Iffat Ishaq - Shaukat Khanum

Institute of Business & Finance
Department of Accounts & Finance

Lahore Campus
INTERNSHIP REPORT ON
SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL
AND RESEARCH CENTRE
SUBMITTED BY:
IFFAT YASHMEEN
ROLL NO. NUML-1-16-302
M.Com (Masters in commerce)
Session: from 2016 to 2018
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Internship Report on
SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL
AND RESEARCH CENTRE
National University of Modern Languages

Faculty of Management and Science
It is hereby certified that the report has been thoroughly and carefully read and recommended to
the Faculty of Management and Science for acceptance of final internship report by:
Name: IFFAT YASHMEEN

Roll No: NUML 1-16-302
Program: M.com
Session: (From 2016 to 2018) Morning
This is in partial fulfillment of the requirement for the degree of National University of Modern
Languages, Lahore.
Date: ____________________
Supervisor's Name:
Supervisor's Signature:
Panel Member Name:
Panel Member Signature:
Head of the Department:
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Letter of Transmittal
Head of Accounting & Finance Department,

National University of Modern Languages,
IBF Campus, Lahore.
Dear Sir/Madam;
It is to present you the Internship Report which is executed at, Shaukat Khanum
Memorial Cancer Hospital, as required by the university as a degree requirement for M.com
(Masters in commerce) program.
This report has been prepared in accordance with the guidelines issued by the department. It is
the result of my first professional experience.
This is a partial application, of whatever; I studied as a business graduate of National University
of Modern Languages. In the report, I have covered the introduction of “Shaukat Khanum
Memorial Cancer Hospital”, detail of my work and learning in corporate environment. I
performed there as an HR internee so I have to look up the matters taking place in HR
department and in quality and assurance department also.
I have put all my efforts to summarize my knowledge and experience in this report, to make it
comprehensive and readers’ expectations.
Sincerely,
Iffat Yashmeen
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ACKNOWLEDGEMENT
“All praises for Almighty Allah, Who guides us in darkness and helps us in difficulties and due
respect for the Holy Prophet (Peace be upon him), Who enables us to recognize our creator.”
I have no words to express my deepest sense of gratitude and thanks to Almighty Allah,(The
Compassionate and The Merciful), Who enabled me to complete this report.
I render deep appreciation and gratitude to, Shaukat Khanum Memorial Cancer Hospital staff,
Specially Miss. Saleha and other staff for their valuable suggestions and kind cooperation.
I am grateful to the National University of Modern Languages and my respected teachers who
gave me an opportunity to enhance my capabilities. This was very much helpful for me because,
I have learnt a lot by applying theoretical knowledge in practical field.
I am also grateful to all the employees of Shaukat Khanum Memorial Cancer Hospital who
guided me. The behavior of the employees of all departments was very good and they gave a lot
of time to guide me. At the end, I would like to thank to my parents who always guided,
supported & directed me to the right way that enabled me to reach this stage.
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Table of Contents
Contents
Letter of Transmittal ....................................................................................................................... 4
ACKNOWLEDGEMENT .............................................................................................................. 5
Table of Contents ............................................................................................................................ 6
Chapter 1 ......................................................................................................................................... 9
Executive Summary ........................................................................................................................ 9
Mission Statement......................................................................................................................... 12
Vision Statement ........................................................................................................................... 13
Chapter 2 ....................................................................................................................................... 14
Introduction ................................................................................................................................... 14
Brief introduction of the organization’s business sector............................................................... 14
Business Sector ......................................................................................................................... 14
Brief History of Hospital .............................................................................................................. 14
Chapter 3 ................................................................................................................................... 17
Nature of the Organization........................................................................................................ 17
Business Volume ...................................................................................................................... 17
Competitors ............................................................................................................................... 18
Board of Governors................................................................................................................... 18
Chapter 4 ....................................................................................................................................... 19
Organizational Structure ............................................................................................................... 19
Organizational Hierarchy Chart .................................................................................................... 19
Numbers of Employees ............................................................................................................. 20
Main Offices ............................................................................................................................. 20
Chapter 5 ................................................................................................................................... 22
Introduction of different Departments ...................................................................................... 22
Human Resource Department ....................................................................................................... 22
Management Information System ............................................................................................. 22
Chapter 6 ....................................................................................................................................... 25
Projects of SKMT ......................................................................................................................... 25
Chapter 7 ....................................................................................................................................... 43
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Financial Position over the years .................................................................................................. 43
Financial Statements ..................................................................................................................... 47
Chapter 8 ....................................................................................................................................... 51
Horizontal and Vertical Analysis .................................................................................................. 51
Horizontal Analysis .................................................................................................................. 51
Vertical Analysis ....................................................................................................................... 52
Vertical Analysis vs. Horizontal Analysis .................................................................................... 54
Chapter 9 ....................................................................................................................................... 55
Ratio Analysis ............................................................................................................................... 55
Return on Assets ....................................................................................................................... 55
Fixed- Asset Turnover .............................................................................................................. 56
Operating cash Flow/Sales Ratio .............................................................................................. 57
Cash Ratio ................................................................................................................................. 59
Current Ratio ............................................................................................................................. 60
DEBT RATIOS ......................................................................................................................... 61
Quick Ratio ............................................................................................................................... 62
Chapter 10 ..................................................................................................................................... 63
SWOT ANALYSIS ...................................................................................................................... 63
The elements of a SWOT analysis ............................................................................................ 65
Internal factors .......................................................................................................................... 65
External factors ......................................................................................................................... 65
Benefits and limitations of SWOT analysis .................................................................................. 66
Benefits of SWOT analysis ....................................................................................................... 66
Limitations of SWOT analysis.................................................................................................. 67
Strengths ................................................................................................................................... 67
Weakness .................................................................................................................................. 68
Opportunities............................................................................................................................. 68
Threats....................................................................................................................................... 69
Chapter 11 ..................................................................................................................................... 70
Pestle Analysis .............................................................................................................................. 70
Pestle Analysis for Shaukat Khanum Hospital ............................................................................. 76
1. Political Factors .................................................................................................................... 76
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2. Economic Factors.................................................................................................................. 76
3. Sociocultural Factors ............................................................................................................ 76
4. Technological Factors ........................................................................................................... 77
5. Environmental Factors .......................................................................................................... 77
6. Legal Factors ......................................................................................................................... 78
Chapter 12 ..................................................................................................................................... 79
Internship Plan .............................................................................................................................. 79
Conclusion .................................................................................................................................... 84
Recommendations ......................................................................................................................... 85
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Chapter 1
Executive Summary
I joined SKMCH & RC from July 03, 2017 to August 21, 2017. My internship report includes all
the information about my internship in HR department. This report will show complete historical
background of SKMCH and major services that is provided to its customers and employees.
The information is collected from both the sources, primary and secondary.
SKMCH was inaugurated in 1994. It is a charitable organization. The inspiration for this hospital
came from the death of Imran khan’s mother. Imran khan made a nationwide appeal for
fundraising. During the entire campaign for the construction of the hospital, over a million
individual donors from ordinary citizens to the rich people participated in this campaign. This
hospital was specially built for the victims of cancer patients.
During my internship over SKMCH it was an immense pleasure for me to be there to serve for
some time period. I learnt a lot there. As Experience is the key. During my stay there, I
experienced different type of tasks. I started from the section of compensation and benefits of
human resources. There I learnt to forward different letters and the way in which the letters are
forwarded. Filing and maintenance of employee record files in record room. Handing over
experience letters to employees and side by side maintained a record file. I also did record
keeping of nurses and doctors of all departments over there. I also work on ISO audit standards
which are recently adopted by many organizations and SKMCH as well.
The operations of HR are very smooth and ongoing for every employee being hired or recruited.
Employee demands are forecasted and called for interview on demand. SKMCH offers medical
trainings and medical educations for their doctors and nurses. These training will help them to
work better in future and these skills will be the return on investments that SKMCH makes.
In this report you will see the role of HR and quality and assurance that how human resource is
playing its role there. For every new joiner training and development executive arranges the
orientation, manages their performance appraisals and employee development trainings.
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This report will also include the role of employee relation officer that how Employee relation
officer is handling employee relations with employees and employer. Responsibilities included
are to resist the employee to move on court and solve matters internally.
As the hospital is functional type all its departments are working very efficiently and
independently. Shaukat Khanum hospital is working fully functionally. Hospital capacity for
patients is decreasing it needs a new building or more capacity so that patients are adjusted. As it
is a cancer specialized hospital in Pakistan it needs more care and attention from the perspective
of threats and security. I always believed that we cannot solve the challenges of our times unless
we solve them together.
Being a cancer hospital, it is a blessing for patients from all over the Pakistan. Also, quality is
the first priority here and quality is something that we would have to earn through great effort
and determination. In the end I would like to thank all who helped me in internship as well. I
wish success for Shaukat Khanum hospital in future.
May Allah Almighty bless Imran Khan for building such a cancer specialized hospital in the
history of Pakistan.
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Mission Statement
“To act as a model institution to alleviate the suffering of patients with cancer through the
application of modern methods of curative and palliative therapy irrespective of their ability to
pay, the education of health care professionals and the public and perform research into the
causes and treatment of cancer. “
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Vision Statement
“Imran Khan was a fine all-rounder cricketer and an inspirational captain whose biggest
achievement in cricket was winning the 1992 World Cup. Now being a cricketer his vision for
Shaukat Khanum Hospital is Lets Bowl out cancer.”
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Chapter 2
Introduction
Brief introduction of the organization’s business sector
Business Sector
Over the past decade, Shaukat Khanum Memorial Cancer Hospital & Research Centre has
established itself as a center of excellence providing comprehensive care free of cost to
thousands of indigent cancer patients. This pioneering, state-of-the-art hospital located in the
heart of the Punjab was founded by Imran Khan, one of Pakistan's most illustrious cricketers. As
a charitable institute, it is funded predominantly from the donations of friends and well-wishers
from around the country and across the world.
The miracle of Shaukat Khanum Memorial Cancer Hospital & Research Centre does not just lie
in its creation but the fact that it has been providing free treatment facilities to over 70% of its
patients since over a decade now
Brief History of Hospital
SKMCH & RC is the brainchild of Pakistani cricket superstar, Imran Khan. The inspiration came
after the death of his mother, Mrs. Shaukat Khanum, due to cancer.
Imran Khan made a nation-wide appeal for the collection of funds from a match between
Pakistan and India on November 10, 1989 at Gaddafi Stadium, Lahore which raised Rs.
2,902,600. This was followed by a series of more than 50 successful fund raisers held throughout
the world. Pakistan's win under Imran's captaincy in the 1992 cricket world cup in Melbourne
helped fundraising efforts. He was able to collect one and a half million pounds in just six weeks
after the World Cup when the same amount had taken 2 years to collect earlier. He donated his
entire prize money of 85,000 pounds for the project. In 1994 when the project required more
financing for the ongoing construction, Imran Khan launched a mass contact campaign in which
he toured 27 cities in the country and collected Rs. 120 million. During the entire campaign for
the construction of the hospital, over a million individual donors from ordinary citizens to the
rich and famous pitched in. Everything from cash to jewelry and valuables was donated.
Dr. Nausherwan K. Burki MB, PhD, FRCP, FCPS, FCCP developed the Master Plan for the
Hospital in 1990, while he was Professor of Medicine at the University of Kentucky, USA. He
oversaw the building of the Hospital, which was designed by Graham Rapp of Aerosmith, Judd
& Rapp, Architects in Health Planning, Louisville, Kentucky, USA. Design details on site were
handled by Messrs. Nayyar Ali Dada & Associates of Lahore. Local engineering was performed
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by Messrs. Progressive Consultants, Lahore. Ground was broken in April 1991 and the hospital
opened its doors on December 29, 1994.
Dr. Burki was the first CEO of the Hospital until September, 1996, while on sabbatical leave
from his University. He was responsible for recruiting all the consultant/attending medical staff
and senior nursing and administrative staff. He remains the Chief Medical Advisor and Member,
Board of Governors, continuing to be involved with program development, quality control, and
recruitment of consultant staff, as well as Professor of Medicine at the University of Connecticut
Health Center, in Farmington, Connecticut, USA.
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Chapter 3
Nature of the Organization
Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) is a state-of-
the-art cancer center located in Lahore, Pakistan. It is a project of the Shaukat Khanum Memorial
Trust, which is a charitable organization established under the Societies Registration Act XXI of
1860 of Pakistan.
Business Volume
December 29, 1994

Inaugurated
Founder Imran Khan (Chairman, Board of Governors)
Annual budget Rs. 13.5 billion (Year 2019)
Financially supported patients 75% (since 1994)
Philanthropic spending to date Rs. 32.835 billion (US$ 371 Million)
Area/Location 20 acres in Lahore, Pakistan
Beds 195
New registrations 9,004 (Year 2017)
Outpatient visits 243,663 (Year 2017)
Chemotherapy 47,983 (Year 2017)
Radiation treatments 64,885 (Year 2017)
Admissions 12,054 (Year 2017)
Surgical procedures 14,906 (Year 2017)
Pathology tests 4,915,390 (Year 2017)
Imaging studies 171,968 (Year 2017)
Pharmacy Dispensing 1,606,274 (Year 2017)
Staff 2,866
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Competitors
SKMCH & RC does not have any such competitors in Asia because it is a specialized hospital
for only cancer patients but if we think about anyone its AGHA KHAN hospital but only in
cancer research. SKMCH & RC has the competitive advantage on AGHA KHAN Hospital in
quality treatment and revenue generation.
Board of Governors
The Board of Governors of the Shaukat Khanum Memorial Trust comprises of bankers,
researchers, businessmen and physicians that are.
 Mr. Imran Khan (Chairman)
 Dr. Nausherwan Khan Burki
 Mrs. Aleema Khanum
 Dr. Uzma Ahad
 Mr. Ashiq Hussain Qureshi
 Mr. Sarfaraz Ahmed Rehman
 Mr. Zain ul Hassan Shabbir
 Mr. Mujahid Hamid
 Mr. Mansoor A. Javed
 Dr. Tauseef Ahmed
 Mr. Saifuddin Zoomkawala
 Mian Arshad Alam
 Mr. Ali Habib
 Mrs. Marriana Karim
 Mian Muhammad Abdullah
 Mr. S. M. Muneer
 Mr. Liaquat H. Merchant
 Mr. Munir Kamal
 Mr. Irfan Mustafa
 Mrs. Ronak Lakhani
 Justice (R) Nasir Aslam Zahid
 Mr. Tariq Shafi
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Chapter 4
Organizational Structure
SKMCH is falls under the functional type of organization. Functional organizational structures
are the most common. A structure of this type groups individuals by specific functions
performed. Common departments in SKM such as human resources, accounting and purchasing
are organized by separating each of these areas and managing them independently of the others.
Organizational Hierarchy Chart
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Numbers of Employees
In SKMCH & RC the division of employees working here is as:
Daily Wagers: 04
Employee (Contract): 302
Employee (Permanent): 1237
Locum employees: 17
Internee: 01
Short term employees: 04
Hence, total numbers of employees working are more than 1500.
Main Offices
Shaukat Khanum memorial cancer hospital and RC has 6 main offices. Main Head office is in
Lahore and then Islamabad, Karachi, USA, UAE, UK. But the offices except Lahore are working
for fundraising and hospital marketing purposes. One more branch same as of Lahore is going to
construct in Peshawar.
Lahore Office
Shaukat Khanum memorial cancer hospital and RC Johar Town
Phone #: 35945100
Islamabad Office
Shaukat Khanum Memorial Trust 2 Royal Centre 106-West, Fazl-e-Haq Road, Blue Area
Phone #: 051-2273400
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Karachi Office
Shaukat Khanum Memorial Trust Suite# 10, Mezzanine Floor, Hamilton Courts, G-II, Near Teen
Talwar
Main Clifton Road, Clifton,
Phone #: 21 35872573
UAE Office
Shaukat Khanum Memorial Trust P. O. Box 506032 International Humanitarian City (IHC) UK
Office:
Phone #: 971501021697
USA Office
Imran Khan Cancer Appeal Inc, Suite # 201, 195 Farmington Avenue Farmington CT 06032
Phone #: +1(860)6748865
UK Office
Imran Khan Cancer Appeal PO Box 786, 66 Little Horton Lane, Bradford, BD5 0YE
Phone #: +44 1274 424 444
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Chapter 5
Introduction of different Departments
Human Resource Department
Organizations that are small, government agencies or multinational they all depend upon the
people who are their strength. Organizational strength is its resources. HR department of SKM
hires a competitive, skilled and up-to-date person for their organization and convince them by
offering and paying job benefits, job environment and many other facilities. HR department
trains the employees that are nominated by their HOD. HR department is also facilitating doctors
with medical education. HR department is performing different functions that are:
1. Trainings
2. Recruitment management
3. Hiring forecast
4. Interviewing and selection
5. Career management
6. Staffing and HR budgeting
7. Procedures and policies
8. Employee orientations
9. Final settlements
10. Leave records
11. Medical records
12. Compensations and benefits
13. Employee records and updating
14. Payroll
15. Security Management
16. Transport management
Management Information System
MIS is the information system that provides information to different departments with the ease of
use technology. Teams of developers are working under this department. These resources are not
only contributing to the hospital HIS but also generating the revenue for hospital. It consists of
technology, resource persons and information. MIS in SKMCH is playing vital and prominent
role that we see in each and every department. MIS introduced with HIS (Hospital Information
System) that is a huge application running on every system of the SKM and providing ease to not
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only employees but also to patients. HIS has taken place of manual systems of the SKM. It has
application related to all departments. Each department works with and on its related module.
MIS has its own sections that are providing assistance not only to programmers but also to
hospital employees who own system. Sections of MIS are:
 Network Section
 DBA Section
 Hardware Section
 Telecommunication Section
 MIS Helpline
 Developers
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Chapter 6
Projects of SKMT
The Shaukat Khanum Memorial Trust realizes its responsibilities in the fight against cancer and
therefore, it has established a number of canters all over Pakistan that help in the awareness,
diagnosis, and treatment of cancer in Pakistan. Shaukat Khanum Memorial Cancer Hospital and
Research Centre
Hospitals
Shaukat Khanum Memorial Cancer Hospital and Research Centre (Lahore, Pakistan), the first
specialized cancer facility in the entire region with all the cancer diagnostic and therapeutic
facilities under one roof, inaugurated on December 29, 1994.
Shaukat Khanum Memorial Cancer Hospital and Research Centre (Peshawar, Pakistan), built
according to the latest international healthcare standards, inaugurated on December 29, 2015.
Shaukat Khanum Memorial Cancer Hospital and Research Centre (Karachi, Pakistan) Land
Awarded, Planning in progress
Outreach Cancer Screening Clinics
 Shaukat Khanum Walk-In Clinic (Karachi, Pakistan)
 Shaukat Khanum Walk-In Clinic (Peshawar, Pakistan)
 Shaukat Khanum Walk-In Clinic (Lahore, Pakistan)
 Shaukat Khanum Walk-In Clinic (Multan, Pakistan)
Diagnostic Centres
 Shaukat Khanum Diagnostic Centre (Lahore, Pakistan)
 Karachi Diagnostic Centre and Clinic (Karachi, Pakistan)
Laboratory Collection Centres

173 Shaukat Khanum Laboratory Collection Centres (all over Pakistan)
Their Services
As one of the largest cancer care centres in Pakistan, Shaukat Khanum Memorial Cancer
Hospital and Research Centre offers a complete range of health care services including clinical,
diagnostic, out-patient, and others.
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Clinical Services
Shaukat Khanum Memorial Cancer Hospital and Research Centre offers a complete range of
health care services. Find a clinical service below by searching their Departments.
1- Anesthesiology
Anesthesia Department at Shaukat Khanum Memorial Cancer Hospital and Research Centre
provides anesthesia to a wide variety of surgical patients inside the four operating rooms.
Facilities & Services

Anesthesia is also provided in MRI suit, where a state-of-the-art MRI compatible anesthesia
machine and monitoring is used for safe conduct of the diagnostic test. Sedation and anesthesia is
provided in Endoscopy unit for either Gastro-esophageal or pulmonary interventions. Sedation
and anesthesia are also provided for vascular coiling and for neuro-interventional radiology.
Other areas for activity are sedation for Radiation simulations in children in the dept. of
Radiation Oncology. Shaukat Khanum Memorial Cancer Hospital and Research Centre.
Their practice is as wide based as are the demands for anesthesia requirements in different
specialties and varied locations throughout the hospital. The dept. is well equipped with the latest
tools to safely conduct anesthesia and sedation. Operating rooms are equipped with most modern
anesthesia machines with availability of invasive monitoring, they are in the process to updating
all the older equipment in the operating rooms and the PACU (post anesthesia care unit) to the
most modern equipment available.
Wide variety of interventional pain procedures including Radiofrequency Nerve and Joint
Ablations as well as permanent neurolysis for cancer pain are routinely performed. Interventional
Pain Service with dedicated pain nurse provides a wide variety of solutions to patients in severe
pain.
Training
The dept. has 10 Resident Doctors positions, Training is provided as per collage of physicians
and Surgeons Pakistan curriculum. Departmental academic activity includes daily patient rounds,
weekly presentations, weekly interactive problem-based anesthesiology meeting, weekly Journal
Club meeting and fortnightly M& M meetings
Trainees get training for Invasive monitoring, Fibro-optic intubations in a wide case mix of
clinical scenarios, both inside as well as out of operating rooms. Shaukat Khanum Memorial
Cancer Hospital and Research Centre.
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Research
Comparison of Quality of Pain control in patients having Total Knee Replacement with epidural
infusion consisting of morphine with preservative compared to epidural infusion consisting of
preservative free morphine.
Comparison of degree of pain relief with continuous epidural infusions containing 0.125%
Bupivacaine with epidural infusions containing 0.125% Bupivacaine and Morphine.
Quality and duration of analgesia after Pulsed Radiofrequency ablation of the Glossopharyngeal
nerve in patients with Oral cancer and Glossopharyngeal Neuralgia.
Comparison of recovery and quality of analgesia between inhalational anesthesia compared to
total intravenous anesthesia in patients having Brachytherapy.
Awards, Certifications & Affiliations

The Department of anesthesiology is recognized for full four-year training program for FCPS
(Anesthesiology) and MCPS (Anesthesiology) degrees by the College of Physicians and
Surgeons of Pakistan
2- Clinical Radiology
Their Radiology Department conducts more than 400 diagnostic and therapeutic procedures per
day, while maintaining the highest standards of clinical excellence. Led by the most competent
group of professionals, the department is committed to providing their patients with a
compassionate and caring environment using the most modern technology and research in
clinical imaging.
SKMCH&RC has the largest concentrations of equipment focused on cancer and non-cancer
imaging in Pakistan. The installation of Pakistan’s first PET/CT scanner, a hybrid technology
that gives more accurate picture of what is happening inside the body, has revolutionized their
diagnosis, treatment and management of cancer.
The Radiology Department also has a fully equipped DSA suite, digital DR and CR fluoroscopic
units, Pakistan’s only full-field digital mammography unit with CAD (computer assisted
diagnosis), and Pakistan’s first ultrasound Toshiba APLIO XG capable of elastography for breast
tumors. They are also equipped with 64-Slice CT scanners that capture and construct three
dimensional images of anatomy as thin as a credit card, with unprecedented speed and accuracy,
allowing referring physicians and patients to easily review and understand the findings on the
scan.
There are dedicated workstations for image processing and analysis. A filmless digital
environment for processing and viewing images exists across the Hospital through their modern
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Picture Archiving Communications System (PACS) and an electronic medical record system is
in use. This, together with their dedicated staff, enables both high-quality image acquisition and
display besides interpretation. Shaukat Khanum Memorial Cancer Hospital and Research Centre.
The Radiology Department at SKMCH&RC provides a full spectrum of radiology services that
includes not only diagnostic imaging but also complex and delicate interventional radiological
procedures.
Diagnostic Radiology Services
 MRI perfusion studies where the scans determine the blood flow to each organ
 MRI spectroscopy to determine the chemical nature of the tumor
 MRI of each body organ can be exclusively performed at the Hospital
 Cardiac CT
 CT colonoscopy
 All types of image guided biopsies
 Digital subtraction angiography to obtain real-time images of blood vessels in body
organs
 PET/CT scanning for assessing metabolism level of disease process
Interventional Radiological Procedures
A variety of specialized studies and interventional therapeutic procedures are performed by their
radiology professionals:
Neuro Intervention using state-of the art equipment to place coils and glue through micro
catheters and devices directly to target sites deep within the head through a small skin incision.
Embolization to deliver medication and block the blood flow to different organs. Trans arterial
Chemo Embolization (TACE) is an example in which chemotherapy is injected through the
hepatic artery targeting the tumor in liver.
Treatment of liver cancer with ablative techniques such as radio frequency ablation (RFA) and
alcohol ablation
Peripheral or vascular stenting, gastrointestinal stenting and stenting across biliary and urologic
tumors.
Training
As an affiliate of College of Physicians and Surgeons Pakistan, the department trains and
prepares residents for FCPS. Additionally, they offer fellowship programs in interventional
radiology and PET/CT.
The Department of Radiology is ISO certified and working towards JCIA
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3- Medical Oncology
Offering state-of-the-art medical treatment in a prompt, efficient and compassionate manner is
what makes SKMCH&RC stand out amongst the medical institutions within the region. The
Medical Oncology department at SKMCH&RC aims to make international standard cancer care
available to the people of Pakistan. Shaukat Khanum Memorial Cancer Hospital and Research
Centre.
Almost all consultants in Medical Oncology department at SKMCH&RC hold foreign
qualifications. Due to a shortage of highly experienced staff, consultants are also training their
own doctors to become accomplished oncologists in near future. An intense, fiercely intellectual
academic atmosphere exists at SKMCH&RC, where the latest advances in different fields of
medicine are discussed in various teaching sessions held weekly.
Cancer is a complex and multidimensional disease. Patients at SKMCH&RC are assessed in
multidisciplinary clinics where a team of medical, radiation and surgical oncologists work
together to prepare personalized treatment plans. Patients are then treated in accordance with
disease-specific internationally-accepted management guidelines. The latest and novel treatment
is given to their patients irrespective of their background.
The broad range of diseases treated by the department includes leukemia and lymphomas to
brain tumors as well as solid tumors. From morning till midnight, between 80 and 100 patients
receive chemotherapy in their specially designated chemotherapy ward. Since 2006, they also
offer autologous bone marrow transplant for adults and children.
There is a weekly long-term follow up clinic in which patients that have completed five years of
treatment are evaluated for long-term side effects of chemotherapy and radiotherapy.
At SKMCH&RC, patients are given up-to-date and understandable information about their
disease and treatment process. They also understand the emotional needs of their patients. Those
patients who are diagnosed with cancer are guided and supported by their team of psychologists,
play therapists for pediatric patients, trained oncology nurses, social workers, nutritionists, and a
cancer support group made up of successfully treated cancer patients at the Hospital.
One Stop Breast Clinic
Breast cancer is one of the most common malignancies amongst women worldwide and
Pakistani women carry one of the highest incidences of this cancer in all of Asia. Due to this
heavy burden of this disease, SKMCH&RC shoulders the responsibility of accurately and
efficiently diagnosing breast cancer while making sure that they differentiate cancer from the
wide spectrum of other benign disorders that exist in women.
Therefore, the creation and management of the One Stop Breast Clinic is considered as one of
the Medical Oncology department’s leading achievements. The mission of the One Stop Breast
Clinic is to assist each woman through an imaging work-up efficiently and seamlessly with
minimal discomfort and anxiety. Over 500 patients visit the One Stop Breast Clinic each year.
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Housed in the Radiology Department, the multi-modality One Stop Breast Clinic is supervised
and run by staff from SKMCH&RC’s Surgery, Pathology, Radiology and Nuclear Medicine
departments with the option of calling oncology consultants for opinions and advice when
necessary.
In the span of one appointment, which lasts between 2-3 hours, each patient undergoes an initial
assessment with investigations aimed at an accurate diagnosis and a proper outlined course of
treatment. A new patient is registered on the morning of an appointment and proceeds onwards
with an initial history and physical examination by a Breast Surgeon.
Appropriate investigations are decided upon and completed by expert radiologists right then and
there, which generally includes a mammogram and an ultrasound complemented by a needle
biopsy where indicated. SKMCH&RC’s efficient pathology services deliver a prompt
preliminary diagnosis which aids in planning treatment. Shaukat Khanum Memorial Cancer
Hospital and Research Centre.
Nearly 80% of patients are assessed for benign disease with prompt reassurance and further
management plans chalked out and handed to them at the end of the appointment. This efficiency
helps to alleviate the excruciating stress of waiting for results. Those patients diagnosed with
cancer complete a staging work-up, greatly expediting their transit to initiation of targeted
therapy and minimizing unnecessary delays.
Training
Training in Medical Oncology has been established within the department. The fellowship
program in Medical Oncology provides training in all aspects of medical oncology through a
structured training program recognized by the College of Physicians and Surgeons Pakistan,
leading to FCPS in medical Oncology. The department also supports a training program in
Clinical Oncology leading to FRCR (clinical oncology).
Research
The department has been involved in a number of in-house clinical research projects as well as
participating in several multinational clinical trials. The department has contributed posters and
abstracts to several national and international meetings
4- Internal Medicine
The Department of Internal Medicine provides clinical cover for the following medical
specialties:
Intensive Care: They are staffed with board-certified critical care consultants, formally-trained
respiratory therapists and offer one-to-one nursing services. All of their intensive care unit (ICU)
rooms are fully ventilator equipped. The ICU also has the facility to perform continuous veno-
venous hemodiafiltration (CVVHDF) and intermittent Hemodialysis for critically ill patients.
30
Pulmonology; Their board-certified pulmonary consultants with formal training in interventional
pulmonology have the ability to perform fluoroscopy, bronchoscope tumor debulking, stent
placement, trans-bronchial needle aspiration, trans-bronchial lung biopsies and percutaneous
tracheostomies.
Gastroenterology: Experienced senior consultants perform both diagnostic and therapeutic
endoscopies with capability to perform stenting and endoscopic ultrasound. They have state-of-
the-art endoscopy suites with cutting-edge technology, fully-trained, specialized technicians and
nurses managing patients’ side by side with skilled specialist physicians, both consultants and
fellows, before, during and after the procedures.
Infectious Diseases: Board-certified, US-trained specialist consultants manage patients with
complex diseases. They also offer dedicated HIV clinics, backed by state-of-the-art microbiology
and PCR laboratory facilities.
General Internal Medicine and Hospitalist: This is available in the wards as well as the
Emergency Assessment Room. In addition, there is a provision for CHCC Comprehensive
Health Care Check-ups (CHCC) or annual wellness check visits, with specialists trained in this
field. They also thoroughly assess those patients under-going surgeries for medical fitness prior
to the procedure.
Palliative Care: This service is geared towards symptom control, especially pain, of patients who
are terminally ill and towards the end of life. Prominent services include specialist palliative care
physician led multidisciplinary outpatient clinics per week, inpatient and emergency room
consult service for patients needing urgent symptom management, and a 24-hour palliative
nursing telephone helpline with physician cover as needed.
End of life care, according to the internationally-recognized Liverpool Care Pathway, is provided
to terminally ill patients. SKMCH&RC is the only site in Pakistan registered with the Marie
Curie Palliative Care Institute in Liverpool, UK to use this pathway.
The Department of Internal Medicine also offers basic cardiology, nephrology and
endocrinology consultations and care. Additionally, the department has the capability to provide
services for ECG, ETT, Echocardiography (Trans Thoracic Echocardiographs and Trans
Esophageal Echocardiographs) as well as spirometry (PFTs) and cardio-pulmonary exercise
testing.
Training
The department is recognized for both FCPS and MRCP training in Medicine. The Department is
also recognized for FCPS training in Gastroenterology and infectious Diseases.
 The department offers a one-year diploma in Respiratory Therapy.
 ACLS Courses every 06 weeks for all health care staff.
 MRCP PACES preparatory courses twice a year.
 TOACS preparatory course held quarterly.
31
Research
List of publications IM Department.
The Department of Medicine is working towards JCIA recognition.
5- Nuclear Medicine
Their department delivers comprehensive diagnostic and therapeutic applications of this unique
specialty, which employs minute amounts of radioactive material called radio pharmaceuticals to
study the function of body systems and organs. Handling and use of radio- pharmaceuticals is
governed by stringent international and national regulations and their team of highly-qualified
consultants ensure the compliance with the standards set for the safe and appropriate use radio
pharmaceuticals in medicine. Their physicians are backed by a team of physicists, radio-
chemists, cyclotron engineers and technologists to deliver this technology and labor-intensive
service.
Unlike conventional x-rays and CT where an individual is exposed to radiation from an external
source, the radio pharmaceuticals in nuclear medicine are introduced in to the body through an
injection, food or aerosols. Shaukat Khanum Memorial Cancer Hospital and Research Centre.
A patient undergoing a nuclear scan is a source of radiation for a brief period during which
images are acquired and judgment is made about the functional status of the organ or system
utilizing a gamma camera or a PET/CT scanner. The amount of radio pharmaceuticals is
carefully calculated and varies according to a patient’s age, size and type of investigation.
Portable Molybdenum- Technetium generators are the primary source of radio-active material,
which is sourced from internationally licensed vendors.
Their department acquires these generators from three different sources to ensure constant
availability. PET radio pharmaceuticals have to be produced on site and since 2009,
SKMCH&RC houses Pakistan’s first IBA Cyclotron for this purpose.
The Nuclear Medicine Department is also equipped with two dual-head GE gamma cameras and
one hybrid imaging Philips PET/CT scanner. The hot labs for preparation of radio
pharmaceuticals are equipped with Lamer isolators and Synthera® synthesizers. Images are
processed and analyzed on dedicated work stations and archived on the Picture Archiving
Communications System [PACS], accessible throughout the Hospital, making SKMCH&RC a
filmless digital setup.
Their department has an unwavering commitment to education and research. They are affiliated
with College of Physicians and Surgeons Pakistan for training in FCPS Nuclear Medicine.
Additionally, they also host visiting MSc. in Nuclear Medicine fellows from Pakistan Institute of
Engineering and Applied Sciences in Islamabad.
32
Former trainees from their department have been awarded fellowships in UK and USA. Their
faculty is also involved in teaching of medical imaging technologists enrolled in the BSc (Hons)
in Medical Imaging program in collaboration with University of Bradford and the medical
technologist program of the University of Health Sciences in Lahore. Their physicists are
involved with MSc in Physics students from University of the Punjab with special focus on
medical physics. Research work from their department has been presented and published at both
the international and national level.
Even after 16 years of persistent progress and investment in technology, equipment and human
resource, the Nuclear Medicine Department at SKMCH&RC remains the foremost department
for the specialty in Pakistan.
6- Pathology
Shaukat Khanum Pathology Laboratory, one of the nation’s largest and most sophisticated
facilities, uses state-of-the-art equipment for all tests, setting a standard for result accuracy and
reliability.
The Pathology Laboratory consists of the Anatomic and Clinical Pathology sections including
the Blood Bank. With its comprehensive test menu, more than 4 million tests and procedures are
performed every year. Both the Laboratory and the Blood Bank are open 24 hours a day, 7 days a
week, with Consultant Pathologists available on call round the clock.
For your convenience, laboratory test results can be accessed online on their website. Test results
remain with us indefinitely as a result of their advanced patient data management systems.
Their modern laboratory facility has a robust quality assurance and quality control program and
is registered with the College of American Pathologists for proficiency in testing and sustaining
100 per cent accuracy results over the years, which is evidence of their high standards and
constant pursuit of excellence.
A combined commitment to quality and service is magnified by the talent and expertise of their
staff.
Anatomical Pathology
The Anatomical Pathology division, the heart of the Pathology Department, provides surgical
pathology and cytopathology services. A close liaison exists between pathologists and treating
physicians in order to optimize patient care.
33
Clinical Pathology
Routine Chemistry: The Routine Chemistry section is equipped with state-of-the-art chemistry
analyzers. Clinical chemistry is primarily concerned with biochemical analysis of a wide range
of biological samples for diagnosis and monitoring of patients. The section is involved in
investigative and clinical research activities.
Special Chemistry: The Special Chemistry section offers a vast menu of specialized tests using
the latest analyzers and equipment.
Blood Bank: A full service Blood Bank is available. Each donor or donated blood sample is
screened for major infectious diseases. The Blood Bank is also equipped with top-of-the-line
apheresis machines, allowing us to separate the blood component and perform therapeutic
apheresis.
Hematology and Coagulation: This section is one of the vital components of the Pathology
Laboratory. It is equipped with a 5-part differential analyzer which includes the measurement of
nucleated RBC’s and auto-correcting the WBC count. The Auto-Steiner, manages to create
peripheral smears in minutes for manual assessment.
For coagulation studies, a coagulation analyzer performs a complete profile from PT/INR, APTT
and clotting factor assays.
Other tests offered in hematology include CBC with manual differential, RBC morphology,
reticulocyte manual estimation, G-6PD quantitation, RBC fragility studies, and hemoglobin
electrophoresis, among others. The Hematology and Coagulation section also has a dedicated
bone marrow evaluation service.
Flow Cytometry: The section is equipped a multi-color flow cytometry machine, offering
complete immune-phenotyping for leukemia and lymphoma patients on blood, bone marrow
aspirate, body fluids and solid tissue.
Diagnostic tests for paroxysmal nocturnal hemoglobinuria and, CD4 and CD8 subset quantitation
are also offered. DNA ploidy and S-phase studies as well as fetal hemoglobin detection will be
offered in the near future.
Microbiology and Molecular Biology: The Microbiology section provides bacteriology,
mycology and urinalysis services used in diagnosis, therapy and management of infectious
diseases including cultures and drug susceptibility testing. The section is equipped with an
automated blood culture system. There is a dedicated TB lab for the detection of MTB and
sensitivity testing. Food, water and environmental testing are also offered. Shaukat Khanum
Memorial Cancer Hospital and Research Centre.
The Molecular Biology section offers PCR-based assays for early detection of hepatitis C,
hepatitis B and MTB. HCV genotyping is also available using a protocol developed by the
34
SKMCH&RC’s research division. The section also offers FISH testing for Her2Neu and plans to
launch tissue typing in the near future.
Training
The Department of Pathology conducts a one year Post Graduate Diploma Program in Medical
Laboratory Technology in Clinical Pathology.
The Faculty comprises Pathologists, Molecular Biologists, Microbiologist and Senior Medical
Technologists.
Research
All areas in anatomic and clinical pathology engage in developmental and research activities.
Shaukat Khanum Cancer Hospital laboratory has been acting as the “Central lab” of the region
for multinational clinical trials.
The Department of Pathology works in close collaboration with the Basic Sciences Department
of the Research Wing of SKMCH&RC.
The Department of Pathology at SKMCH&RC is recognized by the College of Physicians and
Surgeons of Pakistan for FCPS-II training in Anatomic Pathology.
The Department of Pathology is ISO 9001-2008 (QMS) certified and is registered with the
College of American Pathologists in their External Survey Program for proficiency testing.
7- Diagnostic Services
Choosing a diagnostic facility is the most crucial step in the treatment planning process because
only accurate and timely results lead to the right treatment decisions.
At Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC), they
recognize the importance and impact their diagnostic services can have on people’s lives. In line
with their vision, they seek to increase the access of Pakistani people to the latest internationally-
acclaimed, diagnostic techniques available today.
Equipped with modern technology, Shaukat Khanum Diagnostics offer a vast range of testing,
imaging and screening facilities all under one roof, where procedures are carried out by highly
trained, competent experts in their field, many of them foreign qualified. These individuals bring
their knowledge of the most up-to-date in research and cutting-edge technology from across the
world to the people of Pakistan to serve the nation.
Today, their network of laboratory collection canters is spread across major cities in Pakistan,
providing testing facilities to you at your convenience, with two pathology laboratories, one in
35
Lahore and other in Karachi, analyzing your results. The main Hospital in Johar Town, Lahore
offers radiology services. These services are also available at their diagnostic centers, one
located on Jail Road in Lahore and the other in DHA, Karachi.
The Shaukat Khanum Diagnostic Centre and Clinic in Karachi only has x-ray, ultrasound, and
mammography services available at the moment. A complete range of nuclear medicine services
is also offered at the main Hospital.
Comprehensive Health Checkup
Health is an area of growing concern. Minor complaints are frequently ignored but a timely
diagnosis of a disease may assure you of your good health because prevention is better than cure.
At Shaukat Khanum Memorial Cancer Hospital and Research Centre, they offer a
comprehensive medical examination facility that provides you an opportunity to evaluate your
health status with qualified health care professionals. The program is offered in the form of a
package that allows two visits giving you an opportunity to get a detailed picture of your health.
Shaukat Khanum Memorial Cancer Hospital and Research Centre.
Appointment Scheduling
Please call Shaukat Khanum Memorial Cancer Hospital and Research Centre on 111-155-555,
042 35905000 Ext: 3433, 3435, to book an appointment and to get further details if desired.
Visit 1
Kindly report to the Outpatient Department at Shaukat Khanum Memorial Cancer Hospital and
Research Centre, 30 minutes before your appointment time.
After your examination you will be taken for your chest X-ray, ultrasound and ETT. You will
also be provided with sample collection containers (for stool & urine samples), and your 2nd
appointment will also be booked at this time. Next morning, simply drop the samples (urine &
stool) either at the hospital or at the Shaukat Khanum Diagnostic Centre on Jail Road, where
your blood sample (with fasting) will also be drawn.
Visit 2 (Follow up Visit)
On the follow up visit, the consultant physician will discuss your reports and current health status
with you. If any potential problem is identified, the consultant physician will advise you the
further plan of action. You will also meet their clinical nutritionist for a dietary consultation.
This will conclude your evaluation, following which you will be provided a complete set of your
reports and clinical summary.
Instructions
Kindly report to the Outpatient Department at Shaukat Khanum Memorial Cancer Hospital and
Research Centre, 30 minutes before your appointment time for registration of demographic
information.
36
Please confirm your appointment 24 hours in advance. If not confirmed you might lose the
appointment.
Please bring along the authorization form, in case your company is sponsoring your CHCC visit.
Do not smoke or eat anything three hours prior to your appointment time, your bladder must be
full for which you will be required to take 4-6 glasses of water
In case, you are on medication kindly bring your medicines/previous reports along with you.
You must remove chest hair, wear casual clothes & running shoes (Jogger) before coming for
your appointment. (Without Chest Shave & running shoes, ETT test cannot be performed).
Bring sample of urine and stool, on your following day (Sterilized containers for samples will be
provided to you on your first visit)
they accept payments by cash & credit cards only.
Additional investigations that may be required (not mentioned in the package) will be charged
separately.
Important Instructions for Female Clients
Pregnant ladies or if suspecting pregnancy, please inform the doctor and the Radiology staff
before the X-ray.
You are advised not to undergo CHCC during your menstrual period.
Menu of Test
 Complete History & Physical Examination
 Complete Blood Count
 RBC Morphology
 Blood Grouping
 CO2 Urea and Electrolytes (Na, K, Cl, Urea, Creatinine)
 Uric Acid
 Blood Sugar
 Urine Analysis
 Liver Function Test (LFT’s)
 Lipid Profile (TRIG, CHOL, LDL, HDL, VLDL)
 Complete stool Examination
 Faecal Occult Blood
 Hepatitis B (HBV) Screening
 Hepatitis C (HCV) Screening
 Thyroid Stimulating Hormone (TSH)
 Ultrasound Abdomen & Pelvis
 Chest X-Ray
 Exercise Tolerance Test (ETT)
37
 Dietary Consultation (by qualified Nutritionist)
 Package Price: Rs. 31,000 (Non-Refundable)
 Cardiac CT Scan: Rs. 27,500/- Optional
8- Pharmacy
The Department of Pharmacy provides integrated, cost-effective pharmaceutical care to both

inpatients and outpatients. These patient-focused services include medication delivery,
therapeutic drug monitoring, and promotion of optimal drug therapy. Their clinical Pharmacists
works as an integral member of health care team to achieve desired therapeutic outcomes,
prevent or minimize drug-related problems, and improve medication use.
The department consists of a Dispensing Pharmacy, Aseptic Pharmacy, Clinical Pharmacy,
Inpatient Pharmacy, Drug Information Services and Satellite Pharmacy. With the objective “To
Ensure the Optimization of Pharmaceutical Care to all Patients”, the department ensures
excellence in quality through high quality medicinal products, qualified and well-trained staff of
Pharmacists, Pharmacy Technician and Pharmacy Assistants. Shaukat Khanum Memorial Cancer
Their Inpatient Pharmacy supplies round the clock medication to the hospital’s inpatients as well
as the wards. Pharmacy personnel check the patients’ prescriptions for accuracy and
appropriateness of treatment at the point of dispensing as well as before the administration of
medications. Upon discharge, patients are counseled on their discharged medications before
leaving the hospital.
In Outpatient Pharmacy, Prescriptions from both internal and external doctors are accepted here.
A wide range of medications including their specialty chemo drugs are available at the
Outpatient Pharmacy including controlled medications as well as customized preparations
including Total Parental Nutrition to those patients who are not on natural diet. Their Aseptic
Pharmacy staffed by personnel trained in chemotherapy drug reconstitution techniques. This
ensures patients’ chemotherapy drugs are prepared correctly under sterile area and are safe to use
by both the patients and the nurses administering the oncology treatment.
To advance their mission, the department provides a supportive environment for professional
training and development. One residency training program is being offered including internship
program and clerkship rotations to the students in hospital pharmacy.
Training
Department of Pharmacy takes keen interest in providing training and educational services that
can be gauged from the periodical Pharmacy News Letter and the compiled Hospital Formulary.
They have a comprehensive Internship program for fresh pharmacy graduate from various
Universities of the country as well as foreign Pharmacists. Shaukat Khanum Memorial Cancer
38
Awards and Recognitions
For more than two decades, SKMCH&RC has been committed to the highest standards of patient
care, education, and research. The Hospital’s commitment has been recognized at both, national
and international levels.
 Global Good Governance (3G) Award
 Shaukat Khanum Memorial Cancer Hospital and Research Centre received the Global Good
Governance (3G) Awards in the category “3G Leadership Award for Social Sector &
Philanthropy 2017” for Service Excellence and Cancer Treatment & Research.
 Management Association of Pakistan (MAP) Certification
 SKMCH&RC was awarded the Corporate Excellence Certificate by MAP in 2016
 Pakistan Centre for Philanthropy Certification (PCP)
 SKMCH&RC was awarded the NPO Certification for meeting standards in the areas of
internal governance, financial management, and program delivery by the PCP in 2015. The
PCP has renewed it every three years since then.
 Pakistan Advertisers Society (PAS) Award
 SKMCH&RC won the PAS Awards 2015 in the ‘Hospital and Healthcare Category’ for its 5
Rupee Daily campaign
 SKMCH&RC was awarded the Corporate Excellence Certificate by MAP in 2015.
 SKMCH&RC was the winner of the PAS Awards 2014 not only in the ‘Hospital and
Healthcare Category’ but also in the ‘Campaign of the Year Award’ for its Zakat campaign
“Main To Sirf Bara Hona Chahta Hoon”.
 SKMCH&RC was awarded the Corporate Excellence Certificate by MAP in 2014.
 Employer Federation of Pakistan (EFP) Award
 SKMCH&RC was awarded the second place in the category of Human Resource
Development by EFP in 2014.
 SKMCH&RC was the winner of the PAS Awards 2012 in the category of Public Service,
Government & CSR for its campaign “Kho Na Jaye Koi”.

 Management Association of Pakistan (MAP) Award
 SKMCH&RC was awarded the Corporate Excellence Award by MAP in 2012.
 Pakistan Centre For Philanthropy Certification (PCP)
 SKMCH&RC was awarded the NPO Certification for meeting standards in the areas of
Internal Governance, Financial Management, and Program Delivery by the Pakistan Centre
for Philanthropy in 2012.
 Management Association of Pakistan (MAP) Award
 SKMCH&RC was awarded the Corporate Excellence Award by MAP in 2010.
 Health Level 7 Pakistan Benefactor Membership
39
 SKMCH&RC was designated as a Benefactor Member of HL7 Pakistan in 2010. This
membership enables SKMCH&RC to make healthcare systems inter-operable by adopting
health standards such as HL7.
 American Association of Continuing Medical Education (AACME) Accreditation
 SKMCH&RC became the first hospital in Pakistan to have accreditation by AACME as a
Continuing Medical Education provider for healthcare professionals in 2009.
 Hazard Analysis Critical Control Point (HACCP) Certification
 The Food and Dietary Services department of SKMCH&RC was awarded the HACCP in
2008.
 Capability Maturity Model (CMMI) ML2 Certification
 SKMCH&RC was the first hospital in Pakistan and the first cancer hospital in the world to
achieve the Capability Maturity Model Integration (CMMI) Maturity Level 2 in 2008.
 Human Rights Society of Pakistan Award
 SKMCH&RC was awarded for its humanitarian efforts on the 27th Award Ceremony of the
Human Rights Society of Pakistan in 2008.
 College of Physicians & Surgeons of Pakistan (CPSP) Recognition
 The Department of Anesthesia was recognized by the CPSP in 2008.
 Quality Management Systems Certification
 SKMCH&RC was awarded the ISO 9001: 2008 certification for Diagnostic and Therapeutic
Cancer Services in 2007. The Hospital was awarded the original certification in 2001.
 World Health Organization (WHO) Award

 SKMCH&RC was presented the World Health Organization’s UAE Foundation Prize for
‘Outstanding work in health development that has already been accomplished and that has
extended far beyond the call of normal duties’ in 2006.
Institutional Management Certification Program (IMCP)
 SKMCH&RC successfully participated in capacity building process for meeting the USAID
Management Standards under the IMCP in 2006.
 International Network for Cancer Treatment and Research (INCTR) Membership
 SKMCH&RC was granted Associate Membership of INCTR in 2005.
 The Department of Internal medicine was recognized by the CPSP in 2004.
 Pakistan Software Export Board Registration
 SKMCH&RC is registered with Pakistan Software Export Board of the Ministry of
Information Technology, Government of Pakistan, since 2003.
 College of American Pathologists (CAP) Registration
 SKMCH&RC is registered with the CAP for Proficiency Testing Survey since 2002.
 The Department of Pathology was recognized by the CPSP in 2001.
40
 The Department of Nuclear Medicine was recognized by the CPSP in 1999.
 The Department of Radiology was recognized by CPSP in 1998.
 The Department of Clinical and Radiation Oncology was recognized by the CPSP in 1996.
 The Department of Medical Oncology was recognized by the CPSP in 1996.
9- Nursing Services
Professional nursing practice at SKMCH&RC is promoted through membership of the Pakistan

Cancer Nursing Forum affiliated to the International Society of Nurses in Cancer Care and
through membership of the Asia Pacific Hospice Network.
Nursing at Shaukat Khanum offers much more than the traditional image of nursing. Nurses
provide care to patients receiving complex treatment for their disease through surgery, radiation
therapy, chemotherapy and nuclear medicine processes. In addition to informing patients about
their disease and its treatment, nurses provide emotional support.
A large part of what they do is patient education. Patients are advised on what to expect during
their stay and after they are discharged. It also includes teaching them about what drugs they will
be taking and the side effects of those drugs, blood transfusions, how to look for signs of
infection and bleeding and dietary changes. Team Nursing and Nursing Documentation are seen
as very important as they foster team spirit and improve the quality of care given to patients and
their families.
The Nursing Division is ISO 9001: 2008 Quality Management Certified and working towards
JCIA, therefore is continually striving to improve its practice and thereby its quality of care to
patients and their relatives.
Professional Structure
The Nursing Division is headed by the Director of Nursing/Nursing Education. There are five
grades of clinical nursing staff – Clinical Nurse Managers, Team Leaders, Senior Staff Nurses,
Staff Nurses and Trainee Staff Nurses. A competitive salary package is available for all levels of
Nursing Staff.
The Nursing Environment Includes:
Inpatient Departments that cover Adult and Pediatric Oncology, Peri-operative Nursing,
Intensive Care Nursing, Surgery, Internal Medicine, Radiation Nursing, Nuclear Medicine
Nursing and Palliative Care Nursing.
In the busy Outpatient Department, The Chemotherapy Day Suite and The Emergency
Assessment Room nursing provide a comprehensive service to support adult and pediatric
patients.
41
Specialist roles in nursing have being developed to support and advance nursing practice – roles
in Infection Control, Nursing Risk Management/Evidence-Based Practice, Breast Care Nursing.
These new roles aim to improve the quality of care to patients and their families.
Professional Development / Educational Pathway
All nurses must complete a series of workshops designed to enhance their practice, including
Induction and Orientation Program, Core Competencies in Cancer and Palliative Care Nursing,
Basic Cardiac Life Support, Cytotoxic Drug Administration, Pharmacology and Drug
Calculations, Health Assessment, Infection Control, Blood and Blood Products, Nursing Risk
Management & The Diploma in Oncology / Cancer Nursing
Philosophy of Nursing
They believe:
 Nursing is a universal need for all human beings and an essential service in health care.
 Nursing recognizes the uniqueness of each human being and aims to provide care which is
holistic and individualized and covers physical, psychological, social, spiritual and cultural
needs.
 Nursing is both an art and a science and works in collaboration with medicine and other
health professionals.
 Nursing should be non-judgmental providing equal, high quality care underpinned by
research.
 Nursing recognizes that patients with cancer and their families require on-going support and
that nurses are in a unique position to provide encouragement, reassurance and hope through
difficult times.
 Nursing recognizes that through communication, understanding and empathy patient’s
difficulties can be shared.
 Nursing promotes the patient’s independence through education and ongoing support and
discharge planning provides for the transition from hospital to community and home and is
an integral part of the patient’s plan of care.
 Nursing should act as the patient’s advocate in appropriate situations, whilst recognizing
social, cultural and religious norms.
 Nursing promotes the concept of life-long learning and nurses should continually strive to
keep their knowledge base up-to-date and accept responsibility for their own actions and
decision-making.
 Nursing recognizes that nurses need support to provide this care and aim to provide a caring
supportive working environment.
42
Chapter 7
Financial Position over the years
The financial statements of the Shaukat Khanum Memorial Trust are annually audited by a
reputable auditing firm, that is, A.F. Ferguson and Co. Here is a breakdown of the revenue and
expenditure of the Trust.
Revenue (Rs. in Millions)

1994-2017
Hospital Other Total

Year Zakat Donations
Services Income Revenue
2017 3,934 2,583 1,897 445 8,859
2016 3,739 2,342 1,960 312 8,354
2015 3,384 2,226 3,101 250 8,961
2014 2,924 1,863 1,311 210 6,308
2013 2,592 1,944 1,555 155 6,246
2012 2,202 1,669 1,156 165 5,192
2011 1,972 1,345 904 68 4,289
2010 1,554 807 608 44 3,013
2009 1,281 865 620 47 2,813
2008 1,125 646 460 37 2,268
2007 954 535 486 33 2,009
43
2006 750 438 273 34 1,495
2005 573 265 320 29 1,186
2004 424 397 368 33 1,222
2003- 374 287 238 14 913

04
2002- 261 244 178 15 698

03
2001- 234 152 174 17 577

02
2000- 211 131 190 15 547

01
1999- 139 117 152 17 425

00
1998- 113 100 129 11 353

99
1997- 90 99 103 11 303

98
1996- 62 117 105 7 291

97
1995- 35 109 87 18 249

96
44
1994- 5 46 85 5 141
95
Financial year changed from June 30 to Dec 31 in December 2004. Therefore, December 2004
represents 12 months results – 06 Months from Financial year ended June 30, 2004 and six
months ended December 31, 2004.
Operating Expenses (Rs. in Millions)

For the Year 2017
Category Amount Percentage
Salaries and Benefits (Medical Staff) 1,694 20%
Salaries and Benefits (Admin Staff) 966 11%
Consultants Fee 760 9%
Medicines 942 11%
Pathology, Nursing & Other Supplies 1,835 22%
Utilities 432 5%
Fundraising Expenses 392 5%
Financial Costs 24 0%
Repairs and Maintenance 430 5%
Depreciation 760 9%
45
Category Amount Percentage
Other Operating Expenses 264 3%
Total Operating Expenses 8,499 100%
46
Financial Statements
47
48
49
50
Chapter 8
Horizontal and Vertical Analysis
Horizontal Analysis
Horizontal analysis is used in financial statement analysis to compare historical data, such as
ratios, or line items, over a number of accounting periods. Horizontal analysis can either use
absolute comparisons or percentage comparisons, where the numbers in each succeeding period
are expressed as a percentage of the amount in the baseline year, with the baseline amount being
listed as 100%. This is also known as base-year analysis.
Horizontal analysis allows investors and analysts to see what has been driving a company's
financial performance over a number of years, as well as spotting trends and growth patterns
such as seasonality. It enables analysts to assess relative changes in different line items over
time, and project them. By looking at the income statement, balance sheet and cash flow
statement at the same time, one can create a complete picture of operational results, and see what
has been driving a company’s performance and whether it is operating efficiently and profitably.
The analysis of critical measures of business performance, such as profit margins, inventory
turnover and return on equity, can detect emerging problems and strengths. For example,
earnings per share (EPS) may have been rising because the cost of goods sold have been falling,
or because sales have been growing strongly. And coverage ratios, like the cash flow-to-debt
ratio and the interest coverage ratio can reveal whether a company can service its debt and has
enough liquidity. Horizontal analysis also makes it easier to compare growth rates and
profitability among different companies.
Horizontal Analysis Cons
Depending on which accounting period an analyst starts from, and how many accounting periods
are chosen, the current period can be made to appear unusually good or bad. For example, the
current period's profits may appear excellent when only compared with those of the previous
quarter, but are actually quite poor if compared to the results for the same quarter in the
preceding year.
A common problem with horizontal analysis is that the aggregation of information in the
financial statements may have changed over time, so that revenues, expenses, assets, or liabilities
may shift between different accounts and therefore appear to cause variances when comparing
account balances from one period to the next. Indeed, sometimes companies change the way they
break down their business segments, in order to make the horizontal analysis of growth and
profitability trends harder.
Calculating Horizontal Analysis
51
The statements for two or more periods are used in horizontal analysis. The earliest period is
usually used as the base period and the items on the statements for all later periods are compared
with items on the statements of the base period. The changes are generally shown both in dollars
and percentage.
Dollar and percentage changes are computed by using the following formulas:
For Net Income:
Dollar change = 485449003-989388855
−503939852
Percentage Change = ∗ 100 = −50.93
989388855
For Clinical Expenses:
Dollar Change = 5923605007- 5346205221

577399786
Percentage Change = ∗ 100 = 10.80
5346205221
Horizontal analysis may be conducted for balance sheet, income statement, schedules of current
and fixed assets and statement of retained earnings.
Vertical Analysis
Vertical analysis is a method of financial statement analysis in which each line item is listed as a
percentage of a base figure within the statement. Thus, line items on an income statement can be
stated as a percentage of gross sales, while line items on a balance sheet can be stated as a
percentage of total assets or liabilities, and vertical analysis of a cash flow statement shows each
cash inflow or outflow as a percentage of the total cash inflows.
52
Vertical analysis makes it much easier to compare the financial statements of one company with
another, and across industries – because one can see the relative proportions of account balances.
It also makes it easier to compare previous periods for time series analysis, in which quarterly
and annual figures are compared over a number of years – in order to gain a picture of whether
performance metrics are improving or deteriorating.
For example, by showing the various expense line items in the income statement as a percentage
of sales, one can see how these are contributing to profit margins and whether profitability is
improving over time. It also makes it easier to compare the profitability of a company with its
peers.
Financial statements that include vertical analysis clearly show line item percentages in a
separate column. These types of financial statements, including detailed vertical analysis, are
also known as common-size financial statements and are used by many companies to provide
greater detail on a company’s financial position. Common-size financial statements often
incorporate comparative financial statements that include columns comparing each line item to a
previously reported period.
Calculating Vertical Analysis
To conduct a vertical analysis of balance sheet, the total of assets and the total of liabilities and
stockholders’ equity are generally used as base figures. All individual assets (or groups of assets
if condensed form balance sheet is used) are shown as a percentage of total assets. The current
liabilities, long term debts and equities are shown as a percentage of the total liabilities and
stockholders’ equity.
To conduct a vertical analysis of income statement, sales figure is generally used as the base and
all other components of income statement like cost of sales, gross profit, operating expenses,
income tax, and net income etc. are shown as a percentage of sales.
In a vertical analysis the percentage is computed by using the following formula:
A basic vertical analysis needs an individual statement for a reporting period but comparative
statements may be prepared to increase the usefulness of the analysis.
53
Vertical Analysis
2016 2017
Clinical Expenses 63.22 % 70.05 %
Marketing Expense 17.97 % 22.66 %
Finance Loss 0.29 % 0.28 %
Clinical Expenses
5346205221
For 2016 = ∗ 100 = 63.22
8455600657
5923605007
For 2017 = ∗ 100 = 70.05
8455600657
Marketing Expense
1519731058
For 2016 = ∗ 100 = 17.97
8455600657
1916285176
For 2017 = ∗ 100 = 22.66
8455600657
Finance Loss
24685690
For 2016 = ∗ 100 = 0.29
8455600657
24059007
For 2017 = ∗ 100 = 0.28
8455600657
Vertical Analysis vs. Horizontal Analysis

While horizontal analysis looks at how the dollar amounts in a company’s financial statements
have changed over time, vertical analysis looks at each line item as a percentage of a base figure
within the statement. Thus, line items on an income statement can be stated as a percentage of
gross sales, while line items on a balance sheet can be stated as a percentage of total assets or
liabilities, and vertical analysis of a cash flow statement shows each cash inflow or outflow as a
percentage of the total cash inflows. Vertical analysis is also known as common size financial
statement analysis. For more, read The Common-Size Analysis of Financial Statements.
54
Chapter 9
Ratio Analysis
Return on Assets
Return on assets is the ratio of annual net income to average total assets of a business during a
financial year. It measures efficiency of the business in using its assets to generate net income. It
is a profitability ratio.
Formula
The formula to calculate return on assets is:
𝑁𝑒𝑡 𝐼𝑛𝑐𝑜𝑚𝑒
𝑅𝑒𝑡𝑢𝑟𝑛 𝑜𝑛 𝐴𝑠𝑠𝑒𝑡𝑠 =
𝐴𝑣𝑒𝑟𝑎𝑔𝑒 𝑇𝑜𝑡𝑎𝑙 𝐴𝑠𝑠𝑒𝑡𝑠
Net income is the after-tax income. It can be found on income statement. Average total assets are
calculated by dividing the sum of total assets at the beginning and at the end of the financial year
by 2. Total assets at the beginning and at the end of the year can be obtained from year ending
balance sheets of two consecutive financial years.
485449003
𝑅𝑒𝑡𝑢𝑟𝑛 𝑜𝑛 𝐴𝑠𝑠𝑒𝑡𝑠 = = 0.8290
5855346265
ROA = 8.290%
The amount in the numerator is the Net Income for Shaukat Khanam Hospital as of December
31st, 2015, as reported in the financial press or over the internet. In the denominator, Average
Total Assets is mentioned. By simply dividing, the equation gives us the Return on Asset ratio
Commentary
This number tells you "what the company can do with what it's got", i.e. how many dollars of
profits they can achieve for each dollar of assets they control. Thus, higher values of return on
assets show that business is more profitable. Several profitability ratios examine the relationship
between revenues and income. Return on assets is a measure that relies on the balance sheet as
well as the income statement. The assets required to produce revenues will vary by
industry. When drawing conclusions about the relative performance of a company, benchmark
comparisons should be made with competitors in the same industry. This ratio should be only
used to compare companies in the same industry. The reason for this is that companies in some
55
industries are most asset-insensitive i.e. they need expensive plant and equipment to generate
income compared to others. Their ROA will naturally be lower than the ROA of companies
which are low asset-insensitive. . Capital-intensive industries (like railroads and nuclear power
plants) will yield a low return on assets, since they have to own such expensive assets to do
business. (And if they have to pay a lot to maintain these assets that will cut into the ROA even
more, since the maintenance costs will decrease their earnings). Shoestring operations (software
companies, job placement firms) will have a high ROA: their required assets are minimal.
An increasing trend of ROA indicates that the profitability of the company is improving.
Conversely, a decreasing trend means that profitability is deteriorating.
Fixed- Asset Turnover
The fixed asset turnover ratio is an efficiency ratio that measures a company’s return on their
investment in property, plant, and equipment by comparing net sales with fixed assets. In other
words, it calculates how efficiently a company is a producing sale with its machines and
equipment. Generally, a high fixed assets turnover ratio indicates better utilization of fixed assets
and a low ratio means inefficient or under-utilization of fixed assets. The usefulness of this ratio
can be increased by comparing it with the ratio of other companies, industry standards and past
years
Formula
𝑅𝑒𝑣𝑒𝑛𝑢𝑒
𝐹𝑖𝑥𝑒𝑑 𝐴𝑠𝑠𝑒𝑡 𝑇𝑢𝑟𝑛𝑜𝑣𝑒𝑟 𝑅𝑎𝑡𝑖𝑜 =
𝑃𝑟𝑜𝑝𝑒𝑟𝑡𝑦, 𝑃𝑙𝑎𝑛𝑡 𝑎𝑛𝑑 𝑒𝑞𝑢𝑖𝑝𝑚𝑒𝑛𝑡
485449003
𝐹𝑖𝑥𝑒𝑑 𝐴𝑠𝑠𝑒𝑡 𝑇𝑢𝑟𝑛𝑜𝑣𝑒𝑟 𝑅𝑎𝑡𝑖𝑜 = = 6.246%
7771715254
The amount in the numerator is the Revenue for Shaukat Khanam Hospital as of December 31st,
2017, as reported in the financial press or over the internet. In the denominator, Fixed Assets are
mentioned. By simply dividing, the equation gives us the Fixed Assets Turnover Ratio.
Commentary
A high turnover indicates that assets are being utilized efficiently and large amount of sales are
generated using a small amount of assets. It could also mean that the company has sold off its
equipment and started to outsource its operations. Outsourcing would maintain the same amount
of sales and decrease the investment in equipment at the same time.
56
A low turnover, on the other hand, indicates that the company isn’t using its assets to their fullest
extent. This could be due to a variety of factors. For example, they might be producing products
that no one wants to buy. Also, they might have overestimated the demand for their product and
overinvested in machines to produce the products. It might also be low because of manufacturing
problems like a bottleneck in the value chain that held up production during the year and resulted
in fewer than anticipated sales.
Keep in mind that a high or low ratio doesn’t always have a direct correlation with performance.
There are a few outside factors that can also contribute to this measurement. Accelerated
depreciation is one of the main factors. If a company uses an accelerated depreciation method
like double declining depreciation, the book value of their equipment will be artificially low
making their performance look a lot better than it actually is. Similarly, if a company doesn’t
keep reinvesting in new equipment, this metric will continue to rise year over year because the
accumulated depreciation balance keeps increasing and reducing the denominator. Investors and
creditors have to be conscious of this fact when evaluating how well the company is actually
performing.
For Example, LinkedIn Corporation has most efficiently used its fixed assets. It generated $6.44
of revenue per $1 dollar of its net fixed assets over the year. Face book, Inc. on the other hand,
generated a fixed asset turnover ratio of 2.63, which means $2.63 of revenue per $1 of
investment in fixed assets. LinkedIn and Face book are competitors with almost the same age;
hence the comparison using fixed asset turnover ratio is very relevant. LinkedIn appears to be the
clear winner on this parameter. Comparison between Face book and Wal-Mart on fixed asset
turnover ratio might not be very useful because they belong to different industries and they have
different age. Wal-Mart's higher fixed asset turnover ratio might be due to old age (and hence
lower book value) of Wal-Mart's assets. Lower book value of fixed assets means smaller
denominator in the ratio and hence higher fixed asset turnover ratio. There might be difference in
capital intensity requirements of the industry.
Operating cash Flow/Sales Ratio

This ratio compares the operating cash flows a company to its sales revenue. This ratio gives the
analysts and investors indications about the ability of a company to generate cash from its sales.
In other words, it shows the ability of a company to turn its sales into cash. It is expressed as a
percentage.
Ideally there should be a parallel increase in operating cash flows with the increase in sales. It
will be worrisome if the changes in cash flows are not parallel to the changes in sales revenue. If
the cash flows do not increase with the increase in sales it may indicate the following two
factors:
 The change in terms of sales
 Inefficient or ineffective management of trade receivables
57
The higher this ratio is the better it is for the company. Greater amounts of operating cash flows
are always desirable. Although there is not any standard guideline for this ratio but a consistent
and/or increasing trend in this ratio is a positive indication of good debtor’s management.
Companies with such a trend in this ratio are good investment opportunities. Cash is very
important for all companies. Cash is needed for payments to suppliers, employees, shareholders,
and for operating expenses and investment in capital assets. Therefore, cash is just as important
as sales and profits. This ratio indicates the ability of a company to translate its sales into cash.
Formula
𝑂𝑝𝑒𝑟𝑎𝑡𝑖𝑛𝑔 𝐶𝑎𝑠ℎ 𝐹𝑙𝑜𝑤
𝑂𝑝𝑒𝑟𝑎𝑡𝑖𝑛𝑔 𝐶𝑎𝑠ℎ 𝐹𝑙𝑜𝑤 =
𝑁𝑒𝑡 𝑆𝑎𝑙𝑒𝑠 (𝑅𝑒𝑣𝑒𝑛𝑢𝑒)
The figure for operating cash flows can be found in the statement of cash flows. It is also
sometimes described as “cash flows from operating activities” in the statement of cash flows.
The figure for sales revenue can be found in the income statement.
804393148
𝑂𝑝𝑒𝑟𝑎𝑡𝑖𝑛𝑔 𝐶𝑎𝑠ℎ 𝐹𝑙𝑜𝑤 = = 1.657
485449003
The amount in the numerator is the Operating Cash Flow for Shaukat Khanam Hospital as of
December 31st, 2017, as reported in the financial press or over the internet. In the denominator,
Revenue is mentioned. By simply dividing, the equation gives us the Fixed Assets Turnover
Ratio.
Commentary
Cash flow adjusts the income figures to a cash basis. Cash flow from operations is cash flow
after adjusting for operating differences such as depreciation, but before adjusting for
investments (such as purchases of plants or equipment) or financing. This information is taken
directly from the cash-flow statement of the company's most-recent annual report. Example: A
media company posts net income of only $73 million. Its cash flow from operations, on the other
hand, is $1.4 billion. (The reason: Big depreciation and amortization charges weigh down net
income, but since they really aren't cash outlays, these changes have no effect on cash flow.) The
company is a much healthier company than its net income would lead you to believe.
Many investors focus on cash flow from operations instead of net income because there's less
room for management to manipulate, or accounting rules to distort, cash flow. If net income is
much larger than cash flow from operations, it's a signal that the company's earnings quality-the
usefulness of earnings-is questionable. If cash flow from operations exceeds net income, on the
58
other hand, the company may be much healthier than its net income suggests. That's why many
investors, when they try to value a stock, will use the price/cash-flow ratio the share price
divided by cash flow from operations per share-instead of the P/E ratio.
Cash Ratio
The cash ratio is an indicator of a company’s liquidity that further refines both the current ratio
and the quick ratio by measuring the amount of cash; cash equivalent or invested funds there are
in current assets to cover current liabilities.
Formula
𝐶𝑎𝑠ℎ + 𝐶𝑎𝑠ℎ 𝐸𝑞𝑢𝑖𝑣𝑎𝑙𝑒𝑛𝑡 + 𝐼𝑛𝑣𝑒𝑠𝑡𝑒𝑑 𝐹𝑢𝑛𝑑𝑠
𝐶𝑎𝑠ℎ 𝑅𝑎𝑡𝑖𝑜 =
𝐶𝑢𝑟𝑟𝑒𝑛𝑡 𝐿𝑖𝑎𝑏𝑖𝑙𝑖𝑡𝑖𝑒𝑠
1124652446
𝐶𝑎𝑠ℎ 𝑅𝑎𝑡𝑖𝑜 = = 1.018
1104461486
The amount in the numerator is the Cash + Cash Equivalent +Investment funds for Shaukat
Khanum Hospital as of December 31st, 2017, as reported in the financial press or over the
internet. In the denominator, Current Liabilities are mentioned. By simply dividing, the equation
gives us the Cash Ratio.
Commentary
The cash ratio shows how well a company can pay off its current liabilities with
only cash and cash equivalents. This ratio shows cash and equivalents as a percentage of current
liabilities. A ratio of 1 means that the company has the same amount of cash and equivalents as it
has current debt. In other words, in order to pay off its current debt, the company would have to
use all of its cash and equivalents. A ratio below 1 means that the company needs more than just
its cash reserves to pay off its current debt. As with most liquidity ratios, a higher cash coverage
ratio means that the company is more liquid and can more easily fund its debt. Creditors are
particularly interested in this ratio because they want to make sure their loans will be repaid. Any
ratio above 1 is considered to be a good liquidity measure. Therefore, creditors usually prefer
high cash ratio. But businesses usually do not plan to keep their cash and cash equivalent at level
with their current liabilities because they can use a portion of idle cash to generate profits. This
means that a normal value of cash ratio is somewhere below 1.00.
59
Current Ratio
The Current Ratio is a ratio used to test a company’s liquidity by deriving the proportion of
current assets available to cover current liabilities. The concept behind this ratio is to ascertain
whether a company’s short-term assets are readily available to pay off its short-term liabilities.
Formula
𝐶𝑢𝑟𝑟𝑒𝑛𝑡 𝐴𝑠𝑠𝑒𝑡𝑠
𝐶𝑢𝑟𝑟𝑒𝑛𝑡 𝑅𝑎𝑡𝑖𝑜 =
𝐶𝑢𝑟𝑟𝑒𝑛𝑡𝑠 𝐿𝑖𝑎𝑏𝑖𝑙𝑖𝑡𝑖𝑒𝑠
6016890744
𝐶𝑢𝑟𝑟𝑒𝑛𝑡 𝑅𝑎𝑡𝑖𝑜 = = 5.447
1104461486
The amount in the numerator is the Current Assets for Shaukat Khanam Hospital as of December
31st, 2017, as reported in the financial press or over the internet. In the denominator, Current
Liabilities are mentioned. By simply dividing, the equation gives us the Current Ratio.
Commentary
The current ratio is used extensively in financial reporting. However, while easy to understand,
it can be misleading in both a positive and negative sense - i.e., a high current ratio is not
necessarily good, and a low current ratio is not necessarily bad. Here's why: Contrary to popular
perception, the ubiquitous current ratio, as an indicator of liquidity, is flawed because it's
conceptually based on the liquidation of all of a company's current assets to meet all of its
current liabilities. In reality, this is not likely to occur. Investors have to look at a company as a
going concern. It's the time it takes to convert a company's working capital assets into cash to
pay its current obligations that is the key to its liquidity.
In a word, the current ratio can be "misleading. “A simplistic, but accurate, comparison of two
companies' current position will illustrate the weakness of relying on the current ratio or a
working capital number (current assets minus current liabilities) as a sole indicator of liquidity.
When looking at the current ratio, it is important that a company's current assets can cover its
current liabilities; however, investors should be aware that this is not the whole story on
company liquidity. Try to understand the types of current assets the company has and how
quickly these can be converted into cash to meet current liabilities.
The following table shows current ratios for both companies for all three years:
60
Companies 2014 2013 2012
Coca Cola 1.02 1.13 1.09
PepsiCo 1.14 1.24 1.10
We see that PepsiCo. Has higher current ratio than Coca Cola in each of the three years which
means that PepsiCo is in a better position to meet short-term liabilities with short-term assets.
However, current ratios for Coca Cola too have stayed above 1 in all periods, which is not bad.
Both companies experienced improvement in liquidity moving from 2012 to 2013, however this
trend reversed in 2014.
DEBT RATIOS
Debt ratios can be used to determine the overall level of financial risk a company and its
shareholders face. In general, the greater the amount of debt held by a company the greater the
financial risk of bankruptcy.
Formula
𝑇𝑜𝑡𝑎𝑙 𝐿𝑖𝑎𝑏𝑖𝑙𝑖𝑡𝑖𝑒𝑠
𝐷𝑒𝑏𝑡 𝑅𝑎𝑡𝑖𝑜 =
𝑇𝑜𝑡𝑎𝑙 𝐴𝑠𝑠𝑒𝑡𝑠
1348814080
𝐷𝑒𝑏𝑡 𝑅𝑎𝑡𝑖𝑜 = = 9.366%
14400034813
The amount in the numerator is the Total Liabilities for Shaukat Khanam Hospital as of
December 31st, 2017, as reported in the financial press or over the internet. In the denominator,
Total Assets are mentioned. By simply dividing, the equation gives us the Debt Ratio.
Commentary
The debt-to-equity ratio is a measure of the relationship between the capital contributed by
creditors and the capital contributed by shareholders. It also shows the extent to which
shareholders' equity can fulfill a company's obligations to creditors in the event of Liquidation.
In general, a high debt-to-equity ratio indicates that a company may not be able to generate
enough cash to satisfy its debt obligations. However, low debt-to-equity ratios may also indicate
that a company is not taking advantage of the increased profits that financial leverage may bring.
61
Capital-intensive industries tend to have higher debt-to-equity ratios than low-capital industries
because capital-intensive industries must purchase more property, plants and equipment to
operate. This is why comparison of debt-to-equity ratios is generally most meaningful among
companies within the same industry, and the definition of a "high" or "low" ratio should be made
within this context. Lenders and investors usually prefer low debt-to-equity ratios because their
interests are better protected in the event of a business decline. Thus, firms with high debt-to-
equity ratios may not be able to attract additional capital.
Quick Ratio
The quick ratio or the quick test ratio is a liquidity indicator that further refines the current ratio
by measuring the amount of the most liquid current assets there are to cover current liabilities.
The quick ratio is more conservative than the current ratio because it excludes inventory and
other current assets, which are more difficult to turn into cash. Therefore, a higher ratio means a
more liquid current position.
Formula
𝐶𝑎𝑠ℎ&𝐸𝑞𝑢𝑖𝑣𝑎𝑙𝑒𝑛𝑡 + 𝑆ℎ𝑜𝑟𝑡 − 𝑇𝑒𝑟𝑚 𝐼𝑛𝑣𝑒𝑠𝑡𝑚𝑒𝑛𝑡𝑠 + 𝐴𝑐𝑐𝑜𝑢𝑛𝑡𝑠 𝑅𝑒𝑐𝑖𝑒𝑣𝑎𝑏𝑙𝑒

𝑄𝑢𝑖𝑐𝑘 𝑅𝑎𝑡𝑖𝑜 =
𝐶𝑢𝑟𝑟𝑒𝑛𝑡 𝐿𝑖𝑎𝑏𝑖𝑙𝑖𝑡𝑖𝑒𝑠
1124652446
𝑄𝑢𝑖𝑐𝑘 𝑅𝑎𝑡𝑖𝑜 = = 1.018
1104461486
The amount in the numerator is the Current Assets for Shaukat Khanam Hospital as of December
31st, 2017, as reported in the financial press or over the internet. In the denominator, Current
Liabilities are mentioned. By simply dividing, the equation gives us the Quick Ratio.
Commentary
The quick ratio is a more conservative measure of liquidity than the current ratio as it
removes inventory from the current assets used in the ratio's formula. By excluding inventory,
the quick ratio focuses on the more-liquid assets of a company.
The basics and use of this ratio are similar to the current ratio in that it gives users an idea of the
ability of a company to meet its short-term liabilities with its short-term assets. If the current
ratio is significantly higher, it is a clear indication that the company's current assets are
dependent.
62
Chapter 10
SWOT ANALYSIS
63
A successful business is founded on a series of sound decisions, so the way you analyze
situations and choose to react is essential. When trying to assess the lay of the land, few tools are
more useful than the SWOT analysis. It stands for strengths, weaknesses, opportunities, and
threats; the SWOT analysis is a planning process that allows your company to overcome
challenges and determine what new leads to pursue.
The primary objective of a SWOT analysis is to help organizations develop a full awareness of
all the factors involved in a decision. This method was created in the 1960s by Edmund P.
Learned, C. Roland Christensen, Kenneth Andrews and William D. Book in their book "Business
Policy, Text and Cases" (R.D. Irwin, 1969).
"It is impossible to accurately map out a small business's future without first evaluating it from
all angles, which includes an exhaustive look at all internal and external resources and threats,"
said Bonnie Taylor, chief marketing strategist at CCS Innovations. "A SWOT accomplishes this
in four straightforward steps that even rookie business owners can understand and embrace."
When should you use SWOT?
You could employ SWOT before you commit to any sort of company action, whether you're
exploring new initiatives, revamping internal policies, considering opportunities to pivot, or
altering a plan midway through its execution. Sometimes it's wise to perform a general SWOT
analysis just to check on the current landscape in which your business finds itself. Performing a
SWOT analysis is also a great way to improve business operations, said Andrew Schrage, partner
and editor-in-chief of Money Crashers.
"It allowed me to identify the key areas where my organization was performing at a high level,
as well as areas that needed work," said Schrage, who expanded on his thoughts about business
decision making in a blog post. "Some small business owners make the mistake of thinking
about these sorts of things informally, but by taking the time to put together a formalized SWOT
analysis, you can come up with ways to better capitalize on your company's strengths and
improve or eliminate weaknesses."
While the business owner should certainly be involved in creating a SWOT analysis, it could be
much more helpful to include other team members in the process. Shawn Walsh, founder and
CEO of Paradigm Computer Consulting, said his management team conducts a quarterly SWOT
analysis together.
"The collective knowledge removes blind spots that, if left undiscovered, could be detrimental to
our business or our relationship with our clients," Walsh said.
64
The elements of a SWOT analysis
A SWOT analysis focuses on the four elements comprising the acronym, allowing companies to
identify the forces influencing a strategy, action or initiative. Knowing these positive and
negative elements can help companies more effectively communicate what parts of a plan need
to be recognized.
When drafting a SWOT analysis, individuals typically create a table split into four columns to
list each impacting element side-by-side for comparison. Strengths and weaknesses won't
typically match listed opportunities and threats, though they should correlate somewhat since
they're tied together in some way. Billy Bauer, managing director of Royce Leather, noted that
pairing external threats with internal weaknesses can highlight the most serious issues faced by a
company.
"Once you've identified your risks, you can then decide whether it is most appropriate to
eliminate the internal weakness by assigning company resources to fix the problems, or reduce
the external threat by abandoning the threatened area of business and meeting it after
strengthening your business," Bauer said.
Internal factors
The first two letters in the acronym, S (strengths) and W (weaknesses), refer to internal factors,
which means the resources and experience readily available to you. Examples of areas typically
considered include:
 Financial resources (funding, sources of income, investment opportunities)
 Physical resources (location, facilities, equipment)
 Human resources (employees, volunteers, target audiences)
 Access to natural resources, trademarks, patents and copyrights
 Current processes (employee programs, department hierarchies, software systems)
External factors
External forces influence and affect every company, organization and individual. Whether these
factors are connected directly or indirectly to an opportunity or threat, it is important to take note
of and document each one. External factors typically reference things you or your company do
not control, such as:
65
 Market trends (new products and technology, shifts in audience needs)
 Economic trends (local, national and international financial trends)
 Funding (donations, legislature and other sources)
 Demographics
 Relationships with suppliers and partners
 Political, environmental and economic regulations
Once you fill out your SWOT analysis you will need to come up with some recommendations
and strategies based on the results. Linda Pophal, owner and CEO of Strategic Communications
consulting firm, said these strategies should be focused on leveraging strengths and opportunities
to overcome weaknesses and threats.
Benefits and limitations of SWOT analysis
A SWOT (strengths, weaknesses, opportunities and threats) analysis can help you identify and
understand key issues affecting your business, but it does not necessarily offer solutions. You
should be aware of the limitations as well as the benefits of a SWOT analysis before you decide
to conduct one. Knowing what you can reasonably expect to achieve will make the SWOT
analysis more useful for your business, and will save you time. Ultimately, you must be prepared
to spend the time to review your SWOT analysis and use it to determine the best way forward in
your business.
Benefits of SWOT analysis
The main advantages of conducting a SWOT analysis is that it has little or no cost - anyone who
understands your business can perform a SWOT analysis. You can also use a SWOT analysis
when you don't have much time to address a complex situation. This means that you can take
steps towards improving your business without the expense of an external consultant or business
adviser.
Another advantage of a SWOT analysis is that it concentrates on the most important factors
affecting your business. Using a SWOT, you can:
 Understand your business better

 Address weaknesses
 Deter threats
 Capitalize on opportunities
 Take advantage of your strengths
 Develop business goals and strategies for achieving them.
66
Limitations of SWOT analysis
When you are conducting a SWOT analysis, you should keep in mind that it is only one stage of
the business planning process. For complex issues, you will usually need to conduct more in-
depth research and analysis to make decisions.
Keep in mind that a SWOT analysis only covers issues that can definitely be considered a
strength, weakness, opportunity or threat. Because of this, it's difficult to address uncertain or
two-sided factors, such as factors that could either be a strength or a weakness or both, with a
SWOT analysis (e.g. you might have a prominent location, but the lease may be expensive).
A SWOT analysis may be limited because it:

 Doesn't priorities issues
 Doesn't provide solutions or offer alternative decisions
 Can generate too many ideas but not help you choose which one is best
 Can produce a lot of information, but not all of it is useful.
Strengths
 Quality in their treatment: Shaukat Khanum’s one of the major strengths lies in its
quality of treatment given to its patients. The hospital unlike many of the government
hospitals pays close attention to its patients. Special care is taken for the patients
admitted. The hospital works on by adopting modern techniques and also equipment’s
which facilitates in the patient’s treatment.
 Lesser contradiction in their real and stated culture: Another factor which has long
contributed to the success of the hospital is the hospitals lesser contradiction in their
real and stated culture. The hospital is well known for free treatment of patients who
are unable to afford the expense of their treatment. And this is what actually happens.
 Enjoy a good reputation: Shaukat Khanum is one of those hospitals who enjoy a good
reputation not just within Pakistan but also internationally. It is big key factor in its
success especially in today’s time when hospitals are finished on the basis of non-
compliance with the stated rules or poor treatment. Its good reputation makes people
go this particular hospital when there are many hospitals operating in Lahore. And not
only from Lahore but people from different cities of Punjab come for their treatment
because of their good reputation and healthy environment.
 Transparent business processes: During my six weeks internship at the hospital I
found their business processes transparent and clear. There was no ambiguity in my
mind regarding their business process. One thing which I as an intern liked about the
67
hospital was that they don’t keep secrets around when you are working with them
which makes one’s mind clear as to procedures and methods are adopted by the
hospital.
 Even when it comes to hiring the process is transparent and merit based. An
individual who qualifies for the job is selected on the basis of merit and not on the
basis of reference given by anyone.
Weakness
 Time consuming process for patients who need financial support for treatment
 Capacity limitation of building
 Heavy reliance on charity-based fundraising.
 Heavy reliance on Imran Khan (many believe that the organization cannot function without
him).
 The research facility has been recently developed and so lacks expertise.
 195 beds are not too large a capacity.
 A small international footprint.
The Project is mainly based on the following topics:

 Overview of the Marketing department's structure
 Key Marketing Strategies
 Advertising Campaigns
 Impact of Imran Khan's Political activity on fund raising and how the department copes with
it
Opportunities
 To open new branches in other cities: Due to its good reputation the hospital is in a
position to cater patients who live in other cities. This would open doors foe
expansion and this is indeed what the hospital has planned to do. Shortly they would
be working upon opening up a new branch in Peshawar thus facilitating people who
either live in that region or even nearby.
 To begin a new business related to medicine: The hospital still has a pharmacy
department within its premises but it would be a good opportunity for the hospital to
offer its pharmacy services outside the boundaries of the hospital. They can open up a
medical shop at a good location in the city within the reach of an ordinary man to
facilitate them more.
68
Threats
 Donor insufficiency: Although the hospital preserves blood in its blood bank for
treatment of its patients but at times insufficiency of blood creates problems. The
hospital does organize a blood campaign which receives a very good response but
still they need more blood preserves for the treatment of their in-house patients.
 Entrance of new competitor: There are many private hospitals operating in Pakistan.
Amongst them is Shaukat Khanum which specializes in cancer treatment and this is
where it gets an edge over other hospitals. Regardless of the fact of being the major
cancer treatment specialist the hospital cannot ignore the entrance of a new
competitor. Any new competitor being in the same field can be a good competitor.
69
Chapter 11
Pestle Analysis
A PESTEL analysis or PEST analysis (formerly known as PEST analysis) is a framework or tool
used to analyze and monitor the macro-environmental factors that may have a profound impact
on an organization’s performance. This tool is especially useful when starting a new business or
entering a foreign market. It is often used in collaboration with other analytical business tools
such as the SWOT analysis and Porter’s Five Forces to give a clear understanding of a situation
and related internal and external factors. PESTEL is an acronym that stand for Political,
Economic, Social, Technological, Environmental and Legal factors. However, throughout the
years people have expanded the framework with factors such as Demographics, Intercultural,
Ethical and Ecological resulting in variants such as STEEPLED, DESTEP and SLEPIT. In this
article, we will stick simply to PESTEL since it encompasses the most relevant factors in general
business. Each factor will be elaborated on below:
Political Factors
These factors are all about how and to what degree a government intervenes in the economy or a
certain industry. Basically, all the influences that a government has on your business could be
classified here. This can include government policy, political stability or instability, corruption,
foreign trade policy, tax policy, labor law, environmental law and trade restrictions. Furthermore,
the government may have a profound impact on a nation’s education system, infrastructure and
health regulations. These are all factors that need to be taken into account when assessing the
attractiveness of a potential market.
Economic Factors
Economic factors are determinants of a certain economy’s performance. Factors include

economic growth, exchange rates, inflation rates, interest rates, disposable income of consumers
and unemployment rates. These factors may have a direct or indirect long-term impact on a
company, since it affects the purchasing power of consumers and could possibly change
demand/supply models in the economy. Consequently, it also affects the way companies price
their products and services.
70
Social Factors
This dimension of the general environment represents the demographic characteristics, norms,
customs and values of the population within which the organization operates. This includes
population trends such as the population growth rate, age distribution, income distribution, career
attitudes, safety emphasis, health consciousness, lifestyle attitudes and cultural barriers. These
factors are especially important for marketers when targeting certain customers. In addition, it
also says something about the local workforce and its willingness to work under certain
conditions.
Technological Factors
These factors pertain to innovations in technology that may affect the operations of the industry
and the market favorably or unfavorably. This refers to technology incentives, the level of
innovation, automation, research and development (R&D) activity, technological change and the
amount of technological awareness that a market possesses. These factors may influence
decisions to enter or not enter certain industries, to launch or not launch certain products or to
outsource production activities abroad. By knowing what is going on technology-wise, you may
be able to prevent your company from spending a lot of money on developing a technology that
would become obsolete very soon due to disruptive technological changes elsewhere.
Environmental Factors
Environmental factors have come to the forefront only relatively recently. They have become
important due to the increasing scarcity of raw materials, pollution targets and carbon footprint
targets set by governments. These factors include ecological and environmental aspects such as
weather, climate, environmental offsets and climate change which may especially affect
industries such as tourism, farming, agriculture and insurance. Furthermore, growing awareness
of the potential impacts of climate change is affecting how companies operate and the products
they offer. This has led to many companies getting more and more involved in practices such as
corporate social responsibility (CSR) and sustainability.
71
Legal Factors
Although these factors may have some overlap with the political factors, they include more
specific laws such as discrimination laws, antitrust laws, employment laws, consumer protection
laws, copyright and patent laws, and health and safety laws. It is clear that companies need to
know what is and what is not legal in order to trade successfully and ethically. If an organization
trades globally this becomes especially tricky since each country has its own set of rules and
regulations. In addition, you want to be aware of any potential changes in legislation and the
impact it may have on your business in the future. Recommended is to have a legal advisor or
attorney to help you with these kinds of things.
PESTEL Analysis in Sum
This article covers only some examples of general external factors that companies may want to
take into account. There are probably many more factors that could influence a certain business.
Besides it really varies from industry to industry and from nation to nation how important certain
factors are. The software industry might for example have less to do with environmental and
ecological factors than the oil or automotive industry. A lot of data on the aforementioned factors
can be found on websites such as tradingeconomics.com, theglobaleconomy.com, data.oecd.org
and data.worldbank.org.
Full list of PESTEL factors:

 Defense expenditures
 Level of government subsidies
Political factors
 Government stability/instability
 Corruption level
 Tax policies  Bilateral relationships
 Freedom of press  Import-export regulation/restrictions•
 Government regulation and deregulation  Trade control
 Special tariffs  Lobbying activities
 Political action committees
 Government involvement in trade unions
and agreements
 Competition regulation
 Voter participation rates
 Amount of government protests
72
Economic factors
 Growth rate
 Interest rate
 Inflation rate
 Exchange rate
 Availability of credit
 Level of disposable income
 Propensity of people to spend
 Federal government budget deficits
 Gross domestic product trend
 Unemployment trend
 Stock market trends
 Price fluctuations
Social factors  Minorities

 Crime levels
 Population size and growth rate  Attitudes towards saving
 Birth rates  Attitude towards investing
 Death rates  Attitudes towards retirement
 Number of marriages  Attitudes towards leisure time
 Number of divorces  Attitudes towards product quality
 Immigration and emigration rates  Attitudes towards customer service
 Life expectancy rates  Attitudes towards foreign people
 Age distribution
 Wealth distribution
 Social classes
 Per capita income
 Family size and structure
 Lifestyles
 Health consciousness
 Average disposable income
 Attitude towards government
 Attitude towards work
 Buying habits
 Ethical concerns
 Cultural norms and values
 Sex roles and distribution
 Religion and beliefs
 Racial equality
 Use of birth control
73
Technological factors
 Technology incentives
 Automation
 R&D activity
 Technological change
 Access to new technology
 Level of innovation
 Technological awareness
 Internet infrastructure
 Communication infrastructure
 Life cycle of technology
Environmental factors
 Weather
 Climate
 Environmental policies
 Climate change
 Pressures from NGO’s
 Natural disasters
 Air and water pollution
 Recycling standards
 Attitudes towards green products
 Support for renewable energy
Legal factors
 Discrimination laws
 Antitrust laws
 Employment laws
 Consumer protection laws
 Copyright and patent laws
 Health and safety laws
 Education laws
 Consumer protection laws
 Data protection laws
74
75
Pestle Analysis for Shaukat Khanum Hospital
1. Political Factors
Changing tax legislation, consumer protection and employment regulations, and insurance
mandates are all elements in the political sphere that could have an impact on healthcare. For
example, a change in tax policies may call for a strategy adjustment that either takes advantage
of increased government spending for healthcare or makes allowances for reduced government
subsidies. Or, changes in employment law, legislation that impacted employee overtime
requirements, could mean major adjustments in staffing and overtime needs.
2. Economic Factors
Unemployment, inflation, and interest rates are examples of economic issues that both directly
and indirectly influence the financial performance of healthcare organizations. These changing
conditions can have an impact on public spending policies and your purchasing power. For
example, if you manufacture healthcare equipment, a high rate of unemployment will mean
fewer people are able to purchase your products. Or, more people losing jobs means a greater
loss of health insurance coverage, which will affect the types of health services people seek out.
In High unemployment people without good jobs won’t be able to pay the entire cost of any
hospital or emergency room visit. They’re less likely to seek help when they become ill. The
public will have a limited selected of health services they can actually afford.
3. Sociocultural Factors
A PEST analysis should also identify changes in demographics, values, and beliefs of your
various consumer groups. A hospital, for example, should be knowledgeable about the
community it serves to avoid violating widespread values or norms. Factors like these should
also play into your organization’s marketing strategy. Using content that shows you’re aligned
with a specific sociocultural set of beliefs/values will boost the effectiveness of your marketing
and impact your performance.
Certain communities can share fears, beliefs, and cultural norms. If a healthcare professional or
hospital isn’t aware of these conditions while they treat that public, it can cause problems.
Additionally, medical professionals need to stay on their toes about new trends.
For example, the use of essential oils as a cure for various illnesses including cases of flu, fevers,
and even incurable conditions like autism, are on the rise. Understanding why people are turning
76
to these natural remedies can help healthcare professionals talk and discuss concerns or treatment
with these users.
Another example is the new trend of eating detergent pods. Understanding why kids are turning
to such dangerous activities can help prepare clinics if they children need assistance at their
location.
People are also becoming more health conscious. Some business across the country must now
post the calorie amount of each item on their menu, giving people the option to choose what to
eat based on these numbers.
The public, in general, is turning towards specific health diets including paleo and keto. Or
they’re making changes, like eating less f artificial sugars and processed chemicals. This is in
response to the growing threat of obesity in adults and children. Hospitals and health
professionals can benefit from following these shifting and progressive trends.
4. Technological Factors
Technological advancements specific to hospitals and healthcare manufacturers could have a

varying range of effects on your overall performance. The equipment being manufactured and
used is continually changing, as is the development of new treatments. And new technology
outside the healthcare field could also affect how an organization communicates with their
consumers, as in app development or digital marketing. Planning ahead to take advantage of
those advancements could mean good opportunities for growth.
We’re seeing changes in app developments, allowing patients to get care faster than ever before.
More businesses are using apps to connect doctors with patients right in their homes. And the
ability to ask questions about illnesses now include email and live-chat on websites. We’re
heading towards a positive direction for patient care thanks to our ever-evolving technology.
5. Environmental Factors
Environmental sustainability practices have both environmental and financial benefits for
healthcare organizations. Many hospitals are now seeking LEED certification for
environmentally-friendly building design; waste disposal programs are also coming under
scrutiny. Leadership in the areas of green environment practices also illustrates corporate social
responsibility (CSR)—which should be a key part of any strategic plan.
77
6. Legal Factors
Failure to follow new laws and legal procedures that govern healthcare could lead to immediate
failure of your strategy. The legal implications of pending lawsuits, HIPAA compliance,
potential hospital mergers and more should all be taken into consideration as part of your overall
strategy.
Following the set policies and laws also offer an opportunity for selling consultancy. Lastly, the
environmental factors have also impacted the health care industry. Many governments have
adopted the “Green” information technology whereby political imperatives can be achieved
electronically.
For medical industry to be successful in the modern age, adhering to the widely acknowledged
criteria for cutting cost is effective. Government should stop making unnecessary drug imports
and agents. Increasing budgetary allocations for public health centers is a great strategy. With
enough funds, it can be easier to train medical experts and help expand medical tourism industry
for more revenues. Thus, it is upon the government and medical institutions to analyze factors
that impact the industry for economy growth and good wellbeing of the being without any future
regrets.
78
Chapter 12
Internship Plan
A brief introduction of the branch where I did my internship:
Main Head Office
Lahore, Pakistan
Shaukat Khanum Memorial Cancer Hospital and Research Centre
7-A, Block R-3, Johar Town, Lahore
Tel: +92 42 35945100
Fax: +92 42 35945208
UAN: 111-155-555
Departments of this main Head Office
There are total 42 departments in this main head office that are shown in organizational
hierarchy chart.
79
Introduction
Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) is a state-of-
the-art cancer center located in Lahore, Pakistan. It is a project of the Shaukat Khanum Memorial
Trust, which is a charitable organization established under the Societies Registration Act XXI of
1860 of Pakistan.
Start and ending dates of my internship
• Start Date: July 03 , 2017

• End Date: August 21, 2017
Name of the department in which I got training and the duration of my training
I got training only in HR department of the hospital and the duration of my training was 6 weeks.
Training program
Detailed description of the activities of department I worked in:
Human resource department
An Individual person who make the workforce of the organization. HR is responsible for making
and implementing policies within the hospital premises. HR is responsible for the well-being of
the employees. HR department is responsible for organizing and reporting relationships. HR
department is also responsible for employee trainings on week areas.
Functions of HR department
 Staffing (Recruiting, Selection)
 Employee compensations and benefits
 Employee Training and Development
 Medical Training
80
 Human Resource Development
 Employee Relations
Beside all these functions there are some other sub-functions of HR that are:
 Payroll process
 Leave records
 Medical leave record
 Final settlements
 Recruitment management
 Interviewing + Selection
 Incentives + allowances
 Policy and procedures management
 Internship programs
 Summer volunteer programs
 Employee record management
 Performance management
 Orientations
 LFA management
 Contract management
 Employee cards management
 Employee certificate management
Detailed description of tasks assigned to me
• Filing of employee’s record
I filed the employee files in HR department. Filing system in HR department is different. On

Files of employees I pasted a paper on which different sections are written like employee
recruitment, selection, certificates, post-employment section and different other sections and
same as all these sections in a employee file are separated by a separator. Papers related to
different sections are placed on their related section in an employee file.
• Assisted in Final settlement

When employee has last day of job, his/her final settlement is arranged and sent to the finance
department. I moved employee resignation for clearance by all concerned departments. A
clearance paper is moved from the original department signed by HOD and moved to telephone
exchange for bill payments, finance department for final check, MIS for account closing of
81
employee in HIS, HR department for employee experience certificate and final settlement. After
signing from all the departments, I forwarded employee’s personal file with clearance paper and
employee resignation acceptance to the finance department for final check.
• Handed over experience letters

I handed over the experience letters to internees, volunteers and employees. Experience letters
are of different types such as job experience letter, internship letter, and volunteer ship letter.
Experience letters are formed and issued on two reasons when employee demand and when
employee has last day of his/her job in SKM. I handed over the letter to employees, internees and
volunteers and took the receiving of those letters. I maintained that receiving in record file.
• Made the employee’s cards

Mostly I made the employee cards. Employee card is the unique card issued on the basis of
Employee code. Employee code is a unique code assigned to employee after his/her joining in
SKM. This employee card contains a bar code that is read by the machine for attendance of
employee. I also issued employee cards to employees who lost their cards. In case of card lost
the employee has to fill the Employee Lost Card form that is also sent to the finance department.
Finance department deduct the charges of card lost, from the salary of employee. Third reason on
which I issued employee card is, the damaged card of employee that was already issued. In this
case no charges are deducted and new card is issue to the employee.
• Made the volunteer’s records
SKM starts Summer Volunteer Program in summer vacations for the students of schools and
universities for 15 days each student. I issued volunteer cards to volunteers, as whenever a
volunteer joins the hospital volunteer card is issued to him/her for identification. The card
contains complete identification like, his/her department, complete name, start date, end date and
session (morning, evening). Volunteers have to take this card with them while moving within the
hospital premises. One advantage that SKM is paying to volunteers is they get discount in lunch
of Rs.20 from their total amount of lunch.
• I did time adjustments of employees in HIS

Time adjustment is a form used by all the departments in SKM and that is used whenever the
time adjustment is needed. Mostly nursing staff and security staff adjustments are made in HR. I
made these adjustments on two reasons. First, when employees forget their card at home they
cannot swipe their cards so send time adjustment that is done through HIS. Second, I made time
adjustments whenever some problem occurred in hospital HIS system because in this case
machine does not keep record of the card swipe.
82
• Maintained the record room
I maintained employee files in record room. Record room or File room is the separate room that
is within the boundary of HR department. Each file of employee contains a complete record from
recruitment to employee development. There are many cabinets in that room. Each cabinet
contains files of some department. I arranged the files according to the employee code in order.
At the end of my internship all the files were in a complete order. Whenever file of employee
was needed I used to go in file room to the concerned department cabinet and took the file. After
using I used to keep it back to its position.
• Filing of documents
There were different papers that were the part of employee file like, interview evaluation papers,
salary fixation paper, joining report, employee spouse information, Nikkah Nama, training
records, re-fixation of salary and record of children births. I arranged all these papers according
to the sections in which they fall. These sections are already categorized in order.
83
Conclusion
Shaukat Khanum is fully committed, motivated and aimed to do exactly what is mentioned in its
mission statement. It has ability to face the challenges of present dynamic world. Skilled and
highly talented staff is keen to provide best services to the patients in most efficient and effective
way.
Hospital management is fully aware of present health related issues and has taken necessary
steps to satisfy all of its patients. The hospital aims to build long term relationships with people,
thus making profitable relationship with them. Shaukat Khanum pays full concern towards its
employees and it rewards and motivates them by awarding different incentives.
Overall SKM is providing quality and cost-free treatment with highly equipped machinery to the
patients who are not in a position to bear the expenses. Donors from all over the world are
donating for a Nobel cause of humanity. It can bring more efficiency in its routine tasks by
minimizing the mess. As patients are increasing day by day so it needs a capacity to entertain
them. Employee productivity can be increased by increasing benefits for employees.
My experience at Shaukat Khanum has helped me grow as a person. The knowledge and value I
learned over here will be with me for rest of my life and in the end, I would like to say bundle of
thanks to Shaukat Khanum as a whole that they gave me an admiration so that I can learn from
them.
84
Recommendations
 The authority should recruit more employees to serve the customers.

 They should welcome a person whenever she/he comes for internship even if they don’t
belong to the department.
 An internship officer should be at place who should check that whether the intern is being
given with fruitful activities to perform or is sitting idle.
 Conflict behaviors between medical staffs and patients or their relatives should be avoided in
emergency room or outpatient department.
 In addition to avoidance of individual heroism, department supervisors should work with
great enthusiasm and care for colleagues. Moreover, opportunities to receive education and to
grow up should be provided to create an environment for encouraging colleagues to make
progress and for performing their abilities and wisdoms.
 As more hospitals are appearing in the face of healthcare institutions donors’ insufficiency
can be decreased. SKM should empower its marketing resources so that they can easily
increase the donors and funds.
 As regards to patients’ requirements of both transferring treatment and transportation,
euphemistic explanations should be made to enable patients and their relatives to fully
understand standpoint of the hospital and necessity. In the case that patients require
hospitalization, medical staffs should explain in details based on patients’ conditions to allow
patients to achieve their purposes or to passably accept medical staffs’ suggestions, even with
a little dissatisfaction.
 Structured questionnaire and open-ended questionnaire can be employed at regular intervals
for sampling survey on patients’ and their relatives’ opinions as well as employee’s job
condition on various services of the hospital. Furthermore, hospitals should publicly respond
to these opinions to improve communication channels between the hospital and the common
people monthly.
 SKM arranges employee night show and concerts for the employee once a year usually at the
end of the year. SKM should keep continue such entertainments so that employee feel fresh
in their hectic routine.
85
National University of Modern Languages
Institute of Business & Finance
Faculty of Accounting of Finance
Lahore Campus
Evaluation Performa
Name of Intern:
His Internship started on (date) and was completed on
At
Please give a brief summary of internship.
Evaluation of Personal/Professional qualities of the intern observed during the internship.
Select one evaluation level of each area by making “X” under that level that represents the
intern’s performance.
Excellent Good Average Poor Does Not Apply
Ability to adapt to a variety of tasks
Decision- Making, Priorities
Judgment, Setting
Persistence to complete tasks
Reliability and dependability
Enthusiasm for the experience
Attention to accuracy & details
Willingness to ask for and use
guidance
Ability to cope in stressful situation
Ability to organize, classify and
deliver information effectively
Ability to plan with and work
co-operatively with others
Professionalism; Demonstrated
interest related to the field in the
issues, policies and organizations
Additional Comments:
Signature & Stamp of concerned Official & date of evaluation:
86

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Institute of Business & Finance

Department of Accounts & Finance

M.Com (Masters in commerce)

Session: from 2016 to 2018

National University of Modern Languages

Name: IFFAT YASHMEEN

Head of Accounting & Finance Department,

Brief introduction of the organization’s business sector

Brief History of Hospital

Nature of the Organization

December 29, 1994

Organizational Hierarchy Chart

In SKMCH & RC the division of employees working here is as:

Hence, total numbers of employees working are more than 1500.

Introduction of different Departments

Human Resource Department

Management Information System

Laboratory Collection Centres

Facilities & Services

Awards, Certifications & Affiliations

The Department of Pharmacy provides integrated, cost-effective pharmaceutical care to both

Professional nursing practice at SKMCH&RC is promoted through membership of the Pakistan

Financial Position over the years

Revenue (Rs. in Millions)

Hospital Other Total

2017 3,934 2,583 1,897 445 8,859

2016 3,739 2,342 1,960 312 8,354

2015 3,384 2,226 3,101 250 8,961

2014 2,924 1,863 1,311 210 6,308

2013 2,592 1,944 1,555 155 6,246

2012 2,202 1,669 1,156 165 5,192

2011 1,972 1,345 904 68 4,289

2010 1,554 807 608 44 3,013

2009 1,281 865 620 47 2,813

2008 1,125 646 460 37 2,268

2007 954 535 486 33 2,009

2006 750 438 273 34 1,495

2005 573 265 320 29 1,186

2004 424 397 368 33 1,222

2003- 374 287 238 14 913

2002- 261 244 178 15 698

2001- 234 152 174 17 577

2000- 211 131 190 15 547

1999- 139 117 152 17 425

1998- 113 100 129 11 353

1997- 90 99 103 11 303

1996- 62 117 105 7 291

1995- 35 109 87 18 249

Operating Expenses (Rs. in Millions)

Category Amount Percentage

Salaries and Benefits (Medical Staff) 1,694 20%

Salaries and Benefits (Admin Staff) 966 11%

Consultants Fee 760 9%

Medicines 942 11%

Pathology, Nursing & Other Supplies 1,835 22%

Fundraising Expenses 392 5%

Repairs and Maintenance 430 5%

Other Operating Expenses 264 3%

Total Operating Expenses 8,499 100%

Horizontal and Vertical Analysis

For Net Income:

Dollar change = 485449003-989388855

For Clinical Expenses: