Spotlight

Healing with Compassion

Shalby Hospitals has transitioned from a joint replacement centre to a full-fledged multispecialty hospital, offering care in over 25 medical disciplines. Sonal Shukla takes a look at the journey of the hospital

Today, healthcare in Gujarat is developing at a rapid pace with many corporate groups trying to grab a significant pie of this emerging market. In such a competitive market, there are few hospitals who have carved a niche in a particular speciality and now moving towards multi specialty status at a lightening speed. One such group is Ahmedabad-based Shalby Hospitals, the 240-bed multi speciality private hospital. Shalby Hospitals transitioned from a small 15-bed single specialty unit established in 1993 to a technologically-advanced 200-bed multi-specialty hospital in 2007. Though the hospital earns 70 per cent of its revenue through joint replacement, today the multispecialty hospital offers care in over 25 medical disciplines ranging from cardiology, cardiothoracic surgery, trauma, cosmetology to ENT.

The Origin

The hospital was started by Dr Vikram Shah, a well known joint replacement surgeon. After returning to India, Dr Shah started Shalby Hospitals offering for the first time in the city— Total Knee Replacement (TKR) surgery. The hospital near Vijay Cross Roads was commissioned in 1993 with six beds, one operation theatre, five staff, three level building and a small built-up area. The hospital offered only joint replacement and his dental surgeon wife Dr Darshini Shah practiced high-end dentistry with oral implantology. Though it started with joint replacement, in a short span of time, the hospital became an acclaimed joint replacement centre. Over 20,000 TKRs were performed during the period 1993-2009 by the joint replacement team spearheaded by Dr Shah. The hospital today is globally renowned for TKR and hip replacement surgeries.

"We consider ourselves as our competitor. The hospital has grown 60 per cent over last 15 years. We have achieved a growth of over 60 per cent (CAGR) each year. Where we had performed 15 operations during the first year, it grew to 600 about five years ago, but last year alone, we performed around 3,000 operations," shares Dr Vikram Shah, Chairman and Managing Director. According to him, the hospital will be conducting 6,000 TKR operations and group will clock a revenue of Rs 100 crore this financial year.

The Trendsetter

"The hospital has grown 60 per cent over last 15 years. We have achieved a growth of over 60 per cent (CAGR) each year" - Dr Vikram Shah Chairman Shalby Hospitals

"The modern hospital with seven OPDs in different cities is adding 10 more in tier II and III cities" - Wing Commander Arun Kaul (Retd) Executive Director Shalby Hospitals

The hospital always had an eye for innovation. Be it implementing the green building concept in the hospital or reducing the surgical time in joint replacement. The hospital building is environment-friendly with green features like fire brick construction to reduce energy loss, dual reflective vacuum spaced glasses, rain water harvesting for reduced RO water requirement and use of cooled compressed air for air-conditioning.

The hospital took efforts in bringing in efficiency by adopting process-driven approach in areas required. The surgical time in the hospital has been dramatically reduced from 1:20 mins / TKR in 1994 to approximately 22 mins, thereby reducing the infection rate from 1-2 per cent in 1994 to .03-.04 per cent today. "Surgical time has been brought down by incorporating a process-driven approach, making the surgical procedure simplified and systematic," shares Dr Shah.

The hospital offers more space per patient for increased comfort and at home feeling with the patient area of over 900 square feet. It has also incorporated infection control measures like HEPA filters, laminar air flow, body exhaust system, plasma steriliser and Maquet operating tables. The hospital also initiated cardiac stem cell transplant, ozone therapy for non-invasive and painless uterine fibroid embolism and Kyphoplasty to treat painful, progressive vertebral compression fractures (VCFs) in the Western region. It is believed that this is the first hospital in Gujarat to procure fractional lazer for high-end cosmetic treatments.

With patient care and infection control being the focus, Shalby Hospitals boasts of Class 100 OTs for enhanced infection control. Single-level enhanced emergency care is another feature making the hospital a notch above the league in critical care. The hospital has also started the ground work towards achieving NABH accreditation and is nearing completion.

Tech Savvy

View of one of the presidential suites

State-of-the-art neuro OT

Over 16,000 TKRs were performed during the period 1993-2009 in Shalby Hospitals

Keeping abreast with the globally developing technologies is an integral part of Shalby's mission, says Dr Shah. The hospital has invested heavily in IT Infrastructure with Cisco and Nortel networking infrastructure. It has a fully integrated Hospital Management and Information System which is designed to manage every aspect of information flow and control across the hospital. Right from vendor records to patient record, everything is electronically managed. "This will eventually help achieve the goal of a paperless office," shares Dr Shah. Imaging technology is enhanced further by incorporating a mini PACS radiology viewing system. This enables doctors to view patient's scans online, saving time taken for reporting.

"At Shalby, we try to indigenise technology to suite the changing requirements of the patients and ensure that we deliver at affordable costs," states Dr Shah. The hospital took few steps towards adapting new technologies by recently acquiring plasma sterilizer, 5-part blood cell counter, Vitros 250 dry chemistry analyser, ECQI immunology analyser and fully-automated urine analyser-U411.

Productivity Personified

The hospital has dedicated patient relations officers for each floor and encourages patients to give feedback of their stay during the treatment. There is a systematic follow-up system that the hospital follows for each patient discharged from the hospital. "We believe that patient feedback is not just important, it is critical for us to amend / improve the systems in the hospital," quips Dr Shah.

The hospital has been a profit centre right from its inception; it is currently operating at EBIDTA margins of 20-22 per cent. To ensure its focus on medical excellence, the hospital has outsourced ancillary patient care services like laundry, kitchen, housekeeping and security. "At Shalby Hospitals, we try and ensure our patients feel like a maharaja' — it is rarely that a patient is transferred from a bed to the other. The same electronically controlled bed will take the patient through the hospital whether it is a X-Ray, CT or even surgery preparation," says Dr Shah.

Socially Inclined

Dr Virkam and his wife Dr Darshini Shah have formed a trust to effectively contribute to the society. The trust activities involve extending financial aid to the needy patients. "The Vijay Cross Roads unit of Shalby Hospitals extends support to the underprivileged by performing surgeries at a low cost," says Dr Shah.

The trust also publishes a monthly magazine 'Shalby Times' with an intention to spread awareness about wellness, which is distributed to all its in-patients. Free camps and public outreach programmes at various locations across India are organised at regular intervals.

High on Medical tourism

Shalby Hospitals today is also proving to be a substantial contributor to the booming medical tourism in the state of Gujarat. Since last year, the group has been focusing more on medical tourism and has seen 10 to 15 per cent increase in medical tourism patients.

The first foreign patient was operated in the hospital for TKR way back in 1994. The hospital has been receiving patients from over 16 countries, especially for joint replacements. Dr Shah agrees that even though his contacts with fellow doctors and the representatives of Gujarati community abroad helped him propagate his skills at the initial stages, but what has acted as a catalyst for Shalby is word-of-mouth publicity.

"Patients who have taken treatment at Shalby have always referred patients. We keep our patients informed (especially international) about the addition of new facilities, enhancement of services etc. and the patients always respond to us in a positive fashion," says Dr Shah. The hospital has specially recruited an international patient coordinator dedicated completely to the international patients wing.

The hospital has been getting a large pool of patients from destinations within India too, including Kolkata, Jaipur, Chennai and Mumbai. "We are attempting to channelise this as a business phenomenon to work for us. We strongly feel that there is enough scope to grow even if we just focus on treating our fellow Indian friends," shares Himanshu Sharma, Senior. Manager- Strategic Initiatives, Shalby Hospitals.

Challenging the Odds

The biggest challenge faced by Shalby Hospitals is creating awareness about new upcoming technologies which it is incorporating to help its patients. It took almost 15 years for joint replacement to establish itself in Gujarat, in spite of the state being techno-savvy. According to Dr Shah, same is the situation for propagating Kyphoploasty and Ozone Therapy. The hospital is therefore using outreach programmes and CMEs to propagate the concepts.

Paving the Way

The modern hospital, which currently has seven OPDs (clinics) in different cities of the country, is adding 10 more to provide facilities in tier II and III towns, informs Wing Commander Arun Kaul (Retd), Executive Director.

The group is investing Rs 450 crore in the next five years to set up OPDs in eight cities of the world and 10 more clinics in the country to expand its reach to patients. It will fund its expansion plans through internal accruals. The outstation centres would coordinate between foreign patients and the Ahmedabad-based hospital which plans to rope in travel agencies to offer the patients travel-cum-treatment package.

Shalby has charted out expansion plans within Gujarat. The group will add another 600 beds in the State within next one and an half years. Two units of 150 bed each is coming up at distinct locations in Ahmedabad city and a 300-bed unit in Surat. All the three hospitals will be multi-specialty units offering global class healthcare facilities. All the units will be built to the requirement and the group does not plan any acquisitions at this point in time. A total of Rs 300 crore would be pumped in for the upcoming projects. "Our strength is in the Western region and we have a growing clientele here. We wish to cater to our clients in the region and then look for areas outside. All our upcoming units will be designed to support medical tourists," he adds.

sonal.shukla@expressindia.com