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27th JANUARY, 2020

COMMUNITY WORK GROUP – 1 “SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE”

GROUP LEADERS: ➢ MALIK ASFAND YAR KHAN (LEADER) CSID 4704129

0333-5673124

➢ SYEDA YUSRA GILANI (D. LEADER) CSID 4706261

ADVISOR: Mr. Kamran Ahmad (Director CB) 0301-5299669

0331-8215158

Focal Person: Miss Saima Khan (Shaukat Khanum Hospital) 0300-0800433

SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

ABSTRACT

Shaukat Khanum Memorial Hospital and Research Centre is a state of the art facility that deals in providing efficient and equal treatment to its cancer patients, irrespective of their ability to pay. It has become a role model for its sister organizations. Shaukat Khanum largely relies on donations and Zakat. It also has indigenous source of revenue which includes selling its IT services. SKMCH&RC has a rigorous recruitment policy which further inculcates good incentives to keep its personnel motivated. Its impact is well known. Shaukat Khanum has a finance department that determines whether a patient is eligible for financial support or not. It though is dependent on the personality of Mr. Imran Khan, which its administration is trying to nullify.

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SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

ABSTRACT...................................................................................................................................................... 2 1.

HISTORY ................................................................................................................................................ 5

2.

ORGANIZATION CHARACTERISTICS....................................................................................................... 5 ➢

MISSION AND OBJECTIVES ................................................................................................................ 5

➢

SCOPE OF ORGANIZATION ................................................................................................................ 6

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LEGAL STATUS ................................................................................................................................... 6

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STRATEGY .......................................................................................................................................... 6

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LITIGATIONS ...................................................................................................................................... 7

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ACCOUNTABILITY SYSTEM ................................................................................................................ 7

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IMPACT ASSESSMENT (BEFORE & AFTER)......................................................................................... 7

3.

CRITICAL APPRAISAL OF THE OBJECTIVES AND STRATEGY OF THE ORGANIZATION ............................ 8 ➢

4.

ADMINISTRATION OF SKMCH&RC ........................................................................................................ 9 ➢

HIERARCHY ........................................................................................................................................ 9

➢

HUMAN RESOURCE MANAGEMENT ............................................................................................... 10

➢ 5.

•

RECRUITMENT OF STAFF............................................................................................................. 10

•

MOTIVATING AND INCENTIVIZING OF STAFF ............................................................................. 10 FUNCTIONING OF ORGANIZATION ................................................................................................. 10

FINANCES ............................................................................................................................................ 11 ➢

INCOME ........................................................................................................................................... 11

➢

EXPENDITURE .................................................................................................................................. 12

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SUSTAINABILITY ..............................................................................................................................12

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MARKETING EXPENDITURE BREAKDOWN ...................................................................................... 13

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“SELF-PAYED” VS “FINANCIALLY SUPPORTED” PATIENTS ............................................................... 13

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CRITERIA FOR FINANCIAL ASSISTANCE DETERMINATION............................................................... 13

6.

7.

AWARDS AND RECOGNITIONS .......................................................................................................... 8

SWOT ANALYSIS .................................................................................................................................. 14 ➢

STRENGHTS ..................................................................................................................................... 14

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WEAKNESSES................................................................................................................................... 14

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OPPORTUNITIES .............................................................................................................................. 14

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THREATS .......................................................................................................................................... 14 CONCLUSION....................................................................................................................................... 15

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SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

8.

RECOMMENDATIONS.......................................................................................................................... 15

Annexure - A DIVISION OF GROUPS AND RESEARCH AREAS ASSIGNED........................................................................... 18 Annexure - B COMPLETE ACTION PLAN OF THE VISIT ..................................................................................................... 20 ➢

VISIT ................................................................................................................................................ 20 •

DAY 1 ........................................................................................................................................... 20

•

DAY 2 ........................................................................................................................................... 20

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ROLES AND RESPONSIBILITIES OF SUB-GROUPS............................................................................. 20 •

SUB-GROUP 1 .............................................................................................................................. 20

•

SUB-GROUP 2 .............................................................................................................................. 21

•

SUB-GROUP 3 .............................................................................................................................. 21

•

SUB-GROUP 4 .............................................................................................................................. 22

Annexure - C SUB-GROUP REPORTS ................................................................................................................................. 29

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SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

1. HISTORY Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) is a state-of-the-art cancer center located in Lahore, Pakistan. It is a project of the Shaukat Khanum Memorial Trust, which is a charitable organization established under the Societies Registration Act XXI of 1860 of Pakistan. The institution is the brainchild of Pakistani cricket superstar, Imran Khan. The inspiration came after the death of his mother, Mrs. Shaukat Khanum, from cancer. Fundraising Imran Khan made a nation-wide appeal for the collection of funds from a match between Pakistan and India on November 10, 1989 at Gaddafi Stadium, Lahore which raised Rs. 2,902,600. This was followed by a series of more than 50 successful fund raisers held throughout the world. Pakistan’s win under Imran’s captaincy in the 1992 cricket world cup in Melbourne helped fundraising efforts. He was able to collect one and a half million pounds in just six weeks after the World Cup when the same amount had taken 2 years to collect earlier. He donated his entire prize money of 85,000 pounds for the project. In 1994 when the project required more financing for the ongoing construction, Imran Khan launched a mass contact campaign in which he toured 27 cities in the country and collected Rs. 120 million. During the entire campaign for the construction of the hospital, over a million individual donors from ordinary citizens to the rich and famous pitched in. Everything from cash to jewelry and valuables was donated.

2. ORGANIZATION CHARACTERISTICS

➢ MISSION AND OBJECTIVES “To act as a model institution to alleviate the suffering of patients with cancer through the application of modern methods of curative and palliative therapy irrespective of their ability to pay, the education of health care professionals and the public and perform research into the causes and treatment of cancer.” The core values include “quality” and “equality”. Besides that, it ensures access, clinical facilities and hotel facilities to its patients.

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SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

➢ SCOPE OF ORGANIZATION The scope of the organization includes: Investment in state-of-the-art technology, Continuous Quality Improvement System, Research, Medical Training Programs, Paramedical and Nursing Education and Training Programs, HIS (Hospital Information System), Clinical & Support Services.

➢ LEGAL STATUS SKMCH&RC is a project of the Shaukat Khanum Memorial Trust, which is a charitable organization established under the Societies Registration Act XXI of 1860 of Pakistan. There are several laws, which the organization has to abide by such as Labor Laws, Societies Act etc. Some of the laws are directly applicable while others apply indirectly. There is an online legal obligation register too. Some of these laws are: The Trust Act 1882, Charity Laws of Pakistan, Regulatory Compliance Laws of Trusts and Section 42 of Companies Act.

➢ STRATEGY Mostly Non-Profit Organizations or Trusts face an issue of continuous support in terms of donations from the masses. They fear decline in these donations once their nominal partner leaves the organization or dies. So, to address this issue, SKCMH has come up with a two tier strategy. The first is to build SKCMH as a brand itself and second is to reduce dependence on donations and zakat by augmenting their revenue generation through various sources. So far, this strategy seems to be working effectively as, gradually, appearance of Imran Khan in donation drives has reduced significantly. Similarly, on other hand, the income of the hospital has increased to 44% from 21% since its creation. In addition to that, their pricing strategy is based on the sharing model. 75% of patients are treated free of cost. Moreover, no matter how much a patient can pay, rest is paid by the trust itself in order to facilitate every possible patient. Prior to admission, the hospital evaluates the financial status of the respective patients within two hours and decides how much support should be lent. The hospital is focused on a niche market where it only caters to the needs of a niche market segment i.e. Cancer Patients. Their future strategy also revolves around the same market segment.

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SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

Instead of associating themselves with any teaching hospital or building a teaching hospital of their own, they are focusing only on cancer treatment. As far as their distribution strategy is concerned, they are going with market development strategy. Under this strategy, they are offering the same facilities by penetrating into new markets i.e. Peshawar and Karachi. SKMCH Peshawar is already operational with the exception of a few facilities. SKMCH Karachi is expected to be completed by 2023.

➢ LITIGATIONS No organization is immune to litigations. So, in the case of SKMCH too, there were minor litigations in the past. These litigations were related to patients and employees. However, as per the data provided, all patient-related litigations were always won by the organization, a success it proudly presents.

➢ ACCOUNTABILITY SYSTEM The accountability system is very strong right from the collection of donations till their right appropriation. For collection purpose, they have a single bank account for all the hospitals under SKMCH Trust. System is being moved to a paperless environment as much as possible. Cash or receipt system is discouraged and cheques are preferred. Even the collection boxes have their own location ID’s. Coin collection is also done carefully and forecasting method is used to avoid any embezzlement. An electronic system HIS, then, keeps track of all the system input and changes. Proper audit starts in January every year and ends by April following all the rules and regulations imposed by the State.

➢ IMPACT ASSESSMENT (BEFORE & AFTER) Around 150000 new cases of cancer reported in Pakistan each year. Before SKMCH, each year more than 200000 people lost their lives. Due to SKMCH and the facilities provided by it the death toll significantly reduced to 60000 -120000. Since it enhanced the overall awareness about cancer

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SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

through its dynamic awareness and marketing campaigns, it gave a hope to those who earlier felt alienated or helpless in their fight against cancer. About 147,450 patients have been admitted to the hospital and 2.62 million OPD visits are catered to so far by the hospital. Prior to this hospital, there was no such facility to cater to the needs of people at such massive level.

3. CRITICAL APPRAISAL OF THE OBJECTIVES AND STRATEGY OF THE ORGANIZATION Shaukat Khanum Memorial Cancer Hospital and Research Centre (Lahore, Pakistan), has gained the status of a model and standard for the other medical Institutes of Pakistan. It is running efficiently and effectively. Due to its success in dealing with cancer patients, another similar hospital has been recently established in Peshawar. Another similar hospital is planned to be established in Karachi in the years to follow. Its Financially supported patients amount to 75%. Since its establishment: New registrations amount to 170,458 Outpatient visits amount to 2,626,547 Admission amount to 147,450.

➢ AWARDS AND RECOGNITIONS For more than two decades, SKMCH&RC has been committed to the highest standards of patient care, education, and research. The Hospital’s commitment has been recognized at both, national and international levels. •

ACCREDITATION FROM JOINT COMMISSION INTERNATIONAL

•

EFFIE AWARDS PAKISTAN

•

ACCREDITATION FROM JOINT COMMISSION INTERNATIONAL

•

PAKISTAN CENTRE FOR PHILANTHROPY CERTIFICATION (PCP)

•

INTERNATIONAL HOSPITAL FEDERATION (IHF) MEMBERSHIP CERTIFICATION

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EMPLOYER FEDERATION OF PAKISTAN (EFP) AWARD and more

4. ADMINISTRATION OF SKMCH&RC ➢ HIERARCHY

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SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

➢ HUMAN RESOURCE MANAGEMENT • RECRUITMENT OF STAFF Shaukat Khanum Hospital and Research Centre is “State of the Art” Hospital and in order to maintain its standards, it vows to recruit the most competent professionals, may that be Consultants, Resident Doctors, Pharmacists or the Nurses. The recruitment process follows a phase wise procedure that includes multiple tests and interviews by the competent relevant senior Professionals in order to ensure that the best of the professionals come through.

• MOTIVATING AND INCENTIVIZING OF STAFF As per the words of the CEO of Shaukat Khanum Memorial Hospital and Research Centre, SKMH &RC is known as the “Pay Master” because it gives its employees their pays as per their qualification and experience. There is no delay in the payments. Moreover, the Staff, which is more than 3000 in number only in the Lahore Center and an additional 400 in Peshawar Center, is inspired to work their best by the periodical awards that are given by the SKMH & RC based on their performance.

➢ FUNCTIONING OF ORGANIZATION The organization works with the sole aim to cure and treat cancer patients through the application of modern curative and palliative therapy irrespective of their ability to pay. The organization is diverse in terms of its numerous functions. At the core, the organization provides medical services at the largest. The basic operation works with the walk-in. The patient is given a temporary number and the sent to the OPD for the issuance of Medical Record number. Afterwards, the junior doctor takes the history taking of the patients, and then sent to the consultant. The consultants then offer recommendations in terms of the financial evaluation. Once the recommendation is made the patient is then treated accordingly.

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SHAUKAT KHANUM MEMORIAL CANCER HOSPITAL AND RESEARCH CENTRE, LAHORE

Within the medical services, there are two further domains, clinical and diagnostic services. In the clinical services, Shaukat Khanum facilitates the following: Ancillary Health Services, Anesthesiology, Clinical and Radiation Oncology, Clinical Radiology, Internal Medicine, Medical Oncology, Nuclear Medicine, Pediatric Oncology, Pathology and Surgical Oncology.

5. FINANCES

➢ INCOME

SKMCH has diverse sources of funding, ranging from donations, Zakat, fund-raisers as well as hospital’s own revenue generation. The donations were received from both domestic and overseas donors, with the former accounting for 70% of the donations. The fund-raising is an essential part of SKMCH&RC. The hospital’s Fund-Raising events are highly efficient, with efficiency of minimum Rs 3 per each rupee spent on organizing such-raising events. The funds are raised through corporate support as well w...