Hospitals can provide a homely birth setting for the mother, baby, and extended family. A hospital is a kind of facility that increases the efficacy of all other facets of the health-care system by ensuring consistent access to treatment for both acute and chronic diseases. To respond effectively to public health needs, a hospital should focus its resources to maximize benefits to its patients throughout its healthcare network.
KMCH (Kovai Medical Center and Hospitals) is the second oldest Corporate Hospital in the country. It was founded in 1986 and opened its doors in Coimbatore in 1990. Since then, it has been steadily growing from its original multi-speciality 200-bed size to 1000 bed corporate hospital and 720-bed medical college hospital on a 25-acre campus with four peripheral centers. It is patient-focused and the cost sensitivities of the Tier two population of the city have been kept in mind.
On the technical side, KMCH gradually built-up excellence in service. The hospital has a fetal medicine department, which does fetal MRI and is dedicated to trained fetal medicine specialists capable of doing intrauterine procedures such as laser ablation, fetal reduction, etc. It has a dedicated geneticist for counselling and is also a tertiary referral center for complex cases of dengue, haemorrhagic shock in pregnancy, uncontrolled postpartum bleeding requiring embolization. The hospital has also started handling COVID patients recently and set up a dedicated COVID positive maternity unit to handle COVID positive expectant mothers. It is a tertiary referral center for Neonatal ICU cases as well as 2 neonatal ICUs with combined 40 + beds. Cases of complex cardiac diseases discovered antenatally may be planned for cardiac surgery during the neonatal period.
KMCH Dynamics
When a pregnant patient first enters KMCH, they are sent to the OB & Gyn department. There the doctors focus on customer care and ease of service. Patients can have appointments with their selection of six OB & Gyn consultants. OB & GYN consulting rooms, Dietician Counselling, Cash counter, vaccination center, phlebotomy, NST testing, and Dedicated Pharmacy are located on one dedicated OPD area on the 3rd floor with Fetal medicine and genetic counselling are on the fifth floor with four dedicated USG rooms. This is separated from the rest of radiology. This is done so the patient does not have to mingle with other sicker patients inside a multi-speciality hospital but having all those services available if necessary. Patients have a choice of three cafeterias (Veg, Non-veg and full-service higher-end AC rooftop restaurant) while they wait. In-house Maternity store is run by “Born Babies”.
The hospitals do not have to offer any Package per se, as charges are the same given to all patients who visit the corporate hospital. The main difference is in the Room tariff. KMCH has spacious deluxe suites which are quite popular. For very poor patients, KMCH has a medical college hospital that charges only Rs 30 for consultation and a delivery package for Rs 10,000 including three Ultrasounds and follow-up visits.
The Vision for the hospital is to be a high-level tertiary referral center for all maternity and neonatal care. No one should leave Coimbatore to go to any part of the world for any procedure and their mission is to be a center of excellence in maternity and neonatal care.
One with Technology
During the Initial years in the 1990s, India as a whole was very behind in Equipment and trained staff and expertise in Neonatal care. On their inauguration day, KMCH was bagging a neonate with a probable cardiac dysfunction looking for a cardiologist and cardiothoracic surgeon to assess and intervene. There was no ventilator for neonates. KMCH has come a long way and now has equipment and personnel that are equal to the world.
However, there is a hesitancy when KMCH takes on new responsibilities and tougher cases that others reject. Convincing patients for Genetic counselling is easier said than done. Willingness to take on complex fetal procedures in Antenatal mothers brings about new fears that if anything bad happens, let it be in some other place. However, the doctors have risen to the challenge and improved their skill levels to handle almost any challenge.
A lot of technological advancements and innovation in the healthcare space has influenced the maternity hospital’s daily operations. KMCH has adopted HIS systems from the 1990s. The team of KMCH has not adopted complete Electronic Medical Records, as it is not very cost-effective but will implement it in the coming years. It has smart data analytic tools which can mine data and target people who have missed appointments and vaccination. Past records are available in computer systems for emergency reference. Most of the benefits have been on the backend where doctors have high-efficiency administrative targets and goals are tracked. The data is then processed to suggest changes to patient flow. Like changing pharmacy shift times, arranging extra phlebotomists, rearranging Vaccination, etc.
There are strategically driven plans to be implemented to enhance the efficiencies of the maternity hospital in the upcoming year. KMCH is focusing on bringing a lot of online content for expectant mothers. For example, in India, depending on what background or states patients are from, they have very different food habits. So dietary advice given in one printed format is completely useless to them. Patients need content, ideally in their language, which they can easily refer to and is relevant to them. This brings down the stress of normal pregnancy.
Towards a Glorious Future
Advice for young doctors:
- Patient care is first. Never forget this.
- Communication with the patient is highly critical to your success or failure as a doctor
- You don’t just treat patients, you treat families
- Fancy equipment, marble floors, and air-conditioned waiting halls can’t make up for a bad doctor on your team.
- Always improve yourself.
The future looks bright for maternity hospitals in terms of growth and expansion. Patient centricity is on the rise and a lot of customization will be required to keep up with changing demands. Patient experience and customer journey through systems will be critical. This is extremely easier said than done as patient feedback and data collected may not represent what does a patient value.
The Covid-19 pandemic has created a lot of workload for caregivers and ancillary healthcare service providers. There are problems being faced by maternity hospitals specifically in this ongoing pandemic. As a tertiary referral center that gets patients to form other states and districts, the patient flow was extremely restricted. COVID positive patients and attenders were constantly being picked up but only 70 % could be detected by RT-PCR meaning exposure to COVID was almost certain and a high amount of personnel protection and safety measures had to be taken. A dedicated COVID unit had to be set up as the hospital had a lot of long-standing patients with strong relationships, they did not want to break plus KMCH had a huge community responsibility. If they didn’t do it, who would?
Telemedicine will grow and help. But initially but initially will be impact except for high-end niches where patients can access high-end advisory services like endocrine issues or low-end services, online diet counselling and yoga, antenatal classes from the comfort of their home.
The volume of people using these services has increased, but still, a large section of patients need face-to-face contact. In places like Kerala and Tamil Nadu, there is a high doctor-patient ratio and the local Government service is good to handle all basic pregnancy care and the health data supports that. The only thing that makes them travel is a strong relationship and belief in their doctor. “Without relationship building, doctors will struggle to retain patients and our experience online is that it is hard to build these relationships online,” concludes the team of KMCH.
