.2.21 WASTE MANAGEMENT Muthoot hospital is considered as an environment friendly hospital as it manages the waste efficiently. A major portion of the non-degradable waste are collected by an outside agency called IMAGE (registered under government of Kerala). The employees of IMAGE come daily to collect the wastes. The hospital employees are advised to separate the waste in different colored bags provided by the agency.

Procedure 1) General Awareness should be given to everyone in the hospital for the generation, collection, identification and disposal of different types of wastes The wastes are potential source for infection and hence its collection and disposal merit highest priority Necessary identified containers are provided at different locations for their collection, segregation, disinfection, transport, treatment and disposal 2) Waste reduction

Whenever possible the use of disposables may be limited by the extent required 69

Organisational Study At Muthoot Hospital, Kozhencherry

3) Segregation at source General wastes are including kitchen wastes, dry waste (paper, packing, glass ware and metal), infections waste- including pathological and anatomical, chemical waste including effluents from different locations, lab, wards etc shall be collected in identifiable containers at locations Whenever possible one type of waste shall be deposited in a particular container suitably identified The container when not in use shall be kept properly covered to avoid spillage or misuse 4) Transportation The containers, on specified occasions shall be shifted to other locations for incineration or land filling as the case may be The containers after disposal of the contents shall be replaced at the specified locations after disinfection 5) Awareness and training The most important aspect is the education and training to all concerned including medical, paramedical employees on source reduction, segregation, disinfection, transport and disposal


Organisational Study At Muthoot Hospital, Kozhencherry

3.2.22 ECHS Hierarchy of the department

Ex-servicemen contributory health scheme was launched with effect from 1st April 2003 .the aim of the scheme are to provide quality Medicare to its members and their authorized dependents through ECHS polyclinic. From the polyclinic they refer patients to ECHS authorized specialty hospital. After one month of treatment the hospital will give treatment bill to polyclinic and the polyclinic will pay it to the hospital. The advantages of becoming an ECHS member are as under:

a) The scheme will provide quality Medicare to all pensioners, their widows and authorized dependants, and is within easy to reach. b) It covers complete spectrum of ESM settled in far flung areas, through a network of polyclinics in Military and non-military stations c) The scheme is fully financed by the government. d) An ECHS member who possesses an ECHS smart card can avail immediate treatment at any ECHS polyclinic anywhere in India. e) There is no restriction on age or medical condition at the time of seeking membership of the scheme. 71

Organisational Study At Muthoot Hospital, Kozhencherry



Organisational Study At Muthoot Hospital, Kozhencherry

4.1 SWOT ANALYSIS STRENGTH Modern sophisticated equipment and facilities Goodwill of the firm The hospital has experienced doctors providing quality services Availability of expertise nursing staff Availability of job description for all level of nurses Periodically evaluation for nursing staffs Availability of in-service education program and training Availability of hospita