CAM:CEO:CIRCULARS:

June 1, 2013

Office Order

In order to move towards a physician-led organization, and to bring about greater focus on the
functional aspects of our work, related both to patient care and medical education, the following groups
are being created, with immediate effect:

Patient Care:

Education:

Humane Care Group

Curriculum Design and Implementation Group

Rational Care Group

Clinical Training Group

Efficient Care Group

Assessment Group

Affordable Care Group

Student Support Group

Quality Improvement Group

Academic Administration Group

In addition to the above, there would also be a Research Group, which would be responsible for
directing and co-ordinating the activities of the Central Research Services and a Professional
Development Group, which would be responsible for developing the competence and ability of
teachers.
In order to develop policy and design interventions to improve the quality and range of medical services
available to the community, through our own extension centres and other institutions engaged in
healthcare, a Public Health Initiatives Group is being put in place.

In so far as the groups related to patient care are concerned, the first four groups; i.e. Humane Care,
Rational Care, Efficient Care and Affordable Care Groups, would be responsible for laying down policies,
guidelines and practices related to their functions while the last group, i.e. Quality Improvement Group,
is tasked with implementation of these policies, guidelines and practices across all patient care areas.
The Quality Improvement Group would also have the mandate of managing quality of operations and
consequently accreditation of services. For operation convenience, this group would also be responsible
for processes related to NAAC accreditation for academic institutions. The Management Support and

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Quality Assurance Groups would be merged with Quality Improvement Group, to facilitate its
functioning.

With regard to groups related to education, while the activities of these groups would be confined for
the present to the MBBS and medical PG courses, these would eventually be extended to other
institutions as well. At that time, suitable representation from these branches would be added to these
groups.

The first three of the groups related to education; viz. Curriculum Design and Implementation, Clincial
Training and Assessment, are expected to lay down policies, guidelines and practices, while the
Academic Administration Group would be responsible for implementation of these policies, guidelines
and practices across all teaching departments. The existing UG and PG Cells as well as the Student
Section are merged with the Academic Administrative Group. Clerks assigned to various departments
would functionally report to the Academic Administration Group.

The mandate of the Research and Professional Development Groups would extend to all the institutions
of the Mandal.

Each of the groups has a minimum of three physicians as its members. The physician heading the group
would be designated as Chairman of the group, while the others would be designated members. The
term of the Group would be three years, at the end of which the constitution of the group would be
reviewed. In case of a vacancy arising during the period of three years in any of the groups, it would be
filled up by the Chairman of the group with another physician. Annex 1 provides the names of those
associated with various groups.

Attachments to this order provide names of those associated with various groups, details of Guiding
Philosophy and scope of work of each group and the administrative and financial powers available to the
Chairmen of groups.

The above arrangement would replace the vertical structure so far as patient care is concerned.
Dr.Apurva Patel would, however, continue as Head of Trauma Centre and exercise such powers as he did
earlier.

With the above structure in place, it is expected that all departments would receive uniform guidelines
with regard to various functions related to patient care and education. The Heads of each department
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are, therefore, expected to assist in implementation of these guidelines in their department. As

indicated in the Delegation of Powers, however, the functional groups now formed would have direct
access to the members of all departments and its postgraduate students and assume administrative
control over their actions, if this is deemed to be important for the implementation of the policies laid
down. They would, however, keep the Heads of Departments informed of their actions.

In order to create a system of governance which is accountable to itself, all staff and the society, the
following mechanisms are expected to be followed:
1. Regular meetings within each group, preferably daily for some time,
2. A meeting once a week, if not more, among groups related to patient care as well as among
those related to education, to address areas related to both co-ordination and conflict in their
work,
3. A monthly meeting with the concerned Heads of Departments; last Wednesday of the month for
patient care groups in a forum that would be called Patient Care Council, last Friday of the
month for education groups in Medical Education Council and the first Tuesday of the month for
Public Health Initiatives in Public Health Council, and
4. A meeting of a Board of Management for each of the three areas once every quarter with the
Chairman and Secretary of Charutar Arogya Mandal as well as outside experts. The Board of
Management of the College would be redesignated as Board of Management for Education,
while the Boards for the other two areas would be shortly constituted.

This arrangement would come into effect immediately.

Chief Executive Officer

Cc to: Chairman/Secretary, Charutar Arogya Mandal
Dean/Principals
Chairmen/Members of all functional groups
Heads of all teaching departments
Heads of all management groups
Management Support Group/Quality Assurance Group

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Attachment 1
Mandate of the Functional Groups
Their Guiding Philosophy and Scope of Work

Patient Care Groups:

Group
Humane Care

Guiding Philosophy

Scope of Work

To evolve practices that would make staff of

the hospital see themselves as a part of the
team that deliver a humane experience to
patients and their families and to each
other.

1. To restructure the care program keeping

the well-being of patients at its centre
point.

2. Development and evaluation of the key

elements in healing environments
3. To strive for synthesis of art and science
of healing so as to create an exemplary
model of health care and healing.
4. To add spiritual dimension in patient care
5. To offer integrative therapies in a better
way, and make this change be known
widely to our patients and the
community.
6. To introduce training programs for
sensitization for the new incumbents
(staff members and students).

Rational Care

To create an enabling environment where

our clinical practices follow the most current
evidence based medicine, appropriate to the
requirements of the institution and patients
and that uniform standards of care are
evolved and followed across the institution.

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Development of patient management protocols

for uniform and evidence based treatment,
including:
1. Rational diagnostic practices, i.e.
appropriate and optimal lab tests, X-ray
and other imaging procedures.
2. Rational prescription of drugs for
treatment which is efficient, consistent,
most recent evidence based, safe, cost

effective, and easy to administer.

3. Appropriateness of surgical management.
4. Promotion of infection control and
antibiotic policies.
5. Promotion of clinical audit in each
department.
Efficient Care

To make the work flow of various cadres of

care-givers hassle-free, error-free and
prompt so that the care of the patient is
completed within the optimum time and
with minimum discomfort.

1. To develop policies with regard to the

response time of various patient care
services, including equipment downtime,
and strategies to improve it.
2. Identify areas for enhancing the level of
computerization and automation.
3. Identify practices which cause errors in
patient management and documentation;
develop strategies to minimize these
errors.
4. Identify logistical obstacles in provision of
services, including structural deficiencies,
and recommend alternatives to overcome
them.

Affordable Care

To ensure that the costs incurred by the

healthcare facilities for various clinical
activities and services are at levels that
match the most-efficiently run hospitals, so
that the cost of treatment to patients is as
affordable as is possible.

1. Ensure that the materials used in patient

care as well as equipment are purchased
at the most optimum price.
2. Review practices in management of
patients to identify areas where cost to
patients can be reduced and effect
measures, including staff orientation, to
minimize wastages.
3. Review usage of electricity to optimize
the energy cost.
4. Review manpower deployment for
patient care to optimize the manpower
costs.
5. To work in tandem with other patient
care groups, especially Rational Care and
Efficient Care Groups, to reduce the cost
of treatment to patients.

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Quality
Improvement

To create a culture of quality using the

policy initiatives provided by the groups
assigned specific responsibilities for quality
of healthcare and its validation through
accreditation.

1. Implementation of the policies and

protocols decided by the functional
groups related to patient care.
2. Developing capacity of staff to meet the
implementation challenges.
3. Improvement of patient care standards to
meet the highest norms for accreditation
of various services nationally and
internationally.
4. Respond to feedback, suggestions and
complaints from patients and ensure
corrective action.
5. Co-ordinate the accreditation of
educational institutions.

Education Groups:
Group

Guiding Philosophy

Scope of Work

Curriculum
Design &
Implementation

The group will design policies and a formal

plan of Educational Experiences and
activities that would be offered to students
of PSMC & HM Patel Institute of
Postgraduate studies with the aim to groom
the student for acquisition of knowledge
and skills (problem solving, psychomotor,
communication & behavioral) required in
dealing with the common clinical conditions
prevalent in the community to become a
healthcare professional with a humane
approach so as to deal with medicine in a
holistic manner.

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To design and implement curricula for both

undergraduate and postgraduate medical
courses to see that 1. These are structured in such a way that
the students graduating meet the
expectations set for them at various
stages of their study.
2. The structure also brings in both
horizontal and vertical alignment of
various departments engaged in
providing training in such a way that
students are taught holistically rather
than departmentally.
3. The syllabus is designed to cover
common clinical problems of the
community and includes the most
current medical literature for both core
and non-core as well as scholastic and
non-scholastic elements.

4. These are delivered regularly and using

pedagogical methodologies that are
innovative and relevant.
5. The progress of the students is
documented and assessed.
6. Review of the UG & PG programmes.
Clinical Training

To design a formal plan of Educational

Experiences and activities that would be
offered to students of PSMC & HM Patel
Institute of Postgraduate studies with the
aim to groom the student for acquisition of
knowledge and skills (problem solving,
psychomotor, communication & behavioral)
as per the expectations set for
undergraduate and postgraduate students,
using the most current and innovative
methods, at various stages of their study in
order to develop them as competent
healthcare professionals.

To design and implement clinical training

programmes, both at undergraduate and postgraduate level, to see that
a. These are in line with learning objectives
defined for various stages of study
bearing in mind the expectations from
students at that stage,
b. These are implemented as designed and
in doing so, using the most current and
innovative methods,
c. The progress of students is documented
and assessed.
d. UG & PG training is reviewed externally.

Assessment

To develop and administer assessment

systems, in respect of both internal and
external assessment, that test the technical
and behavioural competence of the
students in line with the expectations set for
graduates from the medical college, using
the most current and innovative methods, at
various stages of their study.

1. Periodic evaluation of assessment

systems along with its alignment with
learning objectives & expectations of the
institution.
2. Implement systems to ensure secure
data management.
3. Introduce innovations in assessments.
4. Ensure fairness and transparency in
assessment.
5. Improvement in the capacity of teachers
to assess students for both technical and
behavioral competence.

Student Support

To facilitate extra-curricular development of

in-training students and to help them
develop, together with the alumni, as
ambassadors of the vision of the institution.
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1. Ensure comfortable campus life for

students.
2. Design and implement Integrated

Mentorship & Feedback Programme.

3. Develop strategies for enhancing
involvement of students in meaningful
extracurricular activities.
4. Develop strategies for Life Skill
Development of students, including
maintaining a Student Library (Book
Club).
5. Develop and implement policies related
to deputation of students for curricular,
co-curricular and extra-curricular events
outside the institution.
6. Organize meetings and seminars for
students and alumni to improve and
develop life skills.
7. Develop mechanisms for enhancing
alumni involvement.
Academic
Administration

To provide administrative support in

delivery of curriculum and assessment to
both faculty and students.

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1. In co-ordination with the other 3

groups (Curriculum, Clinical Training
and Assessment), provide the
following:
a. Support for implementation
b. Infrastructure
c. Manpower
2. Monitoring Timetable Scheduling.
Communicating information to
respective departments and to
students.
3. Documentation and Recordkeeping
of attendance and marks (centrally).
4. Display of marks centrally.
5. Preparation of internal marks.
6. Preparation of Academic Calendar in
co-ordination with other groups
including Student liaison.
7. Preparation & issue of various
certificates.

Other Groups:
Group
Research

Guiding Philosophy

Scope of Work

To encourage a culture of research amongst

academic departments, both among the
faculty and students, that result in
progressively higher number of research
projects and publications, reaching
eventually to match the highest standards
established by any academic institution, not
just in terms of output but also content.

1. Increase the spirit of inquiry of the

students and the faculty.
2. Promoting & Facilitating research (At
Institutional & Gujarat level).
3. Promoting ethical research and the
understanding of ethics in the medical
community of Gujarat.
4. Capacity building of students and faculty
of the Institution and also that of
Gujarat.
5. Improving dissemination of research in
terms of presentations, publications,
working papers, etc.

6. Facilitating Research Collaborations

between Institutions of State, Nation
and Abroad.
Professional
Development

To create excellence among the teachers so

that they are able to fulfill their
responsibilities for both patient care and
teaching in the most effective manner and a
spirit of scholarship among the teaching
departments to extend the vision and
excellence of the institution beyond itself.

1. Needs assessment for faculty

development.
2. Enhancing institutional capacity in
Faculty development.
3. Needs assessment for CPD in individual
disciplines.
4. Institutional support mechanisms for
CPD of faculty.
5. Documentation system for capturing
CPD activities of faculty.
6. Institutional mechanisms for faculty
recognition based on excellence and
scholarship in teaching and individual
discipline.
7. Encouraging scholarship amongst faculty
through institutional support
mechanisms for organizing conferences
etc.

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8. Evaluation of faculty development

programs and CPD activities.
Public Health
Initiatives

To influence directly issues present at the

local level so far as health issues of the
community are concerned and at the same
time work towards creating an influence at
the state and national level. This will be
done by creating a platform for networking
with likeminded organisations, capacity
building and influencing policy makers.

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1. Service delivery (in Anand & Kheda

districts of Gujarat)
2. Public health research and advocacy
3. Public health training
4. Networking and Collaboration

Attachment 2
Composition of the Functional Groups

Patient Care Groups:

Group
Humane Care

Chairman

Members

Dr.Bhalendu Vaishnav

Dr.C Haritha
Dr.Ravindra Hadakshi

Rational Care

Dr.Smruti Vaishnav

Dr.Madhavi Chaudhari
Dr.Nimit Khara

Efficient Care

Dr.Rajiv Paliwal

Dr.Sanket Sheth
Dr.Apurva Patel
Shri RR Ubgade

Affordable Care

Dr.Jitesh Desai

Dr.Alpa Leuva
Dr.Nikhil Dave
Shri PN Ganju

Quality
Improvement

Dr.Monica Gupta

Dr.Nitin Raithatha
Dr.Chirag Modi

Education Groups:
Group
Curriculum
Design &
Implementation

Chairman

Members

Dr.Jyoti Mannari

Dr.Suman Singh
Dr.Wasim Shaikh
Dr.Devangi Desai
Dr.Sohil Vadiya

Clinical Training

Dr.Hemlata Kamat

Dr.Harsha Jani

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Dr.Ravish Kshtriya
Dr.Prachi Bichpuria
Assessment

Dr.Shirish Srivastava

Dr.Praveen Singh
Dr.Sanjay Gupta

Student Support

Dr.Sunil Trivedi

Dr.Manisha Gohel
Dr.Mudita Paliwal

Academic
Administration

Dr.Ashok Raman Nair

Dr.Satish Patel
Dr.Bharat Gajjar

Other Groups:
Group
Research

Chairman

Members

Dr.Somashekhar Nimbalkar

Dr.Swapnil Agarwal
Dr.Jagdeesh Vankar

Professional
Development

Dr.Himanshu Pandya

Dr.Rupal Patel
Dr.Anusha Prabhakaran
Ms.Jaishree Ganjiwale

Public Health
Initiatives

Dr.Nikhil Kharod

Dr.Dinesh Kumar
Dr.Shyam Sundar Raithatha

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Attachment 3
Delegation of Powers

Policy-making Groups:
(Humane Care, Rational Care, Efficient Care, Affordable Care, Curriculum Design and
Implementation, Clinical Training, Assessment, Student Support, Public Health Initiatives)
Administrative

Financial

1.

Authority to declare policy related to the Group.

1.

Approve
incidental Rs. 2000/- per prg. (Max
expenses for organising Rs. 10000/- per year)
internal trainings.

2.

Authority to seek information from HoD's and 2.

other Groups related to their scope of work.

Approve
incidental Rs. 500/- per mtg. (Max
expenses for organising Rs. 5000/- per year)
internal meetings.

3.

Arrange internal training programmes/workshops 3.

with the support of HR Group.

Approve expenditure of Rs. 1000/- per instance

urgent nature.
(Max Rs. 10000/- per year)

4.

Recommend nomination of Faculty / staff for any 4.

external training to Professional Development
Group.

Purchasing books related Rs. 2000/- per instance

to their scope of work.
(Max Rs. 20000/- per year)

5.

To seek liaison/consultation from institutions or 5.

experts to help further the functional area.

Approve
expenditure Rs 10000/- per instance
related to travel, food and (Max Rs. 30000/- per year)
stay of experts.

Professional Development Group

Administrative
1.

Authority to declare policy related to the Group.

Financial
1.

Approve expenditure for

reimbursement of various
expenses and type of
leave
for external
trainings, workshops and
conferences.

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Full (TA / DA as per

eligibility), within the
approved policy and the
annual budget.

2.

Authority to seek information from HoD's and 2.

other Groups related to their scope of work.

Approve
incidental Rs. 500/- per mtg. (Max
expenses for organising Rs. 5000/- per year)
internal meetings.

3.

Approve nomination of Faculty / staff for external 3.

training.

Approve expenditure of Rs. 1000/- per instance

urgent nature.
(Max Rs. 10000/- per year)

4.

To seek liaison/consultation from institutions or 4.

experts to help further the functional area.

Purchasing books related Rs. 2000/- per instance

to their scope of work.
(Max Rs. 20000/- per year)

5.

Approve
expenditure Rs 10000/- per instance
related to travel, food and (Max Rs. 30000/- per year)
stay of experts.

Research Group
Administrative

Financial

1.

Authority to declare policy related to the Group.

1.

Approve
incidental Rs. 2000/- per prg. (Max
expenses for organising Rs. 10000/- per year)
internal trainings.

2.

Authority to seek information from HoD's and 2.

other Groups related to their scope of work.

Approve
incidental Rs. 500/- per mtg. (Max
expenses for organising Rs. 5000/- per year)
internal meetings.

3.

Arrange internal training programmes with the 3.

support of HR Group.

Approve expenditure of Rs. 1000/- per instance

urgent nature.
(Max Rs. 10000/- per year)

4.

Co-ordinate for undertaking Clinical Trials and 4.

other related work.

Purchasing books related Rs. 2000/- per instance

to their scope of work.
(Max Rs. 20000/- per year)

5.

To seek liaison/consultation from institutions or 5.

experts to help further the functional area,
including inviting them to visit the institution.

Approve
expenditure Rs 10000/- per instance
related to travel, food and (Max Rs. 30000/- per year)
stay of experts.

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Implementation Groups
(Quality Improvement, Academic Administration)
Administrative

Financial

1.

Seek information for monitoring implementation 1.

of the policies approved by various Functional
Groups.

Approve
incidental Rs. 500/- per mtg. (Max
expenses for organising Rs. 5000/- per year)
internal meetings.

2.

Fix responsibilities for failures / lapses in 2.

implementation.

Approve expenditure of Rs. 1000/- per instance

urgent nature.
(Max Rs. 10000/- per year)

3.

Respond to feedback, complaints and suggestions 3.

received from patients and ensure corrective
action.

Purchasing books related Rs. 2000/- per instance

to their scope of work.
(Max Rs. 20000/- per year)

4.

Issue reprimand letters to staff, including 4.

residents, for any lapses (copy to be sent to P&A
for personal files)

Approve
expenditure Rs 10000/- per instance
related to travel, food and (Max Rs. 30000/- per year)
stay of experts.

5.

Recommend disciplinary action for inefficiency / in

discipline against any employee, including
residents, to P&A Group.

6.

To seek liaison/consultation from institutions or

experts to help further the functional area.

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