Hospital

(1)

PROJECT REPORT

NEW ERA PATIENT-FRIENDLY

HOSPITAL PRIVATE LIMITED

SHUKUL BAZAR, SULTANPUR,

UTTAR PRADESH, INDIA

Bejon Misra, Managing Director

[email protected]

&

Dr. Bidhan Das, Consultant

MBBS, MHA (AIIMS)

(2)

1. Layout Map of the Facility (Annexure-1) 38 2. List of Equipment and Furniture (Annexure-2) 42 3. List of Drugs (Annexure-3) 50 4. Universal Precautions (Annexure-4) 62 5. Charter of Patient’s Rights as a Consumer (Annexure-5) 64 6. Financial Details (Annexure-6) 66 7. Geographical Map of the Location (Annexure-7) 86 8. Micro Health Insurance 88

(3)

E

XECUTIVE

S

UMMARY

It is rightly said that India lives in its villages. About 78% of the population of the country lives in rural India.

The country has the dubious distinction of being the 2nd largest populous country in the world. The flip side is that in spite of being a vast country having a huge population of 108 crores the health status of the country is very poor.

As evidenced by the World Health Report, the health indicators are far inferior to its neighboring developing countries. Health being a state subject the government has a very well structured public health system.

The three tier level of health-care organization with the root at the level of primary health centers going through CHCs, DHs and tertiary centers like medical colleges and centers of excellence like AIIMS, PGI etc.

In spite of all this, the reach and acceptance of the facilities particularly in the PHCs and CHCs is very poor.

(4)

Several studies have revealed that the community prefers to go to a private provider and pay out of pocket rather than going to a public facility even though it is free. This is evidenced by the fact that the GDP on account of health is 5.2%. out of which the share of the Government is only 1.8% and the rest is from the private providers.

Health care in India is a sunrise sector and the country is witnessing a mushrooming of corporate hospitals being ironically concentrated at the Metropolitan cities with a focus on the international health business. At the end the rural sector is left untouched even if the population is ready to pay.

Govt. has taken a revolutionary step in the form of National Rural Health Mission (NRHM) and furthered it by laying standards for the same in the form of IPHS 2006. The results of this program are to be seen in the years to come.

The basic issue is to regain the trust of the community on the public health facilities.

The areas of concern in order to achieve the trust is - Accessibility

- Availability - Affordability - Affability

(5)

I

MPLEMENTING

A

GENCY

:

N

EW

E

RA

P

ATIENT

-F

RIENDLY

H

OSPITAL

P

RIVATE

L

IMITED

OBJECTIVES:

To develop and implement state-of-art health delivery system for providing quality healthcare facilities at an affordable price for all.

To conduct research and development studies for bringing policy changes in the healthcare delivery system globally especially in developing countries for the poor and disadvantaged consumers.

To educate consumers and make them aware on their rights and provide informed choice in an effective and efficient manner.

New Era Patient-Friendly Hospital Private Limited has ventured into this area so as to create a model incorporating all the features stated in the NRHM, National Population – Policy and IPHS 2006.

Located in rural surrounding the place is 70 km off Lucknow in the State of Utter Pradesh (INDIA) and close to Jagdishpur Industrial Area on the Lucknow to Sultanpur Highway in a village called Pureshuklan in Shukul Ka Bazar Block, district Sultanpur.

This initiative will function as a private ‘for profit’ model. The aim is to emulate and replicate this model to other parts of the country particularly in the

(6)

economically back ward states and in turn help the Government to implement the NRHM in the real sense of the term.

The facility has been planned and designed as per BIS standards for 30 bedded hospital as well as IPHS 2006.

It has 30 beds with basic broad specialties, supplemented with diagnostic services including an ultrasound, ICU and an operating room.

The structural standards have been met with, the process and outcome standards are being worked upon so as to enable the hospital to be accredited by the National Accreditation Board for Hospital and health care providers in the days to come.

The concept of Public Private Partnership can very well be applied to this model. The facility is geared up to handle and support all national health programs, Counseling services, NGO participation, PRI involvement, preventive health, IEC services, Sanitation, Hygiene and safe water supply to the community apart from patient/consumer education and awareness on rights and responsibilities.

The rights of patients and staff are to be respected and the approach will be market/consumer driven. Governance of the facility will be professionally managed.

(7)

P

REAMBLE

This report has been prepared to formulate the project “commissioning of the New Era Patient-Friendly Hospital Private Limited at “Pureshuklan” (Post Office Shukul Bazaar), District Sultanpur in the State of Uttar Pradesh in INDIA.

The report is based on the discussion and data generated, from various meeting held with the promoters of the project, who are members of the Governing Board and visits to the sights. Data is also collected for the disease pattern, incidence of various diseases and other relevant social, cultural and health status indicators. All the data has been qualified to accommodate the functional requirements of various departments in this hospital.

The Departmentation plan as listed has been discussed and approved. The hospital activity has been adopted to be of primary to secondary level of health care, so as to be in the linen of NRHM and Millennium Development goals (MDG). The provision in this report has been made for specific purpose of conceptual proposal and designing of the hospital. In this report, due consideration has been given to under stand the market needs of the locality, research has been conducted for various national health programs, national health policy, NRHM, world health report, IPHS 2006, and BIS standards for 30 bedded hospital.

New Delhi

Dated : 30 August 2006 Bejon Misra & Dr. Bidhan Das

(8)

I

NTRODUCTION

Pursuant to the executive summary in the report it has very adequately been emphasized that the need for a model rural hospital meeting all possible standards to a reasonable extent be created in order to provide quality health care at the most affordable cost. However, needless to say that the infrastructure so created shall be easily replicated all over the country and other developing countries so as to bring good quality health care to the door step of the community and in turn progress towards HEALTH FOR ALL and achieving the MDGs.

In order to meet this demand for comprehensive health care services this model hospital has been named as “New Era Patient-Friendly Hospital Private Limited” hospital. The hospital shall not only provide and supplement the much needed beds in this segment but also augment the emergency health care services and prove to the world that quality health care services can be provided at a very low capital cost. It will further demonstrate how this model can be financially viable and sustainable. The hospital addresses the unmet needs of the community as consumers and therefore empowers them with their right to health and availability of services for the money paid, so as to appreciate the value for money. The proposed hospital shall provide a comprehensive medical, surgical, obstetrics, pediatrics, orthopedics, eye & ENT, Ayurveda, Homeopathy as well as

(9)

all the needed support services. Most importantly it will be functional 24/7 all through out the year so as to make available emergency medical care round the clock at a very reasonable cost which the community can afford.

The Mission of the Hospital

“To provide quality health care accessible and affordable to all round the clock”.

Proposal

To commission this multi specialty hospital so as to provide comprehensive medical, surgical, obstetrics, pediatrics, orthopedic, eye & ENT, Ayurveda, Homeopathy care as a not for profit venture but a self sustaining model. The hospital shall be linked with telemedicine to designated centers of excellence in the country and coupled with a micro insurance model for the community to pay for their health care needs.

The services provided will be at a very nominal and affordable price. However, for the underprivileged group a self-financing scheme based on a co-operative model will be created.

(10)

Objectives

1. To ensure availability of comprehensive quality health care accessible to all without any discrimination or bias.

2. To provide the services round the clock 24/7.

3. To enable access of the services to the community at an affordable price.

4. To run the facility in a transparent manner so as to create an environment of empowerment and ownership of the community.

5. To provide value for money to the consumers of health care. 6. To act as a role model for others to emulate.

(11)

N

AME OF THE

H

OSPITAL

NEW ERA PATIENT-FRIENDLY

HOSPITAL PRIVATE LIMITED

“Demand Quality Health Care”

Location: Pureshuklan, District Sultanpur, U.P. India

Size of the Hospital

30 bedded in patient unit with suitable component of out patient unit, Emergency Department, ICU, OT, and needed support services.

Organisation Owning the Hospital

New Era Patient-Friendly Hospital Private Limited

The Registered office: National Capital Territory of Delhi. Date of Commencement of Business of the Hospital

(12)

Governing Board of the Hospital

1. Dr. Mahendra Pratap Narain Pande, D.O. (Lon) Chairman

2. Mr. Bejon Misra

S/o Late Satyendra Nath Misra

W018, Regency Park II, DLF Phase IV, Gurgaon (Professional)

3. Mr. Rajeev Misra S/o Late Mahesh Misra

C-20, Defence Colony, New Delhi – 110024 (Professional)

4. Dr. Mahendra Jeet Sharma S/o Late Sh. Gopi Nath Sharma 572/1B, Civil Lines, MGS Gate, Sultanpur – 22804

Uttar Pradesh

5. Mr. Trtirunillai Krishanan Govindan S/o Late Sh. T.D. Krishan (Retired) 90C, Pocket L, Mayur Vihar Phase I, Delhi – 110091

(13)

T

ECHNICAL

A

NALYSIS

Located in village for Pureshuklan, surrounded by many mango groves and farmland. The building is well ventilated and certain portions are air-conditioned. There is adequate access from the main road on two sides. Approach road is wide enough for cars, jeeps, vans, Lorries and other means of transport.

The building plan has been considered keeping the location and socio cultural habits of the community. It is a two storied building having ramps so as to transport immobile patients to the first floor. The hospital will have an advanced pathology lab based on semi automation, a good imaging department; emergency services round the clock, an operating room and an ICU to provide critical care and life stabilization care for all cases.

Equipped with an ambulance it can provide safe transportation of both stable and unstable patients to the designated referral hospitals. The nearest tertiary care hospital is SGPI, Lucknow and KGMC, Lucknow which are approximately 70 kms away with a driving time of 1 ½ hours. It has been envisaged to contain the cost of health care to bring it within the reach of the population who at present are not able to afford the cost of health care.

(14)

In addition, we bring out the following points for consideration. General

1. For selected specialties as stated above the hospital shall provide all needed services.

2. For all other specialties it shall provide only essential services to preserve life and stabilize the patient’s condition and evacuate the patient to an alternative health care facility.

3. The hospital shall maintain its accounts in a very transparent manner, and make it public.

4. It will accept grants/donations from all concerned and submit the income/expense statement to the funding organization.

5. Being governed by a collaborative approach it will take the mandates of the stakeholders in the business in to consideration.

Degree of Specialization

1. The hospital shall provide primary as well as secondary level care including the preventive, promotive, curative and rehabilitative services within the ambit of its capacity.

2. The hospital has made provisions for future expansion for size and adding on departments if need be.

3. It will provide comprehensive intensive care for all types of medical and surgical cases.

(15)

4. The hospital shall be equipped to provide expert first aid and all services for resuscitation and preservation of life.

5. It will provide a basic casualty unit, a comprehensive critical and intensive care unit providing ventilator support, shock therapy, and backup support for all there services.

6. The various activities as listed above shall be supported by the following clinical support services.

a. 1 operating room / labor room b. 1 four bedded ICU

c. Imaging department with 1 portable X-ray machine 1 fixed X-ray machine 1 ultrasound machine 1 theatre sterile supply unit d. Laboratory services

7. The hospital will have an out sourced laundry service to provide clean linen. The sterilization of requisite linen shall be carried out in-house. 8. The hospital will also have an organized catering service to provide

regular and therapeutic diets.

9. The hospital shall have relationship with more than 1 hospital at Sultanpur, Barabanki and Lucknow for casualty evacuation, specialized investigation and other services not available in-house.

(16)

C

ATCHMENT

A

REA

a. Shukla Bazar b. Jagdishpur c. Odoria d. Dadera e. Munimpur f. Nindura g. Banikader h. Fatehpur i. Haidergarh j. Mawai k. Puredalai l. Ram Nagar m. Rudauli n. Siddhaur o. Sirauli Gauspur p. Suratganj q. Trivediganj r. Sultanpur s. Baba Ka Bazar t. Suleha

(17)

u. Inhauna v. Rae Bareli w. Rani Ganj x. Rudauli y. Faizabad z. Barabanki

The hospital will be geared up to cater to the requirement of the population within a radius of 10 kms from the site.

Work Load

The proposed hospital shall attract adequate number of patients from the neighboring blocks. Once stabilised it shall also attract patients from neighboring district.

Population of attachment area - 500,000

Sex ratio - 933 females/1000 males Growth Rate - 1.46% per year

Broad Age Distribution of Population Below 15 - 39.77% 15 – 59 - 53.56% Above 59 - 6.67%

(18)

Health Indicators

Birth Rate - 25.8% / 1000/year Death Rate - 8.5% /1000/year General fertility rate - 103.2% /1000/year Infant Mortality Rate - 710% /1000/year

Expectancy of life at birth - 66.04% year (64.8 for all India) Proportion of workers to

total population - 34.18% (51.00% for males only) General morbidity rate - 81.0% once a year

Accident/emergency rate - 7.5% year

Hospital occupancy rate - 18.0% year of population day

Facilities Available

There are primary health centers, community health centers, sub-centers, FRUs along with district hospital in the catchment area. However, the consumers are not happy with the services provided by them and avail their health care services from private providers as evidenced by several studies.

There are certain private providers along with Ayurveda and Homeopathy practitioners but none of them provide the comprehensive range of services. Hence this effort of providing all services under one roof is envisaged.

(19)

Disease Profile

Uttar Pradesh Male Female 1. Infectious & Parasitic Diseases 16.6 14.3

2. Neoplasms 3.0 3.5

3. Endocrine, Nutritional, Metabolic 3.0 3.3 Diseases & Immunity Disorders

4. Diseases of Blood & Blood 2.0 2.8 Forming Organs

5. Mental Disorders 0.1 0.1 6. Diseases of the Nervous System 3.1 3.2

& Sense Organs

7. Diseases of the Circulatory System 23.0 20.8 8. Diseases of the Respiratory System 7.2 7.0 9. Diseases of the Digestive System 5.6 3.5 10. Diseases of the Genito-urinary System 1.6 1.4 11. Complications of Pregnancy 0.0 2.1 12. Diseases of the Skin & Subcutaneous Tissues 0.2 0.2 13. Diseases of the Musculoskeletal System 0.1 0.1

& Connective Tissues

14. Congenital Anomalies 0.5 0.7 15. Certain Conditions Originating in 8.6 9.1

Perinatal Period

16. Symptoms, Signs and ill Defined Conditions 13.9 14.8 17. Injury and Poisoning 11.5 13.1

(20)

The data used has been taken from Health Information of India 2001. Published in June 2003 by Central Bureau of Health Intelligence, Min. of Health and Family Welfare, Govt. of India or the previous edition.

JUSTIFICATION

According to the World Health Report 2000 — “while private health expenses in industrial countries now average only some 25 percent because of universal health coverage (except in the United States, where it is 56%), in India, families typically pay 80 percent of their health care costs as "out-of- pocket" expenses when they receive health care”.

The above table gives an idea about the household spending or out of pocket expenses in India as per source mentioned in the table.

(21)

The above table reveals that in spite of the huge Government infrastructure in terms of health care in rural areas it has failed to meet the requirements of rural masses.

This table clearly reveals that the private providers in health care capture a larger market share of the health care business in our country.

(22)

This table elaborates clearly that the private practition ers and smaller nursing homes capture a larger share of the rural health care market. The figure explains the reasons for preferring private providers vis-à-vis govern-ment providers

(23)

It has been made very clear by several studies including the above that majority of the health care providers in rural India have less than 30 beds.

Studies further reveal that the private for profit hospitals capture most of the private health care market.

(24)

The above table elaborates that hospitals in rural areas should have met minimum standards laid down by NABH.

(25)

Projected Work Load of the Hospital

For the population base growing at rate of 1.5% approximately per annum and hospital beds growing at the rate of 10% per annum.

OPD

From the catchment area - 23,250 per year Referral Cases - 9,200 per year Emergency - 1% of total OPD –

325 patients per year Say 1 patient per day In Patients

Average length of stay - 5 days

15% of OPD Patients visits x 5 days (average length of stay = 17,520 patients bed days per year)

Hence total number of bed required will be 47.

All the processes will be very structured so as to bring down the average length of stay to 3-4 days. Therefore a bed strength of 30 will be sufficient.

Details of Site

Location : Pureshuklan Size of the Plot : 12,000 sq. ft. Specific use of Land : Hospital Permissible floor space index : 30%

(26)

Building Height : 8 meters Road Access : Available Public Transport Service : Available Electric Supply : Available Water Supply : Available

Sewage Treatment : Will be met with

Refuse Disposal : Will be out sourced & Treated by Deep Burial

(27)

P

HYSICAL

F

ACILITY

(All Data are derived from BIS Standards for 30 bedded Hospital, IPHS 2006) Area

a. Total built up area 8,000 sq. ft. b. Area of ground floor 4,000 sq. ft. c. Area of First Floor 4,000 sq. ft. Building Height - 8 meters

Hospital Engineering Services

a. Load of Electricity - 25 KVA b. Generator - 10 KVA

c. UPS – 3 KVA

d. Electrical Distribution box and panels Fire Fighting System - Yes

Solar Heating System - Planned

Telecommunicating System

- EPBAX having 3 incoming and 10 out going Nurse call system - Yes

Computers - HIS

(28)

H

EALTH

C

ARE

P

LAN

Objective

It is proposed that the hospital positions it self as a center of excellence, providing health care services to the targeted community and the following services to capture the market in the society.

a. Pre-marital counseling

b. Registration of young couples c. Marriage counseling

d. Sex education

e. Ante-natal checking of expecting mothers f. Natal services for mother and child

g. Post natal monitoring of mother and child upto 3 years including immunization, child’s growth monitoring and support for birth of the sibling

h. Care of child in pre-school and school i. Child counseling

j. Tobacco cessation campaign k. School health

l. First AID and emergency services

m. Continuing health education to the community n. Evacuation of patients to tertiary facilities

(29)

o. Specialty clinics p. Telemedicine facility

q. To co-ordinate with the district health and family welfare department in implementing all national health programmes in the region.

r. Comprehensive medical records keeping

s. Co-operative based micro health insurance scheme t. Health Check package

u. Preventive health v. Health education

(30)

F

UNCTIONAL

P

LAN AND

P

ROGRAMS

1. The hospital shall provide its services on a fee for service basis to all. However, due consideration will be given to the socio economic status of the community.

2. Capital cost of plan and building is Rs. 42 lakhs.

3. Projected cost of medical equipments and building utility equipments will be around Rs. 72 lakhs.

4. The hospital will be self-sustaining financially.

5. The calculations of occupancy rate and break even are enclosed. 6. Depreciations as applicable are adapted.

7. Technology up gradations will be supported by donations

8. Hospital tariff will be so structured that it provides sustainability along with maintenance of the building, and equipments.

9. Hospital accounts shall be computerized and all taxes shall be accounted for.

10. The medical superintendent will be the designated authority for authorizing any incidental expenditure and shall maintained an account for the same.

(31)

12. Patients shall sign the respective general and informed consent form.

13. Operations of the hospital will be carried out according to the laws of the land.

14. The hospital shall provide services as per the following timetable.

IPD

Ward Rounds Morning 9 1.m. – 12 noon, 7 days a week Evening 7 p.m. – 9 p.m. 7 days a week

Urgent Consultations On call from the ward sister, 24 hours, Round the year

Cross Consultations Routine Morning: 9 a.m. – 12 p.m., 7 days a week

Urgent On call from the ward sister, 24 hours, Round the year

Diagnostic Services Routine Morning: 8 a.m. – 11 a.m., 7 days a week

All Nursing Procedures, as required, shall be provided as per the ward schedule.

Therapeutic Services (Other than Nursing Procedures)

Routine Afternoon: 2 p.m. – 5 p.m., 7 days a week

Discharge Routine To be initiated during the ward rounds and all formalities to be completed and patient discharged by Noon of same day or next day.

Urgent On call from the ward sister, 24 hours, Round the year.

(32)

OPD

Routine Consultations

12 hours per day, 6 days a week Special

Clinics

3 – 4 hours in the afternoon hours, after notified lunch interval, 4 days a week, in Hospital OPD.

Emergency Services

To be provided 24 hours, Round the year, and will include all other hospital services that are needed including emergency surgery.

Surgical Suit Services

Elective Surgery, Surgical Suit,

As per schedule of the surgical suit, 6 days a week after finishing the OT list on 6th, once a week.

Maintenance Special Dressings

After Notified lunch interval, 6 days a week

Imaging Services

Registration of cases

4-6 hours in the morning hours, upto notified lunch interval, 6 days a week Examination

– IPD cases

8-11 a.m. 6 days a week

- OPD Cases 9 a.m. upto notified lunch interval, 6 days a week.

After notified Lunch Interval, 5 days a week

Delivery of Reports

(33)

Laboratory Services

Registration of cases

4-6 hours in the morning hours, upto notified Lunch Interval, 6 days a week Collection of

Samples

4-6 hours in the morning hours, upto notified lunch interval, 6 days a week. For special clinics: 4 days a week in the clinics.

Delivery of Reports

All Stat tests, as soon as possible. For all other tests, results shall be posted to requesting location .

Hard copies shall be delivered in the notified schedule, 6 days a week. Ancillary Therapies

Routine As per schedule of the respective department, 6 days a week

Special procedures

On call from the ward sister, 24 hours, Round the year.

15. There shall be a proper admission and discharge procedure. 16. Patient has to pay for all the medication and surgical supplies. 17. Money to be collected at a central billing and reception area. 18. A discharge summary will be given to all the discharge patients. 19. Fire and emergency drills to be carried out regularly.

20. Casualty Medical Officer shall control the ambulance services 21. Staff in the hospital to be provided health care facilities

according to the policies.

22. Laundry services to be out sourced.

23. Flow diagrams to be displayed at all areas.

(34)

25. Medical Superintendent shall conduct periodic staff meetings. 26. All major hospital routines to be documented.

27. The governing board shall designate by a written resolution authorizing the medical superintendent to give concessions to patients as an when required.

28. Medical consultants will be on free for service basis.

29. A token amount of 10% from their fees will be deducted as hospitals share.

30. Free treatment could be given to the underprivileged sections of the society.

OPD

a. OPD consulting room shall be utilized on a three hours slot basis in four shifts in two chambers from 8 a.m. to 8 p.m.

b. Female ayahs to be deployed in the OPD. c. Citizens’ charters to be displayed.

(35)

D

EPARTMENTATION

1. Functional Department

a. General Surgery b. Internal Medicine

c. Gynecology and Obstetrics d. Pediatrics e. Orthopedics f. EYE g. ENT h. Ayurveda i. Homeopathy

j. Physical Medicine and Rehabilitation k. Anesthesia

l. Radio Diagnosis m. Laboratory Medicine n. Emergency Medicine 2. Support Departments

a. Reception and Public relationship b. Hospital administration

(36)

d. Finance and Accounts e. Medical Records f. Purchase and Store g. Cafeteria

h. Laundry i. Maintenance j. Pharmacy k. Security

3. Hospital Shall Provide Residential Accommodation for Nurses 4. Functional Areas

a. ICU - 4 beds

b. Observation ward – 2 beds c. Male ward – 12 beds d. Female ward – 12 beds

OPD

a. OPD - 2 rooms b. Casualty – 1 room

(37)

Support Areas

a. Imaging Departments b. Laboratory

c. Physiotherapy d. Generator Room

e. Electricity Distribution panel f. Water Storage

g. Medical Gas Storage Area h. Cafeteria

i. Pharmacy

F

ACILITY

M

ANAGEMENT

- Temple

- Public Education Centre - MSW’s Desk - Cafeteria - Pharmacy - Emergency - O.P.D. - Reception

- Distribution Panel/Switch Box - Generator Room

(38)

- Laboratory - X-Ray

- Ultrasound Room

- Admin. Area and IT + Accounts - Accounts / HR

- Observation Room - Wards (Male + Female) - Doctors duty room - Nurses Changing room

- Store and Medical Record Room - I.C.U.

- O.T. Complex - Conference room - Corridors

- Guest Room

- Solar Heating System

L

ICENSES

P

ERMITS AND

S

TATUTORY

O

BLIGATIONS

a. Building Permit (Completion Certificate) b. Registration under MTP Act

c. Registration of the Ultrasound machine under PNDT Act. d. The Wholesale and Retail Drug-License

(39)

e. The Excise Permit to store Spirit.

f. The permit to store opium and its derivatives under the Narcotic and Psychotropic Substances Act.

g. No Objection Certificate from the Chief Fire Officer, from the Region. h. No Objection Certificate under Pollution Control Act.

i. No Objection Certificate under Bio-medical Waste Rules, 1998.

j. The Vehicle Registration Certificates in respect of all vehicles the hospital owns.

k. Radiation Protection Certificate in respect of All X-ray Equipment from BARC.

l. PAN Number m. ESI Registration

n. Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002: “All hospitals are obliged to provide medical care to preserve life to all injured citizens brought to hospital”.

(40)

O

RGINASTION

S

TRUCTURE

Governing Body

Medical Superintendent

Consultants Nurses Administration ICU/OT/Casualty

• Surgery • Medicine • Gynaecology • Paediatrics • Orthopaedics • EYE • ENT • Lab • Radiology o Nursing Supdt o Nurses o Ward Boys o Ayahas o Sweepers IT Receptionist

Billing & Accounts MRD

Security Drivers Maintanance Store & Purchase

o Anesthesist o Technicians o TSSU o CMO

(41)

S

TAFFING

P

ATTERN WITH

Q

UALIFICATION

1. Medical Superintendent - MBBS, DHA, 10 years of experience 2. Nursing Superintendent - Diploma Nursing, 15 years of experience 3. GDMOs - MBBS, BUMS, with 1 year experience 4. Nurses - Diploma Nursing – 1 year experience 5. Receptionist - Graduates

6. IT Manager - 5 years experience in Software & Hardware 7. Admin./HR - Graduate with MBA 8. Accounts - B.Com.

9. Lab Technician - MLT.

10. X-Ray Technician - Radiography Course 11. OT Technician - ORA Course

12. Electrician - ITI Diploma 13. Plumber

14. Driver - Heavy vehicle License with 5 years exp. 15. M.S.W. - Counselling Course

16. Ward Boys - 17. Sweepers - 18. Ayahas

(42)

A

NNEXURE

-

1

(43)

(44)

(45)

(46)

ANNEXURE -2

L

IST OF SUGGESTED EQUIPMENTS AND FURNITURES

1. Normal Delivery Kit

2. Equipment for assisted vacuum delivery 3. Equipment for assisted forceps delivery

4. Standard Surgical Set (for minor procedures like episiotomies stitching) 5. Equipment for Manual Vacuum Aspiration

6. Equipment for New Born Care and Neonatal Resuscitation 7. IUD insertion kit

8. Equipment / reagents for essential laboratory investigations 9. Refrigerator.

10. ILR/Deep Freezer 11. Ice box

12. Computer with accessories including internet facility 13. Baby warmer/incubator.

14. Binocular microscope

15. Equipments for Eye care and vision testing: Tonometers (Schiotz), direct opthalmoscope, illuminated vision testing drum, trial lens sets with trial frames, snellen and near vision charts, Battery operated torch 16. Equipments under various National Programmes

(47)

18. Baby scale

19. Table lamp with 200 watt bulb for new borne baby 20. Phototherapy unit

21. Self inflating bag and mask-neonatal size

22. Laryngoscope and Endotracheal intubation tubes (neonatal)

23. Mucus extractor with suction tube and a foot operated suction machine 24. Feeding tubes for baby

25. Sponge holding forceps – 2 26. Valsellum uterine forceps – 2 27. Tenaculum uterine forceps – 2

28. MVA syringe and cannulae of sizes 4-8 (2 sets; one for back up in case of technical problems)

29. Kidney tray for emptying contents of MVA syringe 30. Containers for tissues

31. Torch without batteries – 2

32. Battery dry cells 1.5 volt (large size) – 4

33. Bowl for antiseptic solution for soaking cotton swabs

34. Tray containing chlorine solution for keeping soiled instruments 35. Residual chlorine in drinking water testing kits

(48)

Requirements for the Labour Room 1. A labour table

2. Suction machine

3. Facility for Oxygen administration 4. Sterilisation equipment

5. 24-hour running water

6. Electricity supply with back-up facility (generator with POL) 7. Attached toilet facilities

8. An area earmarked for new-born care

9. Emergency drug tray: This must have the following drugs a. Inj. Oxytocin

b. Inj. Diazepam c. Tab. Nifedepine d. Magnesium sulphate

e. Inj. Lignocaine hydrochloride f. Inj. Methyl ergometrine maleate g. Sterilised cotton and gauze

10. Delivery kits, including those for normal delivery and assisted deliveries.

(49)

PRIVACY of a woman in labour should be ensured as a quality assurance issue.

List of Equipments for Pap Smear

1. Cusco’s vaginal speculum (each of small, medium and large size)

2. Sim’s vaginal speculum – single & double ended - (each of small, medium and large size)

3. Anterior Vaginal wall retractor 4. Sterile Gloves

5. Sterilised cotton swabs and swab sticks in a jar with lid 6. Kidney tray for keeping used instruments

7. Bowl for antiseptic solution

8. Antiseptic solution: Chlorhexidine 1% or Cetrimide 2% (if povidone iodine solution is available, it is preferable to use that)

9. Chittle forceps

10. Proper light source / torch 11. For vaginal and Pap Smears:

a. Clean slides with cover slips b. Cotton swab sticks

c. KOH solution in bottle with dropper d. Saline in bottle with dropper

e. Ayre’s spatula

(50)

Requirements of the Laboratory Reagents

1. For Cyan meth - haemoglobin method for Hb estimation 2. Uristix for urine albumin and sugar analysis

3. ABO & Rh antibodies 4. KOH solution for Whiff test 5. Gram’s iodine

6. Crystal Violet stain

7. Acetone-Ethanol decolourising solution. 8. Safranine stain

9. PH test strips

10. RPR test kits for syphilis Glassware and other Equipment

1. Colorimeter for Hb estimation 2. Test tubes 3. Pipettes 4. Glass rods 5. Glass slides 6. Cover slips 7. Light Microscope

(51)

List of Furniture (including surgical)

Examination table 5

Writing tables with table sheets 8 Plastic chairs (for in-patients’ attendants) 10

Armless chairs 12

Full size steel almirah 8

Labour table 1

OT table 1

Arm board for adult and child 4

Wheel chair 1 Stretcher on trolley 1 Instrument trolley 2 Wooden screen 1 Foot step 5 Coat rack 2

Bed side table 30

Bed stead iron (for in-patients) 30

Baby cot 2

Stool 30

Medicine chest 4

Lamp 5

(52)

Side Wooden racks 10

Fans 10

Tube light 18

Sundry Articles including Linen:

Buckets 10

Mugs 10

LPG stove 1

LPG cylinder 2

Sauce pan with lid 2

Water receptacle 2

Rubber/plastic shutting 10 meters Drum with tap for storing water 5

I V stand 16

Mattress for beds 30

Foam Mattress for OT table 1 Foam Mattress for labour table 1

Macintosh for labour and OT table 4 metres Kelly’s pad for labour and OT table 2 sets

Bed sheets 50

Pillows with covers 40

Blankets 30

(53)

Towels 30

Curtains with rods 50 metres ANNEXURES -3

DRUGS

(To be vetted by the Hospital Drug Committee)

Oxygen Inhalation

Local Anaesthetics

Lignocaine Hydrochloride Topical Forms 2-5%

Preoperative Medication and Sedation for Short Term Procedures Diazepam Tablets 5 mg

Injection 5 mg / ml

Analgesics, antipyretics and Non-Steroidal Anti-inflammatory Medicines, Non-Opioid Analgesics, Antipyretics and Nonsteroidal Anti-inflammatory

Medicines

Acetyl Salicylic Acid Tablets 300mg & 50 mg Ibuprofen Tablets 400 mg

(54)

Syrup 125 mg / 5ml Antiallergics and Medicines used in Anaphylaxis

Adrenaline Injection Chlorpheniramine Maleate Tablets 4 mg

Dexchlorpheniramine Maleate Syrup 0.5 mg / 5 ml Dexamethasone Tablets 0.5 mg

Pheniramine Maleate Injection 22.75 mg / ml Promethazine Tablets 10 mg, 25 mg

Syrup 5 mg / 5 ml

Capsules 250 mg, 500 mg Ampicillin Capsules 250 mg., 500 mg

Powder for suspension 125 mg / 5 ml Injection 500 mg

Benzathine Benzylpenicillin Injection 6 lacs, 12 lacs, 24 lacs units Benzylpenicillin Injection 5 lacs, 10 lacs units

Cloxacillin Capsules 250 mg, 500 mg Liquid 125 mg / 5 ml

Procaine Benzylpenicillin Injection Crystalline penicillin (1 lac units)

+ Procaine penicillin (3 lacs units) Cephalexin Syrup 125 mg/5 ml

(55)

Ciprofloxacin Injection 200 mg / 100 ml Hydrochloride Tablets 250 mg., 500 mg

Co-Trimoxazole Tablets 40 + 200 mg, 80 + 400 mg (Trimethoprim + Sulphamethoxazole) Suspension 40 + 200 mg / 5 ml Doxycycline Capsules 100 mg

Erythromycin Estolate Syrup 125 mg / 5 ml Tablets 250 mg, 500 mg

Gentamicin Injection 10 mg / ml, 40 mg / ml Metronidaozle Tablets 200 mg, 400 mg

Injection 500 mg / 100 ml Antidotes and Other Substances used in Poisonings

Nonspecific

Activated Charcoal Powder

Atropine Sulphate Injection 0.6 mg / ml

Specific

Antisnake Venom Injection Polyvalent Solution/ Lyophilyzed Polyvalent Serum Anticonvulsants/Antiepileptics

Carbamazepine Tablets 100 mg, 200 mg Syrup 20 mg / ml

Phenytoin Sodium Capsules or Tablets 50 mg, 100 mg Syrup 25 mg / ml

(56)

Antiinfective Medicines Anthelminthics Intestinal Anthelminthics Mebendazole Tablets 100 mg Suspension 100 mg/ 5 ml Albendazole Tablets 400mg Antifilarials

Diethylcarbamazine Citrate Tablets 150 mg Antibacterials

Amoxicillin Powder for suspension 125 mg / 5 ml Capsules 250 mg, 500 mg

Cardiovascular Medicines Antianginal Medicines

Acetyl Salicylic Acid Tablets 75 mg,100mg,350mg. Glyceryl Trinitrate Sublingual Tablets 0.5 mg.

Injection 5 mg/ml Isosorbide 5 Mononitrate Tablets 10 mg. Propranolol Tablets 10mg,40mg

Injection 1mg/ml. Antihypertensive Medicines

(57)

Atenolol Tablets 50 mg,100 mg Enalapril Maleate Tablets 2.5 mg, 5 mg, 10 mg

Injection 1.25 mg / ml Methyldopa Tablets 250 mg

Dermatological Medicines (Topical) Antifungal Medicines

Benzoic Acid +Salicylic Acid Ointment or Cream 6% + 3% Miconazole Ointment or Cream 2%

Antiinfective Medicines

Framycetin Sulphate Cream 0.5% Methylrosanilinium

Chloride (Gentian Violet) Aqueous solution 0.5% Neomycin +Bacitracin Ointment 5 mg + 500 IU Povidone Iodine Solution and Ointment 5% Silver Nitrate Lotion 10%

Nalidixic Acid Tablets 250 mg, 500 mg Nitrofurantoin Tablets 100 mg

Norfloxacin Tablets 400 mg

(58)

Antileprosy Medicines and Anti-tubecullar medicines as per national programmes

Antifungal Medicines

Clotrimazole Pessaries 100 mg, 200 mg, Gel 2% Griseofulvin Capsules or Tablets 125 mg, 250 mg Nystatin Tablets 500,000 IU

Pessaries 100,000 IU Antiprotozoal Medicines

Antiamoebic and Antigiardiasis Medicines

Diloxanide Furoate Tablets 500 mg

Metronidazole Tablets 200 mg, 400 mg Injection 500 mg / 100 ml Tinidazole Tablets 500 mg

Blood Products and Plasma Substitutes Plasma Subsitutes

Dextran-4 Injection 10%

Dextran Injection6%

Silver Sulphadiazine Cream 1% Antiinflammatory and Antipruritic Medicines

Betamethasone Cream / Ointment 0.05% Dipropionate Calamine Lotion

(59)

Astringent Medicines

Zinc Oxide Dusting Powder Medicines Affecting Skin Differentiation and Proliferation

Glycerin Solution

13.6 Scabicides and Pediculicides

Benzyl Benzoate Lotion 25% Disinfectants and Antiseptics

Antiseptics

Benzoin Compound Tincture

Cetrimide Solution 20% (conc.for dilution) Chlorhexidine Solution 5% (conc. for dilution) Ethyl Alcohol 70% Solution

Gentian Violet Paint 0.5%, 1% Hydrogen Peroxide Solution 6% Disinfectants

Bleaching Powder Powder Formaldehyde IP Solution

Potassium Permanganate Crystals for solution Diuretics

Furosemide Injection, 10 mg/ ml, Tablets 40 mg

(60)

Gastrointestinal Medicines

Antacids and other Antiulcer Medicines

Aluminium Hydroxide+ Magnesium Suspension

Hydroxide Tablet

Omeprazole Capsules 10 mg, 20 mg, 40 mg Ranitidine Hydrocholoride Tablets 150 mg, 300 mg

Injection 25 mg / ml Antiemetics Domperidone Tablets 10 mg Syrup 1 mg / ml Metoclopramide Tablets 10 mg Syrup 5 mg / ml Injection 5 mg / ml Antispasmodic Medicines

Dicyclomine Hydrochloride Tablets 10 mg, Injection 10 mg / ml Hyoscine Butyl Bromide Tablets or 10 mg

Injection 20 mg / ml Laxatives

Bisacodyl Tablets/ suppository 5 mg Isphaghula Granules

Medicines used in Diarrhoea

(61)

Hormones, other Endocrine Medicines and Contraceptives Adrenal Hormones and Synthetic Substitutes

Prednisolone Tablets 5 mg, 10 mg Antidiabetics and Hyperglycaemics

Insulins and Other Antidiabetic Agents

Glibenclamide Tablets 2.5 mg, 5 mg Insulin Injection (Soluble)

Injection 40 IU / ml Metformin Tablets 500 mg For Specific Group of Individuals

Rabies Vaccine Injection Tetanus Toxoid Injection Ophthalmological Preparations

Antiinfective Agents

Chloramphenicol Drops/Ointment 0.4%, 1% Ciprofloxacin Hydrochloride Drops/Ointment 0.3% Gentamicin Drops 0.3%

Miconazole Drops 1%

Sulphacetamide Sodium Drops 10%, 20%, 30% Tetracycline Hydrochloride Ointment 1%

Antiinflammatory Agents

Prednisolone Acetate Drops 0.1% Prednisolone Sodium Phosphate Drops 1%

(62)

Xylometazoline Drops 0.05%, 0.1% Local Anaesthetics

Medicines used in Psychotic Disorders

Chlorpromazine Hydrochloride Tablets 25 mg, 50 mg, 100 mg Syrup 25 mg / 5 ml

Injection 25 mg / ml Medicines used for Generalized Anxiety and Sleep Disorders

Diazepam Tablets 2 mg, 5 mg, 10 mg Antiasthmatic Medicines

Aminophylline Injection 25 mg / ml

Beclomethasone Dipropionate Inhalation 50 mg, 250 mg/dose Salbutamol Sulphate Tablets 2 mg, 4 mg

Syrup 2 mg / 5 ml

Inhalation 100 mg / dose Theophylline Compounds Antitussives

Codeine Phosphate Tablets 10 mg Syrup 15 mg / 5 ml Dextromethorphan Tablets 30 mg

Solutions correcting Water, Electrolyte and Acid-Base Disturbances Oral

Oral Rehydration Salts Powder for Solution As per IP Glucose Injection 5% isotonic

50% hypertonic Glucose with Sodium Chloride Injection 5% + 0.9%

(63)

Normal Saline Injection 0.9% Potassium Chloride Injection 11.2% Sol. Ringer Lactate Injection

Sodium Bicarbonate Injection Miscellaneous

Water for Injection Injection 2 ml, 5 ml, 10 ml Vitamins and Minerals

Ascorbic Acid Tablets 100 mg, 500 mg Calcium salts Tablets 250 mg, 500 mg Multivitamins Tablets

(64)

ANNEXURE -4

S

TANDARD

P

RECAUTIONS

The standard precautions should be understood and applied by all medical and paramedical staff involved In providing health services. The basic elements include:

1. Hand washing thoroughly with soap and running water. a. Before carrying out the procedure

b. Immediately if globes are torn and hand is contaminated with blood or other body fluids.

c. Soon after the procedure, with gloves on and again after removing the gloves.

2. Barrier precautions: using protective gloves, mask, waterproof aprons and gowns.

3. Strict asepsis during the operative procedure and cleaning the operative site. Practise the “no touch technique” which is: any instrument or part of instrument which is to be inserted in the cervical canal must not touch anynon-sterile object / surface prior to insertion.

4. Decontamination and cleaning of all instruments immediately after each use.

(65)

5. Sterilisation / high level disinfection of instruments with meticulous attention.

6. Appropriate waste disposal. Sterilization of Instruments

1. Instruments and linen must be autoclaved.

2. In case autoclaving is not possible, the instruments must be fully immersed in water in a covered container and boiled for at least 20 minutes.

Sterilisation of Copper T insertion instruments 1. Copper T is available in a pre-sterilised pack

2. Ensure that the instruments and gloves used for insertion are autoclaved, or fully immersed in a covered container and boiled for at least 20 minutes

Sterilisation and maintenance of MVA equipment The four basic steps are:

1. Decontamination of instruments, gloves, cannulae and syringes in 0.5% chlorine solution

2. Cleaning in lukewarm water using a detergent. 3. Sterilisation / High Level Disinfection

4. Storage and re-assembly of instruments.

(66)

ANNEXURE -5

C

ITIZEN

’

S

C

HARTER

Charter of Patients’ Rights for the Hospital

1. Preamble

Hospital exists to provide health care to every citizen of the locality within the allocated resources and available facilities. The Charter seeks to provide a framework, which enables citizens to know.

a. What services are available and their charges b. The quality of services they are entitled to

c. The names through which complaints regarding denial or poor qualities of services will be addressed.

2. Objective

a. To make available health care services and the related facilities for consumers.

b. To provide appropriate advice, treatment, referral and support that would help to cure the ailment to the extent medically possible.

c. To redress any grievances in this regard. 3. Commitments of the Charter

(67)

b. To provide emergency care, if needed on reaching the hospital

c. To provide adequate number of notice boards detailing the location of all the facilities and the schedule of camps and other activities.

d. To provide written information on diagnosis, treatment being administered.

e. To record complaints and respond at an appointed time. 4. Grievance Redressal

a. Grievances that consumers have will be recorded.

b. Aggrieved user after his/her complaint recorded would be allowed to seek a second opinion at a referral hospital.

5. Responsibilities of the Users

a. Users of hospital would attempt to understand the commitments made in the charter.

b. Users would not insist on service above the standard set in the charter because it could negatively affect the provision of the minimum acceptable level of service to another user.

c. Instructions of the hospital personnel would be followed sincerely, and d. In case of grievances, the redressal mechanism machinery would be

(68)

ANNEXURE -6

F

INANCIAL

D

ETAILS

Total Cost of Project

Cost / Sq. ft Rate / Sq. ft Amount (Rs.) Cost of Land 500,000 Cost of Construction 500 8000 4,000,000

(This includes civil Construction, Electrical, Ducting)

Cost of Equipments 7,200,000

Contigency & Working Capital 1,100,000

12,800,000

The Total Cost of the Project is Rs. 1.25 Crores

Pre Operative Expenses Rs. 5,00,000

a. Consultancy

b. Travelling and Logistics c. Adminitrative Expenses

The pre operative expenses have not been considered in calculating the viability.

(69)

Cost of Equipment

No. Price / Unit (Rs.) Amount (Rs.)

Hospital Furniture All 250,000

Fire Fighting Equioments All 50,000

Medical Gases All 100,000

Autoclave 1 75,000 75,000 OT Table 1 200,000 200,000 Boyle's Separators 1 150,000 150,000 Coutery Machine 1 150,000 150,000 Ventilator 1 150,000 150,000 Infusion Pump 1 50,000 50,000 Suction Machine 3 15,000 45,000

Defibrillator, Monitor, Recorder 2 150,000 300,000

Portable Emergency Light 1 50,000 50,000

Laprascope Set 1 1,000,000 1,000,000

Cardiac Monitors 4 50,000 200,000

Pulse Oxy Meter 1 25,000 25,000

Nebulizer 2 2,500 5,000

Ultrasound Machine with 2 Probes 1 600,000 600,000

Portable X - Ray Machine 60 MA 1 75,000 75,000

X - Ray Machine 100 MA 1 150,000 150,000

View Box 5 2,000 10,000

Semi Auto Analyser 1 300,000 300,000

Electrolyte Analyser 1 200,000 200,000

Microscope 1 40,000 40,000

Labarotary Autoclave 1 30,000 30,000

Refrigerator 3 10,000 30,000

Wax Bag 1 5,000 5,000

Short Wave Diathermy 1 25,000 25,000

Ultrasonic Therapy 1 30,000 30,000

ECG Machine 2 40,000 80,000

Opthamology OPD Setup 1 100,000 100,000

HIS & Computers All 1,000,000

OT Light 1 100,000 100,000

Silent Genrator Set 1 700,000 700,000

UPS 1 300,000 300,000

Surgical Instruments & Drums 1 150,000 150,000

Linen All 50,000

Water Pump & Motor All 100,000

Surgical Consumables & Dugs All 300,000

Miscellaneous 25,000

(70)

Revenue Streams Month Wise

Nov-06 Dec-06 Jan-07 Feb-07 Mar-07 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

OPD Consultation 7500 7750 7750 10500 11625

Lab Tests - OPD 15000 15500 15500 19600 21700

Lab Tests - IPD 12000 12400 12400 16800 18600

X - Ray - OPD 6000 6200 6200 5600 6200 X - Ray - IPD 3750 3875 3875 7000 7750 Ultra Sound 18000 18600 18600 16800 18600 Physiotherapy 4500 4650 4650 4200 4650 Counselling 1500 1550 1550 1400 1550 MTP 11250 11625 11625 10500 11625 Delivery 30000 31000 31000 28000 31000 Surgeries 45000 46500 46500 42000 46500 Indoor Stay 9000 9300 9300 12600 13950 ICU 60000 62000 62000 56000 62000 Health Checks 15000 15500 15500 14000 15500 Ambulance 15000 15500 15500 16800 18600

Drugs & Consumables 63000 65100 65100 84000 93000

(71)

Apr-07 May-07 Jun-07 Jul-07 Aug-07 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Lab Tests - OPD 21000 21700 30000 31000 31000

Lab Tests - IPD 18000 18600 36000 37200 37200

(72)

Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Lab Tests - OPD 30000 31000 36000 37200 37200

Lab Tests - IPD 36000 37200 48000 49600 49600

(73)

Feb-08 Mar-08 Apr-08 May-08 Jun-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Lab Tests - OPD 34800 46500 45000 46500 45000

Lab Tests - IPD 46400 93000 90000 93000 90000

Drugs & Consumables 261000 372000 360000 372000 360000 Total Revenue 757625 1143125 1106250 1143125 1106250

(74)

Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Lab Tests - OPD 46500 68200 66000 68200 75000

Lab Tests - IPD 93000 111600 108000 111600 120000

Drugs & Consumables 372000 465000 450000 465000 450000 Total Revenue 1143125 1367875 1323750 1367875 1416750

(75)

Dec-08 Jan-09 Feb-09 Mar-09 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

OPD Consultation 38750 38750 35000 38750

Lab Tests - OPD 77500 77500 70000 77500

Lab Tests - IPD 124000 124000 112000 124000

X - Ray - OPD 27900 27900 25200 27900 X - Ray - IPD 23250 23250 21000 23250 Ultra Sound 74400 74400 67200 74400 Physiotherapy 10850 10850 9800 10850 Counselling 5425 5425 4900 5425 MTP 27900 27900 25200 27900 Delivery 74400 74400 67200 74400 Surgeries 111600 111600 100800 111600 Indoor Stay 93000 93000 84000 93000 ICU 186000 186000 168000 186000 Health Checks 93000 93000 84000 93000 Ambulance 31000 31000 28000 31000

Drugs & Consumables 465000 465000 420000 465000 Total Revenue 1463975 1463975 1322300 1463975

Assumptions

OPD - 10 Patients per day at a charge of Rs.25 per patient Lab Tests - 5 Patients of OPD at Rs.100

Lab Tests - 2 Patients of In-house at Rs.200 X-Ray- 2 OPD at Rs.100 X-Ray- 1 OPD at Rs.125 Ultra Sound - 2 at Rs.300 Physiotherapy - 3 at Rs.50 Counselling - 2 at Rs.25 MTP - .5 at Rs.1000 Delivery - .5 at Rs.2000 Surgeries - .5 at Rs. 3000 Indoor Stay - 2 at Rs.150 ICU - 1 at Rs.2000 Health Checks - 1 at Rs.500 Ambulance - 1 at Rs.500 Drugs & Consumables - 4000 No.of Beds – 26 + 4

(76)

Month Wise Expenses

Nov-06 Dec-06 Jan-07 Feb-07 Mar-07 Particulars Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Salary 258,500 258,500 258,500 258,500 258,500 Electricity 10,000 10,000 10,000 10,000 10,000 Water 2,000 2,000 2,000 2,000 2,000 Telephone 5,000 5,000 5,000 5,000 5,000 Transportation 8,000 8,000 8,000 8,000 8,000 Maintainance 10,000 10,000 10,000 10,000 10,000

Drugs & Consumables 53,550 55,335 55,335 67,200 74,400 Marketing & Promotion 25,000 20,000 20,000 15,000 15,000 WebSite Designing &

Maintainance 10,000 15,000 0 0 0

Miscellaneous 15,000 15,000 15,000 15,000 18,000

Total Expenses 397,050 398,835 383,835 390,700 400,900

Month Wise Expenses

Apr-07 May-07 Jun-07 Jul-07 Aug-07 Particulars Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Maintainance 0 0 0 0 0

Miscellaneous 18,000 18,000 18,000 18,000 18,000

(77)

Month Wise Expenses

Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Particulars Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Salary 284,350 284,350 314,850 314,850 314,850 Electricity 11,000 11,000 11,000 11,000 12,000 Water 2,200 2,200 2,200 2,200 2,500 Telephone 5,500 5,500 5,500 5,500 6,000 Transportation 9,000 9,000 9,000 9,000 11,000 Maintenance 11,000 11,000 11,000 11,000 12,000

Maintainance 0 10,000 0 0 0

Miscellaneous 18,000 15,000 20,000 20,000 20,000

Total Expenses 439,650 449,770 594,550 601,750 606,550

Month Wise Expenses

Feb-08 Mar-08 Apr-08 May-08 Jun-08 Particulars Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Maintainance 0 0 0 0 0

Miscellaneous 20,000 20,000 20,000 20,000 22,000

(78)

Month Wise Expenses

Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Particulars Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Maintainance 0 0 0 0 10,000

Miscellaneous 22,000 22,000 22,000 22,000 22,000

Total Expenses 754,975 829,375 817,375 829,375 827,375

Month Wise Expenses

Dec-08 Jan-09 Feb-09 Mar-09 Particulars Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.)

Salary 386,875 386,875 386,875 386,875 Electricity 12,000 12,000 12,000 12,000 Water 2,500 2,500 2,500 2,500 Telephone 6,000 6,000 6,000 6,000 Transportation 11,000 11,000 11,000 11,000 Maintenance 12,000 12,000 12,000 12,000

Drugs & Consumables 372,000 372,000 336,000 372,000 Marketing & Promotion 5,000 5,000 5,000 5,000 Website Designing &

Maintenance 10,000 10,000 10,000 10,000

Miscellaneous 22,000 22,000 22,000 22,000

(79)

Salary

Nov-06 Dec-06 Jan-07 Feb-07

1.00 1.00 1.00 1.00 Medical Superintendent 15000 15000 15000 15000 15000 Nursing Superintendent 10000 10000 10000 10000 10000 Nurses 5000 80000 80000 80000 80000 Receptionist 4000 12000 12000 12000 12000 IT Manager 6000 6000 6000 6000 6000

Ward Boys / Ayahs 2500 10000 10000 10000 10000

Admin & HR Officer 8000 8000 8000 8000 8000

Accounts Officer 5000 5000 5000 5000 5000 Billing Clerk 2000 2000 2000 2000 2000 Driver 3000 6000 6000 6000 6000 MSW / Counsellors 4000 8000 8000 8000 8000 Lab Technicians 4000 12000 12000 12000 12000 X - Ray Technicians 4000 12000 12000 12000 12000 OT Technicians 4000 12000 12000 12000 12000 Security Guards 2500 12500 12500 12500 12500 Electrician 2000 2000 2000 2000 2000 Plumber 2000 2000 2000 2000 2000 GDMO's 10000 40000 40000 40000 40000 Physiotherapist 4000 4000 4000 4000 4000 258500 258500 258500 258500

(80)

Salary

Mar-07 Apr-07 May-07 Jun-07 Jul-07

1.00 1.00 1.00 1.00 1.00 Medical Superintendent 15000 15000 15000 16500 16500 Nursing Superintendent 10000 10000 10000 11000 11000 Nurses 80000 80000 80000 88000 88000 Receptionist 12000 12000 12000 13200 13200 IT Manager 6000 6000 6000 6600 6600

Ward Boys / Ayahs 10000 10000 10000 11000 11000

Admin & HR Officer 8000 8000 8000 8800 8800

Accounts Officer 5000 5000 5000 5500 5500 Billing Clerk 2000 2000 2000 2200 2200 Driver 6000 6000 6000 6600 6600 MSW / Counsellors 8000 8000 8000 8800 8800 Lab Technicians 12000 12000 12000 13200 13200 X - Ray Technicians 12000 12000 12000 13200 13200 OT Technicians 12000 12000 12000 13200 13200 Security Guards 12500 12500 12500 13750 13750 Electrician 2000 2000 2000 2200 2200 Plumber 2000 2000 2000 2200 2200 GDMO's 40000 40000 40000 44000 44000 Physiotherapist 4000 4000 4000 4400 4400 258500 258500 258500 284350 284350

(81)

Salary

Aug-07 Sep-07 Oct-07 Nov-07 Dec-07

Ward Boys / Ayahs 11000 11000 11000 13500 13500

Admin & HR Officer 8800 8800 8800 8800 8800

(82)

Salary

Jan-08 Feb-08 Mar-08 Apr-08 May-08

Ward Boys / Ayahs 13500 13500 18750 18750 18750

Admin & HR Officer 8800 8800 10000 10000 10000

(83)

Salary

Jun-08 Jul-08 Aug-08 Sep-08 Oct-08

Ward Boys / Ayahs 18750 18750 18750 18750 18750

Admin & HR Officer 10000 10000 10000 10000 10000

Hospital

PROJECT REPORT

NEW ERA PATIENT-FRIENDLY

HOSPITAL PRIVATE LIMITED

SHUKUL BAZAR, SULTANPUR,

UTTAR PRADESH, INDIA

Bejon Misra, Managing Director

[email protected]

&

Dr. Bidhan Das, Consultant

MBBS, MHA (AIIMS)

CONTENTS

E

XECUTIVE

S

UMMARY

I

MPLEMENTING

A

GENCY

:

N

EW

E

RA

P

ATIENT

-F

RIENDLY

H

OSPITAL

P

RIVATE

L

IMITED

P

REAMBLE

I

NTRODUCTION

The Mission of the Hospital

Proposal

N

H

NEW ERA PATIENT-FRIENDLY

HOSPITAL PRIVATE LIMITED

T

ECHNICAL

A

NALYSIS

C

ATCHMENT

A

REA

P

HYSICAL

F

ACILITY

H

EALTH

C

ARE

P

LAN

F

UNCTIONAL

P

LAN AND

P

ROGRAMS

D

EPARTMENTATION

F

ACILITY

M

ANAGEMENT

L

ICENSES

P

ERMITS AND

S