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Study the home health care service
provided by the hospital and
develop a business model plan
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Home healthcare-an overview
• Number of people over 60 years is set to double by 2050
(WHO-International day of older persons)- 1st October.
• Based on World Health Report on Ageing & Health 2015 –
Govt must ensure policies that enable older people to
continue participating in society.
FUTURE SCOPE
• 177 million elderly people in our country by the year 2025 &
343 million by 2050- UN Population Division (UN 2011).
HOME HEALTH CARE AT GODREJ MEMORIAL HOSPITAL
• Service started – 2006.
• In starting phase – doctor’s & physiotherapist’s visit at home.
• At present -blood sample collection, physiotherapy, nursing
care, nursing aide, doctor’s visit.
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Introduction
Home health is a wide range of health care services
that can be given at home for an illness or injury .SCOPE OF SERVICE
Elderly care
Wound care for pressure sores
Monitor serious illness
Suture removal and drain care
New born and maternal care
Post surgical care and care for chronically ill patients
Equipment provision(rental or purchase) for patient
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Objectives
Work flow analysis of current home health
Find, compare and analyse the expectations versusexperience of service seekers
Find issues in present service
Recommend hospital business plan
METHODOLOGY-QUANTITATIVE STUDY
Data collection- feb to july’2015, to analyse product
outreach ,demand of service and age distribution . Survey of 20 patients- for feedback.
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OUTREACH OF SERVICES wrt HOSPITAL
0
10
20
30
40
50
60
70
80
90
100
vikhroli ghatkopar kanjurmarg bhandup
feb'2015
march'2015
april'2015
may'2015
june'2015
july'2015
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PERCENTAGE DEMAND- FOR DIFF SERVICES
0
10
2030
40
50
60
70
Feb'2015
March'2015
April'2015
May'2015
June'2015
July'2015
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Service demand segregated into age of patients
0
10
20
30
40
50
60
70
80
90
feb'15 march'15 april'15 may'15 june'15 july'15
less than 40 yrs
40-60 years
more than 60 years
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Process mapping
• Doctor’svisit, nursing, physiotherapy,nursing aide, pathology
• Call from reception is forwarded
Raising of request forservice
Enquiry & Counseling
• Log book maintained• Time of incoming call, location, service
required noted
Enrolment by staff
• Blood sample collection & report dispatch
• Physiotherapy at home
• Emergency ambulance service
Delivery of service
Payment is received
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Composition of home health team visiting
patients
0
10
20
30
40
50
60
70
80
90
100
Doctor/Physiotherapist Nurse Nursing aide
no
yes
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Customer feedback about home health team
0
2
4
6
8
10
12
14
16
18
20
keep updated
during arrival
listen carefully behave properly courteous&polite
never
sometimes
usually
always
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Customer experience about the home care
service
0 5 10 15 20 25
good experience
satisfied
faced problem
will recommend further
no
yes
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Issues
Service provider team is small
Doctor busy – emergency cases
No team leaders
Ambulance is used
No facility for night service
Inadequate branding
No advertising or marketing for servicepromotion
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Business model planMarketing & Business
Assessment
o market survey, analysis &market segmentation.
o demand analysis
Clinical services planning o full service healthcare provider
o commitment to employee quality
o Clinical development centers
Equipment planning &
review
o multipurpose utility products
Manpower planning o analyze current manpower inventory
o
making future manpower forecasts
Financial modeling o financial analysis
o technical requirements
o safety measures, guidelines & SOPs
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Multipurpose equipment model
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OT Costing• 4 operation theatres.
•
Timing = 9 hours (8 am – 5 pm) + Emergency.• Staffing = 12 Nurses, 2 OT Technicians, 4 CSSD, 4 Boys (HKS).
OBJECTIVES
• Calculate OT cost per minute and utilization percent of all 4 OTs
• Collect data of laparoscopic surgeries performed over past one year.
• Categorize the operative time of lap surgeries.
• Standardize the operative time in order to benchmark time which should
be taken by surgeons during uncomplicated small incision laparoscopic
surgeries.• Calculate average cost of laparoscopic surgery.
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OT Cost per minuteFixed cost Variable cost
Cost related data
Salary staff = 238798 Salary Surgeons= 700000
OT Tech = 38529
CSSD Staff = 65928 1077255
HK Staff = 34000
377255
Activities related dataDirect cost Indirect cost
Consumables = 1235485 4576485 Electricity expense= 300000
Equipment dep = 3000000 Water tax = 16000
Notional OT Rent = 25000 5653740 316000
4260485Total case minutes= 306.20 x 60 = 18372 minutes
OT Cost per min = Total allocated expense to OT/ Total case minutes
5653740/18372=307.73 ( Rs 308 approx)
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OT Utilization review for July’2015
Total working hours = 27 days x 9 hours per day = 243 hours (b)
OT Number Procedure hours (a) Utilization Rate = (a) /
(b)
OT 1 114 46.91 %
OT 2 132.20 54.40 %
OT 3 30 12.35 %
OT 4 30 12.35 %
Average cost of lap surgery= avg OT time for lap surg x OT cost per minute
75 x 308 = Rs 23100 per laparoscopicsurgery
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Distribution of lap surgeries
0 1 2 3 4 5 6
September'14
October'14November'14
December'14
January'15
February'15
March'15April'15
May'15
June'15
July'15
August'15
Ing hernia
Lap app
Lap chol
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Financial impact of calculating OT cost per min
• It is estimated differently
• Reducing turn over time and
• Improving scheduling process may allow
hospital to regularly schedule additionalshort cases or day care surgeries without
adding staff. By routinely adding a one
hour case everyday a hospital canincrease its margin to a great extent.
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Recommendations for Fertility centre
Day care services
Complete infertility evaluation
Intrauterine insemination (IUI)
In vitro fertilisation
- Intracytoplasmic sperm injection (ICSI)
- Oocyte & Embryo donation , Assisted hatching- Sperm, Ovum & Embryo freezing(Vitrification)
Percutaneous Epididymal Sperm Aspiration (PESA)
Testicular sperm aspiration(TESA)
Endometrial Receptivity Array (ERA)- Diagnostic
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