A Project Report on

“Promotion Activities for Retention of Patient”

At: -

Metro Heart Research Institute

Harni Road, Vadodara

Submitted To: -

THE SCHOOL OF MANAGEMENT,

SUMANDEEP VIDYAPEETH

Submitted By: -

Bhoumik Bhoi
SM20090002

Under the Guidance of

FACULTY GUIDE COMPANY GUIDE

Mr. SAMIR ROY Mr. DEVANG PARMAR

Finance Executive
LECTURER
School of Management Metro Heart Research Institute

Piparia, Vadodara Vadodara, Gujarat

July, 2010
CHAPTER – 1. SELECTION OF TOPIC

1.1 Topic:
“Promotion Activities for Retention of Patient”

1. Why?
– Promotional Activities is very important in any organization. Today we now that the
competition & technology is very fast. Every hospital needs promotional activities to
some extent .so the topic conveys the study why hospital needs promotional activities so
the topic is taken too in the study of marketing structure in the hospital i.e. Metro heart
institutes

1. Whom?
– The topic selection was done by HR Department superior .Has HR dept. is the reformer
who convicts the delegations.

1. Where?

The research is conducted in one of the coming health care services institute in Baroda i.e.
Metro heart institutes
1.1 Definition and Background Information about the topic:

Hospital marketing comes of age

Developed by corporatization of healthcare, India’s promotion as a sought after medical
tourism destination and threatened by the mushrooming of new hospitals, it is becoming
difficult for hospitals these days to depend on mere word of mouth promotion to attract
patients. Hospital managements are putting extra effort in carving a brand image of the
hospital and improving hospital’s visibility. In other words, many would agree, that
hospitals marketing has evolved from being subtle to aggressive.
Hospital marketing as a concept
According to Ashok Anantram, president, business development, Apollo Hospitals,
Chennai, “Marketing as a concept is the same in product and service industry. There is a
product or service - one section produces it and the other consumes it. Marketing is an
interplay between producers and consumers.” However, the difference comes in
marketing tangible and intangible products. While products that can be seen, felt,
touched and tasted are tangible, the products that are based on post-sale experience is
intangible. Consumers can come up with desirable parameters for a tangible product in
terms of productivity, efficiency, etc. It is very difficult to rate an intangible product, he
explains.
Experts opine that healthcare marketing is a complex equation because most often the
producer, that is, the doctor, himself is the marketer. Since the production and
consumption takes place simultaneously, as in the case of performing an operation, he or
she should ensure zero-error delivery each time and every time. There is no physical or
time gap between the production and consumption.

Future
Would hospital marketing become more aggressive in the future? “We can no longer rely
on word of mouth for getting patients. Hospitals, mainly the corporate ones, would
definitely get more aggressive to survive the intense competition,” avers Juhi Bhandari,
marketing manager, Hinduja Hospital. However, Nabar disagrees, saying, “Aggressive
marketing is not necessary in healthcare sector as it would not fetch more patients.
Patients’ decision to choose a hospital is based on three factors: facilities available in
the hospital, expertise of doctors and vicinity.”
Will new marketing mantras emerge in the future? The answer lies in the thought process
of the new faces in this sector. According to Manish Sharma, management trainee,
Hinduja Hospital, “As in the West, in future, tertiary care Indian hospitals need to
conduct research so as to segmentize the market and tap that area from which patients
are not turning up.” For instance, if research shows that a hospital is not attracting
enough patients from a particular age group or a disease profile, it needs to strategize to
get those patients.”

1.2 Variables and Parameters

➢ Client satisfaction
➢ Promotional Activities
• Client satisfaction:
– Low cost
– Good services
– Treatment
– Scheme facilities
– Good Doctor
• Promotional Activities: Discount Facilities
– Advertising
– Tele Marketing
– Location
– Facilities
– Brand
– Pharmacy
– Corporation Relation
– Radio Marketing
– Specific Doctor
CHAPTER – 2. COMPANY PROFILE

2.1 Company Profile

HISTORY
A vision to provide the utmost level of healthcare to the common man, at the most affordable
cost, a group of NRI physicians led by Dr. Purshotam Lal (Padmavibhushan and Dr. B.C.
Roy National awardee), a pioneer of Interventional Cardiology in India, founded Metro
Group of Hospitals. The first hospital was set up in Noida in June 1997 by the name of Metro
Heart Institute

Followed by Metro Centre for Liver & Digestive Diseases, Metro Center for
Respiratory Diseases, Metro Heart Institutes at Meerut, Faridabad; Lajpat Nagar, Patel
Nagar, Preet Immediately after foraying into the heart care segment, Metro Multispeciality
Hospital was started in September 1998, Vihar at Delhi and Metro Hospital & Research
Centre at Vadodara.
Metro Hospital & Heart Institute is world renowned for its work and contribution
in Cardiology & other specialities. Our hospital is committed to providing the state of the
art technology in healthcare treatment, for excellence patient satisfaction. Since 1994, we
have helped enhance the lives of thousands of people who have chosen us for quality
healthcare service.

Technological advancements aside, we continue to be a leader in the industry

for the personal approach we take with every patient. Our professional team provides
exceptional service and employs the highest standards of patient care. Many hospitals across
the country refer their most difficult cases to Metro Hospital. This is a true testimony to the
skill and knowledge of Dr. P Lal and his professional team.

The Most Decorated Interventional Cardiologist

Dr Purshotam Lal, Chairman

MD, AB(USA), FRCP(C), FACM, FICC,
FACC, FSCAI (USA)
DIRECTOR INTERVENTIONAL CARDIOLOGY & CHAIRMAN, METRO GROUP OF
HOSPITALS, INDIA

Careers
The talent and passion of our people is critical to our success and we foster it by providing
an exhilarating working environment that inspires lateral thinking, fosters team spirit and
encourages open communication. Metro Hospital provides excellent opportunities for the
right people to progress with it. Remunerations are one of the best in the market. We have
created an environment conducive to challenging and rewarding career paths for passionate
professionals
Chairman's message

India’s large and diverse population warrants as efficient

health care infrastructure, that should be accessible to all strata’s of society. Good quality
health care should not only be a privilege of the elite. Since I set up Metro Hospitals in 1997,
my vision and endeavor has been to bring state-of-the-art health care to the masses of India.
In order to achieve this, we at the Metro Group of Hospitals, are committed to providing
advanced medical care at a minimum cost. Our focus has always been on the patients of the
lower and middle sections of society, patients who are rejected by the large corporate
hospitals, patients who cannot afford expensive medical care, but more than deserve it as
humans. I believe that medicine is a noble profession and that sick patients can never be
rejected on monetary grounds. This belief is our main strength
To help achieve this, I have an outstanding team of doctors in
various specialties including cardiology, gastroenterology, nephrology, respiratory,
oncology etc. All our senior doctors are former deans, professors or directors of reputed
institutes. It is a matter of great pride that we, at Metro, have created a facility and an
atmosphere of academic research like a mini AIIMS. This input and discussion between many
scientific minds, greatly benefits our patients.

Our hospitals are equipped with the latest medical

technologies. Each specialty is therefore able to provide the patient with an array of the
state-of-the-art procedures and both invasive and non-invasive technologies. Now-a-days
India is far ahead of other medically advanced countries in tense of interventional cardiology
techniques. It has been my continuing effort to stress on preventive cardiac care, and to
remove the fear of screening procedures like angiography from the minds of people. This is
one of the reasons why we are spreading the Metro Heart & Multispeciality Hospitals to the
peripheral, rural areas. This is why I have developed the ‘Metro Coronary Screening’
whereby an angiography can be done with the use of minimal dye from the elbow area. The
procedure reduces the cost of an angiography and can be done on an out patient basis.
We believe in building relationships with patients.
From spending time with them in order to understand and assess their medical issues to
empathizing with them and guiding them about the current and most cost effective course of
action. When a patient recovers, my happiest moments are when I send them home, and wish
sincerely from the bottom of my heart, that they remain well and do not need to come back to
the hospital!
Metro Hospital Vadodara is the 10 th Independent Unit
of our group spread over 4 lakh sq.ft. With 120 beds. Metro Hospital in now fully
operational, Located on Harni Savli Road, Opposite Kendriya Vidyalaya, amidst serene,
pristine and green environment, providing faster recuperation patients with human approach
GROWTH AND DEVELOPMENT:

The growth & development of the organization is based on the techniques and getting
inclusive to the new therapies and other new curing technologies. And, the growth
and development of any industry or company is based on some of the factors of the
company which concern to the affecting factors.

Some of the factors affecting to the company in growing rates and other
skilled positioning are:

• Infrastructure
• Customer Services
• Policies
• Employee participation
• Cleanliness
• Daily resemblance of the patients
• Visiting Doctors
• Surrounding Environmental factors
• Pharmacy Facilities
• Substitutes
• Competitors
These are some of the factors affecting to the company for their growth and
development.
WHO’S WHO

D.N. Suyal : chief Admintration

Dr.vikesh chauhan : Radiology Department

Finance Depatment

H.D. Joshi : Finance Department

Deven Parmer : Finance executive

H.R Head

Nutan shukala : H.R Head

Umesh prajapati :I.T incharge

MARKETINING

Amit shrivastav : Assistance Manager

Nigam Purohit : Executive Manager

Medical Department

Dr.Mitesh Shah : Medical supritandance

Pharmarcy Depatment

Mittal shah : Pharmarcy Head

Bio-Medical Department

Hasumati : Bio-medical Head

O.P.D incharge

Shittal christane : O.P.D incharge Head

Store Department

Nitin Patel

Health check upNamrata solanki

2.1 INDUSTRY PROFILE

A. COMPETITIVE SCENARIO

✔ The close Competitor are listed below

• Sterling Hospital .Race course. Baroda.

• Bhilal amin.Gorva.Baroda.

• Banker’s Heart.Chaklli circle. Baroda.

• Baroda Heart Institue.OP.Road.Baroda.

➢ Strength – Weakness: Compared to other companies in the industry.

 Strength:
Big Infra – Structure.
One of the oldest hospitals in town.
ISO 9001:2000 Certification
24 hours Emergency Services
Many care specializations
OT facilities
Therapy systems
Treatment systems
Good Pharmacy Medication
Experience Doctors Crew and Team
Good training deeds for the new recruits.
Big Pathology Lab
Different kinds of specialized departments
Good maintenance services to the customers.
Greater environmental surroundings
Good Help – Desk services.
Customer Satisfaction provisions
All kinds of facilities provide to the customers.
 Weakness:

Canteen Facilities
Pricing for the operations taken into care over in the company
Place of the infra – structure of the company
Based on the upper class and upper middle class people only
(As the pricing is to be taken into consideration)
  Difference from other competitors:
Specialized experience doctors in fields
Visiting doctors
Heart treatment facilities
Key Hole Surgery
Renal Transplant Program

A. MARKET SHARE:

➢ Positioning:
 The market positing is quite good then the other competitors as the
company is one of the oldest hospitals in the town.
 The facilities they provide for the customers.
 The ethical views of the company compared to the others.
 New technological therapy systems add on to the company.
 Adaptability to the new environmental factors in the current scenario

A. INDUSTRY LIFE CYCLE:

➢ The industrial life cycle is totally based on to the health care services. The
company i.e. Metro Hospital established their entire scenario towards the
conception of to be the best in the fields..
➢ It was the autonomous hospitalized company which provided the seek facilitation
to the people.
➢ The establishment was in 1997, and from that never looked back
➢ After that the company got the promotional services to their own premises and the
company was then one of the leading health care servicing institutes on the city.

LIFE CYCLE:

 The growth stage consist of such things and mentioned as you follow:

Introduction:
The induction of the product i.e. when the hospital was been
brought to be used and start was taken to cure the customers.

Growth:
The growth stage of the company took place when the ages went to
be passed out and with it the new dimensions of the diseases took
pathway in between the life cycle of the people of the particular
city or town.
.

Maturity:
 The maturity stage of the company came when the “treatments
came true” for the new formations of the diseases.
The new techniques and new formations for operating the patients
came true and then was the maturity took place for the company.

Decline:
Still, the decline stage is not overt to the company because they are
in that type of profession that development is the prior factor.
So, the growth of the company is in every short cleft of the
period. Everyday update is necessary to the company and they are
at the path of the cleft development.
– PHASE:

 The phase in which company is in the maturity stage but still in the
developing mode because in the kind of health care field they are in, they
are always in the verge of better development.
 So this kind of industry always needs to be in the motto of getting more
and more developing static
 Always in the reform kind of mind set because it is the need of the
company to say to their position in the current market.

A. INDUSTRY SPECTRUM:

– The growth and development of the company deals with the reining improvements
in their structuring.
– The crafting of new technology in the development of the company’s participations
in treatments.
– The new recruitments of the promising interns & also the flicks of experienced
doctors in their respective fields.
 CHAPTER – 3.

3.1 OVERVIEW OF FUNCTIONAL AREA

MARKETING:

• Product Portfolio: The product portfolio is the collection of businesses and products
that make up the company. The best product portfolio is one that fits the company's
strengths and helps exploit the most attractive opportunities.

And, the products of the company are listed as you follow

✔ Cardiology & cardiac surgery

✔ Respiratory Medicine
✔ Advanced Orthopedics
✔ Medical and Surgical Oncology
✔ Gastroenterology
✔ Trauma & critical care
✔ Neurology & Neuro Surgery
✔ Nephrology & Nephro surgery
✔ Plastic & Cosmetic Surgery
✔ Urology Cardiology & cardiac surgery
✔ Respiratory Medicine
✔ Advanced Orthopedics
✔ Medical and Surgical Oncology
✔ Gastroenterology
✔ Trauma & critical care
✔ Urology
✔ Burn unit
✔ Laparoscopic surgery
✔ Trauma & Critical Care
✔ Radiology
✔ Physiotherapy
✔ Laboratory
✔ Pharmacy
✔ ICU On Wheels

• Distributing Network / Channels:

–
– Newspapers
– Magazines
– Medical Magazines
– Website
 – Contributary Services
– Events
– Contributions

Pricing:

– In the company, as per the given above product list, the pricing also depends on
every individual services they provide.
– All cases, the fluctuating of the pricing is placed.
– It also depends on the customers needs and demands from the company which
provide the facilities of the above given options.
– It also depends on the priority factors of the services rendered to the customer of
the company.
– Some of the exmaples are listed as you follow:

METRO MASTER HEALTH CHECK PACKAGES

Metro Checks offer you a wide range of screening programmers to suit all individual needs.
METRO MASTER HEALTH CHECK
2550/-
✔ History and physical examination
✔ Kidney assessment (urea, creatinine).
✔ Live function test.
✔ Liver function test.
✔ Blood group.
✔ Urine &stool Examination.
✔ X-ray chest, ECG (resting).
✔ Ultrasound screening whole abomen.
✔ Entail Check-up.
✔ Final report assessment by senior physician.
METRO EXECUTIVE HEALTH CHECK
3250/-
✔ This includes all tests METRO MASTER HEALTH CHECK an in addition Lung
Function test (PFT) cardiac assessment (ECG, TMT).
✔ Final report assessment by senior physician.
METRO WHOLE BODY CHECK
5350/-
✔ This includes all tests in Metro Master Health Check
✔ Metro Executive Health Check and in addition serum calcium, phosphorus, Hb1Ac,
PSA for males, papsmear for females, Echocardiography, consultation by
Gynaecologist.
✔ Gential and Rectal examination general surgeon.
✔ Eye Check-up
✔ Dental check-up by senior physician
METRO HEART CHECK
3925/-
✔ History and physical examination.
✔ Haemogram.
✔ ESR.
✔ Peripheral Smear.
✔ Blood sugar (Fasting and P.P) uric acid lipid profile kidney assessment (Urea,
Creatinine).
✔ Lever function test blood group, Rh Typing, Lung function test.
✔ Cardiac Assessment (ECG, Echocrdiography, Treadmill test)
✔ Urine examination
✔ X-ray chest.
✔ Ultrasound Screening whole abdomen.
✔ Final report assessment by senior physician and cardiologist.
METRO DIABETIC CHECK
2450/-
✔ History and physical examination.
✔ Haemogram.
✔ ESR, Peripheral Smear.
✔ Blood sugar (Fasting and P.P) uric acid lipid profile..
✔ Serum Creatinine.
✔ Serum Electrolyte.
✔ Urine Examination.
✔ Urine for micro albumin.
✔ Eye check-up. Final report assessment by Dialectologist.
METRO WELL CHILD CHECK
750/-
✔ History and physical examination.
✔ Haemogram,
✔ ESR.
✔ peripheral Smear.
✔ Blood grouping.
✔ Montaux test.
✔ Urine And Stool Examination.
✔ X-ray chest
✔ Dental check-up. Final report assessment by Pediatrician.

METRO WELL WOMEN CHECK

1325/-
✔ History and physical examination.
✔ Haemogram
 ✔ ESR.
✔ Peripheral Smear
✔ Blood sugar (Fasting and P.P).
✔ Urine and Stool Examination.
✔ Papsmear.
✔ Ultrasound screening breast and lower abdomen.
✔ Breast examination.
✔ Dental check-up.
✔ Final report assesment by gynaescologist.
METRO PREMARITAL HEALTH CHECK
1500/-
✔ History and physical examination
✔ Haemogram.
✔ ESR, Peripheral.
✔ Blood sugar (Random).
✔ Creatinine.
✔ Cholesterol.
✔ HIV screening.
✔ Thalassemia.
✔ screening.
✔ Liver function tests.
✔ Blood group.
✔ Urine & Stool examination.
✔ X-ray chest.
✔ Final report assessment by Gynaecologist & Senior Physician.
METRO ASTHMA ASSESSMMENT PACKAGE
1500/-
✔ History and physical examination.
✔ Heaemogram.
✔ ESR.
✔ Absolute Eosinophil count.
✔ X-ray chest.
✔ X-ray PNS.
✔ Lung function tests (PFT).
✔ Final report assessment by chest specialist.

METRO EXECUTIVE EYE CHECK

1100/-
✔ Vision.
✔ Color Vision.
✔ Refraction.
✔ Slit lamp examination.
✔ Applanation Tonometry.
✔ Screening Perimetry.
✔ Funds Examination & Retina assessment.
✔ Eye health education.
 ✔ Free follow-up for 2 months (upto 5 visits).
METRO EXECTIVE DENTAL CHECK
1100/-
✔ Full mouth examination,
✔ Scalling & Polisjhing,
✔ Full mouth X-rays (4-6 as required),
✔ Oral Hygiene education & free follow up for one month.
Instructions to undergo Metro Health check up:
✔ Kindly take prior appointment, if possible.
✔ Please ensure you have been fasting for 12 hours prior to check-up.
✔ Please bring all your medical prescriptions & previous medical records with you.
✔ Please wear two piece loose comfortable clothes & shoes.
✔ Kindly inform the counsellor in case you have a history of diabetes or cardiac
problem.
✔ Kindly avoid bringing valuables.
✔ Drink 2-3 glass of water before leaving home, this will help speed-up Ultrasound
that requires a full bladder.
✔ Plan to spend upto 4-5 hours for the programme.
✔ Please do not smoke, consume alcohol, tea, coffee, biscuit on the morning of your
check-up. You may drink water.
✔ If our wear contact lens remove it from your eyes 12 hrs. Before and kindly bring
it along with you.
✔ Please get your morning stool sample in the plastic container provided to you.
✔ Breakfast will be provided.
✔ Then final reports will be available in afternoon/next day/after 2 working days
HUMAN RESOURCE:
• Organizarional Structure:

PERSONNEL MANAGER

OFFICER JUNIOR OFFICER ASSISTANT

The structure of the Human Resource Department consist of the “PERSONNEL MANAGER”
and with it, one officer is been appointed. A junior officer too which is on through to the
helping hand of the officer. And, assistant also is been a key to the organizational chart of
the Human Resource Department of the Company i.e. Metro.

• FUNCTIONING OF HUMAN RESOURCE DEPARTMENT:

• RECRUITMENT OF EMPLOYEES FALLING IN NON – MEDICAL

PRACTITIONER CATEGORIES:
– Crystallizing job descriptions & job specifications.
– Finalizing selection procedures for every position.
– Organize selection procedures: INTERVIEWS.
– Negotiating with the candidates for offer.
– Pre – employment medical check – up.
– Appointment order to selected candidates.

• JOINING:
➢ Salary fixation of newly joined candidates..
➢ Functional / On the Job induction programs.
➢ Issuing identity cards.
➢ Issuing punching cards.

• MAINTENENCE & UPDATION OF PERSONNEL RECORDS OF ALL THE

EMPLOYEES.

• TIME – KEEPING:
➢ Attendance monitoring for non – punching categories.
➢ Data management for salary purpose.
➢ Generation & analysis of reports: Absenteeism, over – time, Compensatory offs,
Late Coming, etc.
➢ Identification of chronic late comers & consequential actions for improvement.
✔ SALARY ADMINISTRATION:
➢ Earnings: Attendance, leave, other allowances, etc.
➢ Deductions: Statutory under PF, I – Tax, professional tax, etc.
➢ Deductions: Non – statutory – advances, loans, etc.
➢ Periodic Increments.

✔ VOUCHER PAYMENT ADMINISTRATION:

➢ Preparation of list for such payments.
➢ Payment calculations.
➢ Incentives / allowances payment for different categories.

✔ PERFORMANCE PAYMENT:
➢ Periodic appraisal through formal & non – formal systems.
➢ Conformation / extension of probation of employees.
➢ Promotions & consequential salary function.

✔ OPD MANAGEMENT:
➢ General management of OPD.
➢ Daily arrangement of staff & doctors.
➢ Execution of social work assignment.
➢ Routine administrative activities.

✔ LEGAL FORMALITIES UNDER VARIOUS LABOR LAWS VIZ. EMPLOYMENT

EXCHANGE ACT, PF ACT, GRATUITY ACT, PAYMENT OF WAGES ACT, ID ACT,
ETC:
➢ Liasioning with various government authorities prescribed under labour officer,
Asst. Commissioner of Labour, PF Enforcement officers, etc.
➢ Filing of returns / maintaining the documents.
➢ Notification of vacancies to employment exchange.
➢ Attending conciliation proceedings, labour court matters, etc.
➢ Liasioning with advocate for legal cases.

✔ PROCEEDING RESIGNATIONS & RETIREMENT: SETTLEMENT OF DUES.

✔ COMMUNICATION ADMINISTRATION:
➢ Preparation of various forms of management communications viz. Circulars,
office orders, notices, etc.
➢ Distribution of management communications.

• EVENT ORGAQNIZATION:
➢ Organization of various festivals’ celebrations.
➢ Management of other general functions.
➢ Conference management.

• WELFARE ACTIVITIES:
➢ Staff Welfare loan, poor fund loan, PF loan, etc.
 ➢ Uniforms distribution.
➢ Quarters’ allocation & maintenance activities.

• CONTRACT MANAGEMENT
➢ Designing & finalisation of contracts with medical consultants.
➢ Renewal of contracts.
➢ Operating various terms of contracts.

• CENTRAL REGISTRY
➢ Management of posts’ requirement –To & Fro postal assistance.
➢ Assistance for tax / Photocopying requirements.

• GRIEVANCE HANDLING & CONFLICT RESOLUTION.

• KITCHEN:
➢ General coordination.
➢ Administrative work in consultation with dietician.
➢ Maintenance of discipline: Counselling & or disciplinary actions.

• SECURITY:
➢ Administration of security contracts.
➢ Security regulations & systems / procedure.
➢ Keys management of entire Hospital premises.

• CAFETERIA
• ROUTINE ADMINISTRATION OF CAFETERIA
• TRANSPORT MANAGEMENT
• LIBRARY MANAGEMENT
• GARDEN SUPERVISION
• PUBLIC RELATIONS
• ADVERTISEMENT & PRESS NOTE IN NEWSPAPER
• GENERAL COORDINATION
• LABOURATORY / RADIOLOGY / PHYSIOTHERAPY STAFF MANAGEMENT CO -
ORDINATION FOR ADVISORY COMMITTEE MEETINGS
 ORGANIZATION STRUCTURE

Chairman

Dr. Purshotam lal

Chief administrator
D.N.SuyaL

Finance/Account manager DMS HR

Mr. S.D.Joshi Dr.Mitesh Shah Nutan

Account Marketing HCP TRA

Deven Parmar Amit shrivastav Namrata Solanki Bhumika

Valsama

Billing Reception ICU SPW GEW

OPD

Payal SHITTAL Mariatma Rashmika Dhara

Clerish
Laxmi
Senior management of Metro Hospital

Chief Administrator Finance Account Manager DMS

D.N.Suyal S.D.Joshi Dr.Mitesh Shah

FINANCE DEPARTMENT:

• Function of finance department:

➢ Accounting
➢ Budgeting
➢ Payment
➢ Filing

Let us brief out the functions of the finance departments:

1. ACCOUNTING:

• BANKBOOK
➢ Prepare debit vouchers.
➢ Prepare credit vouch
➢ Prepare pay - order
➢ Cheque deposit in the bank

• PURCHASE BOOK
➢ Bills receive from purchase department
➢ Checking & scrutiny of govt & purchase bill

• PETTY CASH BOOK

➢ Voucher receive from account dept
➢ Checking & scrutiny of petty cash voucher

• JOURNAL CASH BOOK

➢ Prepare journal voucher

2. BUDGETING (twice in the month):

• OBTAIN DATA FROM VARIOUS DEPT

• PREPARE BUDGET WITH ACCOUNT DEPT
• DISCUSS BUDGET IN MEETING WITH MANAGING TRUSTEE & OTHER

3. PAYMENT

• PARTY PAYMENT
➢ Party wise bill pullout from the scar file
➢ Prepared pay orders
➢ Prepare cheque
➢ Put paid ,cheque number & date rubber stamp on all purchase bills

• DOCTORS PAYMENT
 ➢ Received doctor share sheets from account dept
➢ Checking & scrutiny of the data
➢ Prepare cheques
➢ Dispatch cheques to the account dept

• RETAINERS PAYMENT
➢ Received data from personnel dept.
➢ Checking & scrutiny of the data
➢ Prepare cheques
➢ Dispatch cheques to the concern retainer

4. FILLING
• Debit voucher
• Credit voucher
• Bank books
• Journal voucher& book
• Purchase voucher & book
• Petty cash voucher & book
• Income tax dept
➢ Deduct tax from the salary of employee
➢ Prepare challan &deposit in the bank
➢ File the annual return in form no. 24

• Function of Account Department:

– Daily cash/petty cash statement verification
– Supervision and modification for OPD, indoor on a/c(company),paid patient.
– Maintain asset register
– Daily verification and sealing of cash flow in presence of te security
– Floor wise billing supervision and deposit follow up
– Doctor share verification and trustee signature for payment.
– Medico-legal Liasioning &co-ordination
– Citibank payment system taking authorization, and payment follow-up
– Arrangement of staff for OPD registration counter, indoor billing counter, account
office in case of any absence
– Organizing and presenting cash flow statement for payment meeting with trustee
– Audit coordination with internal – external auditors
– Staff medical expense detail to the concern

• Function of purchase department

– Purchase of hospital material
– Medicine
– Surgical
– Laboratory
– Blood bank
– Cath lab
– Bio-medical
– Housekeeping material
– Hospital furniture & fixture
– Stationary
– General provision
CHAPTER – 4.

4.1 MODEL APPLICATION

➢ Porter’s 5 Forces Model:

The Porter's 5 Forces tool is a simple but powerful tool for understanding where
power lies in a business situation. This is useful, because it helps you understand both
the strength of your current competitive position, and the strength of a position you're
looking to move into.

Under stated is the Porter’s 5 Forces Model:

Supplier Power

Barriers to Threats of
Entry RIVALRY
Substitutes

Buyer Power

Brainstorm the relevant factors for your market or situation, and then check against the
factors listed for the force in the diagram above.

Supplier Power:

Here you assess how easy it is for suppliers to drive up prices. This is driven by the
number of suppliers of each key input, the uniqueness of their product or service,
their strength and control over you, the cost of switching from one to another, and so
on. The fewer the supplier choices you have, and the more you need suppliers' help,
the more powerful your suppliers are.

And, it includes:
– Suppliers large
– Similar products
– Differentiation of inputs
– Impact of inputs
 1) Barriers to Entry:

Power is also affected by the ability of people to enter your market. If it costs little in
time or money to enter your market and compete effectively, if there are few
economies of scale in place, or if you have little protection for your key technologies,
then new competitors can quickly enter your market and weaken your position. If you
have strong and durable barriers to entry, then you can preserve a favorable position
and take fair advantage of it.

And, it includes:
– No technology protection
– Brand Identity
– Government Policy
– New product launch

1) Buyer Power:

Here you ask yourself how easy it is for buyers to drive prices down. Again, this is
driven by the number of buyers, the importance of each individual buyer to your
business, the cost to them of switching from your products and services to those of
someone else, and so on. If you deal with few, powerful buyers, they are often able to
dictate terms to you.

And, it includes:
– Product differentiation
– Price sensitivity
– High buyer power

Threats of substitution:

This is affected by the ability of your customers to find a different way of doing what
you do – for example, if you supply a unique hard ward materials that automates an
important process, people may substitute by doing the process manually or by
outsourcing it. If substitution is easy and substitution is viable, then this weakens
your power.

And, it includes:
– Price Performance
– Competitors

1) Rivalry:
 What is important here is the number and capability of your competitors – if you
have many competitors, and they offer equally attractive products and services, then
you’ll most likely have little power in the situation. If suppliers and buyers don’t get
a good deal from you, they’ll go elsewhere.if no-one else can do what you do, then
you can often have tremendous strength.

➢ ETOP:

ETOP is commonly used to report the external environment situation. It is used to relate to
external business environment. It considers with the external factors of the company. And,
also deals with the Opportunities and Threats.

Environment Threats:

– The environmental threats are not yet been briefly contrasted in the hospital scenario
because the environment is very friendly to the company i.e. to the company namely
Metro Hospital
– Though the company is situated in one of the wisest industry estate i.e. Alembic Ltd.
– But, still the environmental threatening factors are not yet defined and are at its one
of the safest place to continue its factorial and business work outs.
– The environment threats are totally based on the surroundings. And, the surrounding
factors are the same factors which are defined in the environment factors earlier.
 ➢ BCG Matrix:

BCG Matrix is basically based on the study of the review note. It is a study of relation
between market share and market growth. And, the level of high and low rating scale is
classified.

BCG Matrix Model:

Now, here it says like the rating scale relation between Market Share and Market Growth.

– The Market share serves the measure of strength in the market.

– The Market growth rate provides a measure of market attractiveness.

Let us see it in detail in further:

1) Stars:
a. Stars are high growth businesses or products competing in markets where
they are relatively strong compared with the competition. Need of the heavy
investment is necessary to sustain growth.

b. So, in here, the company relates to heavy investment and in return the heavy
returns for their customers.
c. And, the company was in that position in the initial stages. As, in the initial
stages the companies have to make certain investments into get in to the
market.
d. So, for the initial stages the returns also are in the verge to be done by the
company.
 e. So, majorly the STARS Stage is not in the suitable position to be called to be
the company’s motive for long term periods. They relate this activity in the
initial stages as to get into market and held their position.

2) Cash Cows:
a. Cash cows are low-growth businesses or products with a relatively high
market share. These are mature, successful businesses with relatively little
need for investment. They need to be managed for continued profit - so that
they continue to generate the strong cash flows that the company needs for its
Stars.

b. Now, our company i.e. Metro Hospital Institutes is in the cash cows stage in
present. As, from the establishment in year 2008, the investments are made to
give the best out of the company. There is a stagnant appeal growth in the
company which lead the company to this level where it is successful and
mature in flowing of funds and profits.

3) Question Marks:
a. Question marks are businesses or products with low market share but which
operate in higher growth markets. This suggests that they have potential, but
may require substantial investment in order to grow market share at the
expense of more powerful competitors. Management have to think hard about
"question marks" - which ones should they invest in? Which ones should they
allow to fail or shrink?

b. Luckily, our company i.e. Metro is not in the position. It is never in the stage
like this where they need potential to be grown up. From the initial stage only
the company is in the pathway of growth and development.

c. And, there grow up into the market share in the market; they had been
successful in generating funds for their expenses at the vital intervals.

4) Dogs:
a. The term "dogs" refers to businesses or products that have low relative share
in unattractive, low-growth markets. Dogs may generate enough cash to
break-even, but they are rarely, if ever, worth investing in.
b. Our company situation has never been into such practices to be into such
stages. In here, it says that the company can get into such low practices. But,
METRO is always at its reining best so the “Dogs” situation didn’t took he
part in the flow of the company.
 ➢ VALUE CHAIN

Michal Porter of Harvard proposed the value chain as a tool for identifying ways to create
more customer value. Every firm is a synthesis of activities that are performed to design,
produce, market, deliver, and support its product. Value chain identifies nine value creating
activities consist of five primary activities and four support activities.

The primary activity includes the following points: Porter's

• Inbound Logistics
• Operations

• Outbound Logistics
• Marketing & Sales
• Service

Now let us see the above points into the company’s terms:

1. Inbound Logistics:
Bringing new material into the business is the purpose of the inbound logistics.
And, in the company, as it is the “health care service” company so the inbound
services could be taken as a new therapy and a medicine.

2. Operations:
Operation relates with the motive, goal and subject. A specific goal for the inputs
made in the inbound stage. So, we have to define a goal for the inputs made.
 Likewise, let’s take example of a new medicine in the hospital and the goal for the
new made medicine would be to cure the disease. And, the medicine is still in the
verge to be manufactured.

So, the operation includes the motive and goal part.

3. Outbound Logistics:
It relates to the finished goods. The medicine now are been manufactured and are
ready to be launched into the market for their sales and stacks.

4. Marketing & Sales:

The marketing and sales plays a vital role in the part of the medicine manufacturing
for the company because if marketing is done in a proper way then it is obvious that
the sales of the medicine would take place.

And, if sales are made in the proper channel then the marketing could be carried out
as well. So, sales and marketing are inter related. And, it also includes the channel of
distribution.

5. Services:
It leads the after sales services and the in - stock services given by the company. The
services provided to the customers of the company also plays major role in success of
product launch. Because, customers if are in trouble using it then there should be
someone who can guide tem at the trouble shoot.
CHAPTER – 5. RESEARCH METHODOLOGY

5.1 Research Methodology: -

Introduction
In today's challenging economy and competitive business world, retaining their
customer base is critical to organization success. If they don't give their customers some
good reasons to stay, organization’s competitors will give them a reason to leave. Customer
retention and satisfaction drive profits. It’s far less expensive to cultivate organization
existing customer base and sell more services to them than it is to seek new, single-
transaction customers. Most surveys across industries show that keeping one existing
customer is five to seven times more profitable than attracting one new one.

A customer-focused approach among its employees is still not present. In this era of
intense competition, it is very important for any service company to understand that merely
acquiring customers is not sufficient because there is a direct link between customer
retention over time and profitability & growth. Customer retention to a great extent depends
on service quality and customer satisfaction. It also depends on the ability of the
organization to encourage customers to complain and then recover when things go wrong.
Complaints are natural part of any service activity as mistakes are an unavoidable feature of
all human endeavor and thus also of service recovery. Service recovery is the process of
putting things right after something goes wrong in the service delivery.

5.2 Main objective

✔ To study the structure of services provided to their customers.
✔ Promotional Activity necessary for the retention for the patients or
not?
✔ To study of awareness of Health care services
✔ To identify the strategies to retaining customers

5.1 Sampling Scheme

– Convenience Sampling

5.1 Sampling Size

– The sampling size taken for the study is 25 (as approx)
 5.1 Tools for Data Analysis
– Measures of Central Tendency
– Measures of Variation
– Factor Analysis

5.1 Scope of the study

– The scope of the study is to learn the retention of Metro hospital
– The scope of the study is limited because the research is in Metro hospital only.

5.1 Benefits of the Study

– The benefit of the study would, the organization would know the capabilities of
themselves in context to their working standards.
– The benefit of improvement, if any, in context to the services provided to their
customers.

5.1 Assumptions
– The data which is collected is assumed to be relevant data as it is a primary data
which is carried in a very efficient way.
– It is free from internal bias which is supposed to occur from customer & patient side.

5.1 Types of research design:

The research designs are of three type

• Exploratory
• Diagnostic
• Experimental

My research design is exploratory as the study of research would provide the

new dimension in the market structure in the hospital. As, the primary data is taken into
consideration

5.1 Unit of Analysis.

The unit of Analysis of my study is the customer & Patient of the Hospital i.e. Metro
Heart Research institute

5.2 Data Collection Method

 ✔ Interview
✔ Questionnaires

5.1 Reliability Validity:

The Data which is collected is reliable has the data collection method is
prominently in the format of interview and questionnaires

5.2 Limitation of study

✔ Time was limited
✔ The hospital staff was not that much helpful in resourcing the data
✔ Number of respondence were limited
CHAPTER – 6. DATA COLLECTION & ANALYSIS

QUESTIONNAIRE

1) Name:
2) Age:
3) Gender: MALE FEMALE
4) For which purpose you are admitted in the hospital?

5) Which doctor is treating you?

6) How is the doctor treating you?

7) Which scheme facilities are they providing you?
Satisfied
Neutral
Dissatisfied
8) How are the facilities in hospital?
Satisfied
Neutral
Dissatisfied
9) How are the doctor associated you?
Satisfied
Neutral
Dissatisfied
10) How are the treatments associated to you?
Satisfied
Neutral
Dissatisfied
11) How is physical surrounding?
Satisfied
Neutral
Dissatisfied
12) How is the hospital staff associated to you?
Satisfied
Neutral
Dissatisfied
13) How the supervisory treat you?
Satisfied
Neutral
Dissatisfied
Promotional Activities

1) Are you aware about the hospital’s scenario: Metro Heart Research Institute?
Yes
No
2) How would you relate it?
Satisfied
Neutral
Dissatisfied
3) How would you relate about hospital location?
Satisfied
Neutral
Dissatisfied
4) How did you get to know about the hospital?
Newspaper
TV News
Internet
Other
5) What are the different facilities provided by the hospital to you?

6) How would relate it?

Satisfied
Neutral
Dissatisfied
7) How would you associate the medicine provided to you?
Satisfied
Neutral
Dissatisfied
8) How would you relate the care taking abilities of the hospital?
Satisfied
Neutral
Dissatisfied
9) What are the Additional facilities to you?

10) How would you rate the hospital from your convenience?
Satisfied
Neutral
Dissatisfied

FACTOR ANALYSIS
 ➢ Client Satisfaction

Factor Analysis
Communalities

Initial Extraction

DT 1.000 .631

DF 1.000 .511

DA 1.000 .600

TA 1.000 .533

PS 1.000 .233

HS 1.000 .639

ST 1.000 .256

Extraction Method: Principal Component

Analysis.

Total Variance Explained

Component Initial Eigenvalues Extraction Sums of Squared Loadings

Total % of Variance Cumulative % Total % of Variance Cumulative %

1 2.002 28.593 28.593 2.002 28.593 28.593

2 1.402 20.022 48.615 1.402 20.022 48.615

3 .976 13.942 62.557

4 .955 13.646 76.204

5 .661 9.448 85.651

6 .553 7.898 93.549

7 .452 6.451 100.000

Extraction Method: Principal Component Analysis.

Component Matrixa
 Component

1 2

DT -.761 .227

DF -.120 .705

DA .133 -.763

TA .671 .289

PS .441 -.196

HS .783 .158

ST .363 .352

Extraction Method: Principal Component

Analysis.

a. 2 components extracted.

➢ Promotional Activities

Factor Analysis

Communalities

Initial Extraction

SR 1.000 .798

HL 1.000 .731

Ph 1.000 .947

CTA 1.000 .762

HR 1.000 .628

Extraction Method: Principal Component

Analysis.

Total Variance Explained

Component Initial Eigenvalues Extraction Sums of Squared Loadings

 Total % of Variance Cumulative % Total % of Variance Cumulative %

1 1.499 29.978 29.978 1.499 29.978 29.978

2 1.275 25.493 55.471 1.275 25.493 55.471

3 1.092 21.843 77.314 1.092 21.843 77.314

4 .807 16.137 93.451

5 .327 6.549 100.000

Extraction Method: Principal Component Analysis.

Component Matrixa

Component

1 2 3

SR .856 .235 -.103

HL -.131 .824 .186

Ph -.142 .042 .962

CTA .468 -.664 .320

HR -.715 -.312 -.140

Extraction Method: Principal Component

Analysis.

a. 3 components extracted.
 DATA COLLECTION

Table 1
How is the doctor
treating you?

Satisfied 8

Neutral 10

Dissatisfied 9

Total 27

Table 2
How are the facilities in
hospital?

Satisfied 12

Neutral 8
Dissatified 7

Total 27
Table 3

How are the doctor

associated you?

Satisfied 13

Neutral 11

Dissatified 3

Total 27
Table 4
How are the treatments
associated to you?

Satisfied 12

Neutral 11

Dissatisfied 4

Total 27
Table 5

How is physical
surrounding?

Satisfied 12

Neutral 8

Dissatisfied 7

Total 27
Table 6

How is the hospital staff

associated to you?

Satisfied 14

Neutral 7

Dissatisfied 6

Total 27
Table 7

How the supervisory

treat you?

Satisfied 11

Neutral 12

Dissatisfied 4

Total 27
Table 8
How would you relate
hospital scenario?

Satisfied 8

Neutral 12

Dissatisfied 7

Total 27
Table 9
How would you relate about
hospital location?

Satisfied 10

Neutral 12

Dissatisfied 5

Total 27
Table 10
How would you associate the medicine
provided to you?

Satisfied 15

Neutral 9

Dissatisfied 3

Total 27
Table11
How would you relate the care taking
abilities of the hospital?

Satisfied 10

Neutral 10

Dissatisfied 7

Total 27
Table 12
How would relate the hospital from
your convenience?

Satisfied 16

Neutral 4

Dissatisfied 7

Total 27