Reinventing Ruby Hall Clinic

The Pune-based multi-speciality hospital, which began as a nursing home with two beds, today stands tall with seven buildings housing 550 beds. Rita Dutta writes about the interesting journey of the hospital

On Sassoon Road, five kilometres from Pune airport and a stone's throw from the railway station, stands Ruby Hall Clinic. Even though it is situated in the hustle and bustle of the city, the impeccable white-painted buildings and a splash of greenery from the garden soothe the eyes. The hospital is spread in seven tall buildings, over four acres.

Interesting Journey

The hospital has had an interesting journey from 1959, when it had only two beds to today's 550 beds, boasting of the latest equipment and skilled clinical acumen. The history goes like this. In the year 1959, Dr KB Grant, founder of the institute, bought Ruby Hall for a sum of Rs 4.5 lakh from Mumbai's MC Patel. "Ruby Hall was the palatial home of former Governor-General David Sassoon's wife, Ruby. Even while it changed many hands, Ruby Hall retained its name. So, when I bought it, I also did not alter the name," explains 86-year-old Dr Grant, who is now the Managing Trustee of the hospital.

Dr Grant started his practice from Ruby Hall in September 1959. At that time, it had only one consulting room and two beds. The original Ruby Hall fell to the grinding teeth of bulldozers, during the expansion of the hospital. While all other buildings were subsequently added in the same premises, it was only the land for the nursing college, near the hospital, which was bought for Rs 27 lakh, 15 years back. Though the hospital retained its original name, the name of the trust managing it has changed. From Pune Medical Foundation, around five years back the name of the Trust was altered to Grant Medical Foundation.

With the passage of time, the hospital expanded. From 1959 to 1999, the hospital expanded from 2 to 300 beds. The major expansion, however, happened only in the late '90s, when another 250 beds were added. Explains Bomi Bhote, CEO, Ruby Hall Clinic, "We took a quantum leap in 1999. From 10 ICU beds we expanded to have 130 beds and from 10 private rooms to 80." Why this sudden expansion? "Because in the last few years, Pune's population has exploded. And people's increasing awareness about healthcare has also created a need for more beds. Today, Pune is perceived as a centre for medical and academic excellence."

A view of presidential suite

Keeping in mind the various sections of the society that it wants to cater to, the hospital has a general ward at Rs 150 per day to presidential suite at Rs 15,000 per day.

Cancer Hospital: The Latest Addition

The hospital has recently added a seven-storey cancer hospital— Kamalnayan Bajaj Centre at the Zavaray Poonawalla Cancer Building within the hospital premises. The Centre, spread over 70,000 sq ft and built with a total investment of Rs 45 crore, boasts of a 20-bed chemotherapy daycare unit, a 20-bed surgical daycare unit, and six operation theatres.

The Centre, besides providing medical oncology, surgical oncology and radiation therapy, is equipped to offer superlative stereotactic radio-surgery and therapy that involves treatment of brain tumours without surgery. The Radio Therapy Department offers Intensive Modulated Radio Therapy (IMRT) and Image Guided Radio Therapy (IGRT). In IGRT, 3-D imaging focuses on just those cells affected by cancer.

The radiation locks the tumour and moves along with it, thus killing only the cancerous cells and not the good cells. "This causes less side effects and the therapy is more accurate," explains Chief Medical Physicist, V Sathiya Narayanan. "Besides Tokyo, this is the only Centre in Asia to have this facility," he adds. The cost per patient receiving this IGRT treatment would be Rs 1.5 lakh.

The Centre has entered into a 10-year collaboration with Siemens for technology and product development. The agreement identifies Ruby Hall Clinic as Siemen's beta site centre; the fifth site in the world and Asia's only beta site. It is this agreement that has brought about the installation of the only linear accelerator with IGRT at the cancer centre.

"Our Centre is declared as a 'centre of excellence' by Siemens, which implies that all new product launches in cancer will first be tested in our hospital. Our inputs would be taken in product development," says Bhote. According to him, the hospital would not accrue any monetary benefit from the tie-up. "It is meant for imparting knowledge. As per the agreement, Siemens will hold three scientific workshops every year for us," he added.

The Centre has introduced the concept of chemotherapy on daycare basis, where patients troop in for their dose of chemotherapy in the morning and return home before dusk. Says Dr Shona Nag, Medical Oncologist, "The belief that chemotherapy requires full-day hospitalisation is considered outdated. Now, with improved medication and nursing care, chemotherapy patients can return home that very day. Our nurses are trained and hand-picked for this job." According to Joyleen Jonahs, Nursing In-charge, Daycare Unit, "It is always better to send the patient back to their natural environment among their near and dear ones than confine them to the hospital."

The Centre also has speciality OPD, which is a cohesive network of experts from various disciplines of oncology to help and guide patients under one roof. Mobile screening units have been planned to reach rural areas of Maharashtra so as to spread awareness on cancer and facilitate early diagnosis to reduce the mortality rate in these areas.

For lending moral support to cancer patients and their families, the Centre has tied up with Prashanti Cancer Care Mission, an NGO that offers cancer patients support from counselling to rehabilitation. What about organising stay for relatives of cancer patients, a practical necessity? "Well, the hospital is quite close to the station, hence it would not be very difficult for patients outside Pune to come to our hospital. Then, we do have rooms where relatives of patients can stay," says Narayanan.

Ruby Hall Clinic plans to set up five satellite cancer centres in Maharashtra. The first of the five will start operations at Aurangabad's Kamalnayan Bajaj Cancer Centre which will aid doctors to treat patients without either of them travelling. According to Dr Chaitanyanand Koppiker, Director, Cancer Centre, "This Centre is a significant event in Pune and will bring about a quantum of change in the quality of care being provided to the suffering patient."

Other Areas Of Excellence

The hospital has always been on the forefront of technology. It offered Maharashtra's first Cardiac CT. It has state-of-the-art facilities in cardiology, cardiac surgery, nephrology, urology, neurology, nuclear medicine centre and obesity-related surgery. Every month, the hospital conducts around 600 angiograms, 150 angioplasties and 150 open heart surgeries.

"Ruby has witnessed the birth of intensive care in Pune. We have 52 ventilators, the latest equipment and dedicated and trained staff in intensive care," says Bhote.

Along with a group of hospitals, Ruby Hall Clinic has made a paradigm shift in Pune's healthcare by reversing its flow of traffic to Mumbai. Around 9,000 patients flock to its OPD per month and 2,500 patients are admitted in its in-patient departments per month.

While Puneites now seek treatment in Pune, Ruby Hall has started receiving patients from Solapur, Nashik and Aurangabad. It also gets a steady stream of patients from the UK, Nigeria, South Africa, UAE and Israel. The volume of foreign patients, around 10 per month, is primarily due to word of mouth. "We have not made any effort so far to market ourselves as a medical tourism hub," says Bhote.

The hospital lays special emphasis on research, medical education and training. It has 23 ongoing research trials in various specialities. It has collaborations with institutions across the globe, like West Midlands Ambulance Service, UK, the University of Illinois, Chicago, and the University of Seychelles for medical education. The hospital's nursing college, Tehmi Grant Nursing College, holds classes for training their nurses for hospitals abroad, and runs a BSc nursing degree programme.

On The Anvil

Having found its feet in Pune, the group now wants to spread its wings outside the city. Up its sleeve is a 50-bed hospital building at Al-hayet in Bahrain on a 10-year lease. This secondary care centre will be equipped, manned and run by Ruby Hall Clinic. "The Al-hayet hospital would have its own CEO, Medical Director and staff provided by us," says Bhote. Explaining why the group chose Al-hayet, Bhote says, "There is an acute shortage of hospital beds there. Sixty per cent of our beds have been booked by the government and another 20 per cent by the armed forces."

The group has inked a deal to do operations management for the 500-bed Terna Medical College in Navi Mumbai. This joint venture with Terna's management is on a revenue-sharing basis. Also in the pipeline is a 100-bed unit in Sahara's Amby Valley. The Pune hospital would function as the corporate office for all these projects.

Keeping in mind the burgeoning patient population, the hospital is building a 10-storey car park, which will provide 350 car parking and 350 scooter parking slots.

With such ambitious plans, it remains to be seen how the already renowned hospital will add value to the changing healthcare profile of Pune.

rita@expresshealthcaremgmt.com