PROJECT REPORT ON PLANNING OF

CHARITABLE EYE HOSPITAL

Prepared By:

Dr. Parag Rindani

Manager Medical services

Mrs. Bhavisha Kharnare Dr. Jigna Joisher

Sr. Executive Administration Management Trainee
Table of Contents

Need of Charitable Eye Hospital 3

1) Scope of services 4
2) Plan of Eye Hospital
a. Area requirement 5
b. Layout 6-8
c. Manpower Planning 9
d. Consumables List 10
4. Financial Analysis
a. Workload Analysis 11
b. Project Cost Summary
- Fixed Cost 12
- Operational Cost 13

List of Annexure

1. Surgical techniques
2. OR Layout
3. Medical Equipment Planning and Costing
4. List of Consumables used in Cataract surgery
5. List of Consumables and Drugs used in OPD
6. List of Instruments used in Cataract & Glaucoma Surgery
7. Furniture & Fixture Cost
8. Linen Set Costing
9. Sample Forms
i. Registration form sample
ii. Ophthalmic Examination format sample
iii. Examination Form Sample
iv. Consultant Examination Form Sample
v. Glasses Prescription Format Sample
vi. Cataract Surgery Booking Format Sample
vii. Consent form sample for Surgical / Invasive Form
viii. Consent form sample for Fundus Fluorescein Angiography /
Ophthalmoscopy

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 Need for an Eye Hospital

"One of the basic Human Right is to see and, therefore, it is to be ensured that no
citizen goes blind needlessly; or being blind does not remain so, if, by reasonable
deployment of skill and resources, his eye sight could be prevented from
deteriorating and if already lost could be restored”:
- Resolution of the Central Council of Health & Family Welfare at
its meeting in the year 1975.

Blindness is defined as visual acuity of less than 6/60 or a corresponding visual field loss
to less than 10 degrees in the better eye with best possible correction.

Fifty per cent of total world blindness is thought to be due to cataract and the majority of
blinding cataract is found in developing countries. Magnitude of Blindness in India is
huge. Posing as a major public health problem, there are around 14 million blind persons
in the country, of which around 60% are due to cataract, which is a surgically curable
disease. Refractive errors, childhood blindness, glaucoma, diabetic retinopathy and
corneal blindness are other important causes of blindness.

To tackle this problem, National Programme for Control of Blindness was launched in
1976 with the goal to reduce the prevalence of blindness from 1.4% (1974) to 0.3 % by
developing eye care infrastructure and human resources, increasing accessibility to eye
care services and improving quality of eye care services and visual outcome following
medical and surgical management.

The purpose of cataract surgery is to restore vision of the affected person through
provision of package of services that can enable the person to not only gain sight but also
return to his normal routine before the visual disability.

In India alone over three million cataract surgeries are now performed annually.

Contribution from private health care providers will complement government initiatives
towards control of blindness. A Charitable institute providing quality care will be boon to
the society and a step forward towards fulfillment of corporate social responsibility.

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 SCOPE OF SERVICES

Proposed Eye hospital will be equipped to provide both diagnostic and therapeutic
facilities. Although a general screening by a trained ophthalmologist will be available for
all needy patients, diagnostic, therapeutic and surgical facilities will focus on 2 disease
groups i.e. Cataract and glaucoma. All surgical facilities will be on day care basis only.

• Services will be provided to below poverty line population.

• O.P.D and Surgical services will be provided on all weekdays except Sundays,
between 9 AM to 6 PM.

• 4 OPD rooms will be planned for this set up out of which 3 consulting rooms will
be with slit lamp and 1 room will be for optometrist with standard auto refractor.

• Day care unit will be equipped with 8 beds. Patients requiring surgery will be
admitted, prepared and discharged from this unit. Also emergency care if any,
required by the O.P.D patient can also be provided in this unit.

• 2 Operation theaters, along with a minor procedure room will be equipped for
surgical work.

• Phacoemulsification will be used as a surgical technique for cataract removal.

Details regarding surgical technique are given in annex-1.

• Proposed hospital will have air conditioning facilities only in special areas like
O.T. No central air conditioning is being planned.

• Since the proposed hospital is designated as charitable hospital, patients will not
be charged for the services provided by the hospital.

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 AREA REQUIREMENT OF PROPOSED HOSPITAL
Following is the area requirement of different areas across the hospital.

Standard requirement Required area

Area No. Required
(m2) (Sq.Ft)
O.P.D
4
Registration Counter 1 43
Consulting Room 8.75 3 282
Optometrist room 8.75 1 94
Surgery Investigation
10.0 1 107
room
Laser Room 16.0 1 172
Perimetry room 8.75 1 94
Minor procedure room 10.0 1 107
Patient waiting area 24.0 40 seater 258
TOTAL 90.25 1157
OPERATION
THEATER
Operating Room 31.5 2 677
CSSD area 26.25 1 282
OT stores 10.12 1 108
Changing Rooms 5.65 2 121
Doctors Lounge 7.87 1 84
TOTAL 81.39 1272
DAY CARE
COMPLEX
Patient rooms / Cabins 85 8 914
Nursing Station 1
Staff room 1
TOTAL 256.64 3343
20% of Total
WORK SPACE 668
area

Total Area (Approx) – 4000SQ.FT / 371m2

LAYOUT
Designing of the set up will be in accordance to standard infection control criterion,
wherein movement is from non-sterile to clean to sterile area and never reverse.
The proposed hospital will have the following areas:
1) OPD: The OPD will have the following rooms

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 i. Registration and reception Desk
ii. 3 Consulting Rooms
iii. Optometrist Room
iv. Surgery Investigation Room
v. Laser Room
vi. Perimetry Room
2) Operation Theater Complex: The complex will have the following rooms
i. 2 Operation Theaters
ii. 1 Sterilisation Room
iii. Doctors / Staff Lounge Area
iv. Male / Female Changing Areas
v. Toilet
vi. Store & Equipment Room
3) Day Care Complex: The Day Care area will function as the preparation as well as the
recovery area. It will consist of
i. 8 Patient Recovery Beds
ii. Nursing Station
4) CSSD: The CSSD is included in the Operation Theater Complex.

A suggested layout for the O.T complex is attached herewith. (Annex-2).

Layout of each specific room will be as follows:

Items Quantity
Employee Chair 2
Personal Computer 2
Reception desk 1
Printer with fax and Xerox. 1
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Telephone 1
Storage area for stationary 1
Consulting Room -3
Items Quantity
Examination Chair 3
Patient Relative Chair 3
Refraction Unit 3
Slit lamp with direct and 3
indirect Ophthalmoscope
Mirror 3
Optometrist room
Items Quantity/Room
Examination Chair 1
Patient Relative Chair 1
Autorefractometer 1
Non Contact Tonometer 1
Ophthal Chair Unit + 1
Lensometer
Mirror 1
Surgery Investigation
room
Items Quantity/Room
Examination Chair 1
Patient Relative Chair 1
Patient examination couch 1
A/B scan Machine 1
IOL Master 1

Laser Room
Items Quantity/Room
Examination Chair 1
Patient Relative Chair 1
Laser Chair Unit 1
YAG Laser 1

Perimetry room
Items Quantity
Examination Chair 1
Patient Relative Chair 1
Perimeter 1

Layout of Daycare Complex will be as

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follows:
Items Quantity
Nursing Desk 1
Computer 2
Patient Beds 8
Bedside Lockers 8
Service Table 8
Stretcher 2
Wheel Chairs 2

Layout of CSSD will be as follows

Items Quantity
Ultrasonic Cleaner 1
(Optional)
Flash Autoclave 1
Horizontal Sterilizer 1

The list for all Biomedical Equipments is attached here with. (Annex-3)

Manpower Planning

Average cost Average cost Average cost @

@ 50% @ 75% 100%
Sr. Salary/ Utilisation Utilisation Utilisation
Category Qualification
No Person
N NO NO
Total Total Total
O. . .
Customer
1 Graduate 7,500 2 15,000 2 15,000 2 15,000
Care staff
2 Optometrist B.Sc.Optometr 10,000 2 20,000 2 20,000 2 20,000
8
 y
Consultant,
3 D.O.M.S 30,000 2 60,000 2 60,000 2 60,000
Full Time
Part Time Fee For
4 D.O.M.S 4 4 4
Consultant Service
XIIth with
OT
5 relevant 7,000 1 7,000 1 7,000 1 7,000
Technician
experience
B.Sc. Nursing
6 OT In-charge with relevant 12,500 1 12,500 1 12,500 1 12,500
experience
B.Sc. Nursing
Staff Nurses
7 with relevant 6,500 7 45,500 11 71,500 15 97,500
for OT
experience
Ward Boys / XIIth with
8 Housekeepin relevant 3,000 2 6,000 3 9,000 5 15,000
g Staff experience
1,95,00
1,66,000 2,27,500
TOTAL 21 / month
26 0/ 32
month / month

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 Consumables & Instruments Costing

Consumables used for Cataract Surgery

Average set of consumables used for Cataract surgery costs Rs.1800. List of common
cataract consumables is attached herewith. (Annex-4)

Cost of IOL ranges from Rs.1400 (used in Regular package at Wockhardt Eye Hospital)
to Rs. 7000 (Used in Premium Package at Wockhardt Eye Hospital). For calculation of
cost of consumables for proposed hospital, IOL cost of Rs.1400 per patient has been
taken.

List of Consumables and Drugs for O.P.D

Average consumption of consumables, stationery and drugs used per month in OPD costs
Rs.12,300. List of consumables, drugs and other stationery items that are used in the OPD
is attached herewith. (Annex-5)

Instruments List
The list of instruments used in cataract and Glaucoma Surgery is attached herewith. The
cost of the instruments is not included in the costing, as it is yet to be determined.
(Annex-6)

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 WORK LOAD ANALYSIS

O.P.D Workload

At 100% utilization:

Available Consultation/hr OPD rooms Daily OPD Load

hours
OPD room 8 5 3 120

Flow of Ophthal O.P.D

Registration (5 min.) ⇒ Examination by optometrist (10min.) ⇒ Dilation if Required

(20min.) ⇒ Consultation (10min.) ⇒ F.U

Time spent by a person in O.P.D can range from 30-50min, i.e. Avg. 40min.

Considering avg. 1 relative / patient, a waiting area for around 30 persons will be
required in Ophthalmology department.

O.T Workload

At 100% utilization:

Available Surgeries/hr Number of Daily OT Workload

hours OT
OT 9 1 2 18

Work Flow of Ophthalmic O.T

Registration (5 min) ⇒ Admission assessment (30 min) ⇒ Surgery (50min) ⇒ Post Op

Monitoring ⇒ Food Provided ⇒ Post Op Instructions/Medication ⇒ Discharge
⇒ F.U in O.P.D

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 Project Cost Summary

Fixed Cost

S.No Description Cost Estimate (Rs)

1 Land and Development Cost

Land (4000sq.ft) N.A1

2 Civil Work (4000sq.ft@ 1000 /sq.ft)

Structure Rs.700 / Sq.ft 28,00,000
Finishes Rs.300 / Sq.ft 12,00,000

3 Furniture and Fixture2 10,00,000

4 Bio medical equipments 3,22,80,800

5 Hand Instruments To be determined

6 Support Services
Air Conditioning for O.T3 10,00,000
UPS for OT 20,00,000
D.G Set for Wards and O.P.D 2,00,000
Linen sets4 70,000
TOTAL 4,05,50,8005

1 - Land Cost has not been taken into consideration.

2 – Details of costing of furniture & Fixtures attached herewith. (Annex-7)

3 - Air conditioning will be provided by means of separate A.H.U for 2 operation

theaters. HEPA filters will also be a part of this system. There is an option of
providing window A.C in theaters, but with window A.C system HEPA filers cannot
be installed.

4 – Details of costing of linen sets attached herewith. (Annex-8)

5 – Total cost does not include the land and development cost and cost of hand
instruments.

Depreciation of fixed assets has not been accounted in the calculation.

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Operating Cost / Month
The Operating cost details are as follows:

Cost Head Cost per Unit Avg. Cost Avg. Cost Avg. Cost
/Month @ /Month @ /Month @
50% 75% 100%
Utilization Utilization Utilization
Electricity1 @5.5 Rs/KW Rs. 58,437 Rs. 87,656 Rs. 1,16,875
Rs.16,500 Rs.16,500 Rs.16,500
2
Maintenance @4.5Rs/ Sq.ft Rs. 9,000 Rs. 13,400 Rs.18,000

Laundry3 @ 3.50 Rs per Rs.37,500 Rs.56,250 Rs.75,000

piece
Direct Rs.1800 + Rs. 405,000 Rs. 607,500 Rs. 810,000
Consumables4 Rs.1400
OPD Rs. 6,150 Rs. 9,225 Rs. 12,300
Consumables,
Drugs &
Stationery
Staff Salary Rs. 1,66,000 Rs. 1,95,000 Rs. 2,27,000
Total Rs. 6,98,587 Rs. 9,85,531 Rs. 12,75,675

1 - Considering load of 85kw /hr and working time of 10 hrs for the unit.
2 - Rs.4.5/sq.ft. has been taken as an average from expenses at Mulund Hospital.
3 - Rate of Rs.3.50 per piece for outsourced services and avg. of Rs.3000/day
4 - Cost of cleaning material and other non-chargeable material like scrub solution etc.
has not been taken into consideration.

• Break-even analysis has not been done in consideration of working of

proposed hospital as a charitable entity.

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