Hospital Management.docx

HOSPITAL MANAGEMENT A case study of Vathsalya Nursing Home, Shivamogga CONTENTS CHAPTER 1 INTRODUCTION  Introduction  Scope of the study  Aims and objective of the study  Methodology  Needs for the Study  Limitation CHAPTER 2 DEVELOPMENT OF MODERN HOSPITAL IN INDIA  Discoveries  Establishment of Private Hospitals  Adopting New Technology  Construction of Modern Hospital CHAPTER3 GENERAL INTRODUCTION TO VATHSALYA NURSING HOME  Doctors  AIMS and Objectives  Thesis on Administration and Management Relationship CHAPTER 4 WORKING OF VARTHSALYA NURSING HOME

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CHAPTER 5 MANAGERIAL STRUCTURE OF VATHSALYA NURSING HOME A. Modern and ultra modern facilities available patience  Auto calve  Ultra sound scanning  Medical laboratory with auto analyzer  Intensive care unit with ventilators  Physiotherapy  Well woman clinic  Uninterrupted power supply system B. C. D. E. F.

Details of intensive care unit Details of accounting procedure of the hospital Details of the operation available theaters Detail of the instrumental and equipment available Detail of the medical laboratory available

CHAPTER 6 DATA ANALYSIS AND INTERPRETATION CHAPTER7 SUGGESTIONS AND CONCLUSION

ANNEXURE  Questionnaire  Bibliography

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CHAPTER 1 INTRODUCTION  Introduction  Scope of the study  Aims and objective of the study  Methodology  Needs for the Study  Limitation

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INTRODUCTION Hospital in India has been modernized to a greater extent after independence. In 1947 prominence was being given to the clinical pathological examination only in those days the patents were mobile. Now, this system has completely changed, today the clinic have become mobile the system as the clinical examinations of pathologic has been shifted by the medical laboratory examination that too with the aid of well equipped medical laboratories. Health is an important factor in the formation of human resources development which will play a vital role in improving the qualities of human beings, who are the active agents of economic development. So any measure of development achievement in a nation must affect the state of personal wealth in the nation. Better wealth would contribute to improving the economic status of the poor and for expanding total output. This demands sound management of a hospital. Therefore in this chapter the researcher has made an attempt to discuss about the meaning of hospital and hospital management, evolution of hospitals, changing concept of hospital, role of hospital administrator, functions of hospital management, hospital services and to present a picture of number of public hospitals and beds in India. Meaning of hospital management : Hospital Management can have different meanings Management as a process: Often it is said that it is a professionally managed hospital; it is well managed hospital, meaning thereby the management is described as an activity, type of work. Management applies certain principles, techniques and activities which are performed by certain management functions.What the hospital Management does is Management. 4

Hospital Management is a subject: A subject, a discipline taught in universities, colleges or institutes. It is an accumulated body of knowledge that can be learned, at some places the broad specialty is Health Management including Hospital Management.Various degrees, diplomas, certificate courses are run by the institution/universities. Hospital management as people: The Management of this hospital is very insensitive, the hospital management of this hospital is not responsive to society are the terms often used. While using these terms, we are referring to body of people responsible for management, the board of directors, director, medical superintendent and his team. Hospital management as career: News published in the national daily says that hospital management will be among top ten careers in the next decade. Such statements imply that hospital management is a career. Scope of the study As the study aims at single hospital the scope of the study is verified to “Vathsalya nursing Home”, Shimogga only the management research survey has been conducted to study the management structure as the hospital what are departments wards staff non staff are involved in finding the draw backs of the nursing home. Separate chapter continuing of remedies on over coming these drawbacks. This draw back suggestive tip for effective management has also been included in the report. Aims and objective of the study The study aims at the fllowing objectives  Studying the history of nursing home. 5

 Analysing the administrable structure of the nursing home.  Analysing the managerial structure of the nursing home.  Analysing the problem of the patients, the medical staff and the non medical staff of the Nursing home.  Suggesting the remedies with respect to the surveyed problem and the some tips for the effective management. Methodology This is an analytical study of Vathsalya Nursing Home Shimoga. The following method has been adopted to collect the necessary Information required for the preparation of the report. 1) Primary Data:- In the section of primary data the data has been collected from the personal interviews done with the patients, the medical staff and non medical staff. The similar data collection structured questionnaire has also been used for the collection of the data. 2) Secondary data: The secondary data section containing of information of gathered from third parties. The person who don’t passes any kind of relation with nursing home at present, which include. Example patients of the nursing home etc. Needs for the Study Hospitals are highly complex organizations by venture of the many functions they seek to fulfill. The multiplicity as activity and tasks variety of staff with a plethora as skill mix avid repertoire of technologies in we convenes of human suffering and continuous pressure to no matters pertaining to life and death.. 6

1) The main objective of this topic giving an idea of the product. 2) Consumer perception about the product. 3) To rich the product ultimate consumer. 4) The product can rich all geographical area 5) Main target of product.

Limitation  Here we can’t contact all types of respondents.  Respondents will not give correct opinion about survey.  The availability of data is limited.  Accuracy of this project report is limited because of factors, like limitation of time constructions.

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Chapter 2 DEVELOPMENT OF MODERN HOSPITAL IN INDIA  Discoveries  Establishment of Private Hospitals  Adopting New Technology  Construction of Modern Hospital

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DEVELOPMENT OF MODERN HOSPITAL IN INDIA

History in India has been modernized to a greater extent otter independence. In 1947 prominence was being given to the clinical pathological examination only in those days the patent were Mobile now this system has completely changed today the clinic have become mobile the system of the clinical examination of pathologic has been shifted by the medical laboratory examination that too with the aid of well equipped medical laboratories. During that time only one physician or doctor was presented in one clinic and he was suppose to look after all the patents irrespective at their diseases. The hospital. Which was available that time. Was not offering better consultations to the patients who were coming for getting the remedies now the system has completely change. Discoveries The discovery as vaccination was a key medical achievement of the 18th century Lady Mary wotley Montagu ( 1689 -1762) brought to England the asian technique of variolation which she observed in Turkey. Dr. Clarified W. Long (1815-1878) as Georgia was the first surgeon to perform Minor operations using sulphuric either as on a anesthetic agent in 1842 . The discovery as anestnetic agents sulh as ether. Nitrus oxide and chloroform and development of steam sterilization techniqul in 1886. The discovery of XRays by with elm Konrad Rontgen (1845- 1923 ) lead to further development in the Medical techniques.

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Establishment of Private Hospitals Albuquerque built Royal hospital in Goa awhile the English established a military hospital in Madras Later it was declared to be a civilian hospital after J.J Hospital founded in 1843 began functioning in 1845. The hospital numed after Sir . Jamshetty

jejeebhoy. The Formation of KEM hospital in

1926.Famous physicians such as Jivraj. N. Mehta and R.N Vakil. Surgeons such as R.N Cooper P.K sen and pathologists such as V.R Khanolkar were associated with majestic KEM hospital. The tata group of industries built the tata memorial hospital in 1941 and cancer research institute in 1958 with an intention of providing cancer treatment to patients in India. The facilities which patient can avail on those days were only. None angled to keep single channeled electro cardio graphs etc. Which were not able to detect the disborders properly the facilities of sterilization was able to limited notable instruments equipment. Which resulted in unnecessary infections to the patients. The functions of surgical operation were very poor and were taking a ling time because of the non –availability as the ultra modern operations theaters. Today the managements as the hospital have been completely decent ralizal up to the extent as one patient one specialist the old hospital has been shifted by hi- tech hospital the patients these days are getting not only modern facilities but also the ultra Modern facilities. Which include by ex ..X- rays. Portable X- ray computer added to topography scanning. Now a day the detection as a minute disease has also become possible we can have the instance of the CAT scanning for this. This is a test performed to detect the compressions/ expansion of the human brain. Today hospital 10

bedighted with another hi 0tech treatment called magnetic resonance imaging invasive or painful surgical operation as the olden days have been shifted by non invasive optic surgical operation which aim at surgery without wound and blood number as hospital are considerably increased as compared to those olden days. 1. Adopting New Technology The hospital at present providing so many ultra modern facilities to its patience to eradicate their disease and to rectify their disorder within a short period of time. The hospitals keeps continuously upgrading their facilities b/s having purchased the most recent sophisticated instruments & equipments for the place as old existing machines. Some of the modern and ultra modern facilities which are as below in the form a list;  Ultra sound scanning  Intensive care unit with ventilators  Physiotherapy  Medical laboratory with auto analysis.  The Epabx facsimile system  Advance cardiac care  Portable day x-ray 2. Construction of modern hospitals In India construct modern hospital with all facilities is very helps to the patients the hospital keeps continuously upgrading the modern facilities by 11

having purchased the modern technical instruments and machines with good attracting modern building hospital the following are some. The available the modern standard of operations theater with good medical instruments. Available the lifting facility to available the attaching hospital canteen.

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CHAPTER-3 GENERAL INTRODUCTION TO VATHSALYA NURSING HOME  Doctors  AIMS and Objectives  Thesis on Administration and Management Relationship

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General introduction to Vathsalya Nursing Home Vathsalya hospital is the surgical centre Pvt. Ltd, was established in 1998 in the heart of city at civil lines in Shimoga. It is a multispecialty hospital providing all the services to the patients in all departments. This fuelling its name VATHSALYA i.e “ affection of the mother to child “. It is established in land area 24,000 sq. feet it being surrounded by the greenery all over provides the patient an open atmosphere to breath. Doctors;_ Dr. Basaveshvara .M Dr. Preetheei Dr. Mahesh newthi B.R Dr. Pradeep .S Dr. Ravi The hospitals aim to surviving the necessary treatment with ultra modern facilities along with a greater hospitality to the patients for general objective for the treatment with maximum care for no charges. Aims and Objectives 1) Maximum health cared for minimum fees and charges 2) Facilitating the treatment with modern and ultra modern equipment. 3) Treatment with a greater hospitality

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4) The nursing home maintains a drug store to also save the precious time of the patients. 5) The nursing home in rich in specialist of all branches as medicines. Surgery because it aim at “trouble ness and total treatment”. 6) The nursing home aims at treating the patients with respect to time. The total capital introduced at the time of opening will be 20 lakhs. This includes the cost of all the modern and ultra modern equipped in the hospital this amount excludes the building charges of the current hospital building when shown to the proprietor. This amount also includes all the legal expenses such as registration charges telephone connection charges advance period to the medical and now medical staff etc. At its birth the hospital was consisting of specialists of all branches of medicine and surgery on those days the department of orthopoedist and gynecology and obstetrics were very rich. Today all the other departments are maintaining to that standard. Management deals with establishing the scope for administration, While administration function with in the scope established by the management. Administration in concerned with only the top level management. While the management relates more with middle and lower level management on an organization. Administration in a part as management in an organization where as the management on concerned with controlling of the entire organization including the administration division.

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To conclude with administration is concerned with the installation of producers while the management is concerned with making co- operative endeavors and setting the works done on order to reach a particular objective Thesis on Administration and Management relationship Administration basically in concerned with the determination of corporate objectives policies and many strategies of a firm of determines manly the co ordination of different major function with in the organization. While the managements as the other face of the same coin in which the administration with one face in concerned with the exclusion of plan and policies has laid down by the administration. The following few are the point. Which prove that the administration differs from the management up to a greater extent. Administration in concerned with formulation of the policies whereas the management relates with executing them. Administration sets the 4th general purpose of an enterprise establishes its major policies and inaugurates the board whole the management deals particularly with the board whole the management deals particularly with the entire direction of the human effort. The hospital is planning to absorb another 10 to 20 non- medical staff member to make the services richer and more effective.

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CHAPTER-4 WORKING OF VARTHSALYA NURSING HOME

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WORKING OF VARTHSALYA NURSING HOME Number of different department available The hospital maintains 10 different surgery. Which include the most recent ones such as gastro enter logy and plastic surgery., it also maintains sophisticated equipment to cater to t he needs of the daily coming patients. The list below represents the different available departments on Vathsalya nursing home. Department of orthopedics and trauma This department cater to the needs as treatment as all injuries and wounds and disorders on bones. This includes the different traction operation given to the patient as the extension. This departments maintains the departments of physiotherapy to cater to the need as removed of muscular pain. But in t6his hospital minor operation given to the patient as the extension. Department of general surgery and gastro enter logy This department renders its at most services to the different needs on the general surgery and aim at treating at the different disorder of stomach detection as different minute disorder in also a function at this departments. Department of gynecology obstetrics Main aim of this hospital is midwifery needs. This department serves to all the needs and disorders of the female patients in having a specialized branch of detecting the different organic disorder. Which are found in female. This department also looks after the midwifery needs. 18

Department of ophthalmology This department serves as its best to the diseases. Which patent to the eye this department possesses different ultra modern equipment to render the non invasive surgical operations. Department of Dermatology This department in rendering of the best service to the treatment of disorders as the human skin. The nursing home maintain a separate branch to look after the cause of burn and scalds as a sister departments to this department. Department of plastic surgery This department render the best service to the cosmetological needs at the human skin. This departments too is having computerized testing equipment which are used to reframe the different shapes of the skin. Department of Ear Nose and Throat This department treats all the disorder of the ear, nose and throat. Department of pediatrics This department serves the diseases and disorder of the children patients Department of Neurology This department is well equipped to treat the diseases and disorder of the nerves. Department of general medicine and cardiology

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This departments renders the best service to the needs of general medicine and cardiac needs. This department is well equipped with sophisticated ultra modern instruments to serve the patients who come under the light of the departments. Detail of the available wards The nursing home at present is maintaining different kind of ward viz. 1. Male general ward 2. Female general ward 3. Children ward Special ward 4. Emergency ward 1. Male general ward Male general ward is well equipped with all the modern facilities and equipment foam beds are made available to the patient 24 hour water facility can also be availed by the patient, not water is available on demand of the patients. Each and every bed is given a hand table with chambered. Drawer to keep the belonging of patients. Bathrooms along with latrine are maintained an hygienic condition for the usage, for the patients visitors are allowed to meet the patient and only one of the relatives. Friends are allowed to stay with the patients during the night time. The patients in male general ward can avail the facility of intercom to communication with their relatives/ friends from the wards its thought EPABX facsimile system. Specialist and duty doctor give frequent visit to this ward from dawn to dask during night time the doctor who are present at the time after the patient . The 20

specialists maintain a case sheet to record the improvements of the patients. The records like besides chart. Medical chart temperature diabetes record chart of each patient are also general wards for male contain 10 beds with 10 separate ceiling fames. Which are of recent models and in excellent functioning condition. The male out patients are required to register their name for the admission by paying the registration charge at Rs 50. Further they have to pay Rs. 150 for every 24 hour there from 2.Female General Ward All the facilities, which are available in the male general ward are made available here too in addition to this. The nursing home provides curdle beds for the female patients patients who have given birth to their offspring’s very recently. Female general ward

8 beds and the management of the nursing home is

planning to increase this no 10 -15 with in a very short period. The procedures for admission into this ward are as same as that of the male general ward. 3.Children ward This ward consist of 6 beds al the facilities which are male general ward are made available in this ward too. The admission is restricted to the children within the age group to 10- 12 year being the procedure for admission are as same as that at male general ward.

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4. Semi Special ward 6 semi special wards are there in this hospital. In each semi- special ward for female as well as male patients contain 1 bed with 1 separate ceiling fans which are recent models and in excellent functioning condition and 24 hours water facility can be availed by the patient, hot water is available on demand of the patients. In this ward providing one bed to the patient with attached bathroom facilities. But in general providing 5 beds to the patients but not with attaché bathrooms. All the facilities which are available in the general ward are made available here too in addition to this. The procedures for admission into this ward are as same as that as the general ward. 5.Special ward Apart from the above 3 different types of ward the nursing home. Who maintain special wards. This ward offers some special facilities other than the facilities available in the general wards. One separate room is considered as one special ward and this consisting of 2 cushion beds one for the patient and the other for the patient attended a separate cupboard is available with 5 shelves and a locker to it in each special wards, 3 tub light and a ceiling fan keep continuously working in this ward hot water as well as cold water is available in any time of the day. These special wardrooms are having an attached bathroom and latrine. Which are having an attached in a good hygiene condition. The EPABX system of communication provides the patients in this wards to communication to 1 from the outer world. Being in

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their room it self the facility of special wards can be availed by the out patient subject to availability and the admission on open to both the gender. Specialist keep visiting this ward for every 1 hour from dawn to dask available duty doctor will look after patient on there wards during night times all the charts including a case sheet of a patients are maintained by the doctors. Specialist to record the developments of the patients. For getting admission into this ward the out patients are required to pay the registration fees up to 50 after being prescribed by the concerned doctor for admission further they are required to pay Rs 360 for every 24 hours there from. 6.Emergency ward Three emergency ward are there in this hospital. Emergency ward is hospital to emergency patients and this ward contain 2 beds with ceiling fans and attached bathroom. But in this hospital for getting admission into this ward the out patients are not required do pay the registration fees.

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CHAPTER-5 MANAGERIAL STRUCTURE OF VATHSALYA NURSING HOME

G. Modern and ultra modern facilities available patience  Auto calve  Ultra sound scanning  Medical laboratory with auto analyzer  Intensive care unit with ventilators  Physiotherapy  Well woman clinic  Uninterrupted power supply system

H. Details of intensive care unit I. Details of accounting procedure of the hospital J. Details of the operation available theaters K. Detail of the instrumental and equipment available L. Detail of the medical laboratory available

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MANAGERIAL STRUCTURE OF VATHSALYA NURSING HOME A. Modern and ultra modern facilities available patience The hospital at present providing so many modern ultra modern facilities to its patience to eradicate their diseases and to rectify their disorders with in a short period at time the hospital keep continuously upgrading these facilities by having purchased the most recent sophisticates instrument and equipments for the place of old existing machines. Some of the modern and ultra modern facilities which are being availed by the patients from the hospital with their description are resented below in the form of a list. 1.Auto clave This is a one ultra modern and recent achievements in the fields of medical electronic this is nothing but a sterilized which keeps all the surgical instrument from hand glosses to surgical knives in a hygienic and non infections condition. 2.Ultra Sound scanning This is a process in which the instrument aided by the computers will detect the very minute disorders in any part of the human body and this is the most recent ais from the computer to the field of the medical surgeries. 3.Medical laboratory with Auto Analyzer This is an modern ultra equipment used in the recent medical laboratories which is also an advanced in the field of general medicine. 25

4.Intensive care unit with ventilators This facility is one of the advancement in the field of medicine. The intensive care unit (ICU) with this facility protects the patients kept in with a greater care. Patients from other nursing home also come here for setting availed this facility. 5.Physiotherapy This is advancement in the field orthopedics and master in removing all most all kind of muscular and bionic pains. An electrically instrument spreads its ultra sound rays to the further advancement in this branch is was both ultra sound massage and fraction for pain relief. 6.Well woman clinic This is advancement in the field of gynecology obstetrics. Which tests for any abnormal developments or growth in the female who are aged 30 years and above. The abnormal development includes womb cancer embryonic discorders etc. 7.Uniterrupted power supply system This modern facility keeps supplying power to the entire hospital premises without the noise and causing destructions to the patients whenever the default supply of power falls. B.DETAILS OF INTENSIVE CARE UNIT This hospital maintain 1 separate intensive care unit to keep the patients whose condition is too critical these wards are totally air conditioned these wards contain 15 oxygen cylind to facilitate the necessary treatment these unit 26

Wards are packed up with uninterrupted supply of power so as to avoid unnecessary delays in treatments. In this hospital maintain refrigerator is maintained to keep the necessary drugs and medicine. Which become poison when exposed to the room temperature. Admission of the patients and attainders to these wards is strictly not allowed so as to keep the patients away from unnecessary distributions. These units are provided with ultra modern equipment called ventilation. These wards are maintained in a hygienic condition and sweeper cleaners are ordered to clean these wards at regular frequencies and to take greater care while cleaning these wards. Admissions to these wards are made to patients of the hospital on the standing instruction of the specialists. The charges for this ward are Rs 2000 for every 24 hour and refund able caution deposit of Rs. 500 is also recovered from the patients. .C.DETAILS OF ACCOUNTING PROCEDURE OF THE HOSPITAL The hospital maintains all types of books and accounts which included the duty: book different ledger accounts for handling different type of account. For preparation of fixed account at the end of a final year the hospital makes one of the computerized accounting system by name “ tally”. The hospital close its day accounts 12 hours later to the actual time to as to record the transaction which take place at night times the annual closing of accounts and preparation of final accounts are done at 31st day \of March every.

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D .Details of the operation available theaters At the birth of the hospital it was having 1 minor O.T and 2 major O.T and 2 labour theaters. Today it has extended its hands of service to the patients by adding one more major OT attached to the intensive care unit. These OT’s are maintained in a hygiene condition and all the moderns and ultra modern surgical equipments are made available here which include powerful operation light multi angled flexible surgical bed with an elevator. Pure stainless steel instrument. Which are not disposed to nature. An equipment of refrigeration. Which is used for the storage recently. An ultra modern sterilizer called auto clave has bought into keep the instruments and equipments from had glouses to surgical knives in a sterilized condition. The charges to this ors are fixed after observing the necessaries and conditioned requirements of the operation generally these charges start from Rs. 1000. A consent sheet has to filled by the patient himself or by his attender stating that neither the operating surgeon not the hospital is responsible for any worse thing which may occur during operating. E .Details of the instrumental and equipment available The hospital possess all the instrument and equipments The following are the some of the important short listed ones.          

Ventilator use in intensive care units (ICU) Boyell apparatus used in operation theater Auto scanners used in general medicine and surgery Portable dye x- ray used in general medicine and surgery Channeled stress EGG used in the dept of cardiology Auto analyzer used in the medical laboratory Massagers used in the dept of physiotherapy Ultra sound scanner used in the 10 dept of general pathology Saws used in the dept of orthopedic and trauma Obituaries 28

     

Driller used in department of orthopedic and trauma Hubilizer used in the department of gynecology and obstetric. Cardiac monitors used in operation theaters Section apart us used in operation theatres Doppler’s used in the department of gynecology and obstetric Incubators used in the department of gynecology and obstetric.

F. Detail of the medical laboratory available The medical laboratory which is well equipped by specialized equipments is maintained by the hospital. This laboratory caters to the needs of all pathologically examination of the patients some important investigation which are performed in this laboratory are short listed below.                 

Testing blood glucose and sugar Random blood glucose and sugar. Serum cholesterol Serum total protein Hemoglobin count Albumin globulin ratio Serum alkaline phosphate Serum total and direct bilirubin R.H Typing and cont Malarial parasites Absolute eosionse phil count Bleeding and clotting time Physical and chemical analysis Liver function test Differential leukocyte count Viral test UDRL test.

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SURVEY OF DRAWBACKS PERTAINING TO THE HOSPITAL AND THE PATIENTS The survey of drawbacks resulted in finding out the several problems. On the patient as well as the stiff members. The familiar too questionnaire tried its best together the information from the concern. Within its limits out of there surveyed problem. Some can be rectified immediately and some can be corrected in the lines run of the nursing home. For the rule of accuracy the problem have been divided and analyzed. Under the two main heads vi 1) Problem of patient 2) Problem of hospital 1) Problem of patient: Here our or we responds each and every responds has responded in his own way, since it is not possible to high light each and every response they have been some one and analyzed on the basis of majority. a) Absence of treatment in recent branches medicines and surgery:- Out patients as wells as in patients argued about the absence on the treatments in the recent branches on medicine on surgery like urology endocrinology etc b) Absence of semi special watch: In patients or in there response had nut their view that the semi special wards should be introduced as early as possible by the management of the hospital.

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c) Absence of the nurse who know the regional language: The patients have stated that the words who are aware of the regional language should he recruited to the Nursing home. d) Absence of talented doctor: Out patients as well as in patient’s state that doctor will experience in depth knowledge should be recruited to be nursing home. Reduction of charges A small no. of patients responded about the reduction existing fauves and charges.  Absence of hospital relation officer There in a need of nursing home religion officer a he can work on the main link between the management and patients.  Improper top–level management The top–level management in root attending towards the needs of duty doctors other staff numbers which in turn covers them not to work with zeal.  Absence of cordial relationship between the management and patients Since the top level management un not cordial towards the patients their in setting had the patients to address their grievances about the nursing home.  Absence of silence during night times They are in a need of silence during the night hours in the nursing home.  Absence of a proper functioning schedule

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The nursing home does not maintain a proper functioning schedule for the staff which again in a problem for the patients. 

Problem of the nursing home In this section out of 100 respondents people have stated their own view, the summed on and shortlist drawbacks which are bender on the majority are analyzed under the following heads.

 Absence of the hospital manager 

The survey of problems amongst the staff members revealed that they are in a need of the member by the designation manager.



Absence of basic necessities The staff members have argued about provision for the basic necessities such as uniform provident fund concession on treating the staff member etc, which the hospital cannot provide

 Absence of encouragement to the hardworking staff The survey also revealed another important aspects that the management is not encouraging the hard working staff.  Non scheduled pasting of the staff The hospital doesn’t maintain a proper schedule for the pasting of the staff which in resulting in the improper postings.  Absence of an attached canteen The hospital is not maintaining a canteen attached to the hospital premises which again in money drawbacks for the patients as well as the staff members apart from there drawbacks the following are the other problem from which the staff member are suffering.  Staff members are not being respected

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The management of the hospital does not respect the staff in all the times which is again a drawback for the staff members.  Absence of Mutual understanding between staff members There is an absence of mutual understanding between the staff members which again does not allow the worker to work with zeal.  Staff members are not allows to participated in the management The staff members of the nursing home are not allowed to participated in the decision making activities of the management.  Complete job satisfaction of the workers The hospital is not creating the environment from which worker can get his complete job satisfaction.  The higher rate as labor turn over The rate of turn over is higher in the hospital there is also a drawback because the existing workers may takes a long time to get the mutual understanding between the new comers which result in the declinometer as zeal amongst the workers.

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Chapter 6 DATA ANALYSIS AND INTERPRETATION

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Table- 1 Respondents based on their family monthly income Income from Rupees

No. of respondents

Percentage

Below Rs. 10000

20

50

11000 – 20000

12

24

21000 -30000

6

12

Above 31000

12

24

Total

50

100

20

12

12

6

Below Rs. 10000

11000 – 20000

21000 -30000

Above 31000

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Table -2 Respondent based on you came to know about this hospital Came to know about this

No. of Respondent

Percentage

Friends

12

24

Relatives

16

32

Advertise

10

20

Others

12

24

Total

50

100

Hospital

16

12

12 10

Friends

Relatives

Advertise

Others

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Table 3 Respondents based on their service provided by hospital their service provided by hospital

Service

No. of Respondent

Percentage

Excellent

7

14

Good

24

48

Fair

13

26

Average`

6

12

Total

50

100

Excellent

Good

12%

Fair

Average`

14%

26%

48%

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Table-4: Respondents based on their identification with this nursing home Identification

No. of Respondent

Percentage

Out patient

25

50

In patient

12

24

Consulting patient

13

26

Total

50

100 %

25

12

Out patient

In patient

13

Consulting patient

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Table -5 Respondents based on looking treatment Ward

No. of Respondent

Percentage

Male General ward

6

12

Female general ward

24

48

Children ward

12

24

Special ward

5

10

Intensive care unit

3

6

Total

50

100

24

12 6

5 3

Male General ward

Female general ward

Children ward

Special ward

Intensive care unit

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Table -6 Respondents base on their service given by the doctor Service the doctor

No. of Respondent

Percentage

Excellent

7

14

Good

24

48

Fair

12

24

Average

7

14

Total

50

100

24

12 7

Excellent

7

Good

Fair

Average

40

Table -7 Respondents base on their service given by this medical facilities Medical facilities

No. of Respondent

Percentage

Excellent

5

10

Good

11

22

Fair

12

12

Average

22

44

Total

50

100

22

11

12

5

Excellent

Good

Fair

Average

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Table -8 Respondent basis on rates and charges levied by nursing home for the service

Rates and charges

No. of Respondent

Percentage

Lower

13

26

Higher

25

50

Reasonable

12

24

Total

50

100 %

24%

26%

50%

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Table-9 Respondents basis on their service at the staff Service of the staff

No. of Respondent

Percentage

Excellent

8

16

Good

16

32

Fair

20

40

Average

6

12

Total

50

100

20 16

8 6

Excellent

Good

Fair

Average

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Table 10 Respondents based on their many years you are service in Vathsalya nursing home Years in Service

No. of Respondent

Percentage

1 year

25

50

2 year

12

24

5 years

7

14

6 years

6

12

Total

50

100

25

12 7

1 year

2 year

5 years

6

6 years

44

Table 11 Respondent basis on their relation ship with the hospital Relationship

No. of Respondent

Percentage

Regularly

13

26

Rare

30

60

Occasionally

7

14

Total

100%

Total

30

13 7

Regularly

Rare

Occasionally

45

Table -12 Respondent basis on their you feel about the Vathsalya nursing home Feel about

No. of Respondent

Percentage

Very good

22

44

Available

24

48

Poor

4

8

Total

50

100 %

24 22

4

Very good

Available

Poor

46

Table -13 Respondent basis on their would you prefer the hospital Prefer the hospital

No. of Respondent

Percentage

Vathsalya

24

48

Nirmala

12

24

Meghana

6

12

Other

8

16

Total

50

100

Vathsalya

Nirmala

Meghana

Other

16% 48%

12%

24%

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CHAPTER-7 SUGGESTIONS AND CONCLUSION

48

SUGGESTIONS AND CONCLUSION

The remedies listed below are necked on the majority of drawbacks surveyed through each staff member and each patients have put their own set of problem however each and every questionnaire used for the survey has been Arleen into consideration on to a minimum event while giving the remedies. The following are some of the vital remedies which have been against the drawbacks surveyed. 1) Introduction of recent branches of medicine and survey: The nursing home in required introducing the recent branches on medicine and surgery along with the deferent therapies pertaining to them. 2) Recruitment of public relation officers There in a need as recruitment of a public relation officer thin don of the management

will ensure the patient satisfaction which inform

enables the hospital to gain the name and fame in the society. 3) In take of the staff who proposes in depth mute realistic knowledge The hospital staff wills in depth subject knowledge should be recruited to the hospital. 4) Reduction in fares and charges The fares and charges up to the possible extent should be brought down. 5) Development of mutual understanding between the levels of management

49

All the level of management in the hospital are required to interest to one another problem and developmental understanding between them. 6) Encouragement to the hard working staff The management of the hospital is required to encourage the hard working staff by increasing the pay and the O.T scales etc, which in turn makes the other staff to work efficiently. 7) Provision of basic necessities The hospital should provide the basic necessities such as the uniforms deduction of P.R rest room for the staff etc, within its limits it may increase the efficiency of the workers. 8) Allowing the staff to participate in the management The hospital should allow the staff members to participate in the management so as to create a confident on the management amongst workers. Management should cordial towards the staff at all the times. The management of this hospital should thin that this is a team work and needs to be cordial towards the staff as well as the patients at all the times.

Suggestions for the effective management The following are some vital suggestions from which the hospital un witness a like in the efficiency of the workers and better of the management. 1) Recruitment of a manager The hospital has top recruit a person with the designation manager for whom the staff may address their grievances an suggestions. 50

2) Recruitment of the personal who know the regional language The hospital an much as possible should recruit the personal that know regional language so that the patient can communicate with them with case. 3) Maintaining of a proper functioning / posting The hospital has to introduce maintain a proper functioning schedule while ensures the proper low of work and the right person to the right point. 4) Introduction of a grievance cell and feedback collecting cell The hospital introduce agric evince cell along with a deed back collecting unit which collects the grievances and complaints de from the patients further the top level management in required to go through the collected complaints and immediate solutions for them at least once in a fortnight. 5) Organization of a staff welfare Staff welfare programmers such as staff day hospital

day

interaction day etc Must be organized once in over 6 months in which the staff are allowed to came out with their individual problem their ensure the staff that they are being cured by the hospital and in the long run thin will reduce the rate of such or turnover. 6) Implementation of the solutions The solution so found against the problem of the patients collected through the grievance cells and problems of the staff welfare programmer should be implement nee up to the limits of the nursing home infrastructure.

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7) Opening of a canteen The hospital is surveyed to open a canteen within the hospital premises which will be a greater keep for the patients as the staff members 8) Duty doctors should not be Des tribute while they are on fir rounds Duty doctors should not be distributed while they are on rounds. Which will prevent the deviation on their particular attention. 9) Proper maintenance of patient pertaining records The patients pertaining records should be maintained with a greater cure since it since it serves the had in the development of the hospital. 10)

Total management computerization

The existing management should completely he computerized to on to save the precious time and money on the hospital are.

Product planning and development During the yester years a considerable amount of work has been done on the problem on services in the contents of the product planning in the hospital to be more specific the introduction as automation innovate skill and exp. Modern and scientific appliance have the complicated the talk of product planning what do it product to key become outdated tomorrow. Of date specialization has guide significance of high magnitude and the do the magnitude traditional product have lost their sensitivity and effectiveness in the modern world.

52

A good number of hospital like modern facility and a very few having the modern sophisticated facilities are no tin a position to optimize the demand generated by a large number of potential to optimize the demand generated by a large number of potential users. This over attention on the planning and development of hospital produces against the background of Indian special condition. 1) Latest development in the field medical science The innovative spell and overtones the modern and sophisticated appliances the research and inventions are some of the important aspects necessitating a change in the hospital product the beginning of 20th century nerved avenues fro qualitative improvement as specialization gained a rapid momentum it was no larger possible for a doctor to muster hole surgery and medicine a separation was necessary in a true since towards the end of 19th century surgery advanced rapidly with introduction of skepticism since them we find new discoveries all over the world new mach of diagnosis and therapeutic are treatments were divined which necessitated new division and sub division Facilities are available at in natural that the users avail them. It cant the refused that during years there have been multi faceted development in the communication facilities the improved communication has facilitated visits to hospital it growing problem or urban congestion and the over crowed residential to locations gave complicated. The taste as staying at home for treatment them males it clear that all there development have rosined the netsurfs on hospital here . It is initial that while planning the product the transformation in the society get due weight age on the one hand we have the problem of non optimal

53

demographic structure while on the others. The health to consciousness also thrown now trend if the hospital are respected to respond cognitively the qualitative improvements in hospital cant he delayed. 2) Rapid industrialization Industrialization invited multi dimensioned health hazards the problem of environmental and atmospheric pollution aggravator the problem on medical owes in an industrialized society the citizen due to multi pronged pollution are forced to spent a lot on medical care thin males it clear that planning for hospital services require innovative approaches or into make an assault on growing health hazard. It is significant that al be it in the developing countries and if steps have been taken to active the industrialization programmed here one thing is worth nothing that Industrialization also simplifies the tale of innovating sophisticated equipment and appliance for evoking the medical aids. 3) Emerging trade in Competition Like other services the hospital services also depend upon the emerging trades on competition. The developing countries have developed sophisticated devices but in developing countries we find scarcely op modern well developed hospital this melee if all that hospital having traditional device attempt to develop the facilities or melee possible qualitative improvements her the emerging French in competition cant be over looked specially while planning the hospital product. The user as hospital services prefer to avail the possible facilities for medical cure education training and research other services. 4) Regional diversification

54

In addition to the other factor the regional consideration also influence the development of products in the hospital and country like India were rural population are deprived of the proper medical cure services the development and planning of product cant undermine expansion of services in the rural areas. Provision of rural health centers was recoated by the European conference on royal hygiene as genev2qa in 1931 under the health organization of league of nation it defines the rural health centers areas in mutilation for the promotion on present age specialization as gained a raped movement hence it is significant that instead as establishing separate cell we prepare the service of consultants.

55

Conclusions The Indian hospitals have to improve up to a greater extent to scope to the current hospitalization cant challenge the recent physiological disorders it can rectify the disorders up to the extent of 60 % to be more precise the current hospitals have to equip them selves with modern instruments. Different aids computers hi –f medical personnel and the management staff who are versed particularly with the total physiological disorders. From the study conducted in vathsalya nursing home it has become clear that the patients as well as the society expects much more service than what the hospital is currently serving even though the hospital is tendering its services more than its capabilities. The staff circle except a better working environment which offers them a better harmonious relations between the levels of management along with a better pay scale .Which totally result in complete job satisfaction as the employee. On the other hand the deferent groups as patients expect better am for the charges which a middle class family can afford some respondents have also recommended the physical alteration of the words and internal structure of the nursing home.

56

Annexure QUESTIONNAIR Dear Sir, / Madam It is a matter of grate pleasure to introduce myself as a “Business Management” student from “Acharya Tulsi National College of Commerce” As I am obligated from my course to conduct project report work on “Hospital Management”, A case study of Vathsalya Nursing Home, Shimoga. Hence O request your co- operation in completing his work please fill up the enclosed questionnaire and extend year co- operation. Thanking You Yours faithfully Chaithra H.M 1. Name

:

2. Address

:

3. Age :

a) 15- 30

[]

b) 31- 45

[]

c) 45 – 60 `

[]

d) Above 60

[]

57

4. Gender

:

a) Male

[]

b) Female

[]

5. Marital status a) Married

[]

b) Unmarried

[]

6. Educational background a) S.S.L.C [ ] b) PUC

[]

c) Degree [ ] d) Other

[]

7. Occupation a) Student

[]

b) Agriculturist

[]

c) Business man [ ] d) House wife

[]

e) Employee

[]

8. Family Monthly Income a) Below Rs 10000

[]

b) 11000 – 20000

[]

c) 21000 – 30,000

[]

d) Above 31000

[]

9. How did you came to know about this hospital ? a) Friends

[]

b) Relatives

[]

c) Velwishers

[]

d) Others

[] 58

10.Service provided by hospital is a) Excellent

[]

b) Good

[]

c) Fair

[]

d) Average

[]

11.Your identification with this nursing home a) Out Patient

[]

b) In Patient

[]

c) Consulting patient

[]

12.Name of attending Doctor : ______________________________

13.Ward in which you are taking Treatment a) Male general ward

[]

b) Female general ward [ ] c) Children ward

[]

d) Special ward

[]

e) Intensive care unit

[]

14. What is your opinion regarding the service given by the doctor? a) Excellent

[]

b) Good

[]

c) Fair

[]

d) Average

[]

15. What is your opinion regarding the service given by this medical facilities? a) Excellent

[]

b) Good

[]

c) Fair

[] 59

d) Average

[]

16. According to you the rates & charges levied by the nursing home for the service offered is a) Lower

[]

b) Higher

[]

c) Reasonable

[]

17.Your opinion about the service at the staff a) Excellent

[]

b) Good

[]

c) Fair

[]

d) Average

[]

18.From how many years you are service in Vathsalya nursing home. a) 1 year

[]

b) 2 year

[]

c) 5year

[]

d) 6 year

[]

19.How you have the relation ship with the hospital? a) Regularly

[]

b) Rare

[]

c) Occasionally

[]

20.How do you feel about the Vathsalya Nursing Home? a) Very good

[]

b) Available

[]

c) Poor

[]

60

21.What would you prefer the hospital ? a) Vathsalya

[]

b) Nirmala

[]

c) Meghana

[]

d) Other

[]

22.Your suggestion for Vathsalya Nursing Home ? ______________________________________________________ Date : Place :

Signature

61

Bibliography Books  Introduction to social medicine by Dr. G Chaturvedi, New Delhi  Introduction to hospital environment by Dr Sunder Raj, Calcutta  Healthcare issue 2009-10 (Economic Times Group)  Modern healthcare magazine  Human resource development in a government health organization: views of doctors Vivek Handa, A.K. Sood & Rajni Bagga

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