CHAPTER - 1

INTRODUCTION

INTRODUCTION

The health care industry, or medical industry, is a sector within the economic system that provides goods and services to treat patients with, preventive, rehabilitative, palliative, or, at times, unnecessary care. The modern health care sector is divided into many sub-sectors, and depends on interdisciplinary teams of trained professionals and paraprofessionals to meet health needs of individuals and populations. The health care industry is one of the world's largest and fastest-growing

industries. Consuming over 10 percent of gross domestic product (GDP) of most developed nations, health care can form an enormous part of a country's economy. ??????????? For purposes of finance and management, the health care industry is typically divided into several areas. As a basic framework for defining the sector, the United Nations International Standard Industrial Classification (ISIC) categorizes the health care industry as generally consisting of: 1.
2. 3.

hospital activities; medical and dental practice activities; "Other human health activities".

This third class involves activities of, or under the supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratories, pathology clinics, residential health facilities, or other allied health professions, e.g. in the field of optometry, hydrotherapy, medical massage, yoga therapy, music therapy, occupational therapy, speech therapy, chiropody, homeopathy, chiropractics, acupuncture, etc. The Global Industry Classification Standard and the Industry Classification

Benchmark further distinguish the industry as two main groups:

1. 2.

Health care equipment and services; and Pharmaceuticals, biotechnology and related life sciences.

Health care equipment and services comprise companies and entities that provide medical equipment, medical supplies, and health care services, such as hospitals, home health care
2

providers, and nursing homes. The second industry group comprises sectors companies that produce biotechnology, pharmaceuticals, and miscellaneous scientific services. Other approaches to defining the scope of the health care industry tend to adopt a broader definition, also including other key actions related to health, such as education and training of health professionals, regulation and management of health services delivery, provision of traditional and complementary medicines, and administration of health insurance.

A health care provider is an institution (such as a hospital or clinic) or person (such as a physician, nurse, allied health professional or community health worker) that provides preventive, curative, promotional, rehabilitative or palliative care services in a systematic way to individuals, families or communities. The World Health Organization estimates there are 9.2 million physicians, 19.4 million nurses and midwives, 1.9 million dentists and other dentistry personnel, 2.6 million pharmacists and other pharmaceutical personnel, and over 1.3 million community health workers worldwide, making the health care industry one of the largest segments of the workforce. The medical industry is also supported by many professions that do not directly provide health care itself, but are part of the management and support of the health care system. The incomes of managers and administrators, underwriters and medical malpractice attorneys, marketers, investors and shareholders of for-profit services, all are attributable to health care costs. In 2003, health care costs paid to hospitals, physicians, nursing and other

homes, diagnostic laboratories, pharmacies, medical

device manufacturers

components of the health care system, consumed 15.3 percent of the GDP of the United States, the largest of any country in the world. For United States, the health share of gross domestic product (GDP) is expected to hold steady in 2006 before resuming its historical upward trend, reaching 19.6 percent of GDP by 2016. In 2001, for the OECD countries the average was 8.4 percent with the United States (13.9%),Switzerland (10.9%), and Germany (10.7%) being the top three. US health care expenditures totaled US$2.2 trillion in 2006.According to Health Affairs, US$7,498 be spent on every woman, man and child in the United States in 2007, 20 percent of all spending. Costs are projected to increase to $12,782 by 2016.

The delivery of health care services - from primary care to secondary and tertiary levels of care is the most visible part of any health care system, both to users and the general public. There are many ways of providing health care in the modern world. The place of delivery may be in the home, the community, the workplace, or in health facilities. The most common way is face-to-face delivery, where care provider and patient see each other 'in the flesh'. This is what occurs in general medicine in most countries. However, with modern telecommunications technology, in absentia health care is becoming more common. This could be when practitioner and patient communicate over the phone, video conferencing, the internet, email, text messages, or any other form of non-face-to-face communication. Improving access, coverage and quality of health services depends on the ways services are organized and managed, and on the incentives influencing providers and users. In market-based health care systems, for example such as that in the United States, such services are usually paid for by the patient or through the patient's health insurance company. Other mechanisms include government-financed systems (such as the National Health Service in the United Kingdom). In many poorer countries, development aid as well as funding through charities or volunteers, help support the delivery and financing of health care services among large segments of the population. The structure of health care charges can also vary dramatically among countries. For instance, Chinese hospital charges tend toward 50% for drugs, another major percentage for equipment, and a small percentage for health care professional fees.[16] China has implemented a long-term transformation of its health care industry, beginning in the 1980s. Over the first twenty-five years of this transformation, government contributions to health care expenditures have dropped from 36% to 15%, with the burden of managing this decrease falling largely on patients. Also over this period, a small proportion of stateowned hospitals have been privatized. As an incentive to privatization, foreign investment in hospitals up to 70% ownership has been encouraged. Medical tourism (also called medical travel, health tourism or global health care) is a term initially coined by travel agencies and the mass media to describe the rapidly-growing practice of travelling across international borders to obtain health care. Such services typically include elective procedures as well as complex

specialized surgeries such as joint replacement (knee/hip), cardiac surgery, dental surgery,
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and cosmetic surgeries. However, virtually every type of health care, including psychiatry, alternative treatments, convalescent care and even burial services are available. As a practical matter, providers and customers commonly use informal channels of communication-connection-contract, and in such cases this tends to mean less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress, if needed. Over 50 countries have identified medical tourism as a national

industry. However, accreditation and other measures of quality vary widely across the globe, and there are risks and ethical issues that make this method of accessing medical care controversial. Also, some destinations may become hazardous or even dangerous for medical tourists to contemplate.

PHILOSOPHY OF HEALTHCARE

The philosophy of healthcare is the study of the ethics, processes, and people which constitute the maintenance of health for human beings. (Although veterinary concerns are worthy to note, the body of thought regarding their methodologies and practices is not addressed in this article.) For the most part, however, the philosophy of healthcare is best approached as an indelible of component can of be human seen as social a structures. That is, the societal institution healthcare necessary phenomenon of

human civilization whereby an individual continually seeks to improve, mend, and alter the overall nature and quality of his or her life. This perennial concern is especially prominent in modern political liberalism, wherein health has been understood as the foundational good necessary for public life. The philosophy of healthcare is primarily concerned with the following elemental questions:

Who requires and/or deserves healthcare? Is healthcare a fundamental right of all

people?

What should be the basis for calculating the cost of treatments, hospital stays, drugs,

etc.?

How can healthcare best be administered to the greatest number of people?

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What are the necessary parameters for clinical trials and quality assurance? Who, if anybody, can decide when a patient is in need of "comfort measures"

(euthanasia)? However, the most important question of all is 'what is health?'. Unless this question is addressed any debate about healthcare will be vague and unbounded. For example, what exactly is a health care intervention? What differentiates healthcare from engineering or teaching, for example? Is health care about 'creating autonomy' or acting in people's best interests? Or is it always both? A 'philosophy' of anything requires baseline philosophical questions, as asked, for example, by philosopher David Seedhouse. Ultimately, the purpose, objective, and meaning of healthcare philosophy is to consolidate the abundance of information regarding the ever-changing fields of biotechnology, medicine, and nursing. And seeing that healthcare typically ranks as one of the largest spending areas of governmental budgets, it becomes important to gain a greater understanding of healthcare as not only a social institution, but also as a political one. In addition, healthcare philosophy attempts to highlight the primary movers of healthcare systems; be it nurses, doctors, allied health professionals, hospital administrators, health insurance companies (HMOs and PPOs), the government (Medicare and Medicaid), and lastly, the patients themselves.

HEALTHCARE IN INDIA

Healthcare in India features a universal health care system run by the constituent states and territories of India. The Constitution charges every state with "raising the level of nutrition and the standard of living of its people and the improvement of public health as among its primary duties". The National Health Policy was endorsed by the Parliament of India in 1983 and updated in 2002. Parallel to the public health sector, and indeed more popular than it, is the private medical sector in India. Both urban and rural Indian household tend to use private medical sector more frequently than public sector, as reflected in surveys. Malnutrition 42% of Indias children below the age of three are malnourished, which is greater than the statistics of sub-Saharan African region of 28%. Although Indias economy grew 50% from
6

20012006, its child-malnutrition rate only dropped 1%, lagging behind countries of similar growth rate.[4] Malnutrition impedes the social and cognitive development of a child, reducing his educational attainment and income as an adult. These irreversible damages result in lower productivity. High infant mortality rate Approximately 1.72 million children die each year before turning one.The under five mortality and infant mortality rates have been declining, from 202 and 190 deaths per thousand live births respectively in 1970 to 64 and 50 deaths per thousand live births in 2009.However, this rate of decline is slowing. Reduced funding for immunization leaves only 43.5% of the young fully immunized. A study conducted by the Future Health Systems Consortium in Murshidabad, West Bengal indicates that barriers to immunization coverage are adverse geographic location, absent or inadequately trained health workers and low perceived need for immunization. Infrastructure like hospitals, roads, water and sanitation are lacking in rural areas. Shortages of healthcare providers, poor intra-partum and newborn care, diarrhoeal diseases and acute respiratory infections also contribute to the high infant mortality rate. Diseases Diseases such as dengue fever, hepatitis, tuberculosis, malaria and pneumonia continue to plague India due to increased resistance to drugs. And in 2011, India developed a Totally drug-resistant form of tuberculosis. India is ranked 3rd among the countries with the most HIV-infected. Diarrheal diseases are the primary causes of early childhood mortality. These diseases can be attributed to poor sanitation and inadequate safe drinking water in India. However in 2012 India was polio free for the first time in its history. This was achieved because of Pulse Polio Programme was started in 1995-96 by government of India . Indians are also at particularly high risk for atherosclerosis and coronary artery disease. This may be attributed to a genetic predisposition to metabolic syndrome and changes in coronary artery vasodilation. NGOs such as the Indian Heart Foundation and the Medwin Foundation have been created to raise awareness about this public health issue. Poor sanitation As more than 122 million households have no toilets, and 33% lack access to latrines; over 50% of the population (638 million) defecates in the open. This is relatively higher than Bangladesh and Brazil (7%) and China (4%). Although 211 million people gained access to
7

improved sanitation from 19902008, only 31% uses them. 11% of the Indian rural families dispose of stools safely whereas 80% of the population leave their stools in the open or throw them in the garbage. Open air defecation leads to the spread of diseases and malnutrition through parasitic and bacterial infections. Inadequate safe drinking water Access to protected sources of drinking water has improved from 68% of the population in 1990 to 88% in 2008. However, only 26% of the slum population has access to safe drinking water, and 25% of the total population has drinking water on their premises This problem is exacerbated by falling levels of groundwater caused mainly by increasing extraction for irrigation. Insufficient maintenance of the environment around water sources, groundwater pollution, excessive arsenic and fluoride in drinking water pose a major threat to India's health. Rural health Rural India contains over 68% of India's total population with half of it living below poverty line, struggling for better and easy access to health care and services. Health issues confronted by rural people are diverse and many from severe malaria to uncontrolled diabetes, from a badly infected wound to cancer. Postpartum maternal morbidity is a serious problem in resource-poor settings and contributes to maternal mortality, particularly in rural India.A study conducted in 2009, found that 43.9% of mothers reported to have experienced postpartum morbidities six weeks after delivery. Rural medical practitioners are highly sought after by people living in rural India as they more financially affordable and geographically accessible than practitioners working in the formal public health care sector.

Female Health Issues

Malnutrition : According to tradition in India, women requires to eat last, even during

pregnancy and lactating period, which is the main cause of female malnutrition.[25]

Breast Cancer : One of the most growing problem among women causing an increased

number of mortality rate in India.

Stroke Polycystic ovarian disease (PCOD) : PCOD is another issue causing increase in

infertility rate in females. It is a condition in which there are many small cysts in the ovaries, which can affect a woman's ability to conceive. Maternal Mortality : Indian maternal mortality rates in rural areas are highest amongst the world. Healthcare Sector Over View And Trends - 2010 The Indian healthcare industry, unlike other industries, stands untouched by recession. There had been a steady growth in this sector, revenues from the healthcare sector accounts for 5.2% of the GDP, making it the third largest growing sector in India, and further the healthcare sector is projected to grow to nearly 1,80,000 crores by year 2012 and a compounded annual growth Indian The sector rate (CAGR) Healthcare comprises of 15-17 percent for at least / sectors the next 7-10 years. size include:

Sector hospital

structure and allied

Market that

(a) Medical care providers that includes physicians, specialist clinics, nursing homes and hospitals????????????????? (b) (c) (d) Contract Diagnostic service Medical research organizations centers and equipment and pharmaceutical pathology laboratories manufacturers manufacturers

(e) Third party support service providers

In India, 80% of all the healthcare expenditure is borne by the patients. Expenditure borne by the state is 12%. The expenditure covered by insurance claims is 3%. As a result the price sensitivity is quite high. The high level healthcare facilities are out of reach for the patients.

Among the top five therapeutic segments, gastro-intestinal and cardiac are experiencing both high volume and value growth. Opthologicals, cardiovascular, antidiabetic and neurological drugs continue to top the growth list. The anti-infective, neurology, cardiovascular and anti-diabetic segments have witnessed a high number of new product launches in recent years.

Current Healthcare Landscape

Amount spent on healthcare - 103,000 crores / annum 86,000 crores is the Healthcare delivery market 17,000 crores is the Retail pharma market

Key finndings of current private spending

Private spending on healthcare delivery 69,000 crores 61 % of this is spent on OPD services, 44,000 crores Indicates low levels of affordability and a disease pattern dominated by infections

39 % on IPD services = 25,000 crores 85 % of IPD spend is in 5 areas : cardio, cancer, accidents, infections and maternity

Road Ahead 2012

Private spending on healthcare delivery 156,000 crores because of an increase in population will lead to increase treatments

Change in socio-economic mix will lead to 8 % increase in treatment rate and 30 % increase in avg. price paid

Change in prices 26 % increase in price per treatment Change in mix of diseases 50 % increase in prevalence of lifestyle diseases will lead to 12% increase in treatment rate & 7 % in price and this would lead to a change in GDP from 5.2%to 6.2%

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Richest 15% will account for 50% of all private healthcare spending & 60% of inpatient spend

Private spending would increase by another 39,000 crores if the insurance is likely to impact on middle-income households approx. 350 million in 2012, leading to achieving GDP spending to 7.5% and private spending on healthcare delivery to 195,000 cr.

Parameters No. Of Beds No. Of Doctors No. Of Nurses Infant Rate

Current 1.2 beds per 1000 50,00,000 doctors 0.8 per 1000

By 2012 9,14,543 In addition 6,25,130 In addition 8,36,000 In addition 10:1000

Mortality 34:1000

Maternal Mortality 4:1000 Rate % of population 12.00%

1 :1000

50.00%

Insured Total Spending OPD Spending Hospitals 44,000 Crores 30,000 approx Primary Centres Centres Retails outlets Medical Colleges 229 179 New 1,80,000 Crores
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Private 69,000 Crores

156,000 Crores

82,000 Crores

hospitals 17300 In addition

Health 1,50,000 approx /

1,64,000 In addition

Community Health

chemist 3,50,000

24,000 In addition

Estd Current mrkt 103,000 Crores

size Average Expectancy life 63.3 years 74 years

Healthcare Fact File

Investments plan in Healthcare The sector has been attracting huge investments from domestic players as well as financial investors and private equity (PE) firms. Funds such as ICICI Ventures, IFC, Ashmore and Apax Partners invested about US$ 450 million in the first six months of 2008-09 compared with US$ 125 million in the same period a year ago, according to an analysis carried out by Feedback Ventures. Feedback Ventures expects PE funds to invest at least US$ 1 billion in the healthcare sector in the next five years.

According to a Venture Intelligence study, 12 per cent of the US$ 77 million venture capital investments in the July-September 2009 quarter were in the healthcare sector. As part of its Healthymagination initiative, GE will spend US$ 3 billion over the next six years on research and development, provide US $2 billion of financing over the next six years to drive healthcare information technology and health in rural and under served areas, and invest US$ 1 billion in partnerships, content and services.

The government, along with participation from the private sector, is planning to invest US$ 1 billion to US $2 billion in an effort to make India one of the top five global pharmaceutical innovation hubs by 2020.

The Ajay Piramal Group-owned private equity (PE) firm, India Venture Advisers, will launch its second US$ 150 million healthcare fund next year.

Leading international clinic chain Asklepios International is gearing up for a foray into the Indian healthcare market. As part of the 2.3 billion euro groups strategy to enter the sub-continent, Asklepios is mulling the launch of a US$ 100 to US$ 200 million fund.

Gulf-based healthcare group Dr. Moopen is investing over US$ 200 million for setting up hospitals and eye-care centers across India.

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Healthcare major, Fortis Hospitals plans to invest US$ 55 million, to expand its facilities pan-India.

Employment

Opportunities

India faces a huge need gap in terms of availability of number of hospital beds per 1000 population. With a world average of 3.96 hospital beds per 1000 population India stands just a little over 1.2 hospital beds per 1000 population. Moreover, India faces a shortage of doctors, nurses and paramedics that are needed to propel the growing healthcare industry. India is now looking at establishing academic medical centers (AMCs) for the delivery of higher quality care with leading examples of The Manipal Group & All India Institute of Medical Sciences (AIIMS) already in place.

A recent survey conducted by HarNeedi.com, gives an out look on the roles that are in great demand, Specialist doctors such as, Cardiologists, Cardiothoracic surgeons, Interventional Cardiologists, Orthopedics, Emergency Medicine Specialists, Oncologists, Radiologists, Ophthalmologists, Neurologists, Neuro-surgeons, Gynecologists, Urologists, Duty doctors etc are in great demand.

Some of the other profiles that are in great demand are that of experienced nurses and technicians who can handle various specialties such as ICUs, Cath labs, Operation Theaters, Emergency Departments etc. Technicians, like Radiographers, CT Technician, Radiotherapy technicians, emergency medical technicians etc. are also in great demand.

Considering all the above facts and the massive growth in the healthcare industry, huge investments would offer several opportunities for Indian companies to create 'win-win' situations and there would be emerging opportunities for professionals as well in the near future.

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1.1Company Profile

Fortis Healthcare (India) is engaged in providing the latest in internationally recognised medical care to patients with a variety of ailments and medical conditions. Our Network consists of Super Speciality Hospital Hubs that concentrate on one or more specialities. These hospitals are interconnected to a larger network of multi-speciality hospitals that ensures patient access to expert care for any speciality. This unique network architecture provides expert care to our patients and a level of confidence in receiving the latest medicine has to offer. VISION To create a world-class integrated healthcare delivery system in India, entailing the finest medical skills combined with compassionate patient care

Virtuous Values Patient Centricity Commit Treat to best and outcomes their and experience with for our patients. care and

patients

caregivers

compassion,

understanding. Our patients needs will come first Integrity Be Model principled, and open live and our things. as one team. honest. Values.

Demonstrate moral courage to speak up and do the right Teamwork and Put organization needs before department / self interest.
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Proactively

support

each

other

and

operate

Respect and value people at all levels with different opinions,

experiences backgrounds.

Ownership

Be Take

responsible initiative

and and go

take

pride the

in

our call of

actions. duty.

beyond

Deliver commitment and agreement made. Innovation Continuously Adopt improve and a innovate to exceed expectations. attitude.

can-do

Challenge ourselves to do things differently.

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MILESTONE

Specialities
16

Anaesthesia Cardiac Surgery Gastroenterology Dermatology Emergency Medicine

Blood Bank Cardiology Dental Diabetes and Endocrinology ENT

General Medicine GI Surgery Radiology Intervention radiology Neonatology Neurology Psycology Oncology Orthopaedics Physiotherapy Psychiatry

General Surgery Urology & Endrology Internal medicine Laboratory Services Nephrology Neurosurgery Obstetrics & Gynaecology Ophthalmology Paediatrics Rheumatology Pulmonology

International Patient Services: Fortis Healthcare Limited is affiliated with some of the worlds best in the fields of infrastructure, technology, and medical treatments to deliver world class healthcare services in the region. We continuously strive to provide the hassle-free healthcare services to our patients from all
17

over the world. In order to make your treatments seamless, over the years Fortis Healthcare Limited has developed alliance with the top-notch global service providers in the fields of healthcare, insurance,medical tourism, travel, and other sectors.

Our alliance with our international partners ensures seamless healthcare coverage for members while living, studying or travelling throughout India and in the Asia-pacific region. Our alliance with the service provides will facilitate the timely access to world-class healthcare services, medical expertise, and other healthcare related services.

Insurance Services

Fortis has tie ups with various insurance companies for easy payments. We will be happy to discuss payment options with your insurance provider in case your policy covers services rendered away from your home residence. Financial Services Advance payments are welcome but not mandatory. The full estimated payment must be paid on admission. Incidental charges will be due upon the patients discharge.

Fortis Hospital, Shalimar Bagh

Fortis Hospital, Shalimar Bagh equipped with 550 bedded, is a leading hospital providing wide-ranging healthcare services .Fortis Hospital, Shalimar Bagh, is the first hospital building in India to have registered for the green building rating system. It has been
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designed as an energy efficient building that complies with the ECBC (Energy Conservation Building Code) and is undergoing TERI GRIHA (Green Rating for Integrated Habitat Assessment) green rating certification. Sustainable design concepts have been incorporated in different aspects of the building design. In-depth analysis and optimization of the lighting system has resulted in significant savings in lighting system in the building. Simulation of the air-conditioning system has enabled evaluation and selection of various energy efficiency measures.

24 hr services

24 Hrs Emergency Blood Bank Laboratory Radiology Pharmacy Ambulance Dialysis

1.3 About the HR Functions

WHAT IS HR? Human resources is the set of individuals who make up the workforce of

an organization, business sector

or an economy. "human capital" is sometimes used

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synonymously with human resources, although human capital typically refers to a more narrow view; i.e., the knowledge the individuals embody and can contribute to an organization. Likewise, other terms sometimes used include "manpower", "talent", "labor" or simply "people". The Human Resource Department deals with management of people within the organisation. There are a number of responsibilities that come with this title. First of all, the Department is responsible for hiring members of staff; this will involve attracting employees, keeping them in their positions and ensuring that they perform to expectation. Besides, the Human Resource Department also clarifies and sets day to day goals for the organisation. It is responsible for organisation of people in the entire Company and plans for future ventures and objectives involving people in the Company. (Handy, 1999) Research has shown that the human aspect of resources within an organisation contributes approximately eighty percent of the organisations value. This implies that if people are not managed properly, the organisation faces a serious chance of falling apart. The Human Resource Departments main objective is to bring out the best in their employees and thus contribute to the success of the Company. These roles come with certain positive and negative aspects. However, the negative aspects can be minimised by improvements to their roles and functions. These issues shall be examined in detail in the subsequent sections of the essay with reference to case examples of businesses in current operation. Human resource management (HRM, or human or simply HR) It is is the management of responsible while for also

an organization's workforce,

resources.

the attraction, selection, training, assessment,

and rewarding of

employees,

overseeing organizational leadership and culture, and ensuring compliance with employment and labor laws. In circumstances where employees desire and are legally authorized to hold a collective bargaining agreement, HR will typically also serve as the company's primary liaison with the employees' representatives (usually a labor union). HR is a product of the human relations movement of the early 20th century, when researchers began documenting ways of creating business value through the strategic management of the workforce. The function was initially dominated by transactional work such as payroll and benefits administration, but due to globalization, company consolidation, technological advancement, and further research, HR now focuses on strategic initiatives
20

like mergers and acquisitions, talent management, succession planning, industrial and labor relations, and diversity and inclusion. In startup companies, HR's duties may be performed by a handful of trained professionals or even by non-HR personnel. In larger companies, an entire functional group is typically dedicated to the discipline, with staff specializing in various HR tasks and functional leadership engaging in strategic decision making across the business. To train practitioners for the profession, institutions of higher education, professional associations, and companies themselves have created programs of study dedicated explicitly to the duties of the function. Academic and practitioner organizations likewise seek to engage and further the field of HR, as evidenced by several field-specific publications.

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CHAPTER - 2
METHODOLOGY

2.1 OBJECTIVES OF STUDY

22

 To understand the effectiveness of Human Resource Functions at FORTIS HOSPITAL. To analysis the reasons for attrition based on extrinsic and intrinsic factors
To gain an insight into the attrition rate and effectiveness of the measures undertaken

To recommend the organisation on lowering the attrition rate

2.2 METHODOLOGY

1. Research Design: We have used a Descriptive research design as the problem is

already known.I undetook a detailed study as I was working in HR department.So a Descriptive research design is used to find solution to this problem and determine the best possible alternatives.

2. Target Population: Target population for this research was the employees

working/left in FORTIS HOSPITAL , Shalimar bagh ( New Delhi )

3. Research Tool: For this research, Management Information System was used along

with the help of exit interview forms and employee records available at the organisation

4. Action Plan for Data Collection: In the first stage Primary Data was collected

through MIS and employee records and it was then analysed by me.

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CHAPTER - 3
DATA ANALYSIS

CALCULATING ATTRITION

24

1. Attrition: Number of employees who left in the year / average employees in the year x 100. Thus, if the company had 1,000 employees in April 2004, 2,000 in March 2005, and 300 quit in the year, then the average employee strength is 1,500 and attrition is 100 x (300/1500) = 20 percent. 2. A graded system can probably depict the true picture. 3. Fresher attrition: the number of fresher who left within one year. It tells you how many are using the company as a springboard. 4. Infant mortality: percentage of people who left within one year. This indicates the ease with which people adapt to the company. 5. Critical resource attrition: key men exit. 6. Low performance attrition: those who left due to poor performance.

ATTRITION ANALYSIS QUARTER 1

25

Total Attrition in the Quarter 1 of year 2012(Apr12-Jun12) 50 Total employees in the Quarter 1 of year 2012(Apr12-Jun12)- 558

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FACTORS

LEADING TO

ATTRITION

Intrinsic Factors

Intrinsic factors are the factors which are internal to the company Working environment, Correlation between the Departments, etc. These factors can be controlled by the management through various ways and means, for ex. Conducting cross functional trainings, effective policies and strategies, etc. Eg.- Lack of oppoturnities, etc.

Extrinsic Factors

These factors are the ones which are person specific and the management cannot implement a control on these factors. Eg.- Family Issues/Relocation/Marriage

27

ANALYSIS
28

29

Nurses Total attrition : 31

Intrinsic factors were 3 out of 31 factors namely Lack of oppoturnity(2) Unhappy with Compensation(1)

and

Largely Absconding Cases of nurses constitute almost 50% of nurses attrition and 35% of overall quarter 1 attrition.

5 Nurses with tenure of around 27 months left due to personal reasons which includes marriage/relocation/family,higher studies ;

As much as 90 % of the nurses attrition were due to extrinsic reasons.

30

Exit Interview Analysis Nurses(15)

31

Doctors

Total attrition : 8

6 out of 8 factors under doctors attrition were due to personal reasons including lack of oppoturnity and other personal reasons.

Two of the doctors attrition were absconding cases.

Intrinsic Factors included relatively high FHSB experienced doctors.

Doctors with lower fortis experience left due to other personal reasons

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Non-Medical

Executives Total attrition : 5 Controllable factor was 1 out of 5 factors in executives attrition which is lack of oppoturnities.

Primary Reason being family/relocation/marriage constituting to 3/5 of executives attrition.

4/5 of the executives attrition were not under the control of management.

33

All Executives left FHSB due to personal reasons.

Exit Interview Analysis Executives(3)

34

Paramedics/Technicians and Staff

Total Attrition: 3

1 out of 3 employees fall in the category of controllable reasons Employment of one staff was terminated due to misconduct. 2 of the paramedics/technicians and Staff left due to personal reasons. Relatively high experienced employee left FHSB ,reason for which was controllable

35

Exit Interview Analysis -Paramedics/Technicians, Staff(2)

36

Controllable Factors in terms of Total Factors Category

37

CHAPTER - 4
FINDINGS AND CONCLUSION

38

Most of the nurses belong to other state, hence leading to much more absconding cases.

Reasons for attrition were majorly in 4 categories;

1. Absconding Strucked off (34%)

2. Personal Reasons others (34 %)

3. Family/Relocation/Marriage (16%) 4. Unhappy with compensation (14 %)

Two Doctors with Fortis employment of over 28 months and 17 months left FHSB and the reasons were controllable.

15/31 nurses were absconding cases and they are not reachable to conclude the exact reason behind it.

Uncontrollable Reasons are higher than controllable reasons in every category.

Believing the exit interviews, Executives were least satisfied with FHSB.

All Empoyees were deeply satisfied with their job at Fortis except one. .

39

CHAPTER - 4
RECOMMENDATIONS

40

RECOMMENDATIONS
Consistent increment in salary (6 months or yearly) based on the FHSB experience might reduce attrition to a certain extent, as controllable factors revolve around less compensation.

Local Nurses could be appointed to reduce the absconding cases.

Counselling should be provided yearly to deal with employees personal goals along with Fortis goals.

On the Job training could be facilitated to provide employees a better opportunity, feel of the environment and surety of job.

Doctors compensation and their growth/training prospect should not be neglected.

Job Rotation of Trainees under different departments such that trainees are able to choose their job according to their comfort and choice , hence leading to less grievances.

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An anonymous open forum discussion programme could be set up consistently timed to cater the needs and grievances of nurses , executives , paramedics/technicians and staff.

Exit interview forms must be collected and maintained properly from the employees leaving FHSB.

A grievance cell, in the form of post office box to facilitate suggestions, needs, complaints anonymously.

Induction regarding the updates at fortis must be transferred to the employees to make them feel a part of fortis.

Accommodation and Food facilities could be provided to Nurses of other states

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CHAPTER 5 LIMITATIONS

43

Every study has certain limitations and the present study is no more exception. The limitations are:

1. Employees who had left the organisation could not be contacted. 2. Exit Interview Forms were not available ,leading to inadequate data. 3. Time Constraints was one of the limitations of the study, time period was very less to do the research. 4. Confidentiality of data. Elaborate

44

BIBLIOGRAPHY

Book:
Human Resource Management By Dilip Belgaonkar

Newspapers / Magazines:
THE ECONOMIC TIMES TIMES OF INDIA WEBSITES: WWW.FORTISHEALTHCARE.COM

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MAHARAJA AGRASEN INSTITUTE OF MANAGEMENT STUDIES

ATTENDANCE FOR PROJECT REPORT

Name of the student Class Roll No. Name of the Supervisor

: AnubhavGirdhar : BBA (G) Vth (A) : 07714701710 : Mr. Rajiv Jain

S. No. 1 2 3 4 5 6 7 8

Date

Time

Progress Report

Signature the student

of

Signature Supervisor

of

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10

*Minimum (8out of 10) 80% attendance compulsory. Coordinator

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