A Project on

“TO STUDY CHALLENGES & ISSUES IN THE

VACCINATION DRIVE OF A MULTI- SPECIALTY
HOSPITAL”

Submitted by
Hera. H Khan
PRN :20040141117

Under the guidance of

Dr. Shrikrishna Dhale

Submitted to
Symbiosis Institute of Health Sciences,
(Symbiosis International University)
in partial fulfillment of the requirements for the award of the
Degree of Master of Business Administration
2020-2022
 CERTIFICATE

This is to certify that the Project entitled ‘TITLE’ by

Ms.” Hera. H Khan” is the bonafide work completed under my supervision
and guidance, hence approved for submission in Partial Fulfillment of the
requirement for the Degree of Master of Business Administration in Hospital
and Healthcare Management (2020-2022).

Date: ___15/12/21_______
Dr. Shrikrishna Dhale
DESIGNATION, SIHS, Pune
(Internal Guide)
 MBA-HOSPITAL AND HEALTHCARE MANAGEMENT 2015-17

STUDENT
DECLARATION

Name: Hera Hasan Khan

Organization: Kokilaben Dhirubhai Ambani

Hospital

Project Title: ___ TO STUDY THE CHALLENGES & ISSUES IN THE

VACCINATION DRIVE OF A MULTI- SPECIALTY HOSPITAL
Declaration:

I hereby declare that the project entitled “Challenges & Issues in the vaccination drive in
Super-Specialty Hospital” has been submitted during the year 2020-2022 under the
guidance of “Dr. Shri Krishna Dhale” at Symbiosis Institute of Health Sciences, in partial
fulfillment of the requirements of the Master of Business Administration (MBA-HHM)
degree from Symbiosis International University.

I hereby confirm that the project I have provided is solely my own effort. I have not
copied from any other student or from any other source either against payment or free, and
I did not provide any plagiarized material in any section of my report. I further confirm
that the documents provided are genuine and have been issued by the authorized person in
the organization.

______________________________________

HERA HASAN KHAN

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 ACKNOWLEDGEMENT (This is for reference only for students of
MBA-HHM batch 2020-22)

I take this opportunity to express my gratitude to the people who have been involved in the
completion of this project.

First and foremost, I would like to thank Dr. Mihir Dalal, General Manager, Clinical
Administration Department, and Dr. Prakash Padaya, Senior Executive Manager, Clinical
Administration Department, who gave me the opportunity to carry out the major concurrent
project, as well as all other employees of the organization who helped me either directly or
indirectly in this undertaking.

My sincerest thanks to Dr. Rajiv Yeravdekar, Dean, Faculty of Health and Biomedical
Sciences, Symbiosis International University, and Director, Symbiosis Institute of Health
Sciences (SIHS), Pune, to (Dr.) Pramod Kumar Mishra, Head of Department of MBA
(Hospital and Healthcare Administration), SIHS, Pune and to Mrs. Devika Shetty, Head of
Placements and Training, SIHS, Pune for allowing me to undergo the major concurrent
project.

I am extremely thankful to my internal guide, Dr. Shrikrishna Dhale, Assistant Professor,

SIHS, Pune, for her constant and timely support and supervision during my project.

I heartily thank the all the teaching and non-teaching staff members of SIHS, Pune, who
have helped me either directly or indirectly during the training period.

HERA. H KHAN
PR No. ____20040141117_______
MBA-HHM, Batch 2020-22
SIHS, Pune

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PLAGARISIM REPORT

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ABSTRACT:

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 Although the rapid development of the COVID-19 vaccine is a remarkable
achievement, successfully vaccinating the whole population presents many challenges,
from production to distribution, shipping, and most importantly, acceptance. Reliance
on vaccines is important, and relies heavily on the ability of vaccinators to
communicate the benefits of vaccines, as well as to deliver vaccines safely and
effectively. This study is dedicated to developing and validating a tool for interpreting
vaccination challenges and / or doubts by accessing information, attitudes, processes,
and concerns related to the COVID vaccine in a very specialized hospital.
This article discusses the role of employees and the organization in promoting
confidence in efficiency and security through effective communication, as well as
confidence in their ability to buy and distribute equitably and effectively.

TABLE OF CONTENT:

NUMBER TOPIC PAGE NO.

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 TITLE OF THE PROJECT

CHAPTER 1 INTRODUCTION 10-12

1.1 Introduction

1.2 Study Question

1.3 Objective

CHAPTER 2 INTERNAL OVERVIEW 13-18

2.1 Overview of Vaccination Drive of the organization

2.1.1 Eligibility

2.1.2 Registration

2.1.3 Pricing

2.1.4 Documentation

2.2 Work Flow

CHAPTER 3 RESEARCH METHODOLOGY 19-21

CHAPTER 4 DATA &ANALYSIS, DISCUSSION 22-26

INTERPRETATIONS

CHAPTER 5 CONCLUSION AND RECOMMENDATIONS 27-30

5.1 Recommendations

5.2 Conclusions

ANNEXURE 31

References

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Page | 9
 CHAPTER 1

INTRODUCTION

CHAPTER 1- INTRODUCTION:

1.1Introduction:
India has been hit difficult with the aid of the continued COVID waves. it is a primary
undertaking for the authorities of India to release a mass vaccination campaign even as
reducing the following COVID-19 waves. In this paper we look at the demanding
situations and opportunities for mass vaccination in opposition to a high quality, a
super-specialty hospital in Mumbai, Maharashtra in India.
India has three vaccines (i) Covishield [ChAdOx1 nCoV-19; Oxford-AstraZeneca;
developed by the Serum Institute of India], (ii) Covaxin [BBV152; Bharat Biotech],
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 and (iii) Sputnik V [Gam-COVID-Vac; The Gamaleya Research Institute of
Epidemiology and Microbiology]) is permitted for emergency use. about 10 million
doses of Covaxin and Covishield doses of 70 million in keeping with month had been
accomplished in India till may additionally, 2021.
Vaccination planning has also been a main undertaking in India. in advance, individual
Indian citizens needed to sign up with CoWIN or the Arogya Setu internet site to
acquire the COVID-19 vaccine. A restrained number of vaccination spaces have ended
in fewer controls during the first months of the vaccination application. The Indian
government has now amended its vaccination coverage through abolishing the
requirement for pre-registration and providing free vaccinations to hurry up the
program in some provinces. however, overcrowding in health care centers can cause an
growth in the quantity of each day conditions. Because the COVID-19 vaccine has
been authorized for emergency use and is being disbursed for vaccination, there has
been a robust attention on figuring out safe, powerful, and effective vaccination tactics
for many humans as a way of attaining both individual and herd infections. on this
technical paper, we have checked out and described the repetitive manner and
physiological improvement, the usage of a unique hospital parking garage in Mumbai,
Maharashtra to function a SARS-CoV-2 testing middle, well known vaccine
management, and ultimately COVID-19 vaccine administration.

1.2 Study Question:

 What are the main challenges faced by the hospital staffs in the vaccination drive of
a super specialty hospital in Mumbai?

 Also, what are the suggestive measures to make the vaccination process more
efficient, rapid & easier?

1.3 Objective:

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 To learn about vaccination barriers and enablers.
 To make the vaccination process more efficient, rapid& easier.
 To develop strategies to reinforce vaccine confidence among the communities.

CHAPTER 2
INTERNAL OVERVIEW

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 2. INTERNAL OVERVIEW:

2.1. Overview of the vaccination drive in the hospital:

This super- specialty hospital is supporting the fight against COVID-19 through its
COVID Vaccination Drive and are currently administering the following vaccines:
COVISHIELD on Monday, Wednesday and Friday
9:00 AM to 5:00 PM
COVAXIN on Tuesday, Thursday and Saturday
9:00 AM to 2:00 PM
Sputnik V (limited slots) on Saturday
3:30 PM to 4:30 PM

2.1.1. ELIGIBILITY:

• People over the age of 18 and above are eligible for the vaccine.
(Eligibility criteria shall be applicable as per Government notification valid from time
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 to time)
• As per the latest government guidelines, the second dose of Covishield, Covaxin &
Sputnik can only be administered 84 days, 28 days and 21days respectively after the
first dose.

2.1.2. REGISTRATION:
• Beneficiaries can register themselves via COWIN app or on www.cowin.gov.in and
confirmed appointment. No walk-in candidates were allowed.
• Time: 9AM – 4:30PM as per the slot and Vaccine availability.

2.1.3. PRICING:
This Hospital has procured vaccination at differential pricing through private cold
supply chains as per the prevailing policy.
• Charges for vaccination: Rs 1200/- for Covaxin, Rs 780/- for
Covishield, Rs 1145/- for Sputnik V.

2.1.4. DOCUMENTATION:

• A government ID proof for all the eligible candidates and certificate of first dose of
vaccination (if eligible).
• For the safety of the crowd at the venue, adherence to social distancing norms are
strictly followed.

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2.2. Process flow of the vaccination drive:

WORK FLOW:

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  Waiting: This is the first step, there is a separate waiting area in the
basement hall for all the beneficiaries who have appointment for the day.
They are provided a beneficiary information form with the token no for
the entry. Social distancing norms are fully maintained.

 Entry: Entry is done on the basis of token no with the count of 10 people
at a time. The security staff check their appointment & do their thermal
screening and allow them to enter.

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  Billing: There is a separate billing area where beneficiary can pay their
desired vaccination charges through their convenient mode. i.e.,
cash/card and collect their receipt of payment.

 Doctor’s Consultation: It is mandatory to take doctor’s consultation or

advice before taking the vaccine. This can lead to prevent many adverse
health effects to the beneficiaries and make the vaccines safe for them.

 Registration: For registration there are two separate portals for

registration of different age groups i.e., first for age group between 18-44
and other is for above 44 years. Registration involves 3 steps:
(i) Creation of beneficiary ID: A beneficiary ID is created in the
portal if the beneficiary is not registered before.
(ii) Verification: In this process beneficiary is verified through its
valid identification proof (Aadhaar, PAN card, Passport, other)
and the mobile no used at the time of registration.
(iii) Approved: After the successfully completion of above-mentioned
process the beneficiary is approved for the vaccination.

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  Vaccination: There are 6 separate areas for vaccination in the
vaccination room. All the beneficiaries have to show their beneficiary
forms along with billing receipt and in case of second dose they have to
show their first dose certificate to avoid any confusion and then they take
their desired vaccines safely as per their respective slots.

 Adverse Effect Room: If any patient collapsed at the time of vaccination

or any adverse health condition happens, there is a separate adverse
effect room for them to be taken care of with all necessary drugs like
adrenaline etc. There is a Crash cart having IV fluids & cannulation
tools, emergency drugs, paediatric intubation & C.V.P insertion kits.

 Recovery: Beneficiaries are advised to take rest for a while after taking
vaccines and for the same there are two separate recovery rooms with all
the necessary health supplements like water, glucose etc. Vaccination
certificates are also provided here.

 Exit: After collecting their vaccination certificate from the recovery

room beneficiaries can exit from the centre through the same way.

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 CHAPTER- 3

REASERCH METHEDOLOGY

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Chapter 3: Research Methodology:

Methodology is an analytical, formal, evaluation of the processes used inside the study area.
This includes a theoretical evaluation of the strategies and ideas identified with the fact’s
organization. generally, it includes terms which include analytical model, theory, process
and quantitative or qualitative strategies.

METHODOLOGY ADOPTED

 Self- Observation
 Survey from staffs

DATA COLLECTION METHODS

 Secondary Method of Data Collection

SECONDARY DATA COLLECTION

Methods to garner the data from secondary data are as follows:

 Interviews from staffs

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  Magazines & Newspaper
 Internet

STASTICAL TOOLS

Following MS Office tools are being availed while preparing the project:

 MS Excel: Pictorial & graphical representation of data

 MS Word: Preparation of project & other reports

METHODS FOR PRESENTATION OF DATA

 Conventional method of data representation i.e., Bar graph, Pie chart etc.

Research Type: The project will be Descriptive Cross-Sectional Study

Tools for analysis

 Bar graph
 Pie-chart
 Table

IN SHORT

• Area of study: Vaccination Drive Centre at Kokilaben Dhirubhai Ambani Hospital,

Mumbai

• Period of Study: 1st July,2021 – 2nd Sep,2021

• Type of study: Descriptive Cross-Sectional Study

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 • Method of Data Collection: Semi-Structured Interviews

• Type of Data Collection: Mixed (Both qualitative and quantitative data was
collected)

CHAPTER-4

DISCUSSIONS, DATA-
ANALYSIS

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Chapter-4 Data analysis & Discussions:

1. Departments faced challenges in Vaccination Drive:

Fig-1

Interpretations:

This graph depicts that above mentioned three departments faced the most challenges
in the vaccination drive of a super-specialty hospital. Amongst all, the Registration
Department faced the most issues followed by the Billing Department and Waiting
Area.

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 2. Problems in Registration Department:

Fig-2

INTERPRETATIONS:

The Registration Department faced the following two main issues:

 Crowd Handling
 Lack of Documents & Knowledge

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 1. REGISTERATION DEPARTMENT:

This department faced the highest issues in the vaccination drive in the hospital.

Following are the main issues faced by the department:

 CROWD HANDLING:

It is one of the main issues faced by the staffs of registration department. There is

no serial process wise labelling on the desk. Most of the beneficiaries come

directly on the registration counter without taking doctor’s consultation. The

registration staffs have to tell them one by one and send them back. These small

steps kill a lot of time and further delays the registration process.

 LACK OF PROPER KNOWLEDGE & DOCUMENTS:

Many beneficiaries for second dose, mostly age group of 45+ comes without first
dose certificate then the staff have to regenerate the certificate again. This not
only hampers the staff time but also slower the process of vaccination. If we do
process wise labelling on the counter desk and send them advance reminder about
carrying their first dose vaccination certificate with them, this will reduce a lot of
time of the staff and the process becomes much efficient and rapid.

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 2. BILLING DEPARTMENT:

Billing counter is the most rushing area. There were only two desks for more than
350 beneficiaries and they always argue with the staff because of slow billing
process. There is only one card machine in the billing desk for card payment and no
labelling on counter for crowd segregation for both the different payment
modes(cash/card). There is only a single printer at the corner for printing the billing
receipt from both the counters. The server of the billing portal lost quiet often for a
longer period. This hampers a lot of time and energy of the staff and makes the
process slower. By fixing the above-mentioned issues in the billing department
working process will be more efficient and faster.

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 3. VACCINATION ROOM:

Most of the beneficiaries still have doubts regarding the vaccines and they
continuously interrogate the vaccination staffs about the safety, accuracy, efficacy
and hygiene of the process and makes the process slower. Some of them tighten
their muscles due to trypanophobia and often blames or even misbehaves with the
staff for having post vaccination symptoms like body pain or rashes.

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 CHAPTER-5
CONCLUSIONS &
RECCOMENDATIONS

CHAPTER 5: CONCLUSIONS & RECCOMENDATIONS:

5.1 RECCOMENDATIONS:

* Increase the lighting in the waiting area this will not only emit positive energy but also
enhance the look of the area along with, we can also set a screen in the area showing all the
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necessary details like common post vaccination symptoms, safety measures taken by the
centers, protocols before giving the vaccines etc. and can also offer them paid beverages
like tea, coffee or packed snacks like biscuits (parle g) or chocolates etc. This will reduce
the adverse after effects cases of vaccination and help in overcoming the boredom in the
waiting duration and also deviate the mind of the beneficiaries.

* If we do process wise labelling on the counter desk and send them advance reminder
about carrying their first dose vaccination certificate with them, this will reduce a lot of time
of the staff and the process becomes much efficient and rapid.

* If we aware them priorly in the waiting hall through wall posters, short advertisements in
the screen in the hall that their safety is our main priority and the hospital along with the
staff take complete care of all the safety measures in the vaccination and aware them about
the common post vaccination symptoms. This will not only boost the vaccination
confidence among the people but also avoid conflict between the staff and the beneficiaries.
It also the reduce the vaccination time and makes the process more efficient and rapid.

* The glucose is only limit to those who ask for it, rather it should be given in a little
quantity to everyone in the recovery room who have taken the vaccine as it not only reflects
the extra patient care but also improve the patient- hospital relationship, enhance the
prominence of the hospital which makes this hospital to be different in the league.

5.3. CONCLUSIONS:

In conclusions the organization desires to devise powerful health techniques concerning

mass vaccination and avoid assembling people at fitness-care gadgets for vaccination.
The use of the upper basement and parking area served as a super region to offer

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offerings and approaches, SARS-CoV-2 testing and COVID-19 vaccine management.
With months of successive repetition of every manner and recurring physical
surroundings, we find that COVID-19 vaccination region secure, effective & powerful.
Their consciousness is on preserving the high speed of vaccination and the introduction
of dual doses of COVID-19 vaccines. The effects of the survey show the fact that the
corporation have work to make experience of the disaster and how to deal with the
COVID-19 vaccine respectfully, thoughtfully, legally, and in particular – accurately and
safely.

REFERENCES:

[1] European Centre for Disease Prevention and Control. COVID-19 vaccination and
prioritization strategies in the EU/EEA. Stockholm: 22 December 2020.

[2] European Centre for Disease Prevention and Control. Integrated COVID-19 response in
the vaccination era. Stockholm: 1 February 2021.

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[3] V Shah AS, Gribben C, Bishop J, Hanlon P, Caldwell D, Wood R, et al. Effect of
vaccination on transmission of COVID-19: an observational study in healthcare workers
and their households 2021.

[4] Dagan N, Barda N, Kepten E, Miron O, Perchik S, Katz MA, et al. BNT162b2 mRNA
COVID-19 Vaccine in a Nationwide Mass Vaccination Setting. N Engl J Med. 24 February
2021.

[5] Voysey M, Costa Clemens SA, Madhi SA, Weckx LY, Folegatti PM, Aley PK, et al.
Single-dose administration and the influence of the timing of the booster dose on
immunogenicity and efficacy of ChAdOx1 nCoV-19(AZD1222) vaccine: a pooled analysis
of four randomized trials. Lancet. 2021 Mar 6.

[6] Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, et al. Efficacy and
Safety of the mRNA-1273SARS-CoV-2 Vaccine. N Engl J Med. 2021 Feb 4;384(5):403-
16. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33378609

[7] UK Office for National Statistics. Coronavirus (COVID-19) weekly insights: latest
health indicators in England, 12 February 2021. Available at:
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/
conditionsanddiseases/articles/coronaviruscovid19weeklyinsights/
latesthealthindicatorsinengland12february2021#age-differences

[8] Bubar KM, Reinholt K, Kissler SM, Lipsitch M, Cobey S, Grad YH, et al. Model-
informed COVID-19 vaccine prioritization strategies by age and serostatus. Science. 2021
Feb 26;371(6532):916-21. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33479118

[9] Lavine JS, Bjornstad ON, Antia R. Immunological characteristics govern the transition
of COVID-19 to endemicity. Science. 2021 Feb 12;371(6530):741-5. Available at:
https://www.ncbi.nlm.nih.gov/pubmed/33436525

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