Quality at Every Level

A NABH Accredited Hospital
Dr L H Hiranandani Hospital
“Your family hospital TM”
“ To be the preferred choice for healing and good health”

Achieving Patient Delight

With Quality
Dr (Col) V M P Thomas
Associate Vice President
Operations & Projects
Dr L H Hiranandani Hospital
Structure of Presentation
 Introduction
 Quality at every level
 Our experience
 Conclusion
Introduction – Genesis
 Dr LH Hiranandani Hospital Powai
 Conceived in the honor of Padmabhushan Dr L H Hiranandani
 Arguably the fastest hospital project in India
 Broke ground in Nov 2002
 Commissioned 22 Feb, 2004
 Expansion work begins 28 Nov 2008
 Completion – March 2011
 Hiranandani Hospital Thane
 25 July, 2004
 Hiranandani Multispecialty Hospital Thane
 Foundation stone – 17 Sep 2011
Introduction – Focus and strategy
 The Trustees were desirous that the hospital emulate

global standards in healthcare, empathize with patients
and attend to all who applied for assistance
 The hospital’s focus thus encompassed

 Hiranandani Gardens township initially
 The country and then the International scene
 Public charitable trust hospital
 Thus strategically the hospital while being a Trust

hospital was to strive to render the best health care
 This being in line with the below stated mission

Introduction – Mission Statement
“To be the preferred choice for healing and

good health”
Introduction – Quality Policy
“We are committed to rendering the best

available medical treatment to our patients.
Therapy will be evidence based and will
emulate global standards in every sphere.
We will strive to improve the quality of care
at every given time, thus ensuring patient
satisfaction”
Introduction – Values
 Respect and Dignity – Compassion and caring for the

whole person – body and soul
 Continuous Improvement – In every sphere and
emulate global standards
 Teamwork – Many hands, many minds, with a single
purpose
 Service – Enhancing community health by delivering
superior value in high quality cost effective healthcare
 Pride – In ourselves, our hospital and our work
Introduction – Quality
 There are many definitions of quality and possibly text

books written about how one defines quality
 There is one simple definition – Quality is the result

when a task is performed with the greatest care
 In healthcare the watch word is ‘CARE’.
 Care thus will translate into quality and that results in

the happiness quotient - DELIGHT
Introduction
Patients do not care how much you know

They want to know how much you care
Quality at every level
 Every time a patient or family members

interact with a staff member, the patient has an
opportunity to rate us as Delighted, Satisfied
or Dissatisfied
 These are our “Moments of Truth”
 We try to control these experiences by
assuring that all interactions are handled
respectfully and to the best of our ability
Greeting at the door by the

security person
Cleanliness of the lobbies and elevators

Clarity of Interaction with

directions to the information desk
room of the
patient

 Nurses
 Backbone of healthcare delivery
 Highest quality of care & motivation
 Overseas training and external audit
 Soft skills, communication & grooming
 Leadership & managerial skills
 Cadre review
 Altered pay structure
 Doctors
 Judicious blend of full time & part time
 Incentives to get the best out of them
 Full time doctors taken as partners
 Revenue share does not limit the capacity to earn
 Support to part timers by CME & awareness
programmes



 Senior leadership has created an environment
of
 Constant focus on performance improvement
 Team work
 Innovation
 Work force safety
 Fiscal performance
 Process to identify errors and address them

 Strategic planning process has human resource
development as an integral part of the plan
 Hospital staffing
 Adequate for current hospital operations
 Regular salary review
 Salaries are marked to market
 Good selection process to ensure the correct fit of
the individual into the organisation

 Organisation nurtures a culture of motivating
employees to perform well as a team and as
individuals
 Constant training & retraining at all levels
 Best employee every month
 Best department
 Employee satisfaction survey is carried out annually
with trends indicating decreasing dissatisfaction
levels and attrition since inception
 Considerable multitasking – individuals capable of
taking on each others responsibility at various levels

 ISO 9001:2000 / 9001:2008 QMS
certification, NABH & NABL
 Except for the ISO 9001:2001 – without external
consultants
 System based approach
 Perfect documentation
 1800 documents with 26000 pages created
 Environment which fosters and requires
 Legal
 Ethical behaviour
 Ethics committee evaluates ethical issues
Our experience

Our Experience - 2008



Our Experience
 Patient feedback
 Performa clearly indicates shortcomings
 Collected and analyzed for both IPD and OPD
 Regular feed back from doctors in meetings
 Ability to review complaints quickly and resolve
them effectively and promptly by
 Complaint aggregation
 Root cause analysis
 Immediate implementation
 Complaints are reviewed by the apex management
group
Our experience
Patient Delight Jan - Jul 2012
60
50
40
30
%
20
10
0
Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12
Months
Excellent Good Unsatisfactory

Conclusion – Best Practices

 Review and share the monthly comment reports. It's the
fastest way to know what's working and what's not
working for your patients. And you can quickly recognize
individuals or teams who were complimented.
 Communicate about Service Excellence widely and often.
You can make service an agenda item in staff meetings,
put service information on bulletin boards. Be creative
and have fun with it.
 Prepare scripts for patient processes and encounters. You
can select a common, routine patient process and create a
service map (i.e. what happens when and who does it).
Walk in the patients shoes and look ways to help the
patient understand and manage the process better.

 Consider adding the following phrases to your patient
communication:
 Please
 May I
 Thank you
 Explain the rituals to patients. You know what's going to
happen and why, but most patients don't. One of the biggest
complaints of patients is that they aren't kept well informed.
 Keep track of patient likes and dislikes. Some patients (i.e.
patients receiving radiation therapy or rehabilitation) have
multiple recurring visits. They appreciate that you remember a
favorite drink or snack.
 Remember that service recovery is everyone's responsibility. If
a patient complains to you, you own the complaint. And you
need to be provided with the resources and skills needed to
fulfill this responsibility.

 Evaluate service issues from both a systems as well as a
people perspective. If the system doesn't work, think of
ways to change the system to be more patient-friendly.
But never underestimate the power of a smile and a kind
word.
 Identify and manage the "high leverage" processes like
call light response time, pain management, admissions
and discharge. These are the processes that are likely to
raise patient anxiety. Anticipate this and address their
need for explanation and reassurance.
 Increase "face time" with patients whenever possible. If
possible, sit with patients while you do your
documentation. They will perceive that you've spent more
time with them.
 “Wish" people in the hallways. When patients see staff
smiling and greeting others, the environment seems less
cold and more friendly.

 Identify high risk patients (either from a clinical
standpoint or a service standpoint) and do a call back
just to see how they're doing.
 Keeping the place clean is everyone's job.
 Be a "Secret Shopper." Examine processes and first
impressions through the eyes of the customer. A great
way to check phone etiquette is to call your own
department. Or walk onto a unit and imagine what the
patient sees, hears, feels.
 Create a "service disaster plan." Identify the worst
possible service scenario for patients and what you
might do about it. Then you're prepared (rather than
panicked) in case it really happens.

 Manage noise. You may impact the noise level on
your unit by turning the lights down. Or implement a
"quiet hour."
 Clearly establish the difference between "red rules"
and "green rules." "Red rules" are rules that you never
break, no matter what. Rules around smoking and
propping doors are examples of "red rules." "Green
rules" are rules that you can bend, depending on the
circumstances. Sometimes you need to bend the rules
a little to satisfy a patient.
 Remember the "Grandmother Rule" - Do what you
say you're going to do, when you say you'll do it and
do it right the first time.
 Overestimate time frames. Then try to exceed their

expectations.
 Remember the "Iron Law of Customer Service" -
Respond to customer complaints within 24-48 hours.
That doesn't mean you have to solve the problem - if
you can, great. But you need to acknowledge the
problem and let them know when you can get back to
them.
 Implement a "no negativity day" on your unit. The
impact of that may surprise you.
Conclusion
The adopted best practices are not only adding

to Customer Delight but are propelling the
hospital towards its cherished mission
“To be the preferred choice for healing and good

health”
Conclusion
 By applying for and receiving the National Accreditation

for Hospital and Healthcare Providers (NABH) and being
the first hospital in Mumbai to do so, Dr L H Hiranandani
Hospital has demonstrated a commitment to quality
health care. Quality health care is crucial to our people's
welfare and it is important to have organizations that are
willing to measure themselves against national standards
Dr Sujit Chatterjee MD
Chief Executive
Thank you

Quality at Every Level

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Quality at Every Level

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A NABH Accredited Hospital

“ To be the preferred choice for healing and good health”

Achieving Patient Delight

 Quality at every level

Introduction – Focus and strategy

 The Trustees were desirous that the hospital emulate

 The hospital’s focus thus encompassed

 Thus strategically the hospital while being a Trust

 This being in line with the below stated mission

Introduction – Mission Statement

“To be the preferred choice for healing and

Introduction – Quality Policy

“We are committed to rendering the best

 Respect and Dignity – Compassion and caring for the

 There are many definitions of quality and possibly text

 There is one simple definition – Quality is the result

 In healthcare the watch word is ‘CARE’.

 Care thus will translate into quality and that results in

Patients do not care how much you know

Quality at every level

 Every time a patient or family members

Quality at every level

Greeting at the door by the

Quality at every level

Cleanliness of the lobbies and elevators

Quality at every level

Clarity of Interaction with

Quality at every level

Quality at every level

Quality at every level

Quality at every level

Quality at every level

Quality at every level

Quality at every level

Quality at every level

Quality at every level

Our Experience - 2008

Our Experience - 2009

Our Experience - 2010

Patient Delight Jan - Jul 2012

Excellent Good Unsatisfactory

Conclusion – Best Practices

Conclusion – Best Practices

Conclusion – Best Practices

Conclusion – Best Practices

Conclusion – Best Practices

Conclusion – Best Practices

 Overestimate time frames. Then try to exceed their

The adopted best practices are not only adding

“To be the preferred choice for healing and good

 By applying for and receiving the National Accreditation

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