bht - write-up 05

8/10/2019 BHT - Write-up 05

1/29

Shalamar Institute of Health SciencesPast, Present and FutureFINAL

8/10/2019 BHT - Write-up 05

2/29

SIHS Past, Present and Future

TABLE OF CONTENTS

LIST OF FIGURES 3

LIST OF ABBREVIATIONS 4

EXECUTIVE SUMMARY 5

WHO WE ARE 6

OUR FOUNDERS 6

OUR GOVERNANCE STRUCTURE 7

OUR FUNDING 7

OUR FACILITIES 11

SHALAMAR HOSPITAL 11 SERVICES PROVIDED BY SHALAMAR HOSPITAL 13 SHALAMAR NURSING COLLEGE 15 SHALAMAR MEDICAL AND DENTAL COLLEGE 16

WHAT SETS US APART? 17

8/10/2019 BHT - Write-up 05

3/29


LIST OF FIGURES

Figure 1: SH Yearly Financial Snapshot 1988-2010 ................................................................................ ... 8Figure 2: SIHS Donations Over the Years ................................................. ................................................. 9Figure 3: SIHS Journey Through the Years ..................................................... ...................................... 10Figure 4: Hospital Admissions 2006-2010 ........................................................ ...................................... 13Figure 5: Patients Inflow 2006-2010 ......................................................... .............................................. 14Figure 6: Use of Diagnostic Services 2006-2010 ........................................................................... .......... 14Figure 7: Patients Check-ups 2006-2010 ................................................................................................ 15Figure 8: SIHS Strategic Framework .......................................................... .............................................. 21Figure 9: SIHS The Way Forward; 2010-2015 ...................................................................................... 23

8/10/2019 BHT - Write-up 05

4/29


LIST OF ABBREVIATIONS

BHT Businessmen Hospital Trust

CCU Coronary Care Unit

CT Scan Computed Axial Tomography Scan

ENT Ear, nose and throat

HOC House of Charity

ICU Intensive Care Unit

MBBS Bachelor of Medicine and Bachelor of Surgery

MRI Magnetic Resonance Imaging

OB/GYNE Obstetrics and Gynecology

OPD O i D

8/10/2019 BHT - Write-up 05

5/29


EXECUTIVE SUMMARY

Shalamar Institute of Health Sciences (SIHS) is an umbrella organization for ShalamarHospital (SH), Shalamar College Of Nursing (SNC) and Shalamar Medical and Dental College(SMDC). SIHS is undertaking various activities for healthcare service delivery to thedisadvantaged communities and provision of quality health education in Lahore. ShalamarHospital, with its outpatient facilities and the 24-hours emergency department is the

primary source of free and subsidized medical treatment to hundreds of thousands ofpatients of northern Lahore and beyond. While providing the best healthcare facilities to itspatients, Shalamar Hospital is positioned to set highest standards of personalized,specialized, accessible and cost-effective medical care to provide benchmarks for otherhealthcare facilities of Pakistan. Shalamar Nursing College fulfills the vacuum of trained andqualified paramedical staff through pre-service training of nurses, not only for ShalamarHospital but also for other healthcare institutions, whereas Shalamar Medical and Dental

College, a recent addition to the SIHS institutions, aims at extending the same spirit a stepfurther by producing quality medical professionals.

Some of the dimensions that set SIHS apart from other philanthropic institutions, are acarefully selected geographical focus, highly qualified human resource, environmentalresponsiveness, strategic partnerships, state-of-the-art infrastructure, integrated approachand the focus on excellence.

8/10/2019 BHT - Write-up 05

6/29


WHO WE ARE

SIHS aims to serve the disadvantaged community of northern Lahore by providing qualitymedical treatment and developing healthcare capacity in the society through education inthe field of medical and health sciences.

Shalamar Institute of Health Sciences is instituted by Businessmen Hospital Trust, which isinvolved in various activities of healthcare and health education. The main institutions runby BHT include Shalamar Hospital (SH), Shalamar Nursing College (SNC) and ShalamarMedical and Dental College (SMDC). All the institutions run under the umbrella of SIHS andare fully aligned with the organizational vision andhave significant synergies. Shalamar hospital is theprimary source of free and subsidized medical

treatment to hundreds of thousands ofpatients of northern Lahore and beyond. Theseamless operations allow maximum number ofpatients to benefit from the services of thehospital, outpatient facilities and the 24-hoursemergency facility. In order to provide qualitytreatment and round the clock service to hospital patients, trained and qualified

di l ff i i i l i i Sh l i C ll f lfill hi

8/10/2019 BHT - Write-up 05

7/29


five million rupees for developing a state-of-the-art well-equipped hospital for the citizensof northern Lahore. Prof. Mohammad Akhtar Khan has been the moving spirit behindconception, planning and execution of various initiatives undertaken by BHT, since itsinception. Syed Babar Ali, one of the most notable businessmen and philanthropists ofPakistan has also been instrumental in the establishment of SIHS and its various subsidiaryorganizations.

Ch. Nazar Mohammad (Late) Prof.Mohammad Akhtar Khan Syed Babar Ali

8/10/2019 BHT - Write-up 05

8/29


operational shortfall has been on the rise over the past few years. The shortfall in 2010was close to PKR 100 million. SIHS has been quite successful in mobilizing donations,thanks to its large pool of local philanthropists and business houses. In 2010, due tolocally raised donations and government grants, the shortfall was squeezed to a merePKR 25 million.

8/10/2019 BHT - Write-up 05

9/29


Page 9 | 29

Figure 2: SIHS Donations over the Years

8/10/2019 BHT - Write-up 05

10/29


Page 10 | 29

Figure 3: SIHS Journey through the Years

8/10/2019 BHT - Write-up 05

11/29


OUR FACILITIES

Shalamar Hospital

The Businessmen Hospital Trust established Shalamar Hospital in 1982 as a not- for- profit

Hospital to cater the needs of patients belonging to the lower income population of Lahore,a historic city with over 8 million population. With the sustained efforts of the Board ofTrustees and the Management of Hospital, Shalamar Hospital has grown to 350 beds and isnow amongst major health care providers in Lahore.

Shalamar Hospital is exclusively catering to the 2.5 million residents of northern Lahore. Thenorthern part of Lahore includes localities such as Mughalpura, Baghbanpura, Harbanspura,

Tajpura, Tajbagh, Manavan, Batapur, Pakistan Mint, Dharampura, Garhi Sahu, Shalamartown, Angori Bagh, Wapda Colony, G.T. Road, Darogawala, Misri Shah, Chamra Mandi,U.E.T, Momanpura, Mehmood Booti, Shad Bagh, Ghoray Shah, Rizwan Gardens, Jallo Town,Wagah and Railway Colony. Much of the population living in these localities belongs tolower socio-economic strata of society and cannot afford expensive or fully paid medicaltreatment. Most of these localities are underdeveloped in terms of infrastructure andpresence of basic health facilities. The hygiene conditions are poor, owing to rapidly

8/10/2019 BHT - Write-up 05

12/29


Designed by a team of experienced Australianarchitects, the SH complex is a reflection of the70s, with a rectangular design. The widecorridors have windows on both sides so that aircan ventilate naturally throughout the hospital,which reduces odor and provides sufficientnatural light inside the hospital.

Shalamar Hospital serves its patients through anumber of general medicine and surgicaldepartments. The general medicine and allieddepartments include General Medicine, ChestMedicine, Gastroenterology, Diabetes and

Endocrinology, Cardiology, Neurology,Nephrology, Dermatology, Paeds Medicine and Psychiatry, whereas the surgerydepartments include General Surgery, Orthopedic Surgery, Plastic Surgery, Neuro Surgery,Paeds Surgery, Anesthesia, ENT, Ophthalmology, Gynae and Obstetrics, Dentistry andUrology.

Although our Cardiac Care Unit is not functioning as a full-service cardiac department, its

For setting up a medical facility likeShalamar, selection of location is the firstand foremost priority. During the survey an18-acre public land owned by PakistanRailways near Mughalpura, Lahore wasfound best considering the requirement ofcommunity and situation of location. Afterhectic efforts and persuasion the land wasdonated in the name of the hospital by theMinistry of Railways. The hospital wasnamed the Businessmen Hospital Trust,which was later changed to ShalamarHospital for being in the vicinity of thehistorical Shalamar Gardens constructed byMughal Emperor Shah Jahan in 1642.

8/10/2019 BHT - Write-up 05

13/29


The Pathology Department was upgraded and given a brand new image with upgradedservices and advanced equipment.

The Out Patient Department (OPD) provides consultation to about 1,000 walk-in patientsevery day. The number of patients coming for consultation and diagnosis makes it one ofthe busiest hospitals amongst private sector healthcare institutions in Lahore.

Services Provided by Shalamar Hospital

Besides outpatient and emergency healthcare, the hospital is also offering a number ofother diagnostic and treatment facilities. Over the past five years, more than 100,000patients have been admitted to Shalamar Hospital, whereas more than 350,000 patientsbenefit from the hospital every year. The use of diagnostic services such as x-rays,ultrasound, CT Scan and pathological laboratory tests as well as patients services in theareas of dialysis, dental, dermatology, physiotherpay and antenatal have also been on the

rise over the last five years.

8/10/2019 BHT - Write-up 05

14/29


8/10/2019 BHT - Write-up 05

15/29


Figure 7: Patients Check-ups 2006-2010

Shalamar Nursing College

The Shalamar Nursing College is the first private institute in Lahore to offer a bachelor

8/10/2019 BHT - Write-up 05

16/29


Conducive Learning Environment: The classrooms at Shalamar Nursing College areequipped with projectors and multimedia facilities, to facilitate students in learning with thehelp of international videos and pictorial presentations. There is a separate auditorium andconference room equipped with multi-media and projectors as well. The laboratories areequipped with the latest models of multi-purpose teaching manikins for students to learngood nursing skills. Shalamar Hospital is also housing a state-of-the-art laboratory that isenabling the nursing students to enhance their learning. Each member of Shalamar HospitalCollege of Nursing faculty has an advanced degree in nursing. The professional and qualified

faculty also plays a major role in enriching the academic experience of the students.

Hands On Experience: The nursing students utilize the facilities of the 35-bed ShalamarHospital during their clinical practicum. The students gain exposure to ICU, CCU, OB/GYNE,Operation Theatre (General), OB/GYNE Theatre, Dialysis Unit and many other areas.Shalamar Hospital has an ongoing community outreach program that gives another uniquedimension to stude nts learning.

Shalamar Medical and Dental College

The project of Shalamar Medical & Dental College commenced in the year 2007. With themost modern & contemporary building design, Shalamar Medical & Dental College is goingto serve as an emblem for medical education in Pakistan in the 21st century.

Having the capacity to cater to 750 students, the custom made building provides all the

8/10/2019 BHT - Write-up 05

17/29


with the University of Health Sciences for its supervision and conduct of examinations.PMDC offers scholarships to promising students on a need-cum-merit basis.

WHAT SETS US APART?

Although a number of philanthropic institutions are working in Punjab for providing

healthcare services, the SIHS institutions enjoy a unique position in many better ways. Someof the dimensions that set us apart from other organizations, include a carefully selectedgeographical focus, highly qualified human resource, environmental responsiveness,strategic partnerships, state-of-the-art infrastructure, integrated approach and the focus onexcellence.

Carefully Selected Geographical FocusThe SIHS institutions, especially Shalamar Hospital, are catering to the population ofnorthern Lahore, which has limited access to public tertiary healthcare services. Thepopulation in the area exceeds the whopping 2.5 million figure and the high populationdensity takes a toll on the overall living conditions. Most of the localities have poor hygienicconditions, resulting in high incidence of diseases and epidemics. Shalamar Hospital hastherefore filled in a critical vacuum by providing access to quality healthcare services to localcommunity. Moreover, the establishment of Nursing College and Shalamar Medical and

8/10/2019 BHT - Write-up 05

18/29


Indicators Japan India Iran Pakistan Punjab Lahore Northern Lahore 3

Hospital Beds (per10,000 population)

139 9 14 6 4.2 15.27 5.58

Physicians (per10,000 population)

21 6 9 8 6.08 NA 2.30

Nurses andMidwives (per10,000 population)

95 13 14 4 4.67 NA 1.74

Highly Qualified Human ResourceThe SIHS boasts having some of the highly qualified human resource, including 42 full-timeconsultants/specialists, 24 part-time consultants/specialists and more than 800 support andallied staff members. Most of these staff members, especially the consultants/specialistsand faculty members of SMDC are accomplished professionals with impeccable credentialsin their fields of practice. Moreover the establishment of School of Nursing, which was aresult of the perceived need for quality paramedical staff, is a glaring example of SIHSs commitment to quality.

Environmental ResponsivenessSIHS is an environmentally responsible organization, which ensures a hygienic environmentfor its patients. The cleanliness is ensured through regular orientation and training of staff.

8/10/2019 BHT - Write-up 05

19/29


Similarly, the Shalamar OPD is one of the largest outpatient facilities in Pakistan catering tomore than a thousand walk-in patients on a daily basis. The ISO-certified Accidents andEmergency Department is fully functional with adequate capacity to respond effectively andefficiently to various types of medical and surgical emergencies.

Integrated ApproachThe SIHSs holistic and integrated approach not only focuses on provision of tertiary

healthcare services but also encompasses strategic interventions to strengthen thehealthcare sector in general. The establishment of Nursing College addresses the gap inavailability of quality paramedical staff, whereas the Medical and Dental College aims to setnew benchmarks in quality medical education. Moreover, the hospital waste managementinitiative underscores the focus on allied healthcare management issues. The SIHS also hasinitiated community outreach programs through mobile dispensaries to provide basichealthcare services to the doorstep of disadvantaged communities.

8/10/2019 BHT - Write-up 05

20/29


SHALAMAR HOSPITAL WASTE MANAGEMENT

The Shalamar Hospital Waste Management project was initiated with the objective of stopping recycling andreuse of clinical waste such as syringes and other disposables. The recycling of clinical waste results in spreadof typhoid, Hepatitis B, C,HIV and epidemics. In addition to this, many health care providers and diagnosticcenters throw contagious waste on the roadside or in municipality containers. To overcome the menace ofhospital waste disposal in Lahore, a non- profit company was registered in June 2000 for the proper handlingof the Hospital Waste. The project was first of its kind in Pakistan. Under its supervision two incinerators eachare having the capacity of 1600 Kgs/Shift have been installed at the two hospitals i.e. Shalamar and United

8/10/2019 BHT - Write-up 05

21/29


OUR STRATEGY

SIHS aims to serve the disadvantaged community of northern Lahore by providing qualitymedical treatment and developing healthcare capacity in the society through education inthe field of medical and health sciences. In order to realize this vision, SIHS has developed acomprehensive strategy and an action plan for the next five years.

SIHSs strategy revolves around five key pillars Availability of 24-hours highly responsiveemergency and trauma care; Provision of patient-centric healthcare services; Outreachingcommunity for provision of primary healthcare services; Developing a pool of capablehuman resource; and Undertaking credible initiatives to demonstrate social responsibility.SIHS intends to realize its vision, while working around these strategic pillars and adheringto the core values of promoting local philanthropy; ensuring sustainability; adopting patient-centric services and continuously improving quality. The strategy has been translated into afive-year action plan.

8/10/2019 BHT - Write-up 05

22/29

8/10/2019 BHT - Write-up 05

23/29


OUR CORE VALUES

SIHS believes in core values of ensuring sustainability of its initiatives, continually improvingquality of its services, retaining its focus on the end users (i.e., patients) and promoting localphilanthropy. Through our journey, SIHS has held closely to these values and it aims todemonstrate these values across all its future endeavors.

OUR STRATEGIC ACTION PLAN 2010-15In order to implement its strategy, SIHS has also come up with a concrete action plan for thenext 5 years, to undertake a host of initiatives under each strategic pillar. The appendedstrategy matrix presents SIHSs action plan.

Figure 9: SIHS The Way Forward; 2010-2015

8/10/2019 BHT - Write-up 05

24/29


CONCLUSION

SIHS is well positioned to serve the disadvantaged community of northern Lahore throughits various initiatives for providing quality medical treatment and developing healthcarecapacity in the society through education in the field of medical and health sciences. SIHShas ambitious expansion plans to further its scope of activities to benefit a larger chunk ofcommunity. These plans have been developed under a well though out and coherentstrategy, as explained earlier. While working on strengthening its own systems andcapabilities, SIHS is now looking for funding sources to implement its action plan for thenext five years, to transform this strategy into concrete initiatives on ground.

8/10/2019 BHT - Write-up 05

25/29


Page 25 | 29

SIHS STRATEGIC ACTION PLAN 2010-15

Strategic Pillar Key Initiatives Funding Needs Potential ImpactAvailability of 24-hourshighly responsiveemergency and traumacare

Total FundingRequirement: PKR 60Million (USD 0.69Million 4)

1. Up-gradation of Accidents and Emergency Department & OPD: TheShalamar Hospital is planning to upgrade its Accidents and Emergency &General OPD Department to further enhance the capability of handlingdifferent emergency situations and needy patients.

PKR 60 Mil lion Treatment of 500,000 patients per annum,including 140,000

patients free of cost

Availability of state-of-the-art traumamanagement andemergency & OPDservices in a radius of 15kilometers in a highlydense populatedcommunity

Provision of patient-centric healthcareservices

Total Funding

Requirement: PKR 647Million (USD 7.44Million)

2. Systems Strengthening through a Robust Management InformationSystem: SIHS is considering deployment of a state-of-the-art managementinformation system, not only for better internal management but also formanaging an up-to-date patient record database. The solution is includinghardware software and IT personnel are estimated to cost.

3. Expansion of Hospital for Additional 150 Beds Unit: Shalamar hospital iscurrently a 350-bed facility. Out of these 350 beds, 100 beds have beenexclusively dedicated for providing free-of-cost treatment to deserving

patients. However, these 100 beds are n ot sufficient to p rovide tr eatment to acommunity of 3 million people. Shalamar Hospital is planning to expand thehospital capacity by another 150 beds to cater to the heavy inflow of patientsadmissions as well as to comply with the requirements of Pakistan Medical andDental Council. Out of these 150 beds, additional 100 beds will be dedicatedfor free treatment of poor and needy patients (PKR 225 Million). Moreover upgradation of 100 existing free beds of general ward .(PKR 30 Million)

PKR 41 Mi llion

PKR 255 Mill ion

Better patient carethrough maintaining therecord of patientsmedical and visits history;Operational cost

reduction, processimprovement and efficientmanagement; Reducingresponse time.

Addition of 150 beds,resulting in 16,000additional patients treated

per annum. 100 additional beds, dedicated for freetreatment to needy

patients, resulting in7,000 free patients treated

per annum.

4 Exchange Rate: 1 USD = PKR 87

8/10/2019 BHT - Write-up 05

26/29


Page 26 | 29

4. Strengthening of Ophthalmology Unit : The Shalamar Hospital is planningto establish a new ophthalmology unit, to more effectively address eye-related

problems of the patients. Furthermore, the SH is also planning to procureadditional equipment to strengthen its services.

5. Establishment of Neurosurgical Operation Theater: Currently the problems related to neurosurgery can only be effectively dealt with at theGeneral Hospital Lahore, which is the only facility of this kind in Punjab. Tomake these services more easily accessible and to share the burden of patients,the Shalamar Hospital is considering establishment of a new neurosurgicaloperation theater.

6. Establishment of Cardiac Operation Theater : The residents of northernLahore need an economical medical facility to provide affordable cardiactreatment, which calls for establishment of a new cardiac operation theater atShalamar Hospital.

7. Strengthening Gynecology Department : Shalamar Hospital is planning tostrengthen its Gynecological Department to more effectively manage the gynae

patients through e stablishment of a gynae operation (PKR 30 Million) theateralong with reallocation of admin block (PKR 15 Million)

PKR 30 Mil lion

PKR 75 Mil lion

PKR 44 Mil lion

PKR 45 Mil lion

Treatment of 36,000additional patients perannum for eye-related

problems, including29,000 additional OPDvisits per year. Treatmentof 23,000 additional

patients per annum, freeof cost, for eye-related

problems

2,000 surgeries(neurosurgeries) perannum, including 500surgeries free of cost;Availability of state-of-the-art neurosurgeryoperation theater in aradius of 15 kilometers ina highly dense populatedcommunity;

15,000 additional walk in patients treated per a nnumfor cardiac problemsincluding 3,750 patientsfree of cost, and 1000surgeries per annum with200 free of cost

treatments.

70,000 additional walk in patients treated per a nnumfor gynae problems,including 14,000 patientsfree of cost.

8/10/2019 BHT - Write-up 05

27/29

d

8/10/2019 BHT - Write-up 05

28/29


Page 28 | 29

community forprovision of primaryhealthcare services

Total FundingRequirement: PKR 25Million (USD 0.28Million)

undertaking a community outreach program through a mobile dispensary unit.The SH is planning to add another 10 mobile dispensary units to furtherstrengthen its outreach program 10 Mercedes Ambulance

diagnostic services in 12disadvantaged urbancommunities and outskirtsof Lahore;

Providing basic medicalcare to 250,000additionaldeserving patients perannum, through 10 newmobile dispensary units,free of cost

Developing a pool ofcapable humanresource

Total FundingRequirement: PKR1,184 Million (USD13.60 Million)

11. Expanding Medical and Dental College: The SIHS has alreadyestablished a state-of-the-art building for SMDC, however, the project stillneeds substantial capital funding for initiating the dental college.The projected funding requirements include developing a girls hostel for 150students (PKR 111 Million) and establishing a dental college for 50 students(PKR 251 million).

12. Operational Cash Subsidy for SMDC: SMDC has started its operationsand currently the annual operational loss stands around PKR 117 million,however, in 5 years, this loss is expected to come down to merely PKR 21million per annum (for funding scholarships for qualified and needy students).In addition, the accumulated liabilities for SMDC till the end of FY 09-10amount to PKR 212 million, which have so far been funded throughcommercial and supplier credit. In order to sustain itself through the initialyears of its operations, SMDC needs a one-time cash subsidy of PKR 610million to cover these losses. (The ongoing loss to fund scholarships after 5years is proposed to be bridged through an endowment fund; See Para 14).

PKR 362 Mill ion

PKR 822 Mil lion

Producing 100additionaldoctors per annum and 50dentists per annum;Increase in female

participation in SMDCsoncoming class by 70%,resulting in 70 additionalfemale doctors and 35female dentists enteringthe market per annum.

Undertaking credibleinitiatives todemonstrate socialresponsibility

Total FundingRequirement: PKR

1,023 Million (USD11.76 Million)

13. Up-gradation of Hospital Waste Management Unit: Shalamar Hospitalis providing the waste management facility to approximately 220 medicalfacilities, pharmaceutical companies and small medical complexes for their

bio-medical waste. The equipment is almost 10 years old and needs up-gradation. Moreover, the increasing load also calls for its capacityenhancement. The project therefore requires refurbishing of the existing unit adinstallation of an additional unit.

14. Establishment of Endowment Fund to Support Free/SubsidizedTreatment and Other Initiatives by SIHS: SIHS and in particular SH has

been focusing on revenue generation from t hose patients who can afford, to

PKR 200 Mill ion

PKR 823 Mil lion 6

Efficient disposal of 600tones of additionalhospital and medicalwaste per annum for thenext 5 years.

Continued provision offree/subsidized services to500,000 deserving

6 This amount has been calculated, using an expected interest rate of 11% for an annual perpetuity of PKR 90.5 million.

SIHS P t P t d F t

8/10/2019 BHT - Write-up 05

29/29


Page 29 | 29

ensure sustainability of its activities and the annual receipts of SH now exceedPKR 300 million. However, due to heavy inflow of deserving patients, theoperational shortfall has been on the rise over the past few years. The shortfallin 2010 was close to PKR 110 million. SIHS has been quite successful inmobilizing donations, thanks to its large pool of local philanthropists and

business houses. In 2010, due to locally raised donations and governmentgrants, the shortfall was squeezed to a mere PKR 25 million. On an average,this gap for SH is expected to stand around PKR 160 million per annum 5. Theconsolidated average operational loss per annum for SIHS is expected to bearound PKR 181 million, including PKR 160 million for SH and PKR 21million for SMDC.

SIHS plans to raise annual donations to pick up 50% of this operational loss,which would amount to PKR 90.5 million. For remaining PKR 90.5 million,SIHS is now looking for establishing an endowment fund to sustainably bridgethis gap and meet its recurrent expenditures.

patients per annum;Sustained focus of SMDCon quality of incomingstudents, irrespective oftheir capacity to pay and

provision of qualitymedical education tocommunity.

Total PKR 2939.9 MillionUS $ 33.78 Million

5 The loss is expected to increase substantially from FY 2011-12 due to addition of 150 beds.

bht - write-up 05

Documents