Dheeraj Kumar Mba+Pgpha 2003

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SUBMITTED BY:-DHEERAJ KUMAR SINGH

COURSE: MBA(PGPHA)ROLL NO. 09010954



Max passion

To deliver world-class healthcare with a service focus, by

creating an institution committed to the highest standards of medical & service excellence, patient care, scientific

knowledge and medical education



The cross is the accepted symbol for Healthcare the worldover. The hands that you see within it are inspired by

Michaelangelo's famous painting on the roof of the Sistine

Chapel showing the birth of Adam. In this work, which has

endured for centuries, God bestows the gift of life on

mankind through his touch, a truly fitting symbol for a group

that endeavours to enhance the quality of life through

healing and care.

The healthcare green they have finally chosen is fresh, closeto nature and symbolic of life. They hope to use this colour

to differentiate all there healthcare properties.

The Logo Story



MAX HOSPITALS

Max Super Specialty Hospital (A unit of DeviDevi Foundation), Saket

Max Super Specialty Hospital, Saket

Max Super Specialty Hospital, Patparganj

Max Hospital - Pitampura

Max Hospital - Noida

Max Medcentre - Panchsheel Park

Max Speciality Centre - Panchsheel Park

Max Hospital - Gurgaon



Aesthetic and Cosmetic Surgeries

Knee Replacemnet Surgery

IVF and Reproductive Medicine

Minimal Access, Metabolic & Bariatric(Weight loss) Surgeries

Neuron surgeries/Neuron Spine Surgeries

Cancer Treatment

SPECIALITIES AND SERVICES



Orthopedics and Joint Replacements

Heart Surgeries & Interventions

Ortho Spine Surgeries

Eye & Dental Care

Pediatric Surgery



ROLE & RESPONSIBILITIES

Study of following department of hospital :

Marketing

Quality

Linen & Laundry services

Dietary services

Store & equipment



Medical record department

Account & Finance

Front Office

Detail study of Marketing department

(Call handing , Communication with doctors , Publicrelation activities)



CONTRIBUTION

Studied each departments of hospital including their function ,

contribution to hospital ,suggestion and recommendations.

A study on the turn around time for preparation of discharge

summary.

Methodology :- Sample study.

SOURCE :- MEDICAL TYPIST, NURSING STATION AND

TRIAGE ROOM.



PURPOSE OF STUDY :-

The aim of the study is to find out the average time takento discharge a patient.

Discharge of the patient starts when doctor pronouncedthe discharge of the patient, after that nurse prepares thefile (including ECG reports, Path. Lab reports, etc) andsend the file to Medical Typist cabin, where summary isprepared and at the same time activity is sent to Front-

Office.



CONT..

When discharge summary is prepared, the fileincluding summary sent to DMO for check.

As the summary is checked by DMO, it dispatchedto nurse to complete any other formality.

If patient is corporate (TPA) then dischargesummary after checked by DMO sent to the TriageDoc. for counter checking and then dispatchedsummary to the Front-Office for Fax.



Procedure:-

Data is collected from 3rd & 4th I.P.D floor in the ³MaxHealthcare Pitampura´.

My data collection is based on TAT (turn around time), i.e.time starting when discharge is pronounced and finished

when the summary is sent to nurse after checking it by

DMO

.

I had taken reading at every step, i.e. T1, T2, T3, T4, T5, T6



(T1) - TIME DISCHARGE IS PROUNOUNCED BY DOCTOR

(T2) - TIME FILE IS GIVEN TO THE MEDICAL TYPIST

(T3) - TIME DISCHARGE ACTIVITY IS SENT TO F.O

(T4) - TIME DISCHARGE SUMMARY SENT TO DMO FOR CHECK

(T5) - TIME THE SUMMARY IS CHECKED & DISPATCHED TO NURSE

(T6) - TIME THE SUMMRY IS SENT TO TRIAGE FOR COUNTER CHECKING

& F.O FOR FAX



DISCHARGE TAT OBSERVATION

DAY1(28/05/2010)

R.NO/FILE NO. PT. NAME TYPE T1 T2 T3 T4 T5 T6 T2-T1 T5-T4

G Cash 10:00 11:30 12:10 12:15 12:30 1:30 0:15 2:30

B/O H Cash Mrng 11:45 12:00 12:30 12:40 0:10 2:40

S Corp. 11:00 12:05 12:30 12:45 1:00 1:15 1:05 0:15 2:15

B/O S Corp. 11:15 12:30 12:35 12:45 1:50 2:30 1:15 1:05 2:35

S Corp. 11:10 12:25 12:40 1:40 1:55 2:20 1:15 0:15 2:45

B/O S Corp. Mrng 12:55 1:10 1:15 2:15 2:25 1:00 2:25

3109-A M . K Cash 11:00 2:00 2:30 2:45 4:30 3:00 1:45 5:30

3114 P Cash 12:00 2:15 2:20 3:00 5:00 2:15 2:00 5:00

3106 S Cash 2:30 2:45 3:15 3:05 3:20 0:15 0:15 0:50

1417 B/O R Cash 3:00 3:20 3:25 4:00 4:30 0:20 0:30 1:30

N Cash 10:30 10:45 11:12 11:00 12:20 0:15 1:20 1:50

D Corp. 8:00 11:40 1:07 12:00 12:30 2:15 3:40 0:30 6:15

3102 S Corp. 3:00 4:00 4:05 4:35 4:45 5:00 1:00 0:10 2:00

1420 S Corp. 11:30 4:30 4:45 5:00 5:00 5:30



DAY2(29/05/2010)


1402 R Corp. 9:00 9:30 9:35 9:40 10:40 10:45 0:30 1:00 1:45

3111 P Corp. 9:00 9:30 9:35 9:40 10:45 10:50 0:30 0:55 1:50

3114-B AR Cash 10:00 10:55 11:00 11:10 11:30 0:55 0:20 1:30

3104-A H Cash 10:00 11:10 11:15 11:11 11:35 1:10 0:24 1:35

GW2D B C Corp. 10:00 11:45 11:45 11:15 12:35 12:40 1:45 0:20 2:40

3105-B S Cash 10:00 12:00 12:05 1:12 3:30 2:00 2:18 5:30

ICU RK Cash 12:00 12:10 12:20 12:15 12:20 0:10 0:05 0:20

3106-B R Corp. 12:15 12:20 12:25 2:40 3:15 3:30 0:05 0:35 3:15

1412-B A Cash 12:15 12:23 1:40 1:23 1:50 0:08 0:27 1:35

1409 D Corp. 12:15 12:25 12:35 2:00 4:15 4:30 0:10 2:15 4:00

3105-A S Cash 12:45 12:55 1:00 2:35 4:00 0:10 1:25 3:15

3104-B G Cash 10:30 1:00 1:10 1:30 2:00 2:30 0:30 3:30



DAY3(01/06/2010)


3110 J.S.M Corp. 10:00 10:15 10:20 10:20 11:30 12:50 0:15 1:10 2:50

1402 S Corp. 10:00 10:15 10:20 10:20 11:45 12:30 0:15 1:25 2:30

3106-B R Corp. 9:00 10:00 10:15 10:10 12:00 12:30 1:00 1:50 3:30

3109-A S Corp. 9:30 10:25 10:30 10:30 2:00 2:30 0:55 3:30 5:00

3114-B P Corp. Mrng 10:00 10:05 10:15 11:50 12:45 1:35 2:45

1414 A Corp. Evng 10:30 10:40 12:00

(Cancelled

) 1:20

3102-B K Cash Mrng 10:40 10:45 10:50 12:15 1:25 2:15

3111 Y Cash 10:30 10:55 10:55 11:00 12:20 0:25 1:20 1:50

1418 A Corp. 11:15 11:30 11:40 1:00 2:15 2:30 0:15 1:15 3:15

1421 R Corp. 11:00 11:35 12:00 2:00 2:30 2:45 0:35 0:30 3:45

3103-A R Corp. 1:00 1:20 1:30 2:20 2:30 2:55 0:20 0:10 1:55

3105-B K Corp. 3:15 3:25 3:25 3:45 4:15 4:30 0:10 0:30 1:15



DAY4(02/06/2010)


1405 S Corp. Mrng 10:00 10:05 10:30 12:45 1:00 2:15 3:00

GW1A R Cash Mrng 11:00 11:05 11:15 1:35 2:20 3:35

1415 M Corp. Mrng 11:05 11:10 11:30 1:00 1:15 1:30 3:15

1416 H Cash Mrng 10:45 10:50 11:10 1:15 2:05 3:15

1414 A Corp. Mrng 11:00 11:05 11:15 11:45 12:00 0:30 2:00

3106-B M Corp. 9:00 9:40 9:45 9:55 10:15 10:45 0:40 0:20 1:45

3106-A W Corp. Mrng 9:45 9:50 9:55 10:30 10:45 0:35 1:45

3114-A R Cash Mrng 9:45 9:45 10:00 10:30 0:30 1:30

3109-B K Corp. Mrng 11:30 11:50 12:00 1:45 1:55 1:45 3:55

1404 V Corp. 11:00 12:00 12:10 12:15 1:30 1:40 1:00 1:15 2:40

1406 R.K Cash 11:50 12:00 12:05 12:15 1:20 0:10 1:05 1:30

3104-B C Corp. 12:00 12:45 12:50 12:55 1:25 1:40 0:45 0:30 1:40

GW2D S Cash Noon 2:00 2:10 3:15 4:00 4:15 0:45 3:45

GW2B V Corp. 2:00 2:38 2:45 3:20 3:50 4:00 0:38 0:30 2:00



(T2-T1) - TIME TAKEN BY NURSES TO SENT THE FILE

(T5-T4) - TIME TAKEN BY DMO TO SIGN THE REPORT

(T2-T1) (T5-T4)

Avg Time 1:27 1:04

MEAN 1:00 1:01

STD DEV. 0.044 0.0041

MAX - 5:00 3:30

MIN - 0:05 0:05

The main reason of delay in discharging a patient during the time at which nurse

sent the file to the typist, i .e. T2-T1 and when the summary is prepared and

waiting for DMO to sign it, i.e. T5-T4.



(T2 - T1)

TIME DISCHARGES PERCENTAGE

0-30 MIN. 17 44.73684

31-60 MIN. 9 23.68421

1:01-1:30 HRS. 5 13.15789

ABOVE 1:30 HRS. 7 18.42105

0

5

10

15

20

25

30

35

40

45

50

0-30MIN. 31-60MIN. 1:01-1:30HRS. ABOV E 1:30HRS.

DISCHARGES

PERCENTAGE

(T2-T1) - TIME TAKEN BY NURSES TO SENT THE FILE



(T5 - T4)

TIME DISCHARGES PERCENTAGE

0-30 MIN. 23 45.09804

31-60 MIN. 5 9.803922

1:01-1:30 HRS. 12 23.52941

ABOVE 1:30 HRS. 11 21.56863

0

5

10

15

20

25

30

35

40

45

50

0-30MIN. 31-60MIN. 1:01-1:30HRS. ABOV E 1:30HRS.

DISCHARGES

PERCENTAGE

(T5-T4) - TIME TAKEN BY DMO TO SIGN THE REPORT



Average time taken by nurse to send the file to the typist is 1:27hrs.

Maximum time taken by nurse to send the file to the typist is 5hrs.

Minimum time taken by nurse to send the file to the typist is 5min.

Average time taken to sign the summary by DMO is 1:04hrs.

Maximum time taken to sign the report by DMO is 3:30hrs.

Minimum time taken to sign the report by DMO is 5min.

Average time taken to Complete the discharge summary is 2:24hrs.

Maximum time taken to discharge a patient is 6:15hrs.

Minimum time taken to discharge a patient is 0:20hrs.



Time Period Discharges Percentage

within 0-1hrs 2 3.921568627

1-2 hrs 18 35.29411765

above 2 hrs 31 60.78431373

Discharges

within0-1hrs

1-2 hrs

above 2 hrs

DISCHARGE TIME:-



Reasons for Delay:-

Infrastructural issues: as this hospital is a verticalfacility with different floors involved in different dischargeactivities eg., Typist is on 4th floor, Billing section is on 5th

floor, Triage DMO on Ground floor and IPD Patients ondifferent floors.

1- Most of the time DMO came late to counter check thesummary and after that signed it because:-

-either he is busy in rounds.-refuses to check the summary as the file is of different flooror belong to other doctor.-sometimes doctor is busy in surgery.



Cont«

2- Nurses delays to handle the file to the typist because:-

-either she was waiting to attach some report.- waiting for doctors round.-

some correction in prescription written by Doctor orDMO.

3- GDA not available to take the report to the Triageroom.



Recommendations:-

Integration of services close to each other is recommended

Discharges should be planned

Activity should be updated on daily basis.

Investigations should be compiled on daily basis.



Cont..

There should be a separate DMO for checking the

summary.

Typist and the designated doctor for checking of summary should be on same floor.

Separate GDA for dispatching the summary .



Learning experiences

K nowledge about the Health & hospital sector.

Hospital Industry work scenarios

Quality structure in hospital with better patient safety.

K nowledge about Marketing structure in

hospital

Communication with Doctors

Dheeraj Kumar Mba+Pgpha 2003

Documents

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