Hospital

Published on May 2016 | Categories: Documents | Downloads: 52 | Comments: 0 | Views: 726
of 90
Download PDF   Embed   Report

Comments

Content

Page 1

PROJECT REPORT

NEW ERA PATIENT-FRIENDLY HOSPITAL PRIVATE LIMITED
SHUKUL BAZAR, SULTANPUR, UTTAR PRADESH, INDIA

Bejon Misra, Managing Director [email protected] & Dr. Bidhan Das, Consultant MBBS, MHA (AIIMS)

Page 2

CONTENTS
Page

Executive Summary About the Organization Preamble Introduction Technical Analysis & Justification Health Care Plan Functional Plan and Programs Departmentation Facilities Management Licenses permits and statutory obligations Organisation Structure Staffing Pattern and Qualification Annexures 1. 2. 3. 4. 5. 6. 7. 8. Layout Map of the Facility (Annexure-1) List of Equipment and Furniture (Annexure-2) List of Drugs (Annexure-3) Universal Precautions (Annexure-4) Charter of Patient’s Rights as a Consumer (Annexure-5) Financial Details (Annexure-6) Geographical Map of the Location (Annexure-7) Micro Health Insurance

3 5 7 8 12 22 24 29 32 34 36 37

38 42 50 62 64 66 86 88

Page 3

EXECUTIVE SUMMARY
It is rightly said that India lives in its villages. About 78% of the population of the country lives in rural India.

The country has the dubious distinction of being the 2nd largest populous country in the world. The flip side is that in spite of being a vast country having a huge population of 108 crores the health status of the country is very poor.

As evidenced by the World Health Report, the health indicators are far inferior to its neighboring developing countries. Health being a state subject the government has a very well structured public health system.

The three tier level of health-care organization with the root at the level of primary health centers going through CHCs, DHs and tertiary centers like medical colleges and centers of excellence like AIIMS, PGI etc.

In spite of all this, the reach and acceptance of the facilities particularly in the PHCs and CHCs is very poor.

Page 4

Several studies have revealed that the community prefers to go to a private provider and pay out of pocket rather than going to a public facility even though it is free. This is evidenced by the fact that the GDP on account of health is 5.2%. out of which the share of the Government is only 1.8% and the rest is from the private providers.

Health care in India is a sunrise sector and the country is witnessing a mushrooming of corporate hospitals being ironically concentrated at the Metropolitan cities with a focus on the international health business. At the end the rural sector is left untouched even if the population is ready to pay.

Govt. has taken a revolutionary step in the form of National Rural Health Mission (NRHM) and furthered it by laying standards for the same in the form of IPHS 2006. The results of this program are to be seen in the years to come.

The basic issue is to regain the trust of the community on the public health facilities. The areas of concern in order to achieve the trust is Accessibility Availability Affordability Affability

Page 5

IMPLEMENTING AGENCY: NEW ERA PATIENT-FRIENDLY HOSPITAL PRIVATE LIMITED
OBJECTIVES: To develop and implement state-of-art health delivery system for providing quality healthcare facilities at an affordable price for all. To conduct research and development studies for bringing policy changes in the healthcare delivery system globally especially in developing countries for the poor and disadvantaged consumers.

To educate consumers and make them aware on their rights and provide informed choice in an effective and efficient manner.

New Era Patient-Friendly Hospital Private Limited has ventured into this area so as to create a model incorporating all the features stated in the NRHM, National Population – Policy and IPHS 2006. Located in rural surrounding the place is 70 km off Lucknow in the State of Utter Pradesh (INDIA) and close to Jagdishpur Industrial Area on the Lucknow to Sultanpur Highway in a village called Pureshuklan in Shukul Ka Bazar Block, district Sultanpur.

This initiative will function as a private ‘for profit’ model. The aim is to emulate and replicate this model to other parts of the country particularly in the

Page 6

economically back ward states and in turn help the Government to implement the NRHM in the real sense of the term.

The facility has been planned and designed as per BIS standards for 30 bedded hospital as well as IPHS 2006.

It has 30 beds with basic broad specialties, supplemented with diagnostic services including an ultrasound, ICU and an operating room.

The structural standards have been met with, the process and outcome standards are being worked upon so as to enable the hospital to be accredited by the National Accreditation Board for Hospital and health care providers in the days to come.

The concept of Public Private Partnership can very well be applied to this model. The facility is geared up to handle and support all national health programs, Counseling services, NGO participation, PRI involvement, preventive health, IEC services, Sanitation, Hygiene and safe water supply to the community apart from patient/consumer education and awareness on rights and responsibilities.

The rights of patients and staff are to be respected and the approach will be market/consumer driven. Governance of the facility will be professionally managed.

Page 7

PREAMBLE
This report has been prepared to formulate the project “commissioning of the New Era Patient-Friendly Hospital Private Limited at “Pureshuklan” (Post Office Shukul Bazaar), District Sultanpur in the State of Uttar Pradesh in INDIA. The report is based on the discussion and data generated, from various meeting held with the promoters of the project, who are members of the Governing Board and visits to the sights. Data is also collected for the disease pattern, incidence of various diseases and other relevant social, cultural and health status indicators. All the data has been qualified to accommodate the functional requirements of various departments in this hospital. The Departmentation plan as listed has been discussed and approved. The hospital activity has been adopted to be of primary to secondary level of health care, so as to be in the linen of NRHM and Millennium Development goals (MDG). The provision in this report has been made for specific purpose of conceptual proposal and designing of the hospital. In this report, due consideration has been given to under stand the market needs of the locality, research has been conducted for various national health programs, national health policy, NRHM, world health report, IPHS 2006, and BIS standards for 30 bedded hospital. New Delhi Dated : 30 August 2006 Bejon Misra & Dr. Bidhan Das

Page 8

INTRODUCTION

Pursuant to the executive summary in the report it has very adequately been emphasized that the need for a model rural hospital meeting all possible standards to a reasonable extent be created in order to provide quality health care at the most affordable cost. However, needless to say that the infrastructure so created shall be easily replicated all over the country and other developing countries so as to bring good quality health care to the door step of the community and in turn progress towards HEALTH FOR ALL and achieving the MDGs.

In order to meet this demand for comprehensive health care services this model hospital has been named as “New Era Patient-Friendly Hospital Private Limited” hospital. The hospital shall not only provide and supplement the much needed beds in this segment but also augment the emergency health care services and prove to the world that quality health care services can be provided at a very low capital cost. It will further demonstrate how this model can be financially viable and sustainable. The hospital addresses the unmet needs of the community as consumers and therefore empowers them with their right to health and availability of services for the money paid, so as to appreciate the value for money. The proposed hospital shall provide a comprehensive medical, surgical, obstetrics, pediatrics, orthopedics, eye & ENT, Ayurveda, Homeopathy as well as

Page 9

all the needed support services. Most importantly it will be functional 24/7 all through out the year so as to make available emergency medical care round the clock at a very reasonable cost which the community can afford.

The Mission of the Hospital
“To provide quality health care accessible and affordable to all round the clock”.

Proposal
To commission this multi specialty hospital so as to provide comprehensive medical, surgical, obstetrics, pediatrics, orthopedic, eye & ENT, Ayurveda, Homeopathy care as a not for profit venture but a self sustaining model. The hospital shall be linked with telemedicine to designated centers of excellence in the country and coupled with a micro insurance model for the community to pay for their health care needs.

The services provided will be at a very nominal and affordable price. However, for the underprivileged group a self-financing scheme based on a co-operative model will be created.

Page 10

Objectives 1. To ensure availability of comprehensive quality health care accessible to all without any discrimination or bias. 2. 3. To provide the services round the clock 24/7. To enable access of the services to the community at an affordable price. 4. To run the facility in a transparent manner so as to create an environment of empowerment and ownership of the community. 5. 6. To provide value for money to the consumers of health care. To act as a role model for others to emulate.

Page 11

NAME OF THE HOSPITAL

NEW ERA PATIENT-FRIENDLY HOSPITAL PRIVATE LIMITED
“Demand Quality Health Care” Location: Pureshuklan, District Sultanpur, U.P. India

Size of the Hospital 30 bedded in patient unit with suitable component of out patient unit, Emergency Department, ICU, OT, and needed support services.
Organisation Owning the Hospital

New Era Patient-Friendly Hospital Private Limited The Registered office: National Capital Territory of Delhi. Date of Commencement of Business of the Hospital

January 2007

Page 12

Governing Board of the Hospital

1.

Dr. Mahendra Pratap Narain Pande, D.O. (Lon) Chairman

2.

Mr. Bejon Misra S/o Late Satyendra Nath Misra W018, Regency Park II, DLF Phase IV, Gurgaon (Professional)

3.

Mr. Rajeev Misra S/o Late Mahesh Misra C-20, Defence Colony, New Delhi – 110024 (Professional)

4.

Dr. Mahendra Jeet Sharma S/o Late Sh. Gopi Nath Sharma 572/1B, Civil Lines, MGS Gate, Sultanpur – 22804 Uttar Pradesh

5.

Mr. Trtirunillai Krishanan Govindan S/o Late Sh. T.D. Krishan (Retired) 90C, Pocket L, Mayur Vihar Phase I, Delhi – 110091

Page 13

TECHNICAL ANALYSIS
Located in village for Pureshuklan, surrounded by many mango groves and farmland. The building is well ventilated and certain portions are air-conditioned. There is adequate access from the main road on two sides. Approach road is wide enough for cars, jeeps, vans, Lorries and other means of transport.

The building plan has been considered keeping the location and socio cultural habits of the community. It is a two storied building having ramps so as to transport immobile patients to the first floor. The hospital will have an advanced pathology lab based on semi automation, a good imaging department; emergency services round the clock, an operating room and an ICU to provide critical care and life stabilization care for all cases.

Equipped with an ambulance it can provide safe transportation of both stable and unstable patients to the designated referral hospitals. The nearest tertiary care hospital is SGPI, Lucknow and KGMC, Lucknow which are approximately 70 kms away with a driving time of 1 ½ hours. It has been envisaged to contain the cost of health care to bring it within the reach of the population who at present are not able to afford the cost of health care.

Page 14

In addition, we bring out the following points for consideration. General 1. For selected specialties as stated above the hospital shall provide all needed services. 2. For all other specialties it shall provide only essential services to preserve life and stabilize the patient’s condition and evacuate the patient to an alternative health care facility. 3. The hospital shall maintain its accounts in a very transparent manner, and make it public. 4. It will accept grants/donations from all concerned and submit the income/expense statement to the funding organization. 5. Being governed by a collaborative approach it will take the mandates of the stakeholders in the business in to consideration. Degree of Specialization 1. The hospital shall provide primary as well as secondary level care including the preventive, promotive, curative and rehabilitative services within the ambit of its capacity. 2. The hospital has made provisions for future expansion for size and adding on departments if need be. 3. It will provide comprehensive intensive care for all types of medical and surgical cases.

Page 15

4.

The hospital shall be equipped to provide expert first aid and all services for resuscitation and preservation of life.

5.

It will provide a basic casualty unit, a comprehensive critical and intensive care unit providing ventilator support, shock therapy, and backup support for all there services.

6.

The various activities as listed above shall be supported by the following clinical support services. a. b. c. 1 operating room / labor room 1 four bedded ICU Imaging department with 1 portable X-ray machine 1 fixed X-ray machine 1 ultrasound machine 1 theatre sterile supply unit d. Laboratory services

7.

The hospital will have an out sourced laundry service to provide clean linen. The sterilization of requisite linen shall be carried out in-house.

8.

The hospital will also have an organized catering service to provide regular and therapeutic diets.

9.

The hospital shall have relationship with more than 1 hospital at Sultanpur, Barabanki and Lucknow for casualty evacuation, specialized investigation and other services not available in-house.

Page 16

CATCHMENT AREA
a. b. c. d. e. f. g. h. i. j. k. l. m. n. o. p. q. r. s. t. Shukla Bazar Jagdishpur Odoria Dadera Munimpur Nindura Banikader Fatehpur Haidergarh Mawai Puredalai Ram Nagar Rudauli Siddhaur Sirauli Gauspur Suratganj Trivediganj Sultanpur Baba Ka Bazar Suleha

Page 17

u. v. w. x. y. z.

Inhauna Rae Bareli Rani Ganj Rudauli Faizabad Barabanki

The hospital will be geared up to cater to the requirement of the population within a radius of 10 kms from the site. Work Load The proposed hospital shall attract adequate number of patients from the neighboring blocks. Once stabilised it shall also attract patients from neighboring district.

Population of attachment area Sex ratio Growth Rate

-

500,000 933 females/1000 males 1.46% per year

Broad Age Distribution of Population Below 15 15 – 59 Above 59 39.77% 53.56% 6.67%

Page 18

Health Indicators

Birth Rate Death Rate General fertility rate Infant Mortality Rate Expectancy of life at birth Proportion of workers to total population General morbidity rate Accident/emergency rate Hospital occupancy rate

-

25.8% / 1000/year 8.5% /1000/year 103.2% /1000/year 710% /1000/year 66.04% year (64.8 for all India)

-

34.18% (51.00% for males only) 81.0% once a year 7.5% year 18.0% year of population day

Facilities Available There are primary health centers, community health centers, sub-centers, FRUs along with district hospital in the catchment area. However, the consumers are not happy with the services provided by them and avail their health care services from private providers as evidenced by several studies.

There are certain private providers along with Ayurveda and Homeopathy practitioners but none of them provide the comprehensive range of services. Hence this effort of providing all services under one roof is envisaged.

Page 19

Disease Profile Uttar Pradesh Male Female 16.6 14.3 3.0 3.0 3.5 3.3

1. 2. 3.

Infectious & Parasitic Diseases Neoplasms Endocrine, Nutritional, Metabolic Diseases & Immunity Disorders

4.

Diseases of Blood & Blood Forming Organs Mental Disorders Diseases of the Nervous System & Sense Organs Diseases of the Circulatory System Diseases of the Respiratory System Diseases of the Digestive System Diseases of the Genito-urinary System Complications of Pregnancy Diseases of the Skin & Subcutaneous Tissues Diseases of the Musculoskeletal System & Connective Tissues Congenital Anomalies Certain Conditions Originating in Perinatal Period Symptoms, Signs and ill Defined Conditions Injury and Poisoning

2.0

2.8

5. 6.

0.1 3.1

0.1 3.2

7. 8. 9. 10. 11. 12. 13.

23.0 7.2 5.6 1.6 0.0 0.2 0.1

20.8 7.0 3.5 1.4 2.1 0.2 0.1

14. 15.

0.5 8.6

0.7 9.1

16. 17.

13.9 11.5

14.8 13.1

Page 20

The data used has been taken from Health Information of India 2001. Published in June 2003 by Central Bureau of Health Intelligence, Min. of Health and Family Welfare, Govt. of India or the previous edition. JUSTIFICATION According to the World Health Report 2000 — “while private health expenses in industrial countries now average only some 25 percent because of universal health coverage (except in the United States, where it is 56%), in India, families typically pay 80 percent of their health care costs as "out-of- pocket" expenses when they receive health care”.

The above table gives an idea about the household spending or out of pocket expenses in India as per source mentioned in the table.

Page 21

The above table reveals that in spite of the huge Government infrastructure in terms of health care in rural areas it has failed to meet the requirements of rural masses.

This table clearly reveals that the private providers in health care capture a larger market share of the health care business in our country.

Page 22

This table elaborates clearly that the private practition ers and smaller nursing homes capture a larger share of the rural health care market.

The figure
explains the reasons for preferring private providers vis-à-vis government providers

Page 23

It has been made very clear by several studies including the above that majority of the health care providers in rural India have less than 30 beds.

Studies further reveal that the private for profit hospitals capture most of the private health care market.

Page 24

The above table elaborates that hospitals in rural areas should have met minimum standards laid down by NABH.

Page 25

Projected Work Load of the Hospital For the population base growing at rate of 1.5% approximately per annum and hospital beds growing at the rate of 10% per annum.

OPD From the catchment area Referral Cases Emergency 23,250 per year 9,200 per year 1% of total OPD – 325 patients per year Say 1 patient per day

In Patients Average length of stay 5 days

15% of OPD Patients visits x 5 days (average length of stay = 17,520 patients bed days per year) Hence total number of bed required will be 47. All the processes will be very structured so as to bring down the average length of stay to 3-4 days. Therefore a bed strength of 30 will be sufficient.

Details of Site Location Size of the Plot Specific use of Land Permissible floor space index : : : : Pureshuklan 12,000 sq. ft. Hospital 30%

Page 26

Building Height Road Access Public Transport Service Electric Supply Water Supply Sewage Treatment Refuse Disposal

: : : : : : :

8 meters Available Available Available Available Will be met with Will be out sourced & Treated by Deep Burial 3 lines

Telephone Lines

:

Page 27

PHYSICAL FACILITY
(All Data are derived from BIS Standards for 30 bedded Hospital, IPHS 2006) Area a. b. c. Building Height Total built up area 8,000 sq. ft. Area of ground floor 4,000 sq. ft. Area of First Floor 4,000 sq. ft. 8 meters

Hospital Engineering Services a. b. c. d. Load of Electricity - 25 KVA Generator - 10 KVA UPS – 3 KVA Electrical Distribution box and panels Yes Planned

Fire Fighting System Solar Heating System

Telecommunicating System EPBAX having 3 incoming and 10 out going Yes HIS 2 Sources (Municipality and Bore well)

Nurse call system Computers Water

Page 28

HEALTH CARE PLAN
Objective
It is proposed that the hospital positions it self as a center of excellence, providing health care services to the targeted community and the following services to capture the market in the society. a. b. c. d. e. f. g. Pre-marital counseling Registration of young couples Marriage counseling Sex education Ante-natal checking of expecting mothers Natal services for mother and child Post natal monitoring of mother and child upto 3 years including immunization, child’s growth monitoring and support for birth of the sibling h. i. j. k. l. m. n. Care of child in pre-school and school Child counseling Tobacco cessation campaign School health First AID and emergency services Continuing health education to the community Evacuation of patients to tertiary facilities

Page 29

o. p. q.

Specialty clinics Telemedicine facility To co-ordinate with the district health and family welfare department in implementing all national health programmes in the region. Comprehensive medical records keeping Co-operative based micro health insurance scheme Health Check package Preventive health Health education

r. s. t. u. v.

Page 30

FUNCTIONAL PLAN AND PROGRAMS
1. The hospital shall provide its services on a fee for service basis to all. However, due consideration will be given to the socio economic status of the community. 2. 3. Capital cost of plan and building is Rs. 42 lakhs. Projected cost of medical equipments and building utility equipments will be around Rs. 72 lakhs. 4. 5. 6. 7. 8. The hospital will be self-sustaining financially. The calculations of occupancy rate and break even are enclosed. Depreciations as applicable are adapted. Technology up gradations will be supported by donations Hospital tariff will be so structured that it provides sustainability along with maintenance of the building, and equipments. 9. Hospital accounts shall be computerized and all taxes shall be accounted for. 10. The medical superintendent will be the designated authority for authorizing any incidental expenditure and shall maintained an account for the same. 11. All patients will be given and information booklets.

Page 31

12.

Patients shall sign the respective general and informed consent form.

13.

Operations of the hospital will be carried out according to the laws of the land.

14.

The hospital shall provide services as per the following timetable.

IPD Ward Rounds Urgent Consultations Cross Consultations Routine Urgent Diagnostic Services Routine Urgent All Nursing Procedures, as required, shall be provided as per the ward schedule. Therapeutic Services Routine (Other than Nursing Procedures) Urgent Discharge Routine Morning Evening 9 1.m. – 12 noon, 7 days a week 7 p.m. – 9 p.m. 7 days a week On call from the ward sister, 24 hours, Round the year Morning: 9 a.m. – 12 p.m., 7 days a week On call from the ward sister, 24 hours, Round the year Morning: 8 a.m. – 11 a.m., 7 days a week On call from the ward sister, 24 hours, Round the year

Afternoon: 2 p.m. – 5 p.m., 7 days a week On call from the ward sister, 24 hours, Round the year To be initiated during the ward rounds and all formalities to be completed and patient discharged by Noon of same day or next day. On call from the ward sister, 24 hours, Round the year.

Urgent

Page 32

OPD Routine 12 hours per day, 6 days a week Consultations Special 3 – 4 hours in the afternoon hours, Clinics after notified lunch interval, 4 days a week, in Hospital OPD. Emergency Services To be provided 24 hours, Round the year, and will include all other hospital services that are needed including emergency surgery. Surgical Suit Services Elective Surgery, Surgical Suit, Maintenance Special Dressings Imaging Services Registration of cases Examination – IPD cases - OPD Cases 4-6 hours in the morning hours, upto notified lunch interval, 6 days a week 8-11 a.m. 6 days a week As per schedule of the surgical suit, 6 days a week after finishing the OT list on 6th, once a week. After Notified lunch interval, 6 days a week

Delivery Reports

9 a.m. upto notified lunch interval, 6 days a week. After notified Lunch Interval, 5 days a week of Within 2-4 hours of Examination

Page 33

Laboratory Services Registration of cases Collection of Samples 4-6 hours in the morning hours, upto notified Lunch Interval, 6 days a week 4-6 hours in the morning hours, upto notified lunch interval, 6 days a week. For special clinics: 4 days a week in the clinics. of All Stat tests, as soon as possible. For all other tests, results shall be posted to requesting location . Hard copies shall be delivered in the notified schedule, 6 days a week. Ancillary Therapies Routine Special procedures As per schedule of the respective department, 6 days a week On call from the ward sister, 24 hours, Round the year.

Delivery Reports

15. 16. 17. 18. 19. 20. 21.

There shall be a proper admission and discharge procedure. Patient has to pay for all the medication and surgical supplies. Money to be collected at a central billing and reception area. A discharge summary will be given to all the discharge patients. Fire and emergency drills to be carried out regularly. Casualty Medical Officer shall control the ambulance services Staff in the hospital to be provided health care facilities according to the policies.

22. 23. 24.

Laundry services to be out sourced. Flow diagrams to be displayed at all areas. Care should be taken so as to prevent criss- crossing of traffic.

Page 34

25. 26. 27.

Medical Superintendent shall conduct periodic staff meetings. All major hospital routines to be documented. The governing board shall designate by a written resolution authorizing the medical superintendent to give concessions to patients as an when required.

28. 29.

Medical consultants will be on free for service basis. A token amount of 10% from their fees will be deducted as hospitals share.

30.

Free treatment could be given to the underprivileged sections of the society.

OPD a. OPD consulting room shall be utilized on a three hours slot basis in four shifts in two chambers from 8 a.m. to 8 p.m. b. c. Female ayahs to be deployed in the OPD. Citizens’ charters to be displayed.

Page 35

DEPARTMENTATION
1.
a. b. c. d. e. f. g. h. i. j. k. l. m. n. 2. a. b. c.

Functional Department
General Surgery Internal Medicine Gynecology and Obstetrics Pediatrics Orthopedics EYE ENT Ayurveda Homeopathy Physical Medicine and Rehabilitation Anesthesia Radio Diagnosis Laboratory Medicine Emergency Medicine Support Departments Reception and Public relationship Hospital administration Human Resource Development

Page 36

d. e. f. g. h. i. j. k.

Finance and Accounts Medical Records Purchase and Store Cafeteria Laundry Maintenance Pharmacy Security

3. 4. a. b. c. d.

Hospital Shall Provide Residential Accommodation for Nurses Functional Areas ICU - 4 beds Observation ward – 2 beds Male ward – 12 beds Female ward – 12 beds

OPD a. b. OPD - 2 rooms Casualty – 1 room

Page 37

Support Areas a. Imaging Departments b. c. d. e. f. g. h. i. Laboratory Physiotherapy Generator Room Electricity Distribution panel Water Storage Medical Gas Storage Area Cafeteria Pharmacy

FACILITY MANAGEMENT
Temple Public Education Centre MSW’s Desk Cafeteria Pharmacy Emergency O.P.D. Reception Distribution Panel/Switch Box Generator Room

Page 38

-

Laboratory X-Ray Ultrasound Room Admin. Area and IT + Accounts Accounts / HR Observation Room Wards (Male + Female) Doctors duty room Nurses Changing room Store and Medical Record Room I.C.U. O.T. Complex Conference room Corridors Guest Room Solar Heating System

LICENSES PERMITS AND STATUTORY OBLIGATIONS
a. b. c. d. Building Permit (Completion Certificate) Registration under MTP Act Registration of the Ultrasound machine under PNDT Act. The Wholesale and Retail Drug-License

Page 39

e. f.

The Excise Permit to store Spirit. The permit to store opium and its derivatives under the Narcotic and Psychotropic Substances Act.

g. h. i. j.

No Objection Certificate from the Chief Fire Officer, from the Region. No Objection Certificate under Pollution Control Act. No Objection Certificate under Bio-medical Waste Rules, 1998. The Vehicle Registration Certificates in respect of all vehicles the hospital owns.

k.

Radiation Protection Certificate in respect of All X-ray Equipment from BARC.

l. m. n.

PAN Number ESI Registration Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations, 2002: “All hospitals are obliged to provide medical care to preserve life to all injured citizens brought to hospital”.

o.

Pharmacy License

Page 40

ORGINASTION STRUCTURE
Governing Body

Medical Superintendent

Consultants

Nurses

Administration

ICU/OT/Casualty

• • • • • • • • •

Surgery Medicine Gynaecology Paediatrics Orthopaedics EYE ENT Lab Radiology

o o o o o

Nursing Supdt Nurses Ward Boys Ayahas Sweepers

IT Receptionist Billing & Accounts MRD Security Drivers Maintanance Store & Purchase

o o o o

Anesthesist Technicians TSSU CMO

Page 41

STAFFING PATTERN WITH QUALIFICATION
1. 2. 3. 4. 5. 6. Medical Superintendent Nursing Superintendent GDMOs Nurses Receptionist IT Manager MBBS, DHA, 10 years of experience Diploma Nursing, 15 years of experience MBBS, BUMS, with 1 year experience Diploma Nursing – 1 year experience Graduates 5 years experience in Software & Hardware Graduate with MBA B.Com. MLT. Radiography Course ORA Course ITI Diploma

7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18.

Admin./HR Accounts Lab Technician X-Ray Technician OT Technician Electrician Plumber Driver M.S.W. Ward Boys Sweepers Ayahas

-

-

Heavy vehicle License with 5 years exp. Counselling Course

Page 42

ANNEXURE - 1 LAYOUT MAP OF THE FACILITY

Page 43

LAYOUT MAP OF THE FACILITY

Page 44

LAYOUT MAP OF THE FACILITY

Page 45

LAYOUT MAP OF THE FACILITY

Page 46

ANNEXURE -2

LIST OF SUGGESTED EQUIPMENTS AND FURNITURES
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. Normal Delivery Kit Equipment for assisted vacuum delivery Equipment for assisted forceps delivery Standard Surgical Set (for minor procedures like episiotomies stitching) Equipment for Manual Vacuum Aspiration Equipment for New Born Care and Neonatal Resuscitation IUD insertion kit Equipment / reagents for essential laboratory investigations Refrigerator. ILR/Deep Freezer Ice box Computer with accessories including internet facility Baby warmer/incubator. Binocular microscope Equipments for Eye care and vision testing: Tonometers (Schiotz), direct opthalmoscope, illuminated vision testing drum, trial lens sets with trial frames, snellen and near vision charts, Battery operated torch 16. 17. Equipments under various National Programmes Radiant warmer for new born baby

Page 47

18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28.

Baby scale Table lamp with 200 watt bulb for new borne baby Phototherapy unit Self inflating bag and mask-neonatal size Laryngoscope and Endotracheal intubation tubes (neonatal) Mucus extractor with suction tube and a foot operated suction machine Feeding tubes for baby Sponge holding forceps – 2 Valsellum uterine forceps – 2 Tenaculum uterine forceps – 2 MVA syringe and cannulae of sizes 4-8 (2 sets; one for back up in case of technical problems)

29. 30. 31. 32. 33. 34. 35. 36.

Kidney tray for emptying contents of MVA syringe Containers for tissues Torch without batteries – 2 Battery dry cells 1.5 volt (large size) – 4 Bowl for antiseptic solution for soaking cotton swabs Tray containing chlorine solution for keeping soiled instruments Residual chlorine in drinking water testing kits H2S Strip test bottles

Page 48

Requirements for the Labour Room 1. 2. 3. 4. 5. 6. 7. 8. 9. A labour table Suction machine Facility for Oxygen administration Sterilisation equipment 24-hour running water Electricity supply with back-up facility (generator with POL) Attached toilet facilities An area earmarked for new-born care Emergency drug tray: This must have the following drugs a. b. c. d. e. f. g. 10. Inj. Oxytocin Inj. Diazepam Tab. Nifedepine Magnesium sulphate Inj. Lignocaine hydrochloride Inj. Methyl ergometrine maleate Sterilised cotton and gauze

Delivery kits, including those for normal delivery and assisted deliveries.

Page 49

PRIVACY of a woman in labour should be ensured as a quality assurance issue. List of Equipments for Pap Smear 1. 2. Cusco’s vaginal speculum (each of small, medium and large size) Sim’s vaginal speculum – single & double ended - (each of small, medium and large size) 3. 4. 5. 6. 7. 8. Anterior Vaginal wall retractor Sterile Gloves Sterilised cotton swabs and swab sticks in a jar with lid Kidney tray for keeping used instruments Bowl for antiseptic solution Antiseptic solution: Chlorhexidine 1% or Cetrimide 2% (if povidone iodine solution is available, it is preferable to use that) 9. 10. 11. Chittle forceps Proper light source / torch For vaginal and Pap Smears: a. b. c. d. e. f. Clean slides with cover slips Cotton swab sticks KOH solution in bottle with dropper Saline in bottle with dropper Ayre’s spatula Fixing solution / hair spray

Page 50

Requirements of the Laboratory Reagents 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. For Cyan meth - haemoglobin method for Hb estimation Uristix for urine albumin and sugar analysis ABO & Rh antibodies KOH solution for Whiff test Gram’s iodine Crystal Violet stain Acetone-Ethanol decolourising solution. Safranine stain PH test strips RPR test kits for syphilis

Glassware and other Equipment 1. 2. 3. 4. 5. 6. 7. Colorimeter for Hb estimation Test tubes Pipettes Glass rods Glass slides Cover slips Light Microscope

Page 51

List of Furniture (including surgical) Examination table Writing tables with table sheets Plastic chairs (for in-patients’ attendants) Armless chairs Full size steel almirah Labour table OT table Arm board for adult and child Wheel chair Stretcher on trolley Instrument trolley Wooden screen Foot step Coat rack Bed side table Bed stead iron (for in-patients) Baby cot Stool Medicine chest Lamp Shadowless lamp light (for OT and Labour room) 5 8 10 12 8 1 1 4 1 1 2 1 5 2 30 30 2 30 4 5 2

Page 52

Side Wooden racks Fans Tube light Sundry Articles including Linen: Buckets Mugs LPG stove LPG cylinder Sauce pan with lid Water receptacle Rubber/plastic shutting Drum with tap for storing water I V stand Mattress for beds Foam Mattress for OT table Foam Mattress for labour table Macintosh for labour and OT table Kelly’s pad for labour and OT table Bed sheets Pillows with covers Blankets Baby blankets

10 10 18

10 10 1 2 2 2 10 meters 5 16 30 1 1 4 metres 2 sets 50 40 30 2

Page 53

Towels Curtains with rods ANNEXURES -3

30 50 metres

DRUGS
(To be vetted by the Hospital Drug Committee) Oxygen Inhalation

Local Anaesthetics Lignocaine Hydrochloride Topical Forms 2-5%

Preoperative Medication and Sedation for Short Term Procedures Diazepam Tablets 5 mg Injection 5 mg / ml

Analgesics, antipyretics and Non-Steroidal Anti-inflammatory Medicines, Non-Opioid Analgesics, Antipyretics and Nonsteroidal Anti-inflammatory

Medicines Acetyl Salicylic Acid Ibuprofen Paracetamol Tablets 300mg & 50 mg Tablets 400 mg Injection 150 mg / ml

Page 54

Syrup 125 mg / 5ml Antiallergics and Medicines used in Anaphylaxis Adrenaline Chlorpheniramine Maleate Dexchlorpheniramine Maleate Dexamethasone Pheniramine Maleate Promethazine Injection Tablets 4 mg Syrup 0.5 mg / 5 ml Tablets 0.5 mg Injection 22.75 mg / ml Tablets 10 mg, 25 mg Syrup 5 mg / 5 ml Capsules 250 mg, 500 mg Ampicillin Capsules 250 mg., 500 mg Powder for suspension 125 mg / 5 ml Injection 500 mg Benzathine Benzylpenicillin Benzylpenicillin Cloxacillin Injection 6 lacs, 12 lacs, 24 lacs units Injection 5 lacs, 10 lacs units Capsules 250 mg, 500 mg Liquid 125 mg / 5 ml Procaine Benzylpenicillin Injection Crystalline penicillin (1 lac units) + Procaine penicillin (3 lacs units) Cephalexin Syrup 125 mg/5 ml Capsules 250 mg., 500 mg*

Page 55

Ciprofloxacin Hydrochloride Co-Trimoxazole (Trimethoprim + Sulphamethoxazole) Doxycycline Erythromycin Estolate

Injection 200 mg / 100 ml Tablets 250 mg., 500 mg Tablets 40 + 200 mg, 80 + 400 mg Suspension 40 + 200 mg / 5 ml Capsules 100 mg Syrup 125 mg / 5 ml Tablets 250 mg, 500 mg

Gentamicin Metronidaozle

Injection 10 mg / ml, 40 mg / ml Tablets 200 mg, 400 mg Injection 500 mg / 100 ml

Antidotes and Other Substances used in Poisonings Nonspecific Activated Charcoal Powder Atropine Sulphate Injection 0.6 mg / ml

Specific Antisnake Venom

Injection Polyvalent Solution/ Lyophilyzed Polyvalent Serum

Anticonvulsants/Antiepileptics Carbamazepine Tablets 100 mg, 200 mg Syrup 20 mg / ml Phenytoin Sodium Capsules or Tablets 50 mg, 100 mg Syrup 25 mg / ml

Page 56

Antiinfective Medicines Anthelminthics Intestinal Anthelminthics Mebendazole Tablets 100 mg Suspension 100 mg/ 5 ml Albendazole Antifilarials Diethylcarbamazine Citrate Antibacterials Amoxicillin Powder for suspension 125 mg / 5 ml Capsules 250 mg, 500 mg Cardiovascular Medicines Antianginal Medicines Acetyl Salicylic Acid Glyceryl Trinitrate Tablets 75 mg,100mg,350mg. Sublingual Tablets 0.5 mg. Injection 5 mg/ml Isosorbide 5 Mononitrate Propranolol Tablets 10 mg. Tablets 10mg,40mg Injection 1mg/ml. Antihypertensive Medicines Amlodipine Tablets 2.5 mg, 5 mg, 10 mg Tablets 150 mg Tablets 400mg

Page 57

Atenolol Enalapril Maleate

Tablets 50 mg,100 mg Tablets 2.5 mg, 5 mg, 10 mg Injection 1.25 mg / ml

Methyldopa Dermatological Medicines (Topical) Antifungal Medicines Benzoic Acid +Salicylic Acid Miconazole

Tablets 250 mg

Ointment or Cream 6% + 3% Ointment or Cream 2%

Antiinfective Medicines Framycetin Sulphate Methylrosanilinium Chloride (Gentian Violet) Neomycin +Bacitracin Povidone Iodine Silver Nitrate Nalidixic Acid Nitrofurantoin Norfloxacin Tettracycline

Cream 0.5%

Aqueous solution 0.5% Ointment 5 mg + 500 IU Solution and Ointment 5% Lotion 10% Tablets 250 mg, 500 mg Tablets 100 mg Tablets 400 mg Tablets or Capsules 250 mg

Page 58

Antileprosy Medicines and Anti-tubecullar medicines as per national programmes Antifungal Medicines Clotrimazole Griseofulvin Nystatin Pessaries 100 mg, 200 mg, Gel 2% Capsules or Tablets 125 mg, 250 mg Tablets 500,000 IU Pessaries 100,000 IU Antiprotozoal Medicines Antiamoebic and Antigiardiasis Medicines Diloxanide Furoate Metronidazole Tablets 500 mg Tablets 200 mg, 400 mg Injection 500 mg / 100 ml Tinidazole Blood Products and Plasma Substitutes Plasma Subsitutes Dextran-4 Dextran Silver Sulphadiazine Injection 10% Injection6% Cream 1% Tablets 500 mg

Antiinflammatory and Antipruritic Medicines Betamethasone Cream / Ointment 0.05% Dipropionate Calamine Lotion

Page 59

Astringent Medicines Zinc Oxide

Dusting Powder

Medicines Affecting Skin Differentiation and Proliferation Glycerin Solution 13.6 Scabicides and Pediculicides Benzyl Benzoate Disinfectants and Antiseptics Antiseptics Benzoin Compound Cetrimide Chlorhexidine Ethyl Alcohol 70% Solution Gentian Violet Hydrogen Peroxide Disinfectants Bleaching Powder Formaldehyde IP Potassium Permanganate Diuretics Furosemide Injection, 10 mg/ ml, Tablets 40 mg Powder Solution Crystals for solution Paint 0.5%, 1% Solution 6% Tincture Solution 20% (conc.for dilution) Solution 5% (conc. for dilution) Lotion 25%

Page 60

Gastrointestinal Medicines Antacids and other Antiulcer Medicines Aluminium Hydroxide+ Magnesium Hydroxide Omeprazole Ranitidine Hydrocholoride Suspension Tablet Capsules 10 mg, 20 mg, 40 mg Tablets 150 mg, 300 mg Injection 25 mg / ml Antiemetics Domperidone

Tablets 10 mg Syrup 1 mg / ml

Metoclopramide

Tablets 10 mg Syrup 5 mg / ml Injection 5 mg / ml

Antispasmodic Medicines Dicyclomine Hydrochloride

Tablets 10 mg, Injection 10 mg / ml

Hyoscine Butyl Bromide

Tablets or 10 mg Injection 20 mg / ml

Laxatives Bisacodyl Isphaghula Medicines used in Diarrhoea Oral Rehydration Salts

Tablets/ suppository 5 mg Granules

Powder for solution As per IP

Page 61

Hormones, other Endocrine Medicines and Contraceptives Adrenal Hormones and Synthetic Substitutes Prednisolone Antidiabetics and Hyperglycaemics Insulins and Other Antidiabetic Agents Glibenclamide Insulin Tablets 2.5 mg, 5 mg Injection (Soluble) Injection 40 IU / ml Metformin For Specific Group of Individuals Rabies Vaccine Tetanus Toxoid Ophthalmological Preparations Antiinfective Agents Chloramphenicol Ciprofloxacin Hydrochloride Gentamicin Miconazole Sulphacetamide Sodium Tetracycline Hydrochloride Antiinflammatory Agents Prednisolone Acetate Prednisolone Sodium Phosphate Drops/Ointment 0.4%, 1% Drops/Ointment 0.3% Drops 0.3% Drops 1% Drops 10%, 20%, 30% Ointment 1% Tablets 500 mg Tablets 5 mg, 10 mg

Injection Injection

Drops 0.1% Drops 1%

Page 62

Xylometazoline Local Anaesthetics Medicines used in Psychotic Disorders Chlorpromazine Hydrochloride

Drops 0.05%, 0.1%

Tablets 25 mg, 50 mg, 100 mg Syrup 25 mg / 5 ml Injection 25 mg / ml

Medicines used for Generalized Anxiety and Sleep Disorders Diazepam Tablets 2 mg, 5 mg, 10 mg Antiasthmatic Medicines Aminophylline Beclomethasone Dipropionate Salbutamol Sulphate

Injection 25 mg / ml Inhalation 50 mg, 250 mg/dose Tablets 2 mg, 4 mg Syrup 2 mg / 5 ml Inhalation 100 mg / dose

Theophylline Compounds Codeine Phosphate

Antitussives Tablets 10 mg Syrup 15 mg / 5 ml

Dextromethorphan

Tablets 30 mg

Solutions correcting Water, Electrolyte and Acid-Base Disturbances Oral Oral Rehydration Salts Glucose

Powder for Solution As per IP Injection 5% isotonic 50% hypertonic

Glucose with Sodium Chloride

Injection 5% + 0.9%

Page 63

Normal Saline Potassium Chloride Ringer Lactate Sodium Bicarbonate Miscellaneous Water for Injection Vitamins and Minerals Ascorbic Acid Calcium salts Multivitamins

Injection 0.9% Injection 11.2% Sol. Injection Injection

Injection 2 ml, 5 ml, 10 ml

Tablets 100 mg, 500 mg Tablets 250 mg, 500 mg Tablets

Page 64

ANNEXURE - 4

STANDARD PRECAUTIONS
The standard precautions should be understood and applied by all medical and paramedical staff involved In providing health services. The basic elements include: 1. Hand washing thoroughly with soap and running water. a. Before carrying out the procedure b. Immediately if globes are torn and hand is contaminated with blood or other body fluids. c. Soon after the procedure, with gloves on and again after removing the gloves. 2. Barrier precautions: using protective gloves, mask, waterproof aprons and gowns. 3. Strict asepsis during the operative procedure and cleaning the operative site. Practise the “no touch technique” which is: any instrument or part of instrument which is to be inserted in the cervical canal must not touch anynon-sterile object / surface prior to insertion. 4. Decontamination and cleaning of all instruments immediately after each use.

Page 65

5.

Sterilisation / high level disinfection of instruments with meticulous attention.

6.

Appropriate waste disposal.

Sterilization of Instruments 1. 2. Instruments and linen must be autoclaved. In case autoclaving is not possible, the instruments must be fully immersed in water in a covered container and boiled for at least 20 minutes. Sterilisation of Copper T insertion instruments 1. 2. Copper T is available in a pre-sterilised pack Ensure that the instruments and gloves used for insertion are autoclaved, or fully immersed in a covered container and boiled for at least 20 minutes

Sterilisation and maintenance of MVA equipment The four basic steps are: 1. Decontamination of instruments, gloves, cannulae and syringes in 0.5% chlorine solution 2. 3. 4. 5. Cleaning in lukewarm water using a detergent. Sterilisation / High Level Disinfection Storage and re-assembly of instruments. The person responsible for cleaning must wear utility gloves.

Page 66

ANNEXURE - 5

CITIZEN’S CHARTER
Charter of Patients’ Rights for the Hospital

1.

Preamble Hospital exists to provide health care to every citizen of the locality within

the allocated resources and available facilities. The Charter seeks to provide a framework, which enables citizens to know. a. b. c. What services are available and their charges The quality of services they are entitled to The names through which complaints regarding denial or poor qualities of services will be addressed.

2. a.

Objective To make available health care services and the related facilities for consumers. b. To provide appropriate advice, treatment, referral and support that would help to cure the ailment to the extent medically possible. c. To redress any grievances in this regard. Commitments of the Charter a. To provide access to available facilities without discrimination,

3.

Page 67

b. c.

To provide emergency care, if needed on reaching the hospital To provide adequate number of notice boards detailing the location of all the facilities and the schedule of camps and other activities.

d.

To provide written information on diagnosis, treatment being administered.

e. 4. a. b.

To record complaints and respond at an appointed time. Grievance Redressal Grievances that consumers have will be recorded. Aggrieved user after his/her complaint recorded would be allowed to seek a second opinion at a referral hospital.

5. a.

Responsibilities of the Users Users of hospital would attempt to understand the commitments made in the charter. b. Users would not insist on service above the standard set in the charter because it could negatively affect the provision of the minimum acceptable level of service to another user. c. d. Instructions of the hospital personnel would be followed sincerely, and In case of grievances, the redressal mechanism machinery would be addressed by users without delay.

Page 68

ANNEXURE - 6

FINANCIAL DETAILS

Total Cost of Project
Cost / Sq. Amount Rate / Sq. ft (Rs.) ft 500,000 500 8000 4,000,000

Cost of Land Cost of Construction (This includes civil Construction, Electrical, Ducting) Cost of Equipments Contigency & Working Capital

7,200,000 1,100,000 12,800,000

The Total Cost of the Project is Rs. 1.25 Crores

Pre Operative Expenses a. Consultancy b. Travelling and Logistics c. Adminitrative Expenses

Rs. 5,00,000

The pre operative expenses have not been considered in calculating the viability.

Page 69

Cost of Equipment
No. Price / Unit (Rs.) All All All 1 75,000 1 200,000 1 150,000 1 150,000 1 150,000 1 50,000 3 15,000 2 150,000 1 50,000 1 1,000,000 4 50,000 1 25,000 2 2,500 1 600,000 1 75,000 1 150,000 5 2,000 1 300,000 1 200,000 1 40,000 1 30,000 3 10,000 1 5,000 1 25,000 1 30,000 2 40,000 1 100,000 All 1 100,000 1 700,000 1 300,000 1 150,000 All All All Amount (Rs.) 250,000 50,000 100,000 75,000 200,000 150,000 150,000 150,000 50,000 45,000 300,000 50,000 1,000,000 200,000 25,000 5,000 600,000 75,000 150,000 10,000 300,000 200,000 40,000 30,000 30,000 5,000 25,000 30,000 80,000 100,000 1,000,000 100,000 700,000 300,000 150,000 50,000 100,000 300,000 25,000 7,200,000

Hospital Furniture Fire Fighting Equioments Medical Gases Autoclave OT Table Boyle's Separators Coutery Machine Ventilator Infusion Pump Suction Machine Defibrillator, Monitor, Recorder Portable Emergency Light Laprascope Set Cardiac Monitors Pulse Oxy Meter Nebulizer Ultrasound Machine with 2 Probes Portable X - Ray Machine 60 MA X - Ray Machine 100 MA View Box Semi Auto Analyser Electrolyte Analyser Microscope Labarotary Autoclave Refrigerator Wax Bag Short Wave Diathermy Ultrasonic Therapy ECG Machine Opthamology OPD Setup HIS & Computers OT Light Silent Genrator Set UPS Surgical Instruments & Drums Linen Water Pump & Motor Surgical Consumables & Dugs Miscellaneous Total Cost of Equipments

Page 70

Revenue Streams Month Wise
Nov-06 Dec-06 Jan-07 Feb-07 Mar-07 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) OPD Consultation Lab Tests - OPD Lab Tests - IPD X - Ray - OPD X - Ray - IPD Ultra Sound Physiotherapy Counselling MTP Delivery Surgeries Indoor Stay ICU Health Checks Ambulance Drugs & Consumables Total Revenue 7500 15000 12000 6000 3750 18000 4500 1500 11250 30000 45000 9000 60000 15000 15000 63000 316500 7750 15500 12400 6200 3875 18600 4650 1550 11625 31000 46500 9300 62000 15500 15500 65100 327050 7750 15500 12400 6200 3875 18600 4650 1550 11625 31000 46500 9300 62000 15500 15500 65100 327050 10500 19600 16800 5600 7000 16800 4200 1400 10500 28000 42000 12600 56000 14000 16800 84000 345800 11625 21700 18600 6200 7750 18600 4650 1550 11625 31000 46500 13950 62000 15500 18600 93000 382850

Page 71

Revenue Streams Month Wise
Apr-07 May-07 Jun-07 Jul-07 Aug-07 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) OPD Consultation Lab Tests - OPD Lab Tests - IPD X - Ray - OPD X - Ray - IPD Ultra Sound Physiotherapy Counselling MTP Delivery Surgeries Indoor Stay ICU Health Checks Ambulance Drugs & Consumables Total Revenue 11250 21000 18000 6000 7500 18000 4500 1500 11250 30000 45000 13500 60000 15000 18000 90000 370500 11625 21700 18600 6200 7750 18600 4650 1550 11625 31000 46500 13950 62000 15500 18600 93000 382850 15000 30000 36000 9000 7500 27000 6000 2250 11250 30000 45000 27000 90000 30000 18000 117000 501000 15500 31000 37200 9300 7750 27900 6200 2325 11625 31000 46500 27900 93000 31000 18600 120900 517700 15500 31000 37200 9300 7750 27900 6200 2325 11625 31000 46500 27900 93000 31000 18600 120900 517700

Page 72

Revenue Streams Month Wise
Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) OPD Consultation Lab Tests - OPD Lab Tests - IPD X - Ray - OPD X - Ray - IPD Ultra Sound Physiotherapy Counselling MTP Delivery Surgeries Indoor Stay ICU Health Checks Ambulance Drugs & Consumables Total Revenue 15000 30000 36000 9000 7500 27000 6000 2250 11250 30000 45000 27000 90000 30000 18000 117000 501000 15500 31000 37200 9300 7750 27900 6200 2325 11625 31000 46500 27900 93000 31000 18600 120900 517700 18750 36000 48000 12000 11250 36000 6000 3000 15750 42000 63000 36000 120000 45000 21000 270000 783750 19375 37200 49600 12400 11625 37200 6200 3100 16275 43400 65100 37200 124000 46500 21700 279000 809875 19375 37200 49600 12400 11625 37200 6200 3100 16275 43400 65100 37200 124000 46500 21700 279000 809875

Page 73

Revenue Streams Month Wise
Feb-08 Mar-08 Apr-08 May-08 Jun-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) OPD Consultation Lab Tests - OPD Lab Tests - IPD X - Ray - OPD X - Ray - IPD Ultra Sound Physiotherapy Counselling MTP Delivery Surgeries Indoor Stay ICU Health Checks Ambulance Drugs & Consumables Total Revenue 18125 34800 46400 11600 10875 34800 5800 2900 15225 40600 60900 34800 116000 43500 20300 261000 757625 23250 46500 93000 15500 15500 46500 7750 3875 23250 62000 93000 69750 186000 62000 23250 372000 1143125 22500 45000 90000 15000 15000 45000 7500 3750 22500 60000 90000 67500 180000 60000 22500 360000 1106250 23250 46500 93000 15500 15500 46500 7750 3875 23250 62000 93000 69750 186000 62000 23250 372000 1143125 22500 45000 90000 15000 15000 45000 7500 3750 22500 60000 90000 67500 180000 60000 22500 360000 1106250

Page 74

Revenue Streams Month Wise
Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) OPD Consultation Lab Tests - OPD Lab Tests - IPD X - Ray - OPD X - Ray - IPD Ultra Sound Physiotherapy Counselling MTP Delivery Surgeries Indoor Stay ICU Health Checks Ambulance Drugs & Consumables Total Revenue 23250 46500 93000 15500 15500 46500 7750 3875 23250 62000 93000 69750 186000 62000 23250 372000 1143125 34875 68200 111600 21700 19375 65100 9300 4650 25575 68200 102300 83700 186000 77500 24800 465000 1367875 33750 66000 108000 21000 18750 63000 9000 4500 24750 66000 99000 81000 180000 75000 24000 450000 1323750 34875 68200 111600 21700 19375 65100 9300 4650 25575 68200 102300 83700 186000 77500 24800 465000 1367875 37500 75000 120000 27000 22500 72000 10500 5250 27000 72000 108000 90000 180000 90000 30000 450000 1416750

Page 75

Revenue Streams Month Wise
Dec-08 Jan-09 Feb-09 Mar-09 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) OPD Consultation Lab Tests - OPD Lab Tests - IPD X - Ray - OPD X - Ray - IPD Ultra Sound Physiotherapy Counselling MTP Delivery Surgeries Indoor Stay ICU Health Checks Ambulance Drugs & Consumables Total Revenue 38750 77500 124000 27900 23250 74400 10850 5425 27900 74400 111600 93000 186000 93000 31000 465000 1463975 38750 77500 124000 27900 23250 74400 10850 5425 27900 74400 111600 93000 186000 93000 31000 465000 1463975 35000 70000 112000 25200 21000 67200 9800 4900 25200 67200 100800 84000 168000 84000 28000 420000 1322300 38750 77500 124000 27900 23250 74400 10850 5425 27900 74400 111600 93000 186000 93000 31000 465000 1463975

Assumptions OPD - 10 Patients per day at a charge of Rs.25 per patient Lab Tests - 5 Patients of OPD at Rs.100 Lab Tests - 2 Patients of In-house at Rs.200 X-Ray- 2 OPD at Rs.100 X-Ray- 1 OPD at Rs.125 Ultra Sound - 2 at Rs.300 Physiotherapy - 3 at Rs.50 Counselling - 2 at Rs.25 MTP - .5 at Rs.1000 Delivery - .5 at Rs.2000 Surgeries - .5 at Rs. 3000 Indoor Stay - 2 at Rs.150 ICU - 1 at Rs.2000 Health Checks - 1 at Rs.500 Ambulance - 1 at Rs.500 Drugs & Consumables - 4000 No.of Beds – 26 + 4

Page 76

Month Wise Expenses
Particulars Salary Electricity Water Telephone Transportation Maintainance Drugs & Consumables Marketing & Promotion WebSite Designing & Maintainance Miscellaneous Total Expenses Nov-06 Dec-06 Jan-07 Feb-07 Mar-07 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) 258,500 10,000 2,000 5,000 8,000 10,000 53,550 25,000 10,000 15,000 397,050 258,500 10,000 2,000 5,000 8,000 10,000 55,335 20,000 15,000 15,000 398,835 258,500 10,000 2,000 5,000 8,000 10,000 55,335 20,000 0 15,000 383,835 258,500 10,000 2,000 5,000 8,000 10,000 67,200 15,000 0 15,000 390,700 258,500 10,000 2,000 5,000 8,000 10,000 74,400 15,000 0 18,000 400,900

Month Wise Expenses
Particulars Salary Electricity Water Telephone Transportation Maintainance Drugs & Consumables Marketing & Promotion WebSite Designing & Maintainance Miscellaneous Total Expenses Apr-07 May-07 Jun-07 Jul-07 Aug-07 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) 258,500 11,000 2,200 5,500 9,000 11,000 72,000 10,000 0 18,000 397,200 258,500 11,000 2,200 5,500 9,000 11,000 74,400 10,000 0 18,000 399,600 284,350 11,000 2,200 5,500 9,000 11,000 93,600 10,000 0 18,000 444,650 284,350 11,000 2,200 5,500 9,000 11,000 96,720 5,000 0 18,000 442,770 284,350 11,000 2,200 5,500 9,000 11,000 96,720 5,000 0 18,000 442,770

Page 77

Month Wise Expenses
Particulars Salary Electricity Water Telephone Transportation Maintenance Drugs & Consumables Marketing & Promotion WebSite Designing & Maintainance Miscellaneous Total Expenses Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) 284,350 11,000 2,200 5,500 9,000 11,000 93,600 5,000 0 18,000 439,650 284,350 11,000 2,200 5,500 9,000 11,000 96,720 5,000 10,000 15,000 449,770 314,850 11,000 2,200 5,500 9,000 11,000 216,000 5,000 0 20,000 594,550 314,850 11,000 2,200 5,500 9,000 11,000 223,200 5,000 0 20,000 601,750 314,850 12,000 2,500 6,000 11,000 12,000 223,200 5,000 0 20,000 606,550

Month Wise Expenses
Particulars Salary Electricity Water Telephone Transportation Maintainance Drugs & Consumables Marketing & Promotion WebSite Designing & Maintainance Miscellaneous Total Expenses Feb-08 Mar-08 Apr-08 May-08 Jun-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) 314,850 12,000 2,500 6,000 11,000 12,000 208,800 5,000 0 20,000 592,150 386,875 12,000 2,500 6,000 11,000 12,000 297,600 5,000 0 20,000 752,975 386,875 12,000 2,500 6,000 11,000 12,000 288,000 5,000 0 20,000 743,375 386,875 12,000 2,500 6,000 11,000 12,000 297,600 5,000 0 20,000 752,975 386,875 12,000 2,500 6,000 11,000 12,000 288,000 5,000 0 22,000 745,375

Page 78

Month Wise Expenses
Particulars Salary Electricity Water Telephone Transportation Maintainance Drugs & Consumables Marketing & Promotion WebSite Designing & Maintainance Miscellaneous Total Expenses Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) 386,875 12,000 2,500 6,000 11,000 12,000 297,600 5,000 0 22,000 754,975 386,875 12,000 2,500 6,000 11,000 12,000 372,000 5,000 0 22,000 829,375 386,875 12,000 2,500 6,000 11,000 12,000 360,000 5,000 0 22,000 817,375 386,875 12,000 2,500 6,000 11,000 12,000 372,000 5,000 0 22,000 829,375 386,875 12,000 2,500 6,000 11,000 12,000 360,000 5,000 10,000 22,000 827,375

Month Wise Expenses
Particulars Salary Electricity Water Telephone Transportation Maintenance Drugs & Consumables Marketing & Promotion Website Designing & Maintenance Miscellaneous Total Expenses Dec-08 Jan-09 Feb-09 Mar-09 Amount(Rs.) Amount(Rs.) Amount(Rs.) Amount(Rs.) 386,875 12,000 2,500 6,000 11,000 12,000 372,000 5,000 10,000 22,000 839,375 386,875 12,000 2,500 6,000 11,000 12,000 372,000 5,000 10,000 22,000 839,375 386,875 12,000 2,500 6,000 11,000 12,000 336,000 5,000 10,000 22,000 803,375 386,875 12,000 2,500 6,000 11,000 12,000 372,000 5,000 10,000 22,000 839,375

Page 79

Salary
Nov-06 1.00 15000 10000 80000 12000 6000 10000 8000 5000 2000 6000 8000 12000 12000 12000 12500 2000 2000 40000 4000 258500 Dec-06 1.00 15000 10000 80000 12000 6000 10000 8000 5000 2000 6000 8000 12000 12000 12000 12500 2000 2000 40000 4000 258500 Jan-07 1.00 15000 10000 80000 12000 6000 10000 8000 5000 2000 6000 8000 12000 12000 12000 12500 2000 2000 40000 4000 258500 Feb-07 1.00 15000 10000 80000 12000 6000 10000 8000 5000 2000 6000 8000 12000 12000 12000 12500 2000 2000 40000 4000 258500

Medical Superintendent Nursing Superintendent Nurses Receptionist IT Manager Ward Boys / Ayahs Admin & HR Officer Accounts Officer Billing Clerk Driver MSW / Counsellors Lab Technicians X - Ray Technicians OT Technicians Security Guards Electrician Plumber GDMO's Physiotherapist

15000 10000 5000 4000 6000 2500 8000 5000 2000 3000 4000 4000 4000 4000 2500 2000 2000 10000 4000

Page 80

Salary
Mar-07 1.00 15000 10000 80000 12000 6000 10000 8000 5000 2000 6000 8000 12000 12000 12000 12500 2000 2000 40000 4000 258500 Apr-07 1.00 15000 10000 80000 12000 6000 10000 8000 5000 2000 6000 8000 12000 12000 12000 12500 2000 2000 40000 4000 258500 May-07 1.00 15000 10000 80000 12000 6000 10000 8000 5000 2000 6000 8000 12000 12000 12000 12500 2000 2000 40000 4000 258500 Jun-07 1.00 16500 11000 88000 13200 6600 11000 8800 5500 2200 6600 8800 13200 13200 13200 13750 2200 2200 44000 4400 284350 Jul-07 1.00 16500 11000 88000 13200 6600 11000 8800 5500 2200 6600 8800 13200 13200 13200 13750 2200 2200 44000 4400 284350

Medical Superintendent Nursing Superintendent Nurses Receptionist IT Manager Ward Boys / Ayahs Admin & HR Officer Accounts Officer Billing Clerk Driver MSW / Counsellors Lab Technicians X - Ray Technicians OT Technicians Security Guards Electrician Plumber GDMO's Physiotherapist

Page 81

Salary
Aug-07 1.00 16500 11000 88000 13200 6600 11000 8800 5500 2200 6600 8800 13200 13200 13200 13750 2200 2200 44000 4400 284350 Sep-07 1.00 16500 11000 88000 13200 6600 11000 8800 5500 2200 6600 8800 13200 13200 13200 13750 2200 2200 44000 4400 284350 Oct-07 1.00 16500 11000 88000 13200 6600 11000 8800 5500 2200 6600 8800 13200 13200 13200 13750 2200 2200 44000 4400 284350 Nov-07 1.00 16500 11000 98000 17200 6600 13500 8800 5500 2200 6600 8800 17200 13200 13200 13750 2200 2200 54000 4400 314850 Dec-07 1.00 16500 11000 98000 17200 6600 13500 8800 5500 2200 6600 8800 17200 13200 13200 13750 2200 2200 54000 4400 314850

Medical Superintendent Nursing Superintendent Nurses Receptionist IT Manager Ward Boys / Ayahs Admin & HR Officer Accounts Officer Billing Clerk Driver MSW / Counsellors Lab Technicians X - Ray Technicians OT Technicians Security Guards Electrician Plumber GDMO's Physiotherapist

Page 82

Salary
Jan-08 1.00 16500 11000 98000 17200 6600 13500 8800 5500 2200 6600 8800 17200 13200 13200 13750 2200 2200 54000 4400 314850 Feb-08 1.00 16500 11000 98000 17200 6600 13500 8800 5500 2200 6600 8800 17200 13200 13200 13750 2200 2200 54000 4400 314850 Mar-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Apr-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 May-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875

Medical Superintendent Nursing Superintendent Nurses Receptionist IT Manager Ward Boys / Ayahs Admin & HR Officer Accounts Officer Billing Clerk Driver MSW / Counsellors Lab Technicians X - Ray Technicians OT Technicians Security Guards Electrician Plumber GDMO's Physiotherapist

Page 83

Salary
Jun-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Jul-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Aug-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Sep-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Oct-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875

Medical Superintendent Nursing Superintendent Nurses Receptionist IT Manager Ward Boys / Ayahs Admin & HR Officer Accounts Officer Billing Clerk Driver MSW / Counsellors Lab Technicians X - Ray Technicians OT Technicians Security Guards Electrician Plumber GDMO's Physiotherapist

Page 84

Salary
Nov-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Dec-08 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Jan-09 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Feb-09 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875 Mar-09 1.00 18750 12500 125000 25000 7500 18750 10000 6250 2500 7500 10000 20000 15000 20000 15625 2500 2500 62500 5000 386875

Medical Superintendent Nursing Superintendent Nurses Receptionist IT Manager Ward Boys / Ayahs Admin & HR Officer Accounts Officer Billing Clerk Driver MSW / Counsellors Lab Technicians X - Ray Technicians OT Technicians Security Guards Electrician Plumber GDMO's Physiotherapist

Page 85

PROFIT & LOSS ACCOUNT FINANCIAL YEAR 2006 - 2007
Particulars To To To To To To To To To To To To Salary Electricity Water Telephone Transportation Maintenance Drugs & Consumables Marketing & Promotion Website Designing & Maintenance Miscellaneous Depreciation on Equipments Depreciation on Buildings Amount (Rs.) Particulars 1292500 OPD Consultation 50000 Lab Tests - OPD 10000 Lab Tests - IPD 25000 X - Ray - OPD 40000 X - Ray - IPD 50000 Ultra Sound 305820 Physiotherapy 95000 Counselling 25000 MTP 78000 Delivery 720000 Surgeries 200000 Indoor Stay ICU Health Checks Ambulance Drugs & Consumables Loss Carried forward to Balance Sheet Amount (Rs.) 45125 87300 72200 30200 26250 90600 22650 7550 56625 151000 226500 54150 302000 75500 81400 370200

1189570

Total

2891320

2888820

Page 86

PROJECTED STATEMENT OF ACCOUNT FROM 1/4/2007 31/3/2008 PROFIT & LOSS ACCOUNT FINANCIAL YEAR 2007 - 2008
Particulars To To To To To To To To To To To To Salary Electricity Water Telephone Transportation Maintenance Drugs & Consumables Marketing & Promotion Website Designing & Maintenance Miscellaneous Depreciation on Equipments Depreciation on Buildings Amount (Rs.) Particulars 3585025 OPD Consultation 135000 Lab Tests - OPD 27300 Lab Tests - IPD 67500 X - Ray - OPD 114000 X - Ray - IPD 135000 Ultra Sound 1792560 Physiotherapy 75000 Counselling 10000 MTP 223000 Delivery 1440000 Surgeries 400000 Indoor Stay ICU Health Checks Ambulance Drugs & Consumables Loss Carried forward to Balance Sheet Amount (Rs.) 198250 387400 506800 122000 114375 366000 71700 30500 167025 445400 668100 380100 1251000 427000 236350 2240700

386685

Total

8004385

7999385

Page 87

PROJECTED STATEMENT OF ACCOUNT FROM 1/4/2008 31/3/2009 PROFIT & LOSS ACCOUNT FINANCIAL YEAR 2008 - 2009
Particulars To To To To To To To To To To To To Salary Electricity Water Telephone Transportation Maintenance Drugs & Consumables Marketing & Promotion Website Designing & Maintenance Miscellaneous Depreciation on Equipments Depreciation on Buildings Profit Carried forward to Balance Sheet Amount (Rs.) Particulars Amount (Rs.) 383750 762900 1301200 261300 231750 738600 110950 55475 303300 808800 1213200 975900 2190000 927000 316100 5109000

4642500 OPD Consultation 144000 Lab Tests - OPD 30000 Lab Tests - IPD 72000 X - Ray - OPD 132000 X - Ray - IPD 144000 Ultra Sound 4087200 Physiotherapy 60000 Counselling 50000 MTP 260000 Delivery 1440000 Surgeries 400000 Indoor Stay ICU Health Checks 4232525 Ambulance Drugs & Consumables

Total

15694225

15689225

Page 88

ANNEXURE - 7

GEOGRAPHICAL MAP OF THE LOCATION

Page 89

Page 90

MICRO HEALTH INSURANCE

Once the hospital is commissioned a detailed plan of actions will be created for a community based co-operative health insurance. This will unable the beneficiaries to a range of services by the hospital.

However, the following points need consideration: a. Contribution by the population b. Subsidy c. Provider payment mechanism d. Range of services entitled

Sponsor Documents

Or use your account on DocShare.tips

Hide

Forgot your password?

Or register your new account on DocShare.tips

Hide

Lost your password? Please enter your email address. You will receive a link to create a new password.

Back to log-in

Close