PRACTICAL TRAINING SESSION IN A HOSPITAL

A PROJECT REPORT
FOR THE PARTIAL FULFILLMENT FOR THE AWARD OF THE DEGREE OF

MASTER OF BUSINESS ADMINISTRATION IN HOSPITAL ADMINISTRATION

SUBMITTED TO JIWAJI UNIVERSITY, GWALIOR

2010

SUBMITTED BY

DR. VIKASH KUMAR PULAIYA

UNDER THE GUIDANCE OF

DR. V.K. MAHESHWARI DIRECTOR MAHESHWARI NURSING HOME 85 , LAXMIBAI COLONY, GWALIOR (M.P.)

DEPARTMENT OF MANAGEMENT STUDIES SCHOOL OF MANAGEMENT PONDICHERRY UNIVERSITY PUDUCHERRY-605014

CERTIFICATE

This is to certify that this project entitled PRACTICAL TRAINING SESSION IN A

HOSPITAL done for Maheshwari Nursing Home is submitted by Dr. Vikash Kumar

Pulaiya, MBA 1st year to the Centre For Hospital Administration, School of Management, Jiwaji University in partial fulfillment of the degree requirement for the award of the degree Master of Hospital Administration and is certified to be an original and bonafide work.

Place: Date: Signature & Seal

DECLARATION

I hereby declare that this project report PRACTICAL TRAINING SESSION IN A HOSPITAL in Maheshwari Nursing Home, Gwalior (M.P.)submitted in partial fulfillment of the requirement of Master of Business Administration( H.A.) of Centre of Hospital Administration, School of Management, Jiwaji University, Gwalior ( M.P.) is based on primary & secondary data found by me in various departments, books, magazines and websites & collected by me in under guidance of Dr. V.K. Maheshwari director , Maheshwari Nursing Home, Gwalior.

Date .

Dr. Vikash Kumar Pulaiya M.B.A. (Hospital Administration) centre for hospital administration, jiwaji university, Gwalior (M.P.)

ACKNOWLEDGEMENT
I am indebted to the all powerful Almighty God for all the blessings he showered on me and for being with me throughout the study It my privilege to express my gratitude to Dr. V.K. Maheshwari, Director , Maheshwari Nursing Home, Gwalior for giving me permission to undertake the dissertation work at Maheshwari Nursing Home, Gwalior in partial fulfillment of my M.B.A. (Hospital Administration) . I wish to express my indebtness to my respected supervisor Dr. V.K. Maheshwari, Director , Maheshwari Nursing Home, Gwalior, under whose versatile ,expertise, sincere dedication , valuable advice, inspiring presence and uncompromising sustained the execution of this work till the successful completion of my assigned task. He has consistently treated me with great kindness and keen interest in my progress in my project. I express my inexpressibly deep gratitude to Dr. K.S. Thakur, co-ordinater, centre for hospital administration, Jiwaji University, Gwalior. My solemn thanks to Mrs. Arti Pipariya, Miss Sadhana Tiwari, Miss Meghna Mangala, and Mr. Ravi jain sir teaching faculty of centre for hospital administration, jiwaji university, Gwalior their insisting kindness and word of encouragement and genuine affection throughout the degree, their passion of their excellence, love for teaching and untiring zest for work will remain etched in my mind for long. This thesis is ultimately a tribute to my parents and siblings, whose untiring efforts and sacrifices made my pursuit of science possible. They supported me in every field with great confidence, faith munificence. I only wish, I could attain the heights that they have lovingly dreamt for me. Last but not the least, I wish to record my sincere gratitude to all those who helped me directly or indirectly in my endeavor.

DR. VIKASH KUMAR PULAIYA (Signature of the Candidate)

CONTENTS

1. PROCESS OF REGISTRATION AND ADMINISTRATION OF PATIENTS AT RECEPTION 2. FUNCTIONING OF VARIOUS DEPARTMENTS WITHIN HOSPITAL 3. OPD SERVICES 4. PHARMACY SERVICES 5. WARDS 6. PERSONNEL / H R DEPART. & PUBLIC RELATIONS 7. LIBRARY IN HOSPITAL 8. MARKETING 9. LABORATORY SERVICES ( INVESTIGATION) 10. BILLING AND DISCHARGE

TRAINING REPORT

2. functioning of various departments within Hospital

01 October 2010

PROCESS OF REGISTRATION AND ADMISSION OF PATIENTS AT RECEPTION

Every hospital now has an OPD department. This is the first point of contact in the hospital. It is situated in the main entrance of the hospital. The OPD must have the following facilities. 1. Entrance easily accessible with ramp, steps and a wide door. 2. Flooring- tiled with a slope towards an outlet, so that washing with a hose is easier. 3. Reception/Enquiry- can be combined or separate. Reception must have counters, for new and old cases. 4. Waiting hall 5. Consulting rooms 6. Signboards and layout plan. This must be at the entry, and prominently displayed. 7. Boy for trolley and wheelchairs. 8. Toilets, separate for males and females. 9. Public telephone nearby. 10. Board indicating names of consultants who are absent on that day.

Reception/ Enquiry
The reception and enquiry counter can be combined in hospitals, but must separate in hospital of 100 beds and above. A patient coming to a hospital, is a troubled person and requires reassurance. It is preferable to have a social worker here, which will help the patient to find the right counter. The person manning the enquiry, must be pleasant , patient and must be able to give information, regarding location and timing of various clinics, registration procedures , booking rooms, as well as the location of IP patients. The telephonic enquiry can be near the enquiry, and to economize, the same person can man both , depending on the workload.

Registration counter
All patients are required to register here. A new case is given a registration number in the form of a ticket. At the same time an entry is made in the register, and a chart initiated, giving the OP number and the details of the patient. The chart is sent to the concerned clinic or consultation room. Some hospital give a token to indicate, the order in which he will be seen by the consultant, while others endorse, the same in pensile on chart. For the old cases, the patients the OP ticket, his chart is retrieved from the medical records room checked if it is due for renewal, and then the patient is given the token. It is better that new and old patients have token number in a continuous sequence.

Admissions
A separate admission register must be maintained, with an IP number. The admission register is a legal document, and so there can be no alterations or overwriting. If any cancellation has to be done, it must be scored out as done in account books. Moreover the chart must have an admission form, the admission being authorized by a doctor, as well as a consent form signed by the patient or his next of kin.

Medical Records Room

In this room, the records are kept on shelves. The open rack has been found the most suitable, for keeping medical records, arranged OP number wise. The racks must be so arranged, to provide for processing tables, in each cubicle. It is better that non- active files are kept separately, as they are kept for preservation, and are accessed seldom .

Admission Procedure
Way of Admission

Through the admission counter, if you are referred to our hospital by your doctor, and if urgent medical attention is not required. Through the Casualty Medical Officer in the Casualty Department, if you are either o In urgent need of medical attention, or o You come without being referred and therefore need to be admitted under the appropriate consultant doctor.

Submit details of your case i.e. either o o

Your doctor's reference note [which will contain instructions] or The Casualty Medical Officer's note.

Select the class in which you would like to be admitted. [ Please remember that if you desire a change, immediate transfer to another class may not be possible.] Fill in the following documents o Admission Form - This is to ensure you receive appropriate medical treatment while in our care. o Consent Form - relating to your treatment, this form is important; it seeks your acceptance.

Admission
Procedure for Inpatient Admissions You will require an Admit Instruction Slip from a doctor of Mallya Hospital to register for admission.

ROOMS
Various categories of rooms, ranging from the Economic ward to the Deluxe suite are available. Please place your request with the admission assistant. All efforts will be made to provide the room of your preference. In case of non-availability of requested category, an alternate room will be allotted and you will be shifted to the room of your choice as and when it becomes available.

TARIFF
Charges for ICU/CCU/ICCU will vary with the category of bed/room the patient occupied as indicated below. Direct admission and discharge from ICU/CCU/ICCU will be charged at SemiPrivate rates
TYPE TARIFF ICU/CCU ICCU Rs. 2,250/Rs. 2,250/Rs. 2,250/Rs. 2,250/Rs. 2,250/Rs. 2,250/ICU/CCU CCU With Ventilator Rs. 3,000/Rs. 3,000/Rs. 3,000/Rs. 3,000/Rs. 3,000/Rs. 3,000/-

Economic Ward

Semi
4-Bed / Daycare 2-Bed Semi Private Dlx Private Deluxe Neuro ICU

Rs. 600/Private Rs. 750/Rs. 950/Rs. 1,250/Rs. 2,000/Rs. 2,500/Rs. 950/-

Note: 8% Luxury Tax will be charged on Bed charges above Rs.1000/- per day as per the direction of sate Govt. Karnataka.

NURSING SERVICES
The Nursing staff comprises of trained nurses and nursing supervisors with experience in critical care and are imbued with a sense of caring for the patient and the family. A charge is levied for the nursing service which depends on the category of ward/room occupied by the patient.

DEPOSIT

On admission, an initial deposit will be collected at the In-Patient Billing counter. The amount depends on the category of room and the treatment/surgical procedure planned. Reminder for further deposit will be sent from time to time as your credit is utilized. Payments are accepted only by Cash/DD/Credit Card. Cheques are not accepted.
Category of Bed General Ward Deposit Rs. 2,000/Rs. 3,000/Rs. 5,000/Rs. 6,000/-

Semi Private
Private Deluxe

ICU/CCU/ICCU

Rs. 5,000/-

Medical Insurance Card Holder

The following procedure is adopted for Admission. 1. All planned admissions for hospitalization/surgical procedures will be made only after the receipt of PreAuthorization approval from the concerned TPA/Insurance Company. 2. Pre-Authorization form for all Mediclaim policyholders shall be issued from Admission Counter to the patients requiring admissions. 3. Admission Counter will validate the identity of the patient prior to giving a request form of the concerned TPA/ Insurance Company 4. The request form consists of 3 parts: Part A: To be filled in by the insured Patient/Attender. Part B: The patients shall then get Pre-Authorization form filled in by the treating Doctor. Part C: Billing counter shall enter the estimated cost of the treatment. 5. Filled in forms shall be submitted to Insurance Cell at Reception counter along with photo ID for processing with the concerned Insurance company/TPA. 6. During the off duty hours of Insurance Cell, the filled in form shall be submitted at Billing for processing. 7. The request will be submitted to the concerned TPA/ Insurance Company, the Turn Around time for authorisation is approx 6-10 working hours. 8. The TPA/ Insurance Company will send Approval/ Denial Letter and the print out of the same will be available at the Insurance Desk. 9. If approved the Approval letter will also indicate the amount upto which the TPA will settle the bill directly with hospital. 10. After receiving Pre-Authorization approval from the concerned TPA/ Insurance Company, the patient can get admitted. 11. If the patient wants to get admitted prior to the receipt of Pre-Authorization approval, deposit has to be made as per the existing system of the Hospital, depending on the room category and 90% of the cost of surgery, if any. This applies to EMERGENCY admissions also. (Subsequently Pre-Authorization would be requested from the TPA/ Insurance Company) as above. 12. Such deposits received will be refunded in cash (if it is within 25,000/-) or by way of A/c payee cheque (in the name of the patient only) on discharge or will be adjusted against balance (if any) in the final bill on receipt of approval.

13. At the time of discharge if the final bill amount exceeds the authorized amount, the consolidated final bill will be processed with the concerned TPA for enhancement for further approval or reconfirmation of the case which will take 3-4 hrs from the time the final bill and discharge summary are processed. We request you to bear with this delay in the discharge formalities. 14. Payments are to be made in full, if Pre-Authorization is not approved under any circumstances. Similarly, difference amount in the bill (if any) not approved by TPA / Insurance along with the non-medical expenses and non-reimbursable charges shall to be paid by the patients at the time of discharge. 15. Please note t hat the rejection of the preauthorisation request is only denial for cashless services and is no way to be treated as denial of treatment. The insured can directly settle the bill with the hospital, the insured retains the right to get treated and submit the bill directly to the TPA for subsequent reimbursement. 16. With regard to all TPA/ Insurance related issues, decision of the Mallya Hospital Management will be final and binding.

CHANGE OF ROOMS
If a patient moves to a higher category room, the charges for ICU/CCU, investigations, operation theatre and professional fee will be as per the higher category of room occupied and will apply from the time of admission. If a patient moves to a lower category room after a cathlab or Surgical Procedure, the charges for Investigations, Operation theatre, professional fees etc. shall be as per the higher category of room occupied before the procedures.

DIET
Diet is provided to the patient as per the doctors advice. Food from home or outside is not permitted in the hospital. Attendants may use the COFFEE SHOP in the basement. Only vegetarian food shall be served to patients and in the coffee shop.

TELEPHONE CALLS
You could make calls from your room. As soon as your bill is settled, the telephone is disconnected call charges Rs. 5/- per call.

PAY PHONE
Public call phones are available in the Basement and on the ground floor.

ISD/STD BOOTH
Facility is available on the main road next to the Flower Shop.

CASH & VALUABLES

Patients are advised not to keep cash and valuables with them. Please deposit your cash with BILLING SECTION and obtain a receipt for it. Baggage items may be deposited with the Security Department. The management is not responsible for the loss of jewellery, cash, camera, walkman, mobile phones or any other valuables.

LINEN
For the attendants of patients in SemiPrivate, Private, and Deluxe rooms a set of linen is provided for a nominal fee. Please contact Housekeeping Department for this service. Do not bring linen from outside.

DISCHARGE
A Patient can be discharged from the hospital on the advice of the consultant. After the discharge intimation is sent by the ward sister, the Billing Section would take atleast an hour to secure clearance from all the departments such as Pharmacy, Housekeeping, Telephones, Food Services and Operation Theatre. The billing assistant will inform you when the bill is ready. The bill may be settled by Cash / DD or Credit Card. (VISA, MASTER CARD, AMERICAN EXPRESS, DINERS CLUB). CHEQUES WILL NOT BE ACCEPTED.

Pay only at the Billing Counter. Please insist on receipt for any payment made towards your treatment in the hospital . Before departure, the ward sister will hand over the prescription and explain to the patient about the treatment to be continued at home Please do not give tips to the staff. If any staff solicits payment kindly bring it to the notice of the administration. We, at Maheshwari Nursing Home, strive to provide the best in patient care. Please contact the Inpatient coordinator or Front Office if you face any problems. Patients suggestions are always considered and many times have proved useful. We value your opinion. We would appreciate your feedback on the services by filling in the patient evaluation form which could kindly be dropped in the suggestion or complain box available at different locations at the floor.

MAHESHWARY NURSING HOME

MAHESHWARI NURSING HOME

ADMIN DEPARTMENT

PATIENT CARE DEPARTMENT

ACCOUNT DEPARTMENT

MAINTENANCE DEPARTMENT ELECTRICAL &POWER

OPD

DEPARTMENTS

IPD

OPD

BILLING

NURSING STAFF NON- NURSING STAFF

PHARMACY

ICCU

ADMISSION

HRA MARKETING PUBLIC RELATION

SECURITY

PATHOLOGY

ICU

MEDICAL RECORD

BIOMEDICAL

X-RAY

ORTHO

PLUMBING

USG

BURN UNIT

HOUSE KEEPING FOOD SERVICES

CSSD

DELIVERY

OPERATION THEATRE

GENERAL

Functioning of Various Departments within Hospital

Administration department
The department strives for establishing the objectives of the Caritas Hospital Trust. It maintains policies and the ethics of a catholic institution. The department ensures that efficient patient care is administered in the Hospital. The department coordinates the Hospital services and the teaching institutions in the same campus with serene and calm atmosphere. Efficient and pleasing Public Relations Officer and Human Resources Manager are its assets.

Accounts Department
The department maintains accounts of various heads backed by internal and external auditing. It maintains National Standards in accounting.

Billing Department
The department functions round the clock for the convenient services to the patients coming to the Hospital. It is fully computerized with networks to other departments in the Hospital. The department creates and maintains a pleasant atmosphere to the patients coming to the Hospital. It maintains a transparency in bills and in its records.

Central Sterile Supply Department (CSSD)

It is the core of the Hospital service since it supplies instruments to various departments in the Hospital under strict sterilized packages. The department maintains national and WHO standards.

Laboratory Department
The department is well equipped with automated and advanced equipments. It functions round the clock with results of International Standards. Experienced and qualified technicians and Doctors are its assets. The department is divided to four different functionaries namely Microbiology, Bio-Chemistry, Haematology and Blood Bank. The Blood Bank adheres to the stipulations and regulations of Government of India and WHO.

Maintenance Department
It attends to all breakdowns and repairs in all the departments of the Hospital. The department does general and specific days to day checkups for any anticipated small and major breakdowns. Electrical, Plumbing, Biomedical and Welding sub divisions are working efficiently in the department.

Medical Records Department (MRD)

A well-maintained medical records department in the Hospital now serves as the backbone to the medical staff in the Hospital. Neatly arranged records make the Department to be prompt in supplying records and case sheets as and when needed. Medico legal records are maintained for medico legal cases. The department functions round the clock.

Pharmacy Department
The department functions regularly to the directives of the Hospital Therapeutic committee. It supplies medicines and other Pharmaceutical materials according to the directions of the medical staff in the Hospital. The department maintains a policy of not supplying Pharmaceutical materials to prescriptions of medical staff outside the Hospital. The department adheres to the regulations and stipulations of the Drug control Department of the State and the Nation. Expiry dated medicines are condemned to maintain quality of service to the patients.

Security Department
The securities do serve in the hospital round the clock. The securities are to protect the hospital and to help the patients in their need. A well-trained Security officer controls them all.

X-Ray Department
The Department functions round the clock with efficient technicians. It maintains its quality as the best X-Ray results in Gwalior. It is now a referral unit for many Hospitals functioning in the surroundings.

USG Department
The Department functions round the clock with efficient technicians and best Machines.. It maintains its quality as the best results in Gwalior. It is now a referral unit for many Hospitals functioning in the surroundings.

OPD Services
Most hospital now has an outpatient department, though some nursing homes have only an inpatient facility, in which outside doctors admit patient. In this department, ambulatory patient are provided medical care. It has been calculated, that a person has 3 to 4 episodes of illness in a year, of which only two episodes require medical attention. The advantage of OPD is that much of the investigative and curative work can be done here, without admitting the patient, thus saving medical expenses, and avoid disruption of family life. The scope of OPD: 1. It gives the first impression of the hospital, and this is the best impression. 2. Helps in reduction of morbidity. 3. Helps in reducing the number of admissions. 4. Acts as the shop window of the hospital.

LOCATION
1. At the main entrance of the hospital 2. Separate from inner patient area, but connected to it. 3. To be easily accessible to medical records, pharmacy, x-rays, laboratory collecting point , and billing counter. 4. Easily accessible by casually. Casually is preferably separate from OPD, with its own entrance.

Types Of Patients In OPD

These can be broadly be divided into, emergency cases, which are first seen in casualty, referred cases from doctors outside and also within the hospital, or direct OP cases. In some of the Hospitals patients are first screened by GPs, thus reducing the load on specialty services. But the trend now is for patients, to seek direct specially consultation.

Waiting Hall

To cater not only for patients, but also those who accompany the patient. In our Country, one or two accompany the patient. Must have comfortable seating arrangements, ceiling fans, and should be well ventilated. must have drinking water arrangements, and possibly a tea counter.

RECEPTION
The reception and enquiry counter can be combined in small hospitals, but must be separate in hospital of 100 beds and above. Where it is separate, it should be adjacent to each other.

ENQUIRY
A patient coming to a hospital is a troubled person and requires reassurance. It is preferable to have a social worker here, which will help the patient to find the right counter. The person manning the enquiry, must be pleasant , patient and must be able to give information, regarding location and timing of various clinics, registration procedures , booking rooms, as well as the location of IP patients. The telephonic enquiry can be near the enquiry, and to economize, the same person can man both, depending on the workload.

Registration counter
All patients are required to register here. A new case is given a registration number in the form of a ticket. At the same time an entry is made in the register, and a chart initiated, giving the OP number and the details of the patient. The chart is sent to the concerned clinic or consultation room. Some hospital give a token to indicate, the order in which he will be seen by the consultant, while others endorse, the same in pensile on chart. For the old cases, the patients the OP ticket, his chart is retrieved from the medical records room checked if it is due for renewal, and then the patient is given the token. It is better that new and old patients have token number in a continuous sequence.

Admissions
A separate admission register must be maintained, with an IP number. The admission register is a legal document, and so there can be no alterations or overwriting. If any cancellation has to be done, it must be scored out as done in account books. Moreover the chart must have an admission form, the admission being authorized by a doctor, as well as a consent form signed by the patient or his next of kin.

Medical Records Room

In this room, the records are kept on shelves. The open rack has been found the most suitable, for keeping medical records, arranged OP number wise. The racks must be so arranged, to provide for processing tables, in each cubicle. It is better that non- active files are kept separately, as they are kept for preservation, and are accessed seldom .

Support Services
Hospital is having all the necessary supportive services within the hospital premises. These services include Catering, Banking, Pharmacy, Social workers, STD & Fax, Ambulance and spacious air-conditioned waiting lounge. Comfortable, well-appointed, well equipped rooms matching your needs in every respect, competent and caring medical and paramedic staff, facilities for patients companions, various types of rooms.

Emergency Medical Services / Casualty

An Emergency Medical service takes care of all emergency patients which has got telephone access and round the clock red alert team along with all concerned specialities. It also includes medical response to disasters, planning for and provision of medical coverage at mass gatherings, and interfaculty transfers of patients. The department of EMS is situated on the ground floor in the 04-storied building of the hospital, right at the front gate. It is accessible fvor the patients from two sides from the front as well as from inside through the main entrance of the hospital. The EMS department has EMS 4 beds with monitors and 3 beds along with minor O.T.

Minor OT to carry out all minor emergency surgeries, three beds with central oxygenation, suctioning and patient friendly trolleys. Casualty and emergency services in Mallya Hospital provide immediate therapeutic and diagnostic care on emergency basis round the clock. The Emergency room is an eight bedded unit and is strategically located. The services/facilities include:

Road Traffic Accident (RTA) Hypoglycemia Management Pain abdomen Poison cases Breathlessness Myocardial Infarction Centralized Oxygen Defibrillator Cardiac monitor ECG Suction tubing Crash trolley (Containing all first aid instruments, medicine box) Endotracheal tube Emergency medication Glucometer Nebulization mask.

Depending upon the ailment, the patient is referred to the concerned specialist for admission and further management.

Most of the diagnostic services required for emergency services are available 24 hours.

Ambulance services
1. There are two standby ambulances: one well equipped Cardiac and the other ambulance is non-cardiac ordinary ambulance. 2. There are five trained ambulance drivers available round the clock. 3. A qualified doctor from the ICCU or EMS, a nurse and a well-trained ward boy mans the cardiac ambulance. 4. The ambulance is equipped with drugs and new machines.

Diagnostic services available in this Hospital:

Gamma & PET Cameras Stress Test Ultra Sonography Digital subtraction Angiography Digital X-Rays Pathology Hematology Microbiology Biochemistry Immunology R.I.A. (Radio-Immunoassay) Endoscopy Services

PHARMACY SERVICES
PHARMACY SERVICE IN HOSPITALS traditionally has been oriented to serve patient areas from a single, central core pharmacy. More frequently than not, the pharmacy has been isolated physically from routine and direct patient care activities, thereby presenting problems both of distribution and communication. A program has been introduced at Memorial Hospital of Long Beach in which the pharmacist becomes a participating member of the patient care team. This program has been designated Patient Care Environment (PACE) pharmacy service, and it will focus pharmacy service in the patient care area. Functioning 24 hours daily, PACE pharmacy service will make use of the professional training and capability of the pharmacist by placing him in the midst of patient care activities. Within this context of care and treatment, the pharmacist will be responsible for all phases of drug use and distribution up to the point of actually administering the drug. Team care is an integral component of patient care at Memorial Hospital, and PACE introduces a new member, the pharmacist, whose specialized knowledge and skill will complement and reinforce the established team approach to patient care. The pharmacist, too, provides an available and competent source of information for the physician and nurse and others involved in the care of the patient. The value of this service would be difficult to quantify, but the entire health care team is made more effective by this increased depth and scope of knowledge. Specific and immediate objectives are these: 1. To provide maximum safety to the patient through direct pharmacist supervision of control in distribution and use of all drugs on a patient unit, up to the point of administration of the dose. 2. To provide an immediate and accessible source of drug information to members of the medical staff, nursing staff, and others involved in patient care on the nursing unit. 3. To reduce the cost of medications to patients. During the study a pharmacist was in attendance on a 24-hour schedule. The pharmacist evaluated and interpreted medical orders and prepared medicines for each patient in advance of dosage times, maintained a record of medication dispensed to patients and in general accepted full responsibility for drug usage on the patient unit. Pharmacists were assigned to 12-hour shifts. The extended length of the shift gave maximum coverage with minimum personnel in a basically simple schedule. Responsibilities of the Pharmacist 1. 2. 3. 4. 5. Control of all drug supplies on the patient-care unit. Receive, evaluate, and interpret physicians' orders for drugs. Maintain a record of drug usage for each patient. Prepare all drugs and dosage forms for administration by the nurse. Regulate and standardize dosage administration schedules.

6. Initiate and develop a drug information service to members of the health-care team according to professional needs. 7. Work cooperatively with members of the nursing service and medical staff in developing programs related to patient care.

Everything was done individually and by hand, a frustrating and wearying business. Instead of freeing the pharmacist for more professional activities as a member of the health care team, he had become trapped in the role of a clerk. This misalliance was resolved by using a pharmacy assistant to do the repetitive work of pulling doses and keeping the records. The pharmacist maintains control by checking all the work, but at the same time is free to assist in his capacity as a professional by initiating action to intercept and correct potentially hazardous drug-related situations. Hospital pharmacies can usually be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition (TPN), and other medications given intravenously. This is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Several hospital pharmacies have decided to outsource high risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology, combined with the potential impact of medications and pharmacy services on patient-care outcomes and patient safety, make it imperative that hospital pharmacies perform at the highest level possible. In Maheshwari nursing home have a pharmacy. Who is working 24X7 in two shift 12 hours. All hospital medicine supplied by this pharmacy. Who is situated in inner part in hospital .

Wards In Hospital
Hospitals vary widely in the services they offer and therefore, in the departments they have. They may have acute services such as an emergency department or specialist trauma centre, burn unit, surgery, or urgent care. These may then be backed up by more specialist units such as cardiology or coronary care unit, intensive care unit, , and obstetrics and gynecology. In this hospital department are divided in to two department. 1. Outer patient department ( OPD ) 2. Inner patient department ( IPD )

1. Outer patient department ( OPD )

OPD department have consulting doctors chambers. They are situated in specialization order as general physician, orthopedic, gastroenterologist, pediatrics, obstetric & gynaecologist, ENT specialist, radiologist, neuro- surgeon, urologist, ophthalmologist, and other specialist doctors.

A. Medicine & cardio-

Dr. Vinod Jain Dr. Sandeep Kumar Dr. Archana Sharma Dr. Sweta Maheshwary Dr. Ajeet Gupta Dr. Atul Sahai Dr. P. Mittal Dr. KC Ahuja Dr. R.K. Gupta Dr. R.K. Kanchan Dr. P.Dutta Dr. V.K. Navkar Dr. S.S. Bhadoria Dr. Rajesh Pippal

B. Obs& Gynae -

C. Orthopedic D. Neuro Surgeon E. PediatricF. ENT.G. Gastro -

H. Optho I. Urology J. Pathology K. USG.& Radiology -

L. General & Laparoscopic - Dr. V.k. Maheshwary surgery M. Burn & Plastic Surgery- Dr. Vaibhav Maheshwary, Dr. Ajeet Gupta N. AnaesthesiaDr. Mukesh Sharma

2. Inner patient department ( IPD )

Maheshwari Nursing Home has 120 bedded hospital. In Inner patient department (IPD), Hospital is running many wards. In this hospital 6 specialist Residential Doctors and many duty Doctors, who working round the clock duty in different wards. In these hospital approx. 50 nurses, who gave their lovely services for patients. And 30 bai and ward boy, 15 sweepers has working here. In this Hospital have many wards with their specialties.

1. Intensive Critical Care Unit (ICCU) The concept of progressive patient care has come in to optimize the nursing services. 20 intensive care beds in various units are recognized as among the best in the city and compare well with international standards. Certain specific areas are dedicated for day care admissions and for patients for deliveries. The hospital has state of the art operating rooms and equipment Nursing supervision has to be maximum for critically ill patients, and this need can be gradually decreased, as the patients get better. In this ward have 16 beds and 4 private rooms. Who has fully air condition, with many latest medical types of equipment. Every bed has separate video camera for regular watching by specialist doctor. At that place every service are available on the bed as USG, X-rays, blood sample collection, etc. Cardio LCD Monitor VentilatorDefibrillatorPulse-Oxy- meterSeparate Suction MachineSeparate Oxygen cylinderCentralized Oxygen FacilityCentral Suction Facilities 16+4 4 4 16+4 5 2 in full ward in full ward.

2. Burn Unitin this ward has 10 beds with 2 private room . This ward has fully sterile ward for patients and staff. Fully aircondition withCardio LCD Monitor 4 Ventilator1 Defibrillator1 Pulse-Oxi- meter4 Separate Suction Machine1 Separate Oxygen cylinder1 Centralized Oxygen Facilityin full ward Central Suction Facilities in full ward

3. Intensive Care Unit (ICU) In this ward have 20 beds with 4 private rooms. Who has fully air condition, with many latest medical types of equipment. The conflicting requirement of continuous observation and privacy, is met by, overhead curtains, in between beds. It should have special ICU beds to facilitate nursing, life saving equipments. Cardio Monitor VentilatorDefibrillatorPulse-Oxy- meterSeparate Suction MachineSeparate Oxygen cylinderCentralized Oxygen FacilityCentral Suction Facilities 10 1 1 10 5 2 in full ward in full ward.

4. Ortho Ward Ortho ward is a orthopedic ward. It has 20 bedded ward. It is divided in to ward pre- operative and post- operative ward.

A. Pre Operative Ortho Ward- in this ward those patients admitted , who wants to traumatic or orthopedic surgery. These patients are admitting for pre treatment and pathology test. In this ward have 10 beds for patients. B. Post Operative Ward in this ward those patients admitted, who have suffer traumatic and orthopedic surgery. in this ward patients have to take after surgery treatment . In this ward have 10 beds for patients.

5. Delivery ward This ward is reserve for pregnancy cases. Those patients, who are suffering from labour pain (delivery), have admitted in this ward. This ward has 10 beds and 2 private, 2 semiprivate rooms. Total beds number is 16. In this ward have 2 labour rooms for delivery.

6. General ward In this hospital have 3 general wards. Every general ward has 8 beds with 2 paramedical staff. Total beds number for all general wards is 24. All type patients who have wanted minimum charges for treatment. They have admitted in these wards. They are admitted for mostly 1-3 days only. And some special cases time duration will be long.

7. Private Rooms the present trend is for the patients and the bystanders, to demand privacy. Most patients in urban areas demand single bedded rooms with attached toilet, to double bedded rooms. The patient rooms are provided with television, telephones and bells to alert the nursing personnel when required. The beds can be positioned to meet the medical requirements and maximum patient comfort. In this hospital have separately 10 private rooms for patients. In this rooms have many facilities as telephone service, LCDTV, With cable, Almirah, Freeze, etc. All rooms have fully air condition.

8. Total Bed NumbersICCU Burn Unit ICU Ortho ward Delivery ward General ward Private rooms Total beds

20 10 20 20 16 24 10 120

PERSONNEL / H R DEPART. & PUBLIC RELATIONS

HUMAN RESOURCE MANAGEMENT IN HOSPITAL

The simple and familiar word hospital represents much, but is not always understood in its entirety and complexity. A hospital cares for patients of all ages and backgrounds, some appreciative and some disgruntled, some happy and some sad. It houses cooks and doctors, cleaners and nurses, technicians and therapists, ambulance drivers and administrators of different kinds, plumbers and clerks, all interacting with each other. It experience love and hate, hope and despair, sympathy and indifference. It is a place which never close complex equipment, has a wide variety of supplies, imposes, policies and rules, has budgets and debts, experiments and learns and for the future. The central theme conspicuous in a hospital is that it gives prominence to the people who deliver services to the wider constituents of a hospital. A human asset, in modern times, is considered to be a treasure rather than a mere resource in progressive business organizations. This is because it is the people who shape the destiny of business, rather than the structures, systems and processes effectively formulated in the organizations. Hospitals are becoming large and complex, with the increase in modern health facilities, increased health awareness among people and the advent of new technologies in medicine. Government intervention in recognizing the hospital as an industry and regulating their purpose and performance has also increased in India. EVOLUTION OF HOSPITAL HRM IN INDIA HR function is in existence in some form or the other in Indian organigations in general and in hospitals specifically. This is because organizations exist for people. They are made of people and by the people. Their effectiveness depends on the behavior and performance of the people constituting them. However, organized HR functions can be traced tohte concept of concern for the welfare of employees that started in the 1920s. today, The status of personel management function in hospital is not much different from what it has been during the last twenty years, not only in terms od its role and execution, but also and more importantly, in terms of the approach and philosophy towards human resources. Neither has the evolution of the function been smooth, nor has any significant progress been made lately.

OBJECTIVES OF HRM SYSTEM IN HOSPITALS The broad objective of HRM is to contribute towards realization of the hospitals goals. The specific objectives are to: Achieve and maintain good human relations within the hospital. Enable each employee to make his/her maximum personal contribution to the effective working of the hospital.

Ensure respect and the well-being of the individual employee. Ensure the maximum development of the individual and to help him/ her contribute his/her best to the hospital Ensure the satisfaction of the various needs of individuals in order to obtain their maximum contribution to achieve the hospitals goals.

HUMAN RESOURSE PLANNING IN HOSPITALS 1. Manpower Estimation Human resource planning is a process of generating a plan, showing the demand for staff over a period of time, based on assumption about productivity and costs associated with the employee. The supply of the resource available within the hospital and the shortfall, that may have to be supplemented form outside, are also estimated, estimates regarding demand for and for the supply of human resource are always generated in relation to the job analysis. Human resource planning is a continuous activity in an organization because people come and go . health statistics of employee( past illness, disabilities, present health condition etc.) compiled according to department , location, occupation, grade, sex, age, etc. Stock is the current number of staff employed. Intake is the predicted demand for the number of staff. Losses are historical turnover rates , that is, the numberof personnel leaving , as a percentage of the existing staff, balance is from stock , adding the requirement are calculated by examining workload predictions, service changes and possible future expansion of services. Additional need is the difference between the balance ,which is likely to be the stock available and that which is predicted as really required. 2. Recruitment Recruitment is undertaken as an activity to fill vacancies from external or internal sources to comply with the human resource plan. It is the process of identifying the number and quality of people required for the hospital, identifying the sources of availability- internal or external to the hospital- preparing a press announcement containg the job description, job specification, person specification, a brief note on career prospect and the history , mission/ vision, image and future plans of the hospital. Inviting application, short listing the applicants on the basis of the conditions specified and intimating prospective candidates for selection tests. In summary, recruitment is a process of attracting a large pool of applicants for a small number of jobs, thus creating an opportunity to pick the best from the lot.

3. Selection As recruitment attracts a large number of applicants, the process of selection is used for choosing a few for further consideration on the basis of predetermined criteria. Achievement test . Personality tests . Aptitude tests . Interview . Interest tests . IQ and EIQ tests 4. Induction or socialization This is a formal programme, designed and partly carried out to introduce new employees to the organization, in all its social and work aspests. It is a systemic, planned introduction to the company. It is also a scientific approach to help solve the problems of the new worker and his / her integration into the organisation of the hospital. The purpose of this programme is: To build the confidence of the new employee in the hospital. To promote a feeling of belonging and loyalty and adjusting to the new circumstances. To give information about essential such as working conditions and terms of employment. In this programme, the employer gives the first impression to the incumbent about the uniqueness of his organization(Hospital). The topics to be covered in the induction programme are about the hospital and its services. They are: The geographical location of the hospital. The structural and functionalaspects of the hospital. Terms and conditions of employment. Standing orders and various provisions. HR policy The department and its employees. 5. Placement This is the last in the series of activities to ensure that the selection of the right man for the right job, as a principle, is following through. The new incumbents need to be put through an intensive training programme in various departments before the ultimate decision is taken about which job they are suitable for. This helps in proper placement. Many organizations which have a high turnover in the initial months of employment do not get the right people for the right job. In brief , the task of a HR functionary include:

Reviewing vacancies. Writing job advertisements. Calling candidates for interviews. Making and obtaining acceptance of offers. Sending for references and arranging medical screening. Informing unsuccessful candidates. Contract preparation, signing, etc. Induction and placement programme.

Public Relations
The public relations department is considered one of the most important departments in the hospital due its multiple services: 1Getting informed on what is being published in the daily news and following up what

it issued about the hospital news. The department photocopies and saves this information in special files then is proposed to the hospital manager. Each specialist is responsible for one newspaper where he follows up the news and then displays and saves it. 2Daily passage on the hospital patients in all floors. It is responsible for following and resolving all the patients problems being faced during their stay in the hospital. They are also responsible for inquiring about the VIPs and welcoming them in the hospital. 2 public relation specialists do this job. 3Reservation for conferences, symposium, debate for thesis statements (masters, PHD)

by filling the form that applies to each of them and writing the kind of debate or the conference, accompanied with the hospital manager signature and issuing the purchase order under item of the scientific activity account. The big amphitheater capacity is rented with an amount of 300 pounds, while the small hall, capacity is rented with an amount of (150) pounds.

The public relation department offers all the necessary services like:

- Setting up for symposiums and the different scientific activities by setting the halls, amphitheaters, and supervising on the cleaning activities and coordinating with the engineering department. - The coordination with the Food & Beverage Department and the cafeteria in case of needing any hotel services. The coordination with the engineering department for the availability of technicians specialized in operation. - Sending faxes for Mass Media and especially to Houras channel and the specialized channels to record and publish the conferences, scientific symposiums and thesis statements.

4- Translation Department: In this section, there are 2 English translators and 1 French translator. They are responsible for welcoming the foreign visitors to visit the hospital and publish on its services in the daily newspapers. This department is also responsible of all the translation activities necessary to the hospital and writing the medical reports in the English language upon request, in addition to the invoices " when necessary .

5- External Relation Department: The External Relations Department is responsible for arranging the arrival of delegations and foreign experts where they are welcomed in the VIP hall, and the department messenger welcomes them at the airport. This department is responsible for arranging different educational and entertaining trips for the coming visitors in order to know the Egyptian culture. It is also responsible for accompanying the hospital medical team back and forth for 24 hours each according the working shift applied.

6- Reception Department: At beginning of the hospital activity, the reception department responsibility was mainly for the main reception, which is located in the basement floor but due to the hospital additional requirements, the reception is distributed as follows: 2 public relations specialists in the hospital main reception in addition to a computer device to facilitate the inquiry process. 2 public relations specialists with a computer device in the first floor reception. One public relations specialist in the corridor of the first floor.

One public relations specialist in all floors, in addition to availability of registered files

listing all the names of resident patients. 1 public relations specialist in the check up department to welcoming the VIPs and explaining the check up program idea to all clients. 2 public relations specialists in the medical committee to meet members of the teaching staff and passing by them in the Internal Departments. All these activities are done for the purpose of elevating the hospital performance and work process.

7-Publishing and Announcement: This department is responsible for publishing all what it receives from hospital ads (job vacancies) from the Human Resource Department. It is also responsible for bids and tenders that concern the Purchasing Department where the ad is published for 2 consecutive days in the official newspapers. This act is the responsibility of two public relations specialists.

8- Services for hospital employees: This department is responsible for making surveys on the hospital employees where it can issue a percentage stated from the total compensation earnings concerning (marriage, death, disasters, and study).

- 1 public relations specialist in responsible for this activity. The department is also responsible for operating transportation lines for employees and nurses and determining the transportation lines, collecting transportation fees and submitting it to the hospital safe box. - This activity done by four public relations specialists. The department is currently setting the operation of new lines to facilitate the transportation problems on the employees. In addition to this, 2 microbuses are assigned to transfer members of the teaching staff from and to Cairo University hospitals and vise versa. - A committee is formed from 2 public relations specialists to investigate the employee problems in order to perform their jobs with full trust. This department is concerned with collecting appreciation letters written by patients and then publishing them on the hospital advertising board and it is concerned with doctors, nurses and employees. - In order to increase the employees spiritual moral, the hospital arranges vacations each year for a duration of 4 months, with an annual trip in the mid year vacation, besides the one day trips. - The department also organizes a monthly party selecting the employee of the month from each department in corporation with the office of the Hospital manager.

- Report on amphitheaters that are rented from the Public Relations Department

THE ROLE OF PUBLIC REALATIONS DEPARTMENT

The PR department deals with the management of both internal and external commutations they responsible for promotions of the health organisations and implementations of the hospitals marketing programmes that are related to Overall Mission and vision of the hospital, also manage and improve the flow of information within the hospital and between the hospital and the community it serve. Public relations professionals have a role to play in helping management to keep in touch with their various public because the role of PR within an organisation has become that of a spokesperson to the management, they actively solicit both employee and consumer opinion and make management aware of the effects various decisions will have on consumers employees. This is similar to the Two-way symmetric PR Model (by Grung and Hunt) which includes equality of communication using extensive dialogue and exchanges of views to change attitudes in order to reach the need of the other. The PR department should also serve as liaisons to the community and work closely with other health partners in the locality in preventive health. The responsibilities of PR specialist in such filed includesWriting and distributing news release, feature articles to the press, compiling press list, witting of newsletters, handing and maintain a media information service, arranging press, radio and television interviews for management, preparing marketing plans for various programmes and strategies promotional and marketing effort. Public relation department is responsible for community relations, hospital publications, media relations special events and support for fundraising. Additional skills for hospital PR Hospital PR practitioner in the area of heath care required special skill in order to work effectively in the field . Understanding the patient confidentiality and privacy act . Ability to communicate thoughts and ideas effectively an accurately . Knowledge of in community and health care administration i.e. patient consent forms an their use . Analytical and problem-solving ability . Knowledge of profit hospital operate and how non-profit one are one are funded . Knowing the hospital structure, department and support groupFamiliar with the community where the hospital is located . Writing skill and ability to handle different type of media.

Positive aspects of roles and functions of the Human Resource Department

Recruitment of employees This is one of the most fundamental roles of the HR department. This is because this function ensures that the Company under consideration selects the most skilful and competent person from a sea of applicants at that time. This function involves evaluation of ability and competency of potential employees in relation to what the Company needs. This role falls under the Staffing role of management. If this function is performed well, then the organisation will increase value consequently being on the right pathway to achieve its organisational and departmental goals and objectives. (Hyde, 2004) Effective recruitment can be done through a number of ways. First of all the Company can conduct educational and psychological measurements. This task will involve assessment of abilities, skills and character evaluation of applicants. Through psychometric evaluation, the Company can ensure that employees have the right attitude necessary to fit into the organisation. Another method Companies use to recruit members of staff is through interviews. Here, the Human Resource Department can ask applicants questions that evaluate their decision making abilities and how they would deal with certain situations if presented with them. The Department can also employ the use of written interviews where applicants answer questions addressing key issues in the organisation. Through these channels, the Department contributes towards organisational performance.

An example of a Company that performs this role well is Tesco Ireland. The Company notifies the public about vacancies. It then posts a questionnaire online and interested parties fill it at that time. This is then evaluated and those who fall within their minimum requirements are invited for an interview. In the interview, applicants are asked a number of questions and those who did extremely well are further analysed and retained. Those who did moderately well are not immediately eliminated; instead, their interview questions are kept on file then these are reviewed after six months. By so doing, the Tesco Ireland makes sure that its employees are highly capable and that they will enrich the organisation. (Hyde, 2004) Improvement of compensation packages One of the major functions of the HR department is to motivate employees. This can be done through rewards especially for those who have done well. The HR department needs to evaluate performance of employees and those who have exceeded expectations should be compensated for their actions. Research has shown that rewarding employees for good performance is the number one incentive for keeping up this trend. These compensation packages can come in the following ways;

Holiday offers End of year bonuses Equities Awards Salary increments Provision of flexible working hours Straight forward promotion schemes and career developments

If the HR department includes these incentives, then it will ensure that employees are satisfied with the Company. It will also contribute towards good staff retention rates. This is especially crucial in increasing stability within the organisation. It also makes employees identify with the firm and instils a sense of loyalty. (Handy, 1999) Planning in the organisation The Human Resource Department is placed with the responsibility of ensuring that it plans adequately for all the organisations future engagements that will involve people. One important aspect of this is planning for employees in the organisation. It is important that the organisation ensures that all the employees under its wing are just enough to increase value to the organisation. The Department must ensure that staff members are not too many because if they exceed this amount, then the organisation stands too lose. It must plan adequately to ensure that staff members are not too few either, otherwise they will be overworking those who are already in place. Consequently, there will be poor motivation resulting from fatigue. The HR department is also bestowed with the responsibility of planning future organisational goal in relation to people or clarifying these same goals to staff members. This function of the department ensures that people in the organisation have a general direction which they are working towards. Organisations that have a clear direction are always more effective; those members of staff will be more result oriented rather than just working for the sake of it. The Department is also responsible for setting day to day objectives necessary for streamlining activities within the organisation and thus ensuring that work is not just done haphazardly. (Hyde, 2004)

LIBRARY IN HOSPITAL

Hospital library's role in medical research

outlines the hospital library on clinical research services in the status quo, development, emphasizing the hospital library should attach importance to clinical research services to improve their own value. hospital library-based research services digital network automation The 21st century is a high degree of integration of information and technology and mutual promotion and common development of the times, in today's information explosion, medical workers in their own frontier scientific research, they must access a large number of literature, information on the dynamics, understanding of academic trends, and thus avoid detours and avoid duplication. Hospital library as a hospital library and information work in the main, are responsible for the clinical medical treatment, teaching and research work such as collection, storage, processing, transmission of information the task and must therefore be actively making data and information services in security work. 1 for clinical research services to provide the status of 1.1 The self-awareness is not enough to restrict the research and service development All along, many hospital libraries in the clinical services, more focus is the completion of teaching tasks and provide documentation of the inquiry, there is 'passive services' awareness of neglected or even forgotten the library for research work services functions. Many hospital libraries difficult for deep-level scientific research to provide support, or not to participate. Many hospital library staff even thought Scientific research is the scientific research departments, hospitals and researchers own business, has nothing to do with the daily work of the library. Such a positioning error of a direct impact on the hospital library a rational allocation of limited funds and daily work, the level of service for the research work. 1.2 low quality of personnel, information services is limited The hospital librarian team structure is irrational, librarians uneven quality, professional knowledge and poor, low levels of foreign languages and computers, the lack of research subjects project reference, information retrieval strategies, information processing screening, information mining innovation research and service skills. Information service direct result of the low level of R & D staff of no confidence in library work, which led to the library and research departments, poor communication and clinical departments, many hospital libraries do not know what the hospital each year, research project and research topics, can not provide research work necessary for investigation of new services, but also a lack of commitment to work on research and services.

1.3 digital, network-based, automated process is slow Modern Library mostly paper-based knowledge and information collection targets, mainly including books, newspapers, etc.; the main accreditation approach to reading reading reading and the museum in two ways. As the hospital library with limited funding and premises, so much knowledge and information storage capacity has been limited; to readers by time and geographical museum a great impact, it is difficult to meet the information age people are a lot of information, timely and convenient request, to the readers access to information resources is a big inconvenience. In today's knowledge-information age, only by achieving the number of hospital libraries, networking, automation, be possible to break through the traditional model of library services, there is limitations. The most hospitals in China today is still far short of the establishment of the library system of integrity, a clear structure, characteristics, highlight the library network service environment level. 2 to improve the quality of services for clinical research and the way 2.1 Establishment and research needs of the collection system compatible Hospital library collection of books do a good job building is the foundation for the research and the provision of services can be through various channels, planned, purposeful collection of a variety of medical literature at home and abroad to strengthen the construction of key subjects of books around the key disciplines of clinical and scientific research, as far as possible representative of the various data collection the whole book to ensure that their academic information, novelty, practicality, systematic, continuity and integrity. With the medical model changes, preventive medicine, basic medicine and clinical cross-penetration and interdependence, and building characteristics, in addition to the collection system for the collection focus on key subjects, the taking into account the relevant disciplines and interdisciplinary literature, so that collection structure was the main cross-dimensional condition. 2.2 to fully tap a variety of bio-medical information resources Provision of services for clinical medical research, relying on the library books and the limited literature is not enough, so make full use of library books, and retrieve the publications, periodicals cumulative index to retrieve the consultation, we should also rely on a strong network of bio-medical information resources, a variety of standard patent databases and CD-ROM database, which is a hospital library for clinical research services to provide an important safeguard. 2.3 to improve awareness of information services librarians and service level Harrison, the British Library of Jurists, said: Even the world-class libraries, if the collections have not been able to fully tap the strengths and well-trained staff, are also difficult to provide extensive and effective service for readers [1].

Team building is the hospital library services to provide the basis for scientific research. The information age the quality of hospital librarians put forward higher demands to the library service staff should have proficient computer skills, database knowledge, information resources development and utilization of the entire sequence, and the ability, higher foreign language proficiency and some degree of medical basic knowledge. At present, the hospital librarians still have a certain distance away from this requirement, therefore, must accelerate the introduction of talents and in-service training, and optimize the knowledge structure, to improve their overall quality. Is the only way for clinical research and to provide efficient quality service. 2.4 provides in-depth reader service With the continuous improvement of reader requests, the hospital library should make use of periodical publishing cycle is short, informative advantage of the high technology, large flow rate in the English medical journals and the latest information on the rapid translation of finishing out provided to the reader, to change the passive services. 2.5 assisting medical personnel do scientific research topics Scientific research topics throughout the entire research work is the main idea is to guide the design of the organization of scientific research and the main line of work. Despite hospital library staff not directly engaged in clinical work, but from the face of a broad array of medical research literature's ability to access knowledge and information the medical staff can not be compared. The clinical staff normally responsible for the heavy work of medical services, read professional literature in other disciplines is relatively small, formal, standardized medical services to some extent confined to their way of thinking, so librarians and information superiority the medical staff thought collide, integration, of things from different perspectives to observe and think, learn from each other to help researchers select a good topic. In the topics of the course should also follow some basic principles, such as the need for the principle of creativity principles, scientific principles, the feasibility of principles. 2.6 to track the entire process of clinical research Topics of service, while doing a good job, librarians should also closely follow the progress of hospital-related issues, to provide timely and abroad the latest developments in the field, allowing the researchers to keep abreast of domestic and international research projects with professional status similar to timely adjustments to research content, avoid lowlevel, repeatability studies. Meanwhile, the difficulties encountered in scientific research and can be re-searching and argument, and even through an online forum to help researchers solve problems promptly.

The preliminary results of research projects is the thesis. Library staff can use their mastery of the advantages of search tools to help researchers select the appropriate publication published papers. After the completion of research projects, through the novelty to determine the novelty of the subject to help researchers select the appropriate level and so the results reported. 2.7 the promotion of medical research results into Hospital There is a widespread emphasis on scientific research, heavy awards, do not attach importance to the outcome of the phenomenon of social value, leading to scientific research is divorced from reality, resulting in the transformation difficult, low economic efficiency, repeatability studies, was affecting the hospital to improve the overall scientific research strength [ 2]. To this end, the library should strengthen intelligence research, to carry out research and Dissemination of information to track service work, reducing the blindness of scientific research to ensure the transformation of scientific research to realize the value of scientific research itself, so that scientific research and sustainable development. 3 to enhance digital, network, automation With public libraries and university libraries in comparison, the hospital faced a shortage of funds the library building and the premises of the limited area and so on, in the digital, the network is becoming a global information infrastructure construction and development trends of today, the realization of information resources Digital technology has also become the 21st century, the theme of career development of hospital libraries. 3.1 to create a good network environment Make full use of various hospitals, medical information institutions, medical research institutions, public network and other information resources, support systems already established network system to enhance the functionality of web pages through the link functions and Web search engine design, production section is complete, fully functional web pages. In addition to set the Library database resources, services, project descriptions, discipline navigation, links to other resources, such as columns, it should also set up the page the user with the user, directly between the user and the library platform for the exchange of information, such as curator-mail, BBS Forum and so on, the information platform will become the public information about the library service needs tend to the main channel. 3.2 strengthen the collection of digital resources Hospital libraries should make greater efforts on the collection of resources to the digital approach to the organization and reveal, and transmitted on the network, the library home page available to users, so that the Library's collection of information resources can be well known, which is the library network management and service base. The digital object should be targeted to those customers demand, utilization of high literature, both precious nor

copyright issues of digital documents should be given priority. Such a selection and evaluation to carry out digitization not only saves a lot of manpower and material resources, but also satisfy the demand of readers. 3.3 self-built characteristics of a database Because the hospital specialist and different research interests, and each library has its own in the literature on acquisition priorities and collection characteristics of the collection. A planned and systematic collection of information resources into a unique part of the transformation of a computer can retrieve data and Internet transmission, which is the current collection of networked library will convert another way. Database construction features, such as library holdings database, thematic databases, full text database. 3.4 increase the intensity of electronic document acquisition In order to better serve the cause of the clinical and scientific research, hospital libraries in addition to their museum collection of resources, but also should further increase the intensity of electronic documents interviews, according to local teaching and research needs, a reasonable complement the electronic literature, from the original single static collection to collection entities, dynamic entities exist side by side with the virtual electronic collection of documents the transformation of the structure optimization of collections to meet the needs of readers. Today's high level of journal databases CHKD, CMCC and so on, e-book publishers are mainly Superstar National Institute for Medical e-books and digital libraries. Purchases and authorization by such means as the use of Web resources to create a virtual collection will be a breakthrough in their own hospital libraries and financial restrictions on the size of the best strategy for career development. References: [1] Sun Xiaofang. Hospital Library for the medical research services, the way [J]. Chinese Journal of Medical Library, 2001 (3) [2] Xiao-Ming Wu. Play literature resources, the promotion of university scientific research [J]. Library Construction, 2001 (6) [3] Sun Qian. On the specialist hospitals, libraries and knowledge management [J]. Library Journal, 2005 (1) [4] Yang Zhi. To play a hydraulic characteristics of superiority on R & D [J]. Library Journal, 2005 (6) [5] Lei Lijuan. Personalized service is the direction of hospital library information services [J]. Medical Informatics, 2008

HOSPITAL MARKETING

Hospital marketing is a specialized field that deals with connecting patients, physicians, and hospitals in mutual relationships. Many people ask, "How can you 'market' a hospital?" But marketing a hospital or health system is no different than "marketing" any other non-profit organization like the American Red Cross or your local charity. There are audiences. There are needs. There is a mission statement. Plus, historically, medicine in America has always been a business. In today's insurance and reimbursement environment, health care and hospital marketing is more needed than ever to ensure continuing viability of American medicine on the local level and to provide the high quality of individual health care that Americans have come to demand. With these ingredients, there is clearly a need for analysis, strategy and communication to make the most of limited resources while providing compassionate health care. This is what hospital marketing does.

HOSPITAL MARKETING COMES OF AGE

EHM Team - Mumbai/New Delhi/Chennai Buoyed by corporatisation of healthcare, Indias promotion as a sought after medical tourism destination and threatened by the mushrooming of new hospitals, it is becoming difficult for hospitals these days to depend on mere word of mouth promotion to attract patients. Hospital managements are putting extra effort in carving a brand image of the hospital and improving hospitals visibility. In other words, many would agree, that hospitals marketing has evolved from being subtle to aggressive. Hospital marketing as a concept According to Ashok Anantram, president, business development, Apollo Hospitals, Chennai, Marketing as a concept is the same in product and service industry. There is a product or service - one section produces it and the other consumes it. Marketing is an interplay between producers and consumers. However, the difference comes in marketing tangible and intangible products. While products that can be seen, felt, touched and tasted are tangible, the products that are based on post-sale experience is intangible. Consumers can come up with desirable parameters for a tangible product in terms of productivity, efficiency, etc. It is very difficult to rate an intangible product, he explains. Experts opine that healthcare marketing is a complex equation because most often the producer, that is, the doctor, himself is the marketer. Since the production and consumption takes place simultaneously, as in the case of performing an operation, he or she should ensure

zero-error delivery each time and every time. There is no physical or time gap between the production and consumption. Marketing department With the realisation of importance of hospital marketing, the presence of a fullfledged marketing department has also been acknowledged. The marketing department is said to be the voice of hospital where the brand is fashioned and communicated, internally as well as to the community at large, says Anne Marie Moncure, managing director, Indraprastha Apollo, New Delhi. According to Dr Mitul Thakkar, senior manager, marketing, Asian Heart Institute and Research Centre (AHIRC), Since a hospital makes a lot of investments in setting up the infrastructure and offering its services, selling the services of a hospital needs a proper system. Therefore, the role of the marketing department in our hospital is of paramount importance. Apart from helping to create a brand image for the healthcare institution, the department acts as an interface between the doctor and the public. Agrees Urmila Nabar, marketing manager, Nanavati Hospital, Mumbai, We provide the liaison between the doctors and the public. The marketing department has assumed more importance after the boost in medical tourism, opines Colonel B S Khimani, director, administration, Jaslok Hospital. The marketing department liaisons with the medical officers of the foreign consulates to bring patients from abroad. FICCI is helping hospitals to utilise the potential of medical tourism. Jaslok hospital has recently tied-up with FICCI to utilise the potential of this upcoming sector, informed an official from Jaslok Hospital. The success of the marketing department depends on its association with various other departments. Organisational excellence is very important than the departmental excellence. The front end cannot perform its duties without the backing of the quality of back end operations, says Anantram. Marketing strategies Though there are no specific strategies for hospital marketing, a systematic approach to marketing has evolved over the past few years. Unlike earlier, now the corporates prefer a long-term association with the healthcare institution by signing a memorandum of understanding (MoU), says Deepika Gupta, marketing executive, S L Raheja Hospital, Mumbai. Marketing experts believe that a sound Client Relationship Management (CRM) forms the basis for soliciting corporate tie-ups, today. Events, both indoor and out-reach programmes, play a significant role in marketing of healthcare institutions. Continuous medical education, awareness sessions for general public, check-up camps for public, organising events on various health days, conducting interviews of specialists on visual media, informative and interactive website, printing and making readily available various emergency or appointment numbers are the commonest marketing tools.

According to Dr K S Bhimwal, medical director, Rockland hospital, with the surge in concern in health check ups, hospitals have fashioned various types of special health check up packages catering to executives, pregnant women, servants, shop keepers to slum dwellers.Recently, we celebrated Liver Day at Apollo, which was aimed at educating and creating awareness amongst children and parents, so we organised a fashion show and health quiz, which generated a lot of interest, says Moncure. Though hospitals are publicising through advertisements, according to Dr Saumitra Bharadwaj, marketing manager at Fortis hospital, NOIDA, hospitals should create goodwill for themselves and should not completely rely on advertisements. As patients are the best ambassadors, it is important to take care of their needs and provide them with best possible care. Their apprehensions should be addressed so that they have the courage to come back to the same facility, he adds. Agrees Anantram, In this business, every satisfied customer brings thousand new customers. Future Would hospital marketing become more aggressive in the future? We can no longer rely on word of mouth for getting patients. Hospitals, mainly the corporates ones, would definitely get more aggressive to survive the intense competition, avers Juhi Bhandari, marketing manager, Hinduja Hospital. However, Nabar disagrees, saying, Aggressive marketing is not necessary in healthcare sector as it would not fetch more patients. Patientss decision to choose a hospital is based on three factors: facilities available in the hospital, expertise of doctors and vicinity. Will new marketing mantras emerge in the future? The answer lies in the thought process of the new faces in this sector. According to Manish Sharma, management trainee, Hinduja Hospital, As in the West, in future, tertiary care Indian hospitals need to conduct research so as to segmentise the market and tap that area from which patients are not turning up. For instance, if research shows that a hospital is not attracting enough patients from a particular age group or a disease profile, it needs to strategise to get those patients. Should Hospitals Increase their Spending on Marketing? Though most hospitals groups are aggressively planning their expansion, marketing their service remains to be the traditional word-of-mouth. Most hospitals spend a meager amount on marketingaround two to three per cent of their revenue. In a competitive environment, should hospitals spend more on marketing? How much should they ideally spend? We ask the experts

'Mere word-of-mouth is not Enough'

"The marketing department is sets the tone of the hospital where the brand is created, carved, fashioned and communicated" - Dr G Surender Rao Executive Director Yashoda Group of Hospitals Hyderabad

Healthcare marketing is a complex equation as Indians don't like hospitals market themselves. The marketing department, where the brand is created, carved, fashioned and communicated, sets the tone of the hospital. Since a hospital makes investments in setting up the infrastructure and offering its services, selling the services of a hospital needs an appropriate system for which spending is also indispensable.

Apart from helping to create a brand image for the healthcare institution, the department acts as an interface between the doctor and the public like a liaison or PR department in any product (or) service sector. The success of the marketing department depends on its association with various other departments. The marketing department is like the front end that cannot perform its duties without the backing of the quality of back end operations. Tertiary care Indian hospitals like us need to conduct continuous efforts so as to segmentise the market, tap that area from which patients are not turning up, a particular age group or a disease profile which is not attracting enough patients. Basically, it needs to strategise to get those patients. We need to train them at regular intervals, We need to promote and position our hospital through perfect branding/advertising. We need to conduct events/seminars/symposiums/conferencesall these exercises requires a good amount of spending. Dr G Surender Rao

'Manpower & Budget has to be Increased' "The role of marketing department is not restricted to creating awareness for external customers only" Hospital marketing is a specialised field that deals with connecting patients, physicians, and hospitals in a mutual relationship. In today's age, hospital marketing is more needed than ever before to ensure continuing viability of hospitals on the local level and to provide the high quality of individual healthcare. With these ingredients, there is clearly a need for analysis, strategy and communication to make the most of limited resources while providing compassionate healthcare. This is what hospital marketing should do. We in India are in infancy in terms of a hospital marketing. Hospitals considered marketing as a byword for sales rather than as a tool for creating awareness amongst the communities for the services

- Dr Dharmendra Nagar Managing Director Paras Hospitals Gurgaon provided by them.

As need is the mother of inventions, demand for quality in this decade has changed the scenario. Now, due to the rising expectations amongst patients demand increases availability of services and thus number of hospitals are coming up in the same geographical area; which has increased the need for marketing by individual hospitals. With increasingly new healthcare providers, the gap has been reduced at least for some people who have the ability to pay. With current structure and budgets of healthcare marketing and individual hospitals may not be able to disseminate information about its services in an effective manner and within reasonable time frame. Healthcare marketing was earlier restricted to most tried and tested tool of word-of-mouth publicity which although effective required long time for the community to learn about the hospital services. Today thanks to increased cost, high competition and obsolesce of technology, hospital need to effectively fill their beds in a shorter period of time. Therefore, marketing in all its facets ranging from business development brand-building, media PR, direct advertisements to the local community play a significant role. Therefore manpower, size and budget for the marketing department have to be increased in order to create the most benefit for hospital and patients. Hospitals should spend four to five per cent of their revenue on marketing. The role of marketing department is not restricted to creating awareness for external customers only. Their job is to disseminate information about services internally to its existing customers and also be initiate a feedback mechanism for the management about perception of the level of services being provided as well any gap within the services which the operational team uses to be on continuous improvement and self assessment path. Dr Dharmendra Nagar

'This Budget should be between 3-5 % of Gross Revenue' "Unless hospitals provide for such investment, success will always elude them' Today, the healthcare industry is moving from monopolistic position to a competitive position. The original face of the industry- Governmental and charitable hospitals, is rapidly shifting towards profit-generating and technology-intensive tertiary hospitals. In this competitive scenario, marketing has assumed an important role to highlight the healthcare organisation to the end users and intermediaries.

Perception of the word 'marketing' needs to be changed in the - Dr Ravindra Karanjekar present context. It is no longer about selling a product or Associate VP marketing a service. In today's age, marketing for direct Wockhardt Hospitals Group business with short-term gain is a last option. Today, Mumbai marketing directs more towards fulfilling the needs of the user rather than selling a product. Today, marketing is more to do with image building and brand development. It is directed towards creating more faith in the organisation, creating awareness about services, quality, cost and philosophy of the organisation.

However, such efforts are not an one-time activity. On the contrary, it a sustained effort on the part of the hospital to inform and showcase the services, quality and capabilities to handle medical/surgical conditions. The hospital must emerge as a clear choice and a reliable brand when the need arises. As of now, the marketing budget provided is minimal and erratic. Mostly, they are event-based or activity-based, which are not sustained over a period and there is no continuity in such efforts. Unless hospitals provide for such investment, success will always elude them. There must be a budget for marketing plan for three to five years, which gets distributed right from launch to more specific focused activities. This budget can be between three-five per cent of the gross revenue. Dr Ravindra Karanjekar

Health Care Packages

Our present day life style makes it mandatory for everyone to undergo complete health checkup at least once in a year. The people are also more Health conscious today and the increasing stress and strain demand every person in Urban areas to undergo Health checkup. In fact it is surprising information to note that, in Western Countries, more than 50% of patients inflow to a hospital is for Preventive Health Check up rather than for the treatment. In response to every persons need for comprehensive health care, Meenakshi Mission Hospital and Research Centre (MMHRC), offers different kinds of Preventive Health Checkup packages.

Master Health Check-up

The Master Health Checkup at MMHRC studies the efficiency of every vital organ in your body and detects any potential major illnesses at an early stage. The package offers the conveniences of all tests, diagnoses and follow-up treatment under one roof.

Investigations

Physical Examination Complete Urine Analysis Stool Routine Lipid Profile Haemogram FBS & PP Sugar Serum Creatinine Serum Cholesterol Blood Grouping & Typing ECG X-Ray Chest Ultra Sound Scan Pap Smear (For Women) General Consultation Gynaecologist Consultation Dental & Ophthalmology Consultation ENT Consultation

Executive Health Check-up

MMHRC's Executive Health Checkup plan has been specifically designed around the work profile of Business Executive keeping mind the busy work schedules. This check-up plan studies the efficiency of every vital organ in your body and detects major illness at an early stage. A volunteer from our hospital will accompany you throughout the checkup for your guidance. Diet advice will be given by our diet clinic according to the health state. This package offers you the convenience of all the tests, diagnosis and follow-up treatment under one roof Program Features.

Investigations

Physical Examination Complete Urine Analysis LFT (Liver Function Test) Stool Routine Haemogram FBS & PP Sugar Serum Creatinine Lipid Profile Electrolytes Serum Bilirubin VDRL Blood Grouping & Typing ECG X-Ray Chest Ultra Sound Scan Gynaecologist Consultation Pap Smear (For Women) General Consultation Dental & Ophthalmology Consultation ENT Consultation Any two Super Specialist Consultation

Whole Body Health Checkup-up

Investigations

Physical Examination Haemogram Stool Routine Serum Creatinine Electrolytes Complete Urine Analysis FBS &PP Sugar Lipid Protile

Serum Bilirubin HIV LFT (Liver Function Test) Blood Grouping & Typing ECG X-Ray Chest Ultra Sound Scan Pap Smear (For Women) ECHO (Echo Cardiogram) TMT (Tread Mill Test) (For Men) Mammogram (For Women) (For women TMT or Mammogram) HBS Ag General Consultation Gynaecologist Consultation (For Women) Dental & Ophthalmology Consultation ENT Consultation Any two Super Specialist Consultation Thyroid profile - T3, T4 & TSH HBA1c

Pre-Employment Check-up
Investigations

Physical Examination Urine Complete Analysis Stool Routine Haemoglobin Total WBC Count WBC Differential Count ESR Fasting Blood Sugar Serum Creatinine Serum Cholesterol Blood Grouping &Typing ECG Chest X-ray Pap Smear (For women only) Counselling Hearing & Vision Checkup HIV/HBS Ag General Consultation Gynaecologist Consultation (For wnmen win) Test for Pre Employment Check-up can be added and deleted from the above list according to the requirements. Test for Pre Employment Check-up can be added and deleted from the above list according to the requirements. The cost for the Pre Employment Check-up will vary according to the tests. SGOT & SGPT

Senior Citizen Health Check-up

Investigations

Physical Examination Stool Routine Haemoglobin Total WBC Count WBC Differential Count ESR X-ray-Chest ECG TMT/ECHO Serum Creatinine Fasting Blood Sugar! PP Sugar Ultra Sound Scan Abdomen ENT Check up PSA (For men only) Pap Smear (For women only) Lipid Prctile Gynaecologist Consultation (For women only) General Consultation HBA1c Blood Grouping

Health Check-up for children

Investigations

Physical Examination Urine Complete Analysis Stool Routine Haemoglobin Total WBC Count WBC Differential Count ESR Mantoux Chest X-ray Blood Grouping & Typing Hearing & Vision Checkup Dental Checkup Immunization Advice Counselling Diet Counselling> Paediatrician Consultation

Comprehensive Diabetic Checkup

Diabetes is a chronic disease in which the human body does not make, or does not properly use, insulin. This is caused by the malfunctioning of an organ called Pancreas. Insulin is the hormone that helps your body use the energy from sugar, starches and other foods. The result is that your body doesn't get the energy it needs, and unmetabolized sugar (glucose), builds up in your blood causing damage to the body and its systems. Symptoms of Diabetes More than 5% of Indian population suffers from Diabetes mellitus, many not aware that they are Diabetic. If you are experiencing one or more of the following symptoms associated with diabetes, immediately consult a healthcare professional at MMHRC for a comprehensive Diabetes Check-up Plan.

Investigations

Physical Examination Urine Complete Analysis Haemoglobin Total WBC Count WBC Differential Count Fasting Blood Sugar PP Blood Sugar Glycosylated Hb Serum Creatinine Ultrasound Scan Kidney Chest X-ray ECG Eye Check up with Dilatation Diet Counseling Urine Micro Albumin Blood Urea

Comprehensive Heart Check-up

Investigations

Physical Examination Complete Urine Analysis Lipid Profile ECG TMT (Tread Mill Test) Haemogram Serum Creatinine X-Ray Chest Ultra Sound Scan Blood Urea

FBS & PP Sugar ECHO (Echo Cardiogram) Cardiologist Consultation Electrolytes HBA1c Blood grouping

OBESITY Health Checkup (Adults)

Investigations

Haemogram FBS & PP Sugar ECG ECHO Serum Cholesterol Lipid Profile Ultra Sound Scan Abdomen Arthritic Profile Thyroid Profile T3, T4, TSH Weight Management Consultation

OBESITY Health Checkup (Child) for 15 years below male

Investigations

FBS Urine routine HB / PCV Blood grouping and typing Serum Creatinine Lipid Profile Thyroid Profile & T1 Weight Management Consultation

OBESITY Health Checkup (Child) for 15 years below female

Investigations

FBS Urine routine HB / PCV Blood grouping and typing Serum Creatinine Lipid Profile Thyroid Profile & T1 Ultra Sound Scan - Abdomen Weight Management Consultation

OPEN HEART SURGERY Check-up

Investigations

PT/INR Blood Urea Hb Serum Creatinine FBS & PP Sugar X-Ray Chest ECG ECHO HB A1C (Diabetic only) Consultation by Cardio Thoracic Surgeon

POST OPERATIVE (CABG) BYPASS SURGERY CHECK-UP

Investigations

HBA1C (Diabetic only) Blood Urea FBS & PP Sugar ECHO Lipid Profile Hb Serum Creatinine ECG X-Ray Chest Tread Mill Test Consultation by Cardio Thoracic Surgeon SGOT & SGPT CPK & K+

CANCER SCREENING for Women

Investigations

Physical Examination including Rectal Examination Urine Complete Analysis Stool Occult Blood Haemoglobin Total WBC Count WBC Differential Count ESR Peripheral Smear Sigmoidoscopy Chest X-ray Mammogram Pap Smear Ultrasound Scan Abdomen

Counseling General Consultation Cancer

CANCER SCREENING for Men

Investigations

Physical Examination including Rectal Examination Urine Complete Analysis Stool Occult Blood Haemoglobin Total WBC Count WBC Differential Count ESR Peripheral Smear Sigmoidoscopy Chest X-ray PSA (Prostatic Specific Antigen) CEA Counseling General Consultation

PRE-MARRIAGE CHECK-UP FOR MEN

Investigations for Men

Basic Investigations Urine Complete Analysis Haemoglobin ANTI HIV (AIDS) VDRL HBs AG Semen Analysis ECG Chest X-ray Family Planning Advice Counselling Cardiologist Consultation Ultra Sound Scan (Abdomen)

PRE-MARRIAGE CHECK-UP FOR WOMEN

Investigations for Women

Basic Investigations ANTI HIV (AIDS) VDRL HBs AG FSH (Follicular Stimulatory Harmones) Ultra Sound Scan (Abdomen) Family Planning Advice Counselling

LABORATORY SERVICES ( INVESTIGATION) Laboratory Service

Maheshwari Nursing Homes 24/7 Laboratory Services are established with a view to provide wide range of Laboratory investigations, necessary for patient care. It consists of disciplines of Hematology, Histopathology, Biochemistry, Microbiology, and Immunology. All these disciplines provide qualitative analysis of biological fluids such as blood, serum or plasma, tissue, urine, stool, etc... for specific constituents to support Clinicians in the practice of medicine. The laboratory is equipped with state-of-the-art equipment. To operate these sophisticated equipments in the laboratory we have a team of efficient, knowledgeable and qualified Doctors and technical staff who are constantly involved in producing World class results and quality assurance. Laboratory is accredited by NABL 15189 norms. To aid the Laboratory Investigations, the hospital is equipped with advanced and sophisticated instruments. The department of diagnostic Lab services is winged with Haematology, Clinical Pathology, Biochemistry, Microbiology and Histopathology sections. Haematology and Clinical pathology sections are equipped with BECKMAN COULTER CELL COUNTER 5PART AND 3PART to carry out Haemogram in just 60 sec's and special test such as PT, APTT, Coagulation Profile, Haemolytic work-up, FDP, OFT, Factor VIII and IX assay etc., Also Haematology Department takes Part in [EQAS] External Quality Assessment Scheme conducted by CMC Vellore. Head of the Department Dr. Sudhindra S.G., MD Pathology, Fellow ship in Histopathology from Hammersmith Hospital UK.

Service wings 1. Biochemistry

Maheshwari Nursing Homes Biochemistry Department is a new generation laboratory, backed by highly qualified and motivated team of Doctors and Technical staff. It is well equipped with latest state of the art technology, to perform not only the routine biochemical test for patients care but also a wide variety of super specialized investigations, such as

Special Chemistry Testing Hormonal Assay Tumor Markers. Drugs of Abuse

2. Pathology

Routine Hematology Coagulation profile Clinical Pathology Histo pathology Cyto pathology including FNAC and Papsmear. Frozen section Reporting.

3. Blood Bank.

Routine donor screening Serology Blood components Plateletpheresis

Online separation of platelets for very good yield of platelets is done by theo Plateletpheresis machine. Plateletpheresis can increase the Platelet count by 40 to 50,000 and it reduces Allo immunization of recipients platelets. This facility is available round the clock and has been found useful in all dengue fever, ITP, Drug induced thrombocytopenia and Chemotherapy patients. Since the facility is available in the heart of the city the neighboring hospitals and health center are also utilizing the facility. This has reduced the need for traveling long distance for procuring Platelets.

4. Microbiology
Maheshwari Nursing Homes Microbiology department provides accurate and reproducible results on clinical material within the shortest possible time. This has been achieved by round the clock laboratory services, online reporting and use of state of the art equipment. Quality control and quality assurance are strictly implemented and usually authenticated by reproducible result from other laboratories in India & abroad. The department is actively involved in infection control activities of the hospital. From time to time guidelines on different topics are issued which are compiled periodically in the Hospital manual. Following are wings of this dept.

Bacteriology Serology Fungal smear and culture.

5. Histopathology
Exfoliative and Aspiration Cytology, responsible for processing, staining and examining tissues removed from the body by syringe or operation, helps in the diagnosis of various diseases, including cancer. Cytological examination to detect cancer cells by PAP technique for the cervix or body fluids and utilizing Fine Needle Aspiration (FNAC) for pre-operative diagnosis of lumps in various organs is also done.

6. Immunology
The Laboratory offers a wide range of investigations in Serology and Immunology. Antibodies to many infectious agents (Hepatitis A, B & C, Toxoplasma, Rubella and Cytomegalo Virus) are assayed. Presence of antibodies to many infectious diseases such as HIV I and II, typhoid fever, Brucellosis and antigen testing for Hepatitis virus are also done here.

BILLING AND DISCHARGE

Your physician will write a discharge order and inform you when you are ready to leave the hospital. However, Jackson Hospital's concern for your healthcare does not end with your physician's discharge order. Throughout your hospitalization, our staff will be planning for your discharge and helping you prepare for any continued care required. Please make every effort to make your discharge arrangements before 11am. Your Hospital Bill Your nurse will give you a discharge slip. You or a member of your family should present this slip to Central Registration on the first floor and complete the necessary financial arrangements. In most cases, a final bill will not be ready at discharge because the business office may not have received charges for treatments or medications administered during the 24 hours preceding discharge. A final bill will be mailed to you upon request. A discharge clerk will be able to determine what portions of your hospital bill will be covered by insurance. Payment for charges not covered by insurance will be expected at discharge. Your daily "room charge" includes many items and services important to your healthcare, including your room, nursing care, meals, housekeeping, linens, building maintenance, telephone service, and fees for admitting, discharge planning, and medical records. Separate charges are made for the operating room, post-anesthesia care unit, critical care units, oxygen, drugs and medications, and special treatments or therapies. Fees from your physician, and if required, services rendered by consulting physicians, radiologists, pathologists, and anesthesiologists are not included. Generally, most of your bill will be covered by your health insurance. This coverage is a contract between you and your insurance company. While we will cooperate to the fullest to do what is necessary for the processing of your claim, you are ultimately responsible for your account. You will periodically receive a statement from the hospital until your account is completely settled, either by insurance or personal payment. Please remember to bring all insurance information with you upon admission. If you have any questions regarding your hospital bill or insurance coverage, please feel free to contact our customer service representative Discharge of Patients: Patient discharge times vary somewhat. Your doctor makes his rounds in the morning and confirms you can be discharged. The nurse in charge will give you your medical prescription, documents if any, date and time of your medical appoint with your specialist for follow-up care. If you have full insurance coverage, you will not need to do anything financially and can leave immediately. If you are a Self-Pay patient the official discharge time is 11:00am. The nurse will give you a discharge note to take to the Admissions/ Discharge office, where the necessary financial settlement and arrangements for your discharge are made. The Discharge Clerk will give you a "Discharge Pass", which you will then take to the nursing station.

At this stage you are allowed to leave the hospital accompanied by family, or a nurse will take you to the exit door. It is highly recommended that you have someone drive you home and stay with you the first hours after discharge and if needed, spend the night with you. Patient Billing: Although we strive to provide you with a complete bill upon your discharge it should not be considered a final bill. There are occurrences when charges are inputted late, that is to say after your discharge. If you are a self-pay patient and there is a balance remaining after your payment, your final billing statement will be mailed to your address after which you must settle immediately. If you have valid insurance coverage your billing statement will be sent to your insurance provider. Should all or a part thereof not be paid, then the billing statement with the balance outstanding will be mailed to you for payment. Refunds of Deposits Made: If you have made a deposit that exceeds the total of your actual charges during your hospital stay, then you will be refunded the difference. Refunds need to pass through our Accounts Payable department, hence you are not able to collect your refund the same day of discharge. The Cashier will advise you when you can collect your check payable to you. Charges appearing on your statement: It is important to remember that when admitted as an inpatient: Your bill includes a daily room rate, additional nursing procedures, radiology and other diagnostic tests, medications, use of the O.R. and other related hospital services. It also includes charges from our staff surgeon and anaesthetist. Your bill does not include charges for laboratory tests, non-staff physicians, other physician consultants or physical therapists. You will receive separate bills from these physicians or institutions. If you have any questions or concerns regarding your billing statement, please call the Patient Financial Services Department. We hope we can resolve any questions that you may have.

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