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    Dr. Usha - Manpower Planning New Hospitals

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    Velram Shanmugam
    This document discusses manpower planning for a new hospital. It outlines several critical steps in manpower planning including assessing changing business paradigms, manpower availability, projected HR requirements, quality determinants, hospital set up analysis, impact of policy issues, and phasing commissioning beds. It provides a simplified manpower planning ratio of 1 bed to 4.45 staff and works out a plan for a 200 bed hospital assuming 50% commissioning and 60% occupancy. Cost implications of wages accounting for 18-20% of cash inflow are also noted.

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    Dr. Usha - Manpower Planning New Hospitals

    Uploaded by

    Velram Shanmugam
    123 views34 pages
    This document discusses manpower planning for a new hospital. It outlines several critical steps in manpower planning including assessing changing business paradigms, manpower availability, projected HR requirements, quality determinants, hospital set up analysis, impact of policy issues, and phasing commissioning beds. It provides a simplified manpower planning ratio of 1 bed to 4.45 staff and works out a plan for a 200 bed hospital assuming 50% commissioning and 60% occupancy. Cost implications of wages accounting for 18-20% of cash inflow are also noted.

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    Manpower planning for hospitals

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    This document discusses manpower planning for a new hospital. It outlines several critical steps in manpower planning including assessing changing business paradigms, manpower availability, projected HR requirements, quality determinants, hospital set up analysis, impact of policy issues, and phasing commissioning beds. It provides a simplified manpower planning ratio of 1 bed to 4.45 staff and works out a plan for a 200 bed hospital assuming 50% commissioning and 60% occupancy. Cost implications of wages accounting for 18-20% of cash inflow are also noted.

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    © All Rights Reserved
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    123 views34 pages

    Dr. Usha - Manpower Planning New Hospitals

    Uploaded by

    Velram Shanmugam
    This document discusses manpower planning for a new hospital. It outlines several critical steps in manpower planning including assessing changing business paradigms, manpower availability, projected HR requirements, quality determinants, hospital set up analysis, impact of policy issues, and phasing commissioning beds. It provides a simplified manpower planning ratio of 1 bed to 4.45 staff and works out a plan for a 200 bed hospital assuming 50% commissioning and 60% occupancy. Cost implications of wages accounting for 18-20% of cash inflow are also noted.

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    Manpower Planning for a

    New Hospital
    HospiArch 2012, Bangalore
    Usha Manjunath, Ph.D.
    Dean-Academics & Student Affairs, IHMR, Bangalore
    Hospital Planning……….

    Aesthetically beautiful building

    Latest Equipment & Instruments

    Latest Technology
    Hospital Planning………….

    Smart People…………
    Greedy HR!!!!!!!!!!

    Wisdom of Experience At the pay


    Drive of a
    a 50 year of a 40 scale of a
    30 year old
    old year old 20 year old
    Manpower: Costly affair……

    Medical professionals 20-25%

    Salary & wages 18-20%

    Medicine & consumables-20-25%

    Hospital running expenses 7-8%

    Administrative expenses 3-4%

    Depreciation 6-7%

    In general, Manpower accounts for around 30% of operational cost for


    any hospital
    Core Team: Starting Point…..

    • Commissioning Team
    – Hospital consultant
    – Administrator
    – Chief of Clinical Services
    – Senior Nurse/s
    – Supplies Officer
    – Others
    Critical Steps in Manpower
    Planning
    Step 1: Changing business
    paradigms
    Sl. Paradigm Earlier Now
    No
    .
    1. Customer Clinical effectiveness & Patient/Customer
    Key Drivers Cost efficiency Perception of Quality and
    Value
    2. Culture & Provider driven Focused on both Clinical
    Service & Customer Service
    Delivery
    3. Staff Focus on clinical skills Focus on both Clinical &
    Training Customer Skills

    4. Service Technical Efficiency & Seamless integration for


    System Clinical Effectiveness high quality Customer
    Design Service across all
    functions
    Step 2: Manpower Availability
    Parameter India China USA UK
    Physicians per 0.6 1.06 2.56 2.03
    1,000 population
    Nurses per 1,000 0.8 1.05 9.37 12.12
    Population
    Midwives per 0.47 0.03 - 0.63
    1,000 Population
    Dentists per 0.06 0.11 1.63 1.01
    1,000 Population
    Pharmacists per 0.56 0.28 0.88 0.51
    1,000 Population
    Lab Technicians 0.02 0.16 2.15 0.34
    per 1,000
    Population

    Source: WHO “World Health Report” 2006


    Projected HR Requirements for Medical
    Personnel in India (in ‘000s)

    2008 2012 2018 2022 Incremental

    Doctors 725 1,208 1,947 2,705 1,980

    Nurses 1,600 2,416 5,192 10,822 9,222

    Technicians, 27 232 530 812 785


    Paramedics &
    others

    Dentists 80 121 389 676 596

    Pharmacists 681 724 779 811 130

    Based on the projected population growth.


    Source: IMaCs Analysis
    News: TOI May 15th 2012

    Ø 2 lakh doctors out of 7.5 lakh have stopped working

    Ø 6 lakh nurses out of 10.7 nurses registered do not exist


    Regional Disparities in Manpower
    Availability
    South India -45% of medical
    colleges with 47% of MBBS
    seats
    West India- 21% of medical
    colleges with 22% of MBBS
    seats
    Central India- 5% of medical
    colleges with 5% of MBBS
    seats
    East India- 10% of Medical
    colleges with 9% of MBBS
    seats
    North India- 17% of medical
    colleges with 16% of MBBS
    seats
    Quality: difficult to determine……

    • Education

    • Experience

    • Employability

    • Talent, Knowledge, Skills and Attitudes


    Step 3: Promoter Vision

    • Secondary, Tertiary, Quaternary


    • Multi or Super specialty
    • Type of clientele (niche market?,
    Boutique hospital???)
    • Service mix of the hospital
    • Funding pattern
    • Plans for accreditation
    • Commercial orientation
    Step 4: Hospital Set Up Analysis

    • Space Planning:
    – Helps in understanding work flows, patient flow, staff flow
    etc which in turn helps in manpower allocation
    • Bed Break Up:
    – Number of beds i.e. bed per floor, suite, single rooms,
    double rooms, ICU, casualty beds etc…
    • Number of OPDs
    • Number of Operating Rooms
    • Type of ICUs
    • Diagnostic Facilities/Labs
    • Business areas/Facilities
    Departmental Assessment

    • Subsections of the department. For e.g. various


    types of labs-biochemistry, histopathology,
    microbiology..
    • Equipment in department
    • Working days/hours of the department
    • Expected work load for each department
    • Types of personnel for various jobs/duties
    • Standards and norms for the department
    Hospital set up

    Servic Person Equip Funcat Project Mornin Evenin Night Total


    e area nel ment ional ed g g
    Catego Quanti Hrs/Da worklo
    ry ty ys ad

    Work out the numbers for Dialysis Services


    Service Area: Dialysis

    Servic Person Equip Funca Projected Morni Evenin Night Total


    e area nel ment tional workload ng g
    catego Quantit Hrs/D
    ry y ays
    Dialysis Technic 8 12*6 11 2 1 - 3
    ian
    Staff 1 - - 1
    Nurse
    Head 1 - - 1
    Ward 1 1 - 2
    boys
    HK 1 1 - 2
    Step 5: Impact of other policy
    issues on Manpower
    Phases of Commissioning

    • Phases of commissioning beds


    • The percent of beds to be
    commissioned at different stages
    – Stage 1- During soft commissioning-50%
    – Stage 2- At 6 months=65%
    – Stage 3- At 12 months=85%
    – Stage 4- At 24 months=100%
    • Work load: Target for Bed Occupancy
    at various stages of commissioning
    Leave Policy

    • Leave policy leading to leave relief


    • 365 days full working
    – 52 sundays
    – 7 PH
    – 21 EL, 7 SL, 7 CL (Total=35 days)
    • 271 actual/12=22.5 p.m. working days in a 30 day month
    • Therefore:
    – 3 personnel for 30 days = 90 days
    – But actually 3X23 days = 69 days
    – Deficit=90-69=21 days (approx-1 extra person
    – Every 3rd person, 1 extra person required i.e. 30% more
    Direct and In-direct Staff
    Manpower Planning Simplified…
    Sl. No. Category Ratio-Bed:
    Manpower
    1. Consultants 1: 0.30
    2. Resident Doctors 1: 0.30
    3. Nurses 1: 1.50
    4. Technicians & Para Medicals 1: 0.45
    5. Management & Administration Staff 1: 0.20
    6. Clerk, Receptionist, Admin & 1: 0.40
    Secretaries
    7. FSD, House Keeping, Laundry, 1: 1.20
    Security
    8. Engineering, Maintenance, 1: 0.10
    Biomedical
    TOTAL INDIRECT STAFF 1: 1.30
    TOTAL STAFF 1: 4.45
    Work Out Manpower Plan
    For a 200 Bed Hospital
    Assumption: Phase 4
    Commissioning 50% Beds with
    Expected Occupancy at 60%
    Plan for a 200 Bed Hospital
    Sl. Category Ratio Phase 4
    No. Bed: Manpower Commissioning-50%
    Beds/Exp
    Occupancy 60%
    1. Consultants 1: 0.30 18
    2. Resident Doctors 1: 0.30 18
    3. Nurses 1: 1.50 90
    4. Technicians & Para Medicals 1: 0.45 27
    5. Management & Administration 1: 0.20 12
    Staff
    6. Clerk, Receptionist, Admin & 1: 0.40 24
    Secretaries
    TOTAL DIRECT STAFF 1: 3.15 189
    7. FSD, House Keeping, Laundry, 1: 1.20 72
    Security
    8. Engineering, Maintenance, 1: 0.10 06
    Biomedical
    TOTAL INDIRECT STAFF 1: 1.30 78
    TOTAL STAFF 1: 4.45 267
    Cost Implications

    • Due to demand supply situation, it is


    important to note that the salaries are
    on the rise.
    • Since 18-20% of the cash inflow is
    spent on salaries, Surplus can effect a
    start up hospital badly and can lead to
    huge financial distress
    • However, poor staffing levels can
    impact quality of services delivered.
    Factors Affecting Wage Mix
    Total Compensation &
    Pay Structure
    HUMAN RESOURCE INFORMATION SYSTEMS
    (HRIS)

    PERSONAL DATA
    Age, Gender, Dependents, Marital status, etc
    EDUCATION & SKILLS
    Degrees earned, Licenses, Certifications
    Languages spoken, Specialty skills
    Ability/knowledge to operate specific machines/equipment/software
    JOB HISTORY
    Job Titles held, Location in Company, Time in each position, etc.
    Performance appraisals, Promotions received, Training & Development
    MEMBERSHIPS & ACHIEVEMENTS
    Professional Associations, Recognition and Notable accomplishments
    PREFERENCES & INTERESTS
    Career goals, Types of positions sought
    Geographic preferences
    CAPACITY FOR GROWTH
    Potential for advancement, upward mobility and growth in the company
    Recruitment & Placement Process

    • Phases of Commissioning
    – Specialists/Consultant Panel and not necessarily
    on pay roll in initial phases
    – Nursing Director as a part of core team, next
    probably Nursing Supervisors & In-Charges; lastly
    Staff Nurses (about a month of actual
    commissioning)
    – Organizational Structure, defining job roles and
    responsibilities, job description
    • Orientation programs list & Trainings
    • Actual Orientation Plan and Materials
    Innovations!!!!!!!!!!!!!
    Thank you……….

    Usha Manjunath, Ph.D.


    Dean-Academics & Student Affairs, IHMR, Bangalore

    usha@iihmr.org
    • Question: How to carry out manpower planning for a new hospital and its
    importance?
    - Dr.Aravinth Reddy, Chennai
    • Answer: Manpower planning is extremely important for a hospitals effective
    functioning. It depends on type of hospital, number of beds, number of departments,
    bed distribution in various rooms/wards/intensive care etc.
    • Manpower planning is an important issue for any hospital since it accounts for
    around 30 per cent of operational cost for any hospital. Most hospitals operate on
    excess man power. “Ideally, total hospital employee to bed ratio should be a
    minimum of four per bed,” As competition increases and margins come under
    pressure, hospitals will have no option but to rationalise manpower, which would
    mean downsizing.
    • Most times, downsizing results in chaos, mainly because of improper manpower
    planning. A multi-skilled workforce is required to carry multiple tasks in order to
    maintain optimum employee per bed ratio, a key to boost and sustain profits. To
    achieve this, manpower planning becomes crucial.
    • Also doing a salary survey is beneficial by which you get to know the competitive
    compensation structure in market and accordingly you can design salary structure
    for your hospital. Manpower planning tells you about the total number of employees
    you need department wise for smooth running of hospital
    • Manpower: Staffing of the operating room, in terms of anaesthetists, nurses and other support
    staff is important for efficient running of theatre and this number should be on par with the clinical
    activity. Experts also feel that the way forward in operation theatre management is to have a
    'Theatre Management Group' with strong leadership and appropriate membership with authority
    to take action. Theatre managers should monitor the actual use of operating room and co-
    ordinate with the surgeons, anaesthetist and other theatre personnel. The importance of each
    activity should be known to all and most importantly all the activities should be documented and
    periodically monitored.
    • "A good surgical registrar is a must. His responsibility begins when a surgical patient comes to
    emergency room. He should see that the patient is admitted and all arrangements are made in
    such a way that he understands the need for surgery," believes Dr Paramesh.
    • Indian Spinal Injuries Centre has a dedicated OT coordination committee, which meets regularly
    to get inputs from the OT users.
    • Dr Chakravarthy believes in having a dedicated staff with designated duties. According to him, it
    is not a good idea to 'multi task' the staff in the OTs. Dedicated staff performing specific duties not
    only improves efficiency, but also increases job satisfaction. It is a common practice in India for
    nurses and the technicians to multi task in cleaning the equipment, the floor and the walls of the
    OTs in tandem with other administrative staff.
    • At Wockhardt Hospital, Bangalore, OT nurses only do nursing-related jobs. "We have a separate
    team of 'boys' who do the cleaning and sterilisation of the OT walls and floors. They go from one
    OT to another doing this job repeatedly. At regular intervals, their efficiency in handing back the
    OT in 'ready' state is assessed. Incentive-oriented training offered to them has made efficiency
    the buzz word and brought attrition to an all-time low," shares Dr Chakravarthy.

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