Managing a Modern Hospital

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Edited by: A. V. Srinivasan

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    List of Tables

    • 1.1 Number of All Hospitals and Beds with Ratio to One Lakh Persons 3
    • 1.2 Ownership of Hospitals and Beds in 2001 3
    • 1.3 Number of Allopathic Hospitals and Beds in Rural and Urban Areas in 2001 4
    • 1.4 Registered Doctors and Nurses per One Lakh Persons 4
    • 1.5 Percentage Distribution of Deaths by Ten Killer Diseases (1998) 5
    • 1.6 Source of Funds for National Health Expenditure 8
    • 1.7 Utilisation of Out-patient Health Care Services 12
    • 2.1 Functional and Area Analysis for a 30-bedded Hospital 31
    • 2.2 Sanitary Requirements 40
    • 2.3 Staff Requirements 45
    • 4.1 Patterns of Health Sector Growth in India 74
    • 4.2 Trends of Growth in Hospitals 75
    • 4.3 Trends of Growth in Hospital Beds 75
    • 5.1 Evolution of Hospital HRM Function in India 99
    • 5.2 Personnel Management and Human Resource Management: Differences in Philosophy 100
    • 5.3 Five-year Manpower Plan (Number of persons) 105
    • 6.1 Types of Selective Controls 127
    • 6.2 Selective Control Procedures for A-B-C Items 130
    • 6.3 When A-B-C Analysis is Not Applied 131
    • 6.4 When A-B-C Analysis is Applied 131
    • 6.5 Control of A-B-C Items with X-Y-Z Classification 133
    • 6.6 Control of Spare Parts 134
    • 6.7 Control of Slow, Fast and Non-moving Items 135
    • 8.1 A-B-C Classification—Bio-medical Department 158
    • 8.2 H-M-L Classification—Bio-medical Department 160
    • 8.3 X-Y-Z Classification—Bio-medical Department 161
    • 8.4 V-E-D Classification 163
    • 8.5 F-S-N Classification 163
    • 8.6 S-D-E Classification 164
    • 8.7 G-O-L-F Classification 164
    • 8.8 S-O-S Classification 164
    • 12.1 Basic Transportation Matrix Data 233
    • 12.2 Final Transportation Allocation 233
    • 12.3 First Feasible Solution Matrix Data 235
    • 12.4 Final Transportation Allocation 236
    • 12.5 Comparative Analysis 240
    • 12.6 Machine Age-cost Data 243
    • 12.7 Launching a New Product in a Hospital 248
    • 12.8 Activity–Slack 248
    • 13.1 Comparison between Peripheral Smear and QBC Test for Detecting Malaria 266

    List of Figures

    • 2.1 Work-flow Analysis 30
    • 3.1 Configuration of a 1000-bedded Government Hospital 63
    • 3.2 Configuration of a 700-bedded University Hospital 64
    • 3.3 Configuration of a 1000-bedded Trust Hospital 65
    • 3.4 Configuration of a 250-bedded Corporate Hospital 66
    • 5.1 General Management vs HRM Functions 101
    • 7.1 Organisation Chart 146
    • 7.2 Pharmacy Organisation 152
    • 10.1 Who is a Customer? 175
    • 10.2 Levels of Relationship Intensity 188
    • 10.3 Customer Care Life-cycle 193
    • 11.1 Structure of a Medical Records Department 209
    • 12.1 Queue Models 238
    • 12.2 ‘Bath Tub’ Curve 244
    • 12.3 The Network 249
    • 13.1 Architecture of a Typical Expert System 253
    • 13.2 Exploratory Development Cycle 255
    • 13.3 Flow of Knowledge Acquisition 258
    • 13.4 Clinical Features and MP Test 270
    • 13.5 Interpretation of Pre-treatment MP Test 271
    • 13.6 Registration 273
    • 13.7 History of Fever 273
    • 13.8 Evaluation of Signs 274
    • 13.9 Investigations 275
    • 13.10 Tests for Malaria 276
    • 13.11 Peripheral Blood Smear 277
    • 13.12 Microscopic Views 278
    • 13.13 Rapid Diagnostic Tests 279
    • 13.14Plasmodium Falciparum280
    • 13.15P. Vivax, P. Ovale and P. Malariae281
    • 17.1 Three-tier Documentation Process 349

    Foreword

    Health care is the world's largest industry. As such, India has to be prepared to meet the health care challenges of the new millennium.

    Many modern disciplines have a long history but a short past. Health care management is one such discipline. Decades ago, the total body of literature on hospital administration was managed by a single doctor. Today, it is well recognised that the system requires a multi-pronged approach and total professionalisation to achieve quality and cost-effectiveness.

    The past decade proved to be a difficult period for health care managers who were limited by the budgetary constraints in both public and private financing sectors, and an ever-increasing concern for the appropriate and optimum allocation of health care resources.

    Hospitals today have to meet the needs of patients and the total focus has shifted to ‘patient services’ instead of only medical and surgical therapies.

    The year 2000 may be characterised as the start of the ‘decade of the administrator’. As we move into this era, the major problems that will be encountered and the issues that will have to be resolved will be clearly administrative in nature—the need for cost containment. The necessity of cost containment, while maintaining quality, is obvious. This concept highlights the society's medical resources and the concept of efficiency with cost.

    There has been growing concern through this decade regarding access to hospitals and medical care for the 1 billion Indians who lack any form of health insurance. On the other hand, as the large majority of Indians are in villages, there is a need to provide them with access to quality care as is given to anyone in the cities. All these factors pose greater challenges for the modern hospital administrator.

    This book is a well-planned and organised collection of essays. The selection offers a good balance of information on hospital structure and management methods which deal with general management principles, techniques of finance, operations and human resources that are of relevance today.

    High quality of care is often equated with access to the newest technology, the most advanced medications and facilities, poised at the cutting edge of clinical care and research. This should go hand in hand with the efficient utilisation of health care resources by hospital professionals.

    The Apollo Hospitals group, with its over one and a half decade of professionalised management, appreciates Dr A.V. Srinivasan's efforts to bring out this book for the benefit of a large number of beneficiaries.

    Dr Prathap C.Reddy, Chairman, Apollo Hospitals Group and Apollo Hospital Educational and Research Foundation

    Acknowledgements

    I am grateful for the resources and facilities provided by Apollo Hospital Educational and Research Foundation, Hyderabad.

    I am grateful to Oxford University Press India for giving me permission for the extensive quotations on pp. 33–36 from Berman's paper, ‘Health Care Expenditure in India’, published in Health, Poverty and Development in India.

    I am grateful to the National Council of Applied Economic Research for giving me permission for the extensive quotations on pp. 36–38 from the paper, ‘Household Survey of Health Care Utilization and Expenditure’ published in their journal, Margin.

    I have adapted selected findings from the report by Ernst & Young—Healthcare: An Unprecedented Opportunity, which appeared in the website of India Brand Equity Foundation, Healthcare page (http://www.ibef.org). I acknowledge this source for the text in Part 5 of Chapter 1.

    AVS

    Introduction

    A quiet revolution is taking place in hospital administration in India. Private sector participation in health care is on the increase because entrepreneurs and technocrats see immense opportunity for earning in this sector. There is enough evidence to show that there is a willingness to pay for the services out of one's own savings or through organisational perquisites. It is no more the era of charity, either by a social organisation, or the government. This has earning potential, and there is a felt need to maximise the use of resources to build surplus to support the needy. The changing scenario of increasing demand, a variety of means to support the rendering of quality health care, and an entrepreneurial spirit, have given a boom to the health care industry in India. Many corporate hospitals and nursing homes have come up because large business houses have found this an area of opportunity; the supporting industries, such as equipments, instruments, software, indigenisation have multiplied and been strengthened. In general, everyone has found the need for sourcing of investment, resource optimisation, increasing productivity, maintaining high quality and service orientation to the customer-patient. Proper rate of return for investment, adopting high technology to hedge over competition, subtle marketing and application of analytical methods to improve efficiency are some of the management techniques which have been accepted by the industry consciously. Like in an engineering industry, hospital executives talk of marketing, promotion, retention of staff, payback period, quality improvement, and so on, which incidentally are typical management terminology. This has created the need for a new breed of hospital administrator, who is not necessarily a medical professional, but has studied management in depth. Until recently, the hospital administrator was, for most of the time, a medical professional who took to administration willingly, because of interest or for reasons of career growth, sometimes or rarely supported by a formal education in management.

    Currently, there are very few schools in the country which are run on the lines of a management institution, where a high specialisation in hospital management is provided. These are the schools, where the entry qualification of the aspiring candidate can be any degree, including one in medicine; and which, like business schools, specialise in and offer a master's degree in hospital administration. The curriculum is oriented to running a hospital in the same way as an industrial organisation. Apart from classroom learning about management, these students learn about the activities in a hospital, through observation, project studies, summer training and internship. Many times, these students are exposed to hospitals, for the first time perhaps, through these methods. Very few management books are available in the country to help them learn the basics of a hospital as an industrial organisation. Managing a Modern Hospital partially fills that void. The urge to publish this book came from my experience while establishing the Apollo Institute of Hospital Administration. For an entrepreneur-doctor, it provides the necessary management knowledge to create a hospital and run it as a viable economic unit. For an investor, this book provides enough information about some of the special features of the hospital as a business organisation. For an administrator in a hospital, it provides enough management material to ensure efficiency. For senior professionals, it provides the rationality for keeping order and discipline (Henry Fayol's Principles of Management) in any hospital, ensuring efficiency, productivity and creating a surplus for the use of the needy. This book will help the medical professional and administrator, irrespective of the ownership of the hospital—corporate, funded, charitable, religious, parochial or government, both large and small.

    The selected topics cover a wide range of interest—from environmental issues to conventional management applied to managing a hospital. Every topic focusses on ensuring efficiency and order. The authors have shown the relevance of the use of computers, and where possible, taken a futuristic outlook. All chapters are practice-oriented and many are supported with case illustrations. Thus, this book will serve as a guide to help students of hospital management learn effectively and develop models for a given situation.

    The opening chapter, ‘Health Care in India—A Profile and the Future’, contains five parts, and the first is an analysis of the official statistics on health care, leading to an estimate of number of hospital administrators that will be required in the country by the year 2001, to support the growing number of hospitals. The second and third parts present different vistas on the health care sector in India. It closes with normative and prescriptive long-term projections for the future, and an estimate of the size of the market. The author traces what has been taking place in the Indian health care sector, to prove its economic potential, the possibility of it becoming an engine for growth, and provides some suggestions for proactive decisions. This chapter contains the present developments in the country and sets the theme for private initiative to open up a segment which will bring health to more people and provide economic benefit to many more.

    Dr (Col.) K.B. Subba Rao has given detailed information to an entrepreneur about the intricacies of creating a hospital, in his chapter, ‘Planning a Modern Hospital’. He has used published standards to help aim at the ideal. Since many states do not impose stringent conditions to start and run a hospital, the condition of many of them is abysmally low in India. His chapter will show the right way of doing it. In his chapter, Dr Srinivasan has indicated the utility, need and efficacy of small hospitals, which may be of the size of 30 to 100 beds. Dr Subba Rao's chapter helps to create such hospitals.

    The chapter written by Dr S.F. Chandra Sekhar, ‘Hospital Organisation Structure’, is a blend of theoretical rationality and pragmatism. He traces various aspects of a structure which is applicable for any organisation, and applies them to four types of hospitals, classified by ownership—a large government-run hospital, a university teaching hospital, a trust hospital and a corporate hospital. He discusses their rationality and indicates the design for the future. He concludes that there is no one right structure that is appropriate for all hospitals, but the circumstances in which an organisation finds itself leads to its structure. He extols the current thinking regarding flat structures to increase efficiency, quicker decision-making and a close relationship.

    From structure, we move on to finance in the next chapter, ‘Financial Management for Hospitals’ by Prof. P. Jangaiah. Many corporate and private-owned hospitals though technologically superior, are inefficient in managing finance. A proper management of finance will not only give a larger surplus, but will also help in cost control and minimisation, the gains of which can be passed on to the patients. He suggests sources for funding a hospital project, be it total creation or expansion, provides rationality for measuring its return, and works out various ratios to keep business operations in check. Many of the principles are supported with live data.

    An important resource in a hospital is human resource. This should be particularly emphasised in the context of a hospital, since human relations plays an important role in providing a cure. In Chapter 5, ‘Human Resource Management in Hospitals’, Dr S.F. Chandra Sekhar applies the functions of general management—planning, organising, directing and controlling—to each one of the tasks of human resource management—procurement, development, compensation, integration, maintenance and separation—to give a holistic view. He gives a detailed working for manpower estimation and an illustrative instrument for selection. His theme is, ‘from control perspective of personnel philosophy to commitment perspective of human resources philosophy’.

    Classification of the materials used in any organisation will itself bring order and efficiency. This is known as Selective Management Principle. This classification can be made on different criteria. Mr V. Venkat Reddy has collected almost all classificatory systems in one place in the chapter, ‘Hospital Materials Management’. He has illustrated each one of them, discussed when and how to use them, and where needed combined two systems in a matrix form for decision-making. For the sake of clarity, he has provided a compare and contrast study between the materials managed in a hospital, and the ones in an engineering manufacturing organisation. Once the classificatory system is in operation, and the policies are stated, a computer programme will help automation by working out the inventory levels, order quantity and order date.

    This is followed by two chapters which are case studies related to the same subject by Dr A.V. Srinivasan, ‘Hospital Stores Organisation and Pharmacy’ and ‘Selective Systems of Materials Management in a Hospital—Case Illustration’. Making use of live data, he illustrates how pharmacy and hospital material stores are organised by structure and policy. All systems discussed by Mr V. Venkat Reddy are illustrated by item name and calculation in the second case study.

    Mr K.P. Kumar has an interesting and novel approach to derive inventory policies for drugs in a hospital pharmacy. He extends the classificatory systems presented earlier, uses combinatorial analysis to reduce the classes, and put them into decision boxes, where the policy and the person in the hierarchy who is responsible for its implementation are clearly stated. The chapter titled ‘MBASIC System for Effective Drug Management’ by Kumar is a good example of decision-support system for drug inventory management. The availability of inventory management software, computer professionals and suitable hardware signal the application of this effective technique.

    Customer Relations Management is now a hot topic in marketing and IT. Ms Pooja Elizabeth George has discussed it in easy language and applied to hospital management in the chapter, ‘Customer Experience Management—A Marketing Initiative’. She has gone a step farther from image with and retention of customers of CRM to learning and adoption of their experience. Hospitals in private sector increasingly face competition and the customers (patients and referees) are getting more information from internet and are demanding. She has shown how to survive in such an environment by building competitive strength. She has supported the rationality with observation and a structure. This and the next chapter are valuable additions of latest knowledge to this edition.

    A medical record is a compilation of pertinent facts about a patient's life and health history, including past and present illnesses and treatment given by health professionals contributing to the patient's care. It is the personal property of the patient and ensures continuity of treatment. The chapter, ‘Medical Records’, by Ms Mamta Edwards, covers the purpose, uses and value of medical records. The author indicates who is responsible for the construction, maintenance, administration of medical records and related legal issues. The formats in which the records are to be maintained, the types of data, and the retention principle are also covered. This chapter concludes with future developments and computerisation of records.

    Operations Research is a multidisciplinary approach for problem-solving and improving efficiency. It uses some of the proven mathematical models to a situation, whether it is simple or complex. This has been used very widely in industries and in Johns Hopkins Hospital, as early as the fifties. Its application has become easier now with the availability of powerful PCs and relevant software. Its utility is so high that it is a core subject in every management curriculum. Dr K.N. Gaur, in the chapter, ‘Operations Research in Hospitals’, traces the history of this approach to provide rationality, makes a listing of the major techniques included under this head, and describes how to build a model. In the second part of his paper, he shows how to apply selected Operations Research techniques to hospital situations. These are Allocation Methods, Queueing Models, Replacement Models and Network Techniques.

    Dr Jeet Patwari has applied the concepts of expert system of decision science and developed a prototype for diagnosis. He has shown the intricacies of this powerful tool, which is difficult to apply. He has given an easy introduction to the concept, shown the steps of diagnosis by taking an example of a specific disease and takes the reader through a sequence of computer outputs of the procedure. This chapter, ‘Computer Aided Diagnosis—Expert Systems’, will show not only a method to develop computerized diagnosis using a database and computer but also create an interest and eagerness to build expert system models in health care. This chapter will be of special interest to IT developers and clinicians with research orientation.

    A hospital produces a large amount of waste, some of them are pollutants and hazardous to health. In India, a large proportion of hospitals and beds are located in urban areas, where the civic conditions may not be at desirable level of efficiency. In the chapter titled ‘Hospital Waste Management’, Dr Homi Mehta presents readily implementable systems. He groups the wastes into different types, in terms of their end effect, and gives a classificatory scheme to segregate them, and eventually manage them in a manner so as to prevent unwanted after-effects. This chapter deals with the collection, disposal and treatment of waste. One aspect of waste management is prevention—how to minimise waste creation. This also forms a part of the chapter. Managing hospital wastes has not been getting the attention it requires from the civic authorities, and also from hospitals in the country. Dr Mehta presents a case study to illustrate the application of his scheme at the end of this chapter.

    Dr U.V.N. Das looks at the need and advantage of keeping the patient comfortable, happy and contented. ‘Patient Relations in Hospitals’ is addressed to all hospital staff, irrespective of their rank and location. He deals with each function in a hospital, and shows how a patient can be kept happy. This, and the following chapters are relevant and apt in today's world of consumerism.

    While Dr Das touches upon creating a ‘delighted customer (patient/ attendant)’, Dr N. Rajaram and Ms Swati Pandey, in their well-researched paper on another aspect of consumerism, insist on the need and importance for ‘Medical Audit and its Administration’. Starting from listing the acknowledged attributes of medical audit, they set up protocols for audit, identify its elements, discuss the audit types, methods and monitoring techniques. They discuss the constraints in auditing and difficulties in implementation. An informative part of the paper is their opinion survey of doctors on medical audit. They express the urgency, need and importance of this management process with the quotation: ‘There is a time to end contemplation and a time to begin’.

    The opening of the European Common Market to Indian industries brought along with it standardisation and third-party certification. Total Quality Management and Control of Variation were widely propagated among the industries—one more aspect of consumerism, ‘the value for money’. One by one, many engineering industries in India went for ISO certification. Now it is the turn of the service industries, such as banking, education and hospitals, to control the variations in their output, and to attract customers through third-party certification of their quality of service. This will provide a competitive edge. A number of hospitals worked hard to obtain the ISO 9002 certification. K. Prabakar in the chapter ‘ISO 9002 Certification for a Hospital—An illustrative Case’, describes what this is all about, explains standard clauses in understandable terms to hospital administrators, and elucidates how Apollo Hospital obtained this certification. This is supported with a case illustration by Dr A.V. Srinivasan in the next chapter.

    Compiling a book of this nature is quite a strenuous task, and is time-consuming. But I enjoyed it as I realised its value for the readers. The interest and continued support provided by Sangita Reddy and Dr Prathap C. Reddy enthused me in creating this collection. I wish to record my appreciation and thanks to them.

    Archana Rajgopal, Ishrath Humairah, Kiranmaye Rao, Arundhati Mamidi and Dharma Tej, who were students of Apollo Institute of Hospital Administration, helped me a great deal in composing and editing the chapters. Their cheerfulness and willingness to share my work made the task a pleasure. Finally, Shaik Khasimbi, with her unlimited patience, supported me in this venture with secretarial assistance.

    A.V.Srinivasan
  • About the Editor and Contributors

    Editor

    A.V. Srinivasan is Director of Corporate Planner-Indian Network, a management consulting firm based in Hyderabad.

    Dr Srinivasan has a Masters in Statistics from Madras University and an MBA and PhD in Operations Research from the University of Chicago. He was until recently, professor of management in the Apollo Institute of Hospital Administration, affiliated to Osmania University, Hyderabad and adviser to Apollo Hospitals Education and Research Foundation. He was a faculty at the Administrative Staff College of India for over 15 years, visiting professor to several universities in the United States and an executive with the Mahindra Group in Pune. He also served as IFCI Professor of Management at Delhi University, and is a fellow of the Indian Institution of Industrial Engineering.

    Dr Srinivasan has developed corporate plans and futuristic studies for several organisations over the course of his career. He has presented papers in international conferences and published papers in several reputed national and international journals. He has authored a number of books on management including Managing a Modern Hospital (Sage, 2000); Indian Leather 2010: A Study of Technology; Japanese Management: The Indian Context; Triumph in Project Management: A Study of Vijaypur Fertilizer Project; and Critical Path Analysis—A Systems Approach.

    Contributors

    S.F. Chandra Sekhar was Reader in Hospital Administration in Apollo Institute of Hospital Administration. He has been teaching, training and conducting research in the fields of health care, welfare and social development for almost a decade. He is on the board of several NGOs, has carried out sponsored research projects, and has over 25 research papers and many working papers to his credit, some of which were presented in national conferences and also published in leading academic journals. He has deep interest in the application of the organisation theory to hospitals and health care institutions. He holds an MSW, an MBA and a PhD in the HRM area.

    U.V.N. Das is Resident Medical Officer in Apollo Hospitals, Hyderabad. He managed the Apollo Health Association and Health Insurance Scheme, and served the Government of Andhra Pradesh as a medical professional in remote tribal areas and in rural Primary Health Centres for several years. Through observation, reading and practice, he has developed an interest and his own style of doctor-patient relationship. He has also worked for corporate hospitals in the Middle East. His educational career spans an MBBS from Andhra University, Post-graduate Diploma in Environmental Sciences, Fellow of the College of General Practitioners, and Diploma in Hospital Management from the National Institute of Health and Family Welfare.

    Mamta Edwards was the Head of Department of Health Information Management in Apollo Hospitals, Hyderabad. She is well-versed in ICD 9 and 10 systems. She was on the Quality Assurance Committee, Mortality and Morbidity Committee and the Medical Records Committee. She participated in reengineering projects in the hospital, and was responsible for organising the medical records department and its later improvisations. She holds a BSc degree and a Bachelors degree in Medical Records Science from MGR University, with a distinction and a gold medal.

    K.N. Gaur was Professor of Operations Research and Health Management in the Institute of Public Enterprise in Hyderabad. He has been a professor in the Indian Institute of Health Management and Research in Jaipur. He has presented several research papers in national and international seminars and has several publications to his credit. K.N. Gaur conducts management development programmes for top and senior-level health professionals and administrators. He has a PhD in Operations Research from the University of Jaipur.

    Pooja Elizabeth George holds a Masters in Hospital Management and a Bachelors in Rehabilitation Science. She has also had formal education in Medical Informatics and in CRM. She has conducted a number of studies in Apollo Hospitals on Corporate Relations and Marketing; and has made a Comparative study of six leading hospitals in Mumbai for Health Alliance, a healthcare management consultancy. She has worked for Hira Nandani Hospital and is presently working for a UK based multinational corporation in their direct sales and marketing division. She is currently an executive in the Home Health Care unit in Care Hospitals.

    P. Jangaiah is Associate Professor at Apollo Institute of Hospital Administration in the area of finance and is currently with ICFAI School of Management. He has carried out research projects in Health Services Financial Management, Hospital Cost Accounting, Security Analysis and Portfolio Management, and has a long teaching experience in several postgraduate institutions and was a financial consultant. He has conducted and guided a number of research/dissertation projects in the areas of finance and cost accounting for hospitals. He has M. Com and MBA degrees to his credit.

    K.P. Kumar is in the HRD and QM department of Nagarjuna Fertilizers and Chemicals Limited in Kakinada. He has served several leading industrial organisations and taught in the Regional Engineering College, Trichy and Bharathiar University in Coimbatore. He is a graduate in engineering and holds an MBA from Andhra University, and a Postgraduate Diploma in production management from Anna University and is trained in SAP R/3.

    Homi Mehta was Director of Research and Development in Apollo Hospital Educational and Research Foundation. He has worked for the State of Connecticut in the USA and the University of Massachusetts at Amherst, and had his postgraduate training in Mangalore and Secunderabad in India, and Tiperrary in Ireland. He holds an MBBS from Kasturba Medical College, Mangalore, a Masters degree in Public Health from the University of Massachusetts and an ISO-14000 Lead Auditors Training Certificate from Marsden Environmental International.

    Swati Pandey earned her Master's in Hospital Management degree from Apollo Institute of Hospital Administration. Some of the projects she carried out are: Assessment of quality in ICUs, and Utilisation and Cost Containment in the Catheterisation Lab.

    Jeet Patwari acquired MBBS degree from Gauhati University and Masters in Hospital Administration from Apollo Institute of Hospital Administration. After obtaining medical degree, he was a Resident in Down Town Hospitals, did private practice, and worked for an NGO, Purna Prayaas, all in Guwahati. He graded healthcare institutions for CRISIL, performed clinical interface in Telemedicine for Max Healthcare and was working with Ernst & Young in health care consultancy developing a Health City in Nagpur.

    K. Prabakar is Director HRD for the Apollo Group of Hospitals in Chennai. He has the responsibility for running the postgraduate diploma programme in hospital management. He has published papers on: employee relations in hospitals; the role of unions in collective bargaining in hospitals; quality system certification in hospitals. His professional career spans about 30 years in human resource management in hospitals; he was also instrumental in securing ISO implementation in Apollo Cancer Hospital, Chennai and Apollo Hospitals, Hyderabad. A graduate in Chemistry, Prabakar has a postgraduate degree in human resource management from the Madras School of Social Work and a PhD from Anna University.

    N. Rajaram is a hospital administration executive with the Alluri Sitarama Raju Educational Society, and is currently establishing a medical college using modern and well-established norms and facilities. He has earlier worked for CARE Hospitals as an administrator, and has rich experience as a medical professional. He has a Bachelors degree in Homeopathic Medicine and Surgery, and a Masters degree in Hospital Management.

    K.B. Subba Rao was Senior General Manager, Indian Hospitals Corporation. He was the project director of Mediciti, and was involved in establishing a medical township. In the first phase, he completed a tertiary care Cardiac Institute, later joining the Indian Hospitals Corporation, and steered the Apollo Hospitals Heart Centre in Visakhapatnam. He served the Indian Army Medical Corps as a commissioned officer for over 25 years, was in action in two major wars, and served in the IPKF before retiring from service. He acquired his medical degree from Osmania Medical College and did his postgraduation in tuberculosis and chest diseases at Andhra Medical College. He was instrumental in the setting up of the TB ward in Adilabad.

    V. Venkat Reddy served as senior executive in leading private sector corporations. He is the Chairman of Indian Institute of Materials Management, Hyderabad Chapter. He has been instrumental, partly, for the growth of materials management movement and literature in India. He works as a visiting professor in management schools and in executive development programmes. He holds B.Sc and MBA degrees and his areas of interest are materials, production and operations management.


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