Health Care, Management & Entrepreneurship

A report submitted to Prof. Ratan Jalan

In partial fulfilment of the requirements of the course HCM 2ND Year

elective

By:
Ayushi Singh (1911049)
Deepanshu Singh (1911076)
Riya Mandlekar (1911207)
Vivek Rathore (188286)
 Patient Interview finding-1
Patient name*(1): Sanskar
Age: 24 yrs.
Ailment: Liver swelling
Relation: IIMU Colleague
Hospital: City Hospital GBH Udaipur
Duration: 4 days
Approx. treatment cost: 25k
Paid via: Insurance (Paramount) (Paid via cash up front, reimbursed it via insurance later)

Timeline of events

Suffering from high fever from past 5-6 days (day 1) Decided to take city hospital (GBH
City hospital Udaipur) Nurse took the reading Decision to admit Upfront payment of
7k Submitted insurance card for concession Non-availability of Insurance dept during
night Paid money on cash Admitted in the general ward for 4 days.
Summary of the Patient interview
The patient was suffering from high fever from past 5-6 days, the institute clinic which
served as the primary health care for the residents of the IIMU, provided the basic medicine
which served no good in alleviating the concern person health, seeming the issue we close
friend decided to take to nearby city hospital GBH upon reaching , the emergency area was
bit spacious and they automatically arrived with a wheel chair for the patient, the on duty
general physician recorded the temp and asked few question and asked to admit the patient
seeing the long duration of the fever, the admit was allowed only after submission of 2 day
upfront hospital fee which amounted to nearby 7000k due to night the insurance dept was
closed and the hospital admission dept refused to take admit with insurance but provided
the insurance officer number as the admission dept don’t have the expertise regarding
payment via insurance nor they had any knowledge which led to delay in patient admission.
However, the patient was admitted to the general ward of the hospital seeing the high fee
for another ward which seemed too unreasonable. The general ward was not spacious an
have the area to sit for the patient dear ones. The hospital has the arrangement of allowing
one member to be with patient at night, but the member had no place to sit in the general
ward and during night member slept near the stairs. However, there was timely check-up
and timetable for food service. Nurse was present for 24 hours and were very supportive.
The 4 days stay would have been better if there is bit cleanliness and more toilets in the
hospital which seems insufficient seeing the capacity of the hospital
Pain points from the patient point of view
1. Incapability of the admission team to pay via insurance
2. Insufficient infra for family members to accommodate patients
3. Unhygienic general ward in spite being the city hospital
4. Unreasonably high price for the service

Disclaimer: Consent granted before furnishing patient name and information in the assignment
Patient name*(2): Geeta Ojha
Age: 65 yrs.
Ailment: Low blood cell count
Relation: Family
Hospital: Leelamani Hospital
Duration: 4 days
Approx. treatment cost: 60k
Paid via: Insurance (GIC)

Timeline of events
Suffering from severe nausea and vomiting from last 2 days Decided to take to the
hospitalTaking a token after giving at the details at the reception  Decision to admit
Upfront payment of 10k Submitted insurance card for concession Left unattended until
the doctor arrived after 2 hrs Paid money on cash Admitted in the private
wardshifted to ICU for 3 daysSent to private ward on the 4th day
Summary of the Patient interview: The patient went to the hospital with a problem of
severe nausea and vomiting. This patient who was a woman aged around 65 years of age
had a history of this problem pertaining to low blood cell count. The first thing that
happened at the arrival was that the reception counter was overloaded with people and the
attendees were quite less which made the process quite time taking. The first information
they asked for was if the patient had a medical insurance. After the initial paperwork was
done, the patient was taken to a private ward and left unattended for around 2 hrs. The
doctor came very late and after the diagnosis wrote some tests to be done. After the test
were done the patient’s family was asked to arrange for blood for blood transfusion.
Meanwhile the patient was shifted to ICU for the treatment. The initial payments and the
medicine cost were paid in cash by the patient’s family and the insurance settlement could
only be done only after the whole treatment was done. The hospital staff and nurses were
not well behaved and were not quite responsive to patient’s queries. Four units of blood
were transfused, and it took 3 days to do that. The patient was shifted to a private ward for
the fourth day for monitoring and then discharged. Although, cleanliness was not a problem
at the hospital, but the food was not provided by the hospital the family had to arrange it on
their own. Also, as mentioned the patient had a history of this kind of problem, the family
felt that many of the tests and treatments were not reasonable and were done only to
increase the bill amount. They also felt moving the patient to ICU only for blood transfusion
was not reasonable. The expenses incurred in the 4 days stay at the hospital were quite high
looking at the ailment and the treatments. Additionally, there were no proper waiting areas
for the family member staying at night with the patient.
Pain points from the patient point of view
1. Unreasonable treatments and medicines just to increase the cost.
2. Misbehaviour of the staff and nurses.
3. Non-availability of food.
4. Inability to pay via insurance.
5. No proper infrastructure for the family member staying with the patient
6. Interview Number 2

Disclaimer: Consent granted before furnishing patient name and information in the assignment
 Patient name (3): Sharad Gupta
Age: 26 yrs.
Ailment: Accident
Relation: IIMU Colleague
Hospital: GBH Hospital Udaipur
Duration: 7 days
Approx. treatment cost: 58k
Paid via: Insurance

Summary of the patient journey

On 23 November 2019, Sharad Gupta met with an accident and got many injuries and
scratches on his right side of the body. He is taken to the hospital and admitted him there
for seven days as the process begins the first step the hospital should provide was the
stretcher, but the stretcher was not provided. As the registration process was going on the
other side the lady on the reception asked some basic questions to fill the entry form as
Amit asked them first to call the doctor and then we can fill the form so she asked Amit
(Friend of Sharad Gupta) to fill the form as she asked ward boy to call the doctor. As
Amit was filling the form there are some points in which some detailed information is
asked with some of the basic questions after that there was some minimum cost that they
have to pay for the registration fee and as they were the student of the IIM Udaipur so
they don’t have to pay anything as collage have a tie-up with the hospital and all the
expenses should be included in the insurance only. After the registration process is done
Sharad is taken to the room where surgery has to take place the surgery is done by doctor
Ashish as he was the surgeon at that time slot after the surgery is completed, a doctor told
Amit that 14 stitches came on the right leg of the patient and some scratches on the elbow
but everything was under control and Sharad fill be fine in some time. After the surgery is
performed successfully the patient is shifted to the other room and a nurse is taking care
of him 24*7 as she was assigned to room 706. The doctor came twice in the night to
check the condition and take an update from the nurse about Sharad as there were some
medicine and injection have to give to the patient and the whole night there was a ward
boy and nurse to see the patient. The next day in the morning doctor again came and
talked to Sharad about how he is feeling and make sure that there should not be any
problem that the patient is facing and if yes then they should keep some track of the
things. After that next day, the hospital services also provided the three-time meal to the
patient that the doctor has suggested. And all the necessary things are provided to patients
in the hospital within full hygiene. The Sharad took 7 days to get back to the hostel and in
this seven days the community has provided all the necessary things that a patient needs
and hygiene factors are taken into the consideration and he is discharged from the hospital
after 7 days but after that also in regular check-up time after 15 days, the hospital staff
and doctor have treated the patient well and gave all the proper guidelines to protect that
injury and bandages well and also told him about medicine consumption rotation and
timings. As the experience of the hospital services was very much liked by the patient.

Disclaimer: Consent granted before furnishing patient name and information in the assignment
 Q1. What are the three most common pain points faced by patients and briefly describe
them?
Answer
The three common points that we analysed are:
1. Insurance issue (Upfront payment while having insurance)
2. Unreasonably high price
3. Unhygienic resting area

Q4. How do you think the hospital could improve patient experience in the three areas,
which the group has identified?
Answer
There are three common stakeholders in every hospital
1. Patients
2. Doctors
3. Infrastructure
If any of the three stakeholder doesn’t meet the threshold criteria the one or the other
suffers, if the volume of the patients is not sufficient in the hospital to manage the hospital
operation the price of the hospital seems to be higher than the average price of the same
ailment in other hospitals, following infrastructure dwindles and other key areas. The
improvement in developing countries or countries where per capita income is lows is always
on the accessibility of the health care rather than the quality of the health care service. If
quality is focused in general hospital focuses more on quality health care equipment’s
rather than services which makes customer experience better. However due to sheer
volume and focus on providing quality health through medicines and instrument patient
comfortable stay and experience has always seen a backdoor in many city hospitals
However, it has been experiencing that capturing customer feedback data after every
journey has helped hospital administration to avoid unnecessary hassles and make
customer staying experience much better. Few hospitals have started taking patient
feedback data for at every process which has helped them take necessary steps.
The insurance coverage has always been the issue since its inception, and the hospital still
has not adopted to the insurance properly. There has always been cash involved even the

Disclaimer: Consent granted before furnishing patient name and information in the assignment
patient have insurance. The insurance system inside the hospital need to be revamped
completely it takes 1-2 days in better facility hospital to get the amount verified from the
insurance payer company and hospital do not admit any patient without paying the
admission pay either one or the other has to change , such that insurance payer have better
experience in paying hospital bills. Having the proper online health care management ERP
portal for insurance can help understand the coverage under the insurance scheme within a
second and in turn help patient experience better. Same is followed in hospitals in America
where patients record, and coverage is always present in their insurance payer site with
their insurance id which can be shared with the hospital payer which can give guidance over
the next step.
Proper resting area is difficult to maintain inside the hospital but the 2 ways approach has
helped hospital to achieve the same amount of cleanliness than other, the resting area
cleanliness depends upon the management way of handling, based on research it has been
quite shown that outsourcing this to other 3 rd party efficient in handling this has helped in
cleaning the surrounding more rather than hospital appointing its own staff and creating
guidelines however in 2 ways approach both hospital staff as 2 nd responder and outsourcing
staff as a 1st responder can help achieve better cleanliness in the premise and the resting
area.

The unreasonably high price has always the cause of nuisance to the patient, while patients
felt almost incomprehensible where the higher amount has gone in getting service and
check-up from the patient. While many hospitals are upfront regarding the fees and admit
cost, but unreasonably high fee has always act as on cause of worry to the patient. The
hospital must adopt and analyse different criteria to come up with the price of the hospital
service. A hospital in rural area cannot demand same price than the hospital in the city, the
bill should be breakdown to its minute component so that patient can have the complete
clarity regarding the where the money was spent. Where as even the medica treatment via
medicines were not that costly as per patient info, but the staying charge or admit charge
was un reasonable for even the general ward which led people to even change the hospital
during payment the price and infrastructure to live should be in accordance to the city type
and its residents.

Disclaimer: Consent granted before furnishing patient name and information in the assignment