Rakesh and Gagan were two brothers who graduated from medical school in 1979. Both

They’ve made a name for themselves as successful practitioners. They decided to open their own hospital in 1992.

as both were well-versed in the nitty-gritty of the business after a decade of success

practitioners. The concept was realized in 1994, when a three-story Arogya Hospital with a

Gwalior now has a total bed capacity of 60. The hospital’s services were excellent.

pathology, X-ray, blood bank, and intensive care unit The number of beds was increased to 100 in 1998.

as well as the addition of a fourth floor A fifth floor was added in 2005, and the hospital opened its doors.

providing radiology, 3D spiral, CT scan, colordoppler, pathology, blood bank, C.C.U., and other services

O.T., maternity unit, emergency and trauma services, in-patient housing, canteen

Communication and entertainment

There were 35 nurses and 55 class four employees at the hospital. The primary task of class four

Employees were responsible for keeping the hospital clean. In addition, they were entrusted with

the task of sponging, bed setting, and patient shifting These employees were paid a salary of

per month ranging from Rs. 1200/- to Rs. 1800/- The hospital staff was divided into various classes.

employees. The first class consisted of MBBS, MD, MS, and Administrative Officers. Threerd grade

Technicians and nurses make up the team. Ayabais, Sweepers, and Guards make up Class 4.

The hospital had 11 full-time doctors, 7 of whom were duty doctors (MBBS) and two full-time MDs for the ICU.

as well as two full-time in-house surgeons (MS). Aside from that, the hospital had 50 visiting doctors.

On a turnkey basis, the operation was carried out. These doctors had their own clinics in various parts of town, and as

They admitted their patents to the hospital as required. There was an agreement reached between

the doctors and the hospital that the hospital would charge the patients and the doctors would profit from it

receive their fees as well as a percentage of the hospital’s share Patients who have been treated at the hospital

were patients in need of intensive care as well as those suffering from minor illnesses. Among the hospital cases reported,

60-75 percent were maternity cases referred to the hospital by the city’s top gynecologists, Dr.

Dr. Manorama and Savita. Work-instructions for doctors are provided to assist them in the treatment of patients.

The Resident Doctors, Supervisors, Wardboys / Ayabais, and Sweeper Boys / Bais were all trained by the

Priya, the newly appointed Hospital Administrator. These instructions were written in English and were distributed.

hung on the enquiry counter’s walls Priya resigned from the hospital after one month.

because of some personal reasons

By the end of 2004, Ritu, a newly minted post-graduate in Hospital Administration from

Gwalior was appointed as an Administrative Officer to oversee the overall operations of the

hospital. Her job was to keep an eye on the activities of employees in classes three and four, as well as other employees.

activities pertaining to the operation of the hospital The first task she faced was to improve the

the hospital’s cleanliness She discovered that the toilets were not properly cleaned, and the room hygiene was poor.

was bleak. She began making regular visits to all of the hospital’s wards and rooms to observe and learn.

Employee monitoring lacked a human touch. In addition, the patients complained that the

Employees demanded payment for services rendered. She arrived at the following conclusion after analyzing the situation:

conclusion that one of the major factors was a lack of motivation among the class four employees

responsible for the hospital’s deplorable conditions There is a lack of motivation in the class.

The presence of four employees was also evident in the form of high employee turnover, work negligence, and absenteeism.

as well as whining behavior High absenteeism among class four employees resulted in work being missed.

Overload for sincere employees, who were forced to work the following shift. This was a common occurrence.

feature in the hospital as a result of which employees were frequently stressed and thus less productive

They are dedicated to their work. Despite the fact that they were provided with dinner and snacks at the

Health and Hospital Management Exam Paper


IIBM stands for the Institute of Business Management.

As a gesture of goodwill for those who worked extra hours for the hospital, the hospital’s expenses were covered. She

It was also discovered that the workers were not reporting for duty on time, despite their arrival in the morning.

on time to the hospital

The second reason she identified for the hospital’s lack of hygiene was that the

Visitors’ visiting hours were not specified, so there was a constant flow of visitors around the clock.

The hospital’s cleaning activity was hampered and affected by the clock. It was discovered that the

Patients’ rooms were always crowded with visitors who didn’t mind eating in the room/ward.

She felt there was no way to solve the visitors’ problem because it was an essential part of the show.

The management’s promotional strategy She also discovered that the work instructions provided to the

The hospital staff spoke English, which was difficult for class four employees to understand.

them. Ritu translated all of these instructions into Hindi so that the employees in class four could understand them.

Put them into action.

Ritu faced the difficult task of reducing absenteeism and increasing employee commitment.

their work and believed that a reward of Rs. 200, if given to an employee who remained present for 31 days, would be appropriate.

days could possibly motivate the employee to keep coming to work on a regular basis. Furthermore, to encourage

She decided to systematize the performance appraisal system by identifying performers and evaluating them.

non-performers. She was nervous about performance evaluation because it was her first job. The

Employees were to be divided into three groups: A, B, and C; “A” was for high performers, “B” was for low performers, and “C” was for everyone else.

The letter “A” stood for average performers, while the letter “C” stood for poor performers. It was decided that the workers in the

The highest increment would go to grade “A,” followed by grades “B” and “C.” To achieve the desired result

She identified various activities for which employees could be evaluated in order to meet the appraisal objective. To

A two-tier appraisal system was developed to make the performance appraisal system more objective.

her. During the first phase, employees were to be evaluated on a regular basis on the identified activities by patients.

as well as their companions Observation of doctors and nurses was to be considered in the second phase.

Despite the fact that Ritu had the full support of the hospital administration, she was concerned about

the acceptance of the new system by the employees She had no choice but to wait and observe.

1. Critically evaluate the Ritu-identified factors for improving organizational effectiveness?

2. Describe a performance appraisal system that you would recommend to Ritu for assessing performance.