Operations Management

Final Report

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Term Report on Locating a hospital in Karachi.

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 Table of Contents

Letter of transmittal ....................................................................................... Error! Bookmark not defined.

Preface .......................................................................................................................................................... 1
Acknowledgement ......................................................................................... Error! Bookmark not defined.
Aims and Objectives...................................................................................................................................... 2
Executive Summary....................................................................................................................................... 3
Introduction .................................................................................................................................................. 4
Observations of Existing Hospitals While Locating A Hospital (Internal and External) ................................ 7
Dominant Factors in Services ........................................................................................................................ 9
Research Methodology ............................................................................................................................... 11
Limitations .................................................................................................................................................. 12
Approaches of Research ............................................................................................................................. 12
Towns of Karachi: ........................................................................................................................................ 13
Layout Description and Location details ..................................................................................................... 15
Preference matrix:...................................................................................................................................... 20
Conclusion ................................................................................................................................................... 22
Bibliography: ............................................................................................................................................... 23

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 Preface

As a part of our course curriculum and in order to gain knowledge about locating decisions in
operation process management, we are required to make a report on locating a hospital for a
population of 02 million people scattered over 10 towns of Karachi.

Through this report we have gained knowledge about various concepts, effects and
implications regarding the locating decision and also gained exposure about different hospitals
existing in Karachi which helped us in our report and we came up with a location that at where
there should be a hospital and that will cover 10 town of the city consisting of 2 million people.

It was amazing experience to get knowledge about such big hospitals about how they work and
a great experience to select our own location by various methods.

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 Aims and Objectives

Following are the aims and objectives of this report:

• Main aim of this report is to locate a hospital for the population of 2 million covering 10

towns of Karachi.

• Understanding and identifying the key methods for locating.

• Focusing on locating it in the centre of the city.

• Easily convenient for the citizens of Karachi to reach the hospital.

• The location where there is a need of hospital.

• Easy transport facility available at that location.

• To finish the given project inside the predetermined time.

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 Executive Summary

One of the basic needs of a citizen of this country is an affordable reach to any health facility.
Hospitals are there to provide all the facilities with diversified treatment equipment to
accommodate patients as they come looking for health care. Establishing a hospital equipped
with all the necessary treatment tools and highly qualified doctors and employees to provide
patients with a treatment in a best way possible. A facility which is providing all the modern
technical equipment and up to date medical research for the treatment of patients, who belong
not only from the category who can afford this facility easily but also to those underprivileged
communities of this country who are deprived of these facilities and are often left unattended
by many is indeed a step to achieve to contribute a share for betterment of our society. The
hospital will provide surgical, medical, maternity, pediatric, inpatient, mental health services,
and ambulatory care, as well as large, modern emergency department. We visit 2 hospitals
from which we gathered the information and observe that there are some factors, that we have
to consider it are, pollution problems for the patients, Patient flow management is considered a
persistent and refractory problem. Blockage in the flow can increase waiting and through put
time creating a negative effect on the quality of service delivery.

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 Introduction

Dr. Ziauddin Hospital

Dr. Ziauddin Group of Hospitals comes under the umbrella of “The Ziauddin Trust”, it’s the
largest private hospitals chain in Pakistan. The prime mission of this group is to provide the best
health and care resources to large population at economical offerings to go a step further to
contribute for the betterment of the health situation of this country. It began with a small
maternity home, and has grown exponentially over the years include five hospitals, including
three tertiary-care facilities, responding to the healthcare needs of the people. The facilities
provided in these hospitals are matched with the status of global health care and equipped
with state-of-the-are-equipment and focused on providing services of the highest quality. The
diagnostic technologies, and medical and surgical treatments provided, are controlled to keep
pace with the technological advancements. The planning and development team of Dr.
Ziauddin Group of Hospitals is working continuously to increase the patient capacity at each of
the hospitals to make quality health care accessible to as many people as possible. Dr. Ziauddin
Group of Hospitals competes with some of the biggest names in the healthcare industry and
aspires to become the preferred healthcare facility for our people and a symbol of national
pride for all.
The hospital come under this group and which are located in Karachi are:

➢ Dr. Ziauddin Hospital, North Nazimabad Campus

➢ Dr. Ziauddin Hospital, Clifton Campus
➢ Dr. Ziauddin Cancer Hospital
➢ Dr, Ziauddin Hospital KDLB, Keamari Campus
➢ Dr. Ziauddin Memorial Hospital

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Dr. Ziauddin Hospitals are lead by the Chairman, Dr. Asim Hussain and with his mission to
expand the hospital facilities more wide the group’s outreach and marketing department
collaborate regularly to initiate community services and engagement programs as part of their
corporate social responsibility. With the implementation of ISO 9001:2008 quality assurance
programs across the Group, the management is hopeful about the quality of service offered at
our hospital. I am certain that such measures combined with a compassionate and safe hospital
environment, dedicated staff and a team of credible Doctors makes Dr. Ziauddin Group of
Hospitals, the most reputed healthcare destination in the country.

South City Hospital

South City Hospital (Pvt.) Limited is a privately owned facility that covers a wide spectrum of
specialties, with an aim to provide top grade medical care in a comfortable and luxurious
environment. It is one of the most trusted institutions in healthcare. It is a privately owned
healthcare with an aim to provide facilities covering a wide range of specialties, providing high
quality medical services in a comfortable and deluxe environment. South City Hospital is
dedicated to a patient-first philosophy that merges care, compassion and medical excellence
with a focus on customer-care services.

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 The Aga Khan University Hospital

The Aga Khan University Hospital (AKUH) in Karachi was established in 1985. It is founded by
His Highness the Aga Khan, the hospital provides a broad range of tertiary and secondary care
and services of diagnosis of diseases and patient care services. The Hospital is principal teaching
sites for nurses and doctors from our school of nursing and Midwifery and the school of
medicine, mainly a teaching site of Aga Khan University’s (AKU) faculty of Health Sciences.
These all safe and high quality services are provided under one roof. The Aga Khan Medical
Complex planned and designed by Payette Associates was built on 65-acre site in Karachi. The
project contains 721-bed hospital, a medical school for 500 students. A school of nursing,
housing for staff and students (hostel) and a mosque. AKUH building is properly structured and
considers the history, climate, environment, symbolism and the spiritual values of the muslim
culture.

The Aga Khan University is an internationally reputable institution, globally recognized with
established working association with other leading University Hospitals in the world. AKUH is a
$250 million Hospital. The clinics and labortary services offer fast and accurate results to
patient disease diagnosis and treatment. Pharmacies supply quality medicines to in-patients
and out-patients. Various clinics are build, multi-specially clinics meet the need of outpatients
based on their health status and lifestyle, the Executive clinics are for patients who lead very
busy lives. Consulting Clinics are for patients who need to see a doctor with specialized training
for a specific disease of illness and CHC (Community Health Centre) includes patient Welfare
offer financial assistance to patients who have general illness but are unable to pay and are
found to meet the eligibility criteria. Zakat programs also financially help patients.

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 Observations of Existing Hospitals While Locating A
Hospital (Internal and External)

South city hospital:

The hospital is located at Shahrah-e-Firdousi Clifton, near sea view. Traffic in that area is usually
smooth and the environment around there is peaceful, hence going in/out of the hospital is
stress free.Traffic of patients inside the hospital is also not an issue, since the hospital is very
spacious (particularly its general/emergency area).

Quality of the waiting area stuff (furniture etc.) is great, especially of the specialized doctors,
which results in a relaxing and comfortable experience for the patients and the people they
may come with. Management is good in general though not great (because of young and
unskilled receptionists). Quality of their doctors are better than most and you can find a doctor
for pretty much any type of illness you may be suffering from.

Aga Khan University Hospital:

The Aga Khan medical Complex is built on 65 acre site in Karachi. The Hospital has 3 main
entrances on Stadium Road. (1) University Entrance Gate (2) Hospital Entrance Gate (3)
University sports Complex. In Pakistan Aga Khan has always been categorized under the best
hospitals for its best services and people still give priority to it despite of their high charges
because the management provides care that is respectful and its responsive to every individual
patient preferences, needs and values. Their medical and administrative staff always listen,
understand, investigate and respond to their patients feedback and complaints in a very
professional manner. And they then use the gathered information for the further improvement
of their services. The hospital facility includes Places to eat and Places to Pray too. The hospital
also have specialized clinics (out patients). The safety and security of patients, visitors, staff and
students is considered very important at Aga Khan University Hospital. Security monitoring
system are in place throughout the hospital. For safety and precautionary measure they fire
exits at different locations. Some detectors have been installed throughout the hospital.

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The Aga Khan University Hospital takes patient confidentiality seriously. The health reports are
accessible to the team of medical professionals and are not shared with anyone without the
permission. Patients admitted to the hospital have to rest to get better quickly that’s why they
have set visiting hours and everyone has to follow that schedule. They also keeps a strict check
on people that anyone doesn’t bring any electrical appliances or weapons in the hospital. We
can say that security and safety over there is good. The hospital has a total of 560 beds, 122
private and 117 semi-private air conditioned rooms, 251 General ward beds and 52 special care
beds available in ICU, CCU and NICU. The hospital has 11 main operating theaters. Patients and
Families can access public transport from the main stadium road. There is also a rickshaw and
taxi stand immediately outside the Hospital.

Dr Ziauddin hospital:

The hospital is a managed by comparable performance charts of all the hospitals operating in
Karachi. Each hospital is located with purpose to cater a significant numbers of populations of
that part of the city. Hospital’s infrastructure is based on the long term strategic planning which
to invest the facilities of health care as hospital becomes stable enough for its operations. The
art of handling patients is prioritized in any case as all the employees from surgeons to support
staff is trained to deal politely with patients. The waiting area, cafeteria, emergency room,
clinical area all are set up very well according to the initial plan of the management. The success
of their strategic goals are result of their competitive planning at the first stage, they focused
more on catering and providing basic health care facilities for as many citizens possible and
then extending their facilities and infrastructure. But the most important observation we
collected while visiting was the fact that they are very clear about the mission statement of
their hospitals and they know what are the current environment regarding health and medicine
facilities globally and they want to provide these “global standard” facilities to general public at
an affordable bills.

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 Dominant Factors in Services

Proximity to customers:
Location is a key factor in determining how conveniently the customers can visit. Being
available and convenient to the people is important, it depends on our market segment that we
choose. We should be in their reach whenever they need us. Since we are locating a hospital
around 10 towns of Karachi, it should be easily accessible by the people living in those 10
towns.

Transportation costs:
The warehouses and distribution operations should be done from a place closer to the hospitals
as it would it save the transportation costs of supply chain and most importantly the time which
could help in the cases of emergencies.

Proximity to markets (raw materials):

The hospitals should be closer to the markets where the raw materials can be bought from. It
would save a lot of time and money as inventory operations can also be done in less time. It will
also result in providing with affective services especially for a service sector like a hospital.

Nearby hospitals (competitors):

Location of competitors should not be at a closer radius as it would definitely affect a business’s
revenue. No matter what the nature of business is; manufacturing or services. Nearby hospitals
within one area can be a diversion for a customer (patient) and then we would have to come up
with a competitive edge in order to compete with others.

Site specific factors:

Residential density, traffic flow and site visibility should be considered before locating a hospital
as location is the most important factor and it should be accessible by as many people as
possible. It should be located at such an area where people from many towns can easily visit.

Infrastructure (roads):
The roads of the respective area should be in good condition because damaged roads cause
traffic and people like to visit where there’s no such disturbance and it is easily accessible.

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Traffic patterns:
The hospital should be located at an area where there is not much traffic disturbance at all
times, the infrastructure should be good enough. Traffic can run many customers away as most
people get irritated easily also the patients staying in the hospital wouldn’t like the noise
pollution.

Power supply:
The hospital should be located where there is electricity at all times as it is really important
especially for the sake of the patients as many of machines that are needed to assist the
recovery of patients run by electricity. Also there should be generators installed in the building.

Water supply:
Water is another most basic necessity needed to assist in the recovery of the patients. Enough
water should be present at all times for the patients as well as the people working in the
hospital.

Hygienic environment:
There should be clean, safe and hygienic environment inside as well as outside the hospitals so
that the patients are able to feel safe and to trust the hospital that it will be able to cure them
and their health and safety matters.

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 Research Methodology

Research method describes how our research has been conducted and what are the
approaches we considered while collection of our data from the respective research areas. We
are conducting this research in order to come up with a suitable area to locate a new hospital
for the population of 2 million within 10 towns of Karachi.

Research area:
Our research areas were stadium road, Shahrah-e-Firdousi (Clifton) and shahrah-e-ghalib
(Clifton) where Aga Khan Hospital, South City Hospital and Zia Uddin hospital are located
respectively.

Sample size:
Our sample size involves these 3 hospitals which are Aga khan hospital, south city hospital and
Zia Uddin hospital.

Research Design:
Our research design is descriptive where we have used the Naturalistic Observation approach.
Natural observation is simply an unstructured observation where the spontaneous behaviors of
participants is judged. We simply record the data on what we see and observe around the
surroundings of our research area. The advantage of this approach is being able to observe the
flow of behavior in its own natural setting, which helps increase the validity of the research.

Research Tool:
The research tool that we used for our data collection is simply observation where we observed
the internal and external environments of the hospitals. For example; the size, capacity, area,
number of people, waiting area, management etc and the infrastructure of the roads and traffic
patterns outside the hospitals.

Data analysis:
Our data analysis is based on observations which falls into the category of qualitative research.

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 Limitations

The research has been by a lot of hard work and countless hours involve in field research.
Nevertheless, there are few limitations of it:

• The information gathered are by the representatives of the hospital we visited. They are
credible to their respected posts but are not verified due to lack of time.
• The sample size, in this case the field work, are too small to come at a verifiable
conclusion.
• Access. If study depends on having access to people, organizations, or documents and,
for whatever reason, access is denied or limited in some way
• If there was more time available then we could get more information
• The quantitative results which mentioned, no doubts have valid reasoning, but still are
done on hypothetical basis.

Approaches of Research

• The biggest source of information was the on-field research in hospitals; Aga Khan,
Ziauddin Hospital, and South City Hospital.
• Apart from that, records and facts regarding populations and possible numbers which
will be catered the hospital were derived from Library and internet research.
• Lastly, the conceptual understanding to analyze everything accurately, the textbook was
used as recommended by faculty.

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 Towns of Karachi:
1. Baldia Town
2. Bin Qasim Town
3. Gadap Town
4. Gulberg Town
5. Gulshan Town
6. Jamshed Town
7. Kiamari Town
8. Korangi Town
9. Landhi Town
10. Liaquatabad Town
11. Lyari Town
12. Malir Town
13. New Karachi Town
14. North Nazimabad Town
15. Orangi Town
16. Saddar Town
17. Shah Faisal Town
18. SITE Town

The population of 10 towns we are taking into consideration are as follows:

Baldia town:

Population as per 1998 census: 406,165

Growth rate of Karachi: 5% per annum

Population of baldia town In 2017: 1,026,359

Shah Faisal Town:

Population as per 1998 census: 335823

Growth rate of Karachi: 5% per annum

Population of Shah faisaln town in 2017: 848607

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Orangi Town

Population as per 1998 census: 723694

Growth rate of Karachi: 5% per annum

Population of orangi town in 2017: 1828738

Gulshan Town

Population as per 1998 census: 646662

Growth rate of Karachi: 5% per annum

Population of gulshan town in 2017: 1634082

Kiamari Town

Population as per 1998 census: 383,778

Growth rate of Karachi: 5% per annum

Population of kiamari town in 2017: 969,787

Korangi Town

Population as per 1998 census: 546504

Growth rate of Karachi: 5% per annum

Population of korangi town in 2017: 1380988

Landhi Town

Population as per 1998 census: 666784

Growth rate of Karachi: 5% per annum

Population of landhi town in 2017: 1684929

New Karachi Town:

Population as per 1998 census: 684183

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Growth rate of Karachi: 5% per annum

Population of new Karachi town in 2017: 1728896

North Karachi Town

Population as per 1998 census: 500000

Growth rate of Karachi: 5% per annum

Population of north nazimabad town in 2017: 1263475

Malir Town:

Population as per 1998 census: 604763

Growth rate of Karachi: 5% per annum

Population of malir town in 2017: 1528205

The total population of the 10 towns we are targeting is approxiamately 12.6 million. And
almost all of the towns are interrelated to each other, thus the population of 2 million can
easily be benefitted from this hospital.

Layout Description and Location details

Centre of gravity method:

The method we are using in this research is center of gravity method. The workings of this
method are shown below. In this method, we have first taken the map of the 10 towns of
Karachi which we are taking into consideration i.e , these towns are closer to each other and if
we locate a hospital somehow in between with the help of centre of gravity method then the
population which is living in these towns which is approx. 10 million will be benefitted from it.

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16
 15
New karachi
(22, 14.5)
14

North Karachi
13
(22, 13)
Orangi,
12
(13, 12)
11
Baldia Gulshan
(13, 10.5) (23, 10.5)
10
(22.3, 9.9) Malir
(32, 9.5)
9
Shah Faisal
(28, 8.5)
8

Landhi
7
(32, 7)
Korangi
6
Kiamari (26, 6)
(14, 5.5)
5

1
2 4 6 8 10 12 14 16 18 20 22 24 26 28 30 32 34 36 38 40

We have made a graph and plotted scattered points along the graph which represents different
towns, i.e orangi Town, malir Town, Korangi, Landhi, Gulshan, Baldia, Kiamari, New Karachi,
North karachi And Shah faisal Town, then we have calculated centre of gravity which is
(22.3,9.9) represented differently with the help of red point, then we have seen the town
which is closest to this point and it appeared to be a gulshan town (23, 10.5) thus it is
concluded that we will locate our hospital in gulshan town as it is in the centre of city and will
serve many people around and also there is no existing hospital over there, so this is the most
ideal location where our hospital can be located.

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TOWNS POPULATI X AXIS Y AXIS LONGI LATIT
ON (in TUDE UDE
millions)

Orangi 1.8 13 12 23.4 21.6

Baldia town 1.0 13 10.5 13 10.5

Kiamari town 0.9 14 5.5 12.6 4.95

New Karachi town 1.7 22 14.5 37.4 24.6

North karachi 1.0 22 13 22 13

Malir 0.9 32 9.5 28.8 8.5

Gulshan town 1.6 23 10.5 36.8 16.8

Korangi town 1.3 26 6 33.8 7.8

Landhi town 1.6 32 7 51.2 11.2

Shah Faisal town 0.8 28 8.5 22.4 6.8

Total 12.6 281.4 125.75

X*=281.4/12.6=22.3
Y*=125.75/12.6=9.9

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With the help of center of gravity, we have determined the point where our facility can be
established as it is located very near to Gulshan town. So we will establish the hospital at
Gulshan town. Because it is at the most suitable place and reaching to all other towns will be
easy and on time.

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 Preference matrix:

Now we are using another method to cross check whether the location we have selected is
correct or not. Thus to check that, we are using preference matrix which will help us
determining the correct location, thus we have given scores to each one of them according to
our own observations, score ranges from 1-5, 5 is for excellent and 1 is for poor.

Location factors are as follows:

A. Availability of skilled doctors

B. Proximity to people
C. Proximity to resources
D. Transportation system
E. Influence of rich people

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 Preference Matrix:

Thus, the highest payoff we got from the preference matrix method is from Gulshan town, and
it is verified from the calculations of preference matrix that the ideal location for a hospital is
Gulshan town keeping certain factors in mind.

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 Conclusion

Karachi is a metropolitan city. And the number of business and economic opportunities are
available here. Hundreds of people migrate every day and come to Karachi to seek jobs and
other employment opportunities, but at the same time, the people in Pakistan are not very
healthy because of the bad food habits, and millions of dangerous diseases take birth every day
and proper treatments are not available and also if they are available they are very expensive
and merely unaffordable for the general public, thus there is a need of locating a new hospital
where we can provide people with good and secured treatments with a safe environment and
most importantly in a affordable price. Thus we located a hospital by using different methods
and doing analysis with the help of observations from existing hospitals.

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 Bibliography:

https://www.google.com.pk/search?q=AGA+KHAN+hospital&espv=2&site=webhp
&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiWmouorfnSAhXThRoKHR0LCQIQ
_AUIBigB&biw=1366&bih=613#imgrc=G8EQsBN5g92a1M:

https://southcityhospital.org/

http://www.zu.edu.pk/

https://www.google.com.pk/search?q=maps+of+karachi+towns&espv=2&source
=lnms&tbm=isch&sa=X&ved=0ahUKEwiH1MCex_nSAhVEiRoKHaotBwYQ_AUIBigB
&biw=1366&bih=662

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