INTRODUCTION TO HEALH CARE

Health care means a wide and intensive form of services, which will be related to well being of human beings. Health Care is a social sector. Health Care services are provided at state level with the help of central government. Health care is a wide and intensive industry, which covers Hospitals, Health Insurances, Medical software, Health- equipments and Pharmacy in it.

Major inputs of health care industry:

The major inputs of health care industries are as listed below: I. Hospitals II. Medical insurance III. Medical software IV. Health equipments

Overview of health care sector in India:

Indias healthcare sector has made impressive strides in recent years. It has transformed to a US$ 17 billion industry and is surging ahead with an annual growth rate of 13% a year. The healthcare industry in India expected to grow in size to Rs270, 000 crores by 2012. The healthcare industry employs over four million people, which makes it one of the largest service sectors in the economy of our country. Healthcare is dependent on the people served; Indias huge population of a billion people represents a big opportunity. People are spending more on healthcare. The risen literacy rate; the higher levels of income; and an increased awareness through the deep penetration of media, has constituted to greater attention being paid to health. India has a very low density of doctors. Infant mortality is amongst the highest in India.

Hospitals in India are running at 80-90% occupancy. Major corporations like the Tatas, Apollo Group, Fortis, Max, Wockhardt, Piramal, Duncan, Ispat, Escorts have made significant investments in setting up state-ofthe-art private hospitals in cities like Mumbai, New Delhi, Chennai and Hyderabad. Good Healthcare in India is in extreme short supply and it is this gap that Corporate are looking to plug. Most users of healthcare prefer private services to government ones. The private Healthcare segment has grown into a formidable industry estimated to be Rs.8, 00,000 crores. Using the latest technical equipment and the services of highly skilled medical personnel these hospitals are in a position to provide a variety of general as well as specialists services. India is well positioned to tap the top end of the $3 trillion global healthcare industry because of the facilities and services it offers, and by leveraging the brand equity of Indian healthcare professionals across the globe, said Vinod Khanna, Union Minister of State for External Affairs. The Government of India places top priority to healthcare in the national agenda. Its very serious about encouraging indigenous R&D and creation of human capital. This would improve the quality of life of our people, leading to greater socio-economic progress of the country. As medical costs sky rocket in the developed world, countries like India have immense potential for what is called "Medical Tourism, highlighted Harpal Singh, Conference Chairman, in his theme address. India, with outstanding human resource talent and the setting up of world class medical facilities, was now poised to take leadership in the fast emerging arena of healthcare management which is witnessing the first signs of globalization.

MARKET ANALYSIS
Market Overview
India has a fairly comprehensive healthcare system comprising of government and private service providers. However, the system reaches barely fifty percent of the population mainly on account of general infrastructure bottlenecks. The country lags behind international standards on basic healthcare infrastructure and facilities. India has 94 beds per 100,000 populations as compared to the WHO norm of 333beds per 100,000. The density of doctors is also low. There are only 43 doctors for a population of 10,000.

Size of Market
India's healthcare industry is estimated at Rs 1000 billion. Of this, pharmaceuticals account for Rs 200 billion. As per some estimates, Rs 185 billion is spent on healthcare annually. On average, Indian families spend 600 per month on healthcare which is 11% of the household income, showing that they are willing to spend provided the service they get is of high standard. According to The World Health Report 2000, Indias health expenditure is 5.2% of its GDP. Public and private health expenditure is 13% and 87% respectively.

CII-McKinsey Study
A joint study "Healthcare in India: The Road Ahead" done by the Confederation of Indian Industry andMcKinsey & Company in 2002 mentions that India has 1.5 beds per 1000 people while China, Brazil & Thailand have an average of 4.3 beds. The study projects that changing demographics and disease profiles and rising treatment costs will result in healthcare spending more than doubling over the next 10 years. Private healthcare will be the largest component of this spending in 2012, rising to Rs 1560 billion from the current level of Rs 690 billion. In addition, public spending could double from Rs 170 billion if the Government reaches its target spending level of 2% of the GDP, up from 0.9% today

PEST ANALYSIS

Political factors
Most of the healthy nations are also wealthy nations. In India even after 53 years of independence we all have to accept that government has failed to provide basic healthcare. Healthcare is the neglected field, only meant for slogans by our politicians. To improve healthcare facilities we have to provide special assistance to private healthcare sector. The reality in private healthcare sector is that as an industry it has long gestation period and so most of the bigger projects fail. Government has to give certain concessions to private health sector. It can be in the form of free land for small hospitals at district levels or concession in power tariff. Government later on gets back revenue in the form of tax when these institutions start making profits. Concessions can be limited to first five years or so. Maharashtra government is playing an important role in the development of the hospital sector.

Economic factors
The Indian healthcare is the next boom in the country after the IT euphoria. Setting up hospitals is not an easy task. The amount of hospitals in India is very less when compared to the other developed countries. Even the urban areas do not have enough medical facilities. In the rural areas one village has only one doctor, who may not be very well qualified. The other governments of other states should take up a cue from the Maharashtra government, in setting up similar Joint ventures all over the state with the assistance of World Bank. The World Bank can make available funds of around Rs 700crore for state health systems and development projects. The people in India do not avail of the hospital facilities very soon. This is because of the high cost related to it. However this may all change because of the increasing deployment of third party payment either in the form of Medical and Allied Insurance, or in the form of reimbursements from the State. This in turn will increase the employment opportunities to many people.

Social Factors
1. Certain percentages of beds have to be kept for poor people. E.g. in Bombay20% of beds has to be kept reserved for poor people. 2. Look after the needs of local poor people. 3. Open counseling and relief centers. 4. Teach hygiene, sanitation among the poor masses. 5. Safe disposal of hospitals wastes like used injection needles, waste blood etc. and taking due care of environment. 6. Spreading awareness about various diseases through campaigns and free medical checkups. 7.In brief the social aspect of hospitals industry is to see that latest treatment and medicines are available to people at large at concessional rates or free of cost and that its activities are not only restricted to rich people.

Technological Factors
We are witnessing Information technologies transforming the way health care shall be delivered. Innovations such as computer based hospital information systems, medical records; decision support systems, health information networks, telemedicine, real-time image transfers and newer ways of distributing health information to consumers are beginning to affect the cost, quality, and accessibility of health care. The technologies today can support vast databases, network communications, quick distribution and reliable image transfers

INTRODUCTION TO HOSPITALS
Until the early 1980s, Government-run hospitals and those operated by charitable organizations. The last two decades have seen the mushrooming of corporate and privately run hospitals. Most large trust and corporate hospitals have invested in modern equipment and focus on super-specialties. The private sector accounts for 70% of primary medical care and 40% of all hospital care in India. They employ 80% of the countrys medical personnel. The corporate hospital sector is most evolved in the south while charitable/trust hospitals proliferate in the west. However, the north and east are also showing a growing trend in private hospital expansion. Key therapeutic areas are cardiology, nephrology, oncology, orthopedics, geriatrics, maternity and trauma/critical care. Hospitals are not for profit making, they are social institution to make available to society the required Medicare services. However this may not be true for private hospitals. Today hospitals are a place of diagnosis and treatment of human ills, for the training research, promoting health care activities and to some extent a center helping biosocial research. WHO states that hospitals are socio-medical organization whose functions are: Curative, preventive, patient services and training of health workers in biosocial research. With time the classes and quality of hospitals have changed a lot today. Most hospitals today are trying to provide all ultra facilities and are in the process of making state of the art hospitals. Hospitals provide the infrastructure facility to healthcare.

CLASSIFICATION OF HOSPITALS
The classification of Hospitals on the basis of objective, ownership, path and size. 1. On the basis of the OBJECTIVE there are three types: Teaching cum research for developing medicines and promoting research to improve the quality of medical aid. General hospital for treating general ailments. Special hospitals for specialized services in one or few selected areas. 2. On the basis of the OWNERSHIP there are four types: Government hospital, which is owned, managed and controlled by government Semi-government hospital, which is partially shared by the government. Voluntary organizations also run hospitals. Charitable trusts also runs hospitals. 3. On the basis of PATH OF TREATMENT there are: Allopath which is the system promoted under the English system. Ayurved, which is based on the Indian system where herbals are used for preparing medicines. Unani Homeopath Others

4. On the basis of the SIZE there are: Teaching hospitals generally have 500 beds, which can be adjusted in tune with number of students. District hospital generally have 200 beds, which can be raised to 300 in contingencies. Taluka hospital generally have 50 beds that can be raised to 100depending on the requirement. Primary health centers generally have 6 beds, which can be raised to 10.

INTRODUCTION TO EMERALD DIABETES HOSPITAL

Diabetic Association of India was formed in 1955. The association was
formed to educate and disseminate information concerning diabetes to the public, it soon became the apparent that members of the medical profession also need to be educated, trained and upgraded in these fields as per recent innovations due to progress of research and development. To accomplish this goal, the All India Institute of Diabetes was established under the aegis of the diabetic association of India in 1974. Diabetes as an ailment found new combatants as the institute educated and trained a whole new generation of doctors, nurses and the required medical staff in the field of diabetology. It was then that S.L. Raheja hospital at Mahim was set up as a specialty hospital in diabetes. Now they too have moved on, and have expanded their services for curing

ailments such as cancer and have become a multi specialist hospital. It is finally now, EMERALD DIABETES HOSPITAL. It is situated at Worli, with a view facing the sea, a very accessible location, the hospital promises to provide quality diabetic care to patients. Also helps in prevention of the disease, as it is not curable. It super specializes in juvenile diabetes. Our aim is to specialize in one area and then move on to another. Our services are the core specialties that provide comprehensive and affordable care to patients suffering from various diabetes related ailments. The bed capacity of our hospital is 50 beds, which will be increased in near future. EMERALD will be a renowned name in the field of medicine. At EMERALD we are aware of our social responsibilities, for which we run various health care camps and sessions that educate the general public about common health problems, their prevention and cure. The hospital has been designed as per the norms and the rules laid down by the All India Association of Hospitals. Also the technology and the equipments are as per international standards. It is started to set a benchmark in quality care, ethical practice, appropriate cost and training for those in the profession.

OUR VISION:
To be a leader in health care services

OUR MISSION:
To provide quality care in key specialties, exploiting the full potential of technology, with medical and managerial expertise

A PIECE OF WORD FROM THE MANAGEMENT

We at EMERALD DIABETES HOSPITAL believe in our motto- let the sweetness remain. For this end we attempt to provide more than just the best possible medical treatment to our patients. Our faith lies in the miraculous power of human touch. In keeping with this faith, our patients are treated with personal care and medical expertise. We strive continuously to invest in technology and healing

techniques. Our aim is to combine expertise, state-of-art-equipment and care- to control the spread of diabetes and manage the lives of diabetic individuals.

Why EMERALD? VALUE STATEMENT:

Offer international standard of quality at reasonable cost. Care with human touch. Maintain a high standard of awareness towards social issues, environment and ecology and contribute towards quality of life of the present as well as the future generations. Maintain mutually beneficial relationships with other agencies involved in healthcare and related areas, both governmental and non-governmental. Support healthcare research.

MARKET ANALYSIS:
STP For Our Hospital:
We have done the STP i.e. Segmenting, Targeting and positioning to help us carry the research forward;

SEGMENTING:
Segmenting variables such as geographic, demographic, Psychographic and behavioral segmentation helps in knowing consumer wants needs and responses of various services and products. It is very essential to know which segment would be right for setting up our hospital as only after studying the diseases and the people who are diseased or at high risk of getting those diseases form our segment.

Geographic Segment:

It calls for dividing the market into different geographical units such as nations, states, regions, countries, cities or neighborhood. One can operate in few geographic areas, or operate in all but pay attention to local variations. After doing research we decided on setting a specialized Hospital which would target all sections of people, by and large the entire mass by delivering varied services to a specific disease. The location for our hospital is Mumbai having population of around13343 thousand people. Apart from being one of the most populous citys it are also a metropolitan and the financial capital of India. In Mumbai there are thousands of people being diseased everyday with hardly any medical centers or Hospitals to treat them. In Mumbai there are lots of people who have Diabetes; some of them dont even know that they have the disease.

Demographic Segment:
The market is divided into groups on the basis of variable such as age, family size, family lifecycle, gender, income, occupation, education, religion, race, generation, nationality and social class. With these variables of segmentation we get to know the preferences and the usage rates associated with different consumers. After doing a research on the following variable sour result showed that Diabetes can be either be inherited or caused due to lifestyle disorders such as wrong eating habits. However Diabetes can happen at any age. Our Hospital would target Section A and Section B people. However people who are from low-income groups also form our segment because EMERALD is the only hospital specializing in Diabetes with super specialization in Juvenile Diabetes thereby providing best services required to treat these ailments.

Psychographic Segment:
As per this segmentation we have divided the patients into categories such as children below 20 who have Juvenile Diabetes and the others who inherit or get Diabetes because of incorrect lifestyles such as wrong eating habits. As told to us by diabetologist at S L Raheja hospital that most people who have greater purchasing power and are relatively rich are the ones who suffer from Diabetes.

Behavioral Segmentation:

In this the segmentation is done as per the following variables i.e. knowledge of, attitude towards, use of, or response to a product or a service. These behavioral variables occasions, benefits, user status, user rate, loyalty status, buyer readiness stage and attitude- are the best starting points for constructing market segments. As per research and analysis any person having diabetes would come to our hospital after knowing the facilities that we offer and the care, comfort we provide. They would slowly develop trust in us. This would help in creating loyal patients and create goodwill for our hospital.

TARGETING
The entire population is our target audience because a lot of people already have the disease but dont know about it and the others can anytime fall prey to the disease. EMERALD in this case, would study the different regions in the city of Mumbai inspect those areas, initially carry on free checkups to do this and draw inferences from those checkups that which people have diabetes and in which area mostly are there diabetic people. These would be the case histories and be helpful in forming our data base. Since EMERALD is a specialty hospital for Diabetes at present its target audience is diabetic people and people who are at high risk. However it has future plans of becoming a multi specialist hospital and then would expand its services. This is called segment by segment invasion.

POSITIONING
EMERALD Diabetes Hospital has been set up after proper research and study conducted on different needs of customers and varied groups in the market place. Also specific targeting of those needs and groups are done to understand which services would be superior and entice patients towards our hospital. Being a new hospital it is very important for us to convey our services and offer facilities which would help in generating a favorable word of mouth and thereby creating the much needed trust factor amongst the masses. The end result of our positioning has led to successful creation of a patient focused value proposition and why diabetic people should come to EMERALD

DIFFERENTIATION

Juvenile diabetes In house pharmacy Chemist in the hospital premises used by outsiders also Diet food with a sugar free department: health and grocery store accessed by outsiders also. Differentiation is like oxygen in Todays competitive environment to survive. It is very difficult for an organization to survive without differentiation. EMERALD specializes in diabetes with super specialization in JUVELINE DIABETES. This will be the first hospital to specialize in JUVELINE diabetes in Mumbai. Thus, we have gone one step further by not only differentiating our service but introducing something for the first time in Mumbai. Also the service delivery will be our differentiating factor will be explained further.

FACILITIES/SERVICES OFFERED AT EMERALD

Highly qualified doctors and paramedical, friendly nurses and ward boys. I.C.U. and Operation theaters with latest technology. Blood banks. State of art laboratory. Casualty ward. Tie ups with Jaslok and Breach Candy hospital. 24hours chemist shop. Availability of stretchers and wheel chairs easily. Lobby on every floor with proper sleeping and sitting facilities. Good infrastructure facilities. Coffee/tea/juice vending machines on every floor.

Dieticians and consultation. Prayer room. Phone booth center. Cyber caf. Ambulance. 6 lifts and 3 exits. Cafeteria with clean and hygienic food. Good sanitation conditions. 24hours ATM facility. Dust bins at short distances.

Signage.

8 PS OF HOSPITALS
1. PRODUCT
Phillip Kotler says a product is anything that can be offered to a market to satisfy a want or a need. Products that are marketed include physical goods, services, experiences, events, persons, places, properties, organizations, information and ideas. The product of a hospital can be any of the following: Medical Services Medical Training Medical Education Medical Research AT EMERALD we believe that the ultimate aim is to make available the best possible medical services and to prepare and train the best medics. Thus, it is very

essential for our service providers to be aware of the nature, behavior, requirements and status of the users. This helps them in planning and development of the services in the background of users changing needs and requirements. The product should be developed keeping in mind the users psychology

2. PRICING
In the words of Philip Kotler, one should try to Sell value, not price. Price is a major determinant of a buyers choice, as a person must have the need, willingness and ability or financial backing to buy the product. At EMERALD services involve the use of expensive and complex machinery, which involve huge investments. Apart from that, the cost of maintaining them and cost of running the hospital is in no terms cheap. We have experienced doctors and also specialist who come from abroad whose salaries along with those of the skilled nurses and helpers constitute a great part of the cost. Sophistication cant be possible unless we change our pricing strategies. The main thing in the pricing strategy is to link it with the paying capacity of the users so that all the classes get medical aids without any discrimination. There are 4 types of costing: Free, subsidized, cost based subsidy and cost plus subsidy. EMERALD follows Cost plus Subsidy This strategy allows charging more than the costs involved on the services, but only from the better-off sections of society. The transfer of these surpluses to the account of subsidy for compensating the losses on account of providing free or subsidized services to the weaker sections and low-income group users is also necessary. On one hand, it is judicious that no discrimination is found in respect of making available the medical aids, but on the other hand, we cant adopt uniform policy while making available to the users and their attendants other facilities like standard of room, indoor facilities and other non medical amenities. This is justified on the ground that all groups are not paying equal fees for availing their services. Moreover when no income group has been availing the services without paying any fee, their expectations would not be more than the proper medical aids

It is difficult to offer free or subsidized services to the masses. On the other hand, the technological sophistication has raised the cost of services, as the inputs used in making available the medical services are found costly. How should prices be communicated to the target market? Patients must be made aware of the prices of different treatments/ services as well a show, where and when that price is payable. This must be done in an intelligible and unambiguous way. In hospitals, generally, customers service representatives give responses to customer queries about pricing, payment and credit. Hospital bills sometimes run to several pages and contain dozens of items. Thus the hospital must ensure that such an itemized bills are accurate and intelligible. At EMERALD, the patient guide in each patients room provides information with regard to billing and payment procedures. Patients can also contact the billing department for any clarification. For the patients convenience, the hospital generates an interim bills a bi-weekly basis. This gives the patient an idea about a charge payable for the specified period and avoids confusion at the time of generating final bills.

3. PLACE
Place refers to the contact point between the service provider and the customer. Two main issues considered regarding the decision of the place are accessibility and availability of the service to the customer. EMERALD is easily accessible, that is, its not located in a heavy traffic zone as this would prove detrimental to the very existence of the hospital. Areas around hospital are silent zones i.e. EMERALD is located near Worli sea face and is near a prominent road so that it can be reached easily. Having in house ambulance services to pick up patients on the other hand increases accessibility to EMERALD. We also have contracts with ambulance services to bring our patients from whichever location to the hospital.

4. PROMOTION
EMERALD relies on favorable word of mouth and not on aggressive promotion. We conduct camps in rural areas to give medical checkups at reasonable prices; we sponsor visits to old age homes and donate them a good amount of food and

medicines. We continuously introduce different health services and we generally advertise in health and fitness magazines and also conduct free checkups. EMERALD holds seminars and conferences relating to Diabetes and latest technology, where we involve the doctors from all around the country, for detailed discussion.

5. PEOPLE
Service personnel play an important role in an organization. For satisfying the users, it is only not essential that they are made available the best possible medical aids. In addition to the medical aids, the behavioral aspect is also found impact generating, especially when we consider marketing a customer satisfactionengineering tool. It is natural that the expectations of all groups cant be uniform. In a hospital the behavior and attitude of the personnel providing services is very important as far as the customers overall perception of the service is concerned. It is necessary that the staff in a hospital is trained to provide quality patient care using state of the art technology. The objective of EMERALD is providing quality service to patients and this can be achieved by: 1. Motivating employees to be efficient, dedicated and loyal to the organization. 2. Providing regular on-the-job training of employees to ensure continuous improvement in health care 3. Utilizing services of professionally competent medical consultants. 4. Use of the latest technology. Motivation is not necessarily by giving high salaries. There are many other ways to motivate employees concessions should be given to the employees near ones and there should be active participation of the employees in the activities of the hospital.

6. PROCESS:
Process is a set of activities that take an input, convert it and add value to the input and finally, create an output. Blueprints design processes, which sets a

standard for action to take place and to implement the service. A process is divided into the following phases in a hospital.

7. PHYSICAL EVIDENCE:
Physical evidence makes a huge impact on the customer. Physical evidence provides customers means of evaluating the service. Corporate image plays an important role in terms of physical evidence. The physical evidence has good and favorable influence on the mindsets of the patients and their relatives who visit the hospital. This helps patients to come again to our hospitals and also do favorable publicity by the most effective weapon the word of mouth.

8. PRODUCTIVITY AND QUALITY:

Productivity in services is how we transform the inputs into outputs, which are valued by the customer. Quality is the degree to which the service satisfies a customer by meeting their wants and expectations. INNOVATION Hospitals will soon go hi-tech, not so much in terms of sophisticated medical equipment, but in that a patients kith and kin can virtually visit him/her from any part of the world and the patient too can communicate with them and relieve their undue anxiety. Bangalore has emerged as a pioneer in the design of an interactive website used in making virtual visits to hospitals, thus introducing a human element hitherto, unthought-of. This breakthrough in the usage of information technology for patients was achieved by the Bangalore based Think Ahead Incorporated, in designing he website for a hospital. The primary advantage of this technology is the mitigation of undue anxiety of relatives particularly, sons and daughters,

children of patients who are settled abroad who cannot be at the bedside of the patient undergoing treatment for a heart ailment or a major surgery. The Virtual Family Visit allows relatives to see real time images of patients through audio visual files which can be downloaded on their computer by entering the hospital website through the Internet. These files of the patient are shot by the hospital using a webcam to show the convalescing patient and his message for his family members. The files are then uploaded in the hospital website. The family members can also communicate with the patient by way of sending online get well card to patient.

SERVICE TRIANGLE:

TOTAL PRODUCT CONCEPT

Levels of service:

Level 1. Core / generic product: This is the basic service product. In hospitals, health or well being by way of the treatment provided by the doctor to deal with the ailment of the patients is the core product or service. Level 2. Expected product: This is the basic product and minimum purchase conditions that must be met. In hospitals, in addition to the core product, all other supplementary services like a bed, waiting area, availability of medicines and drugs, meals, hygiene etc. Level 3. Augmented product: In this, along with the basic and minimum offering, there is something different which enables the product or service to be differentiated from that of the competitors. Hi-tech equipments, good infrastructure, personalized assistance, prayer room, cell charging facilities, gift shop, ambulances, a terrace garden for patients to walk, exercise all form a part of the augmented product. Level 4. Potential product: The potential product contains potentially feasible features and benefits that play a significant role in holding and attracting the customer. These features and benefits are useful or likely to be useful to the buyers. For example, in EMERALD beds are provided for ICU attendants free of charge along with other communication facilities like internet.

SERVICE FLOWER
Information
In a hospital, providing information refers to making the patients or the general public aware of the services and facilities offered by the hospital. At EMERALD, this is done in a number of ways. Information to the general public: The hospital has its own website atwww.emerald.com, containing details about the location, services, etc. New customers or patients in general: A patient guide is made available in each room. This guide provides various points for the patients knowledge and information, right from booking and cancellation procedures, admission rules and procedures, visiting hours, meals, and facilities for relatives and discharge procedures, to procedure for payment of bills. During the patients stay in the hospital: Information regarding services, facilities or various procedures is also provided by the employees as and when the required or on the patients request. For example, at the time of discharge, the ward sister gives the patient a summary as to the formalities like processing papers with insurance company etc.

Consultation
In any hospital, treatment is provided only after a preliminary check-up and/or various tests. Preventive healthcare facilities at EMERALD include a range of sophisticated tests and consultations. The hospital has 24 hour diagnostic services

and state-of-the-art laboratories that help the medical team (doctors and surgeons) diagnose the patients problem and suggest treatments.

Order taking
In a hospital, this is usually in the form of admitting or registering the patient. The process of admission in any hospital should be simple, easy to understand, fast and accurate. Means of quick registration must also be provided for in the case of emergencies. At EMERALD the registration and necessary formalities are done immediately.

Hospitality
This is becoming increasingly important in the healthcare sector, particularly in hospitals as the expectations of people towards medical care are ever increasing. No longer are they limited to only the clinical outcomes but also involve the delivery process, margin of safety and behavior of personnel. The EMERALD provides a host of conveniences to patients and their relatives.

Service to patients:
A choice of packages from twin sharing, single room and deluxe suites are available to patients. A lot of care has been taken to ensure that the patient does not feel walled in. For example, all rooms have natural and indirect lighting with huge windows and in some cases, terrace gardens. A number of facilities are provided to the patient such as a television, in-house meals etc. So as to make the room aesthetically pleasing and improve patient mentality (they are usually depressed), all medical sockets, instruments or attachments are hidden from view, behind a panel beside the bed.

Service to relatives:

The EMERALD hospital in Mumbai provides a separate family waiting area for relatives of patients in ICU. Each cubicle in the waiting area has provisions for sleeping such as a bed, pillows, blankets etc. The reason for such an arrangement is that, in the ICU cases, one person should be present in the hospital 24 hours so that he is available to sign the consent form. Patient number is allotted to the relatives bed and in the case of an emergency; the relative is immediately called by the secretary in charge. Relatives also enjoy facilities like internet connection, a hygienic cafeteria, prayer rooms, library, public call booths, coffee machines, a gift shop etc.

Safety /Caretaking
Safety and hygiene is of utmost importance in any hospital. On the safety front, the EMERALD measures up to the highest international standards, including major/minor operation theaters, keeps a dust free environment, special peat filters for maintaining air quality and highest degree of sterility etc.

Bills/Billing
Hospitals should ensure that billing and payment procedures are quick so as to enable the patient to return home soon after discharge. At EMERALD, two types of bills are generated i.e. Interim bills and Final bill. The interim bills are generated to give on a bi-weekly basis. They give the patient an idea about the charge payable for the specified period. It helps is avoiding any confusion at the time of generating the final bill. The final bill is generated at the time of discharge. This considers all the interim bills and the advance deposit paid.

Payment
There is a separate business centre for payment of bills. An approximate bill amount is collected as deposit before discharge, which is considered at the time of final bill.

Exceptions
These usually occur in the form of emergencies. Hospitals must be well prepared to face any kind of unexpected emergency. For example, EMERALD has special procedures for emergency cases.

Quality dimensions
The rapidly expanding scope of healthcare has led to increasing complexity in its delivery. Patient satisfaction is increasingly taken as an important measure of quality. There is increasing willingness to provide protection against illnesses by way of healthcare insurance. This has made it pertinent that management of quality is done on a wider basis than mere medical audits. Implementing quality system controls the cost by a. Reducing unnecessary interventions. b. Getting it right first time of repeat surgery. c. Avoidable complications e.g. post-operative infections. d. Imbalances of resources: Lack of theatre time or lack of access to diagnostic facilities leading to increased length of stay. e. Employee turnover and consequent training costs.

RATER
Reliability- Reliability refers to the ability to perform the service promised, dependability and accurately. Assurance- Assurance refers to freedom from danger, risk or doubt. It includes creditability, competence, security and courtesy. EMERALD is high in assurance. The hospital also has a world-class team of doctors and surgeons. Tangibility- Tangibility refers to the appearance of physical facilities, equipment, personnel and communication material.

Empathy- This includes access, communication and understanding of the consumers. Responsiveness- EMERALD is also high in responsive i.e. the willingness to help the customer and provide prompt service. It has special procedure in place for emergencies and quick complaint handling procedures. The employee also goes out of their way to help both the patients as well as their relatives. The main products of hospitals are medical services. In addition to medical care, EMERALD DIABETES HOSPITAL also imparts education, training and research facilities and also educates and train paramedical officers, nurses and other technical staff. With the changes in environmental conditions, the staff at emerald has put in tremendous amount of efforts for acquiring sophisticated equipment and appliances, put in process the state-ofart-technology, acquired various quality certifications and also ventured into strategic tie-ups with renowned research and development companies. Medical Care At EMERALD the most important functions are to give care to the sick, to render services to the injured and restore the health of diseased persons. We believe in controlling and managing the entire life of a diabetic patient. All the services like line staff and auxiliary divert a close attention.

Intensive Care Unit

The ICU is considered to be the heart of the hospital. It is for those patients demanding acute, multidisciplinary and special treatment. The staffing pattern of our ICU is planned in a scientific way so that related patients get proper medical aid without a break or gap. Our 10-bedded ICU is equipped with life saving and support systems handles medical as well as surgical emergencies. Round the clock monitoring by nursing staff ensures efficient patient care. There is one nurse per patient; to give the much needed care and attention.

Wards
Centrally air-conditioned wards provide accommodation and services to patients. Least expensive are the general wards where there are10 beds. The deluxe ward has 20 beds. The super deluxe wards include a drawing room, a kitchen, a T.V and exclusive facility having 20 beds.

Day Care Service Unit

Our day care services cater to those patients who require a single day stay at our hospital. Uniquely designed unit offers a comprehensive package of services offered globally. Equipped with sophisticated, state-of-the-art technology, it combines care with medical expertise to tender complete treatment. Its on the same floor of the OT, which helps us to provide both pre-op and postop care in the same department. Artificial kidney dialysis unit Our 24- hour Dialysis unit is a haemodialysis one. Open round the clock, it is extremely feasible for office goers who can make use of this facility and then return to work The unit exploits the expertise of renowned specialist and the advantages of recent technology to formulate a complete treatment plan.

Diagnostics services
Laboratory Services Radiology Multi slice Spiral CT scan Mammography (DMR plus) with stereo tactic X RAY with image intensifier Ultra sonography and color Doppler Per procedural counseling by well known radiologist Laboratory medicine Fully automated laboratory offers services in the fields of biochemistry, clinical pathology, hematology, histopathology, and immunology and sit genetics. Technologies like florescence and Karyotyping ensure instant and accurate results. Blood Bank

Our blood bank is capable of providing whole blood as well as blood components.

All prescribed tests are performed before issuing blood to patients

Endosonography Our endoscopy department is one of the only few hospitals in Mumbai that has digital Video Sono Endoscope facilities. The Facility enjoys unmatched expertise and supervision by renowned consultant.

THE STAFF / SUPPORTIVE SERVICES

Certain supportive services are important e.g. sterilization, supply and maintenance of instruments, materials and garments etc. At emerald these are the support services: The catering department comprises the kitchen, bulk food stores and dining rooms and supplies meals in the hospital. Heated trolleys have to be used to transport meals to patients. Pharmaceutical services play an important role. An official laundry provides bacteria free garments and clothes. The patients are provided with disinfected and clean linen. The laboratories are properly manned and proper diagnosis is given by them to enable right medical prescription. The establishment of laboratories should be between the OPD and indoors so that both areas are covered without delay or disruption. Clinical pathology, blood bank and pathological anatomy are important areas to streamline functional management of hospital laboratories. The radiology department should have hi-tech facilities. Currently ultrasound scanning and CAT scanning have been found significant in improving services of the radiology department. A matron, who is assisted by a sister-in charge, manages the Nursing services. The norms accepted by the Indian Nursing Council should be followed. An ideal nurse-patient ratio is 1:5; however at EMERALD we ensure 2:5.

AIR AMBULANCE CONCEPT

Transfer from military evacuation to todays sophisticated EMS (Emergency Medical Services) programs for all concerned did not occur overnight. Australia, a land of vast distances and scattered population, probably deserves the credit for being the leader in integrating the airplane into the health care delivery system. Get the patient to the best medical care available as rapidly and as safely as possible, a rewarding goal with proven medical benefits.In India this service was only available in the military, but none in civil due to lack of finances and nonavailability of suitable aircrafts. With the onset of liberalization in our country during the early years of the last decade, it became possible to commence dedicated Air Ambulance Service, leading to reduced morbidity and mortality during evacuation.