A Review of Aravind eye care System

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Aravind Eye Care is a high performing hospital that deals with illnesses connected to blindness. It prevents needless blindness in India. The hospital has established a model for eye healthcare for all the societal sectors (Mehta and Shenoy 4). Aravind Eye Care was started by a visionary man from Chennai known as Dr. Venkataswamy. Dr. Venkataswamy was suffering from arthritis, but despite the illness, he became an ophthalmologist and began performing cataract operations in the Madurai Medical College. He also established the concept of eye camp programs in the 1960s (Williams 112). The eye camps made Dr. Venkataswamy develop immense experience in healthcare, and thus he was able to observe the inability of the government in meeting the healthcare needs of all the individuals in the society (Aravind Eye Care System). The failure to offer such services was influenced by several factors such as increased population growth, inadequate infrastructure and limited per capita income.

 Dr. Venkataswamy considered this as an opportunity and established the Aravind Eye care, which served as a self-supporting healthcare institute. The Institute assisted in supplementing governments efforts in overcoming blindness. Dr. Venkataswamy had unabashed respect for the business practices adopted by McDonald's. He ensured that Aravind fostered the devotion held by McDonald's which entails "clear standards, consistency, reliability, and low costs" (Mehta and Shenoy 16).

The first healthcare center for Aravind Eye care was constructed in Madurai in 1976 (Mehta and Shenoy 13). The hospital had a capacity of 11 beds and specialized in providing care for patients suffering from disabling cataract blindness. Today Aravind Eye Care is one of the biggest eye care providers having a network of other five hospitals. These hospitals have a bed capacity of 3,400 beds and cater to all societal sections inclusive of the bottom of the pyramid (Mehta and Shenoy 16).

Aravind also established some vision centers dealing cataracts and rare eye complications, for instance, retinal disorder and glaucoma. Establishment of the first vision center was in 2004. Notably, most of the centers are located in rural areas, where access to care is limited. Every vision center takes care of a population of approximately 50,000. Currently, 14 vision centers are located in Madurai (Aravind Eye Care System).

Over the years, Aravind Eye Hospitals have incorporated other activities, which have made the hospital to evolve to an Eye Care system. There are several divisions in the Aravind Eye Care System, such as Aravind Medical Research Foundation, Aurolab, Rotary Aravind International eye bank and Lions Aravind Institute of Community Ophthalmology (LAICO) which is a training center (Aravind Eye Care System).

The success of Aravind Eye Care system can be attributed to the sustainable solutions that it has adopted. One of these solutions is high utilization of assets. One asset that Aravind has utilized efficiently is the human resources through the adoption of unique management practices. Such practices involve continuous training of the mid-level personnel, especially the women from villages. The women undergo the training through a two-year course. Such women have never had an opportunity of attending college, and thus through the training, they can work as mid-tier technicians. Notably, these women make up 60% of the workforce in the Aravind Eye Care system (Aravind Eye Care System). Usually, they perform numerous routine tasks that assist the surgeons to work with enhanced efficiency and speed.

Additionally, Aravind care system has set up some standardized procedures to ensure the maintenance of high quality in the delivery of medical care services. The use of efficient processes has enabled the hospital to make maximum use of its infrastructure in the operation theatre. Surgical microscopes and operation tables in the theatre have been installed in such a way that surgeons perform one surgery, and can perform a second surgery by moving the microscope to the adjacent table (Mehta and Shenoy 22). Notably, these configurations have enabled Aravind Eye Care to reduce costs, achieve uniform quality output and enjoy economies of scale.

Process re-engineering is also another sustainable solution that Aravind has adopted. Process re-engineering in the hospital has involved the development of the “Forecasting Tale." This “Forecasting table” offers the hospital insights of the anticipated inflow of patients on a specific day. The “Forecasting Tables” development is done through the considerations of indicators like political movements, national holidays and festivals. The table is used as an alert signal in managing the human resources regarding staff and surgeons in an effective manner (Aravind Eye Care System). This table is compiled and developed a year before roll out, but it is revised on a monthly basis.

The hospital also uses an integrated management system. The system assists the Aravind Eye Care staff in monitoring the hospital stays of the patients. For instance, when the length of stay of a particular patient is more than 90 minutes, the system issues a red alert signal. After receiving such an alert, a review is done promptly and determines the reason for the delay. Notably, such warnings are rare in the hospital since the patients' movements are highly monitored and well taken care of (Aravind Eye Care System).

Aravind Eye care has also established financial sustainability as one of its sustainable solutions. The financial sustainability is constructed with a view of ensuring maximum use of the hospital's infrastructure — for instance, operation theaters through the installation of surgical microscopes and operation tables in a way that the surgeons can work effectively (Mehta and Shenoy 22).

Financial sustainability has also been employed by establishing a strategy in human resource policies. This strategy involves dividing the surgery into subparts with specialists working in every section. For instance, ophthalmic surgeons are excellent in performing operations compared to other preliminary tasks and thus, they can utilize the time saved to enhance the number of surgeries. Such actions result to cost savings in the hospital while enabling Aravind to provide more affordable treatment. By following these practices efficiency in Aravind has been achieved whereby a surgeon can perform about 2000 cataract surgeries per year compared to the average of 400 operations and 200 surgeries performed by ophthalmologists in India and the U.S respectively (Mehta and Shenoy 23).

Aravind’s success can also be attributed to the innovation culture that it has adopted. The ability of the hospital to innovate can be traced back to its founders as well as continuous innovation culture that has been perceived in the past years. The innovation culture is ingrained in all the Aravind employees since the hospital was established. This culture entails keeping employees up to date with any new developments. The employees are also encouraged to offer innovative ideas that would serve as solutions to the challenges they experience while working with hospital procedures (Mehta and Shenoy 17). Such ideas are collected in general meetings of the management team, and heads of nursing held every month. The management team ensures that the implementation of the ideas does not take long. For instance, it focuses on implementing the plans within 72 hours (Aravind Eye Care System).

Question#2 Characteristics of Aravind’s Organizational Structure

Aravind eye care system is mainly characterized by a functional organizational structure. Functional organizational structures have several features. One of the features of this organizational structure is the application of a one-line reporting rule (Meng). Unlike the matrix organizational structure, functional management system forms vertically. In other words, communication and reports are delivered to one top management. Such kind of reporting and communication helps in avoiding disorders in taking instruction. It also assists in generating efficiency in the workplace.

This kind of structure is evident in Aravind whereby the systems works under a not-for-profit trust referred as Govel trust. Dr.Venkataswamy is the chairman of the trust. The director of the trust is Dr. Nam while the joint director is Dr.  Natchiar (Prahalad). Dr. Nam also works as the director of all Aravind hospitals. Under the director of hospitals are senior Health Officers who are heads of various Residents, Health centers and Fellows. These Health professionals are usually Aravind’s permanent staffs and report to Dr. Nam. The joint director supervises the nursing and other paramedical employees. The other different divisions like Coimbatore have their leaders who report directly to the director of the trust. Additionally, LAICO and other similar divisions have heads who also report directly to the hospital’s director (Prahalad).

Since the flow of communication at Aravind is vertical, weekly meetings of all hospitals heads are common (Usmani 3). Such meetings offer an excellent opportunity to discuss all strategic and operational matters. During such sessions, the director of the hospital either travels to the other Aravind hospital to meet the other respective hospitals’ heads or talks to them through the telephone.

Another feature of functional management practices is the development of specialists (Meng). The functional organization structure combines the employees with similar expertise (Bugdol and Jedynak 111). Such combinations ensure that employees become highly specialized in their fields through knowledge sharing and discussions. Additionally, such workers are provided with in-depth training of the highest quality which provides them with organizational goals and the means to achieve them (Usmani 8). Aravind eye care system is divided into various units that are specialized for specific tasks. An excellent example of one unit in the system is the Aurolab. Aurolab is the facility that is specialized for manufacturing lenses. Aurolab has 220 employees whereby 10% of them are a graduate or diploma pharmacists, engineers, and marketing personnel (Prahalad 9). It is worth noting that 90% of the trained employees are women (Prahalad 10). The women living in the rural areas having twelve years of formal education are selected along with the people chosen as ophthalmic assistants. Such women undergo a 6-months training as the ophthalmic assistants. They are then given an additional 18 months training that is specifically meant for manufacturing of lenses (Prahalad 12).

The Aurolab is made up of four distinct divisions which include Pharmaceutical Division, IOL Division, Sutures Division, and the Spectacle Lens, Division. The Pharmaceutical Division has a team of specialists who produce the pharmaceuticals that are used for eye related needs and surgery. Another division of the Aurolab, the Spectacle Lens Division also has a team of specialized personnel who offer technical support services for the quality control, production, and training in the optical shops that are found inside the Aravind Eye Hospitals. Additionally, Aravind has numerous units such as outpatient and surgical units with highly competent and specialized teams who perform different tasks at the hospitals. The employees are categorized in subprocesses. Every group of employees is given their responsibility based on their qualifications and specialty.

 Some of the employees include nurses, doctors, logistical specialist and R & D technicians who are involved in processing the patients during the “eye clinics." The employees in Aravind are included in the entire channel of patient-centric activities from the entry of the hospital to discharge. However, the activities are broken down into sets of distinct tasks. The army of paraprofessionals at Aravind perform the majority of the functions except for the final diagnosis and preliminary examinations that are carried out by the doctor. The group of professional is divided among a dozen various sub cadres whereby each group is specialized in some plainly defined set of routine duties (Mehta and Shenoy 17).

Designation of duties is also apparent in the Aravind’s postoperative wards and operating rooms. The role designation is beneficial in that it creates a system that ensures maximization of skill and time of the Aravind’s surgeons. This system is geared toward ensuring that doctors are given the allowance to focus almost entirely on the diagnosis of patients and performing surgeries. As a result, with the limited ophthalmic power in the country, Aravind manages to carry out 5% of the eye care surgeries in India (Mehta and Shenoy 17).

Another characteristic of the functional organizational structures is that they have high productivity. The high levels of expertise in every department or unit result in increased efficiency in work thus enhancing productivity level. Since experts having similar skills are concentrated in the same departments, it is possible that they work confidently and effectively. Working with increased confidence ensures that rates of work-related mistakes are reduced significantly. Such errors are also decreased because of the advice and assistance were given to the departmental team members by their leaders (Meng).

Most of the departmental heads in all departments are responsible for ensuring the productivity of their respective departments. Such arrangements within departments assist the business in ensuring quality control and uniformity in performance. The various departments are sometimes known as “silos” meaning that the system is disconnected and vertical (Meng). The flow of communication in these departments is through the department's heads to the management team.

Aravind is characterized by phenomenal productivity in its departments. An excellent example of one department that has increased productivity in the hospital is the outpatient unit (Meng). The outpatient department workflow of the different units in the Aravind Eye Hospital is almost the same. In these departments, the patients arrive as early and relax waiting in some selected zones. The departmental managers ensure that the first patient is registered in the reception at exactly 7 A.M (Prahalad 12). The registration is computerized and thus takes about sixty seconds after which the patients are shifted to the case sheet counter located just close to the designated waiting room. The counter generates the case sheet for the patient after which they are taken to the medics by the employees. Aravind uses three computers for a new case while one is used for old cases. In that case, the computers can handle 200 cases per hour (Prahalad).

In such departments, the trained paramedical team do the primary checks on the patients while trained clinicians perform the necessary refraction tests instead of the doctors. After all, tests are done on patients; they are directed to the resident doctors in the examination rooms who diagnose their eye defects and record recommendations. The ultimate handling of the medical cases is done by the health officer who is a permanent doctor in the hospital. It is worth noting that the whole process takes approximately two hours but the time can change depending on the tests being carried out. The paying outpatient department examines 1000 patients in a single day for six days (Prahalad).

Aravind follows an authoritarian employee management approach, which may be classified under McGregor’s theory X and Y. Aravind is mainly composed of theory Y employees. These are people who consider efforts in the workplace as play and rest. Such employees do not dislike work. Based on the working conditions, these employees may find work as a source of punishment or satisfaction. Theory Y employees also seek responsibility. Some of the management implications of theory Y workers is the achievement of the organizational goals and rewards of different kinds, which may be the source of motivation. Moreover, theory Y promotes a culture of creativity among employees (Ahmed 6).

Aravind offers its employees creativity. Through its creative constraint of ensuring that it does not compromise of quality and being self-reliant Aravind has been able to operate successfully and achieve its goals. For instance, offering free services while at the same time generating profits for the company. Aravind also focuses on effective utilization of resources, innovative pricing structure, standardization-no downtime, fixed salary structure, cost-conscious and paying or free options that are some of the outcomes of both theory Y and X organizations. This is the discipline and routine of structure that Dr. Venkataswamy adopted (Mehta and Shenoy 14).

Works Cited

Ahmed, Gulzar. "Mcgregor Theory X And Theory Y For Staff And Employees Motivation.” Studylecturenotes.Com, 2014, http://www.studylecturenotes.com/management/mcgregor-theory-x-and-theory-y-for-staff-and-employees-motivation. Accessed 30 Nov 2018.

Aravind Eye Care System. "Aravind Eye Care System." Aravind Eye Care System, 2015, www.aravind.org/default/aboutuscontent/casestudiesOnAravind.

Bugdol, Marek, and Piotr Jedynak. Integrated management systems. Cham: Springer, 2014.

Mehta, Pavithra K., and Suchitra Shenoy. Infinite vision: how Aravind became the world'sgreatest business case for compassion. San Francisco, CA: Berrett-Koehler Publishers, 2011.

Meng, May. "Five Common Characteristics of Functional Org Chart." Org Charting | The Most Popular Org Chart Creator, 2016, www.orgcharting.com/functional-org-chart-characteristics/.

Prahalad, C. K. The Aravind Eye Care System: Delivering The Most Precious Gift. 5th ed., India Institute Of Management, 2004, pp. 18-23, https://www.oreilly.com/library/view/the-fortune-at/9780137042029/ch35.html. Accessed 7 Dec 2018.

Usmani, Fahad. "What is a Functional Organization Structure?" PM Study Circle, 26 Nov. 2018, pmstudycircle.com/2012/08/what-is-a-functional-organization-structure/.

Williams, Logan D. Eradicating blindness: global health innovation from South Asia. Singapore: Palgrave Macmillan, 2019.

January 19, 2024


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