Organizational Operational Reforms.

Submitted To:

Dr. Atta ul Musawir.

Submitted By:

Muhammad Taha Siddiqui (23376) 25%

Muhammad Ali Raza (23377) 25%
Hamza Saleem (23381) 25%
Abdur Rehman (23513) 25%
Submission Date:

19.12.2020
Course Title:

Operations Management (MS-EM)

Introduction
Evolutional reforms, those which are happening around the globe are creating an impact on
human lives and these evaluations are also impacting the reforms that are being made by
humans. Due to globalization changes, evaluations can be visited in the health care sector as
well.
Health care is one of the basic needs of human beings. It has to be up to date and access should
be so easy that everyone living in the same society can avail it to facilitate his/her needs. Here I
would like to discuss one of the best hospitals in the country whose role in providing the best
health care facilities to the children can never be denied and how it is helping the people in the
hour of their need.
Initially established in 1958, Services Hospital started as an outdoor mini hospital for government
employees, as a satellite clinic of Mayo Hospital. The hospital had 60 beds to provide basic health
facilities. In 1960, it was named Wahdat Hospital, and was subsequently renamed to “Services
Hospital”. The hospital has expanded considerably and has been transformed since then. This
started when it was declared a teaching hospital attached to Allama Iqbal Medical College (AIMC)
in 1977. In 1995, the hospital became the teaching hospital for Gulab Devi Postgraduate Medical
Institute. Later in 1999, it was declared as an autonomous medical institute, with a management
board to oversee affairs and give policy guidelines. In 2002, the Services Hospital was declared as
the teaching hospital for the then newly formed Services Institute of Medical Sciences.

About the Organization

“… Services Hospital and Services institute of Medical Sciences…”
Ghous-ul-Azam Rd, Shadman, Lahore, Punjab Pakistan
Being the one of the largest hospitals in Punjab heaving a facility to accommodate 1600 beds,
fully equipped with 50 Operation theaters and 72 bedded ICUS including 32 bedded covid 19 ICU
to provide the best health care facility to the patients but is also named as one of the best
teaching and training centers in Lahore.
Its major health care facilities are categorized in two major domains i.e., Outdoor, Indoor /
Emergency Facilities And teaching Facilities institutes of various departments.

Outdoor, Indoor /Emergency Facilities

Various departments are categorized as under
1. Filter/Fever Clinic. 16. Neurosurgery Department
2. Anesthesia Department 17. Oral & Maxillofacial Department
3. Dental Department 18. Orthopedics Department
4. Dermatology Department 19. Pead’s Surgery Department
5. Diabetes Management Department 20. Pead’s Medicine Department
6. Ent Department 21. Physiotherapy Department
7. Eye Department 22. Plastic Surgery Department
 8. Gynae Department 23. Psychiatry Department
9. Human Fertility Department 24. Pulmonology Department
10. Infectious Diseases Department 25. Radiology Department
11. Medical Department 26. Surgical Department
12. Nephrology Department 27. Thoracic Surgery Department
13. Neurology Department 28. Urology Department
14 Sample Collection Center 29. Social Welfare Department
15 Operation theaters 30. ICU’s

Teaching Facilities
Various Departments include in teaching Facilities are as following
1. ANATOMY
2. BIO CHEMISTRY
3. COMMUNITY MEDICINE
4. FORENSIC MEDICINE
5. MEDICAL EDUCATION
6. PATHOLOGY (HAEMATOLOGY)
7. PATHOLOGY (HISTOPATHOLOGY)
8. PHARMACOLOGY
9. PHARMACY
10. PHYSIOLOGY
11. RESEARCH CENTER SIMS

All above mentioned major divisions are subdivided into the various other division while heaving
the specialized domains equipped with the best doctors and state of the art equipment as per
recommendation of Pakistan Medical Commission (PMC) and Specialized Health Care and
Medical Education Department
Training and education in various fields provided by depart of medical education. This
department is recognized to provide education to the candidates performing house Jobs,
studying FCPS and MCPS in various disciplines as stated below.
The structural Organogram of the entity is described below.

Board of Management

Principle

Medical superintendent Director Finance Professor / Consultant of

Various departments
AMS (Admn.) Audit
B&AO Associate Professor
Officer
AMS (radiology tower)
Assistant Professor

AMS (Gynae/OPD)
DMS (Gynae/OPD) Senior Registrar
AMS (Purchase)
DMS (Purchase)
AMS (SIMS)
DMS (SIMS)
AMS (Emergency)
DMS
(Morning/Evening/Night)
AMS (Stores)

DMS (Stores)
AMS (M&R)

AMS (MOE Deptt.)

AMS (Linen& Laundry)

AMS (Night)

AMS (Biomedical)

DMS (protocol)
(Morning/Evening/Night)

DMS (Admn)
About the selected process
“Complaint Handling/Rectification process of Biomedical Engineering Department”
Biomedical Engineering department plays a vital role in running the operation of the hospital,
their jurisdiction is involved in running the operation of all the equipment those are involved to
provide different vital services to facilitate the day to day need of the patients as per minimum
service delivery standards of PMC, PHCC, and WHO.

BMD is maintaining 1200 equipment inventory of all biomedical equipment allocated in various
departments as mention above

Biomedical Engineering Department.

The jurisdiction of the Biomedical Department is comprised as follows.

 Equipment Planning, Selection & Installation

 Equipment Maintenance

 Documentation & Communication

 Workshop Facility

 Health & Safety

The above mention jurisdictions are discussed below
Equipment Planning, Selection & Installation:
Responsible for medical equipment planning, clinical space planning, need assessment,
identification, technical specifications, technical review, and evaluation of Biomedical Equipment
to assist supply chain department for procurement. Preparation of room-wise equipment lists
and bills of quantities for equipment requirements. Responsible for inspection of incoming
equipment & machinery as per specifications and doing pre-acceptance checks. Ensure the pre-
installation Civil and MEP requirements including equipment technical requirements as per
manufactures guidelines. Recommend equipment purchase and standardization to hospital
management.
Equipment Maintenance:
Responsible to ensure that periodic and situational inspection and maintenance of medical
equipment is being done as scheduled. Trouble shooting and guidance to the end-users for
correct usage of installed medical equipment. Responsible to provide technical support in setting
standards and ensuring their compliance and maintaining the equipment to the best of its
performance by organizing and scheduling resources for planned maintenance program for all
equipment and attending emergency breakdowns and repairs. Coordinate with medical
equipment service suppliers to resolve problems with Equipment, arrange for repair and parts
replacement. Monitoring supplier’s performance on maintenance during warranty and service
contract period.

Documentation & Communication:

Ensure that relevant documentation is kept up to date for all Equipment down to component
level also ensures the department updates files and records about all maintenance operations
such as project folders, vendor's files, purchase orders and services provided for repair and
maintenance at the facility. Responsible to update / manage Equipment inventory. Provide
technical counsel to subordinate staff. Negotiate service agreements with vendors where
appropriate
Workshop Facility:
Responsible to establish & maintain Biomedical Engineering workshop. Responsible to ensure
policies & procedures are followed as defined by department. Responsible to ensure test /
calibration equipment is in working condition and to do testing for Bio-Medical equipment.
Maintain the integrated Bio-Medical equipment information system.
Health & Safety:
Implement hospital / laboratory policies, procedures and safe professionals practice and adhere
to relevant legislation, regulations and standards up to the extent of equipment usage. Work in a
safe manner with due care and attention to the safety of self, patient and others. Be aware of
risk management issues, identify risks and take appropriate action; report any adverse incidents
or near misses. Assist and cooperate with management in procedures aimed at accident
prevention in the workplace. Adhere to department policies in relation to the care and safety of
any equipment supplied for the fulfillment of duty. Investigate accidents, incidents and near
misses, and take the necessary corrective action. Responsible to ensure that dispose-off
procedures are being followed as per procedures in place for Equipment.
Education & Training:
Participate in mandatory training programmers. Facilitate arrangements in the Equipment area
for educating and training staff. Co-operate fully with the implementation of new procedures,
technologies and IT systems.
Before elaborating the details of their roles and how to improve them let's initially discuss the
organogram and individual roles of the individuals working in the Biomedical department.

AMS Bio
medical

General Shift Biomedical

Biomedical Engineers x 2 Engineer

Biomedical Biomedical Biomedical

Biomedical Tech x 3
Clerks x 2
Clerk techanican

Biomedical
Helper
 The Input-Transformation-Output diagram of the selected process is given below:

INPUT OUTPUT

Generalization of Equipment Approved the equipment as

specification per PVMS Specifications

General complaints. Fault’s rectification.

New equipment
requirements. TRANSFORMATION New machine/equipment
PROCESS
installation.
Spares requirements.

Backup inventory.
Quality Assurance
Calibration/Preventive
maintenance of equipment
Equipment Maintenance
They are responsible to ensure that all the equipment is to be kept in healthy conditions by
performing Conditioned based maintenances and preventive maintenances. Types of equipment
include the following.

 MRI Machine.
 CT Scan 640 slice.
 CT Angio.
 Angiographic Machine.
 Xray (mobile + Fixed).
 DR System.
 Ultrasound Machine.
 Anesthesia Machine.
 Ventilators.
 Baby Incubator.
 Color Doppler.
 Dialysis Machine.
 Fluoroscopy.
 Defibrillator
 Patient monitor / Cardiac monitor.
Process Analysis
Keeping the above-mentioned discussion under consideration, we want to analyze the
“…Complaint handling process of Biomedical Engineering Department…”
Since, the complaint process takes plenty of time to resolve, when the fault occurs in any of the
Biomedical equipment at any location within the hospital, whether it’s ICU, Radiology
department, Labs or General ward. It has to be look after and resolved by Biomedical
department with the in-house teams of engineers and technicians or outsourcing it. In this
report, we are analyzing the complaint handling process of Biomedical Engineering Department,
so that they can play their role in an efficient way in their domain.
In order to comprehensively examine how the process goes on, we have used one of the process
analysis techniques (Flowchart) to effectively analyze the process.
Process Evaluation
In order to evaluate the process under discussion, we have used Process Chart, which is an
organized way of documenting the entire activities performed by a group of people in a tabular
form.
As per the process being discussed, we have divided our process activities into four categories:

 Operation
 Transportation
 Inspection
 Delay
Identified areas for improvement from evaluation process
a) Move the steps 2.3.4.5.6.7.8.9.18 and 19, involve traveling just for dispatch of complain and
waste a notable length of time the same is cover up by using Hospital information system
software (HMIS) by which message / complain can be conveyed interdepartmental with in short
period of time.
b) A course of time is consumed at biomedical engineering department to burden of load. It can
be reduced by increasing the workforce / man power (technical staff).
c) From step 14, we have identified that in order to save the time, Backup unit should be
available in the Biomedical workshop.

General Areas for improvement

a) Improvement is required in the following domains to ensure the best operational practices.
b) Critical equipment inventory for departmental use only.
c) Regular training and development of technical staff.
d) Empowerment of the department to take fair decision regarding the needs of the doctors
and paramedical staff.

Recommendations.

Senior Bio medical Engineer Senior

Workshop Team will be available in Biomedical
General Shift only Engineer

Bio Medical Engineers

Working in Shifts Morning
Workshop In Biomedical Biomedical Biomedical
charge Engineer Engineer Engineer
Evening and Nights

Senior Biomedical Technician

Senior Senior Senior Senior
Working in Shifts
Biomedical Biomedical Biomedical Biomedical
Morning, Evening and Nights (One Per Technician x1 Technician Technician Engineer
Shift)

Biomedical Technician
Working in Shifts Workshop Biomedical Biomedical Biomedical
Morning, Evening and Nights (three Per Technician x 3 Technician Technician Technician
Shift)

Junior. Biomedical Technician Workshop Junior Junior Junior

working in shifts
Junior Biomedical Biomedical Biomedical
Morning, Evening and Nights (three Per
Shift) Technician x 3 Technician Technician Technician
 Biomedical Department must have the availability of the critical care equipment
available with them in order to facilitate the need of the hour.
 Biomedical engineering department is often ignored in decision making regarding to BM
equipment.
 Machines are purchase without consultation of biomedical engineer. Mostly biomedical
affairs are administered by the person having very less knowledge about biomedical technology.
 Consequently, low quality and irrelevant equipment’s are purchased caused wastage of
money and bad effect on treatment of patients.