Page |1

Project Report on Total QualityManagement (TQM) of Shifa
International Hospital Ltd.

Total Quality Management (T...
Page |2
Page |3
Page |4
Page |5

Dedication

This project is dedicated to all those people of the world who
never let the candle of optimism to di...
Page |6

MESSAGE FROM
DR. ZAHEER AHMAD
M. Pharm, M.D.
PRESIDENT & CEO
SHIFA INTERNATIONAL HOSPITALS LTD.

I feel pleased a...
Page |7

MESSAGE FROM
SHAFQAT ALI HAMDANI. RPH
CHIEF OF PHARMACY SERVICES
SHIFA INTERNATIONAL HOSPITALS LTD.

It is matter...
Page |8

CERTIFICATE OF APPROVAL
This Project is submitted in the partial fulfilment of the requirement for
the award of M...
Page |9

DECLARATION BY THE CANDIDATE
I hereby declare that the project work entitled “TQM of Shifa International Hospital...
P a g e | 10

Executive Summary
The hospital was established by the assembly of doctors who were
working in USA. It was in...
P a g e | 11
P a g e | 12
P a g e | 13

ACKNOWLEDGMENT
We bow in Gratitude to Almighty ALLAH, for giving us courage and
wisdom to reach this point o...
P a g e | 14

Table of Contents
Page No.s
TITLE PAGES---------------------------------------------------------------------...
P a g e | 15

CHAPTER # 1
Objective and Scope of Shifa
Page No.s
Introduction---------------------------------------------...
P a g e | 16

Chapter # 2
TQM and Services Quality of Shifa & Miscellaneous
Page No.s
Total Quality Management Definition-...
P a g e | 17
Organizing---------------------------------------------------------------------------------------------------...
P a g e | 18

Chapter # 3
Internal and external service quality of Shifa & Miscellaneous
Page No.s
Shifa at Internal Servi...
P a g e | 19
Clinical pharmacy--------------------------------------------------------------------------------------------...
P a g e | 20
Nutrition Clinic---------------------------------------------------------------------------------------------...
P a g e | 21

Chapter # 4
Element of the Task Environment
Page No.s
Labour Supply-----------------------------------------...
P a g e | 22

Chapter # 5
Costumer Clients
Page No.s
Short Time Patients--------------------------------------------------...
P a g e | 23
Kidney care equipment----------------------------------------------------------------------------------------...
P a g e | 24
Outpatient Services
-----------------------------------------------------------------------------------------...
P a g e | 25

Chapter # 8
Government Agencies
Page No.s
Central Board OF Revenue------------------------------------------...
P a g e | 26
P a g e | 27
P a g e | 28

CHAPTER # 1
Objectives and Scope of Shifa

Objectives and Scope of Shifa
 Introduction

Shifa Internaiontal...
P a g e | 29

Internal
medicine
Cardiology

ENT
Nephrology
Neurology

Oncology
Pediatrics
Urology
Orthopedic
Radiology
Reh...
P a g e | 30

i.

Mission & Vision

Mission
“To provide good quality medical care in all disciplines of medicine and surge...
P a g e | 31

•

To Improve competitive position

•

To improve work Environment

iv.

The Values

They contain:
•

Respec...
P a g e | 32

•

Section of Internal Medicine

•

Section of Pulmonolgy

•

Section of Cardiology

•

Section of infectiou...
P a g e | 33

•

Patient Services

•

Material Management & Purchase

•

Bio-Medical

•

Management information System

•
...
P a g e | 34

CHAPTER # 2
TQM and Services Quality of Shifa & Miscellaneous

TQM and Services Quality of Shifa & Miscellan...
P a g e | 35

maintenance and hotel management. As a current focus of e-business, TQM is based on
quality management from ...
P a g e | 36

Fig. 1, TQM structure
People define quality in many ways. Some think of quality as superiority of excellence...
P a g e | 37

•

Adequate time to be spent by physician so all aspects of patient disease are assessed and
treated
•

Prov...
P a g e | 38

•

ER committee

•

Internal Audit committee

•

Waste management committee

•

Social Welfare Affairs commi...
P a g e | 39

4. Ethical Management Practices at Shifa
People at Shifa believe in:
•

Respect

•

Compassion

•

Intergrit...
P a g e | 40

other department. He has to see the reports of the patients. This depicts a level of human
skills.
8. Scient...
P a g e | 41

asked to donate $1000/ child Annually for 12years to provide him/her all needs of life
including quality edu...
P a g e | 42

directed to make rapid Arrangements for Wheel chairs and artificial limbs for disabled
patients, he indicate...
P a g e | 43

green dress. They also provide different types of training to newly hired as well as the
old employees to ma...
P a g e | 44

CHAPTER # 3
P a g e | 45

Internal and External service quality at Shifa &
Miscellaneous

Internal and External service quality at Shi...
P a g e | 46

b) Medical Oncology: The Center provides comprehensive medical oncology care for
solid tumors and hematologi...
P a g e | 47

tissue damage. Shifa International Hospital is one of the only two centers in Pakistan
providing IMRT treatm...
P a g e | 48

2. Diagnostic Services: By LIS it is possible to view every patient’s laboratory and all
other parameters wh...
P a g e | 49

Nephrologists not only across northern area of country but also from Faisalabad,
Lahore and Peshawar are sen...
P a g e | 50

7. Blood Bank: Blood transplant department is supporting big transfusion dependent
venture of liver transpla...
P a g e | 51

10. Microbiology Lab: Microbiology lab is dealing with routine culture and sensitivity
testing since the ver...
P a g e | 52

of dedicated specialists consisting of Neuro, Interventional and diagnostic radiologists
as well as ultrasou...
P a g e | 53

17. Nuclear Medicine: The section consists of dual head spect camera providing
diagnostic options including ...
P a g e | 54

The oncology area also boasts the achievement of dealing online prescriptions, which is
an important step to...
P a g e | 55

Future Goals:Develop a Drug Information Resource and its implementation, Drug Information and
Poison Control...
P a g e | 56

Miscellaneous
1. Shifa Heart Centre: Shifa Heart Center is busy in providing a wide range of general

and sp...
P a g e | 57

text and telephones. It will be a unique and pioneering service and will help establish
our hospital in prov...
P a g e | 58

manages patients with musculoskeletal conditions such as bone and Joint injuries and
degenerative joint dise...
P a g e | 59

i) Ophthalmology: Ophthalmology at Shifa has become a state-of-the-art tertiary referral
center for various ...
P a g e | 60

2. Mother and Child Health
a) OBS/ GYNE: The department of Obs/Gyne at Shifa International Hospital is one o...
P a g e | 61



3) Shifa Center of Liver Pancreas and Biliary Sciences (LPBS): We are
rightly proud of our success in the...
P a g e | 62

b) Critical Care & Pulmonary Medicine: Critical Care & Pulmonary Medicine has taken
a new dimension at Shifa...
P a g e | 63

diabetic foot care and prevention of the complications of diabetes are the areas where we
are making a diffe...
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Finalized project on shifa international hospital ltd. 16.5.2013   copy
Upcoming SlideShare
Loading in …5
×

Finalized project on shifa international hospital ltd. 16.5.2013 copy

2,729 views

Published on

Created by Badar e Alam Anwar

Published in: Business, Health & Medicine
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
2,729
On SlideShare
0
From Embeds
0
Number of Embeds
5
Actions
Shares
0
Downloads
0
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Finalized project on shifa international hospital ltd. 16.5.2013 copy

  1. 1. Page |1 Project Report on Total QualityManagement (TQM) of Shifa International Hospital Ltd. Total Quality Management (TQM) of Shifa International Hospital Ltd. Presented By Badar-e-Alam Anwar MBA (HR) 7th Quatar IN PARTCIAL FULFILLMENT OF MASTER OF BUSINESS ADIMINISRATION IN HUMAN RESOURSE MANAGEMENT PRESTON UNIVERSITY ISLAMABAD CAMPUS 5 June 2013
  2. 2. Page |2
  3. 3. Page |3
  4. 4. Page |4
  5. 5. Page |5 Dedication This project is dedicated to all those people of the world who never let the candle of optimism to distinguish even in every in very crucial circumstance. To those who scarifies their comforts who set noble standards. To those who are hopeful that their efforts for good will be answered one day by Almighty Allah. To those who have love for humanity ... ... ...
  6. 6. Page |6 MESSAGE FROM DR. ZAHEER AHMAD M. Pharm, M.D. PRESIDENT & CEO SHIFA INTERNATIONAL HOSPITALS LTD. I feel pleased and honoured to write this message on the occasion of First National Conference on “Patient Care Pharmacist” by the Department of Pharmacy, Shifa International Hospital. I heartily felicitate the team of Pharmacy Department and the management of Shifa International Hospital for conceiving and executing this idea. Healthcare in our times has undergone tremendous transformation and the term “Quality Healthcare” now refers to a process that represents functioning of various healthcare professionals in complete unison. Only this smooth functioning can help achieve the optimum welfare of the patient and result in a “product” that can be then referred to as “Quality Healthcare”. I am quite happy that like many other 'Firsts', the idea of First National Conference on Patient Care Pharmacist came from the “Team Shifa”. I cordially welcome and congratulate the worthy speakers who have made it to the conference and have become a part of this humble but much-needed beginning. God bless us with courage and vision to do good deeds, amen!
  7. 7. Page |7 MESSAGE FROM SHAFQAT ALI HAMDANI. RPH CHIEF OF PHARMACY SERVICES SHIFA INTERNATIONAL HOSPITALS LTD. It is matter of great satisfaction that Allah (SWT) has bestowed us the courage to organize “1st National Conference of Patient Care Pharmacist”. On behalf of organizing committee I welcome you all on this historic event and first step to establish and achieve the pivotal role of pharmacists in health care system of Pakistan. The objective of the conference is to educate and train the pharmacists to take cognizance of its role as Patient Care Pharmacists to make dream of healthier Pakistan come true by changing health care system drastically. We seniors as a part of society need to set an example for young professional pharmacist to get inspiration from both educational and compassionate quality health care, commitment for patient to bring change. As worldwide there are massive changes in health care industry, and bright future is waiting for those competent professional pharmacists. Who dare and has belief, for such professionals Iqbal has said: ALLAH (SWT) accepts our endeavour. Aameen
  8. 8. Page |8 CERTIFICATE OF APPROVAL This Project is submitted in the partial fulfilment of the requirement for the award of Master of Business Administration of Preston University Islamabad Campus. Submitted BY: Badar-e-Alam-Anwar Registration No: 1432-212048 7th Quarter MBA (HR) Evening Supervised BY: - APPROVED BY:- ___________________ _____________________ Dr. Perwez Nusrat Prof. Dr. Abdul Basit Chancellor of Preston University Islamabad Campus
  9. 9. Page |9 DECLARATION BY THE CANDIDATE I hereby declare that the project work entitled “TQM of Shifa International Hospital Ltd.” submitted by me to Preston University Islamabad Campus. Badar-e-Alam-Anwar in partial fulfilment of the requirement for the award of the Degree of MBA in Human Resource Management is a record of an original work done by under the guidance of Dr. Nusrat Parwez. I further declare that the work reported in this project has not been submitted and will not be submitted, either is part or in full, for the award of any other degree or diploma in this institute or any other institute or university. (Signature of the Candidate) Badar-e-Alam Anwar Registration no. 1432-212048 Date: 5 June 2013
  10. 10. P a g e | 10 Executive Summary The hospital was established by the assembly of doctors who were working in USA. It was integrated as Private Limited Company on 20th September 1987, as Private Company Limited it was converted as public limited company in 20th October 1989. This hospital is scheduled in Karachi, Lahore and Islamabad accumulation interactions. This hospital was fixed by a group of professionals working in USA. The hospital’s group (originator and supporter) reserved getting higher all from corner to corner the world. The Hospital by the time of aperture on June 26, 1993, over 400 plus sponsors supported, with a Rupee 500 million impartiality. Turn over this time the Hospital has not hired a single rupee from any other basis. Within three and half years, the Hospital's Block-A with a five storey structure, plus decorate slab area and a mosque with a total 100,000 square feet covered area was ready to take its first patient on June 26, 1993. Modest start from June 26, 1993, with eight consultants in seven specialties, has developed to more than 70 highly experienced consultants in approximately all specialties under one roof. Shifa International Hospital bid 150 IPD beds with superiority care and OPD facility in 35 different specializations. On the other hand, it is an everlasting journey. Shifa improved by people, bring durable motivated incessantly and uniqueness with every temporary instant. Now after more than one and a part decade Shifa International Hospital proudly rises as a representation of quality healthcare with its own brand name"SHIFA". In Short, Shifa observed exceptional dedication and devotion by their consultants, management and staff who worked hard to make Shifa a reality of its own.
  11. 11. P a g e | 11
  12. 12. P a g e | 12
  13. 13. P a g e | 13 ACKNOWLEDGMENT We bow in Gratitude to Almighty ALLAH, for giving us courage and wisdom to reach this point of completion. We thank our parents who had faith in us and supported us throughout our lives. In the end we would like to thank and praise our Supervisor Dr. Perwez Nusrat and family members who helped me for this project and made me capable of stepping into professional life with courage. THANK YOU Badar-e-Alam Anwar Specialization in HR Preston University Islamabad Campus
  14. 14. P a g e | 14 Table of Contents Page No.s TITLE PAGES------------------------------------------------------------------------------------------15 MESSAGES---------------------------------------------------------------------------------------------67 APPROVEL SHEET------------------------------------------------------------------------------------8 DECLARATION OF THE CADIDATE --------------------------------------------------------------9 EXECUTIVE SUMMARY---------------------------------------------------------------------------10 ALSHIFA HOSPITAL MAP----------------------------------------------------------------------1112 ACKNOWLEDGEMENT-----------------------------------------------------------------------------13 RECOMMENDATION--------------------------------------------------------------------------------94 BIBLIOGRAPHY --------------------------------------------------------------------------------------95 QUOTE--------------------------------------------------------------------------------------------------96
  15. 15. P a g e | 15 CHAPTER # 1 Objective and Scope of Shifa Page No.s Introduction--------------------------------------------------------------------------------------------------------------------25 Background--------------------------------------------------------------------------------------------------------------------25 Mission and vision------------------------------------------------------------------------------------------------------------26 Scope----------------------------------------------------------------------------------------------------------------------------26 Ethics Goal---------------------------------------------------------------------------------------------------------------------26 The Values---------------------------------------------------------------------------------------------------------------------27 Strategic Priorities -------------------------------------------------------------------------------------------------------------27 The Decomposition of Shifa----------------------------------------------------------------------------------------27 The Medical Affairs Department--------------------------------------------------------------------------------------------27 Department of Surgery-------------------------------------------------------------------------------------------------------27 Offices of Chief Operating Officers----------------------------------------------------------------------------------------28 Organization Decomposing Chart -------------------------------------------------------------------------------------------28
  16. 16. P a g e | 16 Chapter # 2 TQM and Services Quality of Shifa & Miscellaneous Page No.s Total Quality Management Definition-------------------------------------------------------------------------------------30 Total Quality Management in Hospitals-----------------------------------------------------------------------------------30 Quality Management at Shifa International Hospital (SIH) -----------------------------------------31 Quality Policy------------------------------------------------------------------------------------------------------------------31 Quality Objective--------------------------------------------------------------------------------------------------------------31 Management practices at Shifa International Hospital ---------------------------------------------------------32 Management functions at Shifa international Hospital-------------------------------------------------------------------32 Planning------------------------------------------------------------------------------------------------------------------------32 Leading-------------------------------------------------------------------------------------------------------------------------32
  17. 17. P a g e | 17 Organizing----------------------------------------------------------------------------------------------------------------------32 Controlling---------------------------------------------------------------------------------------------------------------------32 Executive Management committee-----------------------------------------------------------------------------------------32 Diversity Management at Shifa---------------------------------------------------------------------------------------------33 Ethical Management Practices at Shifa------------------------------------------------------------------------------------34 Centralized Mode of Management at Shifa--------------------------------------------------------------------------------34 Market stage-------------------------------------------------------------------------------------------------------------------34 Management skills------------------------------------------------------------------------------------------------------------34 Scientific Management -------------------------------------------------------------------------------------------------------34 Shifa as an Open System-----------------------------------------------------------------------------------------------------35 Social Responsibilities at Shifa International-----------------------------------------------------------------------------35 Shifa stake holders------------------------------------------------------------------------------------------------------------36 Vanguard Organization-------------------------------------------------------------------------------------------------------37 Type Z Management style at Shifa-----------------------------------------------------------------------------------------37 Inter Organizational Culture at Shifa---------------------------------------------------------------------------------------37 Theory Y-----------------------------------------------------------------------------------------------------------------------37 Employees Departmental Rotation-----------------------------------------------------------------------------------------37 Facilities at Shifa--------------------------------------------------------------------------------------------------------------37
  18. 18. P a g e | 18 Chapter # 3 Internal and external service quality of Shifa & Miscellaneous Page No.s Shifa at Internal Services Quality------------------------------------------------------------------40 Cancer Centre------------------------------------------------------------------------------------------------------------------40 Medical Oncology-------------------------------------------------------------------------------------------------------------40 Radiation Oncology-----------------------------------------------------------------------------------------------------------40 Future Plans------------------------------------------------------------------------------------------------------------------41 Shifa at External Quality services-----------------------------------------------------------------42 Emergency Services----------------------------------------------------------------------------------------------------------42 Diagnostic Services-----------------------------------------------------------------------------------------------------------42 Laboratory----------------------------------------------------------------------------------------------------------------------42 Diagnostic Surgical Pathology----------------------------------------------------------------------------------------------42 Chemical Pathology-----------------------------------------------------------------------------------------------------------43 Haematology-------------------------------------------------------------------------------------------------------------------43 Blood Bank---------------------------------------------------------------------------------------------------------------------44 Flow Cytometry Lab----------------------------------------------------------------------------------------------------------44 PCR Lab(Polymerase Chain Reaction) -------------------------------------------------------------------------------------44 Microbiology Lab-------------------------------------------------------------------------------------------------------------44 Radiology Services------------------------------------------------------------------------------------------------------------45 General Radiology------------------------------------------------------------------------------------------------------------46 MRI(Magnetic resonance imaging)----------------------------------------------------------------------------------------46 CT-Scan(Computerized Tomography) -------------------------------------------------------------------------------------46 Digital Fluoroscopy-----------------------------------------------------------------------------------------------------------46 Ultra Sound ---------------------------------------------------------------------------------------------------------------------46 Nuclear Medicine-------------------------------------------------------------------------------------------------------------47 Pharmacy Services------------------------------------------------------------------------------------------------------------47
  19. 19. P a g e | 19 Clinical pharmacy-------------------------------------------------------------------------------------------------------------48 Future goals-------------------------------------------------------------------------------------------------------------------48 Miscellaneous -------------------------------------------------------------------------------------------49 Shifa Heart Centre------------------------------------------------------------------------------------49 Cardiac MRI Service----------------------------------------------------------------------------------------------------------49 National Integrated Anticoagulation Service (NIACS) ------------------------------------------------------------------49 Patient Education Program---------------------------------------------------------------------------------------------------49 Heart Failure Service---------------------------------------------------------------------------------------------------------49 Lifestyle Improvement Initiative--------------------------------------------------------------------------------------------51 Cardiothoracic Surgery -------------------------------------------------------------------------------------------------------51 Neuro-care at Shifa------------------------------------------------------------------------------------------------------------51 Orthopedics--------------------------------------------------------------------------------------------------------------------51 Transplant & Urology--------------------------------------------------------------------------------------------------------52 Ophthalmology----------------------------------------------------------------------------------------------------------------52 Plastic Surgery-----------------------------------------------------------------------------------------------------------------53 Mother and Child Health----------------------------------------------------------------------------54 OBS/ GYNE-------------------------------------------------------------------------------------------------------------------54 Pediatrics-----------------------------------------------------------------------------------------------------------------------54 Pediatric Surgery--------------------------------------------------------------------------------------------------------------54 Shifa Center of Liver Pancreas and Biliary Sciences (LPBS) --------------------------------55 Gastroenterology--------------------------------------------------------------------------------------------------------------55 Critical Care & Pulmonary Medicine--------------------------------------------------------------------------------------56 Nephrology---------------------------------------------------------------------------------------------------------------------56 Allergy/ Clinical Immunology----------------------------------------------------------------------------------------------56 Endocrinology-----------------------------------------------------------------------------------------------------------------56 Psychiatry----------------------------------------------------------------------------------------------------------------------56 Dermatology-------------------------------------------------------------------------------------------------------------------57
  20. 20. P a g e | 20 Nutrition Clinic----------------------------------------------------------------------------------------------------------------57 Anesthesiology and pain medicine------------------------------------------------------------------------------------------57 General Surgery---------------------------------------------------------------------------------------------------------------57 ENT-----------------------------------------------------------------------------------------------------------------------------58 Shifa Dental Clinic------------------------------------------------------------------------------------------------------------58 Nursing Care Services at Shifa-----------------------------------------------------------------------59 Maintenance at Shifa-----------------------------------------------------------------------------------60 Food & Nutrition Services at Shifa-------------------------------------------------------------------60 External Services Division----------------------------------------------------------------------------61 Shifa Medical Center, F-11, Islamabad--------------------------------------------------------------61 Shifa Medical Center, PWD, Rawalpindi -----------------------------------------------------------62 Community Pharmacies --------------------------------------------------------------------------------62 Laboratory Collection Points --------------------------------------------------------------------------63 Information Technology at Shifa---------------------------------------------------------------------63 Shifa Information Systems----------------------------------------------------------------------------63 EMR (Electronic Medical Record) -------------------------------------------------------------------64 Telemedicine--------------------------------------------------------------------------------------------64 Shifa Network-------------------------------------------------------------------------------------------65 Future Plans--------------------------------------------------------------------------------------------65 ERP (Enterprise Resource Planning) ---------------------------------------------------------------------------------------65 HL7( Health Level Seven) ---------------------------------------------------------------------------------------------------65 Rehabilitation & Home Health----------------------------------------------------------------------------------------------66
  21. 21. P a g e | 21 Chapter # 4 Element of the Task Environment Page No.s Labour Supply--------------------------------------------------------------------------------------------------------------68 Employees at Internal Medicine---------------------------------------------------------------------------------------------68 Employees at Critical Care--------------------------------------------------------------------------------------------------68 Employees at section of Infectious Diseases------------------------------------------------------------------------------68 Employees at Psychiatry Section-------------------------------------------------------------------------------------------69 Employees at Neurology Section-------------------------------------------------------------------------------------------69 Employees at Dermatology Section----------------------------------------------------------------------------------------69 Employees at Cardiac Surgery Section-------------------------------------------------------------------------------------69 Employees at General Surgery Section------------------------------------------------------------------------------------69 Employees at Dentistry Section---------------------------------------------------------------------------------------------69 Employees at ENT Section--------------------------------------------------------------------------------------------------70 Employees at Ophthalmology Section-------------------------------------------------------------------------------------70 Employees at Urology Section----------------------------------------------------------------------------------------------70 Employees at Anaesthesiology Section------------------------------------------------------------------------------------70 Employees at Pediatrics Section--------------------------------------------------------------------------------------------71 Employees at other Branches------------------------------------------------------------------------------------------------71
  22. 22. P a g e | 22 Chapter # 5 Costumer Clients Page No.s Short Time Patients-----------------------------------------------------------------------------------------------------------73 Long Time Patients-----------------------------------------------------------------------------------------------------------73 Chapter # 6 Suppliers Page No.s X-ray imaging equipment----------------------------------------------------------------------------------------------------75 Cardial equipment-------------------------------------------------------------------------------------------------------------75
  23. 23. P a g e | 23 Kidney care equipment-------------------------------------------------------------------------------------------------------75 Operating room equipment--------------------------------------------------------------------------------------------------75 Radiation encology------------------------------------------------------------------------------------------------------------75 Neurological equipment------------------------------------------------------------------------------------------------------75 Chapter # 7 Competitors Page No.s AGA KHAN Hospital Karachi ---------------------------------------------------------------------77 Some General Information ---------------------------------------------------------------------------------------------------77 Operating Rooms --------------------------------------------------------------------------------------------------------------77
  24. 24. P a g e | 24 Outpatient Services ------------------------------------------------------------------------------------------------------------77 Medicine------------------------------------------------------------------------------------------------------------------------77 Surgery--------------------------------------------------------------------------------------------------------------------------78 Pediatrics -----------------------------------------------------------------------------------------------------------------------78 Special Clinics -----------------------------------------------------------------------------------------------------------------78 Diagnostic Services-----------------------------------------------------------------------------------------------------------79 Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore------------79 Services & Facilities----------------------------------------------------------------------------------------------------------79 Medicine Department---------------------------------------------------------------------------------------------------------79 Future Competitors------------------------------------------------------------------------------------------------------------79 SAHARA FOR LIFE TRUST-----------------------------------------------------------------------------------------------79 Outpatient Department-------------------------------------------------------------------------------------------------------79 Inpatient Department---------------------------------------------------------------------------------------------------------79 Allied Facilities----------------------------------------------------------------------------------------------------------------80 Radiology-----------------------------------------------------------------------------------------------------------------------80 Pathology-----------------------------------------------------------------------------------------------------------------------80 Allied Facilities----------------------------------------------------------------------------------------------------------------80 QIH’s (Quaid-e-Azam International Hospital) --------------------------------------------------80
  25. 25. P a g e | 25 Chapter # 8 Government Agencies Page No.s Central Board OF Revenue--------------------------------------------------------------------------------------------------82 Capital Development Authority---------------------------------------------------------------------------------------------82 The Completed Projects------------------------------------------------------------------------------------------------------82 The Continued Projects-------------------------------------------------------------------------------------------------------82 Income Tax It------------------------------------------------------------------------------------------------------------------82 Pakistan Medical & Dental Association-----------------------------------------------------------------------------------82 Bahria University, Islamabad------------------------------------------------------------------------------------------------82 Shifa College of Nursing-----------------------------------------------------------------------------------------------------83 Tameer-e-Millat Foundation-------------------------------------------------------------------------------------------------84 Chapter # 9 Progress Report of Shifa International Hospital Ltd. Islamabad Page No.s SIH Achievement Timeline--------------------------------------------------------------------------------------------------86 Statement of value addition--------------------------------------------------------------------------------------------------89 Horizontal Analysis-----------------------------------------------------------------------------------------------------------91 Vertical Analysis --------------------------------------------------------------------------------------------------------------93
  26. 26. P a g e | 26
  27. 27. P a g e | 27
  28. 28. P a g e | 28 CHAPTER # 1 Objectives and Scope of Shifa Objectives and Scope of Shifa  Introduction Shifa Internaiontal Hospital Ltd. Background: Shifa international hospital was originated by assembly of doctors , it was incorporated on September 20 1987. It rehabilitated into Public limited company on October 12, 1989. This hospital has a covered area of 500,000 plus square feet, and begining the report by CEO who is the Board of Director of Shifa Hospital, COO, Medical Director Cheif financial officer assest the CEO. This Hospital takes experinced cowerd of consultants, Pharamedical staff and highly trained skills staff/empolyees providing the following services.
  29. 29. P a g e | 29 Internal medicine Cardiology ENT Nephrology Neurology Oncology Pediatrics Urology Orthopedic Radiology Rehabilitation Gastroenterolog y Pulmonology Endocrinology Psychiatry General Surgery Ophthamology Obstrictics & Gynecology Body composition Analysis, Paracentesis Diagnostic and Therapeutic Cardiac Surgery, Cardiac Angiography, Angioplasty Holter Monitoring, Exercise Tolerance Test, Echocardiography, Carotid Ultrasounds and Doppler, Arterial and Venous Dopplers, Pericardcentesis Under Echo. ENT Procedures, Tympanometry, Audiological Screening Dialysis catheter placement, Hemo dialysis, Peritoneal dialysis Kidney biopsy, Slow extended dialysis, Pre-transplant work-up, Urine sediment examination Nerve Conduction Studies (NCS), EMG (Electromyography), Evoked Potentials (visual evoked/Somato sensory evoked) EEG (Electro Encephalo Graphy), Trans cranial Doppler (TCD) Botox Injections, Lumber Puncture Medical Oncology, Radiation Oncology, Chemo Therapy Neonatology, Pediatric Infection diseases, Pedratic Psychiatry, Pediatric Surgery, Pediatric Nephrology, Pediatric Gastroenterology, Pediatric Endoscopy. Kidney Transplant, Lithotripsy, General Urology Limb Lengthening Surgery, Arthroscopic Surgery, Joint Replacement Surgery,General Orthopedic Surgery. Sonology, Ultrasound, C.T. Scan, X- Ray Imaging, MRI, Fluoroscopy, Ultrasound Guided Biopsy, Bone Scan, Thallium Scan. Speech Therapy, Physiotherapy, Occupational Therapy Proctoscopy, Colonoscopy, Sigmiodoscopy, PEG Tube, Endoscopy , ERCP (Endoscopic Retrogratic cholingio Pancretography), Digestive and Liver Diease Thoracentesis, Diagnostic and Therapeutic, Pulmonary Function Test, Bronchoscophy, Pulmonology & Critical Care. Diabetic Clinic, Other Psychotherapy, Drug Addiction treatment, Depression, Psychosis Brest surgery, Laparoscopic surgery , Bariatric surgery, appendectomies, Laprotomies, General Surgery Children eye care, Cornea Transplant, intraocular lens implant, Diabetic eye care, General Ophthamology Normal deliveries, C-section, Antenatal care, Postnatal care, Gynecology This Hospital provide s 24 hours diagnostic & treatment services E.g. Clue blue Protocol, 24 Hours Ambulance, Operation Rooms, Emergency Services, Nutrition Clinic, Critical Care, Nuclear Medicine, Clinical Labs & Blood Bank.
  30. 30. P a g e | 30 i. Mission & Vision Mission “To provide good quality medical care in all disciplines of medicine and surgery to all patients in a caring and compassionate manner by an outstanding team of healthcare professionals in an atmosphere conducive to our values and practice of good medicine” Vision Shifa International Hospitals Limited is established to provide the highest quality medical care to the people of Pakistan. Achieving a high level of quality is the result of many factors: • Medical Expertise • Clinical Excellence • State of the Art Technology • Caring People • Preventive Medicine • Health Care Management ii. iii. Scope: Shifa International Hospital Ltd. has foundation of the Quality Management system (QMS) illustrate their capabilities over and over again provides Products/Services that meet to the costumers and valid and rigid requirements and to operate with increases effectiveness and efficiency with on the whole aspire of attractive customer satisfaction. Ethics Goal They contain: • Customer Satisfaction • Service Quality • Sustain long term Viability
  31. 31. P a g e | 31 • To Improve competitive position • To improve work Environment iv. The Values They contain: • Respect • Empathy • Truthfulness • Effectiveness • Quality • Intelligibility v. Strategic Priorities: • Physician Partnership and enhanced Clinical Quality • Provide seamless/Easy Access Care Delivery • Financial Strength/Viability • Strategic Growth vi. The Decomposition of Shifa The whole hospital processes are disintegrated into two major departments. • The Medical Affairs • Support Services. The medical Affairs Department is started by MD (Medical Director) and the Support Services Department is started by COO (Chief Opening Officer). These two departments have further divided into more departments and sub departments. 1. The Medical affairs Department It incorporates other departments similar to: a) -1. Department of Medicine This department further divided into more sections:
  32. 32. P a g e | 32 • Section of Internal Medicine • Section of Pulmonolgy • Section of Cardiology • Section of infectious diseases • Section of Nephrology • Section of Neurology • Section of Radiology b) -2. Department of Surgery • General and Vascular Surgery Section • Orthopedic Surgery Section • Urology Section • Pediatric Surgery Section • Cardio Surgery Section • Neurosurgery Section • ENT Section • Plastic Surgery Section • Anaesthesia Section • Dental Surgery Section • Gynaecology Section • Emergency Room c) -3.Office of Chief Operating Officers It incorporates departments similar to: • Admin & General • Nursing Administration • Accounts and Finance • Pharmacy
  33. 33. P a g e | 33 • Patient Services • Material Management & Purchase • Bio-Medical • Management information System • Maintenance and Plant Operations • Human Resources • Marketing services • House Keeping d) -4.Organization Decomposing Chart (Main Bodies) Hospital Administration Office of Medical Director Office of Chief Operating Officer Emergency Department
  34. 34. P a g e | 34 CHAPTER # 2 TQM and Services Quality of Shifa & Miscellaneous TQM and Services Quality of Shifa & Miscellaneous 1. Total Quality Management Definition: Total Quality Management (TQM) is a comprehensive and structured approach to organizational management that seeks to improve the quality of products and services through ongoing refinements in response to continuous feedback. TQM requirements may be defined separately for a particular organization or may be in adherence to established standards, such as the International Organization for Standardization's ISO 9000 series. TQM can be applied to any type of organization; it originated in the manufacturing sector and has since been adapted for use in almost every type of organization imaginable, including schools, highway
  35. 35. P a g e | 35 maintenance and hotel management. As a current focus of e-business, TQM is based on quality management from the customer's point of view. TQM processes are divided into four sequential categories: plan, do, check, and act (the PDCA cycle). In the planning phase, people define the problem to be addressed, collect relevant data, and ascertain the problem's root cause; in the doing phase, people develop and implement a solution, and decide upon a measurement to gauge its effectiveness; in the checking phase, people confirm the results through before-and-after data comparison; in the acting phase, people document their results, inform others about process changes, and make recommendations for the problem to be addressed in the next PDCA cycle. 2. Total Quality Management (TQM) in Hospitals: Healthcare systems are of fundamental interests to all level of Hospitals in our societies. Eventually, increasing importance and reliance are placed on total quality management in healthcare systems. Due to this rising importance that is also reflected in the increasing percentage of national and international resources for both private and public sector to allocated in hospital management systems. Hospitals and other healthcare organization across the globe have been progressively implementing TQM to reduce costs, improve efficiency and provide high quality patient care. Contrary to popular belief, the TQM movements were not the start of concerns about quality in healthcare. The roots of quality assurance initiatives in healthcare extends at least as far back as the time of Florence Nightingales’ work during the Crimean War(1854-1856),when the introduction of nutrition, sanitation and infection control initiatives in war hospitals contributed to reduction in the death rate from 43% to 10%. TQM can be an important part of hospitals’ competitive strategy. Thus, TQM, which places on improved customer satisfaction, offers the prospect of great market share and profitability. TQM can be an important part of hospitals competitive strategy in quality of healthcare system. Hospitals in competitive markets are more likely to attempt to differentiate themselves from their competitors on the basic of greater service quality. Thus, TQM which places a heavy emphasis on improvement in Customer satisfaction index that offers the prospect of grater combines internal quality measures with value analysis and conformance to specifications. Acceptable quality services not only include direct medical services such as diagnoses, medicines, surgery and treatment but indirect operations such as administration and purchasing whose costs are reflected in what the buyer pays. It may also include Total Quality of performance that is directly related to healthcare safety, security, attitude of nursing and word boy, role of doctors in terms of ‘time’ includes appointment, delay time, service time, timing with regards to medical treatment and surgery. The Concept of Total Quality Management:
  36. 36. P a g e | 36 Fig. 1, TQM structure People define quality in many ways. Some think of quality as superiority of excellence, others vies it as a lack of patient care and service defects. According to Crosby, quality is 'conformance to requirements'. (Zero defects). Today most mangers agree that the main reason to purse quality is to satisfy the customers. The American National Standards Institute (ANSI) and American Society Quality (ASQ) define quality as “The totality of features and characterizes of a care or service that bears on its ability to satisfy given needs”. The view of quality as the satisfaction of customer needs is often called fitness for use. 3. Quality Management System at Shifa International Hospital (SIH) i. Quality Policy The quality policy of Shifa International Hospital is to provide cost effective quality medical care to all patients, ensuring ethical practice of medicine. “Our quality objective is to continuously improve patient satisfaction” It is certified by ISO-9001, today everyone knows about ISO standardisation, the basic Principle of ISO is “write what you do and do what you write”. It means you writing and working should support each other. Quality service needs teams to make or more effective and efficient that brings the Standardisation and Quality. ISO-9001CERTIFIED ii. Quality Objective “Our Quality Objective is to continuously improve patient satisfaction”
  37. 37. P a g e | 37 • Adequate time to be spent by physician so all aspects of patient disease are assessed and treated • Provision of separate examination rooms to provide patient with privacy and to decrease patient waiting time • Patient education to improve disease management which includes written materials and public seminars • Practice guidelines and clinical pathways developed for common diseases in Internal Medicine • Produce chart reviews to monitor compliance with new practice guidelines and clinical pathways 4. Management Practices at Shifa International Hospital (SIH) Since Shifa is an Organization where different people work for Pre-define goal. The management Practices Adopted at Shifa International. 1. Management Functions at Shifa International Hospital (SIH): a) Planning: The chairman of the Shifa, Dr. Zaheer Ahmad has a goal before him. He has plan to extend the hospital business activities all around the year. He thinks that 2005 was a profitable year for them. Their earnings increased up to 53%. Secondly, he has a vision to provide the best medical health care facilities to the people of Pakistan. b) Organizing: Different people from different backgrounds are working at Shifa. Their HR department is responsible for employees and giving them specific jobs. Mr. Shahzad Choudry, Senior Manger HRD is dealing with all these. c) Leading: Every section has a head to lead the others employees under him/her. There is one Head consultant and under him/her, two or more assistant consultants are working. Since there are many sections and each of these sections has the same level of Hierarchy. d) Controlling: To assure the Quality of the Services at Shifa, Different committees have been formed. These committees make sure that the rules are not being violated. The services are quality oriented. Different Quality assurance committees at Shifa included: 2. Executive Management Committee • Quality Assurance Committee • Nursing Quality Assurance Committee
  38. 38. P a g e | 38 • ER committee • Internal Audit committee • Waste management committee • Social Welfare Affairs committee • Pharmacy Committee The QA (Quality Assurance) department is involved in developing and implementing effective quality based management systems, and quality improvement programs. It aims at developing solutions which are quality based and patient satisfaction. 3. Diversity Management at Shifa: The diversity is in: Race Tradition Work Culture Gender Subculture Diversity Group Work Place Ethics Style Religion
  39. 39. P a g e | 39 4. Ethical Management Practices at Shifa People at Shifa believe in: • Respect • Compassion • Intergrity • Efficiency • Excellence • Transparency 5. Centralized Mode of Management at Shifa It is clear from the data given above the there is a strong centralized management at Shifa International Hospital. The CEO and chairman is the main person. The MD & COO come under the CEO. Then there is no Long Hierarchy chain of command at different departments and Sections. Different sections have a head and under that head many consultants and senior consultants are working. This chain of common shows that there is a strong centralized management at Shifa International. 6. Market stage: Right now, Shifa is a totally customer oriented organization. It started as a private sector unite in 1987. Its main concern is on customer satisfaction and care, in a compassionate way. It is a right now in the prosperity stage. 7. Management Skills Since it is a very huge organization, different employees come here with different skills. For example, Dr Zaheer Ahmad the CEO & chairman of the company has mission before him. Different doctors at different levels have key knowledge skills according to their field of specializations. (MD, FCPS, or having any other degree). These also gave relationships with the assistants or subordinates at different levels. For example a doctor from one department has a good relationship with the employees at the radiology or any
  40. 40. P a g e | 40 other department. He has to see the reports of the patients. This depicts a level of human skills. 8. Scientific Management Obviously we find a scientific management sat Shifa. People with different jobs are working and their jobs are broken down into specific routines. There workers are fully trained and selected on a merit basis, then they a relationship among themselves to make sure that they are working in the proper manner. Each person is responsible for performing his own task which is designated to him. Each person is aware of His/her job. We also find bureaucratic management at Shifa where there is an implicate set of formalized rules and regulations Each Employee has to follow the Set of Rules. The organization has a well defined Hierarchy. Everyone knows that he or she is responsible to whom. Obviously, highly qualified doctors are selected and trained. 9. Shifa as an open System Obviously Shifa is an open system. It is using its HR, Financial and other resources, through managerial and technological abilities, to provide best medical care to the people. The system provides services to patients. To get feedback from the environment and stay with tough with the media, Shifa has a magazine named Shifa News International. The editor is MR. Amer farooq. The feedback and certain FAQ’s from the readers are encouraged in the “LETTER TO THE EDITOR “Section of the magazine. The “MEDIA PRINTING & RELIGIOUS “Department is there for this purpose. They also keep arranging different seminars on different health related topics to create awareness among the general public. 10. Social responsibilities at Shifa International The Shifa People are well aware of their social responsibilities. In the recent earth quake in Pakistan, Shifa contributed a lot. The rammer Millat Foundation of Shifa International Hospital has announced to adopt 2,000 children orphaned in the devastating earthquake that struck Pakistan and Azad Kashmir on October8. Muslims, the Voice of Muslims America 18th Nov, 2005 The Tameer-e-Millat Foundation has decided ti initiate a complete rehabilitation program for the affected children in a residential environment, “said TMF chairman Dr. Zaheer Ahmad while announcing the first major Initiative in Pakistan’s private sector for the rehabilitation and resettlement of those children who lost everything in the disaster. The unprecedented initiative has been named “Tameer-e-Jannat ( Building of Heaven)/He informed Muslims Weekly over telephone form Islamabad, Pakistan, that Tameer-e-Jannat is aimed at providing standardized living, brought up, education and training to 2,000 children initially for a period of 12years. He added that if the required support and funding was available, the TMF might adopt as many as 10,000 of these orphans. “We are offering ‘Sponsor in Child’s program to the well off and God-dearing individuals, families and institutions” said Dr. Zaheer while explaining the way his organization intends to raise funds from the project. Every sponsor, he said, will be
  41. 41. P a g e | 41 asked to donate $1000/ child Annually for 12years to provide him/her all needs of life including quality education. Dr. Zaheer Ahmad, it may be recalled, is a respected Pakistani doctor who has spent all his life in the service of humanity. He set a new precedent in Pakistan’s history in the 1980s, when he founded Shifa Hospital in Islamabad. The state of the art hospital, costing hundreds of millions of dollars, toay is one of the best medical facilities in Pakistan which offers diverse and Quality services. In later years, Dr. Zaheer also founded Shifa Foundation which helps the deserving patients in Pakistan and the Tameer-e-Millat Foundation. Tameer-e-Millat Foundation has extensive experience in the education sector. Currently, it is running over 380 schools in rural areas of Pakistan where over 20,000 students are receiving education. The TMF says that because of its strong credentials, it is capable of shouldering this huge task. Daily Mail The Prime Minister Also appreciated the administration of Shifa International for taking care of over 100 injured from the affected areas and for providing them excellent care. He said the patients informed that they were well looked after. “Every individual has an important role in tackling this enormous challenge that confronts the nation. It has shown the capacity of the entire country to cope with such calamities,” he said. He also lauded the role of NGOs, individuals, national and multinational organizations and international community for reaching out the people affected by this tragedy.--- APP “Pak Tribine” ISLAMABAD, November 09(online): Prime Minister shaukat Aziz has said estimate of earth quake loss will be released on Thursday adding that the estimated loss will be presented in donor’ conference on November19. The Prime Minister was talking to journalist here Tuesday in Shifa International Hospital where he had gone to Inquire about the Health of those injured in killer quake. Health minister Dr. Naseer Khan and Secretary Health Syed Anwar Mehmood also accompanied the Prime Minister. Earlier, the Prime Minister Inquired about the health of injured quake survivors and disturbed Rs10000 each in cash among them. “We pay tributes to Private hospitals, which are providing free treatment to the injured survivors,” prime minister underscored. Besides we express gratitude to over sixty countries, which had extended help. The spirit demonstrated by the world countries particularly people of Pakistan in helping the quake affects is unprecedented, he remarked. Shaukat Aziz noted that treatment process of the injured people was moving ahead. Serious patients are being shifted here from the field hospitals. Health ministry has been
  42. 42. P a g e | 42 directed to make rapid Arrangements for Wheel chairs and artificial limbs for disabled patients, he indicated. They also keep on organizing different seminars on different health related topics create awareness among the general public. They also reconstructed the “NALA” passing behind the main building. They had to suffer due to the wrong engineering planning of CDA. They had to lose 40 millions. But the reconstruction was self financed. 11. Shifa stake holders The social stake holders at Shifa are: • Shareholders • Customers • Employees • Society • Local Community 12. Vanguard Organization A vanguard organization is one which pays its social responsibility along with its other operations. A few companies or organizations in the world have attained this status up till now. Shifa tended to play its social duty during the 8th Oct earth quake of Pakistan. It contributed money, looked after patients and provided free medical treatment to them. It has proved itself in the queue of vanguard organizations. They are also keen about their environment. The Shifa people have planned to make the green belt before the hospital more beautiful, as it would make the capital more beautiful. They have passed this plan from CDA and stated working on it. They have one more plan to build a public park for general public and the patients as well. They are well aware of their social responsibility. 13. Type Z management style at Shifa Type Z theory of management is there where there is a medium pace career and workers are given some relaxation and some decision making ability is also given to them. The workers are allowed to some extent to make their own decisions in Theory Z management style. Obviously, when there is problem where the senior doctor or head is not present, the junior level doctors are allowed to take their own decision. They can solve the problem encountered. When the senior manager is not available, then the junior level manager is given the privilege to make his own decision. 14. Inter Organizational Culture at Shifa The inner-organizational culture at Shifa is relaxing. There is a dress code for the nursing staff, ward boys, housekeeping department and for the security guards as well, however, the doctors are to wear the white coat. The surgical staff has to wear blue-
  43. 43. P a g e | 43 green dress. They also provide different types of training to newly hired as well as the old employees to make them more aware about different scenarios and situations. 15. Theory Y Theory Y implies that the workers are highly motivated and hard working. They are fully trained and using their full potential in achieving their goals. This is the assumption used at Shifa hospital. The workers are fully trained personnel in their field of specialization. Each and every one of them is equally responsible for the improvement and work. Different tasks are assigned to different workers and they are there perform these. The Hospital provides a 24 hour service, ensuring that the workers (doctors) are working at their full. 16. Employees Departmental Rotation Employees are subject to departmental rotation after 3-4years based on their experience, to increase their skills and knowledge. The employees at junior levels face more rotation. 17. Facilities at Shifa Shifa is right now providing transport, allowances, bonuses, dividend to their share holders. It also gives shields and certificates to the best performers. Different job incentives are also rewarded according to the efficiency and effectiveness of the employees. • Shifa Card • Shifa Lab Pickup Point. 18. Employees Shift Right now, 3 shifts at Shifa: • 7am-3pm • 3pm-11pm • 11pm-7am The employees can work in any shift which they find comfortable to work in.
  44. 44. P a g e | 44 CHAPTER # 3
  45. 45. P a g e | 45 Internal and External service quality at Shifa & Miscellaneous Internal and External service quality at Shifa & Miscellaneous  Internal Services Quality at Shifa: a) Cancer Centre: It was in the early 90’s, when the pioneers of Shifa International Hospital, made a critical decision to make available much needed state of the art medical treatment for cancer patients. The first phase of this commitment led to the opening of the first radiation oncology department in the private sector at Shifa International Hospital in 1994. This proved to be the focal point for development of additional cancer treatment facilities over the years, till the inauguration of a full fledged Shifa Cancer Center in 2012.
  46. 46. P a g e | 46 b) Medical Oncology: The Center provides comprehensive medical oncology care for solid tumors and hematological malignancies, including chemotherapy and autologous/allogenic Bone Marrow Transplant (BMT). Inpatient care for chemotherapy, supportive care and treatment of emergencies and complications is available. Multidisciplinary Tumor Board is being held regularly at this facility. The Oncology Day Care Unit is a specially designed facility for patients suffering from various benign and malignant disorders. The Day Care Unit offers various diagnostic and therapeutic modalities including blood transfusions for patients with thalassaemia, other types of blood component infusion therapy and outpatient cancer chemotherapy for all types of malignant diseases. c) Radiation Oncology: The department of radiation oncology started with the installation of an advanced linear Accelerator, X-ray Flouroscopic Simulator and computerized 2.D treatment planning. It was probably the first department in the country where each patient underwent proper simulation and treatment planning along with custom made shielding devices. In the decade of 90’s Breast conserving treatment was initiated in Pakistan and made available to suitable patients with the cooperation of surgeon from Shifa and AKUH. A second treatment unit, a Cobalt 60 Phoenix (100cm Ssd) was added in 2004. Our Radiation Therapy services were expanded by the installation of a dedicated CT-simulator and a Linear Accelerator equipped with multi leaf collimeters in 2007. The dedicated CT simulator allows us to plan the radiation treatment and shape the dose precisely according to each patient’s individual anatomy, tumor size, shape and extent. The advanced digital Linear Accelerator with MLC enables to deliver precise radiation to the target with sharp field edges defined by two banks of 40 single focused leaves (collimeters) that can be positioned with an accuracy of 1mm. All patients are thus treated by 3-D conformal techniques. In addition this capability made it possible to start IMRT (Intensity modulated Radiation Therapy) in 2010 for prostate and head & neck cancer. IMRT is a significant development in the field of radiation therapy where the higher dose region can be shaped according to the shape and extent of tumor while reducing dose to normal tissues, thereby improving cure rates and reducing normal
  47. 47. P a g e | 47 tissue damage. Shifa International Hospital is one of the only two centers in Pakistan providing IMRT treatment. The quality of radiation treatment and precision dosage is ensured at Shifa Radiation Oncology, by verifying all treatment plans using specialized dosimetry equipment. d) Future Plans: In near future we plan to acquire equipment and expertise to start Stereotactic radiation therapy, which will give us another tool to treat small tumors in the Brain, Lung, Spine, etc, with sharply focused beam, using a single or few high dose fractions, thus shortening the overall treatment time and further improving results. We also plan to acquire High Dose rate Brachytherapy equipment for intracavitary and interstitial irradiation.  External Quality services at Shifa 1. Emergency Services: Our new and expanded ER is a 24-bedded fully equipped, monitored unit which is staffed with ER trained Medical and Para Medical staff who are capable of dealing with all the major Medical, Surgical, Pediatric and Obs/Gyne emergencies. They are supervised and guided by seasoned consultants who have extensive experience in ER care. Separate area for Pediatric. Surgical and Medical patients are provided OT, Separate Procedure Rooms, Triages area, Pharmacy, Lab and adjacent Radiology Department are the highlights of our new ER. Level of the patient care and satisfaction is very high in this area.
  48. 48. P a g e | 48 2. Diagnostic Services: By LIS it is possible to view every patient’s laboratory and all other parameters which are mandatory for accurate diagnosis. Moreover the department is equipped with latest Immunofluorescence techniques for diagnosis of renal and skin biopsies. This technique needs expertise and fluorescent microscope In this regard. The department is getting popularity in diagnosis of renal diseases as it is evident by continuous expanding workload. 3. Laboratory: Diagnostic services at Shifa International Hospital are rapidly enhancing to achieve the highest standards in the country. There are six subspecialties including diagnostic surgical pathology, Hematology, Blood Bank services, Chemical Pathology, Microbiology and immunology. These departments are rapidly expanding not only in terms of addition of new automated equipment but also with expert and qualified technical staff using them. These departments are working under direct supervision of experienced and foreign qualified consultants. We believe that the knowledge is ongoing process and are expanding it by continuous training abroad as well as conducting seminars for budding pathologists. 4. Diagnostic Surgical Pathology: The diagnostic surgical pathology has grown by leaps and bounds in the past few years and is one of the busiest departments in the country. We offer exfoliative cytology; fine needle aspiration biopsy in addition to routine histopathology. We have extensive panel of Immunohistochemistry antibodies for exact diagnosis of tumor. This panel is continuously expanding day by day. Tumor diagnosis is also made accurate by correlation with radiologic findings and clinical details by our modern Laboratory Information System (LIS). By LIS it is possible to view every patient’s radiology and all other parameters which are mandatory for accurate diagnosis. Moreover the department is equipped with latest Immunofluorescence techniques for diagnosis of renal and skin biopsies. This technique needs expertise and fluorescent microscope In this regard. The department is getting popularity in diagnosis of renal diseases as it is evident by continuous expanding workload.
  49. 49. P a g e | 49 Nephrologists not only across northern area of country but also from Faisalabad, Lahore and Peshawar are sending this test here. Since department also provides specialized transport media which keeps biopsies fresh even for 2-3 days. Frozen section facility for quick intra-operative diagnosis is not only used by our hospital but also by adjacent large hospitals where this facility is not available. The diagnostic surgical pathology team includes six histopathologists with special expertise in renal, liver, breast, head, neck and hematopathology. The technical staff is highly trained and experienced going training programme for technicians. The department is all set to start fluorescence in situ hybridization technique (FISH) initially for Her2Neu for breast and gastric cancer followed by detection of common genetic abnormalities in other tumors. These are needed by our expert oncologists for planning exact treatment of cancer. This is our goal for the coming year. Tumor registry has also started from Jan 2012 which will be a source of reliable data for research of cancer affecting our population. Liver transplant at Shifa International Hospital has added another dimension to our pathology services as we are dealing with biopsies from donors and recipients as well as explanted livers. We hope to gain expertise in this area which is so far uncharted territory in this country. The surgical pathology department also runs a vibrant residency programme to obtain fellowship in this field, with a long list of applicant doctors awaiting entry. We aspire to become one of the best if not “The Best” departments in the whole country comparable to any in the developed world. 5. Chemical Pathology: Department of chemical pathology is utilizing the services of a fully automated state-of-the-art integrated chemistry analyzer. This performs routine and specialized chemistry tests including hormones and drug levels. Ever since its installation five years ago the scope of tests being performed on this instrument has been expanding with addition of newer tests every year. The department is also providing services in emergency rooms as stat chemistry tests which have facilitated health care delivery more efficiently. As liver transplant has started, the department is keeping pace with it providing results within minutes during surgery which facilitates the work of surgeons and anesthetists. 6. Haematology: In addition to routine hematology test, bone marrow biopsies, the department also offer complete set of immune testing for final diagnosis of lymphomas / Leukemias. Department is now recognized for getting fellowship in this specialty and training is also started. We have already started with plan of getting automation in most of sections as this will reduce human error and aid our pathologists for accurate and quick diagnosis. “Nephrologists not only across northern area of country but also from Faisalabad, Lahore and Peshawar are sending this test here. Since department also provides specialized transport media which keeps biopsies fresh even for 2-3 days.”
  50. 50. P a g e | 50 7. Blood Bank: Blood transplant department is supporting big transfusion dependent venture of liver transplantation with successful completion of six critical patients who underwent liver transplant. It is also offering pre-storage leuko-depletion on request in addition to routine bone marrow stem cell separation and plasmapheresis. 8. Flow Cytometry Lab: This is the newest addition to the department of Pathology. Flow Cytometry Lab was recently established after two years through campaign to acquire a state-of-the-art Flow Cytometry. The instrument is 6-8 color laser equipment which is the first of its kind in the whole country. Now Pathology department is fully capable of rendering leukemia and lymphoma diagnosis according to the International Standards in a very short period of time. This process will facilitate the oncologists in their critical management decision. The Flow Cytometric analysis is performed by America Board certified hematopathologist. 9. PCR Lab (Polymerase Chain Reaction): PCR stands for polymerase chain reaction, which is a method for amplifying segments of DNA, by generating multiple copies using DNA polymerase enzymes under controlled conditions. As little as a single copy of the DNA segment or gene can be cloned into millions of copies, allowing detection using dyes and other visualization techniques. The process of PCR has made it possible to perform DNA sequencing and identify the order of nucleotides in individual genes. PCR techniques are applied in many areas of biotechnology including protein engineering, cloning, forensics (DNA fingerprinting) and for analysis of environmental samples. Shifa International Hospital recently also has established a stat-of-the-art PCR Lab for the diagnosis of infectious disease like Hepatitis B, C and genotyping. The lab is equipped with a fully automated walk-away instrument which helps in accurate diagnosis with least chances of any contamination. The results are interpreted by American Board certified Pathologists.
  51. 51. P a g e | 51 10. Microbiology Lab: Microbiology lab is dealing with routine culture and sensitivity testing since the very start of our hospital providing the patient care and catering the needs of our Infection Control department. Since then it established and equipped TB lab which started functioning in 2005 catering the customer’s need for TB identification, 1st line TB Drug Sensitivity Testing (DST) and 2nd line TB Drug Sensitivity Testing. “Microbiology lab is dealing with routine culture and sensitivity testing since the very start of our hospital providing the patient care and catering the needs of our Infection Control department.” Department has Initiated new tests for Fabric Industry mandatory for export purposes in 2010 including Quantitative and Qualitative testing. Microbiology has started full range of viral detection including antibody status. Established and equipped a new PCR diagnostic lab in 2011 which is going to look after the rapid testing of Mycobacterium tuberculosis from smear positive pulmonary specimens. Tumor board meeting is one of the big achievements of the departments. As most of cancer patients are now discussed with whole panel of Oncologists, Radiologists, Pathologists and treating Surgeons before their treatment. In addition to routine Clinic opathologic conferences with departments of urology, nephrology and Gynaecology departments also conducts slide seminars monthly for training of junior pathologists all over the region. 11. Radiology Services: Radiology at Shifa supplements almost every critical specialty by facilitating in prompt and flawless diagnoses. Recent advances in modern technology have revolutionized the health care horizons particularly in the fields of diagnostic and interventional imaging. This has made early diagnosis and prompt treatment of almost all illnesses ever more feasible. This state of the art facility is staffed and run by a team
  52. 52. P a g e | 52 of dedicated specialists consisting of Neuro, Interventional and diagnostic radiologists as well as ultrasound physicians and technical staff. 12. General Radiology: General Radiology at Shifa consists of four computerized radiography X-ray rooms capable of entire gamut of standard, general radiological exams transmitted to all Physicians on Picture Archiving and Communication System (PACS), at their respective clinics for urgent access. 13. MRI (Magnetic resonance imaging): A 24/7 facility in the heart of Capital City Islamabad, MRI at Shifa Radiology is Pakistan’s first wide bore MRI (Vantage Titan) with gantry size of 71 cm has patient focused features which significantly improve patient comfort and increase the range of patients who can undergo an MR exam. Claustrophobic and obese patients can now be imaged with this higher field strength MR as its wide bore provides a greater feeling of openness. Its technology dramatically reduces acoustic noise, the most significant cause of patient discomfort during an MR exam. Patients sensitive to contrast agents can now have excellent quality non-contrast MR angiogram. 14. CT-Scan (Computerized Tomography): CT stands for Computerized Tomography (commonly known as a CAT scan). The Aquilion ONE 640 slice CT-Scan, also first in Pakistan and South Asia with 16 cm of body coverage in single gantry rotation, is a latest addition to Radiology at Shifa. It images the entire brain and heart within 0.35 seconds with very low radiation dose. State of the art imaging of the stroke in single examination in only 50 seconds including a Non contrast CT, CT-Angiography, CTVenogram, 4D-Digital Subtraction Angiography and whole brain perfusion. This CT is capable of doing 4D dynamic imaging of joints and 4D Angiographies. 15. Digital Fluoroscopy: Digital fluoroscopy reduces the radiation dose through improvements in image quality and improved mechanical features. Better image quality and the ability to manipulate contrast and brightness reduce the number of images that must be obtained to complete a procedure. They also shorten procedure time and enhance patient throughput. 16. Ultra Sound: The Department is also equipped with state of the art Toshiba Xario ultrasound systems. Trans Rectal Ultrasound for evaluation of prostate, TRUS guided biopsies, local staging of Carcinoma Prostate, male infertility, 3D & 4D ultrasounds, fetal echocardiography and gray scale color Doppler are also unique ultrasounds services offered by Shifa Radiology.
  53. 53. P a g e | 53 17. Nuclear Medicine: The section consists of dual head spect camera providing diagnostic options including cardiac, renal, endocrine and oncologic imaging. 18. Pharmacy Services: The Division of Pharmacy Services at Shifa international Hospital is not limited to the traditional role of just dispensing of medicines. The primary goal of the division of pharmacy services at Shifa international hospital is to provide safe and effective pharmaceutical care to patients in an efficient manner. Our first line Pharmacists, besides being involved in the traditional jobs of Dispensing medicines and maintaining inventories are involved in reviewing the patients therapy and intervening on, as and when need basis. Our pharmacists review each and every prescription for completeness and appropriateness of the medications and when required consult with the physicians to modify and correct the prescriptions if and when required. Previously the in-patients pharmacy (currently the central pharmacy) was located at A-0, and was working with a limited space and resources; most of the tasks were performed by various individuals due to which the tasks were partially fulfilled. There was limited space for extemporaneous compounding of medicines, and there was no proper sterile area for mixing of chemotherapeutic drugs or for preparation of sterile intra venous preparations. The pharmacy store (presently Pharmacy ware house) was also operating with limited area and resources. The division of pharmacy services has bloomed and expanded very rapidly, and has achieved many milestones in the previous few years. The Central Pharmacy has been shifted to the new H-0 location and has been expanded. The role of pharmacist has also been improved to provide better quality pharmaceutical care. The extemporaneous compounding area has been developed into a whole new setup with improved facilities and many new formulations have been added. The main conspicuous achievement of pharmacy is the establishment of a state-of the art, oncology sterile admixture area, in which specialized pharmacy personnel works to ensure the quality and safety of the prepared medications, which eventually improves the patient safety outcomes.
  54. 54. P a g e | 54 The oncology area also boasts the achievement of dealing online prescriptions, which is an important step towards paper less environment, and it also ensures the timely dispensing of prepared chemo medicines. Modified labeling of the chemo has improved the handling of these medicines by adding warning signs like “cytotoxic medication”,” handle with care” “light sensitive” etc. The oncology sterile admixture area has been divided into two sections, one area has been dedicated for the day care chemotherapy bay, and the other area provides services to inpatients of chemotherapy. The pharmacy store has been developed into a “ware house” with improved systems and better storage conditions. 19. Clinical pharmacy: Clinical Pharmacy is a commonly used term in pharmacy practice. It is a health specialty, which describes the activities and services of the clinical pharmacist to develop and promote the rational and appropriate use of medicinal products and devices. There are following major areas where clinical pharmacy is focusing at SIH (Shifa International Hospital): • Indigenous System Development • Antibiotic Stewardship • Drug Information Resource • Drug intervention • Drug – drug interaction • LASA drugs • High alert medications • Doing pharmacy consultation Technology and transformation will revolutionize the pharmacy working and the health care delivery system. Development of indigenous system is one of the most challenging tasks, and requires deliberation and comprehensive efforts to develop that tool. SIH is working to develop such indigenous system that can support all pharmacists for clinical services. Clinical pharmacist is presently working on Antibiotic Stewardship. Antibiotics are the most widely prescribed and used medicines all over the world. Infections from various microbes and other organisms are responsible for most hospital and clinic visits. The most emerging danger for Antibiotic therapy is the development of resistance, which emerged over the years due to the irrational use of antibiotics Ultimate goal is to optimize the patient’s health-related quality of life, and achieve positive clinical outcomes, within realistic economic expenditures
  55. 55. P a g e | 55 Future Goals:Develop a Drug Information Resource and its implementation, Drug Information and Poison Control Centre. The major future goal of the Pharmacy services division is to develop a computerized Physician Order entry system (CPOE system), to reduce medication errors and improve patient safety. Improve quality of service by providing counselling services to discharged patients and out patients. Add structured Clinical pharmacy rounds with consultants and physicians for better point of care pharmacy services.
  56. 56. P a g e | 56 Miscellaneous 1. Shifa Heart Centre: Shifa Heart Center is busy in providing a wide range of general and specialized cardiac services, including but not limited to angiography, angioplasty, stents, intra aortic balloon pump, EECP and Cardiac MR. In fact the scope of our services encompasses critical areas and conditions and treatments of heart like Heart Failure, Interventional Cardiology/PCI, CHD/Valve Replacement, Peripheral Vascular Disease & Peripheral Artery Disease (PVD & PAD), Electrophysiology/Arrhythmias, Cardiac Imaging and Cardiac Rehabilitation. We are providing EP studies with Cardiac ablation, Cardiac Resynchronization Therapy and Implantable Cardiac Defibrillator. We have Cardiac CT (640 slice) that is advance and fast Technology and has made it possible to record coronary angiogram without placing catheters in the heart and without the risk associated with conventional coronary angiography. Shifa Heart Center including cardiology and cardiac surgery is considered one of the best heart health centers in Pakistan. We are into a fast expansion and improvement plan aimed at revolutionizing heart health facilities’ culture, some of the initiatives in this regard are mentioned below. a) Cardiac MRI Service: We are all set to offer this new and very exciting diagnostic modality full-fledged. It is currently being worked out and we hope we will be able to start the service with full strength in 4-6 weeks. Our goal is to establish a full time and dedicated cardiac MR and cardiac CT set up in next couple of years catering for the needs of the whole region. b) National Integrated Anticoagulation Service (NIACS): Anticoagulation is an important but unregulated and unmonitored therapy in our and most of the developing countries with sometimes catastrophic results. We are currently working on developing a comprehensive and integrated anticoagulation service in collaboration with our Hematology department and National University of Science and Technology (NUST) and Roche pharmaceuticals. Our aim is to provide an INR monitoring and appropriate dosage facility to our and other patients at their doorstep. Currently we are testing the INR testing portable equipment and also developing a software incorporating warfarin dosing algorithms. We have also arranged to acquire smaller strength warfarin for the patients. We hope after establishing the authenticity of the hardware and electronic algorithms, we will start a formal service by mid October, initially at the hospital and later through our outlets and other facilities throughout the region. c) Patient Education Program: We are currently working on a project to provide health education and information for general public in collaboration with NUST. This initiative is called IMPROVED or Improving Public Perception of Diseases. It will be in the form of pamphlets, newspaper articles, emails and mobile text. We hope to start it formally in October or November this year. d) Heart Failure Service: Chronic heart failure is widely prevalent condition with worst prognosis than certain cancers if not managed optimally. We intend to start a heart failure treatment optimization service for such patients in January next year. It will be supervised by the consultants and run by cardiology fellows and nurse practitioners. Patients will not only be provided support in the clinic but also through emailing, mobile
  57. 57. P a g e | 57 text and telephones. It will be a unique and pioneering service and will help establish our hospital in providing extensive and comprehensive health provider. e) Lifestyle Improvement Initiative: In the New Year we are planning to start an initiative and research study to help improve cardiovascular risks in general population. We have termed it INCREDIBLE or Initiative for Cardiovascular Risk Reduction through Dietary, Behavioral, Lifestyle modifications and Exercise. We will be looking for sponsors for such milestone study. It will be aimed at mainly younger and middle aged population with multiple cardiac risks of the capital city and beyond. We will incorporate cardiac rehab program into this initiative and utilize our cardiac rehab facility as a centre for education and exercise program, obviously introducing people to our resources. Cardiothoracic Surgery This is now a firmly established unit, which has completed a decade of its services backed up with internationally comparable results. Ever since its inception, this unit has stayed abreast with technological advancements. We were equipped with most modern heart lung machine, cell saver, high class instruments and IABP from the beginning. We have a latest ultra modern and highly sophisticated new Heart Lung Machine. We also have two systems of Beating Heart Surgery i.e. Genzyme and Medtronic in place which is used in performing procedures on beating heart. f) Cardiothoracic Surgery: This is now a firmly established unit, which has completed a decade of its services backed up with internationally comparable results. Ever since its inception, this unit has stayed abreast with technological advancements. We were equipped with most modern heart lung machine, cell saver, high class instruments and IABP from the beginning. We have a latest ultra modern and highly sophisticated new Heart Lung Machine. We also have two systems of Beating Heart Surgery i.e. Genzyme and Medtronic in place which is used in performing procedures on beating heart. Neuro-care at Shifa:“Our neurologists are highly qualified and trained in different subspecialties. Electroencephalography, nerve conduction studies and electromyography and evoked potential studies are carried out on the latest digital EEG and EMG machines. The addition of a 640 slice CT scanner and an open MRI to the existing CT and MRI machines has further enhanced our diagnostic capabilities in Neurology. The neurology section is providing cartoid artery stenting in collaboration with interventional cardiologists and interventional radiologist”. g) Orthopedics: Orthopedic is a field of surgery in which meticulous care to detail especially with aseptic conditions is absolutely essential The equipment used in surgery has to be of possible highest standards as well the availability of taking X-rays on the specialized orthopedic table with image intensifier and power instruments are some state of- the-art facilities that are available to Orthopaedics at Shifa. The department is staffed with highly qualified US & UK trained surgeons with special interest in trauma and joint replacement surgeries as well as paediatrics and spinal surgeries. This section
  58. 58. P a g e | 58 manages patients with musculoskeletal conditions such as bone and Joint injuries and degenerative joint diseases etc. It provides 24/7 trauma service to the Hospitals. Excellent results have been achieved in hip and knee joint replacement surgeries. Major procedures offered include management of fractures and dislocation, joint replacement, management of upper/ lower limb injuries, arthroscopy, arthrocentesis, muscle biopsy and management/correction of limb deformities. We have the honor of successfully performing the first ASI hip replacement surgery in Pakistan. Our Lead surgeon Dr Mir Amanullah Khan was assisted by Consultant Orthopedic Surgeon Colleague Dr. Sajjad Hassan Orakzai. Pioneering orthopedic surgeon Dr Erik De Witte from the General City Hospital (ASZ) in Aalst, Belgium, has specialized in these procedures. Since 2004, Dr De Witte, who retired on December 31, 2011 has performed the anterior supine intramuscular (ASI) approach in 3,500 hip replacements. Dr. Mir Amanullah Khan, Consultant orthopaedic surgeon at SIH, specializes in this approach for Total Hip Replacement surgery. He has been personally trained by Dr. De Witte in the intricacies of this procedure. Dr Khan has performed multiple combine procedures with Dr DeWitte, both in Belgium and UK. Unlike traditional minimally invasive hip replacement techniques, the ASI technique uses an incision at the front of the hip instead of the side or back of the hip. This modified incision placement allows surgeons to directly approach the hip joint by going between the muscles that surround the hip joint, rather than cutting them. Traditional approaches would require cutting the muscles and/or tendons that surround the hip. The ASI minimally invasive hip replacement procedure is designed to reduce the trauma to the tissues surrounding the hip joint. By preserving the muscles and tendons, surgeons may enable their patients to walk the day of surgery, to experience less postoperative pain, and to return to daily activities more quickly. The potential benefits of this technique include shorter hospital stays ( 2-3 days instead of 5-7), earlier mobilization ( same day walking), fast recovery, lesser blood loss, lesser pain and smaller incision (4-5 cm compared to 12-14cm with traditional incisions). h) Transplant & Urology: The treatment options provided by the section of Urology range from simple urinary tract infections, stones, prostate, diseases, infertility, and impotence to major urological cancer surgeries for kidney, bladder and prostate. All sorts of endourological procedures and re-constructive surgeries are done as well. The provision of renal transplantation has made this a comprehensive unit with internationally comparable results. Lithotriptor is available and helpful for patient with stones in kidney & urinary tract stones.
  59. 59. P a g e | 59 i) Ophthalmology: Ophthalmology at Shifa has become a state-of-the-art tertiary referral center for various types of eye diseases. It is equipped with all the latest equipment for diagnosis and treatment of eye aliments. The section does corneal transplant surgeries besides phacoemulsification, refractive surgeries, glaucoma management, vitreoretinal surgeries, pediatric ophthalmology & diabetic eye care etc. j) Plastic Surgery: Plastic Surgery Clinic was established in 2009 with 2 fulltime consultants and one part-time consultant, who soon after joined Shifa as fulltime consultant. From 150 major cases a year in 2009, we have become a busy clinic with 600 major cases a year now (in 2011). Plastic surgeries are tertiary referred cases and primarily they include reconstruction (major or minor) and micro vascular free tissue transfer. Plastic surgery clinic had marked their 100th micro vascular case (free flap) on June 2012, mostly referred by Ear, Nose, Throat (head & neck reconstruction post cancer), Orthopaedic and General Surgery (sarcoma & breast cancer). Plastic Surgery Clinic got its registration with the College of Physicians & Surgeons Pakistan in 2010 and currently enrolled for residents for FCPS in Plastic Surgery. The clinic is looking forward for performing craniofacial (head or skull plus facial structures) surgery in future.
  60. 60. P a g e | 60 2. Mother and Child Health a) OBS/ GYNE: The department of Obs/Gyne at Shifa International Hospital is one of the busiest and sought after departments. Being the only tertiary-care center in the north of Pakistan, it has become a referral center for the whole region. Obs/ Gyne department works in close collaboration with the department of Pediatrics, which makes it possible to save babies as small as 26-weeks old. The department centers almost all the major sub-specialties of Obs/ Gyne. It is amply equipped with almost all the main equipment for conventional surgical purposes. Besides equipment for conventional surgical procedures, we have the whole range of endoscopic instruments like hysterscopes, laparoscope etc. Laboratory facilities, Ultrasound, Radiology, and Fluoroscopic of the fallopian tubes, Mammograms, Antepartum and Intrapartum fetal monitoring are available 24 hours a day and seven days a week. The provisions of Spinal and Epidural analgesic are also available in the department round the clock. b) Pediatrics: Department of Pediatrics has been established since the beginning of Shifa International Hospital in 1993. The services available are out patient, inpatient, neonatal intensive care, pediatric intensive care. Department of Pediatrics has 73 beds, which includes 32 neonatal intensive care beds; there are about 3000 deliveries per year. 20 % of all the new born would need level-II or level- III care during their stay in the hospital. The pediatric Outpatient has turnover of more than 35,000 patients per year. The facility is considered to be the state of art in the region catering large area of northern Punjab, KPK, and AJK as well as neighboring Afghanistan. Department of Pediatrics have nine faculty members, all have post graduate degrees from USA, UK or Pakistan. The subspecialty services are offered in the disciplines of pediatrics gastroenterology and liver transplant, pediatric nephrology, urology, and renal transplant, pediatric hematology/oncology and bone marrow transplant. Two surgeons are on board that provide pediatrics and neonatal surgery, cardiac thoracic surgery. Department of Pediatrics has 19 postgraduates’ trainees and 6 house officers. Department provides primary care facility that includes routine check-up for the new born, vaccination, developmental assessment and treatment of common childhood illnesses Pediatrics emergency services provide 24 hours coverage via Emergency Department. Department of pediatrics is likely to have more beds in neonatal and pediatric intensive care units in near future., pediatric liver transplant service is expected to expand as people would come to know about this relatively new specialty in Pakistan. c) Pediatric Surgery: The section deals with the surgical treatment of children and newborn babies. It includes the surgery for all types of congenital and acquired diseases up to 12 years. Major procedures being performed include operations for complete anorectal, congenital defects of gastrointestinal tract and hernia repair, correction of undescended testes, hypospadias repair, cleft lip repair, all types of abdominal surgeries and correction of congenital birth defects.
  61. 61. P a g e | 61  3) Shifa Center of Liver Pancreas and Biliary Sciences (LPBS): We are rightly proud of our success in the last quarter of the previous year in very critical area of Liver Transplant. We are the only hospital in Pakistan to have carried out successful liver transplant. We started this journey in May 2012 and have done many Hepatobiliary & Liver Transplants so far. One of our objectives is to set up a Center of Excellence for Liver Diseases in Children. We are in the process of equipping our facility with the service-specific technology and developing infrastructure to cope with the increasing demand for Liver Transplant that has virtually deluged us. Simultaneously we are in the process of hiring highest quality human resource in all areas and from paramedical staff to medical professionals like dedicated liver intensitivist, anesthesiologist, pediatric gastroenterologists and more surgeons. a) Gastroenterology: This is perhaps the busiest section of the department of medicine. It is equipped with the latest video equipment like Gastroscopes, Colonoscopes and Duodenoscopes. We are pursuing to become an academic centre of excellence in Hepatopancreatobiliary diseases. The division is actively pursuing expansion of the services and also involved in the extensive research activities.
  62. 62. P a g e | 62 b) Critical Care & Pulmonary Medicine: Critical Care & Pulmonary Medicine has taken a new dimension at Shifa. In keeping with the International trends and concepts of “Closed ICU”, the patients are managed by the consultants trained in Critical Care and Pulmonary Medicine. The foreign trained and certified consultants are providing a variety of services to patients presenting with a variety of pulmonary problems. Bronchoscopy suite is equipped with two fiber optic Olympus Bronchoscopes. Other state of the art equipment includes new Raphael Silver Ventilators, Pulmonary Function Lab Vitalograph and BEARS Noninvasive Ventilator. We rightly take pride in the fact that after the expansion of our Critical Care Unit that is underway, we shall be offering 100 plus critical care beds which would be the largest number in a single hospital in Pakistan. c) Nephrology: Nephrology at Shifa is one of the key clinics of tertiary level care. Nephrology deals with the care of people having kidney disease of various stages, salt water and other electrolyte disorders and various types of therapies like dialysis and kidney transplant. Over a period of 20 years, Nephrology has grown up from a team of just two nephrologists to a team of three Nephrologists and eight FCPS trainee Fellows. Our fellows will start graduating from 2013. Dialysis at our unit was started soon after the start of the hospital. Our dialysis unit has grown up from just couple of machines to six machines about eleven year ago, and now we have 33 machines. The dialysis unit is open 24/7, even on the holidays. The number of the dialysis has increased from couple of hundred patients per month to 2000 per month. Our dialysis staffs are quite competent and hard working and eager to come up to the expectations of the patients. We have started CRRT treatments for critically ill patients. We also perform kidney biopsies and dialysis access of all kinds is made at our hospital period. We have an active living related kidney transplant program. Our next few years we would like to initiate peritoneal dialysis program. We would like to have a custom made dialysis unit with 50 stations and build a chain of satellite dialysis units in various parts of the country where our trained fellows can facilitate patients near to their homes and start their career in Nephrology. d) Allergy/ Clinical Immunology: The section of Allergy/Clinical Immunology caters to a wider number of allergies related afflictions including bronchial asthma, allergic rhinitis, allergic conjunctivitis, skin rashes/itching, allergic contact dermatitis, atopic eczema, allergic drug reactions, food allergies, pollen allergies and recurrent infections. The section led by an experienced board certified consultant, also conducts allergy skin tests with various techniques. Allergy vaccination injections (immunoa therapy) are also available. The Allergy clinic also deals with life threatening anaphylatic disorders and insect sting allergies, and also offers environmental control methods e) Endocrinology: Diabetes and its complications constitute a major segment of our patients coming to Endocrinology. At Shifa our Endocrinology department is busy in taking care of these and other endocrine patients. Teaching of insulin use, diabetic diet,
  63. 63. P a g e | 63 diabetic foot care and prevention of the complications of diabetes are the areas where we are making a difference in the life of these patients. f) Psychiatry: The department of Psychiatry is recognized for its expertise in the provision of clinical, academic and therapeutic services to adults and old age people in the behavioral and psychiatric disorders. The department also offers personal psychotherapeutic care for individuals, couples and families with emotional and psychological distress. The department also offers long-term care to address drug addictions and related psychiatric disorders. The multidisciplinary team includes consultants with training from prestigious international institutions. g) Dermatology: Dermatology at Shifa provides best facilities for the diagnosis and treatment of skin, hair, and nail diseases. Electrocautery, cryotherapy and surgical procedures to remove moles, cysts and warts are some of the services being offered here. h) Nutrition Clinic: Nutrition is a scientifically rigorous discipline that focuses on the impact of food habits on health and disease management. Globally, nutrition is considered to be an integral part of the medical care of all patients. Nutritional therapy leads to a nutritional prescription, which may include an oral diet plan, anteral and parenteral nutrition for the caring of hospitalized and home patients. Latest dietary delivery techniques are used to administer nutrients both safely and effectively. Clinical services provided by the nutrition team includes; outpatient and inpatient consultation, home nutritional support educational programs for patients, clinicians and professionals. Additionally, our department offers special programs related to weight management, hyperlipidemia, diabetes, eating disorders and hypertension treatment. The program offered by the Nutrition Clinic is supported by the latest computer-based assessment that ascertains the exact amount of fat, lean body mass, water content and basal metabolism of the individuals, which can lead to very precise diagnosis and treatment. Every nutritional plan is tailored to the specific need of individual patients. i) Anesthesiology and pain medicine: Anesthesiology department is providing state-ofthe-art care for all types of surgical procedures, including but not limited to, adult cardiothoracic, congenital cardiac, neurosurgical, major vascular, transplant, general surgical, urological and Ob/Gyne surgeries. They are also providing anesthetic care to MRI, CT and ultrasound guided procedures etc. The department also provides additional anesthesia services like pre-anesthesia evaluation, epidural anesthesia, patient controlled analgesia, acute pain management and chronic pain management. Our anesthesiologists are highly qualified professionals who have been exclusively trained in US, UK and Pakistan. Our anesthesiology program is fully recognized for PG training by College of Physicians & Surgeons of Pakistan. The department has nine stateof- the-art Operation Theaters, which are equipped with the most modern and latest instruments and equipments. Excellent infection control is the hall mark of our operation theaters. Our Pain Management clinics cover prevention, treatment and alleviation of chronic and acute pain like cervical and lumbar radiculopathies, arthritis etc. We have modern modalities and highly trained therapists are available for managing pain. Patients of Cervical spondylosis, lumbar spondylosis etc. can get benefit from this service. Our pain management team includes medical practitioners, clinical psychologists, physiotherapists, occupational therapists, and nurse practitioners. We are the only private hospital in the Capital City offering Pain Medicine facility.

×