PB 21 Health Biz Insight October 2019 Health Biz Insight October 2019

Game Changers

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A Unique Brand PositioningCK Birla Hospital for Women is boosting its presence across India with its unique brand positioning and a Rs. 1000 crore + expansion plan

By: Jayata Sharma

With a plan to expand and invest 1000 crores, the

CK Birla Hospital for Women has its eyes set on the entire country. These expansion plans are good news not just for the healthcare industry but for the country too. India has a huge unmet demand for quality healthcare infrastructure and facilities and healthcare providers are struggling to bridge the gap.

The CK Birla Group’s newest healthcare venture, the CK Birla Hospital for Women, is all set to increase its presence across India. Currently, it has one hospital in North India – located in Gurugram. It is a multi-speciality hospital focused on,

but not restricted to, women’s health. The hospital is a 75-bed facility with ICUs, 15-bed level 3 NICU, 4 operating theatres, spacious patient rooms and suites with all amenities, outpatient rooms, advanced labour and recovery rooms, Chemotherapy Daycare Lounge, state-of-the-art diagnostics, physiotherapy unit and a world class IVF unit and labs.

We met with Akshat Seth, the Chief Operating Officer of the CK Birla Hospital for Women and spoke to him about the hospital’s expansion plans and what makes the hospital unique Akshat joined the CK Birla Group in 2014 to lead the Office of Growth and Strategy at the Group driving strategy, M&A and new business development across

all group companies. In this role, he worked closely with the business leadership teams for strategy formulation, performance tracking and driving special improvement projects.

Prior to joining the Group, he was a management consultant with A.T. Kearney a global management consultancy firm) focused on clients in the Oil & Gas, Energy and Process industries. He specialised in strategy, investment due diligence, performance and profitability improvement and programme management. Having divided

his time between Delhi, Dubai and London offices of A.T. Kearney, he has a multi-geography experience.

Akshat is a Chemical Engineer from Indian Institute

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of Technology (IIT) Delhi, and an MBA from Indian Institute of Management (IIM) Calcutta.

Can you share more about the expansion plans for CK Birla Hospital for Women?CK Birla Hospital for Women plans to be a pan-India chain as we plan to set-up 14 more hospitals by 2025. For this, we will be investing upto about ₹1000 Crores over the next 5-6 years. We have already taken the first step in this expansion journey. Construction is in advanced stages for our second hospital in Punjabi Bagh in West Delhi. We are looking at metros and tier 1 cities as target locations for the newer hospitals.

These plans are in line with our aspiration to be a nationwide chain – an aspiration, we have set for ourselves from the very beginning. We have received a phenomenal response at our Gurgaon hospital. Since we began in September 2017, we

have treated more than 30,000 patients and families. We have constantly grown our service bouquet. In the last one year, we have added specialities like Orthopaedics, Oncology, The Breast Centre, Urology etc. We have set-up a Chemotherapy Daycare Lounge within our Medical Oncology practice. Not only have we expanded our service offerings, we have successfully treated and manged some very complex cases which are reflective of the clinical depth we bring to the table. And above all, we have consistently received great Patient feedback. All this gives us confidence that our business and operating model is robust and ready to be replicated in other locations.

Reaching 15 hospitals by the end of 2025 is not a small target. How are you equipping yourself for this task?The foundation for this expansion was started two years back, when we started the Gurugram hospital and started

getting our war chest ready. Hospitals are a people-

focussed operation. And, hence the most important and No. 1 aspect is having the right talent pool and skillset. We started building our “people” foundation right from Day 1. We hired from industries beyond healthcare thus assimilating learnings from other sectors. We have a very strong training focus – not just on functional training but also on service aspects. I feel that both our leadership and operational team is at a stage where we are ready to move to other locations.

The second critical aspect is having the right processes and protocols. We take pride when we say that our clinical and service proposition is built on international protocols. Our strong emphasis on UK NHS guidelines with policies and protocols adapted from UK’s National Institute for Health & Care Excellence (NICE) guidelines mean a robust focus

As healthcare is people-oriented, you

see the impact of your work almost immediately. The

connect with people and making even a small difference

in their lives is something that has been a huge driver personally for me

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on safety, high quality clinical care and cleanliness at our hospital.

We have put in a lot of effort to define codes, protocols, standard operating procedures (SOPs), and guidelines that drive all our clinical and non-clinical work. All of this now has been refined and are at a stage where we feel confident it can be replicated at other locations. We have also built an IT system that drives very strong compliance around these. All this I feel is key to ensuring that we deliver the same level and quality of care at all our future hospitals.

Number three is that we have the strength of the CK Birla Group behind us. It is a group that has been for around for more than 150 years and has successfully built businesses and institutions. With businesses across multiple industry segments, there’s a lot of management experience and guidance that we leverage from our parent group. That gives us more confidence and greater

sense of purpose to go ahead in this journey.

How do you plan to fund your expansion plans? By when do you see your hospitals breaking even?We are looking at different sources of funding. Right now, we are primarily privately funded through the parent group. Going forward, it will be a mix of funding from the group, internal accruals and we will also tap external sources. So, it will be a combination of these three.

As for break even, we are looking at factors that help in crashing the typical lengthy breakeven timelines of a hospital business. We have done a number of interesting and innovative things that has helped us in reducing not only the time to break-even but also the burn rate in the interim. Our attempt is to be on the lowest end of the industry standards. Needless to say, the exact break-even will also be a function of

which markets we operate in.

The healthcare industry faces a major crunch of trained manpower. How do you plan to ensure quality of your clinicians and staff in this scenario?We couldn’t agree more with this assessment, but there are two things we are doing to tide over this challenge.

Firstly, we are strongly focussed on training, especially for our nursing and other patient facing staff. Nursing as you are aware forms the backbone of clinical care. Any nurse that joins us, goes through a two-month period of preceptorship and induction training before they actually manage a patient individually. Also, every day, they have to dedicate an hour to training – we call it the “study hour”, wherein they go through functional, behavioural, competency and service trainings. We also emphasise a lot on the adherence to checklists and SOPs that we

There are two aspects we are looking at; it is not just the absolute time when you break even, it is also about the burn rate in the

interim period

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spoke about. This training rigour is replicated across all our departments and functions. Our ultimate aim is to provide safe and quality care to our patients. Second, we are also driven by the philosophy that whatever gets measured gets done. So, we have developed this whole system of KPIs and outcome-oriented parameters, which are clinical and non-clinical in nature – these get measured in most cases on a real time basis. This helps in keeping everyone aligned on what is the end quality objective, and it allows us to react immediately. It also enables us to reward people who are helping us deliver that.

Can you tell us more about The Breast Centre? Why did you launch it and what makes it unique?The bleak statistics for Breast cancer in the country was the prime driver for starting the Breast Centre. Incidence of Breast cancer among Indian women is high. In urban areas, 1 in 22 women is likely to develop breast cancer during her lifetime. Out of these women 50% may not survive making the outlook even more bleak.

We launched one of India’s most comprehensive breast health facilities, ‘The Breast Centre’ few months ago. It offers a full spectrum of breast health services including prevention & genomics, screening (breast exams, ultrasound and mammogram) breast surgeries, breast reconstruction and conservation, chemotherapy and post-treatment support in the form of rehabilitation and counselling services. The Breast Centre is probably one of the best examples of our strong commitment to bringing innovative and global best practices in clinical care to our patients. It is inspired by specialised breast health centres in the US and UK.

In the Indian context it is unique in many ways. Firstly, having the entire spectrum - from pre-screening, screening, surgical oncology, to medical oncology - available under one roof, makes it comprehensive. We have added the element of counselling, because it is important to address what the emotional turmoil both the patient and his/her family goes through. We also focus on prevention. Hence, genetic

testing and genetic counselling is a part of the protocol we follow for complete assessment. It allows for a preventive regime to be introduced. genetic counselling is a part of the protocol we follow for complete assessment. It allows for a preventive regime to be introduced.

It is believed that one of the biggest reasons for the high mortality rate is the late diagnosis which is primarily due to lack of awareness and the absence of a proper breast cancer screening programme. Breast cancer if detected at Stage I or II is treatable, improving the life expectancy, the organ can be preserved and the outcomes for the family are manageable. But the reality is only about 1% women undergo any type of screening during their lifetime. Also, the peak age of breast cancer is reducing in India.

Keeping this in mind, we at the CK Birla Hospital for Women have also developed a comprehensive programme for breast cancer screening. Under the programme, we are offering a clinical breast examination, a radiology screening in the form of an Ultrasound or Mammogram depending on the age and risk factor of the woman and a consultation with a breast specialist. The Clinical Breast Examination, that I am referring to here, is a unique technique – Tactile Breast Examination, which uses the highly developed sense of touch of blind women in the early detection of any abnormalities which could be indicative of breast cancer. A trained blind woman spends 40-45 minutes with the patient to not just do a thorough breast examination but also does extensive history taking which helps assess the

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risk. This is an initiative which we are offering in collaboration with the National Association for the Blind (NAB) in India and Discovering Hands, Germany and has been supported by Bayer Group in India. In fact, we are the only hospital to offer this unique service.

What is your competitive advantage in a market like India?We want to be a healthcare brand that not just treats patients but heals them, and our entire proposition is built around this philosophy. We promise clinical quality and a service experience that is par excellence. This I feel is a unique combination and our strength.

We do this through multidisciplinary care teams. Rather than being attended to by a single caregiver, our patients are assigned a Care team with specialists from different disciplines. This multi-skilled collaborative approach allows for well-rounded advice and treatment.

We don’t just want to be a hospital where you come in, we prescribe medicine and you go. There is lot of emphasis on things like how much time your doctor spends with you and

how much we, as a hospital, are embedded into your lives. These elements make our approach far more comprehensive and partnering, rather than transactional.

We do this through multidisciplinary care teams. Rather than being attended to by a single caregiver, our patients are assigned a Care team with specialists from different disciplines. This multi-skilled collaborative approach allows for well-rounded advice and treatment.

We don’t just want to be a hospital where you come in, we prescribe medicine and you go. There is lot of emphasis on things like how much time your doctor spends with you and how much we, as a hospital, are embedded into your lives. These elements make our approach far more comprehensive and partnering, rather than transactional.

What are some of the gender or women specific aspects that you have incorporated in your design and facilities which make you a women focused hospital? We understand that women have specific healthcare needs which need a sharper focus. In

fact, that’s where the whole idea of a women focused hospital started. Women patients seek more personalised care and attention to the smallest of details – not just in terms of aesthetics and amenities, but more importantly in clinical aspects. We have incorporated these preferences in how the hospital and our care bundles are designed.

We are very conscious that globally there are advances rapidly coming in women healthcare. For example, in Orthopaedics there are women specific implants and we offer these to our women patients who are undergoing knee replacement. In birthing, there are advancements in pain management techniques. To our maternity patients we offer water birthing – which is a unique form of natural birth which has great benefits for both the mother and the baby. We also offer Entonox, a pain management method which allow mother’s to be to control how they respond to labour pains.

We also realise that what works well for women works well for men as well. Hence, this allows us to offer our services to not just women but to men and the whole family

Does it dilute your brand positioning as you not just cater to women but also to men despite ‘Women’ being a part of your name? Not really. As a hospital focussed on women, we feel it’s a unique positioning. At the same time, we have seen that women want the same type of personalised and specialised care to be extended to their entire family. So, we cater to those preferences as well. HBI