Research Proposal – Health Care Management – India as Case Study

Sanjivani- The Life Hospital

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Aim The healthcare industry has now developed as the most vibrant industries across the world. With growing size of this industry, demand for prospective and skilful mangers and healthcare specialists is also growing. The demand and requirement for the managers have straddled because there is urgent need for meeting the challenges of this likely market. With the globalization of the healthcare industry, healthcare managers and professionals must possess practice-oriented, international and intellectual skills.

Healthcare management purposes to provide managers with the potentials that are needed for the future global healthcare amenities. With the application of the healthcare management, managers are capable to organize the incompatible managerial skills to boost the quality while declining the cost at a same time.

ObjectiveThe need and demands for quality healthcare services has been increased so fast that it has become an issue in all over world than India is also not untouched from that. The main objective of study is to consider Sanjivani- the Life hospital as a base and hoe they are managing change with change of patient’s expectations. With new trends, pressure is there to deliver new and better delivery services. Earlier people were coming to the healthcare enters but now healthcare centres have located themselves near to the patients’ house. Other issues affecting healthcare management is the managed care contracting, which has become a serious issue for every healthcare organizations. Increasing the growth of healthcare contracting is foreseeable but some of the organization in healthcare field lacks proper data for the managed care contracting

Healthcare management is a kind of process that seeks to accomplish and manage properly one or two elements of the healthcare system. Today, great chances are there to become a manager within the healthcare field. If we find Sanjivani- the Life Hospital groups, it tends clear that they have applied healthcare management properly in their vast business (Mclaughinm, 2008).The present adjoining and environment for the healthcare organizations involves of many forces that demands extraordinary changes in the organizations. These forces comprise of augmented customer look, varying demographics, strengthen governmental pressure and rise in competition. Meeting such challenges requires efforts from the side of healthcare organizations such that they can be thorough with the fundamental changes and steadily inquire the new actions so as to harvest new values. Healthcare is an information-intensive process. Pressures for the professional and healthcare managers’ are rising as healthcare organizations are looking for the ways that lessen the costs, enhance quality and able to access the managed care. Also, healthcare has been developed as complex system. There should be proper coordination of the information technology with the twofold effects of the complicacies in organizations still assuring consistent growth in the field of medical technology. Healthcare organization is a field which is in relation to the set of activities including administering, managing and leading of hospitals, healthcare systems and network of healthcare clinics.

Organizational BackgroundSanjivani- The Life Hospital

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In today’s world, Sanjivani- The Life Hospital Group has not only extended name but has also converted a leader in the field of health care centres by delivering quality health care in Asia. Besides, it is being considered to be the biggest incorporated firm in healthcare aspect as well as it is complete in every aspect. Sanjivani- the Life is a powerhouse which you can trust blindly as its business is vast expanded with over 50 hospitals inclusive of 8500 beds, diagnostic clinics, a chain of hospital management colleges and nursing schools across Asia. Aim of Sanjivani- the Life Hospital is to make use of advanced technology with old traditions which are running down from centuries. Sanjivani- The Life Hospital Enterprise Limited was actually incorporated as a Public companyin1979. With the contributions of Dr. C Reddy, it became the first group that opened up the notion of corporate delivery in healthcare in India. It was then, the first company to be listed on the Bombay stock Exchange

Literature reviewHealthcare professionals or the manager’s plans, coordinates, directs and supervises the healthcare delivery. Rapid changes in the healthcare management lead to refurbishing of authorized standards and curricula. Healthcare management is multidisciplinary in nature which not only covers the healthcare aspects but also borrows the prospects of the public administration and business administration. A survey conducted informally by some trade magazine, Modern Healthcare, suggests that 70% of the business executives and educators believe in employing healthcare management in the healthcare organizations. Whereas 50% of the people believe that other areas or fields like trade finance, IT, etc should be given more importance. Several articles or journals for healthcare management have been published. Many of the research journals have reported the research that has been done on the healthcare and their conduits.

Books Healthcare Administration by Lawrence Wolper - this book says that HealthCare administration has become a major issue since the beginning of 21st century. It also states the ethical issues related to healthcare services as poor are paying more for healthcare services than rich. HealthCare management by John R. Schermerhorn – with the tremendous change in the healthcare workplace, everyone needs to react to these changes. Managers are accountable for delivering high quality and creating diverse work environment. This book also says that at every level, managers have different roles to play and has to perform varied duties (Schemerhom, 2007).

Haimann’s Healthcare management by Rose T Dunn – this book is well written and able to deliver the role, duty and functions of supervisors in healthcare system (Dunn, 2007).

Healthcare Management: Organization Behaviour and Design by Stephen. M Shortell – this book states the purpose of taking decisions by healthcare managers in their respective field. The objective of the book is to state the motivational factors for the employees in the improvement of the healthcare services. Some suggestions are being provided to healthcare mangers for providing motivation to their employees and co-workers (Shortell, 2007).

Principles for Health Care Professionals, by Joan Liebler, Paperback,Fourth Edition, Jones and Bartlett Publishers – The book is perfect for those healthcare professionals without any need for knowing their field for specialty. The realistic commands and instances in the book show the multidisciplinary backgrounds.

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Articles – Jim Ayers & Larry Benson Administrative Radiology Journal, August 1995.

In his article states that there are 10 ways in which managers can coordinate with the difficulties of healthcare environment. These 10 ways are divided into three categories which are operations control, operation effectiveness and operation control. This is basically for healthcare professionals to be able to deal with managed care.

The key to success of healthcare organizations are the people. As there is intense competition among the healthcare organizations, new innovative ideas and rewards for measuring future success is necessary. The article suggests that there is need for evaluating current performance as well as there is need for the development of new reward techniques so as to have satisfaction from the employee side and enhancement of competitiveness

Jim Ayers, Lawrence Benson, & Robert Bonhag DMD Journal of Healthcare Resource Management, October 1996

The healthcare providers are confused so as to which healthcare industry is in difficulty with physicians, hospitals and group of physician to deal with managed care and patient customer providers. It is vital for the providers to respond to the requirements of the managed care organizations and HMO’s.

RationaleThe article shows the research findings that have been conducted to see the impact of development of new HMO for the healthcare organizations. The study shows the association between the initial rationales which leads to the creation of the mission statement for the Sanjivani- The Life hospital and its performance. The findings present importance of the mission statement in the hospital and its likely success if the missions have been created for the organization

HypothesisIf the development of new HMO is in accordance to the cultural, ethical and religion beliefs, then financers as well as the patients is attracted to it.

Research methodologyAim of research: To see the development of new HMO would affect the management activities of Sanjivani- The Life hospital

Objective of the Research: to provide people the facilities and service of a new HMO by optimally using the resources and efforts of the healthcare professionals.

To see how research purpose and research objectives are developed, let us consider the case of Sanjivani- The Life hospital keening healthcare management in their organization. They have decided to use their resources to work a health management organization (HMO). The resources are wide, as

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would be predictable in large teaching and research healthcare centres with a well-built confined reputation.

Leading HMOs are testing with the demi-science called substitute medicine hoping to heal harms when normal medicines are unsuccessful. This is an astonishing drift. Many doctors still sight some substitute methods with great cynicism- the health maintenance organizations have a status for spurning all except the most unswerving treatments. whilst most of the HMOs by now offer chiropractic coverage, a number are adding acupuncturists and massage therapists, in conjunction with the practitioners called naturopaths who use herbal therapies, relaxation remedies, yoga and many more.

Managers of Sanjivani- The Life Hospital enterprise gathered for a meeting and represent their thoughts and research to construct support for the notion within the hospital. The meeting came to an end with some sort of worries and problems. The problem was how to decide the market demand in the region to hold another HMO although each member of the planning committee was persuaded of the potential benefits of the proposal, bed consumption rate and teaching programs, the confirmation is required to demonstrate the financers before they begin investing resources into the proposal (Yin,2009).

Following is the purpose of the study consists of research questions and a statement of the study scope.

ResearchQuestion: what is the demand for the new HMO?

Scope: limited to staff, students and faculty of the university.

The study was restricted to the university students, staff and the faculty for several reasons. First the university management was favourably liable toward the plan, giving it the best possibility of achievement in those surroundings. If support from that group was not in confirmation, then the prediction would not be bright in other organizations .Second, the budget restraint made it improbable that any valuable research should be carried out for more than one organization. No geographic limits were there, as it was consider that distance from the home to HMO should have only a weak pressure on individual choice in the proposed HMO. Finally, the followingset of purposes and objectives are set;

Purpose: what target market segments should the HMO emphasize?

Objective: recognize the market sections which are most paying attention in the proposed HMO. Assess their feasible rate of consumption of medical services from their past medical records.

Purpose: what services should be offered at what price level?

Objectives: recognize the features or characteristics of health plans that would have the greatest control on an individual’s option among options. Number of hypothesis were developed as to who was most probable to be paying attention in the plan. Of course, they would have to express strong interest in the plans described to them. Besides, good prediction would be those who were disgruntled with the treatment or quality of their current plan, did not have a long standing connection with a family doctor, had positive attitudes toward the Sanjivani- The Life Hospital, and were not registered in other healthcare plans through their spouses.

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Research design –

A research design is a blueprint used to guide research study toward sits objectives. The procedure of scheming research study involves many consistent decisions. The most important decision is the alternative of research because it decides how the information will be accessed (KING & VERBA,2004).

Types of approach

Exploratory approach – it is done when one is looking for imminent into the common nature of a problem, pertinent variables that require to be measured and alternative decisions. The research methods are highly elastic, qualitative and amorphous (Hawrtwig, 1979).

Descriptive research – descriptive research clinches a large populace of marketing research. Causal research – when it is vital to present that one variable causes or develops the value for the other variables, a causal research approach must be used. The first step is to use exploratory research approach to generate all possible reasons for the problem (Key, 2012).

Primary research and secondary research

Primary research – primary research is done to collate specific research purpose for the further research. A variety of techniques, ranging from qualitative research to survey methods may be employed To make choice for the best research approach for the HMO, a victorious decision has to be made which having large number of strengths and least weakness in relation to the options. Once this is obtained by uniting quite a few methods to take gains of their best characteristic and curtail their limitations (My Market Research Method, 2011).

Our research for HMO would engage preliminary qualitative research followed by a survey to depict the notion of the healthcare organization to a wide representative sample and test of the hypothesis. The principle survey options were mail questionnaires and personal or telephone interviews.

Personal interviews – the interviewer interviews the respondent in person. There is direct contact between the interviewer and the respondent. Personal interviews using trained interviewers are too costly and would be feasible only with a sample that was too small to identify adequately the differences.

Telephone interviews – the respondent is interviewed by the interviewer on telephone. There is no direct contact between the interviewer and the respondent. Telephone interviews would have been difficult to conduct both because of the length of the questionnaire and the evident need for multiple category questions, which are awkward to communicate orally. Mail questionnaires – the questionnaire is administered through fax. The interview mayor may not have contact with the respondent. The response rate would be low unless substantial incentives and follow ups are not provided (Jeff Anderson Consulting, 2011).

The solution was a self-administered questionnaire, with door to door delivery and pickup by untrained survey assistants.

Secondary research- secondary data are by now available, because they were composed for some other functions other than solving the basic problem. Included here are:

Syndicated data sources, such as consumer purchase panels.

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Databanks and other sources like government sources such as Census Bureau Existing company information system

Research Tactics and ImplementationMeasurement – The first step is to understand the research purpose into information requirements and then into questions that can be answered by expected respondents. One of the purposes of HMO study is to assess viable demand for the proposed HMO in relation to their current health plan. This means the information will be required on the respondent’s overall assessment of the projected HMO, their liking for the proposed HMO relative to their current health plan and their possibility of accepting the new plan if it becomes obtainable.

Once the individual questions have been decided, the measuring instrument has to be developed. The researcher designing an effective questionnaire must be concerned with how questions on sensitive topics such as income can be asked, what the order of the question should be and how misinterpretations can be avoided.

Sampling Plan

Most of the marketing research studies are restricted to the sublet of the total population or sample which is applicable to the research questions. One approach is to select a sample for the proposed HMO is probability sampling, in which all population members have a chance of being in the sample.

Anticipating the Analysis

Before actual data collection commences, the researcher must be attentive to the likelihood that the data will be not enough for testing the theory or will be interesting but unable of supporting act recommendations. With these anxieties in mind, the researcher should map how each of the data items is to be examined. One useful device is to generate imaginary dummy data from the questions in the measurement tool. The dummy data can be examined to make sure that the consequences deal with the objectives.

Analysis of value versus cost and time involved

Cost-benefit analysis should be likely to conclude if the research should be taken as designed or if it should not be conducted at all.

One of the mechanisms of cost is time. A research study for the proposed HMO can take six months or more. It may be place such that a time phase will not delay a decision, thus generating the jeopardy that set of attractive circumstances will be missed. The examination can bring to a close that either the research design is cost efficient and should be preceded further or that it is not and should be ended.

Errors in research design

The value of research project is based on the overall excellence of the research design and on the data collected and examined based on the design. More than a few possible sources of error can have an effect on the quality of a research procedure. The errors can persuade the variety of stages of the research procedure and result in imprecise or ineffective research conclusion.

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Quantitative and Qualitative Methods in Health Care Management

Quantitative research approach

These are research methods that are based on the scientific approaches in providing numeric value for the study. Researcher establishes various relationships among these numeric values. Statistical analysis is also being implemented to find the scope and strength of the causal relationship (Balvanes& Caputi, 2001).

Advantages: The findings of quantitative research are in the form of numeric values or statistics that are easy to explain and bring effective working. Comparing can be done easily as well as the hypothesis can be formulated and development of objectives. The researchers can be tested on the basis of its effectiveness in observations by using effective quantitative methods.

Disadvantages: Any false numeric value can mislead the research study and purpose. With the simplification of research study, the quantitative research becomes less meaningful. Artificial environment can be set up if there is unnatural settling of numeric values.

Qualitative approach

Healthcare management includes the planning, monitoring and coordinating the financing and delivery of medical services. Healthcare professionals and managed care doctors or managers work in such an environment where there is constant increase in costs, demand for innovations in medical and care technology and regulations by government. Also, healthcare managers work with multiple people like third party insurers and health care providers. Healthcare management is therefore a complex and composite process. Luckily, various qualitative methods are there to assist research in healthcare management (Balvanes & Caputi, 2001).

Various qualitative methods In our research h, healthcare managers are concerned with the issues of developing new HMO, in which qualitative methods can be used for the effective working. Qualitative methods helps in reaching to a specific decision related to the research purpose. Qualitative research tools and methods can be applied to Sanjivani- the Life hospital for healthcare management which includes Nominal group technique, focus groups, brainstorming sessions and Delphi (Mariam, 2009).

Nominal group techniques – these are kind of group discussion which are held to deal with a particular issue. At the time of nominal group techniques, each member group independent of others are asked to pen down a list of notions regarding the issue under discussion. Then, group members are asked to present their ideas one at a time which is then followed by a huge discussion. After the entire individual group members have accessed their thoughts and each group has discussed them, each member then ranks the notions which are being presented. NGT is a kind of interactive process that emerges after several ideas and their respective discussions.

Focus groups- it is the most popular technique in marketing and is a group interview. The sizes for the group can vary accordingly from eight to twelve people. In Health Care management, focus groups are best for providing discussion on important issues or in evaluating patient satisfaction.

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Many healthcare organizations make use of focus groups to know their strengths and weaknesses from the view points of the patients.

Brainstorming – in brainstorming sittings or sessions, healthcare managers call together or assemble a group of applicable people like medical professionals and medical providers so as to know the problems or emerging issues evaluate impacts or think for other strategic alternatives. At the time of brainstorming sessions, each individual from the group present their concepts and notions following with a short explanations such that the problems could be addressed. During these sessions, HealthCare managers are needed to provide new ideas so as to meet new challenge. These sessions are helpful for the hospitals as the changes in public policy and medical technology poses new threats and challenges to the healthcare management (Bailey & Hennink, 2011).

Expert insight – According to W.J Duncan and Peter Ginter, brainstorming and nominal group techniques are the effective decision making tools for the HealthCare management. With these techniques healthcare managers are able to know the demand and applicability of the new proposed HMO.

Delphi – it is an effective and popular technique to evaluate qualitative data for the issues which is in relation to the environment in which healthcare organizations works or operates. Under the method of Delphi, healthcare mangers end to seek opinions of professionals on a specific issue. After assessing and collecting the opinions of the professionals, mangers evaluate them and the send further to the experts for their expertise judgments and opinions. By this way, synthesis of opinions generates(Bailey & Hennink, 2011).

Research ethicsEthics in research can be considered to be the vital matter. These can be evaluated by the difference between its acceptability and unacceptability. The key or the most significant ethical issue is the safeguard of data or information obtained from the patient, which is both personal and private. Initially, medical records of patients were available to everybody and anybody but now it is no more obtainable. Nowadays, majority of the healthcare organizations keep the records of patients confidential and safe. An ethical worry of many healthcare professionals, nurses and doctors is to shield themselves from the hazard of obtaining communicable sickness from the patients, particularly if the patient past record is not available for some or any other reason. Even though, healthcare experts have all the rights to secure themselves from the a range of viruses which might be conveyed to them by the patients, yet, simultaneously they are responsible for not showing these protective measure to the patients which might cause them uncomfortably for the patients. Besides, marketing of the healthcare organizations is important to create awareness about its existence and services which it is offering. Precision should be followed such that hospitals and healthcare organizations follow certain rules and ethics (Berg, 2012).

To take care of ethical issues by Sanjivani- The Life Hospital, the staff and authorities of the hospital should be certain about the information which they are going to provide while advertising their organization. The information and data so provided should not be false and have accuracy in it. Whilst marketing their healthcare management in the organization, Sanjivani- The Life should take care that they are not forcing people for adopting their services or they are not making use of any harmful tools of marketing. The main purpose of the marketing should be the health of the patient; this objective should be the main tool for marketing. Profit isvital but should not be the basic principle for the organization. The present issue in healthcare research is concerned with the fact that medical research

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is now only related to developing countries and low income groups. Earlier it was carried in the developed countries. The main purpose of this shift is the rapidness and ease with which healthcare organizations have to spend less money that are needed for running trials in such countries. Even the application of ethical regulations and rules are much less in these countries. It is easy to have participation from the members for trials in low income countries as poor people are in favour of accepting such proposals by the rich medical and HealthCare organizations such as Sanjivani- The Life. The underlying problem in such case is providing information to the participants regarding the research study, effects of the drugs and the kind of medicines they are using which is important to know for carrying out the trials. Another ethical issue is the low quality care is shown to low income countries.

Conclusion:Modernism in medical services and application of the best obtainable medical knowledge tends to solve the problems and concerns of individual patients. as well as provide huge potential in assisting the patients and the overall healthcare system. The development of policies and procedures in Sanjivani- The Life Hospital had been able to decrease the premature deathrate and enhanced the quality life of the patients. Also, healthcare management is cost effective and seeks greater profit for the very hospital. HealthCare management also consist the financial growth and feasibility of the Sanjivani- The Life Hospital. The importance of healthcare organization can be realized only when the hospital is fully staffed with professionals and healthcare managers and is financially sound to invest in the advanced equipment. A basic concept behind the role of healthcare management is to provide affordable healthcare services to an average person. If in a community many people are unable to pay the fees for the laboratory or for prescribed drugs, then there is inadequate access to the healthcare services. Therefore, if people are unable to have adequate access for the medical services then there is not proper application of healthcare management (Kelley, 2007). Sanjivani- The Life hospital has adequately practiced preventive medicine has realized in lessening of premature death, accidental death, preventable death and infections that are being acquired within the hospital. Healthcare management implements policies and procedures which are specifically designed for the improvement in the quality health of patients which it serves. Sanjivani- The Life hospital is being very effective in financial aspect due to which it is able to adopt quality healthcare management in their organization. No organization is able to spend or adapt healthcare management in their system until it is not earning well enough. The outcomes of better healthcare standards cannot be enhanced until it has not effectively implement the healthcare management. Due to this, there are better outcomes from the expected patients and favourable healthcare standards (Gapenski, 2007).

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Time ScaleKey Activities Time ScaleProject Proposal Submission June 2014Introduction, Aim & Objectives June 2014Literature Review July First Week, 2014Reviewing Statistical Method July Last Week , 2014Formulating Questionnaire August ,2014Collection of Data & Analysing Data

September,2014

Conclusion & Recommendation September,2014

Works CitedBailey, A. & Hennink, M., 2011. Qualitative Research Methods. London: Sage Publication.

Balvanes, M. & Caputi, P., 2001. Introduction to Quantitative Research Methods. s.l.:Sage Publications.

Berg, B., 2012. Qualitative Research Methods for the Social Science. 7th ed. Long Beach: Allyn 8c Bacon.

Dunn, R., 2007. Haimmen's Health Care Management, Unites States of America: Library of Congress Cataloging- in Publication Data.

Gapenski, L. C., 2007. Understanding Healthcare Financial Management. 4th Sub Edition ed. London: Health Administration Pr.

Hawrtwig, F., 1979. Exploratory Data Analysis. s.l.:Sage Publication.

Jeff Anderson Consulting, 2011. Interviewing and Research Methods. [Online] Available at: http://www.jeffandersonconsulting.com[Accessed 24 May 2014].

Kelley, D., 2007. Applying Quality Management in Healthcare, America: Library Of Congress Cataloging.

Key, J., 2012. DESCRIPTIVE RESEARCH. [Online] Available at: http://www.okstate.edu/ag/agedcm4h/academic/aged5980a/5980/newpage110.htm[Accessed 23 May 2014].

KING, G. & VERBA, S., 2004. The Importance of Research Design. In: Rethinking Social Inquiry. s.l.:Rowman & Little Field Publishers.

Mariam, S., 2009. Qualitative Management. San Francisco: John Wiley & Sons.

Mclaughinm, 2008. Health Operation Management In America. pp. 34-45.

My Market Research Method, 2011. Primary vs. Secondary Market Research: What’s the Difference?. [Online]

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Available at: http://www.mymarketresearchmethods.com/primary-secondary-market-research-difference/[Accessed 25 May 2014].

Schemerhom, J., 2007. Health Care Management. Inc ed. United States: John Wiley & Sons.

Shortell, S. M., 2007. Investing in E health. s.l.:s.n.

Yin, K., 2009. Case Study Research. Unites States of America: Sage Publication .

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