Manipal Health Enterprises stands proudly as India’s third largest healthcare group, its network of 17 hospitals spread across the nation and into Malaysia offering comprehensive patient care.
The organization carries an ethos of core values which it calls ‘Clinical Excellence, Patient Centricity and Ethical Practices,’ and this shapes everything it strives for. Manipal’s success, then, is not surprising, and this level of effort even led to the flagship Bangalore hospital becoming NABH accredited and ranked among the top 10 multispecialty hospitals in the nation twelve times in a row.
A patient-first approach – something that one would expect but not necessarily receive at a medical facility – is paramount for Manipal, and its dedication to ethical practices and social responsibility manifests itself in the form of the Manipal Foundation, which enables it to extend its services to poorer, less privileged parts of the community.
Prioritizing people, technology, and the highest possible levels of care has led Manipal to effectively manage 5,000+ beds across its network of hospitals, and care for over two million patients from all over the world. The extraordinary work the organization does is best described by Gaurav Rekhi, Managing Director and CEO of the Malaysian branch of Manipal Hospitals, who knows what it takes for a hospital group to be competitive and expand successfully.
After studying hospital and healthcare management and working in various aspects of hospital administration, Rekhi moved into his current position in April 2016 and much of his role entails a responsibility to enable Manipal to expand further into Malaysia. Of course, there are challenges inherent in this kind of expansion, as Rekhi explains.
“To do this, you need two ways to expand: greenfield projects, and brownfield projects,” he states. A greenfield project is one that can be created without the constraints of a pre-existing construction, whereas a brownfield project is one based on prior work where a building already exists and simply needs renovation sometimes. Brownfield projects are preferable for hospital expansions, but Malaysia unfortunately does not contain many of them.
“Our expansion will primarily be greenfield,” says Rekhi. “We currently have a mixture of greenfield and brownfield projects which had taken us to 220 beds, and we have greenfield projects planned that will bring us up to 1,000 beds in Malaysia by 2021. There are two greenfield projects; one in Kuala Lumpur and other states of Malaysia for expansion. We are building and expanding as much as we can, but we are sometimes limited by building capacity.”
In the immediate future, Manipal is working towards having one state-of-the-art flagship hospital in the city center of Kuala Lumpur, adds Dr Arun Kumar, an ENT consultant and Senior Director of the group. “Right now we are in Klang, but we want to move into the city. We look at Malaysia as a big market for us. One in six doctors in Malaysia are alumni’s of Manipal, so we’ve got a huge base there already, especially amongst general practitioners.
“We feel we should do well and expand within Malaysia. We are also looking at countries like Myanmar and Cambodia, and if a reasonably good opportunity comes in those regions, we will consider them as well. We will definitely want to look at other big hospitals, may it be, brownfield or greenfield.”
Of course, expanding and moving from building to building in the healthcare industry is not necessarily smooth sailing. Rekhi tells me about a recent project in which a Manipal hospital in Malaysia needed to move into a larger building, and due to it being an active facility having patients, the move itself had to be as quick as possible. The answer? Limit the shift itself to a 24-hour slot.
“Within 24 hours we had to shut down and re-open in a new hospital,” Rekhi states. “There were some patients who fell asleep in one hospital and woke up in the new facilities. To move everything, we have to be completely prepared so than we didn’t have any issue with operations. All patients were checked every step of the way and the whole transition was done with surgical precision.”
Rekhi and his team moved everything in new hospital ward by ward and department by department and nothing which was required by staff was left behind because every single member of staff was helping. “We had to move patients in a way that meant we didn’t put anyone at risk. All the specifications, all the protocols were gone through twice thrice and communication with staff and clients had to be perfect to ensure full patient safety.”
Every piece of equipment in every department of the hospital was itemized and listed 15 days prior to moving, and the IT systems Manipal uses were being tested at the new facility a month ahead of the shifting.
“We made sure that we had new hospital ready for 70 patients there in advance,” says Rekhi. “We would be almost doubling capacity but had tested what we needed to begin with. On the day we opened, I can’t say there were no hiccups, but there were much less than there would have been. It was manageable move with no patient safety issues.”
Despite moving with patients, each being ferried to the new building by ambulance, Manipal fitted the new facility out with 120 beds to ensure that it had adequate equipment for new patients during the settling-in period. The organization brought a lot of other new inventory items too, to support the inevitable rise in patient numbers and enable the facility to be self-sufficient for up to a month after moving in.
“Our inventory was up to 60 percent higher than what we were used to, but as we moved in we had our major suppliers on our side who also kept an emergency line open for us, so if we needed something, they could quickly send it,” explains Rekhi.
With incredible teamwork, Manipal Hospitals achieved its goal of a 24-hour move. Rekhi cannot praise his staff enough for helping as much as they did, and he very proudly states that not a single doctor left the business during the undoubtedly stressful change.
“Despite the upheaval, despite the competition coming in next door, nobody has left,” he says. “All have been very supportive, and all we’ve achieved are because of the doctors and the team we had.”
Building up to the move, every month, then every week, then every third day, Rekhi and the other executives held meetings with doctors who show them the plans for the new facility, how we are planning, and what help they required from the doctors. This open forum allowed all to voice their concerns too, so there is no surprise when the time came, they were more than happy to throw themselves into the project.
Also it is a once in lifetime opportunity for anyone in healthcare, when you are part of a team, to transit from working hospital to another within 24 hours.
“Everyone worked together, everyone picked up bags and boxes,” concludes Rekhi. “It was the best moment when we had achieved this, everybody have put in their best effort.”
If this single venture is an example of Manipal’s work ethic and resilience, its ambitious plans to expand will surely prove both fruitful successful.