Manipal: The multi-specialty challenge in critical healthcare

Abstract

It wasn’t a sudden occurring. The queue in the various Outpatient Department (OPD) areas of the hospital had stretched to over 4 hours, especially in the Orthopaedic OPD area. This situation had built up gradually over several months in the OPD of the Manipal Hospital Bangalore (MHB), touted as the gem in Multi-speciality in Bangalore. Mr. Gopal, the dynamic CEO had taken over the reins of the hospital in April 2015, following an illustrious career in healthcare management. He was no stranger to the unpredictability of the demand in the industry which could potentially disturb the best laid capacity and lead-time plans of any hospital. Mr. Gopal was worried about the increasing complexity in the overall operations at MHB. The hospital was consistently overflowing with patients, no matter how hard they tried the resources in the hospital were severely constrained during peak hours of approximately 10 am to 2.30 pm, on most days especially on weekends. The rest of the time, the resources operated at less than optimal utilization levels and went to as low as 30% on many counts. The Orthopaedic OPD was the most troublesome. The waiting time for this area stretched to 4.5 hours in extreme cases and 3 hours on average during peak times of the hospital. This waiting time was for the entire cycle of junior doctor consultation, X-ray, and finally Senior Doctor re-consultation. This was the typical schedule or workflow followed by the patient in the Ortho OPD (Exhibit 7). Clearly, there was a large scope for improvement in the setup and processing times of the procedures, but more importantly on how they could spread out the demand, schedule optimally and reduce customer dissatisfaction levels. MHB was already one of the very best in Bangalore, but if it were to compete with the world’s best, it had to brace itself for some tough decisions and operations overhaul to cater to peak demands as well. There was a resurgent need to capture the value created and delivered to the patient from the hospital. It had to ascertain whether the patient was paying for the right reasons and how the hospital could maximise the value it delivered.