Service Management Hospitality and Health Care Services

MR.T.SOMASUNDARAM
ASSISTANT PROFESSOR
DEPARTMENT OF MANAGEMENT STUIDES
KRISTU JAYANTI COLLEGE (AUTONOMOUS)
BENGALURU
UNIT 4UNIT 4
Health Care
Services
Unit 4– Hospitality & HealthCare Services 1

UNIT 4UNIT 4
Hotels; facilities; the guest cycle;
classification of hotels; marketing
mix of hospitality industry –
hospital service management –
facilities;personnel; administration;
hospital service extensions –
pharmacy; Mid Wife; Marketing
the medical transcription services.

HOSPITALITY INDUSTRYHOSPITALITY INDUSTRY
Introduction:
 Hospitality is the act of kindness in
welcoming and looking after the basic
needs of customers or strangers, mainly
in relation to food, drink and accommodation.
 it refers to relationship process between a customer and a
host.
 it refers to company or organizations which provide food or
drink or accommodation to people who are “away from
home”.
 it is unique in nature and strong emphasis on human
exchange in service delivery processes. 3

HOSPITAL – EVOLUTIONHOSPITAL – EVOLUTION
 Establishment of health care units are called
“HOSPITALS” in ancient time culture, religion and
medicines are linked.
 “Asclepius” was healer – god in Greece temples, that is
admitting the sick persons and priests would wait for the
direction.
 In 291 B.C., Rome was performing similar rites as that of
Greek temples and have authorities to admit sick persons.
 First institution created specifically to care for sick
appeared in India.
 Brahmanic hospitals were established in Sri Lanka by 431
B.C.
 King Ashoka founded 18 hospitals in India in 230 B.C. 4

 “Sushruta” performed first operation and then on, the
surgical treatment gained momentum.
 Academy of Gundishapur in Persian Empire, commenced
the first teaching hospital.
 In 100 B.C. Romans created “Valetudinaria” for the care of
sick slaves, gladiators and soldiers.
 Concept of “Care” was expanded by churches for all
including the sick.
 In 325 A.D. in Nicaea, the church to provide care services
to sick, poor, widows and strangers.
 In 8th
and 12th
centuries, Muslim hospitals developed a high
standard of care.
 In 9th
and 10th
century, they employed up to 25 staff
physicians and separate wards.

 China also operated hospitals during 1st
millennium A.D.,
Europe in between 16th
& 17th
centuries.
 In 18th
century, the modern concept of hospital was
emerged.
 In 1724, Guy hospital was started in London by wealthy
merchant by name Tomas Guy.
 1st
hospital started in U.S.A. in British American Colonies.
 In 1751, Pennsylvania General Hospital was founded in
Philadelphia.
 In mid 19th
century, Europe and U.S. established variety of
public and private hospitals.
 Nowadays, in India and other parts of world, hospitals with
different types was emerged and developed into specialty
hospitals.

HOSPITAL – CONCEPTHOSPITAL – CONCEPT
 It is the institutions work for people suffering from pain
and illness.
 Patients remember hospital even after discharged, because
of overall atmosphere.
 It is a place for ailing persons to take medical treatment for
specific diseases.
 Hospital may be good or bad, which was decided by quality
of doctors, medical facilities and administration.
 In middle ages, it was serving other functions as “Alm
House” for poor, pilgrims, later in Latin word “Hospes”
means “Host” and now it was termed as “Hospitality” and
“Hotel”

Two categories of patients come to hospital –
i) Outpatients – came for diagnosis and therapy and leave
the place after treatment gets over.
ii) Inpatients – admitted to stay overnight or for several
weeks or months.
 Best known hospital is “General Hospital” deal with many
kinds of diseases and injury and emergency ward to provide
services.
 it has intensive care unit, surgery, child birth, laboratories,
X – ray unit, blood bank, etc.
 Specialized hospitals like Heart foundation, kidney
foundation, child care, trauma centres, fertility centres, etc
for different problems.
 Hospitals have single building or campus along with
medical research and nursing home for better services. 8

HEALTH CARE – CONCEPTHEALTH CARE – CONCEPT
 “Health is Wealth”, “Health is lost, something is lost” is
saying, where every individual like to have sound health.
 “Health Care” is a concept which tells every one to take
care of health, so that one can have a sound physical body
which motivates to maintain sound mental health.
 Every individual is cautious about maintaining health and
tried to prevent any type of disease. (i.e.) Prevention is better
than cure.
 Uncontrollable factors like no quality in food, not having
congenial living place are bound to get some diseases.
 it occupies major position and increased significantly like
yoga kendras, health clinics, laboratories, gymnasiums,
nature care centres, etc. Unit 4– Hospitality & HealthCare Services 9

CHARACTERISTICS OFCHARACTERISTICS OF
HOSPITALITY INDUSTRYHOSPITALITY INDUSTRY
Some of the key characteristics of hospitality industry are:
1. Product – Service Mix:
- customers rarely consume pure products but a mixture of
products and services.
(E.g.) food in restaurants and facilities in hotel rooms.
It covers both –
a) Tangible services – a glass of house wine, well groomed
service staff and decoration of restaurant.
b) Intangible services – comfortable dining atmosphere,
friendly attitude of staff
- both services are imitated by competitors, hospitality
operations and more resources for standard service. 10

2. Two – way Communication:
- it requires involvement and participation of both customers
and service staff in service delivery process.
- interactions with customers based on their needs and
expectations will improve customer satisfaction.
- interactions between staff or inter departments involve team
work and exchange of information within organization.
3. Relationship building:
- building long term relationship with customers benefit the
organization for stable revenue.
- to develop brand loyalty, different methods like membership
programmes gives privileges and incentives to customers.
- informal ways of building friendship with customers win
customer loyalty for long run.
11

4. Diversity in Culture:
- customers or staff are experiencing a delivery in culture through
interacting with others.
- staff who have interaction with customers from different region
with different background and culture.
(E.g.) from customer perspective, abstain from meat may be religious
beliefs or habit, so restaurants should provide vegetarian food to
satisfy their needs.
5. Intensive Labour:
- it requires a huge supply of labours to create a memorable
experiences for customers.
(E.g.) one-to-one services in 5 star hotels.
- care generally expect high degree of human contacts and
personalized service.
- it need high demand for labour and willing to spent time and join
workforce in hospitality industry. Unit 4– Hospitality & HealthCare Services 12

SCOPE OF HOSPITALITYSCOPE OF HOSPITALITY
INDUSTRYINDUSTRY
 “Guests” means those who are away from their homes,
hospitality industry overlap with tourism industry to certain
extent.
 It not covers all lodging and food service operations but also
tourism related operations like airlines and theme parks.
 It is a part of wider group of economic activities, but not all
hospitality businesses are profit – making business.
Two main business sectors in hospitality industry are:
i) Accommodation – to provide accommodation for people far
away from home.
ii) Food and beverage – to provide food and beverage to local,
commuting and tourists.

A Manager in the hospitality industry follow three objectives:
a) Making the customers feel welcome personally.
b) Making things work for the customers, and
c) Making sure that the operation will continue to provide
service and meet its budget.
Hospital Development:
Health hazards are increasing continuously for two reasons:
i) Out of natural issues such as change in climate, old age
problems, etc.
ii) Hazard emerging out of human factor.
 Hospital services occupied prime place in society as every
human beings needs health care service.
 Due to increase in population, it is unable to provide basic
amenities and created way to increase health hazards. 14

Educated or Uneducated people not adapting food habits,
nutritional values of food and not maintaining sanitary
conditions, which leads to health problems.
Hospital development should focus on varieties of health care
services for curing diseases.
They have responsibility of improving quality of services by
adding value to each services.
Health Care Information System should be innovative to reach
intensive people for availing basic medical facilities.
Development of hospital is at bottom level, specialty hospitals
are emerging in big way in private sector.
Administrators of hospitals in government sector have to change
their attitude, adapt latest technologies in services.
Administrative machinery should have complete knowledge
about hospital operations and its structure differs based on size
and nature of hospital and type of services provided. 15

HEALTH CARE SERVICESHEALTH CARE SERVICES
Some of the Health Care Services are:
1. Environmental Health Services:
It includes –
a) Water supply b) Pollution Control
c) Sewage disposal d) Food hygiene
e) Ecology and Environmental pollution.
2. Public Health Services:
It includes –
a) Control of communicable diseases.
b) Sanitation. c) Maternal and Child health
d) Public health education e) Vital statistics

f) Health Planning
g) Occupational health and reduction of health hazards.
- it has greater impact on improving health than personal
health care services.
3. Personal Health Services:
- this services provided by hospitals, health centres and
nursing home.
It is classified into –
a) Promotion of health b) Prevention of diseases
c) Early diagnosis and treatment
d) Rehabilitation
- it is achieved as joint function of professional groups like
doctor, nurses, paramedical workers, health visitors for
sharing common goal. (i.e.) service 17

CHANGING ROLE OF HOSPITALSCHANGING ROLE OF HOSPITALS
Due to growing awareness and change in perception of
hospitals, which emphasis of medicine now is on “care”.
Some of the factors that led to changing role and function of
hospitals are:
a) Expansion of clientele from dying, destitute, poor and
needy to all classes of people.
b) Improved economic and social status of community.
c) Control of communicate disease and increase in chronic
degenerative diseases.
d) Progress in means of communication and transportation.
e) Political obligation of government to provide
comprehensive health care.

f) Increasing health awareness.
g) Rising standard of living especially in urban areas and
socio political awareness in semi – urban and rural areas.
h) Control and promotion of quality of care by statutory and
professional association.
i) Increase in specialization where need for team approach to
health and disease is now required.
j) Rapid advances in medical science and technology.
k) Increase in population requiring more number of hospital
beds.
l) Sophisticated instrumentation, equipment and better
diagnostic and therapeutic tools.
m) Advances in administrative procedures and management
techniques.

n) Reorientation of health care delivery system with emphasis on
delivery of primary health.
o) Awareness of community.
 Wide coverage of human welfare as part of health care like
physical, mental and social well being, community, training of
health workers, bio social research, etc.
Role of hospital changed with emphasis shifting from –
i) Acute of chronic illness.
ii) Curative to preventive medicine.
iii) Restorative to comprehensive medicine.
iv) Inpatient care to outpatient and home care.
v) Individual orientation to community orientation.
vi) Isolated function to area – wise or regional function.
vii) Tertiary and secondary to primary health care.
viii) Episodic care to total care. 20

HOSPITALS AS A SOCIAL SYSTEMHOSPITALS AS A SOCIAL SYSTEM
 First task of hospital is to reach all people all time at cost the
community can afford.
 It is centre of home care service and centre of preventive
medicine has enlarged its role.
 The primary task of hospitals is provision of medical care to
community.
The other two important roles to fulfill are:
a) to be a centre for education of all types of health workers,
doctors, nurses, midwives and technicians.
b) to be a centre for health education of people.
- increasing demand for better standard of living and health
awareness of people have significant effect on hospital system
and trend of services provided by hospitals.

Components of a Hospital System
Hospital System
Cure subsystem Care Subsystem
Diagnostic
Subsystem
Therapeutic
Subsystem
Supportive
Subsystem
Nursing
Subsystem
Minor Subsystem
Administrative Circulation SocialTechnicalEnvironment

The activities of present day hospital divided into two types:
1. Intramural Activities:
- it is confined within the walls of hospital are known as
intramural activities. It includes functions like –
a) Restorative:
i) Diagnostic – it include patient service involving medical,
surgical and other specialities.
ii) Curative – treatment of all ailments.
iii) Rehabilitative – physical, mental and social rehabilitation.
iv) Care of emergencies – accidents as well as diseases.
b) Preventive:
i) Supervision of normal pregnancies and child birth.
ii) Supervision of normal growth and development of children.
iii) Control of communicable diseases.
23

iv) Prevention of prolonged diseases.
v) Health education and Occupational health.
c) Education:
i) Medical undergraduates.
ii) Specialists and post graduates.
iii) Nurses and Midwives.
iv) Medical social workers.
v) Paramedical staff and Community health education.
d) Research:
i) Physical, psychological and social aspects of health and
disease.
ii) Clinical medicine.
iii) Hospital practices and administration.

2. Extramural Activities:
- these are services which radiate outside the
hospital and to home environment and community.
It includes –
a) Outpatient services.
b) Home care services.
c) Outreach services.
d) Mobile services.
e) Day Care centre.
f) Night Hospitals
g) Medical care camps.

HOSPITAL AND COMMUNITYHOSPITAL AND COMMUNITY
- the ultimate purpose of health services is to meet
effectively total health needs of community.
Some of the factors that determining health requirements are:
1. Demographic factors – age, gender, marital status, family,
family composition and education level of people in
community.
2. Enabling factors – family financial resources, family
relationships in household, availability and accessibility of
services, behaviour of people towards product, attitude, etc.
3. Internal or Health System factors – comprise of manpower
availability, physical facilities, organization and structure
and interface with users.

4. External factors – it covers political will towards general
well being, social and administrative machinery available
to implement various suggestions and recommendations.
A good hospital build its services by depending on
involvement of many groups both professional within and
outside the hospital. They are:
a) Providers – they are the providers of medical care like
doctor, nurses, technicians and paramedical personnel.
b) Support Group – this is management, administrative and
support group dealing with non – clinical functions of
hospitals like diet, supplies, maintenance, accounts, house
keeping, water and ward, etc.
c) Community – it benefit two groups, (i.e.) patients who seek
hospital service and their attendants, relatives and
associates who along with patient in close contact. 27

HOSPITAL – COMMUNITYHOSPITAL – COMMUNITY
RELATIONSHIPRELATIONSHIP
 Conflicts between two groups like care providers and
intermediate support group with patient and community
under normal circumstances.
 People go to hospital with great expectations that every
disease is fully and quick curable.
 Every patient expects sympathetic understanding of
behaviour of patient and his attendants and relatives.
 Cure is more important than care of patients.
 Respect the dignity of patient is one of the most basic rights
and needs of patients.
 Concern for care of human being as a whole needs
contribution from everyone working in hospital.

PRIMARY HEALTH CARE ANDPRIMARY HEALTH CARE AND
HOSPITALSHOSPITALS
PHC is providing comprehensive health care (i.e.)
promotive, preventive, curative and rehabilitative services.
Hospitals have important role in fostering and encouraging
growth of PHC.
Health dependent on economic conditions and correlated to
social and cultural values of society, quality, quantity and
content of health services.
Some of the essential eight elements of PHC are:
1. Adequate Nutrition.
2. Safe and adequate water supply.
3. Safe water disposal.
4. Maternal and Child health and family planning services.Unit 4– Hospitality & HealthCare Services 29

5. Prevention and control of locally endemic diseases.
6. Diagnosis and treatment of common diseases and injuries.
7. Provision of adequate drugs and supplies.
8. Health Education.
Tremendous costs incurred every time a patient is treated in
hospital who can treated in an efficient PHC facility which is
inexpensive can be avoided.
Opening PHC units within premises as first entry point to
hospital for such routine direct cases will reduce avoidable
routine workload for specialized Outpatient Departments
(OPDs).
PHC units can also utilized as laboratories for
experimentation with different models of primary health
care after research.

Position of General Practitioners (GPs) in providing
primary health care and potential for integrating their
activities with other health personnel.
Every hospital have to prepare a PHC policy and strategy.
Policy statement should outline the essential points and list
of actions needed to ensure putting policy into actions.
Hospital’s effective involvement in PHC require much
broader vision than care alone and broader range of action.
Hospital may either assume a lead role in organizing PHC
for population or play a supportive role.
Hospital is in a position to effectively supervise and
monitor PHC work, to provide primary care through
hospital staffed mobile and outreach clinics.

Referral Functions of Hospitals:
1. Organizing a two way referral system from mobile and outreach
clinics to hospital and referral back with reports for follow up.
2. Backing up the referral system with medical records.
3. Organizing visits of hospital specialists to outreach clinics.
4. Carrying out training and reinforcing skills at PHC workers by
visiting specialists.
5. Giving preferences to patients referred from PHC centres for
specialized clinics and for admissions.
Support Functions:
1. Providing logistics support in respect of equipment, materials, drugs
and other supplies.
2. Reinforcing diagnostic capabilities of PHC workers and outreach
clinics.
3. Providing transport for referrals and outreach services.
4. Making hospitals facilities available for training and retraining of
32

HOSPITALS IN INDIAHOSPITALS IN INDIA
Indian rules considered the provision of institutional care to sick
as spiritual and temporal responsibility.
During 6th
century BC, famous surgeon and physician
considered standard works for creation of hospitals and provides
children rooms, maintenance and sterilization and other medical
appliances.
Most notable of early hospitals were built by King Ashok (273 –
232 BC).
Age of Indian medicines started its decline from Mohammedan
invasions in 10th
century, who followed the Greek system of
medicine came to be known as “Yunani”.
This system and its physicians started to prosper at expense of
Ayurveda and Vaidyas and influence of Ayurveda continued in
South. Unit 4– Hospitality & HealthCare Services 33

Modern medicine system in India was introduced in 17th
century with arrival of European Christian Missionaries in
South India.
British Empire in India established its 1st
hospital in 1664 at
Chennai for its soldiers and 1668 for civilian population.
In 18th
and 19th
century, growth of modern system of medical
practice and hospitals.
First medical college opening in Kolkata in 1835, followed
in Mumbai in 1845 and Chennai in 1850.
Many hospitals and dispensaries originally started for army
personnel and handover to civil administrative authorities
for treating civil population.
After independence in 1947, 7400 hospitals and dispensaries
in country with 47000 doctors, 7000 nurses, 36 medical
colleges in the country. Unit 4– Hospitality & HealthCare Services 34

Government need to take stock of health care status of
country and plan appropriate measures for development of
health care delivery system.
Some of the committees like Bhore committee in 1943,
Mudaliar committee in 1959, Hospital Review committee
in 1968 to make necessary recommendations.
In 1910, British Govt. established of station hospitals for
Indian Troops of British Army and proposals were
established in 1918.
As a result 148 hospitals were established.
Second world war and Chinese aggression in 1962 resulted
in expansion and modernization of hospitals.
Tremendous growth in medical resources but still they have
not been able to cope with increasing demand due to
unchecked growth of population. 35

INDIAN HEALTHCARE INDUSTRYINDIAN HEALTHCARE INDUSTRY
Indian healthcare industry is undergoing expansion and
private hospitals invest in public health programmes are
driving boom.
Health infrastructure serves a population of over 1 billion,
growing at about 2% annually, over 300 million strong
middle class, driving demand for quality healthcare.
Costs of advanced surgeries in India are 10 – 15 times lower
than anywhere in world..
Strategic opportunities for foreign investment and
collaboration mark leading Indian hospitals for global
expansion plans and estimated growth are: 15,000 hospitals,
8,75,000 hospital beds, 5,00,000 doctors, 7,37,000 nurses,
170 medical colleges, 3,50,000 retail chemist outlets.

Policy Initiatives:
Health administration in India is governed by Ministry of
Health and Family Welfare, which has three departments:
 Department of Health.
 Department of Family Welfare.
 Department of AYUSH (Ayurveda, Unani, Siddha and
Homoeopathy)
Central administration provides co-ordination and direction
to a network of health ministers.
Central Council of Health & Family Welfare includes health
ministers and secretaries from all India states in primary
advisory and policy making body for health care.
Budgetary outlay for health services increased at over 15%
per year and many governments sought funding for upgrading
health infrastructure. Unit 4– Hospitality & HealthCare Services 37

Key Policies milestones:
Government liberalized entry norms in health care industry for
private in 1980s.
Health insurance market was opened to private competition for
General Insurance Corporation’s Mediclaim in April 2000.
Government of India’s National Health Policy (2002)
envisages overall increase in health spending to 6% of GDP by
2010.
Incentives for Health Care Industry:
Infrastructure status conferred on healthcare industry.
Reduction on import duty on medical equipment (25% to 5%).
Depreciation limit on such equipment raised to 40% from
25%.

Customs duty reduced to 8% from 16% for medical,
surgery, dental and veterinary, 5% reduced to x-ray,
teletherapy simulator machines.
Government announced income tax exemptions under
section 80 1B.
Budgetary allocation to health care is 2% of GDP.
Customs duty exemption on items like writers and
typewriters, hearing aids, lifts, wheel chairs, crutches,
artificial limbs, etc.
Launch of new group health insurance scheme through
public sector non – life insurance companies.
56 million will be earmarked for HIV / AIDS control
programme through the use of primary health centres,
preventing of drug abuse, etc.

Rising Demand for Quality Healthcare:
In between 1993 – 94 and 2001 – 02, aggregate household
expenditure on health services increased at annual
compounded rate of 9.3%.
Multi-specialty private hospitals are preferred even if
consumers bear this expenses personally.
No. of Indian private sector companies have set up hospital
facilities and clinics. (E.g.) Apollo, Max, Fortis, etc.
Private hospitals account over 32% of hospitals beds in
India providing health and medical care services, open-heart
surgeries and kidney transplants.
 Premier players in diagnostic services are Ranbaxy,
Metropolis Health Services, etc.
It need infrastructure facilities, catalyst in
40

Increasing penetration of private health insurance with
growing awareness levels and increasing affordability
arising out of growth of private health insurance.
Insurance market, including health insurance was opened to
private companies in 2000 shows considerable growth.
In 2003, health insurance premia in India crossed US$ 222
million, highest in non life insurance category.
Use of information technology in Health care sector.
Development of Indian health care sector in use of
information technology for upgrading delivery of health
care services.
(E.g.) Computerization of medical records, networking of
various departments in a hospital, providing tele – medicine
services.

Selected Domestic Players in Indian Health Care Sector:
Apollo – 35 hospitals over asian sub continent, 130 retail
pharmacies (Open – heart surgery, angioplastic surgery,
renal transplants).
Escorts Group – cardiac treatment, multi specialty care,
neurology, neurosurgery, plastic surgery, urology, 9
operation theatre, 5 cath labs and world class facilities.
Fortis Health care –multispecialty healthcare centre.
Max Health care – diversified Max group, super specialty
hospital and diagnostic centres.
Wockhardt – leading pharmaceutical and health care
companies.
Aravind Eye Hospital – eye surgery in world (south india
hospital)

Bayer Diagnostics – largest diagnostic centre, manufacture
of chemical and immuno chemical test systems, medical
diagnostic equipment and electrolyte serum analyser.
GE – BEL – joint venture of GE and Bharat electronics
limited, manufacturer of X – ray and CT Tubes in South
Asia.
Philip – tele medicine, with its Distance Health care
Advancement. Proton health care in India with its range of
digital health monitoring devices like BP monitors,
ultrasonic, etc.
Siemens – manufacturer of medical equipment with large
market share of more than 30% in India.
Wipro GE Medical Systems – joint venture of GE and
Wipro corporation, largest medical systems sales and service
provider. (Ultrasound and CT Scanner systems). 43

Risk involved in Healthcare Services:
There is a significant gap between ‘required’ and ‘actual’
health care infrastructure with investment on assets like
hospitals and other facilities over years.
Due to lower costs, India has become an attractive
destination for medical tourism and base for clinical trials.
 Business of health care is becoming more risk due to
following reason:
i) Expansion of population they cover health related events
which is more difficult to predict.
ii) Competition among the service providers is eroding
operating margins.
iii) Management of risk is becoming more complex as
delivery of health care becomes ever more fragmented.

Customer Care in Hospitality Industry:
1. Customer Expectations:
- customer were happy if they just receive ‘please’ and
‘thank you’ or getting service with smile.
- satisfied customer are looking for memorable experience
and dynamic service.
- standard practices can make customers to feel.
2. Deliver on Promise:
- it is necessary to engage guest and to deliver as you
promise.
- customers more likely to get frustrated when you reel them
in a big promise like special services or premium products.
- avoid saying that services is based on luxury which
disappoint them throughout the process of working.Unit 4– Hospitality & HealthCare Services 45

3. Customer Loyalty:
- happy customers are loyalty customers, but not only to
provide seller service, but also awesome products.
- it need to follow customers to keep track on them for
personal assistance services and special concessions.
- keep customers loyal by focusing on them at all times.
4) Let them Vent:
- give your customers an outlet for telling you about poor
experiences.
- if any negative experience, make it easy and clear for them.
- to correct issues than went wrong and look into those that
could stand some improvement.
- communication methods for keeping in contact with your
customers based on changes and improvement occur.

Principles of Customer Service:
Customer service principles within hospitality industry are key
to managing a successful hospitality business.
It is most importance practice within the entire hospitality and
tourism services.
1. Active listening can do wonders. (listening to customers are
valuable practice).
2. Put comfort at the top of the list. (comfort provide variety
of shapes and forms.
3. Make your Guests feel safe. (safety and security).
4. Provide Information to your guests. (offering information).
5. Always Exceed Expectations. (exceed the customer
expectations)

CLASSIFICATION OF HOTELSCLASSIFICATION OF HOTELS
Definition:
“Hotel means an establishment held out by the proprietor as
offering sleeping accommodation to any process presenting
himself who appears able and willing to pay a reasonable sum
for the services and facilities provided and who is in a fit state to
be received.
A hotel classified as commercial establishment providing guest
services based on –
a) Luxury hotels or
b) Budget hotels.
In some hotels, services is provided for middle class families for –
* Conventioneers.
* Business groups.
48

Hotel Classification factors
Function
(E.g.) Meeting an
convention
Function
(E.g.) Meeting an
convention
Price
(E.g.) Budget or
Luxury
Price
(E.g.) Budget or
Luxury
Location
(E.g.) City Centers
Location
(E.g.) City Centers
Market
Segment
(E.g.) Leisure
travelers
Market
Segment
(E.g.) Leisure
travelers
Design
(E.g.) Exterior /
Interior design
features
Design
(E.g.) Exterior /
Interior design
features
Destinctiveness
of property
(E.g.) All suit
hotels
Destinctiveness
of property
(E.g.) All suit
hotels
Rating
(E.g.) 5 star hotels
Rating
(E.g.) 5 star hotels
Staff to room
ratio
(E.g.) 1 staff
servicing 2 rooms
Staff to room
ratio
(E.g.) 1 staff
servicing 2 rooms
Hotel Size
(E.g.) No. of rooms
Hotel Size
(E.g.) No. of rooms

Classification of Accommodation:
It is divided into two main groups –
i) Non – Commercial and
ii) Commercial.
AccommodationAccommodation
Non - commercialNon - commercial CommercialCommercial
Private (E.g.)
Private home
Private (E.g.)
Private home
Non – profit (E.g.)
Shelter
Non – profit (E.g.)
Shelter
Institutional (E.g.)
University
Institutional (E.g.)
University
HotelsHotels
Service ApartmentService Apartment

The following chart shows types of accommodation used by
travelers and their characteristics:
Name Characteristics
City Centre Hotels This is located within heart of a
city
Suburban Hotels It is tend to be smaller properties
usually pride full – service.
Airport Hotels These are designed especially to
accommodate air travelers and
offer a mix of facilities and
amenities.
Highway hotels or motels These are designed for overnight
stays for travelers and offers basic
facilities.
Convention hotels These hotels provide large quantity
of rooms, provide meeting,
function space, 24 hour service, etc.

Commercial Hotels These are located in downtown areas and smaller
than convention hotels.
Resort Hotels These hotels located in picturesque, sometimes
remote settings and travel long distance to
resorts.
Spa Hotels These are located in result – type settings or as
part of city spa hotels. It include fitness, yoga,
weight measurement, therapists, etc.
Casino Hotels They have gambling operations which are major
revenue centres and provide live entertainment.
All suite hotels Guest rooms in this hotels are larger than normal
hotel room with separate area for working,
relaxing, sleeping and kitchen set up.

Boutique hotels It differentiate themselves from traditional
hotels. These are known as design hotels,
varies in different look and feel.
Timeshare or Vacation
ownership
This is a type of shared ownership where a
buyer purchase right to use property for a
portion of each year.
Historic conversion hotels These properties have historic significance
and established as hotel to retain their
historic characters.
Extended stay hotels These properties cater to customers who
stay for an extended period and offer full
services.
Hostels They are very cheap accommodation with
sleeping arrangement and self – catering
facilities.

Bed and Breakfast inns They are usually family – owned, rent our
rooms to overnight customers. It provide
assistance regarding direction and information
regarding local area.
Guest houses It is similar to bed and breakfast inns range
from low budget rooms to luxury apartments.
They tend to be like small hotels in bigger
cities.
Cabins They are bedrooms on a ship or train for
passengers.
Villas or Chalets
(usually found in skiing
and beach resorts).
They are self – catering accommodation in a
private bungalow, usually rented to prestigious
or renowned customers.

Special Hotels Worldwide:
Some of the special hotels located in different countries are:
1. Capsule Hotels:
- this hotel is originated in Japan which provides small and
‘bed-only’ cabinets for guest with size of 2m X 1m X 1.25m
for cheap accommodation.
- services and facilities are limited.
2. Ice Hotels:
- it is mainly built by using snow and ice.
- 1st
ice hotel located in Sweden, followed by Canada,
European countries to attract visitors.
- this hotel is temporary and in nature and rebuilt by artists
and designers in different seasons.

3. Cave Hotels:
- it is found in Turkey and originated from residence for people
in old times who stayed in caves to avoid disturbance and attack
of wild animals.
- different hotels which attracts visitors who like to experience in
deep culture and tradition of host countries.
4. Tree House or Treetop Hotels:
- this is located in countryside, especially in forests.
- it is build in harmony with trees which follow building method
of native tree houses. (jungle walk, nightlife animal tour). Tree
house hotels are in Costa Rica, Kenya, Brazil.
5. Underwater Hotels:
- hotels associate with water contributed to development of
innovative hotels with rooms under water.
- hotel guest required to have a diving certification and dive in
56

Accommodation Product:
“Accommodation products refer to rooms and other related
products or services that hotel guests will consume during
their stays.”
It includes –
1. Types of Room:
- it varies in grading, features and functions.
a) Different in Room grading:
Grade View Furniture / Amenities /
Supplies
Extra services
Standard Average (garden view,
car park view)
Basic setting (furniture,
blanket)
Nil
Superior Superior (city view,
sea view)
Upscale setting (rosewood
furniture, comforter)
Complementary
newspaper, breakfast.
Deluxe Magnificent (sea view
at high floor,
attraction view)
Grand setting (antique
furniture, feather
comforter)
Free access, executive
lounge, welcome drinks,
wi-fi services.
57

b) Common types of room:
- it is available for guest’s selection according to their needs
and preferences.
Types of Room Descriptions
Single Room A room that sleep only one person and fitted with single or
queen size bed.
Twin Room A room that accommodate two person with two twin beds.
Double Room A room that accommodate two persons with double size
bed.
Double – Double
Room
A room that accommodate two to four persons with two
twin, double size beds.
Triple Room A room that accommodate three persons and has been
fitted with three twin beds, one double bed and one twin
bed.
Hollywood Twin
Room
A room that accommodate two persons with twin beds
joined together by common headboard.
Studio / Murphy room A room that is fitted with a sofa bed or Murphy bed (i.e) a
bed that folds out of a wall or closet) which can be
transformed from a bedroom in night time to living room58

Suite A room with one or more bedrooms and a living space.
President Suite The most expensive room provided by a hotel. Only one
president suite is available in one single hotel property and
always has one or more bedrooms and living space with
grand in-room decoration.
Villa A special form of accommodation which can be found in
some resort hotels. It is a stand alone house gives extra
privacy and space to hotel guests.
Accessible room This room types is mainly designed for disabled guests and
it is required by law that hotels must provide certain
number of accessible rooms to avoid discrimination.
Balcony room A room with a balcony.
Executive – Floored
Room
A room located at the ‘executive floor’ which enables
convenient access to executive lounge.
Room for Extended
stay
This room type can be fund in service apartments and
hotels which target for long stay guests. Kitchens and
cooking equipment are usually available.

Smoking / Non –
Smoking Room
Many hotels provide both smoking and non smoking
rooms or their guests in order to minimize the smoking
exposure.
Adjacent Room Rooms close by or across the corridor, but are not side by
side.
Adjoining Room Rooms that are side by side, but don’t have a connecting
door between them.
Connecting Room Two rooms that are side by side and have a connecting
door between them.
Single Room Twin Room

Double Room Double – Double Room
Triple Room Hollywood Twin Room

Studio / Murphy Room Suite
President Suite Villa

Accessible Room Balcony Room
Executive – Floored Room Room for Extended Stay

Smoking / Non Smoking Adjacent Room
Adjoining Room Connecting Room

2. Types of Bed:
- a hotel has different types of guest room and bed for guests
to choose from.
Different types of bed in a Hotel:
Types of Bed Sizes (e.g.)
Twin 39” X 75”
Double 54” X 75”
Queen 60” X 80”
King 78” X 80”
Types of Bed Symbols / Code Sizes Descriptions
Single / Twin S / T 39” X 75” Designed for one person
only, single twin bed sized.
Double D 54” X 75” Designed for two persons.
Queen Q 60” X 80” Designed for two persons,
better comfort.

Types of Bed Symbols / Code Sizes Descriptions
King K 78” X 80” Designed for two persons,
wider than queen beds.
Hollywood
Bed
T 78” x 75” Two twin beds placed side
by side and shared same.
Studio Bed /
Sofa Bed
H 48” X 75” Available in a studio
room, caters needs of
business guests.
Murphy Bed M 60’ X 80” /
78” X 80”
It serves functions as sofa
bed and folds out of wall
or closet.
Roll – away
bed
/ 30” X 72” /
34” X 75”
Extra beds temporarily
added according to guests.
Baby Cot / / Provided to those guests
who bring along with their
babies.

3. Room rates:
- a guest who books accommodation receives more than just
a room with a bed which includes facilities and services
provided by hotel staff.
It includes –
* Room rate.
* Size of beds.
* Frequent – guest programme or
* Other services provided to the guest.
The following criteria will influences room rate charged to
guests:
i) Type, size, décor and location of room.
ii) Meal plan, Season and seasonal events.
iii) Kind of Guest and Length of stay and day of the week. 67

a) Types of Room rates:
- the room rates categories have variations in all hotels.
i) Rack rate – the standard rate charged for room only.
ii) Corporate rate – rate offered to executive personnel who are regular
guests or employees that has contract rate with hotel.
iii) Commercial rate – if offered to executive personnel of an enterprise
who have infrequent visit.
iv) Airline rate – rate agreed between an individual airline and hotel as
determined by volume of business the hotel obtains from airline.
v) Group rate – rate given to bookings for large group of people made
through travel agent.
vi) Children’s rate – specific age limit for child to stay with their
parents in same room.
vii) Package rate – it includes goods and services and rental of a room,
to attract guests.
viii) Complimentary rate – guest is assessed no charge for staying in
68

b) Meal options included in room rate:
Four common meal options are:
c) Other related products and services:
Some of the other products and services are –
 Wake-up call service.
 Safe deposit box, turn down services.
Meal Options Description
European Plan (EP) Room only
Continental Plan (CP) Room with breakfast
Modified American Plan
(MAP)
Room with 2 meals, usually breakfast and
dinner.
American Plan (AP) Room with 3 meals, (i.e.) breakfast, lunch
and dinner. Afternoon tea is also included
in some hotels

 Free Internet and Wi – Fi access.
 Room cleaning services.
 Swimming pool.
 Gymnasium, Valet parking.
 Free shuttle service, Bell service.
 Express check in service, Free access to executive lounge.
 Welcome drinks at bars or lobby lounge, etc.
d) Hotel Brochures and Tariffs:
- these are sales and marketing tools used by hotel to
provide information on room rate charged and facilities and
services provided to guest.
- it contain pictures of guest rooms, restaurant outlets and
other facilities.

HOTEL DEPARTMENTSHOTEL DEPARTMENTS
Classification of Hotel departments:
1. ‘Revenue centered’ and ‘Cost centered’ departments:
Some hotels group their departments into two different
categories:
a) Revenue centres – which generate direct income to the
hotel through the provision of goods and services to guests.
(E.g.) Front desk, Restaurants, room service, gift shop, etc.
b) Cost centres – it is also called ‘support centres’ mainly
assist the functioning of revenue centres with no generations
of any direct income for hotel.
(E.g.) Human resources, purchasing, accounting and
engineering departments.

2. Front-of-the-house and Back-of-the-house
departments:
a) Front-of-the-house – refers to those areas which are
accessible and visible by guests.
(E.g.) Front desk counters, restaurants and bell services.
- they have direct contacts and interactions with
guests.
b) Back-of-the-house – refers to those areas which
rarely have staff-to-guest interactions.
(E.g.) kitchen, housekeeping, HR and Engineering
departments.
- they are connected with major duties rather than
communicating with the guests.Unit 4– Hospitality & HealthCare Services 72

Organization of Hotel Department and their functions:
- it is necessary to understand the structure of hotels in order
to get an overview of how organization fits together.
General
Manager
General
Manager
Resident
Manager
Resident
Manager
Rooms
Division
Rooms
Division
EngineeringEngineering
SecuritySecurity
HRHR
Food &
Beverage
Food &
Beverage
Sales &
Marketing
Sales &
Marketing

1. Duties of Key Executive:
a) General Manager:
- providing leadership to the management team.
- coordinating the work of all departments.
- participating in formulation of hotel policies and strategies.
- leading the hotel staff in meeting financial, environmental and
community responsibilities.
- assuming full responsibilities for overall performance of hotel.
b) Resident Manager:
- holding a responsibility in developing and executing plans
developed by owner.
- checking on operations providing feedback and offering
assistance.
- reviewing and summarizing statistical reports.

2. Functions of Major hotel departments:
a) Engineering – responsible for maintaining physical plant of hotel
such as electricity, plumbing, air conditioning, heating, elevator
system, mechanical and technical conditions.
b) Security – responsible for implementing procedures aim at protecting
the safety and security of hotel guests, visitors and hotel itself.
(monitoring, surveillance, security alarm).
c) Human Resources – responsible for hiring, orientation, training,
wages and benefit administration, labour relations and staff
development.
d) Food and Beverage – provides food and beverage services to hotel
guests and visitors through a variety of outlets.
e) Sales and marketing – generating new business for hotel,
coordinating advertising, sales promotion and public relations which
enhance hotel’s image.
g) Accounts – headed by financial controller, guide hotel to increasing
profitability, asset management, monitoring of financial activities.
75

Types of Hotel Guests:
It can classifies according to –
i) Trip purpose – pleasure of business travellers.
ii) Numbers – independent or group travellers.
iii) Origin – local or overseas travellers.
1. Leisure travellers – who travel to engage in leisure
activities, outdoor recreation, relaxation, visiting friends
and relatives.
2. Corporate Business – who frequently bookings are usually
made by enterprises with reduced room rates to conduct
business meetings or workshops.
3. Free Independent Travellers (FITs) – referred as “foreign
independent travellers” who purchase their own
accommodation and make own travel arrangements.

4. Group Inclusive tours (GITs) – who travel together on
package tours with accommodation which are booked
through travel agents.
5. Domestic Tourists – local residents who stay at a hotel for
special occasions and functions.
6. Conference Participants – who travel to attend the
conference and whose accommodation usually referred by
enterprise or conference organizer.
7. Very Important Persons (VIPs) – include celebrities,
frequent stay guests, guests in expensive rooms and top
executives from enterprises.
8. Incognito – who stay in hotel with concealing identities so
as to avoid notice and formal attention.

GUEST CYCLEGUEST CYCLE
 Front office employee must aware of guest services and
guest accounting activities at all stages of guest stay.
Guest Cycle divided into four main stages:

1. Pre – Arrival:
- guest choose hotel based on previous experience,
advertisement, word of mouth referred by friends and
relatives, hotel name, etc in pre – arrival stage.
- guest’s decision regarding reservation of hotel depend on
hotel room type, rate, facilities, etc.
2. Arrival:
- it includes registration and room assignment process.
- responsibility of front office staff to clarify details of room
rate, packages, check – in, etc.
- after registration process completes, then method of
payment and guest departure date confirmed and duly
signed by guest.

3. Occupancy:
- front office staff represents the hotel is important during
occupancy stage.
- they are responsible for coordinating guest requests and
provide information.
- it is to provide anticipatory service and meet the guests
expectation.
- security is important concern during occupancy of guest.
- charges on telephone, internet, travel desk, etc affect guest.
4. Departure:
- guest vacates the room and get accurate statement of settled
accounts and leaves the hotel.
-front office updates the rooms availability status once guest
has checked out.

CLASSIFICATION OF HOSPITALCLASSIFICATION OF HOSPITAL
Hospital ClassificationHospital Classification
LocationLocation PurposePurposeKindsKinds OwnershipOwnership
1. City hospitals
2.District
hospitals
3. Taluk hospitals
4. Primary Health
care centre at
village level
1. City hospitals
2.District
hospitals
3. Taluk hospitals
4. Primary Health
care centre at
village level
1.Teaching
and Research
2. General
3. Specialized
1.Teaching
and Research
2. General
3. Specialized
1. Government
2. Private
3.Semi-
government
4.Voluntary
agencies
5.Private
charitable
1. Government
2. Private
3.Semi-
government
4.Voluntary
agencies
5.Private
charitable
1. Allopathy
2. Ayurveda
3. Homeopathy
4. Unani
5. Sidda and
Nature care
1. Allopathy
2. Ayurveda
3. Homeopathy
4. Unani
5. Sidda and
Nature care

MARKETING MIX OF HOSPITALITYMARKETING MIX OF HOSPITALITY
INDUSTRYINDUSTRY
1. Price:
- price is not just only marketing mix variables which brings
revenue, also communicates about the quality to customers.
- high priced hospitals carry image of high quality treatment
centres.
Some of the various revenue generating services in hospital –
a) Specialized services like operations and surgeries.
b) General room charges, ICU room charges.
c) Visiting doctors contribute.
d) Inhouse medicine supply.
e) Hospitals promoting medical studies generating extra
83

2. Place:
- distribution of Medicare services, location of hospital
plays a very important role.
- kind of services is also very important for determination of
location of hospital.
(E.g.) Chennai Adayar cancer institute, Aravind Eye hospital.
- particular doctor may not available for all patients and he
became a visiting doctor for different hospitals at different
location.
- place factor for hospitals plays a very crucial rule, because
majority of population lives in rural area.
- patients will have to depend on hospitals in urban area.

3. People:
- it includes all different people involved in service –
providing process. (doctors, nurses, supporting staff).
- control on quality of people is based on selection of
professionally sound doctors and other staff.
- in government hospitals, people has to specially taken care.
- doctors and other staff should be sensitive to sick and
remain constantly.
4) Process:
- it forms different tasks that are performed by hospital.
- it depend on size of hospital and kind of service it offers.
AdmissionAdmission DiagnosisDiagnosis TreatmentTreatment
Post - treatmentPost - treatmentDischargeDischarge

4. Physical Evidence:
- it plays an important role in healthcare services, as core
benefit a customer seeks is proper diagnosis and cure of
ailment.
- small hospital may not help much, recent days speciality
hospital are physical evidence to distinguish themselves
from others.
- like smart buildings, logos, smart infrastructure are all
satisfied the needs of patient.
5. Promotion:
- hospitals should select most effective promotion blend
(i.e.) advertisement or public relations after taking into
consideration target customers, media type, budget and sales
promotion.

- advertisement regarding social issues like family planning,
care of girl child, etc in T.V.
- common man approach is effective than use of celebrities.
- hoardings and wall writings near markets and recreation
centres attract the attention of villagers.
- 1/4th
of our population stays in urban India, 3/4th
of total
doctors have engaged themselves in this part.
- many hospitals have abandoned traditions and adopted
marketing strategies to more and more patients to their
clinics.
- word of mouth and relevant information from family
members, relatives and friends are important role in
promotion of hospitals.

HOSPITAL SERVICE MANAGEMENTHOSPITAL SERVICE MANAGEMENT
Effective Hospital Management:
Some of the basic principles for all hospital management are:
1. Division of work to each worker as per specialization.
2. Authority and responsibility are inseparable, however
authority should be commensurate with responsibility.
3. Unity of command requiring employees to receive orders
from one superior.
4. Unity of direction to ensure that each group of activities
with same objective must have one head and one plan.
5. Centralization of authority refers to extent to which
authority is concentrated.
6. Scalar chain reflects the flow of communication from
highest to lowest ranks in organization. 88

7. Orderliness talks about a place for everything and
everything in its place.
8. Remuneration advocates equal pay for equal work.
9. Stability of tenure requires assurance about the permanent
nature of job, resulting in feeling of security and
involvement in work.
10. Discipline requires good supervision at all levels.
11. Through delegation, subordinates get prepared for higher
responsibility.
12. Employee should be given opportunities for use of
creative ideas in their work.
13. As organization is set up to meet needs of society, the
individuals must sacrifice their self interest.
14. Subordinates should be treated without any bias for race,
89

MANAGERIAL ACTIVITIES OF AMANAGERIAL ACTIVITIES OF A
HOSPITALHOSPITAL
The following activities are common to management of all
hospitals:
1. Determination of goals and objectives - it consists primary with
policy making.
2. Facility and Programme planning - it refers to activities
involved in remodelling existing services, organizing new
facilities, services and programmes.
3. Financial management – relates to financial affairs of hospital
including budgeting and costing.
4. Personnel management – it relates to selection, motivation and
guidance of employees of hospital. (wage & salary).
5. Coordinating Department operations – include coordinating
various interdependent activities to enable smooth function.

6. Programme review & evaluation – it is a continuous
process and relates to functioning of clinical services and
programmes.
7. Public and community activities – it related to development
and maintenance of interaction with other health service
institutions.
8. Health industry activities – it is external to hospitals which
include participation in hospital association, 3rd
party payers
like insurance, etc.
9. Government related activities – it includes legal problems
of the hospitals and dealing with local, state and central
government agencies.
10. Educational development – it covers all teaching
responsibilities, continuing education of hospital personnel
and in professional societies. 91

HOSPITAL FACILITIES / SERVICESHOSPITAL FACILITIES / SERVICES
 Organization should provide variety of medical and related
services on professional lines for successful marketing of
hospital.
 It should provide both medical and other related services.
 New technology, new bio – medical equipment and
apparatus should be used.
 Treatment process should be changed and whole health
process should have new dimensions.
 Physical units in hospitals are considered as goods and
services and consumed instantaneously.
 Hospitals include both services and physical goods and
variety of services.

Following are the services that are observed in
hospitals –
 Occupational medicine.
 Physical services in diagnostic centres.
 Emergency services and Heart services.
 Emergency health care services.
 Hospice care services (rest room for ailing old
people)
 Mother – baby care service.
 Rehabilitation service and Psychiatric service.
 Cancer care service and Catering service for
patients.Unit 4– Hospitality & HealthCare Services 93

Hospital Services / FacilitiesHospital Services / Facilities
Core ServicesCore Services Supportive
Services
Supportive
Services
Ancillary
Service
Ancillary
Service
1. Emergency
• Out patient
• In - patient
2. Intensive Care
3. Surgery
operations
1. Emergency
• Out patient
• In - patient
2. Intensive Care
3. Surgery
operations
1. Registration
2. Record store
3.Transport
(Ambulance)
4.Mortuary
5.Engineering
6. Security
7. Hospital
maintenance
8. Hospital waste
maintenance
1. Registration
2. Record store
3.Transport
(Ambulance)
4.Mortuary
5.Engineering
6. Security
7. Hospital
maintenance
8. Hospital waste
maintenance
1. Radiology
2. Laboratory
3. Nursing
4. Catering
5. Sterile
6. Laundry
7. Dietary
8. Blood bank
1. Radiology
2. Laboratory
3. Nursing
4. Catering
5. Sterile
6. Laundry
7. Dietary
8. Blood bank

PERSONNEL ADMINISTRATIONPERSONNEL ADMINISTRATION
The three main categories of hospital administration are:
a) Medical Staff – it includes expert physicians and surgeons
and duty doctors.
b) Para – medical staff – it includes nursing staff, laboratory
heads who are generally specialized people in particular
activity such as radiologist, laboratory Analysts, etc.
c) Administrative Staff – it consists of Hospitals directors,
General Manager, Front Office staff, Hospital
Maintenance staff, Engineers. Technicians, Plumbers and
other subsidiary staff.
HRD Manager who is called Vice – Chairman – HRD or
Director – HRD is in charge of staff administration and
assisted by qualified staff.Unit 4– Hospitality & HealthCare Services 95

Some of the major issues in personnel administration are:
 Hospital Staff Recruitment, Placement and Training.
 Patient – Staff relationship.
 Management of time is a key factor in hospital
administration.
 Medical staff and para – medical staff relationship.
 Compensation management of hospital staff.
 Problems of working in shifts and related staff issues.
 Over – time working.
 Week – end work and Drug abuse.
 Stress issues of employees and Sexual harassment.
 Financial liability for acts and misconduct of its employees.
 Risk management issues.

Hospital PersonnelHospital Personnel
MedicalMedical Para - medicalPara - medical General
Administration
General
Administration
1. Physicians
2. Surgeons
3. Duty Doctors
1. Physicians
2. Surgeons
3. Duty Doctors
1. Director / Registrar
2. General Manager
3.Engineering Staff
4. Workers in each
division.
1. Director / Registrar
2. General Manager
3.Engineering Staff
4. Workers in each
division.
1. Nursing
2. Lab Technicians
3. Miscellaneous
Services
1. Nursing
2. Lab Technicians
3. Miscellaneous
Services

 The objective of HRD is to improve continuously the
performance and productivity of health workforce.
 Educating health personnel is best management tools for
improving workforce performance.
 Improved performance will ensure the quality of health care
service which is cost effective and high standard.
 Hospital personnel have to work in harmony for providing a
good patient care.
 Misconduct of employees results in bad image for hospitals
and cause severe damage also.
 Every hospital should have special care towards patient
who are vulnerable to violence, abuse, theft and other acts.
 Handling of patients includes some background screening
by hospital authorities.

The background screening are:
- examine the personal profile of applicant to determine that
person’s honesty quotient.
- develop an effective screening programme taking a fresh
look at existing approaches.
- investigate the applicant’s background completely.
Some other damages that cause to administration are:
i) Theft. ii) Embezzlement iii) Property damage
iv) Sexual harassment vi) Financial losses
vii) Time wasted in recruiting, hiring and training.
 Hiring quality people for every segment of hospital,
administration focus on day to day operations will be
effective.

 Administration staff will be wrestling at all levels to provide best
service to them.
 There are jealous workers, violators, etc for disturbing
administration in own way.
 All the issues related to people should solve by HR department.
 Superiors from each department will handle this people, also
guiding, counseling, mentoring them.
 HRD executive and department should adopt “Management
Information System” (MIS) to be updated with latest
information.
 Departmental executives should develop good network with
peers and supporting personnel.
 Hospital administration should work with certain amounts of
ethics, compassion and liberal outlook.
 Personnel – both medical and administration should develop
compassionate approach and positive attitude. 100

HOSPITALS ADMINISTRATIONHOSPITALS ADMINISTRATION
Board of Governors
Head – Chairman / President
Board of Governors
Head – Chairman / President
Chief Executive Officer (CEO)Chief Executive Officer (CEO)
ServicesServices FinanceFinance MarketingMarketing MaintenanceMaintenance
General
Manager
General
Manager
General
Manager
General
Manager
General
Manager
General
Manager
General
Manager
General
Manager
OPDOPD IPDIPD
SurgerySurgery NursingNursing
Working
staff
Working
staff
Field
staff
Field
staff
Engineering
& Other staff
Engineering
& Other staff

Activities Services
Hospital
Departments
Out – patient department, surgery, Opthalmic,
Gynecology, General Medicine, Orthopedic,
Paediatric, Nursing, Pharmacy, etc.
Ancillary Services Room, board, medical nursing services
provided to patients in course of care. Services
like laboratory, radiology, pharmacy, physical
therapy, etc.
Financial
Management
Management of hospital funds &
responsibility.
Communication
System
Transmission of message to staff and patients.
Distribution System Systems for delivering hospital supplies, food,
laundry, etc.
Information System Integrated computer assisted systems designed
store and retrieve information.

Activities Services
Shared Services Co-operation amongst hospitals to share services
such as pharmacy, laundry, data processing, etc.
Shops Stores located in hospitals selling requirement of
patients, staff and visitors.
Library Information centre to serve the needs of medical
staff.
Materials management Management of all procurement distribution,
equipment storage supplies storing and logistics
management.
Medication System Overall system, traditional or automated to provide
medication to patients. Activities like handling of
physician’s order, filling the medication order,
transfer to nursing and patient handling activities.
Product Line
Management
Managing control system for structuring health
care delivery strategies around case types or
specific clinical services.

The administrative aspects to be taken care are:
 Appoints and Schedules.
 Constitution and bylaws.
 Organizational decision – making.
 Fee structure and schedules.
 Governing Board issues and HR Practices.
 Marketing aspects and financial issues.
 Service Innovations and Mandatory programs.
 Public relations and Time Management.
 Program Development and Monitoring.
 Safety Management and Quality Management.
 Patient Identification Systems.
 Risk Management.

 Hospital administration has to be taken as a separate programme.
 The key factor influences hospital administration besides quality
services, is sales and marketing business practices.
 Hospital administration is a behind the screen operation and is not
visible like the work of doctors and nurses.
 Management performs jobs such as keeping corridors clean,
maintaining instruments and equipment, attending patients needs
and complaints, developing good public relations.
 Good hospital administration involves following aspects other
than regular health care activities:
 Sales and Marketing control assessments.
 Operational & Regulatory competence assessments.
 Litigation advisory services.
 Forensic accounting and damage analysis.
 Corporate (Hospital) integrity agreements and Legal aspects.

Information Technology and Health Care Administration:
It need to integrate IT and management systems across the
hospitals for better management, control and patient
experience.
 WIPRO developed a hospital management system called
“Hospital Information Resource Planning System”
(HIRPS).
 Hospital Information System (HIS) interface laboratory
equipment, telephone exchange, mobile phones and pagers,
attendance recording system and patient record
management modules.
Hospital administration is facing many difficulties and core
problems are:
 Loss of revenue due to billable services not getting billed to
patients. 106

 Increased operating costs due to additional
inventory and staff required for back – end
operations.
 Patient dissatisfaction due to time take for various
processes, including registration and final billing.
 Reduced access to paper – based medical records,
leading to both patient and employee dissatisfaction.
 Inefficiencies due to data in disparate systems not
being exchangeable, thus leading to lack of a single
view of patient or hospital information.
IT Solutions adopted for other services like Medical
Transcription, Laboratory Analysis, etc.

HOSPITALS SERVICE EXTENSIONSHOSPITALS SERVICE EXTENSIONS
“Service Extensions in hospitals means rendering Medicare
services out of campus with the assistance of NGO’s like
that of Rotary International.”
(E.g.)
i) Conducting Eye camp outside hospital to provide expert
service to needy people of weaker sections.
ii) Family planning camps, tele – medicine, medical aid given
to patients who are away from hospitals.
 Service Extension also provides supporting service like
pharmacy, nursing, medical research, etc.
 Hospitals and experts in association with NGO’s conduct
frequent free health care camps outside the hospitals as a
social responsibility function.Unit 4– Hospitality & HealthCare Services 108

Pharmacy:
Purchase of drugs and maintaining a satisfactory inventory
of drugs, chemicals and biological accounts for a
substantial amount of money.
 20% of hospital costs (i.e.) more than half of material
budget are accounted for by medicines and pharmaceutical
supplies.
 Availability of right drug at required place at right time is
key to hospital’s existence.
 A well – qualified pharmacist in charge providing it with
all services listed under function of pharmacy.
 Pharmacy unit in hospitals serve the patients by supplying
appropriate and adequate medicines.
 “24 hours Pharmacy Center” is available through out the
day to serve needs of patient. 109

 Pharma units in hospitals stock life saving drugs, latest
medicines, auxiliary medical equipments.
 The objective of these centers is to provide speedy service
to needy patients.
 Health is a fundamental human right and proper quality of
medicines and service by pharmacists help to fulfill that
obligation.
 Rational use of drugs means right drug, right dose and
right duration.
 Delhi Society for Promotion of Rational Use of Drugs says
that only 50% of patients take medicines, because of lack of
instruction provided with prescriptions. Low literacy and
poor dispensing practices.
 Every PHC should have stock of basic drug and medicines

Every taluk hospitals have full fledged stock point of
pharmaceuticals managed by trained by pharmacists.
WHO has clarified the role of Pharmacist in Health Care
System:
 they should take part in health programming campaigns on
drug related topics, rational use of drugs, alcohol abuse,
organic solvent abuse, drug use during pregnancy,
tuberculosis, HIV / AIDS and family planning.
Taluk HospitalsTaluk Hospitals
Public Health CentersPublic Health Centers Primary Health UnitsPrimary Health Units
Male –
Junior
Health
Assistant
Male –
Junior
Health
Assistant
Female –
Junior Health
Assistant
(Midwife)
Female –
Junior Health
Assistant
(Midwife)
Male –
Junior
Health
Assistant
Male –
Junior
Health
Assistant
Female –
Junior Health
Assistant
(Midwife)
Female –
Junior Health
Assistant
(Midwife)

Functions of the Pharmacy:
1. Provisioning purchasing, storing and distributing drugs,
medicinal preparation, chemical and pharmaceutical items.
2. Ensuring potency and quality of drugs during their storage in
hospital.
3. Dispensing prescriptions to inpatients and outpatients, making
preparations to used in prescriptions.
4. Maintaining information regarding quality, cost and sources of
supply of all drugs, chemicals and other items.
5. To investigate pharmaceutical problems arising in use of
medications.
6. Ensuring adherence to laws, acts, rules and regulations applicable
to pharmacies.
7. To promote economy in use of medicines and establishing
accounting procedures.
8. To keep a watch on adherence concerned to hospital formulary. 112

Drugs and Therapeutics Committee is responsible for
–
a) Preparing hospital formulary of accepted drugs for
use in hospital.
b) Selection of suppliers and manufacturers of drugs.
c) Acting as an advisory group on matters pertaining
to choice of drugs to be stocked.
d) Framing of overall policy of pharmacy service for
information of all concerned and monitoring its
implementation.
e) Considering of preliminary budget for pharmacy
f) Development of drug information system.

Need for a Hospital formulary:
- drug formulation with over a thousands manufacturers in
public, private and cooperative sectors.
Formulation of drugs are selected based on criteria –
Sound therapeutics.
Good benefit to risk ratio and Cost – effectiveness.
Hospital formulary serves three basic purposes.
It promotes rational therapeutics.
It prevents unnecessary duplication, waste and confusion.
Promotes economy to both patient and hospital.
- formulary will not complete without indications.
- drugs and therapeutics committee should prepare written
policies and procedures regarding hospital formulary.
- formulary need to be revised every two year. 114

Location and Layout of the pharmacy stores:
- location is important needs to serve both inpatients and
outpatients.
- multi stored building, location of lifts, location of main
stores and arrangement of wards, etc.
Pharmacy department requires space for –
 Dispensing counter.
 Cash counter.
 Drug storage including dressings.
 Cool and Cold storage.
 Administrative office.
 Circulation space.
 Space for compounding and bulk preparation.

Nursing (Mid Wife):
 Concept of “Midwife” in hospital services is considered as a
para medical service.
 It is crucial factor in hospital administration and only nursing
care that cures the patient at faster rate.
Many time patients disturb them more and it takes long time to
cure disease.
 In case of child birth for women, mental and physical strength
is essential and it is provided by medical and para-medical
staff, which is major role of midwife.
Concept of Midwife:
 It was referred to a female expert who was attending to child
birth process.
 She provides support during labour and delivery, supervising
the women and child after birth. 116

 The term midwife meaning “with a woman”, first recorded in
1300.
 She had specific training in care of pregnant patients and
delivery of babies.
 She provide continuous support to women with
uncomplicated pregnancies during pregnancy and labour.
 She focus on working with woman to reduce risk for
complications and needs of the family.
 They pay special attention to the cultural values and personal
preferences of women in their care.
The continuous presence of midwife during labor can reduce –
 Length of labour and Need for pain medication.
 Likelihood of forceps or other operative devices during
delivery and Possibility of cesarean delivery.

Nurse-midwives (NM’s):
- this are registered nurses who have completed accredited
midwifery programs and they are called certified nurse-
midwives (CNM’s).
- they can write prescriptions and provide variety of care like
care after birth, diseases prevention, family planning
assistance, gynecological exams, health maintenance
counseling, newborn care, etc.
- they are collaborate with physicians, especially
pregnancies, to provide health care resources.
- the philosophy of nurse-midwifery is to provide health
care to women, acknowledging and respecting their needs.
- they encourage patient education, active participation,
clear communication between provider and woman.

Role of Midwife in Public Health:
- it is importance in administering public health
programmes.
- it is now called ‘Junior Health Assistant’ responsible for
Health Surveillance, Pre-natal and Post-natal care, child
health care, etc in village.
- Govt. of Karnataka trains the SSLC passed candidates in
basic health care administration in villages.
- all district centers have kind of training centers and they
will be posted to PHC’s across state as “Junior Health
Assistant” and every PHC’s will have 4-6 midwife’s.
- midwife’s collects information about no. of pregnant
women, administers various types of injections to pregnant
women before birth of child, assist the doctors, etc.

Nursing:
Nurses provide extensive help to physicians caring for
patients recovering from an illness or accident. They play
various roles to ensure hospitals run smoothly and
profitably.
 It encompasses autonomous and collaborative care of
individuals of all ages, families, groups and communities,
sick or well and in all settings.
 It includes promotion of health, prevention of illness and
care of ill, disables and dying people.
 Demand for nurses is constantly increasing as the health
problems are increasing.
 There is an increasing demand for homecare nursing and it
has greater demand in international market also.

Functions of nursing services:
a) To assist the individual patient in performance of those activities
contributing to his or her health or recovery that she should perform.
b) To help and encourage the patient to carry out the therapeutic plan
initiated by the physician.
c) As a member of health team, to assist other members of the team to
plan and carry out total programme of care.
Roles played by nurses:
i) To provide sufficient care for patients to make them feel comfortable
while in hospital.
ii) They assign duties to other nurses, setting work shifts for each
employee and ensure that nurse is properly trained.
iii) It provide general information to help the patients and their families
understand what they are experiencing.
iv) Nurse is a doctor’ best friend and help them during time of
operations and emergencies.

Medical Transcription (MT):
 It is accurate and swift conversion of medical records
dictated by doctors or other medical professionals, into
electronic form.
 It includes patient history, reports, clinical notes, operation
reports, medical recommendations, psychiatric relations,
laboratory reports, etc.
 Nowadays, doctor leaves his message in toll free number
that is converted and recorded in server and transcription
unit logs in to server and downloads the material.
 Specialized word processing packages are used for medical
transcription include a medical dictionary for benefit of
person during conversion.
 Dictation speed, medical terminology, English knowledge
is necessary for accessing the medical transcription. 122

 It is an IT solution for handling health care activities of
doctors.
 It is boon in hospital administration as it save times to
doctors to para medical staff.
 It is one of the fastest growing fields in health care and
demand in Western countries.
 The process of MT involves receiving dictation by tape,
digital system or voice file, using ear phones and word
processing system.
 The documents they produce include discharge summaries,
history and physical examination reports, operative reports,
consultation reports, progress reports and referral letters.
 To understand and accurately dictated reports, medical
transcriptionists understand medical terminology, anatomy &
physiology, pharmacology and treatment assessments.
123

 It must comply with specific standards that apply to style of
medical records, in addition to legal and ethical
requirements to keep patient information confidential.
 The process of medical transcription is transferring this
information using word processing.
 It range from small, one-person home-based business, high
tech corporations which employ transcriptionists.
 It is new concept in India, but some companies can’t
survive due to lack of proper training and understanding of
this process.
 The success of the surviving companies proves that Medical
transcription can hold a vital link in altering the Indian Job
scenario.

Marketing of Medical Transcription:
 Hospital administration searched for experts to outsource
this activity.
 Doctors take dictation from them and to convert them into
case sheets.
 The cost of outsourcing activities became expensive.
 The time zone difference between US and India proved to
be a significant factor and give rise to development of MT
market in India.
 It is a service activity and this service is generated and
consumed simultaneously.
 Marketing of these services involves marketing mix such as
Price, Promotion, People and Process.

 Pricing of activity is determined by free play of
demand and supply of activity and it depends on
efficiency level of Indian service providers.
 Promotion is the activity is a reciprocal one, both
service providers and service receivers adopt their
own promotion policy to provide best services.
 Element of place is between US and India.
 People involved in activity are service providers
and service seekers and should have tolerance to
translate as health of patient is critical factor in
activity.
 The marketing of MT can be successful in IT
solutions are efficiently adopted.Unit 4– Hospitality & HealthCare Services 126

Service Management Hospitality and Health Care Services

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to Service Management Hospitality and Health Care Services

Similar to Service Management Hospitality and Health Care Services (20)

More from SOMASUNDARAM T

More from SOMASUNDARAM T (20)

Recently uploaded

Recently uploaded (20)

Service Management Hospitality and Health Care Services