1. Soni Manipal Hospital -
The Transformation Challenge
Abstract
This case is about Soni Manipal Hospital (SMH) which is a multi-speciality hospital and is located at
Vidhyadhar Nagar, Sikar Road, Jaipur. The Soni Manipal Hospital traces its legacy from SK Soni Hospital
which was running successfully for last 26 years. In year 2011, the SK Soni hospital started witnessing the
decline in revenue and hence decided to invite private equity to cope up with the financial crisis. The SK Soni
Hospital was than taken over by the Manipal Hospitals in 2014. This way Manipal Hospitals started its march in
North India in the name Soni Manipal Hospital, Jaipur. This case focuses on handling the challenges of
transforming the family run business into corporate run business coping with the prevailing competitive market
scenario. It also focuses on the challenges faced by Varun Sharma, (CEO) in transforming the organizational
culture and HR practices in traditionally organized employee relation driven system, attitude of old employees,
the dilemma in implementing the ultra - modern technologically oriented clinical diagnostic system.
Keywords: Organisational Culture, Transformation, Challenges, Hospital Management, Employee Motivation, Employer -
Employee Relationship
__________
Dr. Anuradha Parasar, Associate Professor,
NIIT University, Neemrana; anuradha27parasar@gmail.com; Mob. 9468966363, 7023817619
Dr. Kapil Arora, Associate Professor,
JKLU, Jaipur; kapilarora@jklu.edu.in; Mob. 9772153409
Dr. Deepak Yaduvanshi,
Head, Respiratory Unit, Soni Manipal Hospital, Jaipur; drdeepak97@yahoo.com; Mob. 9950995387
Devika Sharma, Research Scholar,
JECRC University, Jaipur ; devikasharmaphd@gmail.com; Mob. 9928001497
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2. Soni Manipal Hospital -
The Transformation Challenge
Change, Adapt and Adjust are the elixir for Transformation
It was a warm summer afternoon in June, 2015. Varun Sharma, the suave, dynamic and entrepreneurial
CEO of the Soni Manipal Hospital (SMH), Jaipur and Unit Head, Manipal Group of Hospital looked out of
his window on the hot sun reflected from the newly surfaced Sikar road located in northern part of Jaipur
city in Rajasthan state of India. He was contemplating the changes he had been instrumental in bringing
about in the SMH, whether in infrastructure, human resources, cultural or process since the six months he
was made incharge of the transformation of the erstwhile family run SK Soni Hospital into the corporate
run Manipal Hospitals. There was lot to be done and Varun was not the guy to shy away from the
challenges. He infact looked forward to such opportunities. He lived on them. Now he started dwindling
between Manipal Hospitals, SK Soni Hospital & Soni Manipal Hospital.
Manipal Hospitals
Manipal Group of Hopitals or Manipal Hospitals is part of Manipal Education and Medical Group
(MEMG) which pioneers in the field of education and health care delivery. Manipal Hospitals are the
India’s third largest health care group with a network of 15 Hospitals at 9 location of 5 States in South
India and two primary clinics (Annexure I). Manipal Hospitals are based on three core values – Clinical
Excellence, Patient Centricity and Ethical Practices. Manipal Hospitals has the best of technological
advancements and the specialised Doctors. Manipal Hospitals has in total 5000 beds taking into account all
the hospitals infrastructure under Manipal group. Manipal Hospitals caters to around 2 million customers
from India and overseas every year.
The focus at Manipal Hospitals is to develop an affordable tertiary care multispecialty healthcare
framework through its entire delivery spectrum and further extend it to homecare.
Manipal Hospital, Jaipur
Manipal Hospitals has a special significance in the overall healthcare industry of India and most
importantly the medical legacy in South India. Manipal Hospitals has now started its expansion in North
India through its first branch in North India by the name Soni Manipal Hospital, Jaipur. Soni Manipal
Hopital is the first expansion experimentation of Manipal Hospitals in North India. Soni Manipal Hospital,
Jaipur is the 10th
branch of the Manipal Groups of Hospital.
The Manipal Hospitals acquired the Soni Hospital, Jaipur in 2014. As per the terms of contract with the
acquired Soni Hospital, it was agreed that Manipal Hospital, Jaipur will retain the term ‘Soni’ name in the
name of the Hospital for three years , hence the hospital is named as Soni Manipal Hospital, Jaipur since
2014 and than in 2018 it can be re-nomenclated as Manipal Hospital, Jaipur.
SK Soni, Hospital, Jaipur – The History
SK Soni Hospital was taken over by Manipal Group of Hospitals in 2014. In 2014 the journey of SK
Soni Hospital started at newly purchased location which was the Trauma Centre premises at the
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3. Vidhya Nagar, Jaipur shifting its venue from JLN Marg, Jaipur. The SK Soni Hospital also has a
chequered history (Annexure II).
Before shifting into the premises of the Trauma Centre Vidhyadhar Nagar, The Soni group of
Hospitals had its legacy, it started Soni Nursing Home at J.L.N. Marg in 1986. It soon expanded to
40 beds multispecialty hospital, by 1990 it expanded to 100 beds and in 1996 got incorporated as
first corporate hospital of Rajasthan.
Rajasthan state and in particular Jaipur community appreciated its good services and twenty years
later under the guidance and dynamic leadership of Dr. B.R. Soni, SK Soni hospital was a 30 crore-
enterprise which was providing world-class healthcare and than it shifted and established at
Vidhyadhar Nagar, Sikar Road, Jaipur in 2004 in the building of the Trauma Centre.
This remarkable progress was due to the work of its top-brass consultants, its world-class healthcare
facilities and the presence of super-specialty services for quality healthcare. Under the guidance of
Ex-Principals and Ex-HODs of Jaipur’s SMS Medical College, it created its brand image of quality
healthcare in Rajasthan.
The SK Soni hospital was family run business and the over all control was in the hands of family
members and it was technically operated by known patronage relationship based experienced but
under qualified paramedical staff and support staff. In between, the hospital was managed by
professional experts like VARUN/ DMS/ Managing Director, Medical Superintendent and few of
administrative staff members who were given limited authority due to unique family driven cultural
mindset and were associated from the beginning of the hospital and bears true allegiance and trust of
the family inspite of trained hospital management experts on and off in the system.
The committed and loyal workers taken as paramedical staff decades back have now been on job
and acquired experience and skilled in nursing operations but lacks professional qualifications and
acumen.
From year 2011, there was significant decline in the revenue generation of SK Soni Hospital due to
following reasons:
i. SK Soni Hospital made a very heavy investment in introducing the world’s top class
machinery taking bank loan, however it could not generate revenue to pay the heavy debts.
ii. The competition from other private players in the Medical care in Jaipur
iii. The patients and society noticed involvement of SK Soni Hospital in some absolutely
unethical and unprofessional practices in delivering its services which also got reported in the
leading newspapers.
Due to all the above reasons the financial status of the hospital started deteriorating and to cope
up with the financial crisis, SK Soni hospital invited private equity and partnership and than
finally in Feb 2014 it was sold to Manipal Hospitals. On 18 Feb 2014 there was a dramatic
changeover and SK Soni hospital was taken over by the Manipal Hopitals with the agreement
that for three years the Manipal Hospital, Jaipur will retainn the name of ‘Soni’ in the name of
the hospital, hence since 2014 the hospital is named as Soni Manipal Hospital, Jaipur.
Soni Manipal Hopital, Jaipur
The acquired Soni Hospital which was family run business is now taken over by the Manipal
Hospitals which is corporate run business. The family run organisation was now required to work on
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4. the norms of corporate culture. The flexible work system was to now transformed into accountable
and performance based system. The traditional medical care was now to transformed into highly
sophisticated, technological, legally compliant Health care oragnisation based on three core values
of Manipal Hospitals– Clinical Excellence, Patient Centricity and Ethical Practices.
Soni Manipal Hospital, Jaipur is having locational advantage as there is no multi-speciality hospital
which is catering on such a large scale within the 10 km radius and the area around the hospital is
highly populated. The hospital is accredited by NABH.
The present workforce of Soni Manipal Hospital, Jaipur in year 2015 comprises of 150 Doctors, 250
Nursing, paramedical & Technical Staff and 450 Support Staff for catering to 26 critical and
specialised Medical care departments (Annexure III). The 90% of the Medical Staff and Non -
Medical staff at present is from Jaipur and nearby cities of Rajasthan i.e. Jhunjhunu, Sikar, Ajmer
etc and 10% workforce is from other States.
The CSR Initiatives
Soni Manipal Hospital, Jaipur since its first year of running i.e. 2014 is actively involved in CSR
Activities and has launched ‘Clean Jaipur, Healthy Jaipur Initiative’ by donating large size dustbins
to society. The Hospital conduct free medical checks camps on regular basis. Since Feb 2014, 45
such free Medical Check-up camps has been conducted at various locations in Jaipur to serve the
society free of cost. At various location, the Hospital has put the signages for educational awareness
about the areas landmarks.
Challenges
The Manipal Hospitals administration was aware of the challenges which they will face in transforming the
family run business into corporate run business, but somehow underestimated the challenges relating to –
Infrastructure, Motivating and Transforming unprofessional manpower into Professionals, linguistic
rudeness and behaviour from rural workforce, legal compliances & documentation, implementation of
uniform for staff etc.
The primary emphasis of Soni Manipal Hospital, Jaipur management is to enthuse professionalism
and modern approach in the hospital. The hospital is now operationally managed in three tiers of
medical consultants / skill providers, administrative staff and technical /non technical paramedical
staff.
Varun Sharma, the new CEO joined in January 2015 and is focussing on building the corporate
image make over of the Soni Manipal Hospital, Jaipur. Varun Sharma is having a very rich
experience of Hospital administration and have worked with institutions of excellence in Health
Care Industry. Hence Varun came well prepared with focussed approach in bringing the required
organisational changes. His approach is very positive, progressive and steady in implementing
organisational changes giving logical awakening, sensitisation along with strongly co-relating the
introduced changes or policy with the patient care.
After analysing the situation Varun Sharma is planning to introduce changes in the organisation
culture to transform the family run culture into corporate run culture targeting following heads:
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5. 1. Infrastructure : Varun is analysing the situation as to how to cope up with the requirement of the
market along with overcoming the competitive forces, one major step required may be to renovate
the 13 years old building and to give it the ultra-modern look accommodating all the highly
specialised technological tools. So he started focussing on the alternatives:
i. To close the hospital for 6 month so as to renovate the building
ii. To renovate the building in phased manner along with running the hospital
simultaneously
iii. Renovating will be not be economically viable, to think for a new building at a new
location (this decision may be out of his domain)
Varun inclination is to complete the phased development of infrastructure transformation within a
year. Varun is looking to the financial statistics which appears to be progressive wrt present revenue
generation. However the heavy financial expenses to be incurred in the renovation of the building is
coming out to be very heavy and is matter of big concern for the administration.
2. Motivating and transforming unprofessional employees into professionally sound and
efficient workforce
Another biggest challenge before Varun is to transform the unprofessional employees into
professionally skilled employees. Varun in consultation with his team is planning for the
following:
i. Workshops, trainings and talks by Professional Trainers and Technicians on daily basis
for one and half hour. It was realised to cater this need there is requirement of a full
Trainer who can train and groom the professionalism in the paramedical and nursing
staff.
ii. Two Motivation Schemes was also under discussion in the name of “ Ekta” and
“Manyata”.
The Ekta policy aims at integrating the workforce by organisation of various
cultural events in the hospital Auditorium on regular basis in which employees
from all the cadre can participate and can show case their talent.
The Manyata policy aims at acknowledging the outstanding performance of the
employees from any cadre based on judgement of the Department Head on
various parameters. Based on the outstanding performance any staff - Medical or
Non - Medical can be awarded Manyata Card. If any employee is awarded with
five cards, than he would be declared as the Manyata Champion and will be
awarded Manyata Champion Trophy. They were also planning if the Manyata
Champion can be invited to attend the annual event in Banglore along with his
family in recognition of his/her outstanding contribution in Institutional
development or related activities.
iii. It was also realised that Manipal HR team will have to play a very proactive role in
making cross functional team in organisation and celebration of various events like
environment day etc.
iv. Varun is also considering whether to give some financial benefits to the employees or
not.
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6. 3. Linguistic rudeness and unprofessional behaviour by rural workforce
The Medical staff is expected to be most polite and humble while administering medical
care and treatments. Varun found that majority of the staff were from nearby villages or
rural background and were sounding linguistically rude and unprofessional in behaviour
due to cultural lag. To handle this situation, Varun is having few alternatives in his mind:
i. Bridging the cultural lag by counselling sessions and sharing the expectation of the
Hospital wrt handling patients in polite and humble way.
ii. Staff who were not professionally certified technicians or were not complying with the
formal qualification requirements be adjusted in back end office.
iii. New recruitments to be made ensuring the professional expertise and requisite
qualification.
Varun plans to ensure HR and HR related issues transformation within next 6 months.
4. Documentation
The Soni Hospital mangement somehow could not sensitized the nursing and paramedical staff
to document the timeline of the medical care administration of the patients, which initially
came out as a big challenge for the Soni Manipal Hospital administration as the emphasis of
Manipal group is proper documentation and legal compliances.
Hence Varun wants to instil the value of proper documentation in the functioning of the staff
members who are carefree in there approach regarding documentation. Employees are resistant
to cooperate as they found this demanding due to self - limitations & constraints in
implementing the documentation process due to unprofessional background. Hence hospital
administration is confused how to solve this issue either by:
i. Investing time along with instituting strict hammering to get the documentation and
compliances processes streamlined
ii. The Manipal Groups of Hospital has ERP system implemented in all their Hospitals except
for this Jaipur Branch due to non - technological perspective of the staff. Varun plans to bring
in ERP in a years time.
5. Implementation of Uniform
The Soni Hospital did not prescribed for any uniform, hence staff were not concerned about
Uniform. The female staff come dressed ornamented with rings, ornaments along with in heavy
bangles in both hands. This was a big concern for the management. On the other hand Varun plans
to introduce Shirts and Pants instead of Saree for Female paramedical staff.
The Varun plans to close Uniform issue within next six months.
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7. Retrospections and Planned Ahead
Varun is retrospecting about the changes which he plans to introduce and the challenges and resistance by
employees he may face. Varun is thinking that the financial implication of renovating the building is
coming very heavy, employees resistance to change and unprofessional behaviour, resistance towards
uniform, softening of linguistic rudeness, motivation boosting etc needs immediate pressing.
Varun plans to expand hospital revenue from present 60 crore to 100 crore in next one year. From present
150 beds he plans to expand to 300 bedded hospital and finally to 500 bedded hospital like other Manipal
Hospitals in South. The hospital is planning aggressively to expand in very new critical specialised areas
like – Encology, Marrow transplantation, Bone Transplantation, Kidney transplantation etc. The hospital
administration intends to transform Soni Manipal Hospital into destination centre for critical and
specialised medical care & treatments nationally and internationally.
Varun is still looking out of his window to figure out the best alternatives.
Questions
1. Do you think that the hospital will be able to make good wrt financial implication for having
decided to renovate the building.
2. What is your opinion on
a. The Varun stand in implementing changes in work culture
b. Employees role in reacting to the organizational culture which is demanding professional
approach.
3. How to handle the challenges of the acquisition process from the employer and employee
point of view.
4. How to make the successful initiatives of Manipal Hospitals of South India to attain the same
success in the northern context of the country.
5. What are the implications if a big ethical high performer group acquires an organisation who
was under performer.
Purpose of Case
Case study method is popular method of teaching in management as it is used as simulation in
classroom to make students aware of real life business issues. Non availability of Indian business
cases specially in hospital industry compels B-schools Faculty members either to use foreign cases
or to avoid case-method of teaching. Foreign cases do not reveal the peculiarities of Indian business
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8. environment. Indian students and case teachers often fail to correlate, comprehend and conjecture
with the foreign case situations.
Objective Of The case
The objective of this case study is to enable students to understand various approaches of employee
management and to create a balance with new modern and systematic management approach and how to
get competitive edge in present scenario.
Target Audience
Target audience will be Instructors, Management students, Medical Practioners, Hospital Administrators
and Paramedical staff
Teaching approach
The case be assigned in a group (4-5 members). The group need to analyse the problem and dilemma faced
by the management with possible alternative solutions keeping in view the basic management principles.
Role Play, Management Game
Analysis
SWOT Analysis
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9. Annexure I
The list of Hospitals and Centre of Excellence (COE) in the Manipal Hospitals Network
1. Manipal Hospital, Bangalore
2. Manipal Northside Hospital, Bangalore
3. Dr. Malathi Manipal Hospital, Bangalore
4. Manipal Hospital, Salem
5. Manipal Hospital, Goa
6. Manipal Mangalore Hospital
7. Manipal Super Speciality Hospital, Visakhapatnam
8. Manipal Hospital, Visakhapatnam
9. Manipal Hospital Vijayawada
10. Soni Manipal Hospital, Jaipur
11. Vedic Lifecare, Lagos, Nigeria
12. Manipal Hospital Klang, Malaysia
13. Manipal Comprehensive Cancer Centre (MCCC), Bangalore
14. Manipal Heart Institute (MHI), Bangalore
15. Manipal Spine Care Centre (MSCC), Bangalore
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10. Annexure II
SK Soni, Hospital – The History
In 1999 the Government of Rajasthan decided to start a Trauma Centre at Vidhyadhar
Nagar in 6 acres of land as an extension of the SMS Hospital Jaipur. SMS Hospital,
Jaipur is a multispecialty state run Government Hospital which provides medical care at
susbsidised rate. The new Trauma Centre building construction was completed by the
Government in 2002 under the auspices of SMS Hospital. The Doctors from SMS
Hospital, Jaipur were then transferred to the Trauma Centre. However inspite of all
efforts by the State Government to run the Trauma Centre deputing Doctors from SMS,
the SMS Doctors were not interested in attending duties at Trauma Centre. The
Government of Rajasthan was then perplexed with the issue of running the Trauma
Centre as they could not get good Doctors for making it functional.
Taking the Trauma Centre running issue and the related challenges, the Government of
Rajasthan decided to invite private players to participate in the running of the Trauma
Centre. However there was no response by any private party. Then in 2004 the
Government decided to globally auction the Trauma Centre. The action was than bid by
Dr. S K Soni and the auction was in favour of him. This way the journey of S K Soni
Hospital started at Vidhya Nagar shifting its venue from JLN Marg.
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11. Annexure III
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