Case Study Analysis - Aravind Hospital

Name: Subhadip Chakraborty
Roll Number: 150103179

Section C
Case study analysis: Aravind Eye Hospital, Madurai, India In Service for
Sight
Scenario of blindness in India (1991):

Population in India was 850 million with 250 million blind eyes (2 million
being added annually).
Main cause was Cataract (75-80%) which was uniformly distributed.
There were 8000 Opthalmologist performing 1.2 million cataract
operations every year.
Total number of eye hospitals in the country was 42,200.
Two third skewed to the Urban areas where less than one third of the the
nations population lived.
Government revenue allocated was Rs. 60 million for blindness prevention
The Challenges faced were:
a) Proper infrastructure
b) State of the art Equipment
c) Training personnel
Aravind Eye Hospital:
Founded by Dr. G venkataswamy in 1976.
1st three surgeons: Dr. Venkataswamy
his sister, Dr.G. Natchian
her husband, Dr.P.Nameperumalswamy
1976:
20 bed eye hospital
Goal: Providing quality eye care at
reasonable cost
1977:
30 bed Annex
Goal: To Accommodate patients after
surgery
1978:
70 bed Free Hospital
Goal: Providing poor with free eye care

Section C
1981:
250 beds
80,000 sq feet space
4 major operation theatres
1992: 240 hospital staf

30 doctors
120 nurses
60 admin personnel, 30 others.
IOL Factory Auro lab

Having grown from strength to strength, Aravind in 1991 made a bold
move to set up a facility for manufacturing intraocular lenses (IOLs).
IOL For ECCE surgery were initially imported from the United States for
Rs.800 a piece.
Later manufactured at auro lab for Rs.200 per lens producing 60,000 units
a year with 50% defect free lenses.
Mr. Balkrishnan, a family member of Dr.Venkataswamy with extensive
engineering experience and doctoral education in US managed Auro Lab.
Aravinds Model Of Delivering Eye Care

Section C
Registration
Vision recording
Preliminary examination
Testing of tension and tear duct function
Refraction
Final examination by senior medical officer
Optical shop
Quality of Service at the Main Hospital:

Reliability: Highly reliable cataract removal technique used gives more
than 95% chance of improved vision. Several highly experienced doctors
on duty hence providing efficiency and trust. Even the nurses were
recruited and trained by the Aravind clinic hence assuring uniform levels
of efficiency in them.
Responsiveness: Highly responsive. Patients were seated and prepared for
surgery in fixed numbers as per the resource availability 15minutes ECCE cataract surgery maintaining time efficiency.
Structure process in operation theatre providing time efficiency and higher
level of trust.
People divided into 2 groups after sequential series of evaluation. Proper
distribution of the patients in a sequential flow hence saving up on time
and speeding up the entire procedure.
Assurance: Most of the senior doctors held degrees from foreign
universities and assured absolutely the best medical treatment. Specialist
use to sit at separate floor and senior medical official use to analyze final
operation report.
Empathy: Doctors would talk to the patients and empathize with them
prior to treatment hence instilling trust and good will. Cost of cataract
surgery was Rs.500 to Rs.1000, hence providing value for money. Patient
awakened early, light breakfast before surgery that displayed
courteousness.
Tangibles: Both ICCE cataract as well as ECCE treatments.
Both the other operating tables were equipped with operating microscope

Section C
A, B and C-class rooms, with diferent privacy and facilities for the patients
hence adding further value.
Testing facilities (Ocular tension, tear duct function, refraction test) hence
providing multiple facilities.
Retina specialty section with knowledgeable employees.
Quality of Service at the free Hospital:
Reliability: Highly reliable Cataract removal technique used gives more
than 95% chance of improved vision. Followed same sequence of
diagnosis and treatment as the main hospital hence ensuring equivalent
quality.
Responsiveness: Highly responsive. At camps, Arvinds team would screen
the patients. Those require surgery were transported to Madurai. They
were returned after 3 days after surgery and recuperation. The nurses and
the staf would help out with the following activities in a highly efficient
manner: Helping and guiding patients, registering the entry, directing
them for respective tests, organizing logistics, arranging physical facilities.
Assurance: Specialist use to sit at separate floor and senior medical
official use to analyze final operation report.
Empathy: Patient relatively poor to main hospital ones, hence providing
them with free treatment served the basic need. Doctor gets into
personalize talk with patient to make them comfortable. There would be
a staf-in-blue helping and guiding patients.
Tangibles: Almost all surgeries ICCE, ECCE only because of medical reason
Only one of the operating table equipped with operating
microscope
Role of Aravinds clinic and support staf:
Aravind clinic strived hard to attain excellence in service marketing by:
a) External Marketing: Ofer quality eye care at reasonable cost and
cure blindness caused by cataract. Cater to the rich and the poor
alike and provide them excellent services.
b) Internal Marketing: Recruiting and completely training the nurses
and other staf to serve the patients well and perform all the
functions efficiently. The doctors were highly educated from
foreign institutions and provided extremely time efficient and
trustworthy services.
c) Interactive Marketing: Organizing Camps, providing
communication services to the poor and food during the entire
duration of their treatment. Sponsored by local businessmen,
turning local colleges into campsites to enable more people from
adjacent areas to get treatment and cure their blindness.

Section C
Weaknesses in Aravinds Model with corrective suggestions

a) Crowd mismanagement: Operations management techniques could
be used to spread out the traffic to the whole day rather than
through the morning only which is generally the scenario in which
the hospital is highly crowded in the mornings.
Manage the 3 most busy days, use token/prior appointment system.
Only critical tasks need to be performed by senior surgeons, routine
tasks can be executed by the junior staf and other employees as
well.
b) Transport and travel issues: Camps and promotional activities did
spread the news of the eye care facilities however it still required
the selected patients to come down to the hospital for surgery and
many could not aford the transportation costs, could not stay away
family for that longer a duration, were afraid of the treatment.
Hence, a high frequency of transport facilities as well as higher level
of interaction with the poor could be a suggestion totally considering
the amount of eforts that were already being taken.
People who would finally opt for surgery was much less than the
potential that could be attained.
Total
Screening
Surgery
Places
Surgery
Camps
visits
rate
Madurai
331
117175
14951
12.7
Tirunelv
eli
293
57924
4922
8.6
Theni
83
15901
945
5.9
c) Remuneration: The salaries(around 80,000 for senior staf and
12,000 for nurses) were comparatively low in comparison to the
private hospitals (salaries for senior staf could go up to 3,00,000 )
which could lead to less dedication and higher attrition rates.
d) Bed occupancy rate was much higher in the free hospitals as
compared to the paid hospitals. So Aravind eye care could lower the
capacity at the free hospitals to increase the utilization of the paid
hospitals and hence make certain profits and save some costs.
Paying
Free
Tirunelv The
Madur Tirunelv
Grand
Madurai eli
ni
Total
ai
eli
Theni Total
Total
Bed
Capacity
324
200
40
564
400
200
60
660
1224

Section C
Beds
occupied
per day
(sixmonth
average)
Occupanc
y rate
265
51
10
326
396
154
28
578
903
81.8
25.5
25
57.8
99
77
46.7
87.6
73.7

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Name: Subhadip Chakraborty

Roll Number: 150103179

Scenario of blindness in India (1991):

Name: Subhadip Chakraborty

1992: 240 hospital staf

IOL Factory Auro lab

Aravinds Model Of Delivering Eye Care

Name: Subhadip Chakraborty

Quality of Service at the Main Hospital:

Name: Subhadip Chakraborty

Name: Subhadip Chakraborty

Weaknesses in Aravinds Model with corrective suggestions

Name: Subhadip Chakraborty

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