Four Skippers and a Goal

‘Our systems need more managers than administrators’

Every hospital has its own pattern of administration. Its own diktat. Rita Dutta explores the administrative pattern of a few successful hospitals through their head honchos.
Vishal Bali Vice President-Operations Wockhardt Hospitals

How do you assess the impact of corporate hospitals on healthcare sector?

There has been a sea change in accountability and today’s manegers realise that it is equally important for their institutions to excel both in clinical arena as well as delivering consistently on patient service expectations.

How different is running a corporate hospital from a trust hospital?

The style of management will always be different primarily because the methodology for both is different. While the decision making in a trust hospital takes into interest the divergent opinions of various trustees, the corporate hospital will have a faster decision making process for it gives higher accountability to the operating team.

How different is Indian pattern of hospital administration as compared to the west?

The administration systems of corporate hospitals in India compare favourably to those of the hospitals abroad primarily because the hospitals here have adopted a leaning system from the West and have a constant exposure to those facilities.

We need to basically improve and make a differentiation that administration is not the same as Managing the hospital. Our systems need more and more managers rather than administrators.

How has hospital administration in the corporate sector changed?

There has been a sea change in the accountability and today’s managers realise that it is equally important for their institutions to excel in the clinical arena and delivering consistently on patient service expectations. As enterprise expand what will become critical is that the healthcare system speaks a common language irrespective of the specialities.

What is the pattern of administration for Wockhardt?

All our hospitals are professionally managed by group of professionals who are both by education and by experience experts in the field of hospital management.

Wockhardt is associated with Harvard Medical International (HMI). Do you in some ways follow the administrative pattern of HMI?

Wockhardt’s association with HMI has benefited us immensely in setting systems in the clinical and administration which conforms to the standard followed by Harvard Medical School. What has emerged is a focus on training and education on an ongoing basis within our healthcare system.

D S Badrinath Founder Chairman Sankara Nethralaya

The first name that comes in everybody’s mind for ophthalmic care in the country is that of Sankara Nethralaya. How has the management achieved this?

One of the important objectives is to provide quality care at affordable cost. Perhaps this is one of the most important reasons for the success of Sankara Nethralaya. Further, under one roof all the sub-specialities of ophthalmology have been developed making it a popular destination. The patient coming with an eye ailment may not know whom (or which under specialist) he should consult. We encourage healthy cross consultations amongst the consultants in our institutions to benefit the patients, for which we do not charge any fee. We also do not charge for reviews for a period of almost one month.

What administrative strategy did you use to attain your objective of affordable care and promote research?

A transparent administration with no favouritism or nepotism with involvement of the people as a team and evolving processes of functioning through ISO 9001:2000 or TQM exercises played an important role in achieving our objectives.

Has the pattern of administration evolved over the years since its very inception?

The board of Medical Research Foundation and Vision Research Foundation, who are experienced businessmen have supervised and walked the doctors through various aspects of administration. The doctors state the requirements and the administration and the board guide them efficiently into execution.

How is your hospital managing to have the best of the ophthalmic surgeons and at the same time serve the poor?

If any institution can provide professional satisfaction to the consultants, it would be able to retain the cream such as what we have done. Many other consultants working at Sankara Nethralaya are happy to serve the poor without differentiation, offering them quality care and also engage in teaching and research. The consultants and administration have to go hand in hand with certain aspects being manned by each group.

What are the plans ahead?

Our plans are always to stand technologically in the forefront as far as ophthalmic care is concerned. Only this would ensure us to be the best ophthalmic institution in India.

Prakash Mhatre Director-Operations Lilavati Trust haospital

What strategies did you use to streamline administration of your hospital?

When I joined there was some 1,400 odd people working for a hospital which has only 260 beds. My first task was to cut down manpower. As and when people quit, I did not fill the vacancy. Now we have 900 people. By cutting corners, I have been able to invest money in buying equipment, open new department, have more phone lines. We have a new MRI, an ophthalmic department with well-qualified ophthalmic surgeons and latest laser techniques, dentistry, obstetrics, endoscopy and two new OTs.

What is the administrative success mantra of the hospital?

I believe in centralised authority. If you invest powers in innumerable people, then people take advantage of it.

In multi-centric authority, if one person takes turns down a proposal, then another person enjoying the same power can approve the proposal, creating unnecessary conflict. So, in Lilavati everything has to go through the centralised authority, whether it is implementing a new idea, addressing grievances or speaking to the media.

Surgeon Rear Admiral Vijay Kumar Singh Commanding Officer Indian Naval Hospital Ship, Asvini.

How do you assess the change in administrative pattern in military hospital?

With the development and progress in the Armed Forces, hospital administration of military hospitals have changed. In the initial phase, we had small medical contingents with troops and their administration was in the hands of troops commanders. In the subsequent years, Base Hospitals started coming up and gradually major and minor hospitals came up all over the country and hospital administration became a professional job.

It is believed that men management is not a problem in military hospital. Comment.

Yes. That is because discipline is extremely important in a military hospital. If a junior does not perform, the senior can take action against him, which is not so with civil hospital. What are the expected changes in hospital administration in near future? In Armed Forces since only aim is to provide better medicare to needy patients in war and peace, hospitals will be commanded by a medico, who knows the need of the patients on the humanitarian ground, preferably the specialist officers, who have been growing with these hospitals will be groomed to command these hospitals.

Why all the military hospitals are headed by medicos?

It is because the main aim of military hospital is to provide medicare to the patients and patient is the priority. Corporate hospitals who are interested only in revenue generation have non-medicos as heads.

What are the qualities that an administrator of a military hospital should have?

Unlike corporate hospitals which need talent because they want to make money, military hospitals need sloggers.

We see people from military background in the helm of many hospitals after retirement. Do you think this is a healthy trend?

Yes, basically military training makes a man disciplined, attentive and punctual in his functioning. In 50s and 60s, there was a scheme where short service commissioned officers were absorbed in administrative cadres. Unfortunately it does not exist any more. The Armed Forces will definitely do a better job while commanding hospital or any other organization because he is trained for working hard, sincerity an honesty.

How has the administrative pattern changed over the years in your hospital?

INHS Asvini which started as a small hospital, has now become the largest Naval hospital in Asia. From basic specialties of 50s and 60s, today it has got all the superspecialties. The administration which used to be in the hands of commanding officer only has gone down to the level of head of department of various clinical and administrative departments, who are running the departments on day to day basis.

What are the management tools you have used?

To dissipate the load of patients in the OPD I started an evening OPD. I am trying to start a HMS whereby all the military hospitals would be connected with each other.