home healthcare services

8/18/2019 Home Healthcare services

1/21

Study the home health care service

provided by the hospital and

develop a business model plan


2/21

Home healthcare-an overview

• Number of people over 60 years is set to double by 2050

(WHO-International day of older persons)- 1st October.

• Based on World Health Report on Ageing & Health 2015 –

Govt must ensure policies that enable older people to

continue participating in society.

FUTURE SCOPE

• 177 million elderly people in our country by the year 2025 &

343 million by 2050- UN Population Division (UN 2011).

HOME HEALTH CARE AT GODREJ MEMORIAL HOSPITAL

• Service started – 2006.

• In starting phase – doctor’s & physiotherapist’s visit at home.

• At present -blood sample collection, physiotherapy, nursing

care, nursing aide, doctor’s visit.


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Introduction

Home health is a wide range of health care services

that can be given at home for an illness or injury .SCOPE OF SERVICE

Elderly care

Wound care for pressure sores

Monitor serious illness

Suture removal and drain care

New born and maternal care

Post surgical care and care for chronically ill patients

Equipment provision(rental or purchase) for patient


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Objectives

Work flow analysis of current home health

Find, compare and analyse the expectations versusexperience of service seekers

Find issues in present service

Recommend hospital business plan

METHODOLOGY-QUANTITATIVE STUDY

Data collection- feb to july’2015, to analyse product

outreach ,demand of service and age distribution . Survey of 20 patients- for feedback.


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OUTREACH OF SERVICES wrt HOSPITAL

0

10

20

30

40

50

60

70

80

90

100

vikhroli ghatkopar kanjurmarg bhandup

feb'2015

march'2015

april'2015

may'2015

june'2015

july'2015


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PERCENTAGE DEMAND- FOR DIFF SERVICES

0

10

2030

40

50

60

70

Feb'2015

March'2015

April'2015

May'2015

June'2015

July'2015


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Service demand segregated into age of patients

0

10

20

30

40

50

60

70

80

90

feb'15 march'15 april'15 may'15 june'15 july'15

less than 40 yrs

40-60 years

more than 60 years


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Process mapping

• Doctor’svisit, nursing, physiotherapy,nursing aide, pathology

• Call from reception is forwarded

Raising of request forservice

Enquiry & Counseling

• Log book maintained• Time of incoming call, location, service

required noted

Enrolment by staff

• Blood sample collection & report dispatch

• Physiotherapy at home

• Emergency ambulance service

Delivery of service

Payment is received


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Composition of home health team visiting

patients

0

10

20

30

40

50

60

70

80

90

100

Doctor/Physiotherapist Nurse Nursing aide

no

yes


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Customer feedback about home health team

0

2

4

6

8

10

12

14

16

18

20

keep updated

during arrival

listen carefully behave properly courteous&polite

never

sometimes

usually

always


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Customer experience about the home care

service

0 5 10 15 20 25

good experience

satisfied

faced problem

will recommend further

no

yes


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Issues

Service provider team is small

Doctor busy – emergency cases

No team leaders

Ambulance is used

No facility for night service

Inadequate branding

No advertising or marketing for servicepromotion


13/21

Business model planMarketing & Business

Assessment

o market survey, analysis &market segmentation.

o demand analysis

Clinical services planning o full service healthcare provider

o commitment to employee quality

o Clinical development centers

Equipment planning &

review

o multipurpose utility products

Manpower planning o analyze current manpower inventory

o

making future manpower forecasts

Financial modeling o financial analysis

o technical requirements

o safety measures, guidelines & SOPs


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Multipurpose equipment model


15/21

OT Costing• 4 operation theatres.

•

Timing = 9 hours (8 am – 5 pm) + Emergency.• Staffing = 12 Nurses, 2 OT Technicians, 4 CSSD, 4 Boys (HKS).

OBJECTIVES

• Calculate OT cost per minute and utilization percent of all 4 OTs

• Collect data of laparoscopic surgeries performed over past one year.

• Categorize the operative time of lap surgeries.

• Standardize the operative time in order to benchmark time which should

be taken by surgeons during uncomplicated small incision laparoscopic

surgeries.• Calculate average cost of laparoscopic surgery.


16/21

OT Cost per minuteFixed cost Variable cost

Cost related data

Salary staff = 238798 Salary Surgeons= 700000

OT Tech = 38529

CSSD Staff = 65928 1077255

HK Staff = 34000

377255

Activities related dataDirect cost Indirect cost

Consumables = 1235485 4576485 Electricity expense= 300000

Equipment dep = 3000000 Water tax = 16000

Notional OT Rent = 25000 5653740 316000

4260485Total case minutes= 306.20 x 60 = 18372 minutes

OT Cost per min = Total allocated expense to OT/ Total case minutes

5653740/18372=307.73 ( Rs 308 approx)


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OT Utilization review for July’2015

Total working hours = 27 days x 9 hours per day = 243 hours (b)

OT Number Procedure hours (a) Utilization Rate = (a) /

(b)

OT 1 114 46.91 %

OT 2 132.20 54.40 %

OT 3 30 12.35 %

OT 4 30 12.35 %

Average cost of lap surgery= avg OT time for lap surg x OT cost per minute

75 x 308 = Rs 23100 per laparoscopicsurgery


18/21

Distribution of lap surgeries

0 1 2 3 4 5 6

September'14

October'14November'14

December'14

January'15

February'15

March'15April'15

May'15

June'15

July'15

August'15

Ing hernia

Lap app

Lap chol


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20/21

Financial impact of calculating OT cost per min

• It is estimated differently

• Reducing turn over time and

• Improving scheduling process may allow

hospital to regularly schedule additionalshort cases or day care surgeries without

adding staff. By routinely adding a one

hour case everyday a hospital canincrease its margin to a great extent.


21/21

Recommendations for Fertility centre

Day care services

Complete infertility evaluation

Intrauterine insemination (IUI)

In vitro fertilisation

- Intracytoplasmic sperm injection (ICSI)

- Oocyte & Embryo donation , Assisted hatching- Sperm, Ovum & Embryo freezing(Vitrification)

Percutaneous Epididymal Sperm Aspiration (PESA)

Testicular sperm aspiration(TESA)

Endometrial Receptivity Array (ERA)- Diagnostic

home healthcare services

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