Project on Fortis Hospital

Organizational Structure Project Fortis Hospital – Noida

Acknowledgement

We would like to express our gratitude to all those who gave us their valuable tie and support to coplete this project! We want to thank Pro"! Neeraj #uar "or giving us the opportunit$ and challenge to explore our knowledge in organizational structure and design skills through this topic which has ultiatel$ enhanced our understanding on the subject besides giving us a practical iplication o" the real tie structure and design o" an organization! %t gave us a chance to visualize and anal$ze the strateg$ and design& which would help us in a long run in our streas o" corporate lives! 'r! Neeraj(s stiulating suggestions during the course o" project were a great help! We would also like to thank )r *!+!,hordi$a& )irector Fortis Noida who supported us on necessar$ research work which laid the "oundation "or our project! -esides& the tea work within the group has been indispensable at di""erent stages o" work and "or the success"ul copletion o" the project! .ach one/s contribution and constant suggestions "or iproveent have gone a long wa$ in bringing the project to the "inal shape!

About Fortis Healthcare

Fortis Healthcare 0iited& a leading healthcare organization in %ndia has a vision o"  1creating a world2class integrated healthcare deliver$ s$ste in %ndia& entailing the "inest edical skills cobined with copassionate patient care1! Fortis Healthcare 0iited is one o" the leading chains o" Hospitals and a leader in healthcare consultanc$ in %ndia which is bencharked to %nternational standards 2 achieving 3ualit$ through the relentless adherence to the protocols observed in soe o" the world4s leading hospitals! %n line with its growth strateg$ and with the recent ac3uisition o" the Escorts Heart Institute & Research Centre& Fortis Healthcare has taken its total operational hospital strength to 28 hospitals (including 2 satellite!heart command centers"# 5he Fortis Healthcare group has progressive plans to change the healthcare deliver$ landscape in %ndia b$ being the preier healthcare provider in the region driven b$ 3ualit$ and ost iportantl$ 1patient2centricit$1! 

0eading healthcare group in %ndia atching international standard

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First hospital opened in 678889 at 'ohali

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Hallark is 6patient2centricit$9 approach

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 *t present it has :: hospitals and :&;s and %,,>s! .ver$ unit identi"ied a 3ualit$ chapion& ideall$ a senior clinician& who was supported b$ a "ull2tie 3ualit$ tea leader and two executive assistants! *ll eplo$ees were trained on 3ualit$ protocols and copliance! Code o0 conduct

5his talk about the guiding principles which are expected to underpin all operations o"  Fortis group copanies and actions o" its people! *dherence to this code o" conduct is expected to be odeled and rein"orced at all tie b$ directors& anageent& eplo$ees and other "ull tie associates o" the Fortis Healthcare group! 5he Fortis Healthcare group o" ,opanies is coitted to uphold its value in all endeavors and shall partner with business associated who believe in and proote siilar values!

*EC'I)1 A% )R,A1IA'I)1A3 4ER*4EC'I$E* 4hilosoph

5he Fortis Healthcare group believes in creating& sustaining and growing success"ul businesses based on 3ualit$ products and servicesA value to custoers and shareholdersA partnership with eplo$ees and other stakeholdersA ethical practices and good corporate citizenship! ni5ersal Causes

5he Fortis Healthcare group is coitted to "ostering the universal causes o"  .nvironental Protection& Huan Bights and Health "or all! * Fortis Healthcare group ,opan$ shall strive to contribute activel$ to these causes where possible and& iniall$& shall ensure that no sphere o" its activit$ ipacts detrientall$ upon an$ o"  these causes! 1ational Interests

 * Fortis Healthcare group ,opan$ is coitted to contribute to the econoic and social developent o" %ndia and other countries in which it operates! %t shall strive to align its activities to the econoic developent and "oreign policies& objectives and priorities o" the nation/s governent and conduct its business a""airs within the legal and statutor$ "raework! 5he copan$ will respect the socio2cultural and religious ores o" the countr$ in which it operates! 4olitical 1on6Alignment

5he Fortis Healthcare group is coitted to and shall support a "unctioning deocratic s$ste in %ndia! * Fortis Healthcare group ,opan$ shall not& directl$ or  indirectl$& support an$ speci"ic political part$ or candidate "or political o""ice! Communit *er5ice

 * Fortis Healthcare group ,opan$ shall activel$ engage in& and contribute to& iproving the 3ualit$ o" li"e o" people in the counities in which it operates& through speci"icall$ identi"ies initiatives! %t shall also encourage and support volunteer  activities "or counit$ service b$ its eplo$ees! Industries -e5elopment

5he Fortis Healthcare group shall activel$ engage with polic$ akers and industr$ associations towards developing the regulator$ "raework o" the industr$& establishing 3ualit$ bencharks "or products and services and prooting ethical business and trade practices! *hareholders

 * Fortis Healthcare group ,opan$ is coitted to enhance shareholder value! 5he copan$ shall copl$ with all regulations and laws that govern shareholders/ rights! 5he board o" directors o" the copan$ shall dul$ and "airl$ in"or its shareholders about all relevant aspects o" the copan$/s business!

Customers

 * Fortis Healthcare group ,opan$ shall position the custoer as the central "ocus

o" all its business activities and providing value to custoers as its central preise! %t shall provide high 3ualit$ products and services towards eeting identi"ied needs and re3uireents o" its custoers and strive to continuall$ upgrade the bencharks o" custoer value and experience! * Fortis Healthcare group ,opan$ shall adhere to the highest standards o" legal and ethical behavior in creating and developing its relationships with custoers! Emploees

5he Fortis Healthcare group recognizes its people as the ke$ source and drivers o"  its endeavors! %t is coitted to upholding its core HB values in all dealings with eplo$ees and other signi"icant associates – huan dignit$& respect& trust and epowerent!  * Fortis Healthcare group ,opan$ shall be an e3ual opportunit$ eplo$er& with erit being the prie consideration in both recruitent and advanceent& and will not discriinate on the basis o" race& caste& religion or sex! %t will be an a""irative action eplo$er and will activel$ "oster diversit$ in eplo$ent!  * Fortis Healthcare =roup ,opan$ shall deand& deonstrate and proote pro"essional behavior and respect"ul treatent o" all eplo$ees! * Fortis Healthcare group ,opan$ shall provide a sa"e& health$& gender2unbiased and supportive work environent to its eplo$ees& "ree "ro an$ t$pe o" harassent& sexual or otherwise& ph$sical or verbal abuse or intiidation!  * Fortis Healthcare group ,opan$ shall base its HB anageent s$stes and processes on the value o" eritocrac$& e3uit$& objectivit$& teawork& collaboration and epowerent! 5he Fortis Healthcare group shall provide opportunities "or& and support eplo$ees in exploring& developing and utilizing their potential and ac3uiring new knowledge and skills! 5he Fortis Healthcare group encourages and supports its eplo$ees in "ollowing the code o" conduct laid down b$ their pro"essional associations and accrediting agencies! *uppliers

5he Fortis Healthcare group recognizes that suppliers are iportant contributors to its business activities and is coitted to partnering suppliers in utuall$ bene"icial and respect"ul relationships! * Fortis Healthcare group ,opan$ shall copl$ with agreeents and conditions o" engageent with suppliers& in letter and spirit! ,o5ernment Agencies

 * Fortis Healthcare group ,opan$ and its eplo$ees shall not o""er or give an$ copan$ "unds or properl$ as donation to an$ governent agencies or their  representatives& directl$ or through interediaries& in order to obtain a "avorable decision in an$ atter!

En5ironment

5he Fortis Healthcare group believes in sustainable developent and is coitted to

best practices in environental attersA * Fortis Healthcare =roup ,opan$ shall copl$ with all applicable environental laws and regulations in conducting its business a""airs! %t shall prevent waste"ul use o" natural resources and iniize an$ hazardous ipact o" developent& production& use and disposal o" its products and services on the environent! Health and *a0et

5he Fortis Healthcare group attaches great iportance to a health$ and sa"e work environent! * Fortis Healthcare group ,opan$ shall provide good ph$sical working conditions and encourage high standards o" h$giene and housekeeping! 5he copan$ shall ensure training o" eplo$ees to increase sa"et$ awareness and adoption o" sa"e working practices to prevent workplace accidents and iniize occupational health hazards! Related Compan 'ransactions & Cooperation within the ,roup

 * Fortis Healthcare group ,opan$ shall cooperate with other copanies within the group b$ sharing ph$sical assets& huan resources and knowledge& where possible& without adversel$ a""ecting its own business interests! * Fortis Healthcare group ,opan$ shall "ive pre"erences to another Fortis Healthcare copan$ in the procureent o" products and services on arket copetitive ters! Aligning 7ork *stems & 4rocesses

%t is the responsibilit$ o" the ,hie" .xecutive o" each business to ensure that the ,ode o" ,onduct is appropriatel$ counicated and propagated in their businesses& and that polic$& s$stes and processes in all areas o" their operations re"lect and rein"orce the guiding principles!

*EC'I)1 % 4ER*)1A3 C)1-C'

5he directors& anageent and eplo$ees o" the copan$& though their personal conduct& shape and conve$ the culture and tone o" the copan$ and its pro"essional

pursuits! %t is expected that each eber o" the Fortis Healthcare group shall constantl$ rein"orce the stated values o" the organization in their behavior and actions& in both internal and external interactions! usiness with Integrit

.plo$ees are expected to carr$ out copan$/s business with pro"essionalis& honest$ and integrit$& displa$ing high oral standards and ethical business practices& and without in an$ anner& coproising the interests o" the copan$ or group! Con0lict )0 Interest

 * Fortis Healthcare eplo$ee shall not engage in an$ business& relationship or  activit$& which a$ potentiall$ con"lict with the interest o" his copan$ or the =roup& without prior perission "ro the anageent! 5his would include but not be liited to concurrent eplo$entA business relationships with suppliersCcustoersA eplo$ing relatives or introducing the "or eplo$entA engaging in business with relatives or introducing relatives "or business relationshipsA "inancial investent with an actual or potential copetitor& supplier& custoer or other business associate! Customers

.plo$ees shall alwa$s keep the interests o" the custoers in the "ore"ront o" their  activities and give the top priorit$! 5he$ are expected to interact with custoers with a high degree o" respect and in the spirit o" services! .plo$ees shall not acceptCgive an$ gi"ts& onetar$ or non2onetar$& "roCto custoers! *uppliers

.plo$ees are expected to ensure that the interests o" the copan$ are aintained in ters o" 3ualit$ o" products& services and copetitiveness o" prices and ters o""ered b$ suppliers! .plo$ees shall ensure that the copan$/s interests are never coproised in dealing with suppliers and will not accept gi"ts& other than those o" a coeorative nature& or an$ gratuit$& pa$ents& coissions or bene"its in kind "ro suppliers! 4rotection o0 Con0idential In0ormation

.plo$ees shall not disclose or use an$ con"idential in"oration gained in the course o" association with the copan$& "or personal gain or "or the advantage o" an$ other  person! No in"oration shall be provided to the press& other publicit$ edia or an$ other external agenc$& "orall$ or in"orall$& expect within approved policies! 4ublic Representation

No eplo$ee& expect speci"icall$ authorized directors and eplo$ees& shall inter"ace with the edia and other public constituencies& such as the "inancial counit$ and shareholders& or disclose an$ in"oration pertaining to the business a""airs o" the copan$& to an$ external agenc$! 'eam 7orking

.plo$ees are expected to cooperate with their colleagues and work together 

cohesivel$ and supportivel$& towards delivering re3uired per"orance and achieving organizational goals! 7orkplace eha5ior 

.plo$ees shall ensure that their behavior at work is aligned with the Fortis Healthcare values and the$ conduct theselves with discipline and decoruA exhibit respect "or others in their dealingsA and do not subject an$ eplo$ee& associate& custoer& supplier or visitor to an$ harassent& sexual or otherwise& verbal or  ph$sical abuse or intiidation! Relationships with Colleagues

%t is expected that eplo$ees shall not allow an$ personal relationships with colleagues to ipact their work related decisions& ani"est in unacceptable conduct in the workplace andCor during working hours& or result in isuse o" copan$ "acilities or bene"its! Adherence to Code o0 Conduct

%t is expected that all eplo$ees will adhere to and proote the Fortis Healthcare code o" ,onduct& in letter and spirit& and will be coitted to building up the iage& reputation and business o" the copan$ and the group!  *n$ instance o" non2adherence to& or potential violation o"& the ,ode should be brought to the attention o" the iediate reporting superior or noinated authorit$ and shall be addressed appropriatel$!

Fortis )perational +anagement and *tructure

5he Fortis hospital network was based on a 6hub and spoke9 odel with ulti2 specialt$ 6spoke9 hospitals providing coprehensive health care services and 6hub9 hospitals with sub specialt$ services in one or ore areas! 5his odel helped Fortis provide coprehensive health care services "ro within its own network to a large geographical area! 5o ake optial use o" the intra2network re"erral odel& the nuber o" patients re"erred "or surgeries "ro within the network versus those who cae "ro outside were constantl$ onitored! Fortis/ hospital services prices were aong the highest in %ndia! Fortis justi"ied the higher prices b$ noting its large investents in in"rastructure& e3uipent& nursing "acilities& and proinent doctors with high salaries! 5he price o" procedures at sub2 specialt$ hospitals was higher than the 6spoke9 hospitals! Fortis bundled services at hospitals as 6Packages&9 a single charge "or a range o" services associated with a diagnosis& including exainations& coon tests& roo charges and procedure costs! Fortis re"ined an$ hospital protocols iported "ro the west "or the %ndian arket! For exaple& a t$pical %ndian patient checked in accopanied b$ three to "our  attendants and this nuber soeties grew to 7< to :< "or patients "ro rural backgrounds! Fortis ensured that the higher nuber o" patient attendants was "actored in hospital design and work"lows! %t also accoodated cultural practices which varied draaticall$ across the countr$! 5he hospitals provisioned "or pra$er  roos "or di""erent counities at di""erent sites! Fortis9 Human Resource 4olicies

Fortis considered the recruitent and retention o" highl$ skilled doctors& nurses and other personnel its top priorit$! 5he sta"" at hospitals operated and anaged b$ Fortis was copensated b$ the respective hospital owners! *t its owned hospitals& Fortis hired reputed ph$sicians at above2arket salaries to access the patient roster and increase the copan$/s standing in the industr$! ,ultural "it was also used as selection criterion in the interview process!  *ll specialists and ost general practitioners were copensated on a salar$ plus incentive basis! 5he$ worked across the network hospitals& depending on deand! 5he ph$sicians who practiced exclusivel$ within the Fortis network earned a guaranteed incoe and had predictable working hours! 5he$ could also provide better continuu o" care to patients& and had ore tie "or resource developent and research! *lthough Fortis paid ore in salar$ costs during the initial $ears& it hoped to lower personnel costs in the "uture as ph$sicians/ practices expanded! Fortis outsourced housekeeping& securit$& grounds aintenance and various other  edical support services! %n ost cases& Fortis replaced the ph$sician2led anageent o" ac3uired hospitals with pro"essional anagers! 5his practice soeties disturbed the power structure within the hospitals& creating "riction between ph$sicians and anagers! * senior  cardiologist at the recentl$ ac3uired .scorts heart hospital rearked& 6Fortis/ anageent is generating ill2will aongst the ph$sicians& soe o" who are the best in the countr$! 5he$ overrule the decisions o" senior surgeons and introduce policies without consulting the ph$sicians!9 5o address such concerns& the Huan Besources departents o" Fortis group hospitals "ocused on balancing business re3uireents with the otivational concerns o" the ph$sicians! ,opensation o" ph$sicians varied signi"icantl$& depending on seniorit$& specialt$& reputation and deand "or their services! Fortis had developed a "orula to calculate

the variable coponent o" salar$& which "actored success rate o" various procedures& patient re"errals& and rapport with patients& adinistrative responsibilities and publications! 5hough Fortis encouraged ph$sicians to conduct research& it had not developed a clear odel to copensate "or the tie! 5he ph$sicians in non2core specialt$ areas& such as dentistr$ and ophthalolog$& and in ulti2specialt$ practices& were peritted to aintain their own separate private practices and to consult at other hospitals! 5he$ were copensated on a "ee2"or2service or revenue2 sharing basis! Fortis/ salaries were considerabl$ higher than the national average! 5he salaries o"  the ost senior consultants ranged "ro >SD7! #her& 6Outsourcing $our heart&9 5ie 'agazine& 'a$ :8& :