Executive Summary

A business plan is essentially a map that defines your business and outlines your strategy for
success. It is also a crucial document to securing business loans. Banks and other investors want
not only to understand your business, but to know you've thought out all the details, have a focused
plan for success and a way to measure success.

The demand for health care services has increased, making this one of the most booming industries
in global economics. If you aim to establish a new hospital, one of the first things you must do is
obtain financing. Writing a business plan for your hospital is the best way to propose, and then
secure, the funding you will need. You must know how much money you will need to start, and
then run, your hospital. Your research should encompass every aspect of the hospital from goals, to
location and development, to construction, to marketing, to staffing and administration. Writing
your plan will require a lot of research, but it will be a tremendous asset to you as you seek funding
and make further decisions about your future hospital.

Indian Health Care Sector

As per statistics published by the WHO, in 2008, the death-rate due to non- communicable diseases
was approx. 55% in the age group of 15 60 years. Lifestyle related diseases such as cardio-
vascular, cancer, gastro-intestinal and respiratory diseases contributed a major portion totaling to
almost 85% of all deaths in this category. The life-expectancy of Indians has been steadily
increasing over the years and this combined with a slow and steady migration of young workforce
to the cities and urban agglomerations has resulted in the increasing share of lifestyle disease
incidence. The projected life expectancy will be 70 years by the years 2025. On the other hand, the
infant mortality rate is on a steady downward trend thanks to the improvements in medical
technology and accessibility to primary care. However, it needs to be noted that the secondary and
tertiary healthcare accessibility is still largely restricted to the metro and the larger Indian cities.

In short, Indians are living longer, steadily migrating to urban areas and are becoming more and
more prone to lifestyle related diseases at a much earlier age than before.

On the other hand, the cost of healthcare has risen steeply over the years. The public spending on
health by the Indian Government is one of the lowest in comparison to other nations, amounting to
only 20%. 80% of the healthcare expenditure is borne by the public.
Indian Health Care VS Global scenario

Indian healthcare has grown rapidly in the last three decades. Corporate groups have revolutionized
the delivery of healthcare, by continuously benchmarking with global standards and striving to
achieve international and national accreditation such as Joint Commission International, NABH
etc.

However, a lack of Government will to promote the growth of healthcare coupled with the
presence of high entry barriers such as steep set up costs, shortage of medical professionals etc.
have ensured that the reach of the corporate healthcare groups have remained largely confined to
the metros and Tier I cities. India currently has approximately 0.9 beds per 1000 population
compared to the global standards of 3.5 beds per 1000 population. This translates to an additional
0.81 million beds at an estimated investment of INR 2.1 Trillion by 2018. The Indian middle class
is expected to grow the most with the workforce in the age group of 15 59 years of age set to
reach 325 million by the year 2050. The demand or health services aided by higher disposable
income, greater insurance penetration and improved awareness levels are factors, which are set to
be the main drivers of the healthcare boom. One other factor aiding the growth of healthcare is that
India currently boasts of the largest number of US FDA approved drug-manufacturing facilities
outside of the US. While these facilities currently focus on serving the lucrative US and European
markets, eventually it can be expected that the strong domestic demand would be met by the
production from these facilities. The prevalence of generics supported by mass-market production
strategies would aid to lower the cost of medicines and consumables for the Indian patient.

Industry challenges

In 2011, India had about 313 medical colleges across the country offering about 34,000 under-
graduate seats and approximately 16,000 post-graduate seats. The acute shortage of medical
professionals has resulted in a skewed distribution with concentration of healthcare workers and
doctors in the main cities. For e.g. Bihar had a patient to doctor ratio of 3400:1 as compared with
the Indian average of 1700:1.

The figure below illustrates the fact that an estimated 100 new medical colleges if opened every
year for the next five years would result in India achieving the global patient to doctor ratio
standard of 500:1 by 2025. The medical colleges across the country are skewed in distribution and
offer inadequate number of admissible seats, leading to alienation of students from states in the
East and North-Eastern part of the country due to widespread disparities in the standard of
education and uneven competing landscape for these students.

LITERATURE REVIEW

A Study on Market Orientation and Service Quality in Multi-Specialty Hospital in Gujarat

State Published by:- MS. Bhutak
Vishlaben Ashokkumar

The service sector plays an increasingly important role in modern economies. Consequently,
service managers and academic researchers are now directing their efforts to understanding how
customers perceive the quality of services. The issue of health-care quality management has drawn
considerable attention from both academics and practitioners over the past few years. In the wake
of pressure to move towards a managed care environment, health-care providers are being forced to
drive down costs, while at the same time maintain acceptable levels of quality. Health care
administrators must contain costs, yet at the same time not sacrifice quality. Consequently, the
ability to define, measure, and monitor quality is critical to the survival of health-care institutions.

Reseachers suggested that superior service quality helps to generate greater revenue and yield
greater profitability. In short, superior service quality has a positive effect on business profitability.
Because both market orientation and service quality moderate offerings and have a positive impact
on business profitability, a subsequent question is how market orientation and service quality are
related. Conceptually, one immediate effect of the offering modifications is a firms improved
ability to satisfy customers needs effectively by realizing what they want. Better served customers
are likely to make repeat purchases and spread out positive word-of-mouth information to potential
new customers. Another direct effect of the offering modifications is the increased capability to
serve customers efficiently by eliminating or reducing nonessential services by learning what
customers do not need. The enhanced effectiveness and efficiency of the service offering can then
lead to stronger profits due to higher revenue and lower cost. Consequently, the strength of the
market orientation- business performance relationship will depend on how much added
effectiveness and efficiency can be accomplished by the market oriented effort. And a direct gauge
of the effectiveness for service firms is service quality.
An application of the marketing concept in health-care services planning
Published by:- Donald W. Eckrich;Warren Schlesinger

In this report, efforts of one hospital to utilize market share estimates as market planning
parameters for their emergency room services are detailed to demonstrate (1) the difficulties and
shortcomings associated with the use of their traditionally used method, (2) the value of a transition
probability matrix defined empirical terms to help simulate future market positions, and (3) how
the perspective afforded by the marketing concept can revitalize an organization and help it to
focus on its primary target the patient.

Health and marketing: The emergence of a new field of research. Published by:- Stefan
Stremersch

Periodically, no matter the discipline, new fields of research emerge. Marketing is no different. A
marketing journal's calling should be to foster new fields of research, as they may prove to be
influential in the long run (Stremersch & Lehmann, 2007, 2008). Research fields can be defined by
their topic (for example, customer relationship manage- ment e.g., Gupta & Zeithaml, 2006),
method (for example, marketing dynamics e.g., Leeflang et al., 2009), or application area (for
example, high tech marketing e.g., John, Weiss, & Dutta, 1999). Health and Marketing is
starting to gain firm ground as a new research field defined by its application area.

The number of papers on Health and Marketing submitted to marketing journals has been
increasing rapidly over the last five years. Mainstream marketing conferences feature special
sessions on health marketing. The increasing expertise on Health and Marketing among faculty,
combined with high societal demand, has induced schools to offer healthcare marketing classes to
students, dual affiliations across economics, psychology, or business, and medicine to faculty, and
new Health and Marketing chairs to faculty. Common concerns in the establishment of a new
research field include the following questions. First, is the field relevant? Second, does the field
present us with new questions that require new knowledge development? Third, does the field yield
knowledge that can be generalized? These questions and the rise of research on Health and
Marketing motivated the International Journal of Research in Marketing and the Marketing Science
Institute to assemble a special issue on the topic. This special issue aims to stimulate more research
in this area, relieve some of the tension between reviewers and authors that characterizes the birth
of any new research field, and induce young scholars to consider it as an area in which they might
want to specialize.
Building upon the papers published in this special issue, the researcher will position the field of
Health and Marketing, provide examples of questions that can be addressed, and cite data
opportunities. I will then address common concerns other scholars express over Health and
Marketing research.

Hospital Nurse Staffing and Quality of care.

Published by:- Mark W. Stanton, M.A.

Hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as
pneumonia, shock, cardiac arrest, and urinary tract infections, according to research funded by the
Agency for Healthcare Research and Quality (AHRQ) and others. Yet increasing staffing levels is
not an easy task. Major factors contributing to lower staffing levels include the needs of todays
higher acuity patients for more care and a nationwide gap between the number of available
positions and the number of registered nurses (RNs) qualified and willing to fill them. This is
evident from an average vacancy rate of 13 percent.

This report summarizes the findings of AHRQ-funded and other research on the relationship of
nurse staffing levels to adverse patient outcomes. This valuable information can be used by
decision makers to make more informed choices in terms of adjusting nurse staffing levels and
increasing nurse recruitment while optimizing quality of care and improving nurse satisfaction.

Nurse Staffing and Healthcare Outcomes A Systematic Review of the International Research
Evidence. Published by:- Annette J. Lankshear, PhD;
Trevor A. SheUion, DSc; Alan Maynard, BPhil

The relationship between quality of care and the cost of the nursing workforce is of concern to
policymakers. Ihis study assesses the evidence for a relationship between the nursing work- force
and patient outcomes in the acute sector through a systematic review of international research
produced since 1990 involving actite hospitals and adjusting for case mix. Twenty- two large
studies of variable quality were included. They strongly suggest that higher nurse staffing and
richer skill mix (especially of registered nurses) are associated with improved patient outcomes,
although the effeet size cannot lie estimated reliably. The association appears to show diminishing
marginal returns.

International Journal of Healthcare Management - Hospital advertising Published by:-

Sibarata Nanda; Gaurav Bhatt; Achyut Telang
With a highly competitive market for the healthcare service, which is characterized by decreasing
number of beds and danger of closure, hospitals are increasingly implementing the advertising and
marketing plans for survival. Advertising seems to be an integral part of the dynamic growth of
hospital marketing. Hospitals can get benefit or lose by how the advertising function is
implemented and managed. This paper is a collective review of some of the previous research
studies in this aspect putting forward the concepts.
Global Health and Primary Care Research Published by:- John
W. Beasley, MD, Barbara Starfield, MD, MPH, Chris van Weel, MD, PhD, Walter W. Rosser,
MD and Cynthia L. Haq, MD

A strong primary health care system is essential to provide effective and efficient health care in
both resource-rich and resource-poor countries. Although a direct link has not been proven, we can
reasonably expect better economic status when the health of the population is improved. Research
in primary care is essential to inform practice and to develop better health systems and health
policies. Among the challenges for primary care, especially in countries with limited resources, is
the need to enhance the research capacity and to engage primary care clinicians in the research
enterprise. These caregivers need to be an integral part of the research enterprise so the right
questions will be asked, the results from research will be used in practice, and a scholarly and
evidence-based approach to primary care will become the norm.
The challenge of developing research in primary care can be met only by creating a strong
infrastructure. This will include strengthening academic departments, enhancing links to
researchers in other fields, improving training programs for future primary care researchers,
developing more practice-based primary care research networks, and increasing funding for
research in primary care. A greatly increased commitment on the part of international organizations
both within and outside of primary care is needed, in particular those organizations involved with
funding research. We provide suggestions to improve the global primary care research enterprise
for the benefit of the world's population.
A strong primary health care system is essential to provide effective and efficient health care in
both resource-rich and in resource-poor countries. To improve equity in health it is vitally
important to improve health services for the world's poorest and least healthy people. Among the
challenges for developing a strong primary care system, especially in countries with limited
resources, is that of developing research capacity in primary care. This capacity is needed to inform
practice and to improve health systems and policies. This paper reviews the evidence supporting
the role of the primary care system in providing effective and efficient health care, the need for
primary care research to be part of this system, a description of the primary care research, and
recommendations to strengthen the primary care research enterprise.

Background Paper on Conceptual Issues Related to Health Systems Research to Inform a

WHO Global Strategy on Health Systems Research. Published by:- Steven J.
Hoffman; John-Arne Rttingen; Sara Bennett; John N. Lavis ; Jennifer S. Edge; Julio Frenk.

Health systems research is widely recognized as essential for strengthening health systems, getting
cost- effective treatments to those who need them, and achieving better health status around the
world. However, there is significant ambiguity and confusion in this fields characteristics,
boundaries, definition and methods. Adding to this ambiguity are major conceptual barriers to the
production, reproduction, translation and implementation of health systems research relating to
both the complexity of health systems and research involving them. These include challenges with
generalizability, comparativity, applicability, transferability, standards, priority-setting and
community diversity. Three promising opportunities exist to mitigate these barriers and strengthen
the important contributions of health systems research. First, health systems research can be
supported as a field of scientific endeavour, with a shared language, rigorous interdisciplinary
approaches, cross-jurisdictional learning and an international society. Second, national capacity for
health systems research can be strengthened at the individual, organizational and system levels.
Third, health systems research can be embedded as a core function of every health system.
Addressing these conceptual barriers and supporting the field of health systems research promises
to both strengthen health systems around the world and improve global health outcomes.

CROSS-CULTURAL ADAPTATION OF HEALTH-RELATED QUALITY OF LIFE

MEASURES

Published by- FRANCIS GUILLEMIN CLAIRE BOMBARDIER and DORCAS BEATON

Clinicians and researchers without a suitable health-related quality of life (HRQOL) measure in
their own language have two choices: (1) to develop a new measure, or (2) to modify a measure
previously validated in another language, known as a cross-cultural adaptation process. We propose
a set of standardized guidelines for this process based on previous research in psychology and
sociology and on published methodological frameworks. These guidelines include
recommendations for obtaining semantic, idiomatic, experiential and conceptual equivalence in
translation by using back-translation techniques and committee review, pre-testing techniques and
re-examining the weights of scores. We applied these guidelines to 17 cross-cultural adaptation of
HRQOL measures identified through a comprehensive literature review. The reporting standards
varied across studies but agreement between raters in their ratings of the studies was substantial to
almost perfect (weighted K = 0.66-0.93) suggesting that the guidelines are easy to apply. Further
research is necessary in order to delineate essential versus optional steps in the adaptation process.
Quality of life Health

The analytic hierarchy process in medical and health care decision making

Published by Robert L. Nydick

This paper presents a literature review of the application of the analytic hierarchy process (AHP) to
important problems in medical and health care decision making. The literature is classified by year
of publication, health care category, and journal, method of analysing alternatives, participants, and
application type. Very few articles were published prior to 1988 and the level of activity has
increased to about three articles per year since 1997. The 50 articles reviewed were classified in
seven categories: diagnosis, patient participation, therapy/treatment, organ transplantation, project
and technology evaluation and selection, human resource planning, and health care evaluation and
policy. The largest number of articles was found in the project and technology evaluation and
selection category (14) with substantial activity in patient participation (9), therapy/treatment (8),
and health care evaluation and policy (8). The AHP appears to be a promising support tool for
shared decision making between patient and doctor, evaluation and selection of therapies and
treatments, and the evaluation of health care technologies and policies. We expect that AHP
research will continue to be an important component of health care and medical.

The effects of woman abuse on health care utilization and health status

Published by- Stacey Plichta

Estimates of the physical abuse of women by husbands or boyfriends in the United States range
from 85 per 1000 couples to 113 per 1000 couples per year. Victims of abuse are much more likely
than non victims to have poor health, chronic pain problems, depression, suicide attempts,
addictions, and problem pregnancies. Abused women use a disproportionate amount of health care
services, including emergency room visits, primary care, and community mental health center
visits. Despite its high prevalence and the disproportionate use of health care services it causes,
woman abuse is rarely recognized by health care providers. Even when the abuse is recognized,
health care professionals often provide inappropriate or even harmful treatment. Because many
abused women pass through the health care system, it is important that providers learn how to
identify those who are abused, treat all the effects of the abuse, and make appropriate referrals.

Barriers to mental health care for hispanic americans: A literature review and discussion

Published by -Albert M. Woodward, Alexander D. Dwinell ,Bernard S. Arons

The Hispanic American population, the second largest and fastest growing minority population in
the United States, faces barriers to access to both medical health and mental health care. This paper
examines both financial and cultural barriers to utilization of mental health care services; it is a
broad review of the literature and is not intended to be comprehensively detailed. The research
review suggests that the financial barrier is a major determinant of mental health service access for
Hispanic American populations. Also, nonfinancial barriers such as acculturation are examined. A
two-part plant is suggested to reduce both financial and nonfinancial barriers. Very little literature
on utilization of substance abuse services was found; suggestions for further research are thus
proposed.

Bernard S. Arons, M.D., is with the Division of Applied and Services Research, National Institute
of Mental Health.

Views contained in this paper may not necesarily reflect the official policy or position of the
National Institutes on Drug Abuse and of Mental Health or any other part of the U.S. Department
of Health and Human Services.

Information needs of health care workers in developing countries: a literature review with a
focus on Africa

Published by- Frederick Bukachi

Health care workers in developing countries continue to lack access to basic, practical information
to enable them to deliver safe, effective care. This paper provides the first phase of a broader
literature review of the information and learning needs of health care providers in developing
countries.
A Medline search revealed 1762 papers, of which 149 were identified as potentially relevant to the
review. Thirty-five of these were found to be highly relevant. Eight of the 35 studies looked at
information needs as perceived by health workers, patients and family/community members; 14
studies assessed the knowledge of health workers; and 8 looked at health care practice.

The studies suggest a gross lack of knowledge about the basics on how to diagnose and manage
common diseases, going right across the health workforce and often associated with suboptimal,
ineffective and dangerous health care practices. If this level of knowledge and practice is
representative, as it appears to be, it indicates that modern medicine, even at a basic level, has
largely failed the majority of the world's population. The information and learning needs of family
caregivers and primary and district health workers have been ignored for too long. Improving the
availability and use of relevant, reliable health care information has enormous potential to radically
improve health care worldwide.

Understanding Health Insurance Literacy:

Jinhee Kim, Bonnie Braun and Andrew D. Williams

The 2010 Affordable Care Act changed health insurance plans for both the insured and uninsured.
Currently insured consumers need to understand changes that impact their purchase decisions, and
newly eligible consumers need to understand how to purchase through the new health insurance
marketplace. Health insurance literacy is a new concept that addresses the extent to which
consumers can make informed purchase and use decisions. Consumers currently exhibit limited
health insurance literacy. Researchers and educators need a comprehensive review of the literature
and existing curriculum and materials to conduct research and to create and test educational
programs that could increase health insurance literacy. This article provides a review of relevant
literature and curricula. It offers implications for additional research, measurement of health
insurance literacy, and development of educational programs to improve health insurance literacy
in the United States.

Current Health Scenario in Rural India in Australian Journal of Rural Health

Ashok Vikhe Patil, et al (2002)

In this study seven that. About 75% of health infrastructure, medical man power and other health
resources are concentrated in urban areas where 27% of the population lives. Contagious,
infectious and waterborne diseases such as diarrhoea, amoebiasis, typhoid, infectious hepatitis,
worm infestations, measles, malaria, tuberculosis, whooping cough, respiratory infections,
pneumonia and reproductive tract infections dominate the morbidity pattern, especially in rural
areas. However, non-communicable diseases such as cancer, blindness, mental illness,
hypertension, diabetes, HIV/AIDS, accidents and injuries are also on the rise. The health status of
Indians, is still a cause for grave concern, especially that of the rural population. This is reflected in
the life expectancy (63 years), infant mortality rate (80/1000 live births), maternal mortality rate
(438/100 000 live births); however, over a period of time some progress has been made. To
improve the prevailing situation, the problem of rural health is to be addressed both at macro
(national and state) and micro (district and regional) levels. This is to be done in an holistic way,
with a genuine effort to bring the poorest of the population to the centre of the fiscal policies. A
paradigm shift from the current biomedical model to a socio- cultural model, which should
bridge the gaps and improve quality of rural life, is the current need. A revised National Health
Policy addressing the prevailing inequalities, and working towards promoting a long-term
perspective plan, mainly for rural health, is imperative.

ICT applications in Public Health Care System in India:

Ranganayakulu Bodavala (2002)

Indias public healthcare network is five decades old. It is plagued by many problems like
absenteeism of doctors, lack of proper facilities and most significantly lack of proper referral
services to urban hospitals and specialist centers. Due to these reasons the utilization and
confidence in the public healthcare system is very low. Successive governments have tried to
improve the various measures in the system with marginal success. Application of ICT tools will
improve access and delivery of healthcare services to Ivast majority of poor people living in rural
areas in india.

Criteria for Evaluating Evidence on Public Health Interventions

Rychetnik, et al (2002)

Public health interventions tend to be complex, programmatic, and context dependent. The
evidence for their effectiveness must be sufficiently comprehensive to encompass that complexity.
This paper asks whether and to what extent evaluative research on public health interventions can
be adequately appraised by applying well established criteria for judging the quality of evidence in
clinical practice. It is adduced that these criteria are useful in evaluating some aspects of evidence.
However, there are other important aspects of evidence on public health interventions that are not
covered by the established criteria. The evaluation of evidence must distinguish between the
fidelity of the evaluation process in detecting the success or failure of an intervention, and the
success or failure of the intervention itself. Moreover, if an intervention is unsuccessful, the
evidence should help to determine whether the intervention was inherently faulty (that is, failure of
intervention concept or theory), or just badly delivered (failure of ). Furthermore, proper
interpretation of the evidence depends upon the availability of descriptive information on the
intervention and its context, so that the transferability of the evidence can be determined. Study
design alone is an inadequate marker of evidence quality in public health intervention evaluation.

Changing Health Care System

Narayana (2003)

To improve the financial viability and quality of health care in public hospitals, the Andhra Pradesh
Government initiated a series of reforms. However, because of lack of resources, there has been
stagnation in the size and decline in the quality of public health care. The states patronage of the
private sector in health care has been justified on the ground that it would ease the pressure on
government hospitals. But in reality private hospitals are replacing rather than complementing
public hospitals by weaning away resources from government hospitals.

Changing Perspectives in Public Health

Vijayakumar Yadavendu (2003)

This paper focuses on the overriding influence of methodological individualism in the historical
construction of public health. While evidence of a holistic approach to health is observed in the
writings of people like Hippocrates, the developments subsequent to the establishment of the
Cartesian paradigm, contained strong elements of individualism. In fact, systematic
epidemiological studies in the 19th century rightly justified epidemiologys claim as the basic
science of public health. But, the gradual progression away from the population perspective
towards risk factor, clinical and finally molecular epidemiology, bears evidence of the increasing
influence of individualism in public health.

Health System Performance in Rural India Efficiency Estimates across States

Deepa Sankar and Vinish Kathuria (2004)

The present study attempts to analyze the performance of rural public health systems of 16 major
states in India using the techniques from stochastic production frontier and panel data literature.
The results show that not all states with better health indicators have efficient health systems. The
study concluded that investment in the health sector alone would not result in better health
indicators. Efficient management of the investment is required.

Budgeting for Health

Shivakumar (2005)

The announcement of the National Rural Health Mission and the commitment in the recent budget
to increase allocations for health are necessary steps in the right direction to correct Indias
shockingly poor health record. As national and state level strategies unfold over the coming
months, a vigorous and informed public discussion is needed to create a national consensus for
dramatically increasing investments in health with concurrent improvements in accountability and
management of the healthcare system. Equally important is induction of a cadre of village-based
health activists, all women, who will link communities to an upgraded public health system. These
women should emerge as the missionaries dedicated to advancing health in India. Money,
medicines and medical facilities will be meaningless without these missionaries. Finally, flexibility,
innovation, focus, inclusion and openness must become essential features of the functioning of the
National Rural Health Mission in its endeavour to provide good quality healthcare for all.

Microbial Pathogens of Public Health Significance in Waste Dumps and Common Sites

Achudume and Olawale (2007)

Microbial pathogens of public health significance found in waste and common sites were collected
from four different dumping sites and assessed for pathogenic agents. The modified methods
employed were based on the classical methods and basic principles of the reactions followed by
biochemical enzymatic standards described for gram negative non fermenting bacteria. The results
have shown presence of bacterial species including Pseudomonas, Mirococcus, Actinomyces,
Neisseria, Bacillus and Klebsiella. These pathogens can infect wounds and cause sepsis and
mortality and can even occur with such organisms to cause secondary infection. These groups of
organisms are almost impossible to control since they are ubitiquous. Public health may be ensured
from pathogenic agents at waste sites by prompt removal of waste and proper management
(mechanical sorting and excavating) methods.

Blurring of Boundaries: Public-Private Partnerships in Health Services in India

Baru and Nandi (2008)

Trace the evolution, structure and characteristics of public-private partnerships in healthcare over
the last six decades. It argues that these partnerships have broken down the traditional boundaries
between the market and the state, leading to the emergence of multiple actors with multiple roles
and newer institutional arrangements that have redefined their role, power and authority. The
fragmentation of role and authority has serious consequences for comprehensiveness, governance
and accountability of health services.
 NOBLE CARE

Vision

To provide high quality healthcare for kids, with care and compassion, at an affordable cost, on a
large scale

Mission

Children hospital is guided by the belief that all children need to grow up in a protective and
nurturing environment, where each and every child is given the opportunity to reach his or her
potential. We believe this vision can provide a brighter future for all children.

SCOPE MANGENMENT

Every day hundreds and thousands of children are treated at a healthcare facility. Hence, it is
impertinent that hospital authorities and owners construct highly sophisticated and state of the art
hospitals for their patients. At noble care, we are willing to go past every hurdle to construct the
ideal hospitals & healthcare facilities for our child patients across the country. Each day, we focus
on developing hospitals that are world-class and feature best of the facilities. We construct modern
hospital infrastructures featuring best of the facilities and amenities.

CONCEPTUAL DEVELOPMENT

Problem Statement: Noble Care aims to provide the service to the society specializing in children
(Pediatrics).

Statement of work: Noble Care aims to state providing services in a year and half from the date of
commencement.

Constraints:
Demonetization because of which there was a money crunch.
Lack of specialization (Pediatrician) opted by medical students.
Time Constraints.
Objectives:
To earn maximum profit
To introduce new technologies to make services better than ever before.
To provide incremental value to our customers.
To protect and maintain our resources.
To respond approximately whenever possible to societal expectations and environmental
needs.
Maintain a positive and steady growth of 15% each year.
Maintain a gross margin of 25%.

Alternative Analysis
With the help of check list method we were able to pick the best alternative or the best project
choice. (Mentioned in the later part of the project report).

SCOPE STATEMENT

Goal Criteria:
To provide out class medical facilities to our patients.
To provide them a favorable environment.
To expand the business.

Management Plan:
 Milestones Description Weeks Start dates
Phase 1- Construction Confirm the needs & project 4 10th jan 2017
plans
Land Acquiring & carry out 4 10th feb 2017
site development
Award of tenders 4 10th march 2017
Phase 2- Equipment Architectural designs 4 10th april 2017
Civil work 8 10th june 2017
MEP 4 10th july2017
Architectural furnishing 12 10th october 2017
Phase 3- Staffing & Recruitment 4 10th nov 2017
Marketing Staffing 4 10th dec 2017
Marketing 4 10th jan 2018
Phase 4- Launch Hospital set up & operational 4 10th feb 2018
readiness
Scope base line:
Scope baseline is a part of the project management plan and acts as the reference point through the
project life. It has several components. These include project scope document and the WBS.

Work break down Structure:

(Mentioned in the later part of the report)

Responsibility Assignment Matrix:

(Mentioned in the later part of the report)

SCOPE REPORTING

Cost, schedule, performance status:

(Financial Plan of the report)

Earned Value:
(Financial Plan of the report)

PROJECT CLOSE OUT

Post Project Analysis: (Financial Plan of the report)

Financial Close Outs: (Financial Plan of the report)

Business Plan

Organizational Financial Plan

Plan
Marketing Plan Operational Plan
 MARKETING PLAN

Role of Marketer in Healthcare Industry:

VARIABLES INCLUDES:

Patient
The Physicians
The employer
The conflicting role of Physicians
Lack of knowledge of the relationship between many healthcare services and their personal
needs Present Era Secret Build Relationship

Promotion of a hospital Marketing

Quality of treatment
Medical tourism
Word of mouth
Major surgeries
Medical camps
Social networking
Demonstration:
Majestic view of Hospital to public Newspaper, Advertisement, Mindset of people for the hospital
Television, Cardboard printing and Radio, Internet circulation, mode of publicity pamphlet printing
and circulation Notice distribution, Poster display and affixing etc.

Public speech and relations

This can be done through the expert committee consisting of the doctors team or the team trained
to explain the various updates.
This process would enhance the relationship between the doctors, hospitals and the patients.

Advertisement of the hospital Doctors profile equipments

It is important to explain the
Only in the Medical profession public or make them aware the name and the fame of the that
your hospital is equipped doctors profile is considered as with modern equipment and equivalency
of the Gods grace technologies in order to ensure that they are better than competitors and or par
with the International standards and quality consciousness.

Media interview on Hospital and Healthcare

These are primary concern about the marketing system and techniques of corporate hospital
It involves large no. of people watching all over the world & clarifying their doubts.
Building a health facility marketing a hospital starts from the structure of the building housing the
facility. The architectural drawings must take cognizance of the nature of hospital and hospital
business. The design must take note of important features like:
1) Car park
2) Ambulance point
3) Emergency management
4) Security posts
5) Reception area
6) Medical records unit
7) Consulting rooms
8) Laboratory and other diagnosis center
9) Wards accounting to sizes
10) Isolation wards
11) Theatres and Labor rooms
12) Administration and accounts offices
13) Conveniences for male and female visitors and patients.
14) Rest rooms for Nurses and Doctors
15) Provision for other Services.

BRAND COMMUNICATION & INTEGRATEDMARKETING COMMUNICATION

Establish Brand Communication & Integrated Marketing Communication for the Hospital in
designing of:
Service Booklet
Information Leaflet
Doctors Profile
Logo Design
Letter Head
All marketing Collaterals-Banners etc.
Visiting Cards
Reports / Envelopes
Doctors letter / prescription pads
Signage of the Hospital

Activities of the Marketing Department

Phase One:
Facilitate corporate tieups for both inpatient and outpatient
Health checkup tieups
Credit client service

Phase Two:
Maintaining the existing tieups and
Renewing contracts,
Maintaining communication channels.

Healthcare Marketing

Branding Matters:
1. Strong healthcare brands control their own destinies
2. A clear brand position aligns physicians and staff
3. Brand tools ensure consistent communications
4. Branding supports multichannel and social media initiatives

Priorities for Marketing of Hospital

1 Patient Satisfaction and Service
2. Physician Engagement and Satisfaction
3. Quality
4. Business Performance
5. Employee Satisfaction

ORGANIZATIONAL PLAN
Form of Ownership:

Form of Ownership in Noble Care Child Hospital is Partnership so the business will be performed
on partnership basis.

Partners and their terms of Agreement:

As the legal status of Noble Care Child Hospital is partnership so there are five partners,
All the partners will have equal responsibility to operate the business and all will be responsible for
any wrong decision.
All the partners have equal investment of in the business and the ratio of profit and loss distribution
will be equal

Categories under Operations:

Intensive Care Unit (ICU)

Emergency
Physiotherapy
Neurology
Laboratory
Pharmacy
Dispensary
Electrical department

Emergency:
Emergency department will be there in the hospital where patients that will be seriously ill will be
admitted. They will remain in emergency for almost two to three hours and then will be shifted to
rooms or intensive care unit depending upon the situation.

Intensive Care Unit (ICU):

In intensive care unit, patients suffering from severe diseases like pneumonia, malaria etc. will be
admitted. They will remain in that unit for two to three days depending upon their condition.

Physiotherapy Department:
We are going to introduce a different kind of hospital. We research in our area there in no
standardized children hospital in which a separate physiotherapy department available. So due to
this reason we are making a special physiotherapy department for those children which are hunted
by polio and other these types of diseases.
We require five million (5,000,000) for a fully equipped physiotherapy department.

Neurology Department:
The section of Pediatric Neurology at hospital is staffed by the experts in their field. We work
closely with other specialists to provide the most advanced care for children with neurological
illnesses. We coordinate pediatric nurse-supervised sedation for CT and MRI scanning with our
neurologists, who provide a full range of radiological imaging of the nervous system for our young
patients. In addition, because of the strong connection between the brain and behavior disorders, a
team of child psychiatrists, psychologists and behavioral pediatricians is also available to work
with patients and their families, as necessary.

Laboratory:
Laboratory will be well equipped with all the necessary equipment and instruments. Almost, all
types of tests can be possible there. E.g. X-Rays, blood test, CITY SCAN etc.

Pharmacy:
This sort of pharmacy has lifesaving drugs and other routine drugs which are recommended by a
consultant physician to a patient. We will be having fully equipped pharmacy.

Dispensary:
We have included dispensary for the patients that come just for time being. The dispensarys
charges will be included in the Doctors fees.

Electrical Department:
Hospital is the place where electricity is most important, not only for operations but also for
patients in wards, laboratories or ICU. So, we have included it as a separate department. This
department will handle the air conditioner plant and the generators for electricity problems.
 CPM METHOD

List of activities for the project.

 Confirm the needs & 4weeks PP
project plans

Land Acquiring & carry 4weeks LA

out site development
Award of tenders 4 weeks AT
Civil work 8 weeks CW
Mechanical, electrical & 4 weeks MEP
plumbing (MEP)
Architectural finishing 12weeks AF
Hospital set up & 4 weeks HOR
operational readiness
Recruitment 4 weeks RT
Staffing 4 weeks ST
Marketing 4 weeks MKT
Architectural designs 4 weeks AD

Start Activity Confirm the needs & project plans

Finish Activity Hospital set up & operational readiness

ORDER OF THE ACTIVITIES.

Activities Preceder
PP -
LA PP
AT LA
CW AT
MEP CW;AD
AF MEP
HOR MKT
RT AF
ST RT
MKT ST
AD AT
 CPM DIAGRAM

12/1
4
AD
0/ 4/ 8/1 2 20/2 24/2 28/3
4PP LA8 2
AT 4
MEP 8AF 2
4 4 4 4 4 RT
4

CW
8
ST
4 MKT HOR
12/2 4 4
0
32/3 mkt
6 36/4 40/4
0 4
Work Breakdown Structure

Constructing a
hospital
 Land acquiring
Confirm the Site Statutory
Equipmen
needs & selection approvals
t&
plan the Negotiations Approvals
furnishing
project Soil testing Vendor for
Market Architectural quotatio constructi
size drawings n on
Cost Colour Master Approval
estimates schemes plans from
Preliminar Flooring, for medical
y fittings & interiors board
schedule fixtures Room Approval
Project Sprinkler furnitur for
feasiblity & ducting e (beds, electricity
Capacity layout
to serve Staircase
General & window
wards(m details Recruitment
ale & Electric & Marketing
female) cable Hiring of
Doctors layouts doctors,
blocks Approvals & nurses,
Admin permits clerks,
blocks Site drivers,
developmen accountant
t s, etc
Water & Print
electricity media
Boundary News
papers
Hoardings
Pamphlets

FINANCIAL PLAN

FINANCIAL ANALYSIS.

PROJECT COST:
PRICING:

It shows leadership pricing to maintain its premium Quality and brand equity.

Doctors Fee Consultant physician 500/-

Physician 500/-

Physiotherapist 800/-
 REVENUES
Ward and room charges per day Ward charges 200/-
Particulars No. of Price per month
Total
Single non AC room (10product
Rooms) 300/-

Patients 500 500/- 750000

50
Singe AC room (10 Rooms) 30

Double non AC (10 Rooms) 500/-

20 admitted out of 100 15 1400 30 630000
( including
Double ACdoctor's
(10 Rooms) 900/-
visiting charge)
ICU (intensive care unit) charges (5 Rooms) 1200/-
Pharmacy 20 700 30
420000
ITR (intensive treatment room) charges( 5 Rooms) 1400/-
Operation 65000 19500000
City Scan 10 800/- 30

Rooms for operated 10 1400 30 420000

patient

Canteen rent 125000

Medicines for operated 10 1000 30 300000

patients

50 500 30 750000
Testing

Monthly revenue 22895000

Yearly revenue for 274740000

1rst year

COSTS:
 Electricity 1500000
Staff salary 5000000
Doctor Salary 12500000
Maintenance 500000
Technology up gradation 2000000

Total of the cost accruing for the month is 21500000/-

B.E.P:

Break even point is a point where a firm achieves no profit no loss; so this project will cover its
invested money in 5-6 years as the yearly income generated is 274740000 and the expenses behind
running this is 258000000.

So 27474000-258000000 = 16740000 yearly net income.

Total money invested is 10cr, so it will take 5-6 years to recover its invested money.

CONCLUSION AND RISK ASSESMENT

We are going to start a standardized children hospital in Vesu. Before this there is no hospital
operating which provide all facilities, which are needed for a children hospital. According to our
research there is a very much need for a standardize hospital that provides all the facilities for the
health to children. So in future our business is 100% successful and the chance of failure is Zero
percent (0%). The involvement of risk in our business is zero percent; the reason behind is that
there is no direct competitor in this region but some small clinics are operating here which are our
indirect competitors. There is no fear from their side because they are operating with single doctor.
Mostly doctors are operating their own clinics inside Noble Care. So in these conditions our
business is not facing any sort of risk.

REFERENCES
wikipedia. 2003. -. [ONLINE] Available at: https://en.wikipedia.org/wiki/Business_plan.

[Accessed 1 February 2017].

IBEF. 2008. Hospital. [ONLINE] Available at: http://www.ibef.org/industry/healthcare-

india.aspx. [Accessed 4 February 2017].

PWC. 2015. PWC. [ONLINE] Available at: http://www.pwc.in/industries/healthcare.html.

[Accessed 14 February 2017].

Spectrum Health. 2015. Children Care. [ONLINE] Available at:

http://www.spectrumhealth.org/locations/spectrum-health-hospitals-helen-devos-childrens-

hospital. [Accessed 12 February 2017].