CHAPTER-1

INTRODUCTION

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 1. INTRODUCTION

An internship is a period of work experience offered by an organisation for a limited period of

time. Inters are usually undergraduates or students. Internship study helps to understand the
working and policy making the activities of a company as whole. It provides the practical
knowledge about the functioning and co-ordination of the activities of HR departments in the
organization and develops practical knowledge about the working of the organization. It provides
both theoretical and practical knowledge regarding various aspects of management and
implication which would condition and gear the prospective managers to face the challenges lying
ahead.

In today’s employment climate, an  internship is often considered to be the major career entry
point for new graduates. Medical assistants who serve as interns can gain invaluable experience in
the administrative and general work responsibilities in cooperation with established professionals.
During the internship, you will be expected to perform certain administrative duties under the
direction and guidance of a supervisor. While the specific duties may vary from one internship
opportunity to the next, you can expect to do any or all of the following Manage communications,
Maintaining health records, Documenting information

This report is a short description of the internship program carried out at Sanjivani Multi-
Speciality Hospital, Kollakadavu. Sanjivani is an ISO 9001:008 certified Multi Speciality
Hospital having 15 departments 26 doctors. Strategically well located at Alacode, about 1 km
from Kollakadavu, with a quiet serene ambience to provide calmness to the restless and the sick.
Sanjivani gives utmost priority to the comfort and early recovery of the patients. The internship
last for 45days.It gives a general idea of the industry and helps to understand the organizational
structure, functions, duties, responsibilities of the various functional departments. More than a
plane account of the tasks assigned and the organizational study, This report reflects upon the
experiences collected during the internship from the perspective of an MBA student.

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(a) DUTIES AND RESPONSIBILITIES ASSIGNED

As an intern the task assigned is:

 Assisting in interview process.

 Calling candidates for interview.
 .Verifying resume of newly recruited employees.
 Designing advertisement for admission.
 Telly calling for admission.
 Counselling of students.
 Preparation of statistics of students.
(b) DURATION

The time allotted for doing internship from college is 45 days(started from 1.06.2019 to
15.08.2019)

(c) DEPARTMENT ALLOTED AND DETAILS OF REPORTING MANAGER

Human Resource and Marketing are the three departments allotted to the interns. Each
departmental activity is control by the departmental heads. Personnel Department has the
responsibility of internships. Before the allocation of the department, the intern was directly
reported to the Personnel officer of the company Mrs.Rejitha and she will allotted to the
Departments. Functions and activities regarding internship were assigned by the manager and if
any doubts arise, she will clarify it and gives feedback. All the interns were reported to manager

(d) BREIF DETAILING ABOUT THE WHOLE INTERNSHIPS

Summer internship in Sanjivani was a good experience for the academic life. The 45 days
internship helps to understand how a public ltd firm performs its functions .Dedication and
corporation of employees and management should necessary for the smooth function of an
organization.HR department has the responsibility of allotting interns to various departments.

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 1.1 OBJECTIVE OF THE STUDY

The main motive of this summer internship is to study the functions, role & responsibilities of HR
department and to know about the activities carrying out by this department. The study also helps
to identify the specific management problems and to come out with the possible solutions and
recommendations. The overall objectives of the study:

 To understand the role of HR in the organization with respect to the duties and
responsibilities.
 To understand the mission and vision.
 To work as an intern and to get familiarized in the overall departmental functions of the
organization.
 To understand the key activities and the overall performance of the institution. To study
about organization structure.
 To study the various policies and procedures adopted by the organization.
 To learn the practical application of theoretical knowledge to the actual working
environment.
 To know about the relationship between employees and the customers

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 1.2 INDUSTRY ANALYSIS

Healthcare Industry

The health care industry is tremendously important to people around the world. This industry
comprises of different players including hospitals, doctors, nursing homes, diagnostic
laboratories, pharmacies, medical device manufacturers, and other components of the health care
system. This article provides an overview of the healthcare industry.

What is Health Care?

Health care (or healthcare) is the diagnosis, treatment, and prevention of disease, illness, injury,
and other physical and mental impairments in humans. Health care is delivered by practitioners in
medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers. It
refers to the work done in providing primary care, secondary care and tertiary care, as well as in
public health.

What is Healthcare Industry?

The health care industry, or medical industry, is a sector that provides goods and services to treat
patients with curative, preventive, rehabilitative or palliative care. The healthcare industry is
composed of establishments devoted to prevention, diagnosis, treatment, and rehabilitation of
medical conditions. Such treatment may be through providing products or services, and may be
provided privately or publicly. The modern health care sector is divided into many sub-sectors,
and depends on interdisciplinary teams of trained professionals and paraprofessionals to meet
health needs of individuals and populations. The health care industry includes establishments
ranging from small-town private practices of physicians who employ only one medical assistant
to busy inner-city hospitals that provide thousands of diverse jobs. Healthcare industry is littered
with risks and challenges as it is an industry that requires constant innovation under increased
regulations.

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Importance of Healthcare Industry:

Aging populations and increasingly prevalent chronic diseases are the fundamental drivers
creating demand for expansion of lifestyle medical procedures and healthcare industry. There will
be huge demand for medical technology products for years to come.

The health care industry also plays an important role as being the largest employer in the global
economy, if we add up the number of people working in each sector across the world. In most
countries, the employment growth rate of the health industry is higher than that of other
industries. However the healthcare industry as it exists today is highly fragmented and divided
among many different companies and different players. No single firm/corporation has large
enough share/monopoly of the market to be able to influence the industry's direction or price
levels

Impact of Healthcare Industry on Economy:

The health care industry is tremendously important to people around the world as well as to the
national economies. It is one of the fastest growing industries in the world. Consuming over 10
percent of gross domestic product (GDP) of most developed nations, a correlation exists between
income levels and expenditure on health care in various countries. For example, some of the large
developing economies, such as Brazil, India, China, and Russia, spend less on health care than
more industrialized economies, such as the United States or France.

The health care industry also plays an important role as being the largest employer in the global
economy, if we add up the number of people working in each sector across the world. In most
countries, the employment growth rate of the health industry is higher than that of other
industries. However the healthcare industry as it exists today is highly fragmented and divided
among many different companies and different players. No single firm/corporation has large
enough share/monopoly of the market to be able to influence the industry's direction or price
levels.

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Classification of Healthcare Industry:

For purposes of finance and management, the health care industry is typically divided into several
areas. As a basic framework for defining the sector, the United Nations International Standard
Industrial Classification (ISIC) categorizes the health care industry as generally consisting of:

Hospital Activities

Medical and Dental Practice Activities

Other human health activities

This third class involves activities of, or under the supervision of, nurses, midwives,
physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health
facilities, or other allied health professions, e.g. in the field of optometry, hydrotherapy, medical
massage, yoga therapy, music.

Global scenario

With financial sustainability, care delivery, patient centricity, digital transformation, and
regulatory compliance at the top of the agenda, health care sector leaders need to collaborate with
all stakeholders—both within the health care ecosystem and those in converging industries—as
they look to shape the future of health care and establish a sustainable smart health community.

The adage, “What goes up, must come down,” isn’t likely to apply to the global health care sector
in 2019. Aging and growing populations, greater prevalence of chronic diseases, exponential
advances in innovative, but costly, digital technologies—these and other developments continue
to increase health care demand and expenditures. Health care stakeholders—providers,
governments, payers, consumers, and other companies/organizations—struggling to manage
clinical, operational, and financial challenges envision a future in which new business and care
delivery models, aided by digital technologies, may help to solve today’s problems and to build a
sustainable foundation for affordable, accessible, high-quality health care. This vision may have a
greater probability of becoming a reality if all stakeholders actively participate in shaping the

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future— by way of shifting focus away from a system of sick care in which we treat patients after
they fall ill, to one of health care which supports well-being, prevention, and early intervention.

Global health care sector issues in 2019

Creating financial sustainability in an uncertain health economy

Global health care expenditures are expected to continue to rise as spending is projected to
increase at an annual rate of 5.4 percent between 2017-2022, from USD $7.724 trillion to USD
$10.059 trillion. The emergence of personalized medicine, increased use of exponential
technologies, entry of disruptive and non-traditional competitors, the demand for expanded care
delivery sites, and revamped payment and public funding models are all impacting the financial
performance of the health care ecosystem. The health care market is looking to health technology
for help, along with mergers, acquisitions, and partnerships.

Using new care delivery models to improve access and affordability

Moving from volume to value will require building an outcomes-based financial model and data
infrastructure to maximize value-based care (VBC) reimbursement pathways, which will likely be
fundamental to many health systems’ sustainable growth. This shift is the most apparent in the
United States, where the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
provisions will see payment adjustments and incentive payments take effect in 2019. Clinical
innovations, patient preferences, and government program payment policies are prompting
hospitals to shift certain services to alternative points of care and even to virtual environments
that benefit from a cost and access perspective. It is also being seen that social determinants of
health often have a greater impact on health outcomes than does health care.

Adapting to changing consumer needs, demands, and expectations.

Patients and caregivers, dissatisfied with poor service and lack of transparency around price,
quality, and safety, are expecting health care solutions that are coordinated, convenient,
customized, and accessible. With health care becoming “shoppable” and increased costs for
patients in a cost sharing model, enhancing the patient experience is a potential area for dramatic
change. Non-traditional companies from consumer, retail, and technology sectors are also making

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forays into the health care value chain with solutions that are disrupting the norm. As preventative
health takes a greater role, “nudging’ is increasingly seen as an option to help with patient
adherence.

Investing in digital innovation and transformation

There is an exponential increase in the pace and scale with which digital health care innovations
are emerging. Digital technologies are supporting health systems’ efforts to transition to new
models of patient-centered care and helping them develop “smart health” approaches to increase
access and affordability, improve quality, and lower costs. From Blockchain, RPA, cloud,
artificial intelligence (AI), and robotics, to internet of medical things (IoMT), digital and virtual
reality are just some of the ways technology is disrupting health care. These technologies are
helping with diagnosis and treatment, helping with speed, quality and accuracy, and improving
the patient experience.

Maintaining regulatory compliance and cyber security

As data is becoming the new health care currency, protecting it will be key. Clinical innovations,
connected medical devices, and market complexity have amplified the continued need for
evolving government policies, regulatory oversight, and risk management. The rapid growth of
"consumptive” health services such as prescription drug pricing in the United States have recently
received a lot of regulatory attention. Cybersecurity is another top concern to the industry. It is the
huge volume of high-value data and growing demand for interconnected IT environments that
make health care an attractive target for cybercrime.

Recruiting, developing and retaining top talent.

An aging workforce, rising demand for health care services, moral and well-being concerns are
driving shortages of appropriately skilled health care staff in both developed and developing
economies. But, there are different dimensions shaping the future of work. While automation is
impacting a number of administrative processes, telehealth and digital medicine tools are enabling
a “care anywhere” model. Organizations are building and deploying new staffing models, such as
allowing nurses to work remotely, while still building strong patient relationships.

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Indian Scenario

Introduction

Healthcare has become one of India’s largest sectors - both in terms of revenue and employment.
Healthcare comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine,
medical tourism, health insurance and medical equipment. The Indian healthcare sector is
growing at a brisk pace due to its strengthening coverage, services and increasing expenditure by
public as well private players.

Indian healthcare delivery system is categorised into two major components - public and private.
The Government, i.e. public healthcare system comprises limited secondary and tertiary care
institutions in key cities and focuses on providing basic healthcare facilities in the form of
primary healthcare centres (PHCs) in rural areas. The private sector provides majority of
secondary, tertiary and quaternary care institutions with a major concentration in metros, tier I and
tier II cities.

India's competitive advantage lies in its large pool of well-trained medical professionals. India is
also cost competitive compared to its peers in Asia and Western countries. The cost of surgery in
India is about one-tenth of that in the US or Western Europe.

Market Size

The healthcare market can increase three fold to Rs 8.6 trillion (US$ 133.44 billion) by 2022.

India is experiencing 22-25 per cent growth in medical tourism and the industry is expected to
double its size from present (April 2017) US$ 3 billion to US$ 6 billion by 2018.

There is a significant scope for enhancing healthcare services considering that healthcare
spending as a percentage of Gross Domestic Product (GDP) is rising. The government’s
expenditure on the health sector has grown to 1.4 per cent in FY18E from 1.2 per cent in FY14.
The Government of India is planning to increase public health spending to 2.5 per cent of the
country's GDP by 2025.

Investment

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The hospital and diagnostic centers attracted Foreign Direct Investment (FDI) worth US$ 6 billion
between April 2000 and December 2018, according to data released by the Department of
Industrial Policy and Promotion (DIPP). Some of the recent investments in the Indian healthcare
industry are as follows:

Healthcare sector in India witnessed 23 deals worth US$ 679 million in H12018.

India and Cuba have signed a Memorandum of Understanding (MoU) to increase cooperation in
the areas of health and medicine, according to Ministry of Health and Family Welfare,
Government of India.

Fortis Healthcare has approved the de-merger of its hospital business with Manipal Hospital
Enterprises. TPG and Dr. Ranjan Pal could invest Rs. 3,900 crore (US$ 602.41 million) in
Manipal Hospital Enterprise.

Government Initiatives

Some of the major initiatives taken by the Government of India to promote Indian healthcare
industry are as follows:

On September 23, 2018, Government of India launched Pradhan Mantri Jan Arogya Yojana
(PMJAY), to provide health insurance worth Rs 500,000 (US$ 7,124.54) to over 100 million
families every year.

In August 2018, the Government of India has approved Ayushman Bharat-National Health
Protection Mission as a centrally Sponsored Scheme contributed by both center and state
government at a ratio of 60:40 for all States, 90:10 for hilly North Eastern States and 60:40 for
Union Territories with legislature. The center will contribute 100 per cent for Union Territories
without legislature.

The Government of India has launched Mission Indradhanush with the aim of improving
coverage of immunisation in the country. It aims to achieve atleast 90 per cent immunisation

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coverage by December 2018 which will cover unvaccinated and partially vaccinated children in
rural and urban areas of India.

Road Ahead

India is a land full of opportunities for players in the medical devices industry. India’s healthcare
industry is one of the fastest growing sectors and it is expected to reach $280 billion by 2020. The
country has also become one of the leading destinations for high-end diagnostic services with
tremendous capital investment for advanced diagnostic facilities, thus catering to a greater
proportion of population. Besides, Indian medical service consumers have become more
conscious towards their healthcare upkeep.

Indian healthcare sector is much diversified and is full of opportunities in every segment which
includes providers, payers and medical technology. With the increase in the competition,
businesses are looking to explore for the latest dynamics and trends which will have positive
impact on their business. The hospital industry in India is forecasted to increase to Rs 8.6 trillion
(US$ 132.84 billion) by FY22 from Rs 4 trillion (US$ 61.79 billion) in FY17 at a CAGR of 16-17
per cent.

India's competitive advantage also lies in the increased success rate of Indian companies in
getting Abbreviated New Drug Application (ANDA) approvals. India also offers vast
opportunities in R&D as well as medical tourism. To sum up, there are vast opportunities for
investment in healthcare infrastructure in both urban and rural India.

Exchange Rate Used: INR 1 = US$ 0.0139 as on Q3 FY19

Kerala Scenario

Kerala has emerged as the best state in the India in terms of healthcare performance. Kerala’s
health status is almost on a par with that of developed economies. The state has succeeded in
increasing life expectancy as well as reducing infant and maternal mortalities. The
implementation of land reforms improved the standard of living of the rural poor.

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The effective implementation of the public distribution of food played an important role in
improving nutritional status. Kerala’s publicly funded healthcare system has helped in providing
treatment facilities to people. The high literacy rate, especially among the females, also played a
major role in improving the health scenario. The Kerala Model of Health is often described as
“good health based on social justice and equity”.

Despite, better health outcomes on certain indicators, the much-proclaimed Kerala model of
health has been showing a number of disturbing trends. Although mortality is low, the morbidity
(those suffering from chronic/non-communicable diseases) levels in urban and rural Kerala is
high in Kerala compared to other Indian States. Thus the paradox is that on the one side Kerala
stands as the State with all indicators of better health care development in terms of IMR, MMR,
birth rate, death rate etc. On the other it outstrips all other Indian States in terms of morbidity
especially the chronic illness. Kerala may have the best health indicators but necessarily not have
the best public health care institutions. The success of Kerala health indicators is more due to the
investment in the social capital rather than only in the public health care, resulting in a more
accountable and integrated primary health care system.

The government of Kerala has taken up the Rashtriya Swasthya Bima Yojana scheme of
Government of India announced by Prime Minister, along with Comprehensive Health Insurance
Scheme for (CHIS) in October 2008. The objective of RSBY/CHIS is to protect below poverty
line (BPL) households from major health shocks that involve hospitalization. Specifically, BPL
families are entitled to more than 700 in-patient procedures with a cost of up to 30,000 rupees per
annum for a nominal registration fee of 30 rupees. The Scheme is jointly implemented by
departments of Labour & Rehabilitation, Health & Family Welfare, Rural Development, and
Local Self Govt. The Labour Department is the Nodal dept. for implementation of CHIS. A
separate agency ‘Comprehensive Health Insurance Agency of Kerala’ (CHIAK) is created for
implementation of the scheme. ‘United India Insurance Company Limited’ is the insurance
provider for all 14 districts. 140 government hospitals and 165 private hospitals have been
empanelled towards implementing the scheme.

Government Hospitals in Kerala

1).General Hospital, Ernakulum (783 Beds)

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General Hospital Ernakulum i.e. GHE is one of the leading hospitals of Ernakulum. It is a 783
bedded multi-specialty famous hospital. It is one of the top well-equipped government hospitals
of Kerala. General Hospital, Ernakulum is NABH (National Accreditation Board for Hospitals)
acceded. It is also awarded by FICCI in 2012. This hospital was started in the year 1845 by the
Maharaja of Cochin. At present, the hospital administration was taken over by State government
of Kerala.

2).Maj Hospital (300 Beds)

MAJ Hospital is a 300 bedded multispecialty hospital located in Ernakulum. It was started in
1946.

Top Private Hospitals in Kerala

1).Aster Medcity (670 Beds)

Aster Medcity is a 670-bedded quaternary care facility with one Multispecialty Hospital and
eight separate Centres of Excellence in Cardiac Sciences, Neurosciences, Orthopaedics &
Rheumatology, Nephrology & Urology, Oncology, Women’s Health, Child & Adolescent Health
and Gastroenterology & Hepatology. It is spread across 40 acres area. It is the first quaternary
care hospital in Kerala to achieve the coveted JCI (Joint Commission International) Accreditation.
Aster Medcity also won the NABH Accreditation, first-ever NABH Award for Excellence in
Nursing and Green OT (Green Operation Theatres).

2).Amala Multi Speciality Hospital(450 Beds)

Amala Multi Speciality Hospital is a 450 bedded hospital Situated at Keezhur by the side of the
Kannur-Mysore Inter- State Highway. The hospital is started at the year 29-April-2011 and is
housed in 15-acre land with beautiful landscaping. It has got a built up area of 2,00,000 square
feet.

3).NIMS Hospitals Kerala (350 Beds)

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 One of the best and largest medical institutes in South India, Kerala is a 350 bedded Super
Speciality Hospital at Neyyattinkara, Trivandrum. NIMS a rare hospital of its kind and top most.

4).Indira Gandhi Co-Operative Hospital (325 Beds)

Indira Gandhi Co-Operative Hospital is a unit of Mambaram Co-operative Hospital Society Ltd.
it’s main operation areas is at Manjodi, Thiruvangadu, Thalassery, Kannur, and Kerala. The
hospital is 325 bedded Multispeciality Hospital.

HISTORY

Hospital and community. The hospital is a unique institution of man. A WHO expert committee

in 1963 proposed the following definition of hospital. A hospital is a residential establishment

which provides short term and long term medical care consisting of observational, diagnostic,

and rehabitative service for suffering or suspected to be suffering from a disease or injury and for

parturient it may or may not also provide services for ambulatory patients on an outpatient basis.

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