The document summarizes the evolution and operational styles of Sri Jayadeva Institute of Cardiovascular Sciences and Research (SJICSR) and Narayana Health (NH). SJICSR started in 1979 with 20 beds and has expanded to 640 beds, performing the highest number of cardiac procedures in India. NH was founded in 2001 and has grown to 5,600 beds across 16 cities, performing over 100,000 cardiac surgeries. Both institutions are committed to providing affordable healthcare. They utilize similar operational styles around vendor management, software use, and utilization of equipment to reduce costs. NH also has unique styles like salary structures and medical team approaches.

1. Operational
Efficiencies:
Presented by Group 4:
REG# 02, 07, 08, 10, 20, 25, 30, 38.

2. Contents
▪ Vision, Mission & Values
▪ Evolution
▪ Focus Areas
▪ Similar Operational Styles of SJICSR & NH
▪ NH Unique Operational Style

3. Our take away:▪ Vision, Mission & Values
• Both the institutes have committed to provide
high quality services to all.
• Affordability for the poor
• Passionate about Patients health
• Innovate & Efficient
• Retain long term values with others
• Both institutes have there own unique
strategies
• Government v/s Private Sectors heath care

4. Highlights
• In 28 years started as small wing in
Victoria hospital complex has now
massively grown into 3 different
locations
• From 20 beds with least facility its now
expanded to 640 beds, 7 Cath Labs,
7 OT’s and 24hrs ICU facilities
• Average of 1K to 1.2K patients visit
every day
• Around 23K In-patients are treated
annually
• Jayadeva is the largest cardiac health
care destination in South East Asia.
▪ Evolution @ SJICSR
▪ In March 1979, it started as a separate and independent Institute of
Cardiology at the Victoria Hospital Complex, Bengaluru.
▪ Initially it had a bed strength of only 20 which became 65 in the year 1982,
today it has got 640 bed strength with the State of art equipment in the
form of 7 Cath Labs, 7 Operation Theatres, Non-Invasive Laboratories
and 24 hours ICU facilities.
▪ Presently, on an average 1000-1200 patients are visiting this hospital
everyday and annually 34,942 In-Patients are treated.
▪ Annually about 3000 Open Heart Surgeries, 14,842 Coronary
Angiograms, 6,926 Procedures including Angioplasties and
Valvuloplasties, Device Closure, Pacemaker [Highest numbers in the
country] are done in this hospital.
▪ Sri Jayadeva Institute of Cardiovascular Sciences and Research is an
Autonomous Institute run by Government of Karnataka in Bengaluru

5. Highlights
• Massive improvement in 13 years from
225 beds hospital to 5600 beds across 16
cities
• 13K employees and 1.5K doctors
• Motivated by the thought that India has
many good hospitals, but not affordable to
the poor sections
• Founded by Dr. Devi Shetty in 2001
• 100K cardiac surgeries and 250K Cath
lab procedures
• 343 Daily average surgeries and
procedures.
• India’s Second largest healthcare operator
▪ Evolution @ NH
▪ In 2001, he founded Narayana Hrudayalaya (later renamed Narayana
Health or NH) in Bangalore with a mission to take affordable health care to
the people.
▪ Started as a 225-bed hospital has, in the last 13 years, grown to become
a 26-hospital network with 5,600 beds across 16 cities employing 13,000
people and 1,500 doctors
▪ Performed over 100,000 cardiac surgeries and 250,000 cath lab
procedures. The group performs 150 major surgeries (including 44 cardiac
surgeries) daily.
▪ NH says about 12 per cent of all cardiac surgeries done in the country are
performed at its hospitals and 50 per cent of its patients are from the
economically-weaker sections

6. Birds Eye
• It its owned by GOK, with good name and
fame
• Yields good results at economic cost
• Now focusing now on Diabetic sector as well
in addition it has own education wing on
Cardiac sector
• Contributes on research articles to domestic
and international journals
• Other GOK related bodies gets additional
benefits
• Created a platform to showcase talents for
international doctors.
• Adopting latest technology to serve better
Government of Karnataka owned medical institute
One of the largest heart hospitals in Asia Pacific region
Country’s biggest Post-Graduate courses
Published 25 Research articles in National and International journals
Credit facilities are provided for Government servants KSRTC, BBMP,
KSDL, BMTC, ISRO, etc
It is attracting overseas doctors from France, Argentina, USA, Middle
East, Ireland, Chine and UK for training Program in various procedures
Jayadeva has also started an institute called as ‘'Karnataka Institute
of Endocrinology and Research' (KIER),
Focus Areas of SJICSR

7. Key Points
• Adopting latest technology and. In order
to keep the capital costs low, machines
are leased on a pay per use basis -
wherever possible.
• Proven CoE in Cardiac & Renal Sciences
• Has its own trust for CSR activities
• Well known for economical cost related
to cardiac care
• Also provides few courses in various
streams
• The hospital has set up a central buying
unit (CBU) and standardised purchase of
consumables and devices
• It deployed its enterprise resource
planning (ERP) on the cloud rather than
setting up data centres. This not only cut
initial costs but was easily scalable. The
IT system helps NH in many ways
Focus Areas of NH

8. Similar
Operational
Styles
@

9. Vendor Management
SJICSR
• Director has been provided to decide
with respect to procurement on an
annual basis with cap of the budget
• GOK and the committee has to take a
call for any huge deals to be done.
NH
• Bulk Orders for optimal cost
• No same vendor is continued if cost is
not working out
• Narayana Health negotiates with vendors and thus
tries to buy items at economical cost rather than
continuing with same vendor
• They focus on more volumes to so as to get raw
materials at economical rates
• Focus on more volumes while procuring surgical
instruments
Source BY-LAW document from website

10. Software's
SJICSR
• Integration of software’s along with in
house software for queue management
and database.
• Reports are being prepared n parallel to
related tests – Don’t have to wait
separately
NH
• ERP System cultivation, no maintenance
of hardware’s / servers and associated
technical staff
• ERP software are used to inform doctors
on appointments & surgeries schedules.
Also cover other departments and connect
related information's.
• ERP is used to measure machines work
loads
▪ SJICR : it has completely automated the Billing and Registration
procedure. This has been implemented by Srishti Software using their
in-house product 'PARAS-HIS‘, which is a bottleneck area for most
hospitals.
▪ The registration module tracks the revisits of patients and bills them
accordingly. The complete investigation, diagnosis rate list has been
entered in the database already with respect to the different schemes
(CGHS, Arogya Bhagya, Yeshaswini etc). This leads to faster data entry.
▪ The report is typed almost in parallel when we are undergoing a test like
echo. You get reports immediately after the tests
▪ It deployed its enterprise resource planning (ERP) on the cloud rather
than setting up data centres. This not only cut initial costs but was easily
scalable. The IT system helps NH in many ways
▪ A management software in place, which ensures that all the activities and
usage of all machines are done with maximum efficiency

11. Utilization & Maintenance
SJICSR
• It has separate equipment's for In-
house patients and separate for OPD
• Fixed amount is decided on annual
basis if any repairs are required.
Decisions left to Director
NH
• Maximum utilization of equipment's
with respect to time and load along
with maintenance
• Multiple machines for blood test
• Digitalization approach to reduce cost
Source BY-LAW document from website
Maximum utilization of infrastructure Example: while most hospitals
employ their CT scanners, MRI and other machines for only eight
hours a day, NH uses them for 14 hours daily, taking care of its
proper maintenance too.
500 blood tests on a machine everyday whereas it is just 2 in other
hospitals
The institution implements cost saving methods such as digital X -
rays rather than use the more expensive films

12. Schemes
• Both support unique schemes for
people who has insurance and for lower
economical class who can or cannot
afford operation cost
• For BPL holders various government
related schemes are applicable.
▪ Yeshasvini
▪ Arogya Bhagya
▪ Insurances. etc.,
▪ Suvarna Arogya Chaitanya Scheme for Children.
▪ Provides credit facilities for Government employees
• Karuna Hrudaya scheme for financially unsound patients where they pay only
RS.65,000 for OHS , rest paid by NH
• Narayana Hrudayalaya Trust which arrange funds to people who cannot afford to
pay from donations
• Railway Clinics
• Mobile mammography screening unit in a bus for free of cost

13. Unique
Operational
Style
@

14. Unique Operational Style
• Doctors get fixed salary rather than a % of revenue
• Spends only 22% on its staff salaries
• Open heart surgery at the most economical rate and as low as RS.1,10,000
• NH leverages the hierarchy of medical talent in optimizing its surgical procedures.
• They also control the design and construction of hospital building in such a way as to bring down the costs very low
than benchmark costs
• In Cayman Islands , it chose to use the cold water available from the sea to replace the energy intensive refrigeration
system, which saves 90% energy
• The institution has also setup embedded heart centers in other hospitals such as Chinmaya Mission, MS Ramiah
Mission and St. Marthas - on a revenue sharing basis.

15. Unique Operational Style
• Its doctors operate in medical teams that comprise of a specialist, junior doctors, trainees, nurses and the paramedical
staff.
• A bypass surgery typically takes about five hours. The critical surgical process of grafting takes only one hour, and is
carried out by the specialist
• The junior doctors harvest the veins/arteries, open and close the chest, and carry out the suturing.
• The nurses and the paramedical staff help to prepare the patient for surgery
• This arrangement saves the specialist’s time, and leaves him free to perform more surgeries.