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HISTORY & BACKGROUND

Over the past decade, Shaukat Khanum Memorial Cancer Hospital and Research Centre has established itself as acentre of excellence providing comprehensive care free of cost to thousands of indigent cancer patients. Thispioneering, state-of-the-art hospital located in the heart of the Punjab was founded by Imran Khan, one of Pakistan'smost illustrious cricketers. As a charitable institute, it is funded predominantly from the donations of friends and well-wishers from around the country and across the world.

Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) is a state-of-the-art cancer centrelocated in Lahore, Pakistan. It is a project of the Shaukat Khanum Memorial Trust, which is a charitable organizationestablished under the Societies Registration Act XXI of 1860 of Pakistan. The institution is the brainchild of Pakistanicricket superstar, Imran Khan. The inspiration came after the death of his mother, Mrs. Shaukat Khanum, from cancer

FAST FACTS ABOUT SHAUKAT KHANAM

Inaugurated December 29, 1994

Founder Imran Khan (Chairman, Board of Governors)Annual budget Rs. 4.7 billion

Financially supported patients 75% (since 1994)

Philanthropic spending Rs. 9.94 billion (US$ 148 million)

Area/Location 20 acres in Lahore, Pakistan

Beds 176

New registrations 9,480 (Year 2011)

Outpatient visits 141,806 (Year 2011)

Chemotherapy 31,367 (Year 2011)Radiation treatments 44,540 (Year 2011)

Admissions 7,618 (Year 2011)

Surgical procedures 6,560 (Year 2011)

Pathology tests 3,251,680 (Year 2011)

Imaging studies 144,216 (Year 2011)

Pharmacy Dispensing 931,848 (Year 2011)

Staff 1,524 (59 Consultants, Physicians & Surgeons)

MISSION STATEMENT

To act as a model institution to alleviate the suffering of patients with cancer through the application of modern



methods of curative and palliative therapy irrespective of their ability to pay, the education of health careprofessionals and the public and perform research into the causes and treatment of cancer.

STRUCTURE OF THE ORGANIZATION:

DEPARTMENTS OF SHAUKAT KHANAM MEMORIAL : there are almost 30different departments of shaukat khanam hospital which includes three divisions

ADMINISTRATIVE DEPARTMENTS CLINICAL SIDE NURSING AND HEALTH CARE

NAME OF DEPARTMENTS ARE :

1. ANCILLARY HEALTH SERVICES2. BASIC SCIENCE LAB

3. BIO MEDICAL ENGEENERING4. BLOOD BANK5. CANCER REGISTERY AND DATA MANAGEMENT DEPARTMENT6. CHEMO THERAPY7. CLINICAL RESEARCH8. CSSD9. EMPLOYEE HEALTH CLINIC10. ENDOSCOPY11. FINANCE DEPARTMENT12. FINANCIAL SUPPORT DEPARTMENT13. FOOD AND DIETARY DEPARTMENT

14. HR DEPARTMENT15. INFECTION CONTROL DEPARTMENT16. MARKETING AND RESOURSE DEVELOPMENT17. MATERAIL MAINTINENCE DEPARTMENT18. NUCLEAR MEDICAL DEPARTMEBT19. MIS DEPARTMENT20. MOLECULAR PATHOLOGY21. OPD22. PATHALOGY23. PALLIATIVE CARE24. PEDIATRIC ONCOLOGY25. PHYSIO THERAPY26. QUALITY ASSURANCE27. RISK MANAGEMENT28. RADIOLOGY29. RADITION ONCOLOGY30. SURGICAL ONCOLOGY



shaukat khanam is having a functional structure with horizantal linkages as the activities of each

department are grouped together by a common function all the human knowledge and skills withrespect to their specific activities is consolidated and there is cordination and communicationamong different departments

as the organization shaukat khanam is a huge organization having a large no. of departments and people employed so for the proper management of their structure they have grouped theirdepartments which have functional structure into three divisions and each divison has a divisionhead

1. administrative departments2. clinical and research side

3. nursing and health care

STRUCTURAL DIMENSION OF THE ORGANIZATION

FORMALIZATION :

the fromalization is high at shaukat khanum due to following

POLICY MANUALS:

Cellular Phones

Please do not use cellular phones in patient care areas. The use of cellular phones in patient careand medical procedure areas can disrupt medical equipment performance. The medical staff can

direct you to public telephones or areas appropriate for usage.

Patient Privacy

Shaukat khanam is committed to protecting your medical information shaukat khanammandated significant changes in the regulations governing the provision of health benefits,delivery and payment of health care services, and security and confidentiality of patient health

information.



Patient Rights

Patients have the right to express concerns or complaints about their care with the assurance thatthe quality of their care or future access to care will not be compromised. You also have the right

to expect a reasonable and timely response to your concerns.

They encourage you to address your concerns immediately to the staff of quality assurancedepartment at the time of service so they can respond quickly to any concerns.

Safety Drills

Safety is a fundamental concern. They participate periodically in fire and emergency drills totest safety equipment and as part of their continuing Safety Education Program for all

employees. If an alarm sounds while you are there they advise you to stay calm and follow theinstructions of the staff. they will take care of everything

Smoking

Hospital patients who smoke will receive nicotine replacement therapy and counseling by theirsmoking cessation team.

Performance Improvement policy1) Clinical and administrative staffs monitor and evaluate the quality of patient care andclinical performance, including proactive risk assessment of selected high-risk processes.

Assess the intended and actual implementation of the process to identify variations orpotential “failure modes”, and report information to the Clinical Board for action. Hospital PolicyManual Policy Number: 1.1.1 Effective Date: 4/01/11 22) Communication of identified failure modes and potential impact on patient care/safetyamong departments/services when opportunities for improvement are multidisciplinary.

3) Identified problems are tracked to assure improvement or resolution through redesign ofthe process.

4) Information from Departments/Services related to tested and implemented processfindings of discrete performance improvement activities are used to detect trends,opportunities to improve, or potential problems.

5) The objectives, scope, organization, and effectiveness of the redesigned processes areevaluated annually and revised as necessary to ensure effectiveness is maintained overtime.

Visitation policy .:



1.Visitation hours for general care units are from 6:00 a.m. to 9:00 p.m. daily. Visitationtimes for Special Care Units (ECC, OB/Peds, Critical Care and Psychiatry) are determinedby each individual special care unit.

2.Only one approved person per patient may remain overnight on the General Care Unitafter 9:00 p.m. Overnight visitors a re not allowed on Women’s Health (fourth floor) unlessthere are extenuating circumstances, in which case visitation will be approved on anindividual bases. All persons staying overnight with a patient after 9:00 p.m. or before 6:00a.m. must be registered at the Information Desk located in the first floor front lobby. Avisitor’s pass, specifying the nursing unit and date, shall be issued for one night only by thePatient Information Desk attendant who will instruct the visitor to remain on the assignedunit, and to wear the pass on the chest area where it is clearly visible at all times.

3.Children (under the age of 16) visiting patient care areas must be accompanied by anadult at all times. Children will not be allowed to stay overnight on a patient care unit or

waiting area. Visitation by children may be restricted dependent upon the patient’s

Consultation policy :

Policy:1. A request for a consultation shall be noted in the physician’s orders or the progress

notes.

2. The consultation request form shall be completed by the requesting physician andplaced on the patient’s medical record. The form should indicate the current date, time,reason for consultation, requesting physician’s signature, printed name, hospital service,and beeper number. A copy of the ED record will be placed in the chart with the writtenconsult.

1. The physician (or designee) requesting an ED or inpatient consult shall contact theservice to be consulted by telephone through the Hospital paging system.

a. Routine inpatient consults should be answered within 24 hours. Routine outpatientconsultations shall be answered within the time frame requested. All requests for consultsshall be immediately communicated, other than those for routine clinic appointments andaccompanied by a legible written consultation request form. Consult forms are never to be

sent via campus mail; consults are delivered by hospital staff to the appropriatearea/department.

b. Emergency or stat consultations shall be requested only when there is an emergency orurgent need for the consultation. The consultation form will remain on the chart. Thephysician will notify the Clinical Service directly of the need for the consultation, giving thepatient’s name and location.



JOB DESCRIPTION OF VARIOUS EMPLOYEES :

when there is some vacancy avialable in shaukat khanam ,first the job description of the post orvacancy is prepared accordding to the nature and requirements of the job ,the hiring request isthen sent to the hr departme nt which places the ad’s in the newspaper and online. job descriptionof each department is designed by the top manager of each department and then it is signed bythe divisional head.

RULES AND PROCEDURES : the rules and regulations are in the written form and they aredifferent for each department . these rules and regulations are standardized and they are made by

the top mangaers of the respective departments which are signed by the divisional head and thenCEO

SPECIALIZATION:

they have three divisions of their departments at the clinical and research division and thenursing and health care division departments specialization of the jobs is high because they

perform only a narrow range of tasks because they perform which are sensitive and related tohealth matters, whereas in the administration division the specialization is low as employees can

perform a wide range of tasks in their jobs

STANDARDIZATION:

Standardization at the organization is high as most of the departments perform similar day to dayactivities according to the standards that are defined

HIERARCHY OF AUTHORITY: the hierarchy is related to the span of control or the no ofemployees reporting to the supervisor . At shaukat khanam span of control is narrow so hierarchytends to be tall

HIERARCHY OF NURSING DIVISION:



OR

HEIRARCHY OF CLINICAL DIVISION:

Hierarchy of administration division:

manager

Dark blue

uniforms

(ICU staff)

Brown uniform

(porters of clinical

work)

White uniform

(nurses)

Green uniform

(OT staff)

Blue cheque

uniform

(health careassistants)

Trainee

Head of deartment

fellows

residents

Clerical staff

Top managers



CONCENTRATION OF POWER:

it is not the vertical structured organization where the control is centralized with th e top managers but

the control is decentralized where the decision making can be made by lower level staff also.

COMPLEXITY :

Complexity at shaukat khanam is low or we can say that it is at a moderate positionbecause there are almost 30 departments and each department is performing their ownspecific tasks and activities ,,there are no sub departments and sub activities ,since theyhave a decentralized concentration of power which executes a flexible structure and opencommunication of inter departments .

Ceo

Divisional head clinical top manger supervisor lowerlevel staff

Divisional head nursing

Divisional head administration

PROFESSIONALISM: as professionalismm is generally measured, the average no. of years ofeducation of employes, employees at shaukat khanam have proper formal education accordding to their

jobs , usually doctors,consultants researchers and clinical staff people have average 16 years ofeducation and more ,the administrative staff have 12 to 14 years of formal education and lower levelstaff have average 12 years of formal education ,so we can say that professionalism is high at shaukatkhanam. Shaukat khanam provides ON THE JOB TRAINING for 3 to 6 weeks (depending upon the natureof the job ) that is mandatory for every employee on the very first day of the job there is a detailedorientation about the job and about the working and rules of shaukat khanam . Even after the formaleducation they provide this mandatory training and they focus on the communication and behavior ofthe staff and lower level employes alot.

Deputy managers

supervisors

General staff



PERSONNEL CONFIGURATION: total no of employees at shaukat khanam are about 1500 to1600. The nursing divison is mostly employeed with 600 employees and all the employees are deployedto the various departments according to the functions they have to perform .

GOALS STRATEGIES AND EFFECTIVENESS

OFFICIAL GOALS :

long run goal or mission statement of shaukat khanam is as follows

To act as a model institution to alleviate the suffering of patients with cancer through the application of modernmethods of curative and palliative therapy irrespective of their ability to pay, the education of health care Shaukatkhanam professionals and the public and perform research into the causes and treatment of cancer.

OPERATIVE GOALS :

Resource based goals : Market based goals : Employee development : Innovation and change : Productivity:

ORGANIZATIONAL SIZE LIFE CYCLE AND CONTROLShaukat khanam is at FORMALIZATION STAGE



because they involve the installation and use of rules,procedures and control systems ,communication becomes lessfrequent and more formal .Top mangment is concerned with making and planning strategies and they left theoperations of the firms to the middle management .Their groups and decentralized units are formed to improvecoordination .They provide incentives to the doctors and staff to get them attracted towards to the hospital and to takedecesions which are best for the overall hospital .This coordination and control system enabled shaukat khanam tocontinue to grow .

MANAGEMENT CONTROL SYSTEMS

Even though many organizations are trying to decrease bureaucracy and used rules and procedures that constraintemployees every organization needs systems for guiding and controlling organization. Employees may have morefreedom in todays companys but control is still a major responsibility

Shaukat khanam out of the three control strategies uses BUREACRATIC CONTROL as their rules and policies areproperly defined and they are standardized .The hierarchy of authority is clear and they are using this mechanism tostandardize and control behavior of their employees and asses their performance .

ORGANIZATION DESIGN & CULTURE :

Shaukat khanam has a MISSION CULTURE as the organization is concerned with serving the cancer patients in theexternal environment irrespective of their ability to pay , so they have too constantly interact with the externalenvironment to raise funds for the organization. Shuakt khanam emphasize on a clear vision of its purpose and onachievement of goals . In shaukat khanam individual employee is responsible for specified level of performance .Shuakat khanam promises specified rewards for group performance i.e

Medical cover for immediate family is free Gym service ,different sports tournament and employee night (a dinner of all shaukat khanam employees

with their families ) 13 salaries ( 12 salaries,1 bonus + 12 holidays ) Salary is incremented every year

ETHICAL VALUES IN ORGANIZATION :

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