Spotlight

A Tech Paradise

It's only seven months that the 303-bed Kokilaben Dhirubhai Ambani Hospital (KDAH) has started functioning, but it has made its mark because of cutting edge technology and latest treatment modalities, says Rita Dutta

Serving a population of 19-million, Mumbai's healthcare landscape has been dotted with leading private hospitals like Jaslok Hospital, PD Hinduja Hospital, Asian Heart Institute, Dr LH Hiranandani Hospital, Bombay Hospital, Leelavati Hospital, Breach Candy Hospital, Tata Memorial Cancer Hospital, Wockhardt Hospital and Nanavati Hospital. To add to this longish list, is the 303-bed Kokilaben Dhirubhai Ambani Hospital (KDAH), expandable to 750-beds, located in Andheri, a suburb of Mumbai.

Overcoming Hurdles

Initially, it was late cardiac surgeon Dr Nitu Mandke who was constructing the project as Dr Mandke's Heart Hospital in 1999. However, his sudden demise in 2003 spelt financial doom for the project. It was in 2004 that cash-rich Anil Dhirubhai Ambani Group revived the project by acquiring it and started transforming it into a multi-super speciality hospital— Kokilaben Dhirubhai Ambani Hospital (KDAH)—that took five-long years to complete.

Worth the Wait

Since this hospital had 'the Ambani' tag associated with it, right from market pundits to the common man, everyone was eagerly waiting for it. The five-year-long wait for the Rs-600-crore KDAH has been worth it as within seven months of its commissioning, it has become a healthcare destination synonymous with excellence in patient care, cutting edge technology and latest treatment modalities. The hospital is housed in 19 floors and spread over 10 lakh square feet. When fully operational, the hospital would have 750 beds with 20 OTs and 130-bed-ICU (the largest in Mumbai). The first phase of the hospital with 125 beds was inaugurated on 26th January, 2009 by Chief Minister Ashok Chavan and the legendary actor Amitabh Bachchan. "Encouraged by 85 to 90 per cent occupancy, we have added more beds in the last few months. As of now, we have 303 beds, out of which 57 are ICU beds," informs Dr Ram K Narain, COO, KDAH.

According to Tina Ambani, Chairperson, KDAH, who continues to play a pivotal role in operations, "Overwhelmed by the love and affection that I received over the years as an actress, I wanted to give back something meaningful to society. Following in the footsteps of my father-in-law Dhirubhai Ambani, who believed in the significance of good health, we have endeavoured to create a global healthcare institution that provides the latest in medical treatment.”

Spacious & Aesthetic

"We are focusing only on further growth. This hospital is not a money-minting project for us, but we have to ensure that it is a sustainable venture" - Tina Ambani Chairperson KDAH

"The paediatric cardiac centre deals with complicated cardiac birth defects by minimally invasive procedures through use of catheters & balloons or open heart surgeries" - Dr Jamshed J Dalal Director - Cardiac Sciences KDAH

One look at the imposing 19-floor building and the grand lobby of KDAH and ones expectation is set. Everything in this hospital is not just gigantic, but also aesthetically designed with focus on patient convenience.

The Lobby: The swanky lobby has only a handful of visitors lounging around, very much like a posh hotel than a hospital. The reason behind the less crowded lobby is that the ground floor does not house the OPD; the ground floor has a 12-bed emergency room, (whose connection with other departments is via a dedicated elevator), a cafeteria and fine dine restaurant.

The Design: The rooms, passages, consultation rooms, waiting areas, et al are spacious and soaked in sunlight. Even the hospital's laboratory is spread over an area of over 30,000 square feet. Special technical features like ceiling- mounted and dual-arm pendants in the ICU also ensure that the space around the patient is uncluttered. No wonder then that the hospital conforms to architectural guidelines developed by institutions such as the American Institute of Architecture, Joint Commission for Accreditation of Healthcare Organisation and American Nursing Association. The spacious and well-lit passages of various floors with signages encrypted in both English and Hindi eases patient movement.

It is important to mention that the hospital has used specialised flooring material that is non-absorbent, seamless and acts as a shock absorber and makes walking easier on the joints.

Have you heard of any hospital with 30 elevators in India? Yes, KDAH has the largest elevator bank for any hospital in India, which can transport over 10,000 persons per hour. Separate elevator banks have been set up for accident and emergency, inpatients, outpatients, staff, sterile supplies, support services and catering.

Says Dr Vikram Chhatwal, Member of Governing Council of KDAH, "In stark contrast to other hospitals, we have used only 40 per cent of built-up area for patient beds. The rest is used for support facilities that significantly improve patient recovery time and outcomes."

Not a 'Sick' Place

What adds to the appeal is the use of multifarious colours, be it pastel coloured wall or beautiful paintings dangling from the wall— all of which make the ambience vibrant. In the OPD section, nestled in the first and second floor, a unique aspect is the coloured pathways on the floors which direct the patients to various departments. It is also soothing to catch a glimpse of water lapping in on the Versova beach from a section of the hospital. The paediatric section is a visual treat to the eyes as multi-coloured cartoons and murals adorn the walls. The opulence of the luxurious presidential suites, with private terrace, just takes your breath away. The cafeteria also needs a mention because of its ambience and the delectable food that it offers.

The Manpower

The colourful paediatric ward

IMRIS at the hospital brings MRI surgical imaging to patients undergoing surgery

Novalis Tx— the world's first whole body radio-surgery systems

The hospital has over 103 full-time doctors, 520 nurses and about 200 paramedics. In a city like Mumbai, it was an uphill task to have full-time consultants. The hospital tackled this problem by taking a healthy mix of city- based and NRI doctors. The city-based doctors had to be sufficiently compensated to be full-time with KDAH.

Centres of Excellence

This institute lays special focus on six centres of excellence: bone and joint; brain and nervous system; cancer; cardiac sciences; paediatrics; and physical medicine and rehabilitation.

Oncology: The centre for cancer provides comprehensive and co-ordinated care for patients with all types of cancers, including solid tumours and blood related diseases. It has also has a bone marrow transplant unit.

Orthopaedics: The centre for bone and joint offers services in reconstruction, (computer-assisted navigation surgery for joints, Minimally Invasive Surgery, deformity correction), spine (Minimally Invasive Surgery, decompression laminectomy, discectomy and spine fusion, correction of spinal deformities), trauma (fracture surgeries, osteoporotic fracture fixation and deformity and disability correction), sports medicine (ligament reconstruction, autologous chondrocyte implantation, arthroscopic shoulder stabilisation and arthroscopic rotator cuff surgery), musculoskeletal cancers (reconstruction of severe bone loss) and limb salvage surgery for malignant bone and soft-tissue sarcomas), and paediatric orthopaedics.

Rehabilitation: Located on a dedicated floor with 30,000 square feet area, the key technologies in this department are Gait & Motion Analysis laboratory, which is useful for patients with neurological illness like stroke, Parkinsons Disease, ataxia or orthopaedic problems like spastic cerebral palsy, amputation and arthritis. It also has a multi-joint dynamometer with work simulator, a Balance Assessment and Training System, a video nystagmography, Body-weight Support Treadmill Gait Training System, EMG Biofeedback and Human Performance Evaluation.

Cardiac Sciences: About the newly inaugurated paediatric cardiology centre, Dr Jamshed J Dalal, Director - Centre for Cardiac Sciences, says "As western India had no comprehensive paediatric cardiac care, patients had to be taken to down South for treatment. Our paediatric cardiac centre can deal with the most complicated cardiac birth defects either by minimally invasive procedures through use of catheters and balloons or through complex open heart surgeries. The diagnosis is often made by ultrasound in utero and the parents are counselled and surgery planned within hours of delivery."

Technology is the Key

Cutting edge technology is the mainstay of the hospital. Besides having a 40-slice PET/ CT, a dual source cardiac CT, a SPECT, a 3 Tesla MRI, it uses navigation systems for orthopaedic, neuro and ENT work. Some other major medical and hospital technologies include:

3-room Intraoperative MRI Suite (IMRIS): This is India's first 3-room intra operative diagnostic and imaging solution where the patient is never moved. IMRIS brings MRI surgical imaging to patients undergoing surgery and enables surgeons to leverage the unique ability to provide better outcomes for their patients.

Radiation Oncology Linac Suites: The versatile system combines imaging and treatment technologies, and can be used to deliver the widest range of external beam radiotherapies- 3D conformal radiotherapy, IMRT, IGRT, fractionated stereotactic radiation therapy and intensity-modulated radiosurgery for cancer and neurosurgical treatments. Advanced imaging capabilities built into the system allow therapists to position patients for treatment with sub-millimetre accuracy. A respiratory gating system compensates for any tumour movement that occurs as a patient breathes.

Stereotactic

Radio-surgery: It has installed Novalis Tx, the world's first whole body radio-surgery systems for treating lesions in the brain, liver, pancreas, prostate and lung. It enables small, deep-seated tumours to be treated by radiation without open surgery.

Use of IT

The hospital uses an end-to-end solution for IT, be it for billing, discharge or CSSD. It has integrated HIS with SAP and management module. It has also integrated PACS with HIS. It is in the process of creating a patient homecare portal, whereby a patient's medical records would be saved in the hospital portal and can be retrieved by the patient using his special identification number and password.

The Road Ahead

So, how close is the hospital to its operational breakeven? "It's too early to talk about that. We are focusing only on further growth. This hospital is not a money-minting project for us, but we have to ensure that it is a sustainable venture," says Ambani.

The immediate future plans include scaling up the bed strength to 400 by November, this year. "The target is to commission all 750 beds within 18 to 24 months, from the date of commissioning of the hospital," says Dr Narain. In the pipeline are nine sub speciality clinics for sections like weight management, diabetic foot, etc. It is also evaluating introduction of robotics in urology and cardiac surgery. Also keen on liver and kidney transplant, it has submitted a proposal for the same. Academics is also on the cards. After commencing a BSc nursing college, KDAH is preparing to start DNB and CPS courses in cardiac sciences, critical care, neuro sciences and bone and joint etc.

With such preparedness and technological advantage, it’s just a matter of time for the hospital to become a renowned destination not only pan India but also globally.

rita.dutta@expressindia.com