Final Project
Final Project
Introduction.. 1
Overview of Six Private Hospitals in Dhaka and Ethical Codes Committed by the Hospitals.....2
Ethical codes as per law19
Ethical codes committed by the hospitals.25
Measuring the Deviation27
Recommendations..33
Conclusion.35
References.36
Appendix
Questionnaire
Articles
Introduction
According to the stakeholders model, an organization has responsibility towards its
stakeholders. A business organizations stakeholders include its customers, suppliers, employees,
Society, Government, and its competitors. Stakeholder theory is a theory of organizational
management and business ethics that addresses morals and values in managing an organization.
In the traditional view of the firm, the shareholder view, the shareholders or stockholders are the
owners of the company, and the firm has a binding fiduciary duty to put their needs first, to
increase value for them. However, stakeholder theory argues that there are other parties involved,
including governmental bodies, political groups, trade associations, trade unions, communities,
financiers, suppliers, employees, and customers. Sometimes even competitors are counted as
stakeholders - their status being derived from their capacity to affect the firm and its other
morally legitimate stakeholders. The nature of what is a stakeholder is highly contested with
hundreds of definitions existing in the academic literature. The objective of this paper was to
determine the commitment a business organization from one industry, which is hospital. The
industry chosen for this research paper is hospitals. We chose 6 different hospitals to compare
their service rules and conduct survey on. The hospitals are Square Hospitals Ltd, Japan
Bangladesh Friendship Hospitals Ltd, Labaid Hospital, Ibne Sina Hospitals Ltd, United Hospital
Ltd and Central Hospital Limited. We conducted survey on United Hospitals patients,
employees, suppliers, doctors & nurses nearby the hospital and in the end we formulated our
own policy after analyzing these results.
Nephrology
Gastroenterology
Nuclear Medicine
Internal Medicine
Radiology and Imaging
Joint Replacement & Arthroscopic Center
Minimally invasive surgical procedure
United Cardiac Center
Physiotherapy
Neonatal Intensive Care Unit
Intensive Care Unit
Square Hospital:
Square Hospitals Limited, a concern of Square Group is a 320-bed tertiary care hospital. The
hospital is an affiliate partner of Methodist Healthcare, Memphis, Tennessee, USA, SingHealth,
Singapore, Bangkok Hospital Medical Centre, Thailand and Christian Medical College, Vellore,
India.
A lot of physicians have joined from CMC-Vellore, India. Bangladeshi Physicians with
impeccable reputation are also part of the medical team. Huge emphasis has been made on
quality nursing services, as we have trained over a hundred nurses for over a year. We have nurse
educators from Australia, UK, India and the Philippines. Nurses and technicians have already
received training from CMC-Vellore which continues to be an on- going process.
Square Hospital is located in the heart of Dhaka and aims to serve greater portion of the capital
city. At present it comprises of two buildings on either side of Panthapath connected by an overbridge. The main hospital building is 18 stories and is approximately 450,000 sq.ft. The second
building (ASTRAS) is located across the street and is 16 stories with 136,000 sq.ft. The second
building is expected to be operational by 2011. Both facilities are constructed in accordance with
US Fire and Building safety standards
The outpatient department of this hospital can serve up to 1200 patients daily, through 60
examination rooms. To ensure optimum healthcare-hospitality, the patients are closely monitored
in their waiting times in outpatient clinics, emergency and admissions.
Services & Facilities:
OPD services
Inpatient Facilities
Coronary Care Unit (CCU)
Intensive Care Unit (ICU)
Ancillary Services
Pathology
Radiology and Imaging
Diagnostic Facilities
Ambulance Services
Medical Specialties:
Ardiology
Plastic Surgery
Ophthalmology
Trauma Surgery
Surgery
Gastroenterology
Colorectal Surgery
Surgical Oncology
Urology
Pulmonary Medicine
Neurology
Infectious Disease
Hepatology
Geriatric medicine
Radiology
Anesthesiology
Nephrology
Clinical Pathology
(MIS)
Clinical Hematology
Medical Oncology
Neurosurgery
Dermatology
General Surgery
Internal Medicine
Surgery
The Ibn Sina Hospital was established in July 1983, Keeping in Pace with continuous
development of medical technologies, Ibn Sina hospital has been rendering its services in the
field of Medicine (Internal, Neuro, Nephro, Gastro-liver, Cardiac, Onco, Endocrine etc.),
Surgery, Gynae, Neuro surgery, Spine Surgery, Knee Surgery, colorectal Surgery, Orthopedics
Surgery, urology etc. It provides tertiary level of medical care in those fields. Besides it has
opened a new horizon in Laparoscopic Abdominal and colorectal Surgery. With affordable cost it
gives services to the ever increasing number of kidney patients through its dialysis unit equipped
with most modern equipment and backed by a dedicated medical team.
IBN SINA Hospital has a good reputation of its ICU unit for rendering round the clock intensive
care services with the help of most modern and sophisticated equipments supported by a very
dedicated, skilled, and efficient team of doctors, nurses and other staffs. Ibn Sina Hospital has 8
well equipped operation theater where C-Arm, Operating Microscope available to make
operation more effective.
Ibn Sina diagnostic and imaging center is one of the largest diagnostic centers in Bangladesh. It
was known as Ibn Sina Diagnostic Laboratory since 2006. It was set up on May 1st, 1981 and
situated on House No # 48, Road No. # 9/a, Dhanmondi, Dhaka-1209.
It is equipped with the latest and technologically advanced appliances. A number of leading
specialized consultants attend here regularly, and it is renowned countrywide for its unparalleled
round-the-clock service and utmost dedication. It has fully computerized Hormone and
Immunology analyzers, Biochemistry and Hematology auto-analyzer, Serology auto analyzer,
Coagulation analyzer, Histo pathology, Cytology, Micro biology, Video endoscope, Digital
E.E.G, Blood culture (Fan Method), Electrophoresis of Hb & protein. Digital X-ray, OPG,
Mammography, 4D USG, Broncoscopy, Colposcopy, Echo, Color Doppler, ETT, ECG, Holter
Monitor,128 slice CT Scan, 1.5T & 18 channel double unit MRI 1st time in Bangladesh.
In addition Ibn Sina Provide general Health Checkup, Executive Health Check Up, Cardiac
health Checkup, Diabetic Health Check Up service. A complete Diabetic Centre Serving Diabetic
patients continuously.
Emergency
Momota/Gynae/Obs
ICU
NICU
Blood Bank
Dialysis
Surgery
General Surgery
Advanced Laparoscopic Surgery
Head & Neck Surgery
Hepatobilliary Surgery
o Upper GI Surgery
o Neuro Surgery
o Spine Surgery
o Knee replacement and Arthoscopic surgery
o Urology
o Paediatric Surgery
o Colorectal surgery
o Orthopaedic surgery
o Plastic and cosmetic surgery
o Barriartic surgery
o Dermato sugery
Cardiac Service
Oncology Unit
Pharmacy/Medicine
Pathology
Coagulation Clinic)
Paediatric cardiology
o Indoor Cardiac Treatment by dedicated Physician, Nurses and Technicians.
o Coronary Care Unit (CCU.
o Intensive Care Unit (ICU).
o Step Down (SD, CCU and ICU).
24/7 most modern Diagnostic Laboratory (Capable to provide almost all reports within 30
minutes).
Blood Bank.
Non-Invasive Laboratory: ECG, ETT, ECHO, 24 hour Holter ECG and Ambulatory
ASD, VSD, MVR, AVR and other heart surgeries are done by highly qualified surgeons.
Volumetric CT (VCT) with the facilities of doing all types of VCT scan.
Nutrition service.
Patient Counseling.
Online Patient Service
Labaid Hospital
Labaid Hospital is introduced itself as an international standard super-specialty hospital of the
country, dedicated exclusively to the diagnosis and treatment of cardiovascular diseases have
been built on a six storied building at, Dhanmondi - a commercial cum residential hub of Dhaka
City, covering a floor space of more than 100000 sq. feet.
Equipped with most modern and state-of-the-art equipment and machineries, the Labaid Hospital
makes a solemn commitment to the patients of the country - a commitment to maintain mastery
and marvel in acre, to be compassionate and respectful to patients' beliefs and values and to
make sound decision in the interest of the patients.
A band of highly skilled, dedicated and experienced surgeons, anaesthesiologists, perfusionists,
nurses and technicians garnered from both home and abroad work synergistically and
collaboratively under close supervision of renowned specialists of international repute not only
provide 24-hour services to the patients but also remain standby to deal with any emergency
conditions. Its approach is comprehensive, physician-led and cost-effective.
The fundamental strength of Labaid Hospital is its two teams - one of cardiologists and other
surgery. The teams are composed of highly skilled, experienced and eminent cardiologists,
surgeons and anaesthesiologists. Besides, a band of qualified and experienced nurses, technicians
and other support personnel garnered from home and abroad are providing constant care to the
patients. There exists an unprecedented amount of amity, understanding and cooperation among
the members of the teams which are sine-qua-non for successful treatment outcome of ailments.
Services & Facilities:
o
o
o
o
o
Emergency Services
Diagnostic Services
Medicine
General Medicine &
Internal Medicine
Diabetology & Endocrinology
Hematology
Pulmonology/Respiratory Medicine
Neuro Science
Anesthesia
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o Corporate Service
o & Health Check-up
Surgery
o Surgery
o General Surgery
o Laparoscopic & Colorectal Surgery
o Burn,Plastic & Cosmetic Surgery
Pain Management
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ESMR
Endoscopic and Laparoscopic Surgery Center
Multidisciplinary Pain Management Center
Cardiac and ECP Center
Women and Mother Care Center
Kidney Diseases and Urology Center
ENT and Endoscopic Sinus Surgery Center
Sleep Medicine Center
Oncology and Terminal Care Center
Plastic & Cosmetic Surgery Center
Colorectal Surgery Center
Diagnostic Services
NICU
Corporate Medical Services Center
EMRT (Emergency Medical Response Team)
24 Hours Diagnostic Service
24 Hours Pharmacy
24 Hours Ambulance Service
Central Hospital:
Central Hospital Limited started its journey aiming at comprehensive Medicare Services through
its humble efforts complimenting the policy priority of the Government.
The Central Hospital made rooms for highly skilled professionals with their variable experiences
and specialization in respective areas. The company was incorporated in 1991. Bangladesh
Shilpa bank, amongst other, has made an investment of sizeable amount as long term loan in this
venture.
12
The complex is located at a point where Dhanmondi Road # 5 meets the Green Road. This has
got all the prospects of an ideal Health Centre. Having foundation structure for 12 storied
building on their own land, the complex has been built up to 6-Storey at the moment. Each floor
covering approximately 10,500 square feet offers a hygienic and spacious area. Whole complex
has been well furnished with imported medical Equipment, Instruments & Medical grade beds.
The striking feature of the complex is its corporate set-up with a unique conglomeration of
professional skills supported by sound financial standings
The inpatient facilities includes 210 beds, 6-bed Intensive Care Unit (ICU) 6-bed Intensive Care
Unit (ICU), 15-bed Neonatal Intensive Care Unit (NICU), Operating Theatre with 5 operating
rooms, specialized hospital beds with all state-of-the-art medical outfits.
The outpatient department of the hospital can serve 1200 patients per day through 70
examination rooms. To ensure optimum healthcare-hospitality, the patients are closely monitored
in their waiting times in outpatient clinics, emergency and admissions.
ICU contains highly technical and sophisticated monitoring devices and equipment, and the
staffs in this unit are educated to give critical care as needed by the patients. The ICU is designed
in a way where the nurses and physicians are situated in a central position with rooms around
them. Patient vitals can be monitored with a central monitor. End to fifteen percent of all
newborn babies require care in a Neonatal Intensive Care Unit, and giving birth to a sick or
premature baby can be quite unexpected for any parent. Neonatal ICU of Central Hospital
Limited is a modern fully equipped facility providing intensive care for these infants.
Services & Facilities:
Inpatient Facilities
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ICU, NICU
Outpatient Facilities
Accidents, Emergency & EMS
Corporate Medical Services Center
Pharmacy Services
Diagnostics Services
Death Care, Death Certificate & Mortuary
Medical Specialties:
o
o
o
o
o
o
o
o
o
o
o
o
o
o
Pediatrics Department
Neonatal ICU Department
Neonatology Department
Medicine Department
Gastroenterology Department
Hematology Department
Cardiology Department
Adult ICU Department
HDU Department
Nephrology Department
Dialysis Department
Neurology Department
Endocrinology Department
Diabetology Department
Department
Oncology Department
Gynecology Department
E.N.T Department
Eye Department
Orthopedic Department
Physical Medicine &
Physiotherapy Department
o Urology Department
o Nutrition Department
o Speech Therapy
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Mi
Cost of Services*
(BDT)
o
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suc
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1s
o
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hy
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her
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Dia
laboratories.
o
o
o
We make every effort to ensure highest level of integrity in doing business. We treat
honesty, truth and fairness as the building block of our entrepreneurship.
We continuously strive to achieve highest possible standard in every activities and in the
quality of products and services we provide. We believe attaining excellence is an endless
Provide total health care including rehabilitation for all diabetics of gender, economic and
Operating at the highest standards of safe and ethical practices and demonstrating
continuous improvement.
Selecting the most appropriate services to produce the desired health outcomes.
Providing clear pathways by ensuring collaboration, consultation. Effective
patients.
Caring for the health of our staff and developing a culture of trust, and training for
personal growth.
o
To help our patients with utmost care and respect, in an ethical way.
To be known as a caregiver by acts.
To be known for treating patients in an ethical and reasonable way.
To be known for good behaviors with humane touch.
To be respectful, trustworthy, experts and serving.
o
o Measuring the Deviation
o The Bangladesh health policy was published in 2011 and adheres to the
following principles:
o Health is defined as A state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity.
1. Every citizen has the basic right to adequate health care. The State and the government
are constitutionally obliged to ensure health care for its citizens.
2. To ensure an effective health care system that responds to the need of a healthy nation,
health policy provides the vision and mission for development.
3. Pursuit of such policy will fulfill the demands of the people of the country, while health
service providers will be encouraged and inspired. People's physical well-being and free
thought process have proved to be a precondition for the growth and intellectual
enrichment in today's human society
4. Bangladesh expressed agreement on the following declarations:
o The Alma Ata Declaration (1978)
o The World Summit for Children (1990)
o International Conference on Population and Development (1994)
1. To develop a system to ensure easy and sustained availability of health services for the
people, especially communities in both rural and urban areas
2. Third to ensure optimum quality, acceptance and availability of primary health care, and
governmental medical services at the Upazila and Union levels.
3. To reduce the intensity of malnutrition, especially among children and mothers; and
implement effective and integrated programs for improving nutrition status of all
segments of the population.
4. To undertake programs for reducing the rates of child and maternal mortality within the
next 5 years and reduce these rates to acceptable levels;
5. To adopt satisfactory measures for ensuring improved maternal and child health at the
union level and install facilities for safe and clean child delivery in each village:
6. To improve overall reproductive health resources and services;
7. To ensure the presence of full-time doctors, nurses and other officers/staff, provide and
maintain necessary equipment and supplies at each of the Upazila Health Complexes and
Union Health and Family Welfare Centers:
8. To devise ways for the people to make optimum usage of the opportunities in government
hospitals and health service system, and to ensure quality management and cleanliness of
service delivery at the hospitals;
9. To formulate specific policies for medical colleges and private clinics, and to introduce
appropriate laws and regulations for the control and management of such institutions
including maintenance of service quality;
10. To strengthen and expedite the family planning program with the objective of attaining
the target of Replacement Level of Fertility;
11. To explore ways to make the family planning program more acceptable, easily available
and effective among the extremely poor and low-income communities.
12. To arrange special health services for mentally retarded, the physically disabled and for
elderly populations;
13. To determine ways to make family planning and health management more accountable
and cost-effective by equipping it with more skilled manpower.
1. To create awareness among and enable every citizen of Bangladesh irrespective of cast,
creed, religion, income and gender, and especially children and women, in any
geographical region of the country, through media publicity, to obtain health, nutrition
and reproductive health services on the basis of social justice and equality through
ensuring everyones constitutional rights.
2. To make essential primary health care services reach every citizen in all geographical
regions within Bangladesh.
3. To ensure equal distribution and optimum usage of available resources to solve urgent
health-related problems with focus on the disadvantaged, the poor and unemployed
persons;
4. To involve the people in planning, management, local fund raising, spending, monitoring
and review of the procedure of health services delivery etc. with the aim of decentralizing
the health management and establishing peoples rights and responsibilities in the system;
5. To facilitate and assist in collaborative efforts between the government and the nongovernment agencies to ensure effective provision of health services to all;
6. To ensure the availability of birth control supplies through integration, expansion and
strengthening of family planning activities;
7. To carry out appropriate administrative restructuring and decentralization of service
delivery procedure and the supply system, and to adopt strategies for priority-based HRD
aimed at overall improvement and quality-enhancement of health service, and to create
access of all citizens to such services;
8. To encourage adoption and application of effective and efficient technology, operational
development and research activities to ensure further strengthening and usage of health,
nutrition and reproductive health services;
9. To provide legal support with regard to the rights, opportunities, responsibilities,
obligations and restrictions of the service providers, service receivers and other citizens,
in connection with matters related to health service; and
10. To establish self-reliance and self-sufficiency in the health sector by implementing the
primary health care and the essential services package, to fulfill the aspirations of the
people for their overall sound health and access to reproductive health care.
o Weak relation between costs that is associated for the service and
its ethical approach in formulation of price schedules
o Policies practicing in United hospital much more same to be standards set by the
government, but when it comes to act as a nonprofit organization they are much
more far away from it. First of all they charge almost40-50% high price of any
kind of test compare to the policy set by the government. They dont have any
discounted section for the poor people as well. Its same for all. So hence it
clearly shows that they are very much up for profit making rather than providing
nonprofit service. For example for a Minor operation in public medical hospital it
will cost not more than 2500BDT at max but if we go to United Hospital it will be
more than 4000Bdt. Then we have found out that in public hospitals the operation
room charge is 3000BDT usually but in United Hospital it is 5000BDT(For Major
operations, such as, Cholecystectomy, partial gastrectomy, caesarian section, etc.).
In case of Intermediate operations, such as, appendectomy,
Suprapubic
Cystotomy, etc. operation room charge is 4000BDT whereas the charges in public
hospitals it is 2500BDT.
o Then they do not have any significant CSR activities to promote a healthy society.
Apart from the national health events which is obvious for every other private
hospitals to participate in.
o Then they are not also contributing in doing any medical research, which would
have been beneficial for the society. As they are charging a good amount of
money hence showing that they have a good amount of capital which can be used
to invest in doing medical research.
o
Recommendation
o After the gap analysis between the actual and the promise, we have given our
findings on deviation that impacts the overall quality of service and the sufferings
the patients face in the private hospitals. According to the findings, we are now
place our recommendation to rectify the issues and to reduce the gap from the
promised level of quality of the services they provide
o Two sets of findings we got from gap analysis, which are:
o 1. Cost of treatment in United Hospital is higher than any other private hospitals
and its unethical and unjustified compared to their service
o 2. High cost does not have any impact in providing better services and high cost
have impact in providing better service and cost of treatment in United Hospital is
higher than any other private hospitals and its ethical and justified compared to
their service.
o And 3 Sets of deviations and impact:
o 1. Every citizen has the basic right to adequate health care. The State and the
government are constitutionally obliged to ensure health care for its citizens.
o 2. To ensure an effective health care system that responds to the need of a healthy
nation, health policy provides the vision and mission for development.
o 3. Pursuit of such policy will fulfill the demands of the people of the country,
while health service providers will be encouraged and inspired. People's physical
well-being and free thought process have proved to be a precondition for the
growth and intellectual enrichment in today's human society
o Our Recommendation for them is to Lower their cost of treatments and try to
improve their service quality in long run.
o 1. Strive to deliver service on the schedule of your patient, not just a schedule that
happens to be convenient for your institution. Examples: Avoid unnecessarily
long waits for lab results to be distributed; this practice is disrespectful and even
cruel.
o 2. A more effective and powerful goal is to create an organization-wide halo effect
that raises your scores as well as your actual rate of referral not just the
hypothetical willingness to recommend.
o 3. Great customer service means systems as well as smiles.
o 4. Not-for-profit hospitals and institutions in healthcare can benefit by recognizing
and embracing their inherent organizational advantage over for-profit institutions,
as follows: It is easier for the employees to identify with the aims of an
organization that doesnt have profit at the center. If youre not for profit, be
aware of this advantage and make the most of it.
o 5. This just in: Bullying and disrespect lead to turnover. According to a recent
study, working in an environment characterized by bullying increases turnover
intentions of nurses, and employees report high turnover intentions whether
directly bullied or simply in a work unit with bullying.
o 6. Every single employee needs to know how to handle customer complaints and
concerns.
o 7. Much of whats wrong in patient satisfaction and customer service is related to
poor use of language, and to nonverbal language cues
o Conclusion:
o The justification of the project from an ethical point of view was missing from the
majority of the statements. It is noteworthy that even after the requirement for an
ethical consideration became mandatory, for health sector of this country. A more
effective and powerful goal is to create an organization-wide halo effect that
raises your scores as well as your actual rate of referral not just the
hypothetical willingness to recommend. Cost of treatment should be reduce
follow by their own pricing research methodology. Hospitals have to make their
service better and try to be a good competitor with other qualitative hospitals
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o References:
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