Management Practices at

Shifa International

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TABLE OF CONTENTS

I PART 1 SOMETHING GENERAL ABOUT SHIFA INTERNATIONAL P #’s HOSPITAL 1

I.1 ORGANIZATION’S BRIEFING 1 I.1.1 THEIR HISTORY 1 I.1.2 THEIR MISSION 1 I.1.3 THEIR VISION 1 I.1.4 THEIR ETHICAL GOALS 1 I.1.5 THEIR VALUES 2 I.1.6 THE DECOMPOSITIONING 2 I.1.6.1 THE MEDICAL AFFIARS DEPARTMENT 2 I.1.6.1.1 DEPARTMENT OF MEDICINE 2 I.1.6.1.2 DEPARTMENT OF SURGERY 2 I.1.6.2 OFFICE OF CHIEF OPERATING OFFICER 3 I.1.7 ORGANIZATION DECOMPOSITIONING CHART 3

II PART 2 MANAGEMENT PRACTICES AT SHIFA INTERNATIONAL HOSPITAL 4

II.1 MANAGEMENT FUNCTIONS AT SHIFA INTERNATIONAL 4II.1.1 PLANNING 4II.1.2 ORGANIZING 4II.1.3 LEADING 4II.1.4 CONTROLLING 4 II.1.4.1 EXECUTIVE MANAGEMENT COMMIITTEE 4II.2 DIVERSITY MANAGEMENT AT SHIFA 5II.3 ETHICAL MANAGEMENT PRACTICES AT SHIFA 5II.4 CENTRALIZED MODE OF MANAGEMENT 5II.5 MARKETING STAGE 6II.6 MANAGEMENT SKILLS 6II.7 SCIENTIFIC MANAGEMENT 6II.8 SHIFA AS AN OPEN SYSTEM 6II.9 SOCIAL RESPONSIBILITY AT SHIFA INTERNATIONAL 7

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II.10 SHIFA STAKE HOLDERS 8II.11 VANGUARD ORGANIZATION 8II.12 TYPE Z MANAGEMENT STYLE AT SHIFA HOSPITAL 9II.13 INTERORGANIZATIONAL CULTURE AT SHIFA 9II.14 THEORY Y 9II.15 EMPLOYEES’S DEPARTMENTAL ROTATION 9II.16 FACILITIES AT SHIFA 9II.17 EMPLOYEES SHIFT 10

III PART 3 ELEMENTS OF MEGA ENVIRONMENT 11

III.1 CHAPTER 1 ECONOMIC ELEMENT 11

III.1.1 PRESENT NATIONAL SCENARIO 11III.1.2 DISTRICT GOVERNMENT SYSTEM 11III.1.3 DEPENDENCE 11III.1.4 PAKISTAN ECONOMY 11III.1.5 BUSINESS ACTIVITES 12III.1.6 THE EMERGING POTENTIAL 12

III.2 CHAPTER 2 TECHNOLOGICAL ELEMENT 15

III.2.1 MANAGEMENT INFORMATION SYSTEMS 15III.2.2 INTERNET ACCESS 15III.2.3 INFORMATION MANAGEMENT TRAINING 15III.2.4 COMMUNICATIONS 16III.2.5 ONLINE APPOINTMENT 16III.2.6 ONLINE PHARMACY 16III.2.7 ONLINE PAYMENT 16

III.3 CHAPTER 3 INTERNATIONAL ELEMENT 18

III.3.1 INTERNTIONAL LEVEL COMPETITORS 18III.3.1.1 ARGENTINA 18III.3.1.2 AUSTRALIIA 18III.3.1.3 AUSTRIA 18III.3.1.4 BAHRAIN 19III.3.1.5 BARBADOS 19III.3.1.6 BELGIUM 19III.3.1.7 BRAZIL 19III.3.1.8 CANADA 20III.3.1.9 COLUMBIA 21III.3.1.10 CUBA 21III.3.1.11 CZETCH REPUBLIC 21III.3.1.12 CHILE 21III.3.1.13 CHINA 21

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III.3.1.14 COST RICA 21III.3.1.15 CROATIA 21III.3.1.16 CYPRUS 22III.3.1.17 DEMNARK 22III.3.1.18 EGYPT 22III.3.1.19 FINLAND 22III.3.1.20 FRANCE 22III.3.1.21 GERMANY 23III.3.1.22 GREECE 23III.3.1.23 HAITI 23III.3.1.24 HONGKONG 23III.3.1.25 HUNGARY

24III.3.1.26 ICELAND 24III.3.1.27 INDIA 24III.3.1.28 IRELAND 24III.3.1.29 ISRAEL 25III.3.1.30 ITALY 25III.3.1.31 JMAICA 25III.3.1.32 JORDAN 26III.3.1.33 JAPAN 26III.3.1.34 KENYA 26III.3.1.35 LEBANON 26III.3.1.36 LITHUANIA 26III.3.1.37 KOREA 26III.3.1.38 MALAYSIA 26III.3.1.39 MALTA 27III.3.1.40 MEXICO 27III.3.1.41 NETHERLANDS 27III.3.1.42 NEWZEALAND 27III.3.1.43 NICARAGUA 27III.3.1.44 NIGERIA 27III.3.1.45 NORWAY 28III.3.1.46 OMAN 28III.3.1.47 PANAMA 28III.3.1.48 PARAGUA 28III.3.1.49 PERU 28III.3.1.50 PHILLINPES 28III.3.1.51 POLAND 28III.3.1.52 PORTUGAL 29III.3.1.53 SUADI ARABIA 29III.3.1.54 SOUTH AFRICA 29III.3.1.55 SPAIN 30III.3.1.56 SWEEDEN 30III.3.1.57 SWITZERLAND 30III.3.1.58 TAIWAN 31

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III.3.1.59 THAILAND 31III.3.1.60 TURKEY 31III.3.1.61 UK 31III.3.1.62 UKRAINE 32III.3.1.63 UNITED ARAB EMIRATES 32III.3.1.64 VIETNAM 32III.3.2 INTERNATIONAL ORGANIZATIONS 32III.3.2.1 WORLD HEALTH ORGANIZATION 32III.3.2.2 WHO INTERNATIONAL DIGEST O F HEALTH LEGIALATION 33 III.4 CHAPTER 4 SOCIOCULTURAL ELEMENT 34

III.5 CHAPTER 5 LEGAL POLITICAL ELEMENT 35

III.5.1 THE PAKISTAN MEDICAL RESEARCH COUNCIL 35III.5.2 NATIONAL HEALTH SURVEY OF PAKISTAN 36III.5.3 NATIONAL INSTITUTE OF HEALTH, ISLAMABAD 36III.5.4 PAKISTAN COLLEGE OF SURGEONS & PHYSICIANS 36III.5.5 HEALTH SERVICES ACADEMY, ISLAMABAD 36III.5.6 PRIVATE MEDICAL INSTITUTIONS 36

IV PART 4 ELEMENTS OF TASK ENVIRONMENT 38

IV.1 CHAPTER 6 LABOR SUPPLY 38

IV.1.1 EMPLOYEES AT INTERNAL MEDICINE 38IV.1.2 EMPLOYEES AT CRITICAL CARE 38IV.1.3 EMPLOYEES AT SECTION OF INFECTIOUS DISEASES 38IV.1.4 EMPLOYEES AT PSYCHIATRY SECTION 39IV.1.5 EMPLOYEES AT NEUROLOGY SECTION 39IV.1.6 EMPLOYEES AT DERMATOLOGY SECTION 39IV.1.7 EMPLOYEES AT CARDIAC SURGERY SECTION 39IV.1.8 EMPLOYEES AT GENERAL SURGERY SECTION 39IV.1.9 EMPLOYEES AT DENTISTRY SECTION 40IV.1.10 EMPLOYEES AT ENT SECTION 40IV.1.11 EMPLOYEES AT OPHTHALMOLOGY SECTION 40IV.1.12 EMPLOYEES AT UROLOGY SECTION 40IV.1.13 EMPLOYEES AT ANESTHESIOLOGY SECTION 40IV.1.14 EMPLOYEES AT PEDIATRICS SECTION 41IV.1.15 EMPLOYEES AT OTHER BRANCHES 41

IV.2 CHAPTER 7 CUSTOMERS & CLIENTS 43

IV.3 CHAPTER 8 SUPPLIERS 44

IV.4 CHAPTER 9 COMPETITORS 46

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IV.4.1 AGA KHAN HOSPITAL KARACHI46

IV.4.1.1 SOMETHING GENERAL 46IV.4.2 SHAUKAT KHANUM CANCER HOSPITAL AND RESEARCH 48 CENTER IV.4.3 FUTURE COMPETITORS 49IV.4.3.1 SAHARA FOR LIFE TRUST 49IV.4.3.2 QIH’S (QUAID-I-AZAM INTERNTIONAL HOSPITAL) 50

IV.5 CHAPTER 10 GOVERNEMENT AGENCIES 51

IV.5.1 CENTRAL BOARD OF REVENUE 51IV.5.2 CAPITAL DEVELOPMENT AUTHORTY 51IV.5.2.1 THE COMPLETED PROJECTS 51IV.5.2.2 THE CONTINUED PROJECTS 51IV.5.3 THE INCOME TAX IT 53IV.5.4 PAKISTAN MEDICAL & DENTAL ASSOCIATION 53IV.5.5 BAHRIA UNIVERSITY 53IV.5.6 OTHER PROJECTS OF SHIFA 53IV.5.6.1 SHIFA COLLEGE OF MEDICINE 53IV.5.6.2 SHIFA COLLEGE OF NURSING 55IV.5.6.3 TAMMER I MILLAT FOUNDATION 56

V PART 5 PROJECT SCHEDULING & MANAGEMENT 58

V.1 MANAGEMENT ACTIVITIES 58V.2 GANTT CHART FOR MANAGEMENT ACTIVITIES 59

APPENDIX AAPPENDIX BAPPENDIX CAPPENDIX DAPPENDIX E APPENDIX F REFERENCES

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I PART 1 SOMETHING GENERAL ABOUT SHIFA INTERNATIONAL HOSPITAL

I.1 ORGANIZATION’S BRIEFING

I.1.1 THEIR HISTORY

The Hospital was founded by a group of doctors who were working in USA. It was incorporated on Sept 29, 1987, as a private limited company and converted into a public limited company in 1989. The hospital is listed in Karachi, Lahore and Islamabad stock exchanges. The project was stated by a group of professionals working in USA. I.1.2 THEIR MISSION

To provide good quality medical care in medicine and surgery to all patients in a caring and compassionate manner by an outstanding team of health care professionals in an atmosphere conductive to values and practice of good medicine.

I.1.3 THEIR VISION

Shifa International Hospital is established to provide the highest quality of medical care to the people of Pakistan. Their objective is to achieve e a high class quality goal in many factors:

Medical Expertise Clinical Excellence State of the Art Technology Caring people Preventive Medicine Healthcare Management

I.1.4 THEIR ETHICAL GOALS

They include:

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Consumer satisfaction Service quality Sustain long term viability To improve competitive position To improve work environment

I.1.5 THEIR VALUES

They Include:

Respect Compassion Integrity Efficiency Excellence Transparency

I.1.6 THE DECOMPOSITIONING

The whole hospital operations are decomposed into two main wings.

The Medical Affairs Support Services

The Medical Affairs department is headed by MD (Medical Director) and the Support Services department is headed by COO (Chief Operating Officer). These two departments have been further decomposed into many departments and sub departments.

I.1.6.1 THE MEDICAL AFFAIRS DEPARTMENT

It includes the other departments like:

I.1.6.1.1 DEPARTMENT OF MEDICINE

This further includes section like:

Section of Internal Medicine Section of Pulmonolgy Section of Cardiology Section of Infectious diseases Section of Nephrology

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Section of Neurology Section of Radiology

I.1.6.1.2 DEPARTMENT OF SURGERY

General and Vascular Surgery Section Orthopedic Surgery Section Urology Section Pediatric Surgery Section Cardio Surgery Section Neurosurgery Section ENT Section Plastic Surgery section Anesthesia Section Dental Surgery Section Gynecology Section Emergency Room

I.1.6.2 OFFICE OF CHIEF OPERATING OFFICER

It includes departments like:

Admin& General Nursing Administration Accounts &Finance Pharmacy Patient Services Material Management & Purchase Bio- medical Management Information Systems Maintenance and Plant Operations Human Resources Marketing Services Housekeeping

I.1.7 ORGANIZATION DECOMPOSINING CHART (MAIN BODIES)

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II PART 2 MANAGEMENT PRACTICES AT SHIFA INTERNATIONAL HOSPITAL

Since Shifa is an organization where different people work for a pre-defined goal. The management practices adopted at Shifa include:

II.1 MANAGEMENT FUNCTIONS AT SHIFA INTERNATIONAL

II.1.1 PLANNING

The Chairman of the Hospital, Dr. Zaheer Ahmed has a goal before him. He has a plan to extend the hospital business activities all around the year. He thinks that 2005 was a profitable year for them. Their earnings increased up to 53 %. Secondly, he has a vision to provide the best medical health care facilities to the people of Pakistan.

II.1.2 ORGANIZING

Different people from different backgrounds are working at Shifa. Their HR department is responsible for hiring employees and giving them specific jobs. Mr. Shahzad Choudry, Senior Manager HRD is dealing with all these.

II.1.3 LEADING

Every section has a head to lead the other employees under him/her. There is one Head consultant and under him/her, two or more assistant consultants are working. Since there are many sections and each of these sections has the same level of Hierarchy.

II.1.4 CONTROLLING

Hospital Administration

Office of Medical Director

Office of Chief Operating Officer

Emergency Department

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Traditions

WorkGroups

Race

WorkPlaces Ethics Style

Religion

Subculture

Culture

Gender

Diversity

To assure the quality of the services at Shifa, different committees have been formed. These committees make sure that the rules are not being violated. The services are quality oriented. Different quality assurance committees at Shifa include:

II.1.4.1 EXECUTIVE MANAGEMENT COMMITTEE

Quality Assurance Committee Nursing Quality Assurance Committee ER Committee Internal Audit Committee Waste Management Committee Social Welfare Affairs Committee Pharmacy Committee

The QA department is involved in developing and implementing effective quality based management systems, and quality improvement programs. It aims at developing solutions which are quality based and patient satisfaction. II.2 DIVERSITY MANAGEMENT AT SHIFA

The diversity is in:

Figure 1

II.3 ETHICAL MANAGEMENT PRACTICES AT SHIFA

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People at Shifa believe in:

Respect Compassion Integrity Efficiency Excellence Transparency

II.4 CENTRALIZED MODE OF MANAGEMENT AT SHIFA

It is clear from the data given above that there is a strong centralized management at Shifa International Hospital. The CEO and Chairman is the main person. The MD & COO come under the CEO. Then there is a long hierarchy chain of command at different departments and Sections. Different sections have a head and under that head many consultants and senior consultants are working. This chain of command shows that there is a strong centralized management at Shifa International.

II.5 MARKETING STAGE

Right now, Shifa is a totally customer oriented organization. It started as a private sector unit in 1987. Its main concern in on customer satisfaction and care, in a compassionate way. It is right now in the prosperity stage.

II.6 MANAGEMENT SKILLS

Since it is a very huge organization, different employees come here with different skills. For example, Dr. Zaheer Ahmed the CEO & Chairman of the company has a mission before him. Different doctors at different levels have key knowledge skills according to their field of specializations. (MD, FCPS, or having any other degree). These also have a relationship with the assistants or subordinates at different levels. For example a doctor from one department has a good relationship with the employees at the radiology or any other department. He has to see the reports of the patients. This depicts a level of human skills.

II.7 SCIENTIFIC MANAGEMENT

Obviously we find a scientific management at Shifa. People with different jobs are working and their jobs are broken down into specific routines. There workers are fully trained and selected on a merit basis. Then they have a relationship among themselves to make sure that they are working in the proper manner. Each person is responsible foe performing his own task which is designated to him. Each person is ware of his/her job. We also find bureaucratic management at Shifa where there is an implicit set of formalized rules and regulations. Each employee has to follow the set of rules. The

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organization has a well defined hierarchy. Every one knows that he or she is responsible to whom. Obviously, highly qualified doctors are selected and then trained.

II.8 SHIFA AS AN OPEN SYSTEM

Obviously, Shifa is an open system. It is using its HR, financial and other resources, through managerial and technological abilities, to provide best medical care to the people. The system is providing services to patients. To get a feed back from the environment and stay in touch with the media, Shifa has a magazine named Shifa News International. The editor is Mr. Amer Farooq. The feed back and certain FAQ’s from the readers are encouraged in the “LETTERS TO THE EDITOR “Section of the magazine. The “MEDIA PRINTING & RELIGIOUS “department is there for this purpose. They also keep on arranging different seminars on different health related topics to create awareness among the general public.

II.9 SOCIAL RESPONSIBILITY AT SHIFA INTERNATIONAL

The Shifa people are well aware of their social responsibilities. In the recent earth quake in Pakistan, Shifa contributed a lot. The Tammer millat Foundation of Shifa International Hospital has announced to adopt 2,000 children orphaned in the devastating earthquake that struck Pakistan and Azad Kashmir on October 8.

MUSLIMS, the Voice of Muslims America 18th Nov, 2005 The Tameer-e-Millat Foundation has decided to initiate a complete rehabilitation program for the affected children in a residential environment," said TMF chairman Dr. Zaheer Ahmad while announcing the first major initiative in Pakistan's private sector for the rehabilitation and resettlement of those children who lost every thing in the disaster. The unprecedented initiative has been named "Tameer-e-Jannat (Building of heaven). He informed Muslims Weekly over telephone from Islamabad, Pakistan, that Tameer-e-Jannat is aimed at providing standardized living, brought up, education and training to 2,000 children initially for a period of 12 years. He added that if the required support and funding was available, the TMF might adopt as many as 10,000 of these orphans. "We are offering ‘Sponsor a Child' program to the well off and God-fearing individuals, families and institutions," said Dr. Zaheer while explaining the way his organization intends to raise funds for the project. Every sponsor, he said, will be asked to donate $1000 / child annually for 12 years to provide him/her all needs of life including quality education. Dr. Zaheer Ahmad, it may be recalled, is a respected Pakistani doctor who has spent all his life in the service of humanity. He set a new precedent in Pakistan's history in the 1980s, when he founded Shifa Hospital in Islamabad. The state of the art hospital, costing hundreds of millions of dollars, today is one of the best medical facilities in Pakistan which offers diverse and quality services. In later years, Dr. Zaheer also founded Shifa Foundation which helps the deserving patients in Pakistan and the Tameer-e-Millat Foundation.

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Tameer-e-Millat Foundation has extensive experience in the education sector. Currently, it is running over 380 schools in rural areas of Pakistan where over 20,000 students are receiving education. The TMF says that because of its strong credentials, it is capable of shouldering this huge task.

Daily Mail

The Prime Minister also appreciated the administration of Shifa International for taking care of over 100 injured from the affected areas and for providing them excellent care.He said the patients informed that they were well looked after. “Every individual has an important role in tackling this enormous challenge that confronts the nation. It has shown the capacity of the entire country to cope with such calamities,” he said.He also lauded the role of NGOs, individuals, national and multinational organizations and international community for reaching out to the people affected by this tragedy.—APP

“Pak Tribune”

ISLAMABAD, November 09(Online): Prime Minister Shaukat Aziz has said estimate of earth quake loss will be released on Thursday adding that the estimated loss will be presented in donors’ conference on November 19.

The Prime Minister was talking to journalists here Tuesday in Shifa International Hospital where he had gone to inquire about the health of those injured in killer quake. Health minister Dr Naseer Khan and secretary health Syed Anwar Mehmood also accompanied the Prime Minister.

Earlier, the Prime Minister inquired about the health of injured quake survivors and distributed Rs 10000 each in cash among them.

"We pay tributes to private hospitals, which are providing free treatment to the injured survivors", prime minister underscored. Besides we express gratitude to over sixty countries, which had extended help. The spirit demonstrated by the world countries particularly people of Pakistan in helping the quake affectees is unprecedented, he remarked.

Shaukat Aziz noted that treatment process of the injured people was moving ahead. Serious patients are being shifted here from the field hospitals. Health ministry has been directed to make rapid arrangements for wheel chairs and artificial limbs for disabled patients, he indicated.

They also keep on organizing different seminars on different health related topics to create awareness among the general public. They also re-constructed the “NALA” passing behind the main building. They had to suffer due to the wrong engineering planning of CDA. They had to lose 40 millions. But the reconstruction was self financed.

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II.10 SHIFA STAKE HOLDERS

The social stake holders at Shifa are:

Shareholders Customers Employees society Local community

II.11 VANGUARD ORGANIZATION

A vanguard organization is one which pays its social responsibility along with its other operations. A few companies or organizations in the world have attained this status up till now. Shifa tended to play its social duty during the 8th Oct earth quake of Pakistan. It contributed money, looked after patients and provided free medical treatment to them. It has proved it self in the queue of vanguard organizations. They are also keen about their environment. The Shifa people have planned to make the green belt before the hospital more beautiful, as it would make the capital more beautiful. They have passed this plan from CDA and started working on it. They have one more plan to build a public park for general public and the patients as well. They are well aware of their social responsibility.

II.12 TYPE Z MANAGEMENT STYLE AT SHIFA

Type Z theory of management is there where there is a medium pace career and workers are given some relaxation and some decision making ability is also given to them. The workers are allowed to some extent to make their own decisions in Theory Z management style. Obviously, when there is problem where the senior doctor or head is not present, the junior level doctors are allowed to take their own decision. They can solve the problem encountered. When the senior manager is not available, then the junior level manager is given the privilege to make his own decision.

II.13 INTER ORGANIZATIONAL CULTURE AT SHIFA

The inter-organizational culture at Shifa is relaxing. There is a dress code for the nursing staff, ward boys, house keeping department and for the security guards as well. However, the doctors are to wear the white coat. The surgical staff has to wear blue-green dress. They also provide different types of training to newly hired as well as the old employees to make them more aware about different scenarios and situations.

II.14 THEORY Y

Theory Y implies that the workers are highly motivated and hard working. They are fully trained and using their full potential in achieving their goals. This is the assumption used at Shifa Hospital. The workers are fully trained personnel in their field of specialization.

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Each and every one of them is equally responsible for the improvement and work. Different tasks are assigned to different workers and they are there to perform these. The Hospital provides a 24 hour service, ensuring that the workers (doctors) are working at their full.

II.15 EMPLOYEES’ DEPARTMENTAL ROTATION

Employees are subject to departmental rotation after 3-4 years based on their experience, to increase their skills and knowledge. The employees at junior levels face more rotation.

II.16 FACILITIES AT SHIFA

Shifa is right now providing, transport, allowances, bonuses, dividend to their share holders. It also gives shields and certificates to the best performers. Different job incentives are also rewarded according to the efficiency and effectiveness of the employees.

Shifa Card Shifa Lab Pickup Point.

II.17 EMPLOYEES SHIFT

Right now, 3 shifts at Shifa:

7am -3pm 3pm-11pm 11pm -7am

The employees can work in any shift which they find comfortable to work in.

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III PART 2 ELEMENTS OF MEGA ENVIRONMENT

III.1 CHAPTER 1 ECONOMIC ELEMENT

III.1.1 PRESENT NATIONAL SCENARIO

Presently Pakistan has a short fall in the context of private sector based hospitals. The population rate in Pakistan is expected to grow at a rate of 2.5% per year. Almost 31% percent population of Pakistan has been declared poor by PRSP (Poverty Reduction Strategy Papers) in 1999. The poverty level has increased up to 32.1 % in 2002. One is considered to be poor if his per capita income is less than Rs. 1800. Planning Commission of Pakistan has got its own standards. A per capita income of about Rs. 670 per month makes a person less poor. Due to the rise in commodity prices and inflation, health care was moving beyond the range of people earning up to Rs. 10,000 per month. The PRSP program was launched to jot down the factors and efforts to change the further process. Federal Budgetary allocation for the health sector has been launched from Rs. 4 million to Rs. 6 million during the year 2004-05.

III.1.2 DISTRICT GOVERNMENT SYSTEM

The district government system provides ground for increase in development at the local level. The NGO’s and other local agencies including WHO have implemented health care programs for the community.

III.1.3 DEPENDENCE

But there is still a dependence on private practitioners. Most of the people go to private dispensaries and hakims, instead of going to the doctors. The availability of doctors and

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time is another constraint for the people of Pakistan. Presently, Pakistan is facing a reduction tendency in health care hospitals in the private sector. As birth rates go high, and death rates go slow, Pakistan has to move ahead in health care privatization.

Since Shifa International Hospital is a private sector based hospital, the days it was being launched, most of the market experts were of the view not to go for a private sector hospital. The government hospitals were much more in fashion. But the investors went for implementing the idea and the result was a positive one within 7-10 years. Pakistan is a developing country, and building a private sector hospital in this regard was an encouraging sign for investors in this sector. It provided a better health care facility and an increase in the governmental revenue. The appendices in the end show that the hospital has earned revenue in millions from the year 2000.

III.1.4 PAKISTAN’S ECONOMY

The Pakistan’s economy has gained more strength in the past few years. The data from different market experts predict that Pakistan’s economy has attained a growth rate of 8% this year. The key indicators of the economy are agriculture, industry and services sectors, which show strong performances.

III.1.5 BUSINESS ACTIVITIES

The business activities of Shifa International hospital have expanded throughout the year. The net revenues for the year have reached Rs. 921 million approximately.

III.1.6 THE EMERGING POTENTIAL

Today, Pakistan is the world’s ninth most populous country with a population exceeding 140 millions. During the past few years, Pakistan has seen a pace of development. The open markets outside and inside do play a vital role. Even there is a demand in the expansion of health care markets as well. Diversification in this regard is required as well. Health care facilities also need to have a change and go beyond limits. Most recent trading on local share market has been there to record the high inflation and changes in price levels. Shifa has already many investors and share holders and made its way through the market economy. The following data relates to Shifa Hospital, Islamabad.

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Figure 2

Figure 3

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Figure 4

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Figure 5

Figure 6

III.2 CHAPTER 2 TECHNOLOGICAL ELEMENT

III.2.1 MANAGEMENT INFORMATION SYSTEMS

MIS at Shifa is being used. It is a network of computer based information supported by manual procedures by computer professionals. To provide concurrent, up to date and accurate information to patients any time. The information may be required in decision making, and research purposes as well. MIS supports and facilitates the needs of all the information users at Shifa Network and helps them in carrying out their tasks. MIS at Shifa provides work flow automation, in-house development of oracle based software, dictation server and clients for medical record transcription, intranet, internet security, automation of lab diagnostic equipment data entry, DICOM imaging standard for cardiology and radiology and implementation of LDAP. Its future plan is to develop market healthcare related software. The objective if MIS includes:

Timely and quick access to the information related to the patient and hospital Improved Data accuracy Balance of appropriate security levels Continual Re evaluation of Critical Information Systems Improve Information Sharing among different departments

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knowledge based information for patients and staff

III.2.2 INTERNET ACCESS

The 24 hour internet access with user authentication facility is also available at Shifa International Hospital. It has:

Dedicated ISDN line LINUX based proxy server for user Router based hardware protection 128 K capacity Centralized anti virus software

III.2.3 INFORMATION MANAGEMENT TRAINING

MIS is responsible for sharing and ensuring that all staff members who use information systems and software packages are trained in using the systems. Different courses are arranged for the staff which is not computer literate, from time to time to make them computer literate. All newly hired employees associated with information systems have to go through on job information systems training.

III.2.4 COMMUNICATIONS

The Shifa International Hospital has aimed to improve communication to ensure good customer service. There is a level of communication between the employees and the customers. Telephone facility is available in each ward and room. Reception operators are there in each department. Fax and PCO services are also available for patients as well as visitors. A new component namely, on the top of line Apollo PABX system has also been installed and put into use.

III.2.5 ONLINE APPOINTMENT

This service is allowed to the authorized users who have a login. It is restricted to everyone.

III.2.6 ONLINE PHARMACY

They are trying to make it online. This process is still under construction.

III.2.7 ONLINE PAYMENT

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They are trying to make this facility on line as well. This project is also in its development process.

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Figure 7

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III.3 CHAPTER 3 INTERNATIONAL ELEMENT

These elements include foreign competitors. International laws, international hospital federations etc. These factors influence the working of an organization. These are the factors which exist in the outside countries of Pakistan.

III.3.1 INTERNATIONAL LEVEL COMPITETORS

III.3.1.1 ARGENTINA

Hospital de Clinicas Jose de San Martin, Universidad de Buenos Aires (UBA) - Buenos Aires, Argentina

Hospital Francisco Santojanni - Buenos Aires, Argentina Hospital Municipal de San Miguel - San Miguel, Provincia de Buenos

Aires, Republica Argentina

Hospital de Niños 'Dr. Ricardo Gutierrez' - Buenos Aires, Argentina Hospital Manuel Belgrano - Buenos Aires, Argentina Hospital de Niños 'Pedro Elizalde' - Buenos Aires, Argentina Hospital Regional Rio Gallegos - Rio Gallegos, Santa Cruz, Argentina Hospital Virtual de Moron - Buenos Aires, Argentina Servico De Quirofano - H.R.R.G. - Rio Gallegos, Santa Cruz, Argentina

III.3.1.2 AUSTRALIA

Australian Medical E-Services Directory (Australian Hospital Index, and more!)

The Austin and Repatriation Medical Centre - Melbourne, Victoria, Australia Avon Health Service - Northam, Western Australia Bendigo Hospital - Victoria, Australia Canberra Hospital - Canberra, Australian Capital Territory, Australia Cape Hawke Community Private Hospital - Forster, Australia Flinders Medical Centre - Adelaide, Australia Freemasons Hospital - Melbourne, Victoria, Australia Fremantle Hospital & Health Service - Fremantle, Western Australia,

Australia Stawell District Hospital - Victoria, Australia Swan Hill District Hospital - Swan Hill, Victoria, Australia Sydney Adventist Hospital - Sydney, Australia Sydney Hospital / Sydney Eye Hospital - Sydney, Australia

III.3.1.3 AUSTRIA

Community Hospital Neunkirchen (surgical dept). - Austria General Hospital Kirchdorf (Radiology Dept) - Kirchdorf, Austria General Hospital Vienna - Vienna, Austria

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Krankenhaus St.Josef - Braunau am Inn, Upper Austria, Austria Krankenhaus Frohnleiten - Styria, Austria Kurbad Althofen - Carinthia, Austria Moorheilbad - Harbach, Austria Privatklinik Althofen - Carinthia, Austria Privatklinik Dobling - Vienna, Austria Privatklinik Josephstadt - Vienna, Austria Sanatorium Villach - Carinthia, Austria Wiener Privatklinik - Vienna, Austria

III.3.1.4 BAHRAIN

Bahrain Defence Force Hopspital - Riffa, Bahrain

III.3.1.5 BARBADOS

Queen Elizabeth Hospital - Bridgetown, St.michael, Barbados

III.3.1.6 BELGIUM

Index of Belgian Hospitals (Belgian Health Forum) - Belgium Academisch Hospitaal van de Vrije Universiteit Brussel AZ-VUB - Brussels,

Belgium A.Z. St. Dimpna - Geel, Belgium Cliniques Universitaires Saint-Luc - Brussels, Belgium Elisabeth Ziekenhuis - Sijsele-Damme, Belgium Europe Hospitals (St.-Elisabeth - 2 Alice - St-Michel) - Brussels, Belgium General Hospital Middelheim - Antwerp, Belgium Heilig-Hartziekenhuis - Roeselare, Belgium Hopital Ambroise Pare - Mons, Belgium Hopital Universitaire Saint Pierre - Brussels, Belgium

III.3.1.7 BRAZIL

Clinica Sao Vicente - Rio de Janeiro, Rio de Janeiro, Brazil Hospital Barra D'Or -Rio de Janeiro, RJ, Brazil Hospital Beneficência Portuguesa de São Paulo - São Paulo, SP, Brazil Hospital Copa D'Or - Rio de Janeiro, RJ, Brazil Hospital das Clínicas da UFMG - Belo Horizonte, MG, Brazil Hospital das Clínicas da UFPE - Recife, PE, Brazil Hospital de Clinicas da UFPR - Parana, Brazil Hospital das Clinicas da FMUSP - Sao Paulo, Brazil Hospital das Clínicas da UFRGS - Porto Alegre, RS, Brazil Hospital das Clínicas da Unicamp - Campinas, SP, Brazil Hospital do Cancer - AC Camargo - Sao Paulo, SP, Brazil Hospital da Criança - São, SP, Brasil

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Hospital Dona Helena - Joinville, Santa Catarina, Brazil Hospital Israelita Albert Einstein - São Paulo, SP, Brazil Hospital e Maternidade Sco Camilo - Sco Paulo, Brazil Instituto Nacional do Cênce - Rio de Janeiro, RJ, Brazil Hospital Sao Marcos - Teresina, Piaum, Brasil Hospital São Paulo - São Paulo, SP, Brazil

III.3.1.8 CANADA

Regional Hospitals in Northwestern Ontario - Northwestern Ontario Locations, Northwestern Ontario, Canada

Alexandra Hospital - Ingersoll, Ontario, Canada The Aphasia Institute - Toronto, Ontario, Canada Atlantic Health Sciences Corporation - Saint John, New Brunswick, Canada Avonlea Care Centre - Kelowna, British Columbia, Canada Baffin Regional Health and Social Services Board - Iqaluit NWT Canada BC Rehab - Vancouver, Canada BC Women's Hospital - British Columbia, Canada Brandon Regional Health Authority - Brandon, Manitoba, Canada British Columbia's Children's Hospital - British Columbia, Canada Burnaby Hospital Society - Burnaby, British Columbia Canada Calgary Regional Health Authority - Calgary, Alberta, Canada Capital Health Authority - Edmonton, Alberta, Canada Centenary Health Centre - Scarborough, Ontario, Canada Centenary Health Centre (Pharmacy) - Scarborough, Ontario, Canada Centre Hospitalier Pierre-Boucher - Longueuil, Quibec, Canada Chedoke-McMaster Hospitals - Hamilton, Ontario, Canada Children's & Women's Health Centre of British Columbia - Vancouver,

BritishColumbia, Canada Children's Hospital of Eastern Ontario - Ottawa, Ontario, Canada Saskatoon City Hospital - Saskatoon, Saskatchewan, Canada Shouldice Hospital - Ontario, Canada Sir Mortimer B. Davis-Jewish General Hospital - Montreal, Quebec, Canada St. Mary's Hospital Center - Montreal, Quebec, Canada Sunnybrook Health Science Center - Toronto, Ontario, Canada Surrey Memorial Hospital - Surrey, British Columbia, Vancouver, Canada Trillium Health Centre - Mississauga, Ontario, Canada University Health Network - Toronto, Canada University of Alberta Hospital - Edmonton, Alberta, Canada Vancouver Hospital and Health Sciences Center - Vancouver, British

Columbia, Canada Vancouver General Hospital (Emergency Medicine) - Vancouver, British

Columbia, Canada Vancouver Island Health Authority - Victoria, British Columbia, Canada Victoria General Hospital - Winnipeg, Manitoba, Canada West Park Hospital - Toronto, Canada

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Whitehorse General Hospital - Whitehorse, Yukon, Canada

III.3.1.9 COLUMBIA

Clinica De Occidente S.A. - Cali, Valle, Columbia

III.3.1.10 CUBA

Centro de Restauraci—n Neurol—gica - Havana, Havana City, Cuba Centro de Retinosis Pigmentaria - Havana, Havana City, Cuba Cl’nica Central Cira Garc’a - Playa, Havana City, Cuba Hermanos Ameijeiras - Havana, Havana City, Cuba Hospital Alcivar La Peninsula - La Libertad, Guayas, Ecuador Medicina Tropical Pedro Kour’ - La Lisa, Havana City, Cuba U.S. Naval Hospital - Guantanamo Bay, Cuba

III.3.1.11 CZECH REPUBLIC

Charles University Hospital - Pilsen, Czech Republic Jablonec nad Nisou General Hospital - Jablonec nad Nisou , Bohemia part,

Czech republic

III.3.1.12 CHILE

Clinical Hospital (University of Chile) - Santiago, Chile Clinica Las Condes - Santiago, Chile

III.3.1.13 CHINA

The First Affiliated Hospital of Nanjing Medical University - Nanjing, Jiangsu, P.R.China

Guang An Men Hospital - Beijing, China Peking Union Medical College Hospital - Beijing, China Suzhou Medical College Hospitals - Suzhou, China

III.3.1.14 COSTA RICA

Hospital San Juan de Dios (Pathology) - San Jose, Costa Rica

III.3.1.15 CROATIA

Clinical Hospital Split - Split, Dalmacija, Croatia Klinicka Bolnica Osijek - Osijek, Slavonia, Croatia

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III.3.1.16 CYPRUS

Larnaca General Hospital (Surgical Unit) - Larnaca, Cyprus

III.3.1.17 DENMARK

Aarhus University Hospital - Denmark Bispebjerg Hospital - Copenhagen, Denmark County Hospital at Sankt Elisabeth - Denmark Hillerød Sygehus - Hillerød, , Denmark Hvidovre University Hospital - Copenhagen, Denmark Odense University Hospital - Denmark Privathospitalet Hamlet - Frederiksberg, Denmark Total Health Services of Frederiksborg County - Frederiksborg County,

Denmark

III.3.1.18 EGYPT

Nasser Institute Hospital - Cairo, Cornich El Nile, Egypt Almoassat Hospital - Alexandria, Alexandria, Egypt

III.3.1.19 FINLAND

Kuopio University Hospital - Finland Tampere University Hospital - Tampere, Finland

III.3.1.20 FRANCE

Assistance publique-HÔpitaux de Paris (AP-HP) - Ile de France, France Amiens University Hospital - Amiens, France Angers University Hospital - Angers, France Broussais University Hospital - Paris, France Claude Bernard University Hospital - Lyons, France EPS Ville Evrard - Seine St Denis, France Grenoble University Hospital - Grenoble, France Henri Poincare University Hospital - Nancy, France Hopital Europeen Georges Pompidou - Paris, France Limoges University Hospital - France Missionsaerztliche Klinik - Academic Teaching Hospital - Wuerzburg,

Bavaria, Germany Nantes University Hospital - Nantes, France Necker University Hospital - Paris, France Reims University Hospital - Champagne, France Rennes University Hospital - Rennes, France Rouen University Hospital - France Saint-Antoine University Hospital - Paris/Jussieu, France

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Tourcoing Hospital (Department of Intensive Care and Infectious Diseases) - Tourcoing, France

University Hospital Wuerzburg - Wuerzburg, Bavaria, Germany

III.3.1.21 GERMANY

Academic Teaching Hospital Juliusspital - Wuerzburg, Bavaria, Germany Academic Teaching Hospital Hannover Nordstadt (Department of

Anesthesiology and Intensive Care) - Hannover, Germany Carl von Hess Krankenhaus - Hammelburg, Germany ( German version) Department of Dermatology and Allergy - Biederstein, Germany Frauenklinik Rheinfelden - Rheinfelden, BW, Germany Johann Wolfgang Goethe University Hospital (Department of Infectious

Disease) - Frankfurt am Main, Germany Klinikum Darmstadt - Darmstadt, Germany Klinikum Wahrendorff GmbH - Hannover, Niedersachsen, Germany Marienkrankenhaus - Bergisch Gladbach, NRW, Germany Ulm Military Hospital - Ulm, Germany University of Bonn Medical Center - Bonn, Germany University Hospital - Magdeburg, Germany. University Hospital "Bergmannsheil" - Bochum, Germany University Hospital of Frankfurt (Department of Pediatrics) - Frankfurt,

Germany University of Regensburg Hospital (Pharmacy) - Germany Urologische Klinik Bamberg - Bamberg, Germany Vinzenzkrankenhaus Hannover - Hannover, Germany Wittgensteiner Kliniken AG - WKA - Bad Berleburg, , Germany

III.3.1.22 GREECE

Metropolitan Hospital - Neo Faliro, Athens, Greece

III.3.1.23 HAITI

Hopital Albert Schweitzer - Deschapelles, Haiti

III.3.1 .24 HONG KONG

Adventist Hospital - Hong Kong, China Castle Peak Hospital - Hong Kong Hong Kong Hospital Authority - Hong Kong Hong Kong Sanatorium & Hospital - Happy Valley, , Hong Kong Prince of Wales Hospital - Hong Kong Queen Mary Hospital - Hong Kong St. Teresa's Hospital - Hong Kong Tuen Mun Hospital - Tuen Mun, New Territories, Hong Kong

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Tung Wah Group of Hospitals - Hong Kong

III.3.1.25 HUNGARY

Szent János Kórház (Saint John's Hospital) - Budapest, Budapest, Hungary

III.3.1.26 ICELAND

Landspitalinn (National University Hospital) - Reykjavik, Iceland NLFI Health and Rehabilitation Clinic - Hveragerdi, Iceland

III.3.1.27 INDIA

Apollo Hospitals - India Amrita Institute of Medical Sciences - Cochin, Kerala, India Arasan Eye Hospital - Erode, Tamilnadu, India BSES MG HOSPITAL - MUMBAI, (BOMBAY), MAHARASTRA, INDIA Arasan Eye Hospital - Erode, Tamilnadu, India BKL Walawalkar Hospital and Diagnostic Centre - Shree Kshetra Dervan,

Tal. - Chiplun, Dist. - Ratnagiri, Maharashtra, India lark County Memorial - Jeffersonville, Indiana Community Hospital Of Bremen - Bremen, Indiana Culver Union Hospital - Crawfordsville, Indiana Dr. U Mohan Rau Memorial Hospital - Chennai(Madras), Tamilnadu, India Neo Clinic - Aurangabad, Maharashtra, India Escorts Heart Institute & Research Center - New Delhi, India Fayette Memorial Hospital - Connersville, Indiana Good Samaritan - Vincennes, Indiana Goshen General Hospital - Goshen, Indiana King Edward VII Memorial (K. E. M.) Hospital - Mumbai, Maharashtra,

India Lilavati Hospital - Bandra, Maharashtra, India Logansport Memorial Hospital - Logansport, Indiana Lutheran Hospital - Fort Wayne, Indiana Marion General Hospital - Marion , Indiana Narayana Hrudayalaya - Bangalore, Karnataka, India Om Hospital - Dombivli East, Thane, Maharashtra, India

III.3.1.28 IRELAND

Beaumont Hospital - Dublin, Ireland Blackrock Clinic - Dublin, Ireland Coombe Women's Hospital - Dublin, Ireland Galvia Private Hospital - Galway, Ireland Mater Misericordiae Hospital - Dublin, Ireland Mater Private Hospital - Dublin, Ireland

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Merlin Park Hospital - Galway City, County Galway, Ireland St. James's Hospital - Dublin, Ireland University College Hospital - Galway, County Galway, Ireland

III.3.1.29 ISRAEL

Hillel Yaffe Medical Center - Hadera, Israel addasah Hospital – Israel Laniado Hospital - Netanya, Israel Rambam Medical Center - Israel Rabin Medical Center - Petah-Tikva, , Israel Schneider Children's Medical Center - Petach Tikva, Israel Shaare Zedek Medical Center - Jerusalem, Israel Soroka Medical Center - Beer Sheva, Israel Tel-Aviv Sourasky Medical Center (Ichilov) - Tel Aviv, Israel

III.3.1.30 ITALY

Azienda Ospedaliera Papardo - Messina, Sicily, Italy Azienda Ospedaliera Policlinico - Bari, Puglia, Italy Bologna Public Health Departments - Bologna, Italy Careggi Hospital of University of Florence - Florence, Italy Cattinara Hospital - Trieste, Italy Ceccarini Hospital - Riccione, Italy Cuneo Health System (Lung Cancer Study Group) - Cuneo, Italy Fondazione Salvatore Maugeri - Clinica del Lavoro e della Riabilitazione -

Pavia, Italy General Hospital of Brescia - Brescia, Italy Hospitaller Order of St. John of God - Italy H San Raffaele - Milano, Italy Mauro Leonardis - Roma, Italy Orthopedic Institute Gaetano Pini - Milan, Italy Ospedale Civile di Desenzano Del Garda - Desenzano Del Garda, Brescia,

Italy S.Camillo Zonal Hospital - Treviso, , Italy San Giovanni di Dio Hospital - Florence, Italy Azienda Sanitaria di Modena - Modena, Italy Azienda Sanitaria Ospedaliera Molinette - Northern Italy United States Naval Station Hospital - Naples, Italy

III.3.1.31 JAMAICA

University Hospital West Indies - West Indies, Kingston, Jamaica St. Josephs hospital - Kingston, Deanery road, Kingston, Jamaica

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III.3.1.32 JORDAN

-Jordan Hospital - Amman, Jordan Speciality Hospital - Amman, , Jordan

III.3.1.33 JAPAN

Akashi Tsuchiyama Hospital (ATMH) - Hyogo, Japan Chidoribashi General Hospital (Rehabilitation) - Hakata-ku, Fukuoka-city,

Japan Fukae Nagasaka Clinic - Ogaki-cho, Fukae, Hiroshima, Japan International Medical Center of Japan - Toyama, Shinjuku-ku, Tokyo, Japan Osaka University Hospital - Osaka, Japan Tokyo Medical University Hospital - Shinjuku, Tokyo, Japan University of Tsukuba Hospital - Ibaraki, Japan

III.3.1.34 KENYA

The Mombasa Hospital - Mombasa, Coast Province, Kenya Ojele Memorial Hospital - Suna , Migori, Kenya

III.3.1.35 LEBANON

American University of Beirut Medical Center - Beirut, Lebanon Hospital Al Koura - Al Koura, Lebanon Sahel Hospital - Beirut, , Lebanon Hopital Libanais Geitaoui - Beirut, Lebanon

III.3.1.36 LITHUANIA

Klaipeda Hospital - Klaipeda, Lithuania

III.3.1.37 KOREA

Samsung Medical Center - Seoul, South Korea

III.3.1.38 MALAYSIA

Damai Service Hospital (HQ) - Kuala Lumpur, Federal Territory, Malaysia Ipoh Specialist Hospital - Ipoh, Perak, Malaysia Johor Specialist Hospital - Johor bahru, Johor Bahru, Malaysia Klang Valley Orthopaedic & Trauma Center - Malaysia KPJ Healthcare Berhad - Kuala Lumpur, Kuala Lumpur, Malaysia Kuala Lumpur Hospital (KLH) - Kuala Lumpur, Malaysia Pantai Medical Center - Kuala Lumpur, Wilayah, Malaysia

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III.3.1.39 MALTA

St Luke's Hospital - Guardamangia, Pieta, Malta

III.3.1.40 MEXICO

The American British Cowdray Medical Center, I.A.P. - Mexico City, Mexico Ameri+Med Hospitals - Puerto Vallarta, Mexico hildren's Hospital of the State of Sonora - Hermosillo, Sonora, Mexico Fundacion Clinica Medica Sur - Mexico City, Mexico Hospital General Dr. Manuel Gea Gonzalez - Mexico City, Mexico Hospital San Jose-ITESM de Monterrey - Monterrey, Nuevo Leon, Mexico Instituto Mexicano de Psiquiatria - Mexico City, Mexico Instituto Nacional de la Nutricion Salvador Zubiran - Mexico City, Mexico Sanatorio Español - Torreón, Coahuila, México Spanish Hospital - Mexico City, Mexico

III.3.1.41 NETHERLANDS

The Digital Hospital - The Netherlands Free University Hospital - Amsterdam, The Netherlands Westeinde Hospital - The Hague, The Netherlands University Hospital of Leiden - Leiden, The Netherlands University Hospital of Rotterdam - Rotterdam, The Netherlands University Hospital St Radboud - Nijmegen, The Netherlands Ziekenhuis Centrum Apeldoorn - The Netherlands

III.3.1.42 NEW ZEALAND

Ascot Integrated Hospital - Auckland, Auckland, New Zealand Canterbury District Health Board - Christchurch, , New Zealand Capital Coast Health - Wellington, New Zealand Healthcare Hawkes Bay - New Zealand New Zealand Hospitals Online - New Zealand Waikato District Health Board - Hamilton, Waikato, New Zealand

III.3.1.43 NICARAGUA

Baptist Hospital - Managua, Nicaragua

III.3.1.44 NIGERIA

Parklande Specialist Hospital - Surulere, Lagos, Nigeria

34

III.3.1.45 NORWAY

Aker University Hospital - Oslo, Norway. Namdal Sykehus - Namsos, Norway National Hospital (Rikshospitalet) - Olso, Norway The Norwegian Radium Hospital - Oslo, Norway university hospital of Trondheim - Trondheim, Norway Vestfold Hospital Trust - T¿nsberg, Horten, Larvik, Sandefjord, Vestfold,

Norway

III.3.1.46 OMAN

The Royal Hospital, Ministry of Health, Sultanate of Oman - Al Ghubra, Muscat, Oman

III.3.1.47 PANAMA

Centro Medico San Judas Tadeo - Panama, Republic of Panama Hospital Nacional - Panama City, Republic of Panama

III.3.1.48 PARAGUAY

Centro Medico Bautista - Paraguay

III.3.1.49 PERU

Children's Hospital of Lima - Lima, Peru Hospital Apoyo Iquitos - Iquitos, Maynas, PERÚ Maison de Sante - Lima, Peru

III.3.1.50 PHILIPPINES

De La Salle University Medical Center - Dasmarinas, Cavite, Philippines Lorma Medical Center - San Fernando City, La Union, Philippines National Kidney and Trnsplant Institute - Quezon City, Metro-Manila,

Philippines Philippine General Hospital (University of the Philippines) - Manila,

Philippines University of Santo Tomas Hospital - Manila, Philippines St. Luke's Medical Center - Quezon City, Metro Manila, Philippines

III.3.1.51 POLAND

Lodz Medical University - Lodz, Poland Ludwik Rydygier State Hospital - Torun, Poland Panstwowy Szpital Kliniczny Nr4 - Lublin, Poland

35

Wojewodzki Szpital im. A.Falkiewicza - Legnica, Poland

III.3.1.52 PORTUGAL

Hospital Distrital de Faro - Faro, Portugal Hospital Feira Min-Saude Portugal Hospital de Santa Cruz - Carnaxide, Portugal Santa Maria Hospital - Lisbon, Portugal Hospital de Sao Teotonio - Viseu, Portugal

III.3.1.53 SAUDI ARABIA

Al Hada & Taif Military Hospitals - Taif, , Saudi Arabia Dr. Erfan and Bagedo Hospital - Jeddah, Western, Saudi Arabia Dr. Sulaiman Al Habib Medical Center - King Fahad-Olaya, Riyadh, Saudi

Arabia King Faisal Specialist Hospital & Research Centre - Riyadh, Saudi Arabia Abha Private Hospital - Abha, Aseer, Saudi Arabia King Abd.Aziz Medical City - Riyardh, Saudi Arabia King Khalid Eye Specialist Hospital - Riyadh, Central, Saudi Arabia Saudi German Hospital - Jeddah, , Saudi Arabia Security Forces Hospital Program - Riyadh, Central region, Saudi Arabia Singapore East Shore Hospital - Singapore Gleneagles Hospital - Singapore Kandang Kerbau Hospital (Singapore Women's & Children's Hospital) -

Singapore Mount Elizabeth Hospital - Singapore National Skin Centre - Singapore National University Hospital - Singapore Singapore General Hospital - Singapore Tan Tock Seng Hospital - Singapore

III.3.1.54 SOUTH AFRICA

Constantiaberg Oncology Unit - Plumstead, South Africa East Cape Oncology Unit - Centrahill, South Africa Medi-Clinic - South Africa Netcare - south africa Panorama Oncology Unit - Panorama, South Africa Pretoria-Oos Private Hospital and The Pretoria Orthopaedic & Neuro

Institute - Pretoria, South Africa Pretoria Urology Hospital - Pretoria, South AfricA

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III.3.1.55 SPAIN

Clinica Moncloa - Madrid, Spain Clinica Universitaria de Navarra - Pamplona, Navarra, Spain Corporación Parc Taulí - Sabadell, Catalunya, Spain Fundación Hospital Ver’n - Verín, Orense (Galicia), Spain Fundacion Hospital Alcorcûn - Alcorcón, Madrid, Spain Hospital de Albacete - Albacete, Castilla-La Mancha, Spain Hospital de Basurto - Bilbao, Bizkaia, Spain ospital de Cabueñes - Gijon, Asturias, Spain Hospital de Cruces - Barakaldo, Bizkaia, Spain Hospital De Figueres - Figueres, Girona, Spain Hospital de Galdakao - Galdakao, Bizkaia, Spain Hospital de Gran Canaria - Canary Islands, Spain ** List of Hospitals in Canary Island. Hospital Carlos Haya - Spain Hospital Centro Medico La Zarzuela - Madrid, Spain Hospital de Laredo - Laredo, Cantabria, Spain Hospital General Yagüe - Burgos, Castilla-León, Spain Hospital Obispo Polanco - Teruel, Aragin, Spain Hospital de Sagunto - Valencia, Spain Hospital San Agustin - Spain Hospital San Jorge Insalud Huesca Huesca - Spain Hospital Sierrallana - Torrelavega (Cantabria), Spain

III.3.1.56 SWEDEN

Akademiska sjukhuset, Uppsala University Hospital - Uppsala, Sweden Karolinska Institute - Stockholm, Sweden Linkoping University Hospital - Sweden Malmö University Hospital - Malmö, Skåne, Sweden Orebro University Hospital - Orebro, Sweden Ostra Hospital (Department of Geriatrics) - Goteborg, Sweden Sahlgrenska University Hospital - Gothenburg, Sweden S:t Görans Sjukhus - Stockholm, Kungsholmen, Sweden University Hospital of Umea - Sweden

III.3.1.57 SWITZERLAND

Cantonal Hospital - St. Gallen, Switzerland Clinique de Montchoisi - Lausanne, Switzerland InselSpital - Berne, Berne, Switzerland Hospital of Lausanne - Lausanne, Switzerland Kantonsspital, Ob/Gyn Ward - Liestal, Basel Land, Switzerland Kantonsspital Basel Universitätskliniken - Bale, Bale, Switzerland Ob/Gyn-Ward, SRO Hospital - Langenthal, Switzerland

37

University Hospital of Bern - Bern, Switzerland University Hospital of Geneva - Geneva, Switzerland University Hospital of Zurich - Zurich, Switzerland University Insel Hospital Berne - Bern, Bern, Switzerland

III.3.1.58 TAIWAN

Jen-Ai Hospital - Taichung & Tali, Taichung, Taiwan Kaohsiung Medical College Hospital - Kaohsiung, Taiwan Mennonite Christian Hospital - Hualien, Taiwan National Taiwan University Hospital - Taipei, Taiwan Show Chwan Memorial Hospital - Changhwa City, Taiwan Veteren General Hospital - Taipei, Taiwan

III.3.1.59 THAILAND

Bangkok Hospital - Bangkok, Thailand Bangkok Phuket Hospital - Phuket, Phuket, Thailand Kluaynamthai General Hospital - Bangkok, Thailand Phyathai Phuket Hospital - Phuket, Thailand Thonburi Hospital - Bangkok, Thailand Trang Ruampat Hospital - Trang, Thailand

III.3.1.60 TURKEY

Ankara Numune Hospital - Ankara, Turkey Clinix Teshis Tedavi Merkezi - Istanbul, Turkey Dokuz Eylul University Hospital - Inciralti, Izmir, Turkey Ege University Hospital - Bornova, Izmir German Hospital (Universal Hospitals Group) - Istanbul,Turkey Haydarpafla Numune Hospital - Turkey International Hospital/ Istanbul - Istanbul, , Turkey Kaskaloglu Eye Hospital - Izmir, Turkey Meltem Birth and Children Hospital - Istanbul, Turkey

III.3.1.61 UK

Addenbrooke's Hospital (Medical Physics Dept.) - Cambridge, UK Aberdeen Royal Infirmary (Aberdeen Medical School) - Aberdeen, Scotland,

U.K. Bath & West Community NHS Trust - Bath, Somerset, England, UK Benenden Hospital - Cranbrook, Kent, UK Birmingham Heartlands Hospital - Birmingham, UK Blackpool Victoria Hospital - Blackpool, Lancs, UK Bolingboke Hospital - London, UK Brighton Healthcare NHS Trust - Sussex, UK

38

Bristol Hospital - Bristol, UK British Hernia Center - London, UK BUPA UK Hospitals * Resource List * Chester and Halton Community NHS Trust - Chester, UK Christie Cancer Research Centre - UK Clementine Churchill Hospital - Harrow, Middlesex, England Coppettswood Infectious Diseases Hospital at the Royal Free - London, UK Countess of Chester Hospital NHS Trust - Chester, UK Devonshire Hospital - London, UK Dorset Health Commission - Ferndown, Dorset, UK Dudley Group of Hospitals (Department of Gastroenterology and Nutrition) -

West Midlands, U K Northampton General Hospital NHS Trust (Northamptonshire Centre for

Oncology) - Northampton, Northamptonshire, UK Nottingham Healthcare NHS Trust (Finance Department) - Nottingham, UK Central Nottinghamshire Healthcare (NHS) Trust - Nottinghamshire, UK The Obstetric Hospital - Huntley Street, London, UK Pinderfields Hospitals NHS Trust - Wakefield, UK

III.3.1.62 UKRAINE

Lviv Regional Neonatal Center (Lviv Regional Clinical Hospital) - Lviv, Ukraine

Zhovkva Central District Hospital - Zhovkva, Lviv Region, Ukraine

III.3.1.63 UNITED ARAB ERIMATES

Zulekha Hospital - Sharjah,United Arab Emirates Universitario de Maracaibo - Maracaibo, Zulia, Venezuela

III.3.1.64 VIETNAM

DialAsie Vietnam: International Hospital of Nephrology and Dialysis - Ho Chi Minh City, Vietnam

III.3.2 INTERNATIONAL ORGANIZATIONS

III.3.2.1 WORLD HEALTH ORGANIZATION

Pakistan is a member of WHO. However, Pakistan is not a member of WMA (World Medical Association).

39

III.3.2.2 WHO INTERNATIONAL DIGEST OF HEALTH LEGISLATION

An Ordinance (No. XXVIII of 1997) further to amend the Unani, Ayurvedic and Homeopathic Practitioners Act, 1965. Dated 13 February 1997. (The Unani, Ayurvedic and Homeopathic Practitioners (Amendment) Ordinance, 1997). (The Gazette of Pakistan, Extraordinary, Part I, 13 February 1997, pp. 193-197) Pakistan Nuclear Safety and Radiation Protection (Treatment of Food by Ionizing Radiation) Regulations, 1996. S.R.O. 166(I) 96. Dated 7 March, 1996.

These Regulations deal with, inter alias, the types of radiation to be used in treating food, licensing, the conditions governing treatment, packaging, re-irradiation, labeling, inspection, the issuance of certificates for irradiated food items, and the import and export of treated food.

“The Employment of Children Rules, 1995. S.R.O. 387(1) 1995.

These Rules, made under Secs. 13 and 18 of the Employment of Children Act, 1991 include the following: 3. Notice of period of work; 4. Certificate of fitness; 5. Register of child workers; 6. Cleanliness in the place of work and its freedom from nuisance; 7. Ventilation and temperature; 8. Lighting; 9. Drinking water; 10. Latrines/urinals/washing/accommodations; 11. Precautions against fire; 12. Fencing of machinery; 13. First aid; 14. Notice of accident; and 15. Excessive weight.

The Factories Act, 1934. As amended to 1997

This Act includes the following Chapters: III. Health and safety (including the following Sections: 13. Cleanliness; 14. Disposal of wastes and effluents; 15. Ventilation and temperature; 19. Lighting; 20. Drinking water; 21. Latrines and urinals; 23. Precautions against contagious or infectious diseases; 23-A. Compulsory vaccination and inoculation; and 32. Prohibition of employment of women and children near cotton openers); IV. Restrictions on working hours of adults; and V. Special provisions for adolescents and children.

An Ordinance (No. XXVII of 1997) to provide for the protection, conservation, rehabilitation and improvement of the environment, for the prevention and control of pollution, and promotion of sustainable development. Dated 11 February 1997. (The Pakistan Environmental Protection Ordinance, 1997). (The Gazette of Pakistan, Extraordinary, Part I, 11 February 1997). An Ordinance (No. III of 2001) to provide for the establishment of the Pakistan Nuclear Regulatory Authority for regulation of nuclear safety and radiation protection in Pakistan and the extent of civil liability for nuclear damage resulting from any nuclear incident. Dated 22 January, 2001.”

III.4 CHAPTER 4 SOCIO-CULTURAL ELEMENT

40

Nothing much has to be discussed about the socio-cultural element of Shifa International Hospital. We have come to know that it is an equal opportunity employment place. Different women are serving at in different departments like Medicine, Radiology, Gynecology, Endocrinology, Dietitians and surgery as well. However, non Muslims also serve in the hospital. Most of the nursing staff is Christian. Ward boys are Christians. People from different parts of Pakistan serve here irrespective of their rank, or caste. (Punjabi, Bloch, Pathan or Sindhi). Since the hospital is a big corporation, consisting of many stock holders, many people serve here. Starting from very senior doctors to young fresh students. Shifa welcomes fresh people and is an equal opportunity place. People from different cultures serve in the hospital. It has created a name in the hospital industry. Basically, the management at Shifa believes in making a strong team of excellent professionals who are able to serve at their core with their best potential, irrespective of their age, sex, culture or gender. The staff they have right now has the best medical specialists from all over Pakistan. It has more than 100 extensively trained surgeons and physicians, form USA. They are all dedicated towards quality, comfort and safety of the patient. They team of professionals work with unity to ensure good customer health and satisfaction. The management at Shifa is handling all these diversifications in an excellent manner. Different shifts like morning and night shifts are working at Shifa. It motivates the workers to be a part of the team and perform well. The overall objective is to provide consumer satisfaction and good quality. Different departments work together in collaboration to attain a long term objective.

III.5 CHAPTER 5 LEGAL POLITICAL ELEMENT

41

Pakistan became an independent sovereign state on 14 August 1947. At the time of independence the territories that became Pakistan had one medical teaching college and attached hospital and one university at Lahore. The health care delivery system consisted of a few district and civil hospitals. As early as 1954 a Medical Reforms Commission was set up to advise the Government on the organization and structure of the medical services. One of the recommendations of the Commission was to establish a Medical Research Fund. In 1962 a subsequent Medical Reforms Committee recommended the establishment of the Pakistan Medical Research Council (PMRC), which was created under the Ministry of Health and assigned responsibility for promoting, organizing and coordinating medical research in the country, and for linking medical research to overall national socio-economic planning.

Over the years, and especially in the 1980s, many commissions and committees were constituted to advise the Government on health sector reform and development. (See Annex I: Chronology of Health Sector Development in Pakistan). The Health Survey and Development Committee (Bhore Committee) was set up in 1946, just a year before partition of the subcontinent. The Committee’s recommendations encompassed the concepts of universal access, equity, quality and community participation in the provision of health care, concepts that were to be incorporated in the recommendations of subsequent commissions and committees. However, to date they have eluded the kind of implementation envisioned.

Under item 6 of the policy document - Resource development for health - community-oriented medical education, the Pakistan Medical and Dental Council, and nursing and paramedical staff development are listed. Under item 8 - Priority health programs - it lists the National EPI Program, the Prime Minister’s Program for Family Planning and Primary Health Care, maternal and child health, reproductive health, the National ARI and Diarrhea Disease Control Program, Malaria Control Program, National Tuberculosis Control Program, National AIDS Control Program, nutrition, mental health, oral and dental health, Health Promotion and Health Education, School Health Program. Under item 22 - Health systems research (HSR) - the policy acknowledges the neglect of health research and promises to give it due importance, promote a research climate in academic institutions, and institutionalize HSR. II.5.1 Health research Institutions in Pakistan

III.5.1 THE PAKISTAN MEDICAL RESEARCH COUNCIL (PMRC)

The PMRC was assigned the functions of promoting, organizing and coordinating health research and linking it to national socio-economic development planning. To achieve its objectives, the PMRC adopted the strategy of establishing research centers in medical teaching institutions, where it was assumed the research capacity was concentrated. The Council has 18 such centers at present, located in major public sector undergraduate and postgraduate medical institutions.III.5.2 THE NATIONAL HEALTH SURVEY OF PAKISTAN (NHSP)

42

The PMRC carried out the NHSP in collaboration with FBS and the National Center for Health Statistics (NCHS), USA, in 1990 – 1994. The sample size of 80 primary sampling units of 30 households each was selected by the FBS within its sampling frame. The objectives of the survey were:

To provide a general health profile of the people of Pakistan; To provide a health profile of high risk groups; To assess the utilization of health services; and To provide this data in a form relevant to the health program, policy and

planning needs of the Government of Pakistan.

The model for the survey was the National Health and Nutrition Examination Survey (NHANES) of the NCHS, USA.

III.5.3 NATIONAL INSTITUTE OF HEALTH, ISLAMABAD

The National Institute of Health (NIH) was established in the early 1960s with the title of National Health Laboratories. The scope and functions of the Laboratories were expanded in the 1980s and the institution was renamed the National Institute of Health. Vaccine and diagnostics development are the major functions of the NIH, for which research was an essential requirement. The Institute has the largest number of health science personnel in the public sector, but in the field of research its contribution has been negligible, due largely to a lack of know-how.

III.5.4 PAKISTAN COLLEGE OF SURGEONS AND PHYSICIANS (PCSP)

This is a fully autonomous institution at the federal level, established with the objective of capacity building in specialized fields of medicine. The college trains for, and awards, fellowships in different specialties (FCPS). The Government recognizes the degree as equivalent to the memberships and fellowships awarded by the Royal Colleges in Britain and the equivalent awards of the American Board.

III.5.5 HEALTH SERVICES ACADEMY, ISLAMABAD

The Health Services Academy, Islamabad was established to train personnel in health management, public health and related subjects. The academy teaches and also undertakes HSR. The Academy is currently offering a one-year course for a Master’s degree in Public Health and short courses in health management and administration. It has organized a field demonstration area for HSR.

III.5.6 PRIVATE MEDICAL INSITUTIONS

The private health sector’s contribution to the GDP of the country exceeds that of the public sector. The National Health Survey of Pakistan has shown that 80% of curative care visits are to private health practitioners. Some very well equipped and high quality hospitals have been established by the private sector, the notable ones being the Aga

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Khan University (AKU) Hospital, the Shaukat Khanum Cancer Hospital, the Al-Shifa Eye Trust Hospital and the Shifa International Hospital. The specialists in these hospitals contribute to the research effort, with the AKU especially in the forefront of medical research. However, their impact on the research environment has yet to be seen. In the field of capacity building, the private sector is a latecomer, but is expanding fast. Already there are three private sector medical universities (all in Karachi) and several medical colleges.

IV PART 4 ELEMENTS OF TASK ENVIRONMENT

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IV.1 CHAPTER 6 LABOR SUPPLY

Labor supply comprises those individuals which are employable by an organization. The people at Shifa are mostly USA qualified professionals who have an urge to serve the people at their most with an objective. Labor supply at Shifa International consists of:

Dr. Zaheer Ahmed, Chairman & CEODr. Manzur Qazi, MD (Medical Director)Syed Illyas Ahmed COO (Chief Operating Officer)

IV.1.1 EMPLOYEES AT INTERNAL MEDICINE

NAME QUALIFICATION POSITIONDr. Mazhar A. Mufti MD, DABIM, USA ConsultantDr. Tara Jaffrey MD, DABIM USA ConsultantDr. Amer Nazir Ahmed MD, DABIM, USA ConsultantDr. Sabeen Mufti MD, DABIM, USA ConsultantDr. Amjad Suhail MD, DABIM, USA ConsultantDr. Mohammad Ata MD, DABIM, USA ConsultantDr. Mahmud Majeed MD, DABIM, USA ConsultantDr. Mohammad Iqbal MD, DABIM, USA Consultant

IV.1.2 EMPLOYEES AT CRITICAL CARE

NAME QUALIFICATION POSITIONDr. Syed Arif Hussian FRCP Consultant Critical Care &

PulmonaryDr. Mohammad Anwar MD, DABIM, USA Consultant Critical Care

&PulmonaryDr. Shazli Manzur MD, DABIM, USA Consultant Critical Care

&PulmonaryDr. Aftab Akhtar MD, DABIM, USA Consultant Critical Care

&Pulmonary

IV.1.3 EMPLOYEES AT SECTION OF INFECTIOUS DISEASES

NAME QUALIFICATION POSITIONDr. Mahmud Haider MD, DABIM Consultant Infectious DiseasesDr. Kh. Sayeed Ahmed MD, DABIM Consultant Infectious DiseasesDr. S. Nayyar Mahmud MD, DABIM Consultant Infectious Diseases

IV.1.4 EMPLOYEES AT PSYCHIATRY SECTION

NAME QUALIFICATION POSITIONDr. Rizwan Taj MRCPych UK Consultant PsychiatryDr. Fawad Kaiser MRCPych UK Consultant Psychiatry

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Dr. Mohammad Amin FRCP Canada, MD DABPych, USA

Consultant Psychiatry

Dr. Mohammad Habib MRCPsych UK Consultant Psychiatry

IV.1.5 EMPLOYEES AT NEUROLOGY SECTION

NAME QUALIFICATION POSITIONDr. Ali Hassan FCPS Consultant NeurologyDr. Arsalan Ahmed MD Neurology Pakistan Consultant Neurology

IV.1.6 EMPLOYEES AT DERMATOLOGY SECTION

NAME QUALIFICATION POSITIONDr. Rezzan Khan PhD Food & Nutrition Consultant NutritionDr. Ikramullah Khan MRCP, UK Consultant DermatologyDr. Rasheed Choudry D. DERM, Pakistan Consultant DermatologyDr. Ahsan Hameed FCPS , Pakistan Consultant Dermatology

IV.1.7 EMPLOYEES AT CARDIAC SURGERY SECTION

NAME QUALIFICATION POSITIONDr. Khalid Rasheed FRCS, UK Consultant Cardiac SurgeryDr. Munir Ahmed FRCS, IRE Consultant Cardiac SurgeryDr. Javed Hayat FRCS,IRE Consultant Cardiac Surgery

IV.1.8 EMPLOYEES AT GENERAL SURGERY SECTION

NAME QUALIFICATION POSITIONDr. Tahir Hussain FCPS, Pakistan Consultant General SurgeryDr. Mohammad Iqbal FRCS UK Consultant General SurgeryDr. Mussadiq Khan MD DABS, FACS USA Consultant General SurgeryDr. Tahira Farooq Mirza EMS USA Consultant General SurgeryDr. Tahir Saleem FRCS DLS IRE Consultant General SurgeryDr. Mohammad Amir FRCS UK, FRSP Pakisatan Consultant General Surgery

IV.1.9 EMPLOYEES AT DENTISTRY SECTION

NAME QUALIFICATION POSITIONDr. Shahid Mehmood BDS Pakistan Consultant Dental surgeryDr. Noeen Arshad BDS Pakistan, MSC UK Consultant Dental surgery

IV.1.10 EMPLOYEES AT ENT SECTION

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NAME QUALIFICATION POSITIONDr. Zafar Iqbal DLO Pakistan Consultant ENTDr. Zaffar Rabbani MCPS, FCPS Pakistan Consultant ENTDr. Zulfiqar Ali FRCS UK Consultant ENT

IV.1.11 EMPLOYEES AT OPHTHALMOLOGY SECTION

NAME QUALIFICATION POSITIONDr. Farooq Afzal FRCS, FRCO UK Consultant OphthalmologyDr. Kamran Hamid FRCS UK Consultant OphthalmologyDr. Zeba Matin FCPS Pakistan, FRCS UK Consultant Ophthalmology

IV.1.12 EMPLOYEES AT UROLOGY SECTION

NAME QUALIFICATION POSITIONDr. Ajaz Sami MD DABO USA Consultant UrologyDr. Saeed Akhtar MD DABO USA Consultant UrologyDr. Mian Khalid Akbar FRCS UK Consultant UrologyDr. Asim Masood Choudry FRCS, D. USA Consultant UrologyDr. Mukhtar Nasir MD DABO FACS USA Consultant UrologyDr. Kamran Majeed FRCS UK Consultant Urology

IV.1.13 EMPLOYEES AT ANESTHESIOLOGY SECTION

NAME QUALIFICATION POSITIONDr. Harris Baig MD DABA USA Consultant AnesthesiologyDr. Mohammad Sami Iqbal MD USA Consultant AnesthesiologyDr. Masooma Syed MD USA Consultant AnesthesiologyDr. Bushra Noman Consultant AnesthesiologyDr. Mohammad Iqbal Memon FCPS Pakistan Consultant AnesthesiologyDr. Rashid Mehmood MD DABA USA Consultant AnesthesiologyDr. Mohammad Asraf FCPS Pakistan Consultant AnesthesiologyDr. Mohammad Nasir Ayub Khan

FCPS Pakistan Consultant Anesthesiology

IV.1.14 EMPLOYEES AT PEDIATRICS SECTION

NAME QUALIFICATION POSITIONDr. Rehana Syed MD USA Consultant PediatricsDr. Ejaz A. Khan MD DAPB USA Consultant Pediatrics Dr. Munir Iqbal Malik MD, DAPB USA Consultant Pediatrics Dr. Iffat Fatima Zaman MD USA Consultant Pediatrics DR. Khawaja Ahmed Abbas DCH FRCP FRCPCH UK Consultant Pediatrics Dr. Musarat Hussain MD DAPB USA Consultant Pediatrics Dr. Kamran Khattak MRCP UK Consultant Pediatrics Dr. Anwar ul Haq FCPS Pakistan Consultant Pediatrics

IV.1.15 EMPLOYEES AT OTHER BRANCHES

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Name PositionSyed Munir Hussain Bukhari GM FinanceMr. Wazir Mohammad Manager Accounts & FinanceMr. Aqeel Mir Associate Manager PurchaseMr. Mohammad Shahid Tanvir Assistant Manager Material

Management Mr. Mohammad Aslam Sr. Manager Patient servicesShahzad Choudry Sr. Manager, Human Recources

& DevelopmentMr. Ahsan Hussain Manager MISMs Nuzhat Sultana Manager NursingMr. Anis Alam GM Allied ServicesMr. A D Zia Manager Food & Nutrition

ServicesMaj. R Qaser Rafiq Manager Bio Medical Services Mr. M Rafiq Choudry Sr. Manager MaintenanceMr. Afzal Ahmed Sr. manager MarketingMr. Azmattullah Qureshi Manager MediaCol. R Saeed Ahmed Associate Manager Security Mr. Amer Farooq Editor Shifa Publications

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IV.2 CHAPTER 7 CUSTOMERS & CLIENTS

Lists of customers of Shifa International Hospital are definitely patients. People having health problems and suffering from any illness are patients. Now there are two Categories of patients. Permanent Patients and short time patients. Short time patients include people suffering from Typhoid, Malaria, Cholera or any dentistry problem. Long term Patients include mothers on family way, Patients suffering from Cancer, Diabetes, Ulcer or High BP. These patients need to go for a check up after certain periods and are placed in the long term period. A person suffering from cancer undergoes many treatments (radiations) and a Diabetic has to check his sugar level after certain time. Kidney Dialysis patients also come in the long term category. They need to under go a dialysis after a certain period of time. Mothers on family way also need to go for a medical check up after several weeks. Patients of plastic surgery might not be the long term patients. They just make it once. Heart patients (Cardiology section) also need to go for a complete check up after some months. These are different categories of patients. There are certain patients who after recovering and discharging, may be prescribed a routine visits, in order to make sure that the relapse does not happen to them

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IV.3 CHAPTER 8 SUPPLIERS

A group of suppliers would include those people who provide services to the Shifa Hospital to run its operations effectively. Since it a big hospital and the no. of suppliers would be a bigger one if mentioned all of them. However some of the suppliers are mentioned:

DESCRIPTION SUPPLIER NAME

A XRAY IMAGING EQUIPMENT

CT Scanner Toshiba JapanLaser Imager Processor Kodak-USAX-Ray Film processors Japan/GermanyUltrasounds Toshiba JapanB CARDIAL EQUIPMENT

Integris SC4000- Digital Angiography Phillips HollandECG & Stress Test USA JapanECHO-Cardiograpghy Toshiba JapanC KIDNEY CARE EQUIPMENT

MFL 5000 Phillips HollandHemoDialysis Equipment Gambro SwedenD OPERATING ROOM EQUIPMENT

Multipurpose Operating Table Siemens GermanyDefiblirator Siemens Elma SwedenServo Ventilator Siemens Elma SwedenHanalus Operating Light System Siemens Elma SwedenOperating Table Siemens Elma SwedenLaparoscopic Equipment Storres GermanyPlastic Surgery Equipment MISCUltrasonic cleaner Siemens GermanySterilizer 666 Siemens Germany

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E RADIATION ENCOLOGY Linera Accelerator Phillips HollandSimulator Toshiba JapanCobalt 60 MDS CanadaF NEUROLOGICAL EQUIPMENT

EEG Toshiba JapanEMG Toshiba JapanG Other EquipmentPulmonary function analyzer Fukuda Denshi Co.Blood Gas Analyzer NOVA USAHematology Analyzer Abbott USALeica Microscope LEICA GermanyVideo Endoscopes for Gastroenterology Olympus

These are the major equipment which helps Shifa People to run their system and impart health care services.

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IV.4 CHAPTER 9 COMPETITORS

We find two competitors of Shifa International Hospital.

IV.4.1 AGA KHAN HOSPITAL KARACHI

IV.4.1.1 SOME GENERAL INFORMATION

This provides high-quality patient care in a broad range of secondary and tertiary care services. This academic medical center’s professional staff and facilities are among the best in the region. Modern patient care is made possible through collaboration between various health professionals and provision of state-of-the-art equipment to support diagnosis and treatment. Care is available to all patients in need.Services & Facilities at Aga Khan

Operating Rooms:

Main: 8 Lithotripsy and Day Care: 4 Obstetrics Labor: 2

Outpatient Services

Emergency Consulting Clinics

Medicine

Allergy Cardiology Dermatology Endocrinology and Diabetes Gastroenterology General Medicine Hematology Infectious Diseases Nephrology Neurology Oncology Pulmonary

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Rheumatology

Surgery

Cardio-Thoracic Dental Ear Nose Throat General Surgery Maxillo-facial Neurosurgery Ophthalmology (Eyes) Orthopedics (Bones) Pediatric Surgery Plastic Surgery Urology including male infertility Vascular Surgery

Pediatrics

Cardiology Gastroenterology General Hematology and Oncology (Blood disease / cancer) Infectious Diseases Nephrology (Kidney) Physiotherapy

Obstetrics/Gynecology and Infertility Psychiatry (Mental Health) Family Medicine Community Health Centre – low cost walk-in clinics

Special Clinics

Anesthesia Breast Screening Cleft Palate Colostomy Dietary/Nutrition ENT Head and Neck Cancer Executive Clinic – annual health screening programme. Family Planning Liposuction Lithotripsy (Stone in Kidneys) Nasal Allergy Physiotherapy

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Speech Therapy Stoma Care Surgical Day Care

Diagnostic Services

Clinical Laboratory Blood Bank and Blood Products Clinical Chemistry Hematology Histopathology Microbiology

IV.4.2 SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTER, LAHORE

Figure 8

Services & FacilitiesMedicine DepartmentThe clinical areas include:

Medicine Surgery Anesthesiology Medicine Pediatric PharmacyRadiation Oncology Nuclear Radiology PathologyNursing

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IV.4.3 FUTURE COMPETITORS

IV.4.3.1 SAHARA FOR LIFE TRUST

Outpatient Department

OPDs

Ø       Internal medicineØ       20 beds Emergency/Trauma centerØ       SurgeryØ       OrthopedicØ       PediatricsØ       Gynecology and obstetricsØ       CardiologyØ       Liver and Kidney clinic

Inpatient Department

Ø       Obs/Gynae WardØ       Male medical wardØ       Female medical -wardØ       Male surgical wardØ       Female surgical wardØ       Pediatrics wardØ       Paeds isolation wardØ       NurseryØ       Dialysis centerØ       Coronary care unitØ       Intensive care unitØ       Operation theatersØ       Labor roomØ Private rooms

Allied Facilities

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Ø 4 state of the art and modern Operation Theatres.Ø Dialysis unitØ Free medicine provided to all the poor and    deserving indoor and outdoor patients.Ø free catering for all indoor patients.

Radiology

Ø       X-rayØ       UltrasoundØ       Color Doppler

Pathology

Ø      24 hours service laboratoryØ      Blood bank facility

Allied Services

Ø      24 hours free ambulance service for poor patientsØ      Laundry, Incinerator, and MortuaryØ      Permanent staff accommodationØ      Help Line managed by duty medical officer to    respond to the queries of the callers. 

IV.4.3.2 QIH’S (QUAID-I-AZAM INTERNTIONAL HOSPITAL)

It is one of the future competitors. It is right now in the process of construction. It is located near Frobles, Peshawar Road, RawalPindi.

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IV.5 CHAPTER 10 GOVERNMENT AGENCIES

The government agencies, with which Shifa operates, are:

IV.5.1 CENTRAL BOARD OF REVENUE

Shifa International Hospital operates under CBR, for paying of its taxes and other bills. The taxes include income taxes, Dispense taxes and other miscleaous taxes. Since, under ordinance Act, some of the taxes are exempted and some have to be paid off.

IV.5.2 CAPITAL DEVELOPMENT AUTHORITY

Shifa is located in H-8/4 Islamabad. It is working on many extension projects like expansion of certain wards and construction of certain departments. All these plans have to be approved by CDA. Right now many under construction projects are:

IV.5.2.1 THE COMPLETED PROJECTS

Floor G-5Under Deck IPD for Social workBlock DBlock E1 Block H1Block H2

IV.5.2.2 THE CONTINUED PROJECTS

Block H3Block H4Block H5Block F2 &3 ( for radiology department)Block D1

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58

Figure 9

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IV.5.3 INCOME TAX IT

It is also an income tax authority with which Shifa operates.

IV.5.4 PAKISTAN MEDICAL & DENTAL ASSOCIATION

The Shifa College of Medicine is recognized by PMDC and it was approved in 2003. The PMDC has the name of Shifa College of medicine in its approved lists of colleges.

IV.5.5 BAHRIA UNIVERSITY, ISLAMABAD

The Shifa College is affiliated with Bahria University for its BDS degree. The final BDS degree is awarded by Bahria University. The University also implements rules and regulations of PMDC to govern the professional MBBS examinations, syllabi and academic standard of the college.

IV.5.6 OTHER PROJECTS OF SHIFA FOUNDATION HOSPITAL

IV.5.6.1 SHIFA COLLEGE OF MEDICINE

IV.5.6.1.1 THE VISION & MISSION

The founders of Shifa college of Medicine opened doors in 1998. It has a mission to graduate doctors by the rule of scientific disciplines and knowledge based profession. Shifa College of medicine is a medical school which strives to be a center of excellence and rigor. It believes in preparing its students for the 21st century.

IV.5.6.1.2 STRUCTURE

The College has faculty heads and is headed by the Dean. It monitors and regulates the clinical activities of the students, compliances with the regulations of Bahria University and PMDC. It provides the best source of training and education. It is recognized by PMDC. It is also included in the world wide directory of WHO. It is also included in IMED (International medical Education Directory) and FAIMER (Foundation for Advancement of International Medical education & Research).

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Figure 10

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IV.5.6.2 SHIFA COLLEGE OF NURSING

It is a project of Shifa Foundation, committed to health education and providing free health care to the needy. SCN is in collaboration with Shifa College of Medicine. The BSCN program is built on the premise that enables the nurse to make critical decisions and providing care to the people. It is following under the rules of PNC (Pakistan Nursing Council). A four year program which helps in basic nursing courses.

Figure 11

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Figure 12

IV.5.6.3 TAMMER MILLAT FOUNDATION

TMF was established in 1987 by a group of USA living Pakistanis. The organization is a registered body. Since TMF is a charity based organization, all decisions related to planning and implementations of projects are taken by Board of Governors. The policy guide lines are also provided by BOG. It has recently launched an education program to help people in getting ideas and its main aim is to educate masses.

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Figure 13

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PART V PROJECT SCHEDULING & MANAGEMENT

V.1 MANAGEMENT ACTIVITES

The management activities included in our project were:

Formation of groupSelection of a team leadProposal writingData gathering Project planning Project costingReport writing and presentations

Activities Time Taken Maximum Time Allotted

Performed By

Formation of Group 1 day NA All of the group members

Team lead selection 1 day NA All group membersProposal writing 1 day NA Sadaf FayyazData gathering 3 days NA Syed Alamdar Hussain

& Malik Waqas AliData Analysis 3 days NA All of the group

members Brainstorming & Group discussion

4 days NA All of the group members

Analysis of core modules 3 days NA Malik Waqas Ali & Sadaf Fayyaz

Report Writing (Documentation)

4 days NA Sadaf Fayyaz

Report Monitoring & Proof Reading

1 day NA Malik Waqas Ali

Presentation 1 day NA All group members

V.2 GANTT CHART OF MANAGEMENT ACTIVITIES

Activities (parallel) Time Taken in Days Performed By

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D1 D2 D3 D4 D5 D6 D7 D8

Group Formation All Group Members

Team Lead selection All Group Members

Proposal Writing Sadaf Fayyaz

Data Gathering Syed Alamdar Hussian & Malik Waqas Ali

Data Analysis All of the group members

Brainstorming & Group Discussion

All of the Group Members

Analysis of Core Modules Malik Waqas Ali & Sadaf Fayyaz

Report Writing (Documentation)

Sadaf Fayyaz

Report Monitoring & Proof Reading

Malik Waqas Ali

Final Presentation and Project Demonstration

All of the group members

APPENDIX A

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APPENDIX B

67

APPENDIX C

68

APPENDIX D

69

APPENDIX E

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APPENDIX F

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REFERENCES

www.globalhealth.org/www.ama-assn.org/ama/pub/category/3345.htmlwww.google.com.pkwww.phrusa.org/Shifa International Annual report, 2005 MUSLIMS, the Voice of Muslims America “Pak Tribune”

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