HISTORY & BACKGROUND

Over the past decade, Shaukat Khanum Memorial Cancer Hospital and Research Centre has established itself as a centre of excellence providing comprehensive care free of cost to thousands of indigent cancer patients. This pioneering, state-of-the-art hospital located in the heart of the Punjab was founded by Imran Khan, one of Pakistan's most illustrious cricketers. As a charitable institute, it is funded predominantly from the donations of friends and wellwishers from around the country and across the world.

Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) is a state-of-the-art cancer centre located in Lahore, Pakistan. It is a project of the Shaukat Khanum Memorial Trust, which is a charitable organization established under the Societies Registration Act XXI of 1860 of Pakistan. The institution is the brainchild of Pakistani cricket superstar, Imran Khan. The inspiration came after the death of his mother, Mrs. Shaukat Khanum, from cancer

FAST FACTS ABOUT SHAUKAT KHANAM

Inaugurated Founder Annual budget Financially supported patients Philanthropic spending Area/Location Beds New registrations Outpatient visits Chemotherapy Radiation treatments Admissions Surgical procedures Pathology tests Imaging studies Pharmacy Dispensing Staff December 29, 1994 Imran Khan (Chairman, Board of Governors) Rs. 4.7 billion 75% (since 1994) Rs. 9.94 billion (US$ 148 million) 20 acres in Lahore, Pakistan 176 9,480 (Year 2011) 141,806 (Year 2011) 31,367 (Year 2011) 44,540 (Year 2011) 7,618 (Year 2011) 6,560 (Year 2011) 3,251,680 (Year 2011) 144,216 (Year 2011) 931,848 (Year 2011) 1,524 (59 Consultants, Physicians & Surgeons)

MISSION STATEMENT
To act as a model institution to alleviate the suffering of patients with cancer through the application of modern

methods of curative and palliative therapy irrespective of their ability to pay, the education of health care professionals and the public and perform research into the causes and treatment of cancer.

STRUCTURE OF THE ORGANIZATION: DEPARTMENTS OF SHAUKAT KHANAM MEMORIAL : there are almost 30 different departments of shaukat khanam hospital which includes three divisions ADMINISTRATIVE DEPARTMENTS CLINICAL SIDE NURSING AND HEALTH CARE

NAME OF DEPARTMENTS ARE : 1. ANCILLARY HEALTH SERVICES 2. BASIC SCIENCE LAB 3. BIO MEDICAL ENGEENERING 4. BLOOD BANK 5. CANCER REGISTERY AND DATA MANAGEMENT DEPARTMENT 6. CHEMO THERAPY 7. CLINICAL RESEARCH 8. CSSD 9. EMPLOYEE HEALTH CLINIC 10. ENDOSCOPY 11. FINANCE DEPARTMENT 12. FINANCIAL SUPPORT DEPARTMENT 13. FOOD AND DIETARY DEPARTMENT 14. HR DEPARTMENT 15. INFECTION CONTROL DEPARTMENT 16. MARKETING AND RESOURSE DEVELOPMENT 17. MATERAIL MAINTINENCE DEPARTMENT 18. NUCLEAR MEDICAL DEPARTMEBT 19. MIS DEPARTMENT 20. MOLECULAR PATHOLOGY 21. OPD 22. PATHALOGY 23. PALLIATIVE CARE 24. PEDIATRIC ONCOLOGY 25. PHYSIO THERAPY 26. QUALITY ASSURANCE 27. RISK MANAGEMENT 28. RADIOLOGY 29. RADITION ONCOLOGY 30. SURGICAL ONCOLOGY

shaukat khanam is having a functional structure with horizantal linkages as the activities of each department are grouped together by a common function all the human knowledge and skills with respect to their specific activities is consolidated and there is cordination and communication among different departments as the organization shaukat khanam is a huge organization having a large no. of departments and people employed so for the proper management of their structure they have grouped their departments which have functional structure into three divisions and each divison has a division head 1. administrative departments 2. clinical and research side 3. nursing and health care

STRUCTURAL DIMENSION OF THE ORGANIZATION

FORMALIZATION : the fromalization is high at shaukat khanum due to following POLICY MANUALS:
Cellular Phones

Please do not use cellular phones in patient care areas. The use of cellular phones in patient care and medical procedure areas can disrupt medical equipment performance. The medical staff can direct you to public telephones or areas appropriate for usage.
Patient Privacy

Shaukat khanam is committed to protecting your medical information shaukat khanam mandated significant changes in the regulations governing the provision of health benefits, delivery and payment of health care services, and security and confidentiality of patient health information.

Patient Rights

Patients have the right to express concerns or complaints about their care with the assurance that the quality of their care or future access to care will not be compromised. You also have the right to expect a reasonable and timely response to your concerns. They encourage you to address your concerns immediately to the staff of quality assurance department at the time of service so they can respond quickly to any concerns.
Safety Drills

Safety is a fundamental concern. They participate periodically in fire and emergency drills to test safety equipment and as part of their continuing Safety Education Program for all employees. If an alarm sounds while you are there they advise you to stay calm and follow the instructions of the staff. they will take care of everything
Smoking

Hospital patients who smoke will receive nicotine replacement therapy and counseling by their smoking cessation team.

Performance Improvement policy 1) Clinical and administrative staffs monitor and evaluate the quality of patient care and clinical performance, including proactive risk assessment of selected high-risk processes. Assess the intended and actual implementation of the process to identify variations or potential failure modes, and report information to the Clinical Board for action. Hospital Policy
Manual Policy Number: 1.1.1 Effective Date: 4/01/11 2

2) Communication of identified failure modes and potential impact on patient care/safety among departments/services when opportunities for improvement are multidisciplinary. 3) Identified problems are tracked to assure improvement or resolution through redesign of the process. 4) Information from Departments/Services related to tested and implemented process findings of discrete performance improvement activities are used to detect trends, opportunities to improve, or potential problems. 5) The objectives, scope, organization, and effectiveness of the redesigned processes are evaluated annually and revised as necessary to ensure effectiveness is maintained over time.

Visitation policy .:

1.Visitation hours for general care units are from 6:00 a.m. to 9:00 p.m. daily. Visitation times for Special Care Units (ECC, OB/Peds, Critical Care and Psychiatry) are determined by each individual special care unit. 2.Only one approved person per patient may remain overnight on the General Care Unit after 9:00 p.m. Overnight visitors are not allowed on Womens Health (fourth floor) unless there are extenuating circumstances, in which case visitation will be approved on an individual bases. All persons staying overnight with a patient after 9:00 p.m. or before 6:00 a.m. must be registered at the Information Desk located in the first floor front lobby. A visitors pass, specifying the nursing unit and date, shall be issued for one night only by the Patient Information Desk attendant who will instruct the visitor to remain on the assigned unit, and to wear the pass on the chest area where it is clearly visible at all times. 3.Children (under the age of 16) visiting patient care areas must be accompanied by an adult at all times. Children will not be allowed to stay overnight on a patient care unit or waiting area. Visitation by children may be restricted dependent upon the patients

Consultation policy :

Policy: 1. A request for a consultation shall be noted in the physicians orders or the progress notes. 2. The consultation request form shall be completed by the requesting physician and placed on the patients medical record. The form should indicate the current date, time, reason for consultation, requesting physicians signature, printed name, hospital service, and beeper number. A copy of the ED record will be placed in the chart with the written consult. 1. The physician (or designee) requesting an ED or inpatient consult shall contact the service to be consulted by telephone through the Hospital paging system. a. Routine inpatient consults should be answered within 24 hours. Routine outpatient consultations shall be answered within the time frame requested. All requests for consults shall be immediately communicated, other than those for routine clinic appointments and accompanied by a legible written consultation request form. Consult forms are never to be sent via campus mail; consults are delivered by hospital staff to the appropriate area/department. b. Emergency or stat consultations shall be requested only when there is an emergency or urgent need for the consultation. The consultation form will remain on the chart. The physician will notify the Clinical Service directly of the need for the consultation, giving the patients name and location.

JOB DESCRIPTION OF VARIOUS EMPLOYEES : when there is some vacancy avialable in shaukat khanam ,first the job description of the post or vacancy is prepared accordding to the nature and requirements of the job ,the hiring request is then sent to the hr department which places the ads in the newspaper and online. job description of each department is designed by the top manager of each department and then it is signed by the divisional head. RULES AND PROCEDURES : the rules and regulations are in the written form and they are different for each department . these rules and regulations are standardized and they are made by the top mangaers of the respective departments which are signed by the divisional head and then CEO SPECIALIZATION: they have three divisions of their departments at the clinical and research division and the nursing and health care division departments specialization of the jobs is high because they perform only a narrow range of tasks because they perform which are sensitive and related to health matters, whereas in the administration division the specialization is low as employees can perform a wide range of tasks in their jobs

STANDARDIZATION: Standardization at the organization is high as most of the departments perform similar day to day activities according to the standards that are defined HIERARCHY OF AUTHORITY: the hierarchy is related to the span of control or the no of employees reporting to the supervisor . At shaukat khanam span of control is narrow so hierarchy tends to be tall

HIERARCHY OF NURSING DIVISION:

director

manager Team leader Senior staff nurses

Staff nurses

Brown uniform

OR
(porters of clinical work)

Blue cheque uniform (health care assistants)

Green uniform (OT staff)

Dark blue uniforms (ICU staff)

White uniform (nurses)

Trainee

HEIRARCHY OF CLINICAL DIVISION:

Head of deartment fellows residents

Clerical staff

Hierarchy of administration division:

Top managers

Deputy managers supervisors General staff

CONCENTRATION OF POWER:
it is not the vertical structured organization where the control is centralized with th e top managers but the control is decentralized where the decision making can be made by lower level staff also.

COMPLEXITY : Complexity at shaukat khanam is low or we can say that it is at a moderate position because there are almost 30 departments and each department is performing their own specific tasks and activities ,,there are no sub departments and sub activities ,since they have a decentralized concentration of power which executes a flexible structure and open communication of inter departments . Ceo Divisional head clinical top manger supervisor lowerlevel staff Divisional head nursing Divisional head administration

PROFESSIONALISM: as professionalismm is generally measured, the average no. of years of

education of employes, employees at shaukat khanam have proper formal education accordding to their jobs , usually doctors,consultants researchers and clinical staff people have average 16 years of education and more ,the administrative staff have 12 to 14 years of formal education and lower level staff have average 12 years of formal education ,so we can say that professionalism is high at shaukat khanam. Shaukat khanam provides ON THE JOB TRAINING for 3 to 6 weeks (depending upon the nature of the job ) that is mandatory for every employee on the very first day of the job there is a detailed orientation about the job and about the working and rules of shaukat khanam . Even after the formal education they provide this mandatory training and they focus on the communication and behavior of the staff and lower level employes alot.

PERSONNEL CONFIGURATION: total no of employees at shaukat khanam are about 1500 to

1600. The nursing divison is mostly employeed with 600 employees and all the employees are deployed to the various departments according to the functions they have to perform .

GOALS STRATEGIES AND EFFECTIVENESS OFFICIAL GOALS : long run goal or mission statement of shaukat khanam is as follows
To act as a model institution to alleviate the suffering of patients with cancer through the application of modern methods of curative and palliative therapy irrespective of their ability to pay, the education of health care Shaukat khanam professionals and the public and perform research into the causes and treatment of cancer.

OPERATIVE GOALS : Resource based goals : Market based goals : Employee development : Innovation and change : Productivity:

ORGANIZATIONAL SIZE LIFE CYCLE AND CONTROL

Shaukat khanam is at FORMALIZATION STAGE

because they involve the installation and use of rules,procedures and control systems ,communication becomes less frequent and more formal .Top mangment is concerned with making and planning strategies and they left the operations of the firms to the middle management .Their groups and decentralized units are formed to improve coordination .They provide incentives to the doctors and staff to get them attracted towards to the hospital and to take decesions which are best for the overall hospital .This coordination and control system enabled shaukat khanam to continue to grow .

MANAGEMENT CONTROL SYSTEMS

Even though many organizations are trying to decrease bureaucracy and used rules and procedures that constraint employees every organization needs systems for guiding and controlling organization. Employees may have more freedom in todays companys but control is still a major responsibility Shaukat khanam out of the three control strategies uses BUREACRATIC CONTROL as their rules and policies are properly defined and they are standardized .The hierarchy of authority is clear and they are using this mechanism to standardize and control behavior of their employees and asses their performance .

ORGANIZATION DESIGN & CULTURE :

Shaukat khanam has a MISSION CULTURE as the organization is concerned with serving the cancer patients in the external environment irrespective of their ability to pay , so they have too constantly interact with the external environment to raise funds for the organization. Shuakt khanam emphasize on a clear vision of its purpose and on achievement of goals . In shaukat khanam individual employee is responsible for specified level of performance . Shuakat khanam promises specified rewards for group performance i.e Medical cover for immediate family is free Gym service ,different sports tournament and employee night (a dinner of all shaukat khanam employees with their families ) 13 salaries ( 12 salaries,1 bonus + 12 holidays ) Salary is incremented every year

ETHICAL VALUES IN ORGANIZATION :