HOSPITAL MANAGEMENT

A case study of Vathsalya Nursing Home, Shivamogga

CONTENTS

CHAPTER 1
INTRODUCTION
 Introduction
 Scope of the study
 Aims and objective of the study
 Methodology
 Needs for the Study
 Limitation

CHAPTER 2
DEVELOPMENT OF MODERN HOSPITAL IN INDIA
 Discoveries
 Establishment of Private Hospitals
 Adopting New Technology
 Construction of Modern Hospital

CHAPTER3
GENERAL INTRODUCTION TO VATHSALYA NURSING HOME
 Doctors
 AIMS and Objectives
 Thesis on Administration and Management Relationship

CHAPTER 4
WORKING OF VARTHSALYA NURSING HOME

1
CHAPTER 5
MANAGERIAL STRUCTURE OF VATHSALYA NURSING HOME
A. Modern and ultra modern facilities available patience
 Auto calve
 Ultra sound scanning
 Medical laboratory with auto analyzer
 Intensive care unit with ventilators
 Physiotherapy
 Well woman clinic
 Uninterrupted power supply system

B. Details of intensive care unit

C. Details of accounting procedure of the hospital
D. Details of the operation available theaters
E. Detail of the instrumental and equipment available
F. Detail of the medical laboratory available

CHAPTER 6
DATA ANALYSIS AND INTERPRETATION

CHAPTER7
SUGGESTIONS AND CONCLUSION

ANNEXURE
 Questionnaire
 Bibliography

2
 CHAPTER 1

INTRODUCTION

 Introduction
 Scope of the study
 Aims and objective of the study
 Methodology
 Needs for the Study
 Limitation

3
 INTRODUCTION

Hospital in India has been modernized to a greater extent after independence.

In 1947 prominence was being given to the clinical pathological examination
only in those days the patents were mobile. Now, this system has completely
changed, today the clinic have become mobile the system as the clinical
examinations of pathologic has been shifted by the medical laboratory
examination that too with the aid of well equipped medical laboratories.

Health is an important factor in the formation of human resources

development which will play a vital role in improving the qualities of human
beings, who are the active agents of economic development. So any measure
of development achievement in a nation must affect the state of personal
wealth in the nation. Better wealth would contribute to improving the
economic status of the poor and for expanding total output. This demands
sound management of a hospital. Therefore in this chapter the researcher has
made an attempt to discuss about the meaning of hospital and hospital
management, evolution of hospitals, changing concept of hospital, role of
hospital administrator, functions of hospital management, hospital services
and to present a picture of number of public hospitals and beds in India.

Meaning of hospital management : Hospital Management can have different

meanings

Management as a process: Often it is said that it is a professionally managed

hospital; it is well managed hospital, meaning thereby the management is
described as an activity, type of work. Management applies certain principles,
techniques and activities which are performed by certain management
functions.What the hospital Management does is Management.

4
Hospital Management is a subject: A subject, a discipline taught in
universities, colleges or institutes. It is an accumulated body of knowledge
that can be learned, at some places the broad specialty is Health Management
including Hospital Management.Various degrees, diplomas, certificate
courses are run by the institution/universities.

Hospital management as people: The Management of this hospital is very

insensitive, the hospital management of this hospital is not responsive to
society are the terms often used. While using these terms, we are referring to
body of people responsible for management, the board of directors, director,
medical superintendent and his team.

Hospital management as career: News published in the national daily says

that hospital management will be among top ten careers in the next decade.
Such statements imply that hospital management is a career.

Scope of the study

As the study aims at single hospital the scope of the study is verified to
“Vathsalya nursing Home”, Shimogga only the management research survey
has been conducted to study the management structure as the hospital what
are departments wards staff non staff are involved in finding the draw backs
of the nursing home. Separate chapter continuing of remedies on over coming
these drawbacks. This draw back suggestive tip for effective management has
also been included in the report.

Aims and objective of the study

The study aims at the fllowing objectives

 Studying the history of nursing home.

5
  Analysing the administrable structure of the nursing home.
 Analysing the managerial structure of the nursing home.
 Analysing the problem of the patients, the medical staff and the non
medical staff of the Nursing home.
 Suggesting the remedies with respect to the surveyed problem and the
some tips for the effective management.

Methodology

This is an analytical study of Vathsalya Nursing Home Shimoga.

The following method has been adopted to collect the necessary

Information required for the preparation of the report.

1) Primary Data:- In the section of primary data the data has been collected
from the personal interviews done with the patients, the medical staff and
non medical staff. The similar data collection structured questionnaire has
also been used for the collection of the data.
2) Secondary data: The secondary data section containing of information of
gathered from third parties. The person who don’t passes any kind of
relation with nursing home at present, which include. Example patients of
the nursing home etc.

Needs for the Study

Hospitals are highly complex organizations by venture of the many functions

they seek to fulfill. The multiplicity as activity and tasks variety of staff with
a plethora as skill mix avid repertoire of technologies in we convenes of
human suffering and continuous pressure to no matters pertaining to life and
death..

6
 1) The main objective of this topic giving an idea of the product.
2) Consumer perception about the product.
3) To rich the product ultimate consumer.
4) The product can rich all geographical area
5) Main target of product.

Limitation

 Here we can’t contact all types of respondents.

 Respondents will not give correct opinion about survey.
 The availability of data is limited.
 Accuracy of this project report is limited because of factors, like limitation
of time constructions.

7
 Chapter 2

DEVELOPMENT OF MODERN HOSPITAL IN INDIA

 Discoveries
 Establishment of Private Hospitals
 Adopting New Technology
 Construction of Modern Hospital

8
 DEVELOPMENT OF MODERN HOSPITAL IN INDIA

History in India has been modernized to a greater extent otter independence.

In 1947 prominence was being given to the clinical pathological examination
only in those days the patent were Mobile now this system has completely
changed today the clinic have become mobile the system of the clinical
examination of pathologic has been shifted by the medical laboratory
examination that too with the aid of well equipped medical laboratories.

During that time only one physician or doctor was presented in one clinic and
he was suppose to look after all the patents irrespective at their diseases. The
hospital. Which was available that time. Was not offering better consultations
to the patients who were coming for getting the remedies now the system has
completely change.

Discoveries

The discovery as vaccination was a key medical achievement of the 18th

century Lady Mary wotley Montagu ( 1689 -1762) brought to England the
asian technique of variolation which she observed in Turkey. Dr. Clarified
W. Long (1815-1878) as Georgia was the first surgeon to perform Minor
operations using sulphuric either as on a anesthetic agent in 1842 . The
discovery as anestnetic agents sulh as ether. Nitrus oxide and chloroform and
development of steam sterilization techniqul in 1886. The discovery of X-
Rays by with elm Konrad Rontgen (1845- 1923 ) lead to further development
in the Medical techniques.

9
Establishment of Private Hospitals

Albuquerque built Royal hospital in Goa awhile the English established a

military hospital in Madras Later it was declared to be a civilian hospital after
J.J Hospital founded in 1843 began functioning in 1845. The hospital numed
after Sir . Jamshetty jejeebhoy. The Formation of KEM hospital in
1926.Famous physicians such as Jivraj. N. Mehta and R.N Vakil. Surgeons
such as R.N Cooper P.K sen and pathologists such as V.R Khanolkar were
associated with majestic KEM hospital. The tata group of industries built the
tata memorial hospital in 1941 and cancer research institute in 1958 with an
intention of providing cancer treatment to patients in India.

The facilities which patient can avail on those days were only. None angled to
keep single channeled electro cardio graphs etc. Which were not able to detect
the disborders properly the facilities of sterilization was able to limited
notable instruments equipment. Which resulted in unnecessary infections to
the patients. The functions of surgical operation were very poor and were
taking a ling time because of the non –availability as the ultra modern
operations theaters.

Today the managements as the hospital have been completely decent ralizal
up to the extent as one patient one specialist the old hospital has been shifted
by hi- tech hospital the patients these days are getting not only modern
facilities but also the ultra Modern facilities. Which include by ex ..X- rays.
Portable X- ray computer added to topography scanning.

Now a day the detection as a minute disease has also become possible we can
have the instance of the CAT scanning for this. This is a test performed to
detect the compressions/ expansion of the human brain. Today hospital

10
bedighted with another hi 0tech treatment called magnetic resonance imaging
invasive or painful surgical operation as the olden days have been shifted by
non invasive optic surgical operation which aim at surgery without wound
and blood number as hospital are considerably increased as compared to those
olden days.

1. Adopting New Technology

The hospital at present providing so many ultra modern facilities to its

patience to eradicate their disease and to rectify their disorder within a short
period of time.

The hospitals keeps continuously upgrading their facilities b/s having

purchased the most recent sophisticated instruments & equipments for the
place as old existing machines.

Some of the modern and ultra modern facilities which are as below in the
form a list;

 Ultra sound scanning

 Intensive care unit with ventilators
 Physiotherapy
 Medical laboratory with auto analysis.
 The Epabx facsimile system
 Advance cardiac care
 Portable day x-ray
2. Construction of modern hospitals

In India construct modern hospital with all facilities is very helps to the
patients the hospital keeps continuously upgrading the modern facilities by

11
having purchased the modern technical instruments and machines with good
attracting modern building hospital the following are some.

The available the modern standard of operations theater with good medical
instruments.

Available the lifting facility to available the attaching hospital canteen.

12
 CHAPTER-3

GENERAL INTRODUCTION TO VATHSALYA NURSING

HOME

 Doctors
 AIMS and Objectives
 Thesis on Administration and Management Relationship

13
 General introduction to Vathsalya Nursing Home

Vathsalya hospital is the surgical centre Pvt. Ltd, was established in 1998 in
the heart of city at civil lines in Shimoga. It is a multispecialty hospital
providing all the services to the patients in all departments. This fuelling its
name VATHSALYA i.e “ affection of the mother to child “. It is established
in land area 24,000 sq. feet it being surrounded by the greenery all over
provides the patient an open atmosphere to breath.

Doctors;_

Dr. Basaveshvara .M

Dr. Preetheei

Dr. Mahesh newthi B.R

Dr. Pradeep .S

Dr. Ravi

The hospitals aim to surviving the necessary treatment with ultra modern
facilities along with a greater hospitality to the patients for general objective
for the treatment with maximum care for no charges.

Aims and Objectives

1) Maximum health cared for minimum fees and charges

2) Facilitating the treatment with modern and ultra modern equipment.
3) Treatment with a greater hospitality

14
 4) The nursing home maintains a drug store to also save the precious time
of the patients.
5) The nursing home in rich in specialist of all branches as medicines.
Surgery because it aim at “trouble ness and total treatment”.
6) The nursing home aims at treating the patients with respect to time.

The total capital introduced at the time of opening will be 20 lakhs. This
includes the cost of all the modern and ultra modern equipped in the hospital
this amount excludes the building charges of the current hospital building
when shown to the proprietor. This amount also includes all the legal
expenses such as registration charges telephone connection charges advance
period to the medical and now medical staff etc.

At its birth the hospital was consisting of specialists of all branches of

medicine and surgery on those days the department of orthopoedist and
gynecology and obstetrics were very rich.

Today all the other departments are maintaining to that standard.

Management deals with establishing the scope for administration, While

administration function with in the scope established by the management.

Administration in concerned with only the top level management. While the
management relates more with middle and lower level management on an
organization.

Administration in a part as management in an organization where as the

management on concerned with controlling of the entire organization
including the administration division.

15
To conclude with administration is concerned with the installation of
producers while the management is concerned with making co- operative
endeavors and setting the works done on order to reach a particular objective

Thesis on Administration and Management relationship

Administration basically in concerned with the determination of corporate

objectives policies and many strategies of a firm of determines manly the co
ordination of different major function with in the organization.

While the managements as the other face of the same coin in which the
administration with one face in concerned with the exclusion of plan and
policies has laid down by the administration.

The following few are the point. Which prove that the administration differs
from the management up to a greater extent.

Administration in concerned with formulation of the policies whereas the

management relates with executing them. Administration sets the 4th general
purpose of an enterprise establishes its major policies and inaugurates the
board whole the management deals particularly with the board whole the
management deals particularly with the entire direction of the human effort.
The hospital is planning to absorb another 10 to 20 non- medical staff
member to make the services richer and more effective.

16
 CHAPTER-4

WORKING OF VARTHSALYA NURSING HOME

17
 WORKING OF VARTHSALYA NURSING HOME

Number of different department available

The hospital maintains 10 different surgery. Which include the most recent
ones such as gastro enter logy and plastic surgery., it also maintains
sophisticated equipment to cater to t he needs of the daily coming patients.
The list below represents the different available departments on Vathsalya
nursing home.

Department of orthopedics and trauma

This department cater to the needs as treatment as all injuries and wounds and
disorders on bones. This includes the different traction operation given to the
patient as the extension. This departments maintains the departments of
physiotherapy to cater to the need as removed of muscular pain.

But in t6his hospital minor operation given to the patient as the extension.

Department of general surgery and gastro enter logy

This department renders its at most services to the different needs on the
general surgery and aim at treating at the different disorder of stomach
detection as different minute disorder in also a function at this departments.

Department of gynecology obstetrics

Main aim of this hospital is midwifery needs. This department serves to all
the needs and disorders of the female patients in having a specialized branch
of detecting the different organic disorder. Which are found in female. This
department also looks after the midwifery needs.

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Department of ophthalmology

This department serves as its best to the diseases. Which patent to the eye this
department possesses different ultra modern equipment to render the non
invasive surgical operations.

Department of Dermatology

This department in rendering of the best service to the treatment of disorders

as the human skin. The nursing home maintain a separate branch to look after
the cause of burn and scalds as a sister departments to this department.

Department of plastic surgery

This department render the best service to the cosmetological needs at the
human skin. This departments too is having computerized testing equipment
which are used to reframe the different shapes of the skin.

Department of Ear Nose and Throat

This department treats all the disorder of the ear, nose and throat.

Department of pediatrics

This department serves the diseases and disorder of the children patients

Department of Neurology

This department is well equipped to treat the diseases and disorder of the
nerves.

Department of general medicine and cardiology

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This departments renders the best service to the needs of general medicine
and cardiac needs. This department is well equipped with sophisticated ultra
modern instruments to serve the patients who come under the light of the
departments.

Detail of the available wards

The nursing home at present is maintaining different kind of ward viz.

1. Male general ward

2. Female general ward
3. Children ward Special ward
4. Emergency ward

1. Male general ward

Male general ward is well equipped with all the modern facilities and
equipment foam beds are made available to the patient 24 hour water facility
can also be availed by the patient, not water is available on demand of the
patients. Each and every bed is given a hand table with chambered. Drawer to
keep the belonging of patients. Bathrooms along with latrine are maintained
an hygienic condition for the usage, for the patients visitors are allowed to
meet the patient and only one of the relatives. Friends are allowed to stay with
the patients during the night time.

The patients in male general ward can avail the facility of intercom to
communication with their relatives/ friends from the wards its thought
EPABX facsimile system.

Specialist and duty doctor give frequent visit to this ward from dawn to dask
during night time the doctor who are present at the time after the patient . The

20
specialists maintain a case sheet to record the improvements of the patients.
The records like besides chart. Medical chart temperature diabetes record
chart of each patient are also general wards for male contain 10 beds with 10
separate ceiling fames. Which are of recent models and in excellent
functioning condition. The male out patients are required to register their
name for the admission by paying the registration charge at Rs 50. Further
they have to pay Rs. 150 for every 24 hour there from

2.Female General Ward

All the facilities, which are available in the male general ward are made
available here too in addition to this. The nursing home provides curdle beds
for the female patients patients who have given birth to their offspring’s very
recently.

Female general ward 8 beds and the management of the nursing home is
planning to increase this no 10 -15 with in a very short period.

The procedures for admission into this ward are as same as that of the male
general ward.

3.Children ward

This ward consist of 6 beds al the facilities which are male general ward are
made available in this ward too.

The admission is restricted to the children within the age group to 10- 12 year
being the procedure for admission are as same as that at male general ward.

21
4. Semi Special ward

6 semi special wards are there in this hospital. In each semi- special ward for
female as well as male patients contain 1 bed with 1 separate ceiling fans
which are recent models and in excellent functioning condition and 24 hours
water facility can be availed by the patient, hot water is available on demand
of the patients.

In this ward providing one bed to the patient with attached bathroom
facilities. But in general providing 5 beds to the patients but not with attaché
bathrooms.

All the facilities which are available in the general ward are made available
here too in addition to this. The procedures for admission into this ward are as
same as that as the general ward.

5.Special ward

Apart from the above 3 different types of ward the nursing home. Who
maintain special wards. This ward offers some special facilities other than the
facilities available in the general wards. One separate room is considered as
one special ward and this consisting of 2 cushion beds one for the patient and
the other for the patient attended a separate cupboard is available with 5
shelves and a locker to it in each special wards, 3 tub light and a ceiling fan
keep continuously working in this ward hot water as well as cold water is
available in any time of the day. These special wardrooms are having an
attached bathroom and latrine. Which are having an attached in a good
hygiene condition. The EPABX system of communication provides the
patients in this wards to communication to 1 from the outer world. Being in

22
their room it self the facility of special wards can be availed by the out patient
subject to availability and the admission on open to both the gender.

Specialist keep visiting this ward for every 1 hour from dawn to dask
available duty doctor will look after patient on there wards during night times
all the charts including a case sheet of a patients are maintained by the
doctors. Specialist to record the developments of the patients.

For getting admission into this ward the out patients are required to pay the
registration fees up to 50 after being prescribed by the concerned doctor for
admission further they are required to pay Rs 360 for every 24 hours there
from.

6.Emergency ward

Three emergency ward are there in this hospital. Emergency ward is hospital
to emergency patients and this ward contain 2 beds with ceiling fans and
attached bathroom.

But in this hospital for getting admission into this ward the out patients are
not required do pay the registration fees.

23
 CHAPTER-5
MANAGERIAL STRUCTURE OF VATHSALYA NURSING
HOME

G. Modern and ultra modern facilities available patience

 Auto calve
 Ultra sound scanning
 Medical laboratory with auto analyzer
 Intensive care unit with ventilators
 Physiotherapy
 Well woman clinic
 Uninterrupted power supply system

H. Details of intensive care unit

I. Details of accounting procedure of the hospital
J. Details of the operation available theaters
K. Detail of the instrumental and equipment available
L. Detail of the medical laboratory available

24
 MANAGERIAL STRUCTURE OF VATHSALYA NURSING HOME

A. Modern and ultra modern facilities available patience

The hospital at present providing so many modern ultra modern facilities to

its patience to eradicate their diseases and to rectify their disorders with in a
short period at time the hospital keep continuously upgrading these facilities
by having purchased the most recent sophisticates instrument and equipments
for the place of old existing machines.

Some of the modern and ultra modern facilities which are being availed by
the patients from the hospital with their description are resented below in the
form of a list.

1.Auto clave

This is a one ultra modern and recent achievements in the fields of medical
electronic this is nothing but a sterilized which keeps all the surgical
instrument from hand glosses to surgical knives in a hygienic and non
infections condition.

2.Ultra Sound scanning

This is a process in which the instrument aided by the computers will detect
the very minute disorders in any part of the human body and this is the most
recent ais from the computer to the field of the medical surgeries.

3.Medical laboratory with Auto Analyzer

This is an modern ultra equipment used in the recent medical laboratories

which is also an advanced in the field of general medicine.

25
4.Intensive care unit with ventilators

This facility is one of the advancement in the field of medicine. The intensive
care unit (ICU) with this facility protects the patients kept in with a greater
care. Patients from other nursing home also come here for setting availed this
facility.

5.Physiotherapy

This is advancement in the field orthopedics and master in removing all most
all kind of muscular and bionic pains. An electrically instrument spreads its
ultra sound rays to the further advancement in this branch is was both ultra
sound massage and fraction for pain relief.

6.Well woman clinic

This is advancement in the field of gynecology obstetrics. Which tests for any
abnormal developments or growth in the female who are aged 30 years and
above. The abnormal development includes womb cancer embryonic
discorders etc.

7.Uniterrupted power supply system

This modern facility keeps supplying power to the entire hospital premises
without the noise and causing destructions to the patients whenever the
default supply of power falls.

B.DETAILS OF INTENSIVE CARE UNIT

This hospital maintain 1 separate intensive care unit to keep the patients
whose condition is too critical these wards are totally air conditioned these
wards contain 15 oxygen cylind to facilitate the necessary treatment these unit

26
Wards are packed up with uninterrupted supply of power so as to avoid
unnecessary delays in treatments.

In this hospital maintain refrigerator is maintained to keep the necessary drugs

and medicine. Which become poison when exposed to the room temperature.
Admission of the patients and attainders to these wards is strictly not allowed
so as to keep the patients away from unnecessary distributions.

These units are provided with ultra modern equipment called ventilation.
These wards are maintained in a hygienic condition and sweeper cleaners are
ordered to clean these wards at regular frequencies and to take greater care
while cleaning these wards.

Admissions to these wards are made to patients of the hospital on the standing
instruction of the specialists. The charges for this ward are Rs 2000 for every
24 hour and refund able caution deposit of Rs. 500 is also recovered from the
patients.

.C.DETAILS OF ACCOUNTING PROCEDURE OF THE HOSPITAL

The hospital maintains all types of books and accounts which included the
duty: book different ledger accounts for handling different type of account.
For preparation of fixed account at the end of a final year the hospital makes
one of the computerized accounting system by name “ tally”.

The hospital close its day accounts 12 hours later to the actual time to as to
record the transaction which take place at night times the annual closing of
accounts and preparation of final accounts are done at 31st day \of March
every.

27
D .Details of the operation available theaters

At the birth of the hospital it was having 1 minor O.T and 2 major O.T and 2
labour theaters. Today it has extended its hands of service to the patients by
adding one more major OT attached to the intensive care unit.

These OT’s are maintained in a hygiene condition and all the moderns and
ultra modern surgical equipments are made available here which include
powerful operation light multi angled flexible surgical bed with an elevator.
Pure stainless steel instrument. Which are not disposed to nature. An
equipment of refrigeration. Which is used for the storage recently. An ultra
modern sterilizer called auto clave has bought into keep the instruments and
equipments from had glouses to surgical knives in a sterilized condition.

The charges to this ors are fixed after observing the necessaries and
conditioned requirements of the operation generally these charges start from
Rs. 1000.

A consent sheet has to filled by the patient himself or by his attender stating
that neither the operating surgeon not the hospital is responsible for any worse
thing which may occur during operating.

E .Details of the instrumental and equipment available

The hospital possess all the instrument and equipments

The following are the some of the important short listed ones.

 Ventilator use in intensive care units (ICU)

 Boyell apparatus used in operation theater
 Auto scanners used in general medicine and surgery
 Portable dye x- ray used in general medicine and surgery
 Channeled stress EGG used in the dept of cardiology
 Auto analyzer used in the medical laboratory
 Massagers used in the dept of physiotherapy
 Ultra sound scanner used in the 10 dept of general pathology
 Saws used in the dept of orthopedic and trauma
 Obituaries

28
  Driller used in department of orthopedic and trauma
 Hubilizer used in the department of gynecology and obstetric.
 Cardiac monitors used in operation theaters
 Section apart us used in operation theatres
 Doppler’s used in the department of gynecology and obstetric
 Incubators used in the department of gynecology and obstetric.

F. Detail of the medical laboratory available

The medical laboratory which is well equipped by specialized equipments is

maintained by the hospital. This laboratory caters to the needs of all
pathologically examination of the patients some important investigation
which are performed in this laboratory are short listed below.

 Testing blood glucose and sugar

 Random blood glucose and sugar.
 Serum cholesterol
 Serum total protein
 Hemoglobin count
 Albumin globulin ratio
 Serum alkaline phosphate
 Serum total and direct bilirubin
 R.H Typing and cont
 Malarial parasites
 Absolute eosionse phil count
 Bleeding and clotting time
 Physical and chemical analysis
 Liver function test
 Differential leukocyte count
 Viral test
 UDRL test.

29
 SURVEY OF DRAWBACKS PERTAINING TO THE HOSPITAL
AND THE PATIENTS

The survey of drawbacks resulted in finding out the several problems.

On the patient as well as the stiff members. The familiar too questionnaire
tried its best together the information from the concern.

Within its limits out of there surveyed problem. Some can be rectified
immediately and some can be corrected in the lines run of the nursing
home.

For the rule of accuracy the problem have been divided and analyzed.

Under the two main heads vi

1) Problem of patient
2) Problem of hospital
1) Problem of patient: Here our or we responds each and every responds
has responded in his own way, since it is not possible to high light each
and every response they have been some one and analyzed on the basis
of majority.
a) Absence of treatment in recent branches medicines and surgery:- Out
patients as wells as in patients argued about the absence on the
treatments in the recent branches on medicine on surgery like urology
endocrinology etc
b) Absence of semi special watch: In patients or in there response had nut
their view that the semi special wards should be introduced as early as
possible by the management of the hospital.

30
 c) Absence of the nurse who know the regional language: The patients
have stated that the words who are aware of the regional language
should he recruited to the Nursing home.
d) Absence of talented doctor: Out patients as well as in patient’s state
that doctor will experience in depth knowledge should be recruited to
be nursing home.

Reduction of charges

A small no. of patients responded about the reduction existing fauves and
charges.

 Absence of hospital relation officer

There in a need of nursing home religion officer a he can work on the
main link between the management and patients.
 Improper top–level management
The top–level management in root attending towards the needs of duty
doctors other staff numbers which in turn covers them not to work with
zeal.
 Absence of cordial relationship between the management and
patients
Since the top level management un not cordial towards the patients
their in setting had the patients to address their grievances about the
nursing home.
 Absence of silence during night times
They are in a need of silence during the night hours in the nursing
home.
 Absence of a proper functioning schedule

31
 The nursing home does not maintain a proper functioning schedule for
the staff which again in a problem for the patients.
 Problem of the nursing home
In this section out of 100 respondents people have stated their own
view, the summed on and shortlist drawbacks which are bender on the
majority are analyzed under the following heads.
 Absence of the hospital manager
 The survey of problems amongst the staff members revealed that they
are in a need of the member by the designation manager.
 Absence of basic necessities
The staff members have argued about provision for the basic
necessities such as uniform provident fund concession on treating the
staff member etc, which the hospital cannot provide
 Absence of encouragement to the hardworking staff
The survey also revealed another important aspects that the
management is not encouraging the hard working staff.
 Non scheduled pasting of the staff
The hospital doesn’t maintain a proper schedule for the pasting of the
staff which in resulting in the improper postings.
 Absence of an attached canteen
The hospital is not maintaining a canteen attached to the hospital
premises which again in money drawbacks for the patients as well as
the staff members apart from there drawbacks the following are the
other problem from which the staff member are suffering.
 Staff members are not being respected

32
 The management of the hospital does not respect the staff in all the
times which is again a drawback for the staff members.
 Absence of Mutual understanding between staff members
There is an absence of mutual understanding between the staff
members which again does not allow the worker to work with zeal.
 Staff members are not allows to participated in the management
The staff members of the nursing home are not allowed to participated
in the decision making activities of the management.
 Complete job satisfaction of the workers
The hospital is not creating the environment from which worker can get
his complete job satisfaction.
 The higher rate as labor turn over
The rate of turn over is higher in the hospital there is also a drawback
because the existing workers may takes a long time to get the mutual
understanding between the new comers which result in the
declinometer as zeal amongst the workers.

33
 Chapter 6
DATA ANALYSIS AND INTERPRETATION

34
 Table- 1

Respondents based on their family monthly income

Income from Rupees No. of respondents Percentage

Below Rs. 10000 20 50
11000 – 20000 12 24
21000 -30000 6 12
Above 31000 12 24
Total 50 100

20

12 12

Below Rs. 10000 11000 – 20000 21000 -30000 Above 31000

35
 Table -2
Respondent based on you came to know about this hospital
Came to know about this No. of Respondent Percentage
Hospital
Friends 12 24
Relatives 16 32
Advertise 10 20
Others 12 24
Total 50 100

16

12 12

10

Friends Relatives Advertise Others

36
 Table 3

Respondents based on their service provided by hospital their service

provided by hospital

Service No. of Respondent Percentage

Excellent 7 14
Good 24 48
Fair 13 26
Average` 6 12
Total 50 100

Excellent Good Fair Average`

12% 14%

26%

48%

37
 Table-4: Respondents based on their identification with this nursing
home

Identification No. of Respondent Percentage

Out patient 25 50
In patient 12 24
Consulting patient 13 26
Total 50 100 %

25

13
12

Out patient In patient Consulting patient

38
 Table -5

Respondents based on looking treatment

Ward No. of Respondent Percentage

Male General ward 6 12
Female general ward 24 48
Children ward 12 24
Special ward 5 10
Intensive care unit 3 6
Total 50 100

24

12

6
5
3

Male Female Children Special ward Intensive

General general ward care unit
ward ward

39
 Table -6

Respondents base on their service given by the doctor

Service the doctor No. of Respondent Percentage

Excellent 7 14
Good 24 48
Fair 12 24
Average 7 14
Total 50 100

24

12

7 7

Excellent Good Fair Average

40
 Table -7

Respondents base on their service given by this medical facilities

Medical facilities No. of Respondent Percentage

Excellent 5 10
Good 11 22
Fair 12 12
Average 22 44
Total 50 100

22

12
11

Excellent Good Fair Average

41
 Table -8

Respondent basis on rates and charges levied by nursing home for the
service

Rates and charges No. of Respondent Percentage

Lower 13 26
Higher 25 50
Reasonable 12 24
Total 50 100 %

24% 26%

50%

42
 Table-9

Respondents basis on their service at the staff

Service of the staff No. of Respondent Percentage

Excellent 8 16
Good 16 32
Fair 20 40
Average 6 12
Total 50 100

20

16

8
6

Excellent Good Fair Average

43
 Table 10

Respondents based on their many years you are service in Vathsalya

nursing home

Years in Service No. of Respondent Percentage

1 year 25 50
2 year 12 24
5 years 7 14
6 years 6 12
Total 50 100

25

12

7
6

1 year 2 year 5 years 6 years

44
 Table 11

Respondent basis on their relation ship with the hospital

Relationship No. of Respondent Percentage

Regularly 13 26
Rare 30 60
Occasionally 7 14
Total Total 100%

30

13

Regularly Rare Occasionally

45
 Table -12

Respondent basis on their you feel about the Vathsalya nursing home

Feel about No. of Respondent Percentage

Very good 22 44
Available 24 48
Poor 4 8
Total 50 100 %

24
22

Very good Available Poor

46
 Table -13

Respondent basis on their would you prefer the hospital

Prefer the hospital No. of Respondent Percentage

Vathsalya 24 48
Nirmala 12 24
Meghana 6 12
Other 8 16
Total 50 100

Vathsalya Nirmala Meghana Other

16%

12% 48%

24%

47
 CHAPTER-7
SUGGESTIONS AND CONCLUSION

48
 SUGGESTIONS AND CONCLUSION

The remedies listed below are necked on the majority of drawbacks surveyed
through each staff member and each patients have put their own set of
problem however each and every questionnaire used for the survey has been
Arleen into consideration on to a minimum event while giving the remedies.

The following are some of the vital remedies which have been against the
drawbacks surveyed.

1) Introduction of recent branches of medicine and survey:

The nursing home in required introducing the recent branches on
medicine and surgery along with the deferent therapies pertaining to
them.
2) Recruitment of public relation officers
There in a need as recruitment of a public relation officer thin don of
the management will ensure the patient satisfaction which inform
enables the hospital to gain the name and fame in the society.
3) In take of the staff who proposes in depth mute realistic knowledge
The hospital staff wills in depth subject knowledge should be recruited
to the hospital.
4) Reduction in fares and charges
The fares and charges up to the possible extent should be brought
down.
5) Development of mutual understanding between the levels of
management

49
 All the level of management in the hospital are required to interest to
one another problem and developmental understanding between them.
6) Encouragement to the hard working staff
The management of the hospital is required to encourage the hard
working staff by increasing the pay and the O.T scales etc, which in
turn makes the other staff to work efficiently.
7) Provision of basic necessities
The hospital should provide the basic necessities such as the uniforms
deduction of P.R rest room for the staff etc, within its limits it may
increase the efficiency of the workers.
8) Allowing the staff to participate in the management
The hospital should allow the staff members to participate in the
management so as to create a confident on the management amongst
workers.
Management should cordial towards the staff at all the times. The
management of this hospital should thin that this is a team work and
needs to be cordial towards the staff as well as the patients at all the
times.

Suggestions for the effective management

The following are some vital suggestions from which the hospital un witness
a like in the efficiency of the workers and better of the management.

1) Recruitment of a manager
The hospital has top recruit a person with the designation manager
for whom the staff may address their grievances an suggestions.

50
2) Recruitment of the personal who know the regional language
The hospital an much as possible should recruit the personal that
know regional language so that the patient can communicate with
them with case.
3) Maintaining of a proper functioning / posting
The hospital has to introduce maintain a proper functioning
schedule while ensures the proper low of work and the right person
to the right point.
4) Introduction of a grievance cell and feedback collecting cell
The hospital introduce agric evince cell along with a deed back
collecting unit which collects the grievances and complaints de from
the patients further the top level management in required to go
through the collected complaints and immediate solutions for them
at least once in a fortnight.
5) Organization of a staff welfare
Staff welfare programmers such as staff day hospital day
interaction day etc Must be organized once in over 6 months in
which the staff are allowed to came out with their individual
problem their ensure the staff that they are being cured by the
hospital and in the long run thin will reduce the rate of such or
turnover.
6) Implementation of the solutions

The solution so found against the problem of the patients collected

through the grievance cells and problems of the staff welfare
programmer should be implement nee up to the limits of the nursing
home infrastructure.

51
 7) Opening of a canteen
The hospital is surveyed to open a canteen within the hospital
premises which will be a greater keep for the patients as the staff
members
8) Duty doctors should not be Des tribute while they are on fir rounds
Duty doctors should not be distributed while they are on rounds.
Which will prevent the deviation on their particular attention.
9) Proper maintenance of patient pertaining records
The patients pertaining records should be maintained with a greater
cure since it since it serves the had in the development of the
hospital.
10) Total management computerization
The existing management should completely he computerized to on
to save the precious time and money on the hospital are.

Product planning and development

During the yester years a considerable amount of work has been done on the
problem on services in the contents of the product planning in the hospital to
be more specific the introduction as automation innovate skill and exp.
Modern and scientific appliance have the complicated the talk of product
planning what do it product to key become outdated tomorrow.

Of date specialization has guide significance of high magnitude and the do the
magnitude traditional product have lost their sensitivity and effectiveness in
the modern world.

52
A good number of hospital like modern facility and a very few having the
modern sophisticated facilities are no tin a position to optimize the demand
generated by a large number of potential to optimize the demand generated by
a large number of potential users. This over attention on the planning and
development of hospital produces against the background of Indian special
condition.

1) Latest development in the field medical science

The innovative spell and overtones the modern and sophisticated
appliances the research and inventions are some of the important
aspects necessitating a change in the hospital product the beginning of
20th century nerved avenues fro qualitative improvement as
specialization gained a rapid momentum it was no larger possible for a
doctor to muster hole surgery and medicine a separation was necessary
in a true since towards the end of 19th century surgery advanced rapidly
with introduction of skepticism since them we find new discoveries all
over the world new mach of diagnosis and therapeutic are treatments
were divined which necessitated new division and sub division
Facilities are available at in natural that the users avail them. It cant the
refused that during years there have been multi faceted development in
the communication facilities the improved communication has
facilitated visits to hospital it growing problem or urban congestion and
the over crowed residential to locations gave complicated. The taste as
staying at home for treatment them males it clear that all there
development have rosined the netsurfs on hospital here . It is initial that
while planning the product the transformation in the society get due
weight age on the one hand we have the problem of non optimal

53
 demographic structure while on the others. The health to consciousness
also thrown now trend if the hospital are respected to respond
cognitively the qualitative improvements in hospital cant he delayed.
2) Rapid industrialization
Industrialization invited multi dimensioned health hazards the problem
of environmental and atmospheric pollution aggravator the problem on
medical owes in an industrialized society the citizen due to multi
pronged pollution are forced to spent a lot on medical care thin males it
clear that planning for hospital services require innovative approaches
or into make an assault on growing health hazard.
It is significant that al be it in the developing countries and if steps have
been taken to active the industrialization programmed here one thing is
worth nothing that Industrialization also simplifies the tale of
innovating sophisticated equipment and appliance for evoking the
medical aids.
3) Emerging trade in Competition
Like other services the hospital services also depend upon the emerging
trades on competition. The developing countries have developed
sophisticated devices but in developing countries we find scarcely op
modern well developed hospital this melee if all that hospital having
traditional device attempt to develop the facilities or melee possible
qualitative improvements her the emerging French in competition cant
be over looked specially while planning the hospital product. The user
as hospital services prefer to avail the possible facilities for medical
cure education training and research other services.
4) Regional diversification

54
In addition to the other factor the regional consideration also influence
the development of products in the hospital and country like India were
rural population are deprived of the proper medical cure services the
development and planning of product cant undermine expansion of
services in the rural areas. Provision of rural health centers was
recoated by the European conference on royal hygiene as genev2qa in
1931 under the health organization of league of nation it defines the
rural health centers areas in mutilation for the promotion on present age
specialization as gained a raped movement hence it is significant that
instead as establishing separate cell we prepare the service of
consultants.

55
Conclusions

The Indian hospitals have to improve up to a greater extent to scope to the

current hospitalization cant challenge the recent physiological disorders it can
rectify the disorders up to the extent of 60 % to be more precise the current
hospitals have to equip them selves with modern instruments. Different aids
computers hi –f medical personnel and the management staff who are versed
particularly with the total physiological disorders.

From the study conducted in vathsalya nursing home it has become clear that
the patients as well as the society expects much more service than what the
hospital is currently serving even though the hospital is tendering its services
more than its capabilities.

The staff circle except a better working environment which offers them a
better harmonious relations between the levels of management along with a
better pay scale .Which totally result in complete job satisfaction as the
employee.

On the other hand the deferent groups as patients expect better am for the
charges which a middle class family can afford some respondents have also
recommended the physical alteration of the words and internal structure of the
nursing home.

56
Annexure

QUESTIONNAIR

Dear Sir, / Madam

It is a matter of grate pleasure to introduce myself as a “Business

Management” student from “Acharya Tulsi National College of Commerce”

As I am obligated from my course to conduct project report work on

“Hospital Management”, A case study of Vathsalya Nursing Home, Shimoga.

Hence O request your co- operation in completing his work please fill
up the enclosed questionnaire and extend year co- operation.

Thanking You

Yours faithfully

Chaithra H.M

1. Name :
2. Address :

3. Age :

a) 15- 30 []
b) 31- 45 []
c) 45 – 60 ` []
d) Above 60 []

57
4. Gender :
a) Male []
b) Female []
5. Marital status
a) Married []
b) Unmarried []
6. Educational background
a) S.S.L.C [ ]
b) PUC []
c) Degree [ ]
d) Other []
7. Occupation
a) Student []
b) Agriculturist []
c) Business man [ ]
d) House wife []
e) Employee []
8. Family Monthly Income
a) Below Rs 10000 []
b) 11000 – 20000 []
c) 21000 – 30,000 []
d) Above 31000 []
9. How did you came to know about this hospital ?
a) Friends []
b) Relatives []
c) Velwishers []
d) Others []

58
10.Service provided by hospital is
a) Excellent []
b) Good []
c) Fair []
d) Average []
11.Your identification with this nursing home
a) Out Patient []
b) In Patient []
c) Consulting patient []
12.Name of attending Doctor : ______________________________

13.Ward in which you are taking Treatment

a) Male general ward []
b) Female general ward [ ]
c) Children ward []
d) Special ward []
e) Intensive care unit []
14. What is your opinion regarding the service given by the doctor?
a) Excellent []
b) Good []
c) Fair []
d) Average []
15. What is your opinion regarding the service given by this medical
facilities?
a) Excellent []
b) Good []
c) Fair []

59
 d) Average []
16. According to you the rates & charges levied by the nursing home for
the service offered is
a) Lower []
b) Higher []
c) Reasonable []
17.Your opinion about the service at the staff
a) Excellent []
b) Good []
c) Fair []
d) Average []
18.From how many years you are service in Vathsalya nursing home.
a) 1 year []
b) 2 year []
c) 5year []
d) 6 year []
19.How you have the relation ship with the hospital?
a) Regularly []
b) Rare []
c) Occasionally []
20.How do you feel about the Vathsalya Nursing Home?
a) Very good []
b) Available []
c) Poor []

60
21.What would you prefer the hospital ?
a) Vathsalya []
b) Nirmala []
c) Meghana []
d) Other []
22.Your suggestion for Vathsalya Nursing Home ?

______________________________________________________

Date :

Place : Signature

61
 Bibliography

Books

 Introduction to social medicine by Dr. G Chaturvedi, New Delhi

 Introduction to hospital environment by Dr Sunder Raj, Calcutta
 Healthcare issue 2009-10 (Economic Times Group)
 Modern healthcare magazine
 Human resource development in a government health organization: views
of doctors Vivek Handa, A.K. Sood & Rajni Bagga

62