Summer Internship Report

Manpower planning and optimization (of technicians) using Erlangs method
1. INDUSTRYOVERVIEW
A hospital is an institution for health care providing treatment by specialized staff and
equipments, and often but not always providing for longer term patient stays. Today
hospitals are usually funded by the state, health organization (for profit or nonprofit), health
insurances or charities, including direct charitable donations. In history, however, they are
often founded and funded by religions orders or charitable trust individuals and leaders.
Similarly modern day hospitals are largely staffed by professional physicians surgeons and
nurses, where as in history, this work was usually done by the founding religious orders or by
volunteers.
The health care industry, or medical industry, is a sector within the economic
system that provides goods and services to treat patients with
curative, preventive, rehabilitative, and palliative care. The modern health care sector is
divided into many sub-sectors, and depends on interdisciplinary teams of trained
professionals and paraprofessionals to meet health needs of individuals and populations.
The health care industry is one of the world's largest and fastest-growing industries.
Consuming over 10 percent of gross domestic product (GDP) of most developed nations,
health care can form an enormous part of a country's economy.
In accord with the original meaning of the word, hospitals were originally "places of
hospitality", and this meaning is still preserved in the names of some institutions such as
the Royal Hospital Chelsea, established in 1681 as a retirement and nursing home for veteran
soldiers. Some patients go to a hospital just for diagnosis, treatment, or therapy and then
leave ('outpatients') without staying overnight; while others are 'admitted' and stay overnight
or for several days or weeks or months ('inpatients'). Hospitals usually are distinguished from
other types of medical facilities by their ability to admit and care for inpatients whilst the
others often are described as clinics.
General
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The best-known type of hospital is the general hospital, which is set up to deal with
many kinds of disease and injury, and normally has an emergency department to deal with
immediate and urgent threats to health.
District
A district hospital typically is the major health care facility in its region, with large
numbers of beds for intensive care and long-term care.
Specialized
Type of specialized hospitals include trauma centres, rehabilitation

hospitals, children's hospitals, seniors' (geriatric) hospitals, and hospitals for dealing with
specific medical needs such as psychiatric problems (see psychiatric hospital), certain disease
categories such as cardiac, oncology, or orthopaedic problems, and so forth. A hospital may
be a single building or a number of buildings on a campus.
Teaching
A teaching hospital combines assistance to patients with teaching to medical

students and nurses and often is linked to a medical school, nursing school or university.
Clinics
The medical facility smaller than a hospital is generally called a clinic, and often is
run by a government agency for health services or a private partnership of physicians (in
nations where private practice is allowed). Clinics generally provide only outpatient services.
Departments
Hospitals vary widely in the services they offer and therefore, in the departments (or "wards")
they have. Each is usually headed by a Chief Physician. They may have acute services such
as a depart mentor specialist trauma centre, burn unit, surgery, or urgent care. These may then
be backed up by more specialist units such as:
Emergency department
Cardiology
Intensive care unit
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Pediatric intensive care unit
Neonatal intensive care unit
Cardiovascular intensive care unit
Neurology
Oncology
Obstetrics and gynecology
Some hospitals will have outpatient departments and some will have chronic treatment units
such as behavioural health services, dentistry, dermatology, psychiatric ward, rehabilitation
services, and physical therapy. Common support units include a
dispensary or pharmacy, pathology and radiology, and on the non-medical side, there often
are medical records departments, release of information departments.
1.1Hospitals in India
Health care is Indias most important service industry. The modern system of
medicine was introduced in 17th century with the arrival of European Christian missionaries
in south India. From its gradual evolution through the 18 th and 19th centuries the hospitals
both in western and eastern world has come of age only recently during the past 50 years. The
concept of todays hospital contrasting fundamentally from the old idea of hospitals as no
more than a place for treatment of the sick, with the under coverage of every aspect of human
welfare viz-physical mental and social wellbeing etc. The health care services have
undergone steady metamorphosis and the role of hospital, has changed with the emphasis
shifting from
A curative to chronic illness

A curative to preventive medicine
Individual orientation to community orientation
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Inpatient care to outpatient and home care
Restorative to comprehensive medicine
Isolated function to area wise or regional function
Tertiary and secondary to primary healthcare
Episodic care to total care
Specialized hospitals are coming up in many places in recent years. If the task of
hospitals is to restore health and hot merely to cure disease entity then the role and
responsibilities of hospital assume to be of great significance.
Background
For purposes of finance and management, the health care industry is typically divided
into several areas. As a basic framework for defining the sector, the United
Nations International Standard Industrial Classification (ISIC) categorizes the health care
industry as generally consisting of:
1. Hospital activities;
2. Medical and dental practice activities;
3. Other human health activities.
This third class involves activities of, or under the supervision of, nurses, midwives,
physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health
facilities, or other allied health professions, e.g. in the field of optometry, hydrotherapy,
medical massage, yoga therapy, music therapy, occupational therapy, speech therapy,
chiropody, homeopathy, chiropractics, acupuncture, etc.
The Global Industry Classification Standard and the Industry Classification

Benchmark further distinguish the industry as two main groups:
1. Health care equipment and services
2. Pharmaceuticals, biotechnology and related life sciences.
Health care equipment and services comprise companies and entities that provide
medical equipment, medical supplies, and health care services, such as hospitals, home health
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care providers, and nursing homes. The second industry group comprises sectors companies
that produce biotechnology, pharmaceuticals, and miscellaneous scientific services.
Other approaches to defining the scope of the health care industry tend to adopt a broader
definition, also including other key actions related to health, such as education and training of
health professionals, regulation and management of health services delivery, provision
of traditional and complementary medicines, and administration of health insurance.
1.2 Providers and Professionals
A health care provider is an institution (such as a hospital or clinic) or person (such as

a physician, nurse, allied health professional or community health worker) that provides
preventive, curative, promotional, rehabilitative or palliative care services in a systematic
way to individuals, families or communities.
The World Health Organization estimates there are 9.2 million physicians, 19.4
million nurses and midwives, 1.9 million dentists and other dentistry personnel, 2.6 million
pharmacists and other pharmaceutical personnel, and over 1.3 million community health
workers worldwide making the health care industry one of the largest segments of the
workforce.
The medical industry is also supported by many professions that do not directly
provide health care itself, but are part of the management and support of the health care
system. The incomes of managers and administrators, underwriters and medical
malpractice attorneys, marketers, investors and shareholders of for-profit services, all are
attributable to health care costs.
In 2003,health care costs paid to hospitals, physicians, nursing

homes, diagnostic laboratories, pharmacies, medical device manufacturers and other
components of the health care system, consumed 15.3 percent of the GDP of the United
States, the largest of any country in the world. For United States, the health share of gross
domestic product (GDP) is expected to hold steady in 2006 before resuming its historical
upward trend, reaching 19.6 percent of GDP by 2016. In 2001, for the OECD countries the
average was 8.4 percent with the United States (13.9%),Switzerland (10.9%), and Germany
(10.7%) being the top three. US health care expenditures totaled US$2.2 trillion in
2006. According to Health Affairs, US$7,498 be spent on every woman, man and child in the
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United States in 2007, 20 percent of all spending. Costs are projected to increase to $12,782
by 2016.
1.3 Delivery of Services
The delivery of health care services from primary care to secondary and tertiary levels
of care is the most visible part of any health care system, both to users and the general
public. There are many ways of providing health care in the modern world. The place of
delivery may be in the home, the community, the workplace, or in health facilities. The most
common way is face-to-face delivery, where care provider and patient see each other 'in the
flesh'. This is what occurs in general medicine in most countries. However, with modern
telecommunications technology, in absentia health care is becoming more common. This
could be when practitioner and patient communicate over the phone, video conferencing, the
internet, email, text messages, or any other form of non-face-to-face communication.
Improving access, coverage and quality of health services depends on the ways services
are organized and managed, and on the incentives influencing providers and users. In market-
based health care systems, for example such as that in the United States, such services are
usually paid for by the patient or through the patient's health insurance company. Other
mechanisms include government-financed systems (such as the National Health Service in
the United Kingdom). In many poorer countries, development aids as well as funding through
charities or volunteers helps support the delivery and financing of health care services among
large segments of the population.
The structure of health care charges can also vary dramatically among countries. For
instance, Chinese hospital charges tend toward 50% for drugs, another major percentage for
equipment, and a small percentage for health care professional fees. China has implemented a
long-term transformation of its health care industry, beginning in the 1980s. Over the first
twenty-five years of this transformation, government contributions to health care
expenditures have dropped from 36% to 15%, with the burden of managing this decrease
falling largely on patients. Also over this period, a small proportion of state-owned hospitals
have been privatized. As an incentive to privatization, foreign investment in hospitals up
to 70% ownership has been encouraged.
1.4Medical Tourism
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Medical tourism (also called medical travel, health tourism or global health care) is a
term initially coined by travel agencies and the mass media to describe the rapidly-growing
practice of travelling across international borders to obtain health care.
Such services typically include elective procedures as well as complex
specialized surgeries such as joint replacement (knee/hip), cardiac surgery, dental surgery,
and cosmetic surgeries. However, virtually every type of health care, including psychiatry,
alternative treatments, convalescent care and even burial services are available. As a practical
matter, providers and customers commonly use informal channels of communication-
connection-contract, and in such cases this tends to mean less regulatory or legal oversight to
assure quality and less formal recourse to reimbursement or redress, if needed.
Over 50 countries have identified medical tourism as a national industry.
However, accreditation and other measures of quality vary widely across the globe, and there
are risks and ethical issues that make this method of accessing medical care controversial.
Also, some destinations may become hazardous or even dangerous for medical
tourists to contemplate.
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2. COMPANY PROFILE
Malabar Institute of Medical Sciences Ltd (MIMS) is a pioneer institute in the state of Kerala
renowned for its excellent medical expertise, nursing care and quality of diagnostic services.
600bedded multi-specialty hospital which is located in the heart of Calicut city is at the
forefront of medical technology and backed by internationally trained and highly qualified
medical professionals, who administer the best available medical services across all major
disciplines of medicine and surgery. MIMS is committed to the achievement and maintenance
of excellence in healthcare for the benefit of the humanity. MIMS is the first multi-specialty
hospital accredited by National Accreditation Board for Hospitals and Health Care Providers
(NABH).
MIMS started as a 300 bed hospital in 2001 and succeeded in being more than just a
quality healthcare provider. It has been a major player in the healthcare sector of Malabar.
The tremendous growth that has been achieved in such a short span of time is mainly because
of our ability to go beyond the expected healthcare to our patients. MIMS has been identified
as a pioneer in patient care, Medical research and education. MIMS has 12 fully equipped
operation theatres and has facilities for conducting the super specialty procedures like Open
Heart Surgeries for adults and children and beating heart surgeries. The hospital has an
excellent emergency and trauma care unit supported by 24 hours diagnostic department and a
blood bank which has component separation facility.
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2.1 Vision
"We shall strive to establish a medical institute of international standard for providing
comprehensive healthcare to the people as a Caring Mission with a Global Vision."
2.2 Mission
Provide Comprehensive, Caring and Cost effective Medical treatment of Global

standard, through a team of highly qualified and committed medical professionals
with state-of-the-art medical equipments.
Involve in Medical Education and Research aiming at contributions in the field of

Modern Medicine.
Nurture rapport among the Medical fraternity with due respect to other systems of
Medicine.
Ensure ethical practice of Medicine upholding the philosophy that profit must only be
a by-product rather than an aim, in the field of healthcare.
Fulfill the social responsibility to the underprivileged by providing free or subsidized

medical treatment.
2.3 Major Accreditations & Award
NABH (National Accreditation Board for Hospitals and Healthcare Providers) MIMS
is the first multi-specialty hospital in India to get this accreditation for its quality service and
patient safety. The implementation process of ISO 14000 for Environment Quality
Certification is going on. State award for pollution control (by Kerala State Pollution Control
Board) MIMS has secured the first place among hospitals making substantial and sustained
efforts in pollution control and conferred the state award for the third consecutive year.
2.4 Divisions
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MIMS Academy, an academic wing under Malabar Institute of Medical Sciences Ltd.,
was established for augmenting the educational programs of MIMS. MIMS Academy is an
accredited centre by the National Board of Examinations, Ministry of Health and Family
Welfare Department, Govt. of India to conduct training for DNB students in ENT, General
Medicine, General Surgery, Family Medicine, Anaesthesia, Paediatrics, Obstetrics &
Gynaecology, Radiology, Cardiology and Cardio Vascular Thoracic Surgery. It also runs
MIMS College of Nursing and MIMS School of Nursing. DMLT Course recognized by the
Government of Kerala is also conducted by the Academy.
MIMS academy is recognized as International Academic Training centre for
conducting three years Masters Program in Emergency Medicine (MEM) under George
Washington University, USA. Academy is also accredited by Ronald Regan Institute of
Emergency Medicine, USA, Indian Institute of Emergency Medicine Services, India and
function as a Regional Training Centre for American Heart Association to Conduct
Lifesaving training programs such as Basic Life Support, Advanced Cardiac Life Support,
Trauma Life support and Paediatrics Cardiac Life Support.
2.5 Unique feature of MIMS
Over a hundred medical professionals as full time doctors
First multi-specialty hospital in the country to gain NABH accreditation
Level IV Trauma care facility
One of the best Intensive care facilities in the country
State of the art Laboratory with highest level of quality control
Blood Bank with component separation facility
The first Cochlear Implant Clinic in the State
Advanced Interventional Radiology
State of the art Nuclear Medicine Department
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Round the clock availability of Interventional Cardiologists for Primary angioplasty
2.6 Quality Policy

Malabar Institute of Medical Sciences is committed to provide excellent quality health
care of international standard at affordable cost to the public. This shall be achieved through
dedicated and caring services of all staff of MIMS. The Management of MIMS totally
commits itself to support this policy with all necessary resources. Continual improvement in
all phases of activity will be achieved by periodical review and repeated training processes.
The motto of the hospital is "Caring mission with a Global Vision" and attainment of highest
quality in our work will be essential part of our policy.
2.7 MIMS Charitable Trust
As a part of Corporate Social Responsibility MIMS has been conducting a lot of

charity services. MIMS has been doing free and subsidized surgeries to adult and paediatric
cardiac surgery patients and free dialysis facility for poor patients. The hospital dedicates 10
beds exclusively for the patients who come under the Below Poverty Line. Under its
charitable wing, MIMS Charitable Trust has adopted Vazhayur Panchayath, Calicut, one of
the most back ward Panchayaths in this area and provides community healthcare. A rural
health centre for the inhabitants of Vazhayur, Calicut was opened. It has a fully equipped
pharmacy, X ray and lab facilities. Sample medicines are collected from our doctors for free
dispensation at the rural health centre.
Now with successful proven track records, MIMS has decided to spread its wings to
further embrace more and more areas and to nourish the ailing sector with healing touch. As
the first step of expansion MIMS step in to Kottakkal, Malappuram District, the very name
itself is registered all over the globe with its unique Ayurveda heritage.
To vanish the stagnant stage of the health care scenario of Malappuram MIMS
generating international standards in healthcare through their various departments equipped
with state of the art facility. The hospital will be having 4 high-tech Operation theatres, ICU
with ventilators, NICU with ventilators, Incubator & Photo therapy, 6 slice CT machine,
Mobile ICU, State-of the art Emergency Department, Ultra sound scanning, Comprehensive
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health check-up, Day Care Wards etc. It is relevant that in todays world, speedy and suitable
health management has increased two folds. The modern society now is afflicted with
ailments, linked to the current stressful and competitive life styles in this harsh and
unforgiving world that did not exist in olden days. The ever increasing cost of medical
treatment deters people living in poverty to gain an access to premium health care.
We witness an apathetic state of affairs where many children and adults afflicted with all sorts
of diseases and ailments are left to die a slow and agonizing death, not for lack of expert
medical treatment but for want of financial support. Knowing that they will not be able to
afford timely medical treatment with prohibitive costs, their vitality and spirit for living ebbs
away and they slowly sink into despair, waiting for death to take over.
MIMS Charitable Trust is the silver lining to this dismal state. The Trust works
tirelessly to bring convenient healthcare to the down trodden. With MIMS Charitable Trust,
life threatening diseases are no more a death sentence to the poor. Patients in large numbers
with a paucity of funds are approaching the Trust for succor. MIMS Charitable Trust channels
its donations from philanthropists and benefactors to mitigate the suffering of the poor who
are sick irrespective of their caste, creed or religion.
The MIMS Charitable Trust, with a tie to parent healthcare institution, is actively involved in
helping the poor who are sick and ailing gain access to expensive and lifesaving surgeries and
procedures; especially those facing a dearth of funds. United to a noble intention of breathing
new life in the future of these hapless patients; MIMS Charitable Trust puts to shame those
with a callous indifference to their plight. MIMS Charitable Trust has supported more than
2000 patients with nearly Rs. 2, 00, 00,000. Save a Heart Save a Life", was a first of its kind
project started by MIMS Charitable Trust to allow philanthropists and eager saviors to
sponsor patients for an Open Heart Surgery. Subsidized Dialysis, Sponsored heart / other
surgeries, fully fledged Rural Health Centre and sponsoring the education of deserving
students in MIMS Academy, MIMS Charitable Trust is evidence that no obstacle is
insurmountable when one is committed to a cause. We were treated with love - A patient's
story
MIMS Charitable Trust has been making news for their humanitarian involvement in the lives
of the downtrodden populace needing immediate medical healing for acute diseases. Many
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poor people have benefited from their charity. Valsan from Tellicherry, a recipient of aid from
MIMS Charitable Trust was brimming with appreciation. In his thank you letter, he expressed
his gratitude and conveyed his best wishes to the MIMS management, the MIMS Charitable
Trust and Shabandri Mohamed Esa MIMS Charitable Trust - Administrator for the excellent
services extended to him. Valsan always remembers them in his prayers and extends his
thanks to Dr. Murali Vettat who operated on him, as well as to his entire team who reversed
his heart ailment. Valsan continues to pray for the continued success of MIMS Charitable
Trust. He hopes that MIMS will grow to great heights in the years to come.
Special acknowledgement is given to the staff for their excellent hospitality during hi and his
family's stay in MIMS.
2.8 The Trustees The Life givers
Life is a gift of God. Good healthcare should never be the prerogative of the
privileged few. The main focus of MIMS Charitable Trust is to fund expensive surgeries /
treatments to poor and down trodden who find these treatments inaccessible. Many
philanthropists and eager benefactors, with an intention to help and improve the quality of
life for the poor - irrespective of caste, creed or religion, have come aboard. These noble
individuals share our philosophy with their kindly gestures, timely donations, and
endorsement of our charitable causes. These trustees help mobilize funds and resources. The
Board of Trustees is comprised of eminent doctors, dedicated and distinguished
Philanthropists. Mr. Shabandri Mohamed, Esa is the Trust Coordinator. The Trust has a tie up
with some well-known Charitable Organizations like Madhya mam Health Care Program,
Heartbeats and Melam Charities who have the same philosophical approach to helping the
sick and needy.
2.9 Administration
Hospital Management Committee:
Chief of medical service Dr.Hamsa

Executive Director Mr. U Basheer
Director
Dr. Ali Faisal
Director
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Dr. Abdul Rahman
Director - Academy, Research & Quality Prof: Dr. K Karthikeya Varma
Chief Financial Officer Mr. Jayakrishnan
Company Secretary Mr. T.P.Udayakumar
Core committee members

Chief of medical service Dr.Hamsa

Director Academy, Research & Quality Dr. K Karthikeya Varma
Chief Financial Officer Mr. Jayakrishnan
Consultant Laboratory Dr. George K.A

General Manager HR Mr. Suhas Pola
Sr. Manager IT Mr. Mohan Kumar
Sr. Manager Engineering Ms.Jessy Raj
Asst. Manager Purchase Mr. Sajith Kumar
Sr. Manager CSSD Mr. Moidu
Company Secretary Mr. Udayakumar
Chief Nursing Officer Ms. Sheelamma
Deputy Nursing Office
Ms. Leena Scaria
Board of Directors
Chairman Dr. Azad Moopen
Vice Chairman Dr. M. Ali
Chief of medical service Dr. Hamsa
Engr. Salahuddin M Mr. Anver Ameen Chelat
Engr. Abdurahman K P Dr. Hamza P M
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Mr. Syed Khalil S M Dr. Ismail K.M.
Engr. Mohamed Vatuvara Mr. Jaleel M.C.
Mr. Kuttan Malattiri Dr.(Prof). Karthikeya Varma
Mr. Wilson T J Mr. Kunhi Moideenkutty Haji T.K
Dr. Abdul Rahiman K Mr. Mayankutty Cholakkal
Mr. Abdul Wahab P.V Dr. Pakkar Koya
Dr. Ali Faizal Mr. Ravindran N
Engr. Ahamed Moopan Mr. Saidalavi Koya Thangal
Engr. Ahamed Moopan Dr. Salim A.R
Mr. Sharfulddeen V K
2.10 Corporate Management of the Company

MIMS is fully committed to good Corporate Governance and believes in complete
satisfaction of its customers, investors, employees and regulatory authorities. It is our
endeavor to provide a transparent and effective system of managing the company.
The day to day affairs of the Company is looked after byMr. Basheer U (Executive
Director) and Dr.Hamsa (Chief of medical service) assisted by a team of professional
managers which includes Mr.Jayakrishnan (Chief Financial Officer ), Dr. Sherbaz
Bichu(Asst. Medical Administrator), Ms.Jessy Raj (Sr. Manager - Maint.), Mr. Mohammed
Sajid (Sr. Manager - IT), Mr.Suhas Pola (General Manager - HR), Mr. Moidu K K (Sr.
Manager - CSSD), Mr. Muthuswamy (Sr. Manager - Purchase) and Mr. Udayakumar
(Company Secretary).
The Company gives due importance to the upholding of Medical Ethics and Professionalism
in all its activities.
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Promoters of the Company
Dr. Azad Moopen M. Engr. A. Rahman
Mr. Abdul Hamid Damudi Mr. Abdul Majeed C.K.
Mr. Abdul Rehman P.A.M. Mr. Abdul Wahab P.V.
Dr. Abdulla Cherayakkat Mr. Alavi M.S.
Mr. Ali K. Hassan Dr. Ali M
Dr. Ali Faizal Mrs. Aleema Usman
Mr. Haneef E.M. Mr. Hussain M
Mr. Ismail Hamza Dr. Ismail K.M.
Mr. Jaleel M.C. Mr. Mayankutty C.
Mr. Kuttan Malattiri Dr. Mohamed Ali V.M.
Mr. Mohamed Vatuvara Mr. Mohammed Ali Mundodan
Mr. Mohammed K Mr. Mohanan V.V.
Mr. Mohammed Ali V.P. Mr. Mustafa E.K.
Mr. Moidu Kannankandy Mr. Ningileri Hamza
Mr. Mustafa M. Mr. Raveendran N.
Dr. Pakkar Koya Mr. Sakhariya V.K.
Mr. Saidalavi Koya Thangal Mr. Saleem K.K.
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Mr. Salahuddin M.
Dr. Salim A.R. Dr. Sayed Mohamed
Mr. Shamsudheen A.P. Mr. Sharafuldden V.P.
Mr. Syed Khalil S.M.
Mr. Shuhaib T.P
2.11 MIMS Academy
MIMS academy is an educational wing of MIMS, established on 7th May 2003 for
augmenting the educational programs of MIMS. In 2006, a separate trust was formed and all
academic activities were brought under the MIMS Academy Trust- a no-Profit organization
registered as a Trust. MIMS Academy is an accredited Centre of the National Board of
Examinations, Ministry of Health and Family Welfare Department, Govt. of India to conduct
DNB training. MIMS College of Nursing, MIMS School of Nursing and College of Health &
Allied Sciences are the academic institutions under the Academy. At present the Academy
runs DNB in 10 specialties, Government approved Diploma, Post Basic Diploma, Degree and
Postgraduate Nursing courses, Masters in Emergency Medicine (George Washington
University), Bharat Sevak Samaj Approved Courses, and various MIMS Academy diploma
and training courses. The Academy is recognized by the Regional Center of American Heart
Association to Conduct Lifesaving training programs such as Basic Life Support, Advanced
Cardiac Life Support, Trauma Life support and Pediatrics Cardiac Life Support.
2.12 Certifications
Malabar Institute of Medical Sciences (MIMS) has bagged the Excellence Award-
2010, instituted by the pollution control Board (PCB) for taking the best pollution control
measures in the health sector and for initiating social Service in the sector. MIMS had bagged
the award for Pollution control activities in 2001, 2007, 2008. The Hospital has also won the
first excellence award instituted by the Government in 2009.
2.13 Technology Absorption
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As part of its mission to provide Health care of International Standards, MIMS has been
keeping pace with the latest developments in the Technology, thus utilizing the technological
advancements for better Patient Service and for Cost Reduction. A new system of Recording
and Retrieval for Discharge Summary Dictation by doctors has been installed, whereby
multiple doctors can dictate the summaries simultaneously. This has reduced the time
Consumed in releasing the patients from our Hospital and also saved the precious time of the
doctors, which can be utilized in caring the other patients.
2.14 DEPARTMENTS
Clinical Departments
Anesthesiology
Cardiac Anesthesia
Cardiology
Cardiothoracic and Vascular Surgery
Critical Care Medicine
Dental And Maxillofacial Surgery
Dermatology
Emergency Medicine
Endocrinology
ENT
Gastroenterology
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Gastrointestinal Surgery
General Medicine
General Surgery
Medical Surgical and Radiation Oncology
Neonatology
Nephrology
Neurology
Neurosurgery
Nuclear medicine
Obstetrics and Gynecology
Ophthalmology
Orthopedics
Pathology
Pediatric Cardiac Surgery
Pediatric Cardiology
Pediatric Surgery
Pediatrics
Physical Medicine and Rehabilitation
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Plastic and Reconstructive Surgery
Preventive Healthcare
Psychiatric Medicine
Pulmonary Medicine
Radiology and Imaging Sciences
Rheumatology
Urology
Service Departments
Blood Bank
CSSD
Department of Nursing
Laboratory Medicine
Medical Nutrition
Units
MIMS Calicut, MIMS Kottakkal, Vadakara Dialysis center, MIMS Academy, MIMS
Charitable trust, Regional Health Center, School of Nursing, College of Nursing.
2.15 MIMS Calicut
MIMS was incorporated in February 1995 to provide advanced medical treatment on

international standards to the people of Kerala at affordable cost. We started on a small scale
with the ENT Department on 8th of April 2001 and become fully functional on 16th May 2002.
The 100 crore 600 bed tertiary referral.
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The Malabar Institute Of Medical Sciences Ltd (MIMS Hospital, Calicut) is a multispecialty
hospital (The first multispecialty NABH Accredited hospital in India) and Medical institute
situated at Calicut city founded by a group of NRIs from Malabar region. The hospital has
earned a very good recognition as a leader in providing world class health care services with
international standards to the common man at an affordable cost. The hospital is continuously
in tune with the latest technology that promotes the health care and wellbeing of passion.
2.16 MIMS Kottakkal

The MIMS Kottakkal is on its way to become a super specialty hospital modeled on the lines
of MIMS, Calicut. Our aspiration here is to go beyond and traditional health care and deliver
the powerful and positive experiences to each of our patients. In this Endeavour of ours we
are backed by cutting edge technology and internationally trained, highly qualified medical
professionals, who administer the best available medical services across all major disciplines
of medicines and surgery.
2.17 MIMS Research Foundation
MIMS Research Foundation was established in 2008. It is a SIRO recognized by the

Department of Scientific and Industrial Research, Ministry of Science and Technology, Govt
ofIndia. MIMS Research Foundation is a subsidiary of MIMS Academy Trust.
2.18 HUMAN RESOURCE DEPARTMENT
The Human Resource Department of MIMS has received greater of attention than ever
before. It acts as a service department for employees and assists hospital management with a
variety of services like employment, training, induction, salary administration, budgetary
control etc.
Aim
The aim of HR Department is to make sure that a fruit full relationship is maintained within
the organization.
Major role
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Staffing
Training
Appraisals
Employee welfare
Comply with statutory governmental bodies
Staffing
The HR Department makes sure that they recruit the right candidate for the right job.
They see to it that proper manpower planning and recruitment procedures are followed.
Training
The HR Department engages the new employee in a structured Induction process that
consist of MIMS overview, rules and regulations, company profile, fire and safety, quality
standard and organization culture. Apart from this departmental training by senior staff, in
house training by faculties, external training by professional training and maintaining a
training Tracking system are also done.
Appraisals
Performance appraisals are carried out yearly for rating the performance of the
employees, to understand the training requirements, confirmation, promotion, salary
revisions, transfer etc.
Employee welfare
The HR Department take care of employees welfare through schemes like EPF, ESI, Free
family insurance etc. 620 employees are included in ESI welfare fund.
Statutory Compliance
The HR Department sees to it there is liaise with statutory government bodies like EPF
Regional office, District lab our office, ESI corporation etc. every month with proper
reports. Apart from this the HR Department conducts Exit interviews for every employee
who leaves the organization.
2.19 Exclusive QWL measures adopted in MIMS
Free treatment for the employees and their family
Job enlargement
Job rotation
Department wise pleasure trips (one day trip paid by the management)
23
Retirement benefit (contributory pension scheme)
MIMS Day celebration (include competitions, prize distribution and family get
together)
Rewards (Best employee award is given to employees of different departments

annually, on the basis of attendance and performance)
Complete health check-up for new employees at half the original cost
Recreational facilities (Indoor games like table tennis, carom, chess etc.
24
2.20 ORGANIZATIONAL STRUCTURE
25
3. HOSPITAL OVERVIEW
The study is conducted in Malabar Institute of Medical Science (MIMS) hospital, Calicut.
MIMS hospital is a multispecialty hospital and is having a large number of employees with
various background and culture. The hospital has more than 1500 employees including the
doctors, nurses, and paramedical and administrative staffs. The aim of this study is to check
the effectiveness of manpower planning. The success of every organization mainly depends
upon the quality and quantity of its manpower planning. Thehuman resourcemanagement
department in this organization handles the manpower planning, recruitmentselection,
training and development activities performance appraisal and compensationalactivities. This
study is based on health care industry.
3.1About Manpower Planning
Manpower planning is also called as Human resource planning. It consist of putting right
number of people, right kind of people at the right place, right time, doing the right things for
which are suited for the achievement of goals of the organization.
Steps of Manpower Planning
Examining the organizational objectives and policies.
Assessing manpower demand.
Forecasting supply of manpower.
Gap analysis.
Designing manpower programs.
Manpower plan implementation.
Evaluation and feedback.
Importance of Manpower Planning
It is the first step towards manpower management.
It refers to the process of using available assets for the implementation of the business
plan.
It also involves the process of coordinating and controlling various activities in the
organizations.
Efficient utilization of skilled labours.
Increase productivity.
It helps to face the shortage of certain categories of employees and/ or variety of skills
despite the problem of unemployment.
Needs of Manpower Planning
All the recruitment and selection programs are based on manpower planning.
26
Reduce labour cost as excess staff can be identified and thereby overstaffing can be
avoided.
It helps to identify the available talents in a concern an according training programs
can be given to develop those talents.
Through manpower planning human resource can readily available and they can be
utilized in this manner.
Growth and diversification of business.
It helps to realize the importance of manpower management which ultimately helps in
the stability of a concern.
Shortage and surplus can be identified so that quick action can be taken whenever
required.
Advantages
Manpower planning ensures optimum use of available human resources

It is useful both for organization and nation
It generalize facilities to educate people in the organization
It brings about fast economic developments
It boost the geographical model
It provides smooth working even after expansion of the organization
It opens possibility for workers for future promotion, thus providing incentive.
It creates healthy atmosphere of encouragement and motivation in the organization
It provides help for career development of the employees
All the recruitment process are based on manpower planning
Reduce labour cost and over staffing can be avoided
Manpower can be utilized properly
3.2 ERLANG STUDY
A.K. Erlang
Erlang is named after a Danish telephone engineer named A.K Erlang (Agner Krarup Erlang).
He was born on 1st January 1878 and although he trained as a mathematician, he was the first
person to investigate traffic and queuing theory in telephone circuits.After receiving his MA,
Erlang worked in a number of schools. However, Erlang was a member of the Danish
Mathematician's Association (TBMI) and it was through this organization that Erlang met the
27
Chief Engineer of the Copenhagen Telephone Company (CTC) and as a result, he went to
work for them from 1908 for almost 20 years. While he was at CTC, Erlang studied the
loading on telephone circuits, looking at how many lines were required to provide an
acceptable service without installing too much over-capacity that would cost the company
money. There was a trade-off between cost and service level. Erlang developed his theories
over a number of years, and published several papers. He expressed his findings in
mathematical forms so that they could be used to calculate the required level of capacity, and
today the same basic equations are in widespread use. In view of his ground-breaking work,
the International Consultative Committee on Telephones and Telegraphs (CCITT) honored
him in 1946 by adopting the name Erlang " for the basic unit of telephone traffic. Erlang
died on 3rd February 1929 after an unsuccessful abdominal operation.
Erlang
An Erlang is a unit of telecommunications traffic measurement. Strictly speaking, an

Erlang represents the continuous use of one voice path. In practice, it is used to describe the
total traffic volume of one hour.
Erlang traffic measurements are made in order to help telecommunications network

designers understand traffic patterns within their voice networks. This is essential if they are
to successfully design their network topology and establish the necessary trunk group sizes.
Erlang traffic measurements or estimates can be used to work out how many lines are
required between a telephone system and a central office (PSTN exchange lines), or between
multiple network locations.
Several traffic models exist which share their name with the Erlang unit of traffic.
They are formulae which can be used to estimate the number of lines required in a network,
or to a central office (PSTN exchange lines). A formula also exists to model queuing
situations, and lends itself well to estimating the agent staffing requirements of call centers.
The main Erlang traffic model is listed below:
28
Erlang traffic model
ErlangB
This is the most commonly used traffic model, and is used to work out how many
lines are required if the traffic figure (in Erlangs) during the busiest hour is known.
The model assumes that all blocked calls are immediately cleared.
ExtendedErlangB
This model is similar to Erlang B, but takes into account that a percentage of calls are
immediately represented to the system if they encounter blocking (a busy signal). The
retry percentage can be specified.
ErlangC
This model assumes that all blocked calls stay in the system until they can be handled. This
model can be applied to the design of call center staffing arrangements where, if calls cannot
be immediately answered
Application of Erlang study in Human Resource Planning

Based on the basic principle of Erlang used in Telecommunication Industry, by
conducting a process study initially and breaking the daily work load of each employee into
individual smaller tasks, we can calculate the number of employees that would be required in
performing the task efficiently with optimum use of human resources.
This study, although not completely a replication of the actual Erlang Study, still
manages to serve the purpose as it works on a principle that can be applicable universally.The
process study helps in classifying tasks into those which are high impact, those which are low
impact and those which are trivial. Based on the process study, the high impact sub tasks can
be studied in detail, as to what are the factors that would facilitate better output.
The hiring policies of the Human Resource Department can be modified according to the
findings in the study which can elaborate on the knowledge and skill requirement in a
particular task.
3.3 SWOT ANALYSIS
STRENGTH
29
MIMS is the first multi - specialty hospital in the country to gain NABH
accreditation.
MIMS has the best intensive care facilities in the country
WEAKNESS
High attrition rate among the nurses work force as many of them move to
western countries for jobs
OPPORTUNITIES
Medical Tourism is an emerging area which in turn prove to be a big opportunity
for MIMS
THREATS
Upcoming Hospitals coming with new facilities and services can be major threat
Competitors, existing hospitals can be a threat for MIMS.
4. REVIEW OF LITERATURE
According to Gorden MacBeath,Apr 24, 2013 - (1992) Manpower planning involves two
stages. The first stage is concerned with the detailed planning of manpower requirements for
all types and levels of employees throughout the period of the plan, and the second stage is
concerned with planning of manpower supplies to provide the organization with the right
types of people from all sources to meet the planned requirements
30
According to Mondy et (1996) Human Resource Planning is a systematic analysis of HR
needs in order to ensure that correct number of employees with the necessary skills are
available when they are required.
Stainer(1971)define manpower planning as Strategy for the acquisition, utilization,

improvement, and preservation of an enterprises human resources. It relates to establishing
job specifications or the quantitative requirements of jobs determining the number of
personnel required and developing sources of manpower.
Application of queuing theory in health care:This paper reviews the contributions and
applications of queuing theory in the field of health care management problems. This review
proposes a system of classification of health care areas which are examined with the
assistance of queuing models. The categories described in the literature are expanded and a
detailed taxonomy for subgroups is formulated. The goal is to provide sufficient information
to analysts who are interested in using queuing theory to model a health care process and who
want to locate the details of relevant models. Lakshmi C, Siva Kumar Appa Ayer on14
March 2013.
Patient flow and resource utilization in an outpatient clinic: This paper describes the
results of a study taken at an outpatient clinic to describe and quantify issues related to patient
flow and resource utilization for an individual physician during the delivery of primary health
care. A discrete-event simulation model is constructed of the physicians practice to examine
the relationship between examining room capacity and patient flow across four clinic-based
performance measures. A simulation experiment is presented with results identifying several
important and generalizable aspects of outpatient clinic operations. In particular, increased
resource utilization does not necessarily imply longer waiting lines or longer patient flow
times. Murray J Ct4, August 1999 (please take care of the format of citation.
Modeling healthcare systems with phase-type distributions: Phase-type distributions

constitute a very versatile class of distributions. They have been used in a wide range of
31
stochastic modeling applications in areas as diverse as telecommunications, finance,
biostatistics, queuing theory, drug kinetics, and survival analysis. Their use in modeling
systems in the healthcare industry, however, has so far been limited. In this paper we
introduce phase-type distributions, give a survey of where they have been used in the
healthcare industry, and propose some ideas on how they could be further utilized. Mark
Fackrell,07 Jun 2008.
Patient flow and resource utilization in an outpatient clinic: Phase-type distributions

constitute a very versatile class of distributions. They have been used in a wide range of
stochastic modeling applications in areas as diverse as telecommunications, finance,
biostatistics, queuing theory, drug kinetics, and survival analysis. Their use in modeling
systems in the healthcare industry, however, has so far been limited. In this paper we
introduce phase-type distributions, give a survey of where they have been used in the
healthcare industry, and propose some ideas on how they could be further utilized. Murray J
Cote, 4 August 1999
Patient flow modeling and performance analysis of healthcare delivery processes in

hospitals: A review and reflections: Analysis of hospital processes is essential for
development of improved methods, policies and decision tools for overall performance
improvement of the hospital system. Amidst the current scenario of continuously increasing
healthcare costs and scarcity of resources, optimal utilization of resources without hampering
the quality of care has gained importance in any country. Modeling, analysis and
management of patient flows, in this context, plays a key role in performance analysis and
improvement of hospital processes as appropriate modeling of patient flows may help
healthcare managers make decisions related to capacity planning, resource allocation and
scheduling, appointment scheduling and for making necessary changes in the process of care.
The concept of patient flow and its modeling has gained much attention in healthcare
management literature over past few decades. In this paper, the existing approaches
pertaining to modeling of patient flows in hospital systems have been classified and critically
appraised focusing on the recent advancements in order to identify future research avenues. A
generic framework for patient flow modeling and performance analysis of hospital systems
that may serve as a guide for the practitioners dealing with similar kinds of problems to
32
improve healthcare delivery has also been provided. Papiya Bhattacharjee, ,Pradip Kumar
Ray, 9 May 2014
The Nursing Human Resource Planning Best Practice Toolkit: Creating a Best Practice
Resource for Nursing Managers: Evidence of acute nursing shortages in urban hospitals has
been surfacing since 2000. Further, new graduate nurses account for more than 50% of total
nurse turnover in some hospitals and between 35% and 60% of new graduates change
workplace during the first year. Critical to organizational success, first line nurse managers
must have the knowledge and skills to ensure the accurate projection of nursing resource
requirements and to develop proactive recruitment and retention programs that are effective,
promote positive nursing socialization, and provide early exposure to the clinical setting. The
Nursing Human Resource Planning Best Practice Toolkit project supported the creation of a
network of teaching and community hospitals to develop a best practice toolkit in nursing
human resource planning targeted at first line nursing managers. The toolkit includes the
development of a framework including the conceptual building blocks of planning tools,
manager interventions, retention and recruitment and professional practice models. The
development of the toolkit involved conducting a review of the literature for best practices in
nursing human resource planning, using a mixed method approach to data collection
including a survey and extensive interviews of managers and completing a comprehensive
scan of human resource practices in the participating organizations. This paper will provide
an overview of the process used to develop the toolkit, a description of the toolkit contents
and a reflection on the outcomes of the project. [This article was originally published in
Nursing Leadership, 23(Special Issue) 2010] Leslie Vincent and Mary Agnes Beduz.
Medical Manpower Planning: Since 1980, numerous articles have discussed impact
analysis; in addition, the Ontario Hospital Association and the Ontario Medical Association
are about to publish guidelines to assess the impact of additional physician manpower and
instructions on various techniques to conduct such an analysis. However, little has been
published on medical manpower planning at the hospital level, in spite of the fact that a
medical manpower plan is at the core of a successful hospital strategic plan. This article
presents a population-service-based model of a medical manpower plan and reviews its use at
Peel Memorial Hospital. William B. MacLeod,Paul W. Huras,Susan Burns on1, January
2014.
33
The impact of human resource management on healthcare quality: The management of

human resources in healthcare institution is essential to enable the delivery of efficient and
effective medical services and to achieve patient satisfaction. This study aims to investigate
the impact of practicing human resources management on the quality of healthcare service
and achieving patients satisfaction. The descriptive methodology was applied to demonstrate
and analyze the previous literatures. The study shows that effective human resources
management has a strong impact on healthcare quality and improving the performance of
hospitals staff. The Study suggests the need to measure the performance of the managers of
human resources department in the hospital before starting performance development process
as well as continuous development and training of staff performance. Hassan Mohamed
Elarabi, Fuadah Johari Faculty of Economics and Muamalat, Universiti SainsIslam
Malaysia (USIM), Negeri Sembilan, Malasya.
4.1 ANESTHESIA DEPARTMENT AND ITS FUNCTIONS
34
Anesthesia is a way to control pain during a surgery or procedure by using medicine called
anesthetics. It can help control your breathing, blood pressure, blood flow, and heart rate and
rhythm.
Anesthesia may be used to:
Relax you. (Avoid youuse the patient instead)
Block pain.
Make you sleepy or forgetful.
Make you unconscious for your surgery.
Other medicines may be used along with anesthesia, such as ones to help you relax or to
reverse the effects of anesthesia.
Types of Anesthesia
Local Anaesthesia: - numbs a small part of the body for minor procedures.
For example, you may get a shot of medicine directly into the surgical area to
block pain. You may stay awake during the procedure.
Regional Anaesthesia: - blocks pain to a larger part of your body. You may
also get medicine to help you relax or sleep. Types of regional anaesthesia
include:
Peripheral nerve blocks- This is a shot of anaesthetic to block pain around a specific
nerve or group of nerves. Blocks are often used for procedures on the hands, arms, feet,
legs, or face.
Epidural and spinal anaesthesia- This is a shot of anaesthetic near the spinal cord and
the nerves that connect to it. It blocks pain from an entire region of the body, such as the
belly, hips, or legs.
General Anaesthesia: - affects your brain and the rest of your body. You may get some
anaesthetics through a vein (intravenously, or IV), and you may breathe in some
35
Anaesthetics. With general anaesthesia, you're unconscious and you don't feel pain during
the surgery.
4.1.1Various activities performed byAnesthesia technicians
Prepare and planning of case (arranging the medicines, machines) 36

Taking patient from pre-operative area.
Bringing to OT
Insertion of iv cannula.
Giving anaesthesia (intubation) of the patient.
According to the type of anaesthesia giving position (GA, Local

etc.).
After anaesthesia documentation (anaesthesia chart) is done.
Drape (cover) the patient with sterile sheet.
Arranging the medicine for the patient which is used in between the
case (antibiotics).
After surgery giving reversal (extubation) to the patient.
Shifting the patient to the bed.
Taking patient to the post-operative area.
Arranging the medicines and machines for the next surgery
4.2 DIALYSIS DEPARTMENT

Dialysisis a process for removing waste and excess water from the blood, and is used
primarily as an artificial replacement for lost kidney function in people with kidney failure.
37
Dialysis may be used for those with an acute disturbance in kidney function (acute kidney
injury, previously acute renal failure), or progressive but chronically worsening kidney
functiona state known as chronic kidney disease stage 5 (previously chronic renal failure or
end-stage renal disease). The latter form may develop over months or years, but in contrast to
acute kidney injury is not usually reversible, and dialysis is regarded as a "holding measure"
until a kidney transplant can be performed, or sometimes as the only supportive measure in
those for whom a transplant would be inappropriate.
The kidneys have important roles in maintaining health. When healthy, the kidneys maintain
the body's internal equilibrium of water and minerals (sodium, potassium, chloride, calcium,
phosphorus, magnesium, and sulphate). The acidic metabolism end-products that the body
cannot get rid of via respiration are also excreted through the kidneys. The kidneys also
function as a part of the endocrine system, producing erythropoietin and calcitriol.
Erythropoietin is involved in the production of red blood cells and calcitriol plays a role in
bone formation.Dialysis is an imperfect treatment to replace kidney function because it does
not correct the compromised endocrine functions of the kidney. Dialysis treatments replace
some of these functions through diffusion (waste removal) and ultra-filtration (fluid removal).
Haemodialysis
Haemodialysis, the patient pumped through the blood compartment of a dialyzer, exposing it
to a partially permeable membrane. The dialyzer is composed of thousands of tiny hollow
synthetic fibres. The fibre wall acts as the semi permeable membrane. Blood flows through
the fibres, dialysis solution flows around the outside of the fibres, and water and wastes move
between these two solutions. The cleansed blood is then returned via the circuit back to the
body. Ultra filtration occurs by increasing the hydrostatic pressure across the dialyzer
membrane. This usually is done by applying a negative pressure to the dialysate compartment
of the dialyzer. This pressure gradient causes water and dissolved solutes to move from blood
to dialysate, and allows the removal of several litres of excess fluid during a typical 4-hour
treatment. In the United States, hemo-dialysis treatments are typically given in a dialysis
centre three times per week (due in the United States to Medicare reimbursement rules);
however, as of 2005 over 2,500 people in the United States are dialyzing at home more
frequently for various treatment lengths. Studies have demonstrated the clinical benefits of
dialyzing 5 to 7 times a week, for 6 to 8 hours. This type of hemo-dialysis is usually called
38
"nocturnal daily haemodialysis", which a study has shown a significant improvement in both
small and large molecular weight clearance and decrease the requirement of taking phosphate
binders. These frequent long treatments are often done at home while sleeping, but home
dialysis is a flexible modality and schedules can be changed day to day, week to week. In
general, studies have shown that both increased treatment length and frequency are clinically
beneficial.Haemodialysis was one of the most common procedures performed in U.S.
hospitals in 2011, occurring in 909,000 stays (a rate of 29 stays per 10,000 populations).
Peritoneal dialysis
In peritoneal dialysis, a sterile solution containing glucose (called dialysate) is run through a
tube into the peritoneal cavity, the abdominal body cavity around the intestine, where the
peritoneal membrane acts as a partially permeable membrane. The peritoneal membrane or
peritoneum is a layer of tissue containing blood vessels that lines and surrounds the
peritoneal, or abdominal, cavity and the internal abdominal organs (stomach, spleen, liver,
and intestines) Diffusion and osmosis drive waste products and excess fluid through the
peritoneum into the dialysate until the dialysate approaches equilibrium with the body's
fluids. Then the dialysate is drained, discarded, and replaced with fresh dialysate. This
exchange is repeated 4-5 times per day; automatic systems can run more frequent exchange
cycles overnight. Peritoneal dialysis is less efficient than Haemodialysis, but because it is
carried out for a longer period of time the net effect in terms of removal of waste products
and of salt and water are similar to Haemodialysis. Peritoneal dialysis is carried out at home
by the patient, often without help. This frees patients from the routine of having to go to a
dialysis clinic on a fixed schedule multiple times per week. Peritoneal dialysis can be
performed with little to no specialized equipment (other than bags of fresh dialysate)
4.2.1 Various activities performed by Dialysis technicians
39
Confirm the booking whether impatient/ outpatient.
Keep the dialysis machine will all necessary sets ready for the procedures.
Receive patient and check weight.
Make him/her comfortable on bed.
Access vital signs
Check doctor order for procedures (duration, ultrafiltration etc.)
Start procedure (start HD)
Continuous monitoring of patient
Termination of procedure after recommended time.
Check vital signs and weight post HD.
Sent the patient with all the documents to the respective ward or home
when he is stable.
Complete the records
Reprocess the daily zee and blood tubing and keep ready for the next use.
Clean the bed and machines and get the machine ready for the next case.
5.PROBLEM STATEMENT, OBJECTIVES AND SCOPE OF THE

STUDY
Research problem:
40
To find out if a change is needed in the existing manpower planning with respect to various
designations in various departments.
Objectives:
1. To find out actual requirements.

2. To forecast staffing level needs.
3. To optimize the utilization of existing personnel.
4. To efficiently utilise workforce to maintain productivity.
Scope of the study
Proper planning and utilization of work force can help the hospital save money and thus plan
for the companies future. The manpower planning using Erlangs method provides a
framework by which the hospital can prepare for and monitor future growth. This study is to
forecast staffing level needs and work with the manager to make sure that each department is
properly staffed.
6.RESEARCH METHODOLOGY
Observational study and secondary data analysis was done.
6.1Research Tools:
Observation
41
Microsoft Excel
Department manuals and documental procedure
6.2 Primary Data:
Primary data was gathered through interaction with permanent senior technicians of
anesthesia and dialysis department.
Observational study was also conducted to know the actual time taken by the
technicians for a particular procedure conducted in respective departments.
6.3 Secondary Data:
Review of similar studies

Information from DHIM
Internet
6.4 Sample Technique
Sample size: 120
Anesthesia Department
Major surgery: 50
Minor surgery: 10
Dialysis Department
Dialysis: 60
Sample Design: Random Sampling
7.DATA ANALYSIS AND INTERPRETATIONS

7.1 ANESTHESIA TECHNICIAN ERLANG CALCULATION
Total number of surgeries Observed = 60
Anesthesia Technicians tasks
1. Time spent preparing and planning the patient prior to the operation
42
2. Time spent in transferring the patient from pre op to OT
3. Time spent in the OT when the surgery is performed
4. Time spent in transferring the patient from OT to post op
5. Miscellaneous activities
Time spent in documentation
Time spent in other departments
Based on the Observational studies done in the OT, the Average time taken for each of the
above mentioned tasks was calculated to arrive at the average total time spent by one
anesthesia technician per surgery. The calculation is as follows;
7.1.2 Time taken for surgery
Time taken Time taken

Task Major Surgery Minor Surgery
(Minutes) (Minutes)
Man-hours spent in preparation and planning of patient
10.08 10.2
prior to the operation
Man-hours spent in transferring the patient from pre
4.88 4.7
op to OT
Man-hours spent in the OT when the surgery is
105.14 23.5
performed
Man-hours spent in transferring the patient from OT to
1.00 1.00
post op
Average Total Time 121.1 39.4
7.2 DATA FROM DEPARTMENT OF HEALTH INFORMATION MANAGEMENT
One year data of all the surgeries performed in the OT complex since April 2014 was
analyzed to arrive at the average number of surgeries performed in a day, including major and
minor.
From the data received, following are the calculations,
7.2.1 Total surgeries
APRIL 2014 to MARCH 2015 NUMBERS

Major Surgeries 11153
Minor Surgeries 1360
43
From the data received, following are the calculations
Total number of working days in a calendar year = 312 (Excluding Sundays)
Hence,
Average number of Major surgeries done per day = 11153 / 312
= 35.75 = 36 (Rounded off)
Average number of Minor surgeries done per day = 1360 / 312
= 4.359 = 4 (Rounded off)
Based on the calculation of the average number of surgeries performed in a day and
average time spent by one anesthesia technician per surgery,
Total Man-hours of Anesthesia technicians currently per day =
(Average number of surgeries performed in a day) x (Average time spent by one anesthesia
technician per surgery)
Hence,
For Major Surgeries, Total Man-hours = 36 x 121.1
= 4359.6 minutes
= 72.66 hours
For Minor Surgeries, Total Man-hours = 4 x 30.9
= 123.6 minutes
= 2.06 hours
Hence Total Man-hours in one day, by the Anesthesia Technicians = 72.66 + 2.06
= 74.72 hours
44
= 75 hours
In addition to the above mentioned tasks,
1. Two anaesthesia technicians are posted mandatorily for night shift which
begins from 5 pm to 8 am, which accounts for a working hour of 15 hours per
technician.Hence, 30 man hours are used every day, irrespective of surgery
posted.
2. Man-hours spent in other departments were found to be 24 hours per day
based on observation and interviews from the anaesthesia technicians.Hence,
7.2.2 The total man-hours per day
PARTICULARS TIME TAKEN (Hours)

Related to surgeries 75
Night duty (two deployed everyday) 30
Time spend in other department 24
Total Man-hours utilized per day 129
Erlang Calculation:
1. Total number of working hours permitted per employee is 8 hours, according to HR

policy.
2. According to HR policy, a 30% Leave vacancy is recruited to account for employees
taking leave.
Calculation:
Total number of staff required = Total man hours utilized per day / 8
= 129 / 8
= 16.09 = 16 (Rounded off)
Addition of 30% Leave Vacancy = 30% of 16 = 4.8 = 5 (Rounded off)
Hence, Total number of Anesthesia Technicians required = 16 + 5 = 21
45
7.2.3 Existing number of Anesthesia Staff
Anesthesia Technician 16
Trainee 8
Student trainee 8
From this analysis we find that there is a deficit of 5 Anesthesia Technicians.
7.3DIALYSIS TECHNICIAN ERLANG CALCULATION
DIALYSIS TECHNICIAN ERLANG CALCULATION
Total number of Dialysis Observed = 60
Based on the Observational studies done in the Dialysis department, the Average time taken
for each of the below mentioned dialysis was calculated to arrive at the conclusion that the
total manpower required in the dialysis department.
The calculation is as follows
7.3.1The time taken forHaemodialysis and peritoneal dialysisdone in a month:
Dialysis Time taken (in hours)

Haemodialysis 4006.5
Peritoneal dialysis 8
The time spends by techniciansfor various other procedures in a month:
1) Renal Biopsy = 45 x 14 (hours) = 630 (hours)
46
2) PermCath = 14 x 1.50 (hours)= 21 (hours)
3) PermCath removal = 45 x 6 (hours) =270(hours)
The time taken for reprocessing = 45 minutes that is hour
= x 30 = 22.5 hours
Total hours in one month = 4006.5 + 8 + 630 + 21 + 270 + 22.5
= 4958 (hours)
Total working hours per day = 4958/ 30
= 165.2666667
Erlang Calculation:
1. Total number of working hours permitted per employee is 8 hours, according to HR

policy.
2. According to HR policy, a 30% Leave vacancy is recruited to account for employees

taking leave.
Leave vacancy = Total working hours per day x 30 / 100
= 165.2666667 x 30 / 100
= 49.58
Total time work per day = Total working hours per day + leave vacancy
= 165.2666667 + 49.58
= 214.8466667
Erlang = Total time / 8 (hours)
=214.8466667/8
47
= 26.85583333
Hence, the total manpower required = 27 (Rounded off)
Existing manpower = 29
The study was conducted for dialysis technicians; since the work is done by both the dialysis
technicians and the nurses together it is difficult to take the time separately. So the total man
power required is calculated for this department including nurses and dialysis technicians.
7.3.2Existing number Anesthesia Staffs
Nurses 22
Dialysis technicians 7
Students 16
From this study we found that, the required manpower in dialysis department is 27. But at
preset they have a surplus of 2 people in dialysis department.
48
7.4Common major surgeries in Anesthesia department:
MAJOR SURGERIES TOTAL TIME(in minutes)

LSCS 40
TAH+BSO 92
Lap Appendectomy 60
VH+PFR 80
Lap chole 100
Excision 200
Lap Hernia Repair 120
Lap B/L Tep 115
Craniotomy and excision of lesion 300
Endoscopic TNTS decompression 180
49
Interpretation and analysis:
From the above analysis we can find that Craniotomy and excision of lesion is taking more
time. And the least time is take for LSCS.
7.5Common minor surgeries in Dialysis department:
MINOR SURGERIES TOTAL TIME(in minutes)

D&Cx Biopsy 22
Wound exploration 50
D&C cervical Biopsy 30
Excision Breast Lump Rt. side 60
DJ Stent Removal 13
50
Interpretation and analysis:
From the above analysis we can find thatExcision Breast Lump Rt side is taking more time.
And the least time is take for DJ Stent Removal.
This analysis is done to understand which surgery is taking more time in anesthesia
department and which dialysis is taking more time in dialysis department so that this will be
helpful for both the departments for any further study.
8.FINDINGS, RECOMMENDATIONS AND LIMITATIONS OF THE

STUDY
Anestesia department
After conducting Erlangs study it was found that there was a deficit of five technicians in the
anesthesia department and a surplus of two employees in dialysis department. From the
observational study it was understood that HR department is not willing to hire more
technicians to the anaesthesia department because they need to be paid more. Majority of the
technicians expressed that their workload is very high .After interacting with some of the
technicians I came to know that majority of the workers are not satisfied with the wages
provided by the hospital. In the OT department, most of the cases the senior technician is
51
replaced by student or a trainee.After conducting the observational study i found that there
islack of break time and free hours for the technicians.
Dialysis department
Dialysis department is highly satisfied with their present manpower since they have a surplus
of two employees. The excess manpower in the dialysis department can be transferred to
other departments as required. The number of per day dialysis can be increased by
accommodating more patients (currently the departments have only 10 beds).
Limitations of the study
a) Unavailability of technicians to answer the queries because of their busy work.

b) Not permitted to observe certain complicated surgeries.
c) Find difficulty in observing aesthesia technicians during surgery because of constant
entry and exit of multiple technicians.
d) Few technicians had a biased reply when asked about convenience of duties.
9. SUGGESTIONS
Since the anesthesia department lack adequate number of technicians HR department should
hire five more employees. More senor technicians should be recruited to the anesthesia
department .In the dialysis department the excess of manpower can be reduced by retaining
the senior most technicians and eliminating the less experienced technicians. The excess
manpower in the dialysis department can be transferred to other departments as required. The
number of per day dialysis can be increased by accommodating more patients (currently the
departments have only 10 beds)
52
10. CONCLUSION
MIMS is a multi-specialty hospital. The hospital has earned a very good recognition as a
leader in providing word-class health care service to the common man at an affordable cost.
The hospital has more than 1300 employees including the doctors, nurses, and paramedical
and administrative staff. The main aim of this study is to check the effectiveness of
manpower planning in MIMS hospital for this an Erlang study was conducted in Anesthesia
and dialysis department for anesthesia and dialysis technicians to know the required
manpower for these two departments. Manpower planning is a process for determining and
assuring that the organization will have an adequate number of qualified persons, available at
53
the proper time, performing jobs which meet the needs of the enterprise.it is essential for the
achievement of its goals and objectives.
After conducting Erlang study for Anesthesia and dialysis department, it is found that there is
an excess of manpower in the dialysis department so the HR department can transfer people
to other departments from dialysis department and there is a deficit in the anesthesia
department so HR department can hire more people to Anesthesia department.
REFERENCE
http://www.managementstudyguide.com/manpower-planning.htm
www.erlang.com. (n.d.). Retrieved from erlang.
www.mimsindia.com. (n.d.). Retrieved from mims
www.whatishumanresourse. humanresource planning. (n.d.). retrieved from
54
health care with PH. pdf. (n.d.). Retrieved from ie.technion.ac.
www.umich.edu. past reports. (n.d.). Retrieved from
55

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Manpower planning and optimization (of technicians) using Erlangs method

Type of specialized hospitals include trauma centres, rehabilitation

A teaching hospital combines assistance to patients with teaching to medical

A curative to chronic illness

The Global Industry Classification Standard and the Industry Classification

1. Health care equipment and services

2. Pharmaceuticals, biotechnology and related life sciences.

1.2 Providers and Professionals

A health care provider is an institution (such as a hospital or clinic) or person (such as

In 2003,health care costs paid to hospitals, physicians, nursing

1.3 Delivery of Services

Provide Comprehensive, Caring and Cost effective Medical treatment of Global

Involve in Medical Education and Research aiming at contributions in the field of

Fulfill the social responsibility to the underprivileged by providing free or subsidized

2.3 Major Accreditations & Award

2.5 Unique feature of MIMS

Over a hundred medical professionals as full time doctors

First multi-specialty hospital in the country to gain NABH accreditation

Level IV Trauma care facility

One of the best Intensive care facilities in the country

State of the art Laboratory with highest level of quality control

Blood Bank with component separation facility

The first Cochlear Implant Clinic in the State

Advanced Interventional Radiology

State of the art Nuclear Medicine Department

Round the clock availability of Interventional Cardiologists for Primary angioplasty

2.6 Quality Policy

2.7 MIMS Charitable Trust

As a part of Corporate Social Responsibility MIMS has been conducting a lot of

2.8 The Trustees The Life givers

Chief of medical service Dr.Hamsa

Core committee members

Executive Director Mr. U Basheer

Consultant Laboratory Dr. George K.A

Chairman Dr. Azad Moopen

Vice Chairman Dr. M. Ali

Chief of medical service Dr. Hamsa

Executive Director Mr. U Basheer

Engr. Salahuddin M Mr. Anver Ameen Chelat

Engr. Abdurahman K P Dr. Hamza P M

Mr. Syed Khalil S M Dr. Ismail K.M.

Engr. Mohamed Vatuvara Mr. Jaleel M.C.

Mr. Kuttan Malattiri Dr.(Prof). Karthikeya Varma

Mr. Wilson T J Mr. Kunhi Moideenkutty Haji T.K

Dr. Abdul Rahiman K Mr. Mayankutty Cholakkal

Mr. Abdul Wahab P.V Dr. Pakkar Koya

Dr. Ali Faizal Mr. Ravindran N

Engr. Ahamed Moopan Mr. Saidalavi Koya Thangal

Engr. Ahamed Moopan Dr. Salim A.R

2.10 Corporate Management of the Company

Dr. Azad Moopen M. Engr. A. Rahman

Mr. Abdul Hamid Damudi Mr. Abdul Majeed C.K.

Mr. Abdul Rehman P.A.M. Mr. Abdul Wahab P.V.

Dr. Abdulla Cherayakkat Mr. Alavi M.S.

Mr. Ali K. Hassan Dr. Ali M

Dr. Ali Faizal Mrs. Aleema Usman

Mr. Haneef E.M. Mr. Hussain M

Mr. Ismail Hamza Dr. Ismail K.M.

Mr. Jaleel M.C. Mr. Mayankutty C.

Mr. Kuttan Malattiri Dr. Mohamed Ali V.M.

Mr. Mohamed Vatuvara Mr. Mohammed Ali Mundodan

Mr. Mohammed K Mr. Mohanan V.V.

Mr. Mohammed Ali V.P. Mr. Mustafa E.K.