HOSPITALITY IN HEALTHCARE

 INTRODUCTION TO HOSPITALITY

The term Hospitality is derived from the word ‘hospitalis’ or ‘hospitalitas’ in Latin. The old French term was ‘hospitalite’ means ‘hospitable’ (hospitable).

The other terms that are used as synonym of the word hospitality are ‘warm reception’,’welcome’,’generosity’.

The term ‘Hospitality’ in general term means friendly and generous reception and entertainment of guests, visitors or strangers Or The term Hospitality is also in reference in relating to or denoting the business of entertaining clients, conference delegates or other official visitors.

‘Hospital’, ‘hotel’, ‘hostel’ and ‘hospitality’ all these words have similar origin from the word ‘hospice’ which means ‘host’ in latin.

Hospitality and hospitals have formed a very close intimate relationship, in recent years. Hospitals consider hospitality as a major part of their progress in this competitive world. To win over new customers and to retain the old ones hospital and hospitality relationship play a major part.

In past years hospitals were considered as an institution where patients were diagnosed, treated, cured of their diseases/ailments by doctors, physicians, medical practitioners etc. But now hospitals have included the term hospitality and taken the concept of hospitals to a new level. Hospitals are now seen as a place of comfort, care, with best modern facilities for patients along with the prevention, diagnosis, treatment, cure of diseases for patients.

Patient care Services

Patients come with various needs and reasons to the hospital. From the very entrance to the hospital by the patient, all through the way of treatment and then exit (including all processes), patients and his/her companions seek comfort on all sides. Among the various services offered by the hospitals are:-

Dietitian Quotient

Among the main services offered by the hospitals in this regard are dieticians for cases where the patients’ diet has to be under strict surveillance. Depending upon the type or acuteness of the case, a therapeutic diet would be suggested for such patients. And with guidance from the dietitian, the patient could select from the therapeutic menu as well.

Most of the Corporate hospitals hire or recruit professionals from the hospitality background (even from hotel management) to ensure patient satisfaction, convenience and quality standards in the department. Its main function is of identifying, organizing , preparing, serving specific food to patients admitted in the hospital.

The types of diets served to patients are:-

Normal diet, liquid diet, low salt based diet, diabetic(for patients with diabetes), low fat diet, high fiber diet, semisolid diet, soft diet, high protein diet, ryles tube diet(diet that can be given through a naso-gastric tube to a critical neuro-surgery patient, who is hypertensive and diabetic)

Management Quotient

Every hospital has a head for F & B(food and beverage) department, who looks into the functioning of  the department and is responsible for quality monitoring. The F&B department is a combination of two sub sections i.e. Operations and Dietetics.

Operations-Operations is involved in food production and food services to the patient.

Dietetics-It involves identifying what needs to be served to the patient, in what quantity and at what time. Dietitians plan the meal for patients on a case to case basis.

Cyclic menus are planned keeping in mind seasonal availability. The menu is planned together by the dietitians, food production team and the department head.

Dietitians go on rounds everyday and plan the meals that need to be served to the patients. This planned sheet is compiled for all patients and various types of meals that need to be prepared for them are identified.

The food tray is then laid out as per the meal requirement of patients and is marked with the room number so that there is no mix-up.

Kitchen Expertise

Kitchens of these hospitals are equipped with specialist food service equipment. Due to the extremely stringent hygiene norms, the hospital kitchens are designed with Hazard Analysis and Critical Control point(HACCP)certificate as a pre-requisite. At the same time, the hospitals will have comprehensive F&B service facilities to become fully self-sufficient thereby avoiding any need for the patients attendants from eating out. The cost of establishing a good kitchen is Rs 60-70 lakhs. In the years to come, the cost will go upto Rs 1-2 Crores in normal cases and 5-6 crores for larger kitchens.

Auxiliary Services (Additional/Supplementary/Reserve services/Business of Goods)

For the convenience of the visitors and attendants, these hospitals have several provisions e.g. Max hospital in Delhi has a provision for supplying food from reputed food chains within the hospital including Café Xpress, Café Coffee Day and Subway.

The F&B department in Corporate hospitals is committed to provide the best quality food served to patients on time and every time to ensure the highest patient satisfaction and convenience for their relatives as well.

Housekeeping-While the food service is one of the areas witnessing a change, another important facility at these hospitals is that of housekeeping. Patients get best of Laundry services at their premises. The pillow covers and bed sheets are regularly changed with many reserve new sets and washed sets available. Every bed has a side table with sanitizers available at each bed side for every patient. Sanitation and Cleanliness is a major issue that is being dealt with in the hospitals to treat the patients. With the recent rise in prevalence of diseases like dengue, zika virus, swine flu, bird flu etc the hospitals have become extra cautious and housekeeping has become an integral part of hospitality around the world.

In some hospitals like Sri Ganga Ram Hospital in New Delhi, special arrangements have also been made for the visitors and relatives of patients visiting the hospital. There is a spacious waiting area with comfortable reclining chairs, a gift shop, cyber café, restaurant etc.

Patient doctor relationship plays a vital role, but in today’s world every staff member is involved and gets involved in better treatment of patients and to make him feel at home(comfortable).

Quality treatment and care is what matters in hospitals today. Especially with the advancement in technology and penetration of Corporate sector in hospital industry something more is required than the treatment.

There are other few factors that are a part of hospitality management in hospitals:-

1)Accessories(Amenities)-Food, private rooms(deluxe and VIP,VVIP),entertainment of visitors(like provision of video games and X-Box, LED’S, LCD’S, Cable TV, Wi-Fi, Charges for mobiles available.

2) Nursing-Attitude,Attentiveness,Responsiveness,Courtsey,Etiquettes and manners, care, treatment of family and visitors

3) Treatment and Therapies-Pain management, stress management, services offered, meditation center, latest technology, vaccination/immunization facilities.

4) Security-Patient safety, privacy, security guards, security alarms, personal safety

5) Physicians/Staff-Access to them, empathy, listening ability, sound knowledge, attentiveness, compassion

6) Atmosphere-Cleanliness, sanitation, hygiene, comfort and relaxing environment.

7) Admission and discharge-HMIS facility (hospital management information system), computer connectivity, timely discharge, follow up ,information, help, support facility

8) Recreational facility-Shopping facility, gift centers, super markets, attached food chains, music facility and ATM’s.

Some hospitals in addition to the above are opting for Green Audit and paperless premises and campus. This is a part of landscape design(aesthetic sense).I-pads and i-phones are used along with laptops in certain areas to record the patient history and maintain medical records as a part of promoting paperless premises.

Medical Tourism-These days hospitality matters a lot to the people coming from abroad to India. The people from the Middle East nations come to India for treatment because the facilities in terms of better treatment are better in India as compared to those nations. Some people from Western nations (mostly Europe) come to India for treatment, even after having modern or latest technology in their native nations, this is because India has lesser (cheaper) costs of treatment with wonderful doctors and their teams available to treat such patients from other far nations with Good technology as well. India is rich in culture and is famous for hospitality around the world.

Patient-The most Important Person

Therefore, with the introduction of Specialty and multi specialty hospitals, the participation of hospitality is sky high. Every staff member is especially trained to treat the patients as their guests. Home like environment is created so that patient doesn’t feel lonely. People come to hospitals for various reasons, some experiences are happy or joyful ones like the birth of a new born baby while other people are sorrowful due to casualties, diseases, deaths etc. But the job of  a good hospital is to be patient centric or patient oriented. You are treated as if you are the only one in the hospital or you are the most important person.

Yes patient has to feel at home but at the same time the hospital staff should make it a priority to provide Quality treatment to patient so that he/she can recover quickly and be healed, discharged and reach home as soon as possible. They should be fully attended to by the staff and also follow up procedure should be appropriate after the discharge of the patient. Throughout the stay of the patient, if the patient or his/her acquaintances have any query, then Doctors, hospital administrator, managers or other concerned staff members should be able to answer and clear all the doubts with great ease.

Patient invests a lot of money in treatment especially in corporate hospitals, so he wants value for his money.

The registration, consultation, investigation, treatment and discharge time takes a lot of time, sometimes waste whole day. But hospitality makes a difference in this aspect too. Therefore, patient must be of utmost priority and importance for every staff member in the hospital. Patient expects someone to guide them from OPD, Registration and various departments. Patients and visitors keep in mind the form of reception, communication and the care offered by the hospital staff. These days centralized A.C’s are installed, private rooms are classified like semi deluxe, deluxe, VIP rooms in the hospitals.

Architecture and design-It plays an important role in the building of the hospital and in turn treatment and quick recovery of the patients. Evidence based designs are focused with additional facilities like interior designing, damp proof ceilings’, paints of high quality, attractive colors, landscape (aesthetic sense),ventilation,proper lighting arrangements,lift facility for invalid or handicapped patients and separate lift facility for elderly people.

Fountains, lush green lawn, parks in the campus add to the aesthetic sense and pure environment. Green tress provide relief from heat of the sun and direct exposure to ultra violet rays of sun to sun sensitive or allergic patients.

In certain large hospitals, over bridge and own transport facilities save energy and time of patients. They get all the facilities within the same campus and premises. The parking facility is separate for patients, visitors, doctors and other staff members. With special emphasis on future expansion of parking and the building. These days as the cashless society is on the rise, people generally use debit card, credit card, net banking facility, mobile banking facility all are available along with the cash deposit facilities are available in hospitals for the convenience of patients. In the coming days with increase of technology and computer internet facilities the concept of digitization or digital currency is upcoming in today’s society. This will facilitate easy conversion of foreign currencies to local currencies in few seconds. This facility is still under review at International level. Many people who come from foreign land, face foreign currency exchange issues, interpretation(translation)of languages, visa issues and transportation facilities and even side seeing, all these concerns are taken care of by the modern hospitals these days as a part of package plan and hospitality management for patients and visitors.

Mailing and Fax-These days Fax has become a sort of outdated technology but emails are sent to patients for follow up and feed back of patients. Any complaints are welcomed and noted down and Good hospitals do take action. Wi-Fi connections are available 24 hrs for uninterrupted internet facility.

Telephone facilities-i-pad and i-phones are being provided to the doctors, hospital administrators, managers for timely preparation of medical reports and easy accessibility to the reports, connectivity to other departments. Online reports are generated and soft copy is mailed to the patients for convenience of not carrying the file and other documents. If you are able to receive phone calls, then they will directly ring you at your unit via hospital operator (extension facilities) and to make a local call dial extension number and the phone number. For long distance call credit card or calling card facilities are also provided.

Services like extending hi-tech single button communication facilities between the patient and his family using affordable DECT (Digital Enhanced Cordless Telephony) technology is being explored. Today many EPABX manufacturers are working towards providing these systems.

Facility Management-In hospital development we cannot neglect support areas like engineering spaces, employee spaces, kitchen and laundry spaces. Just as the operations of hotels where housekeeping forms an integral part, so it is in the case of a hospital. The trend of outsourcing its housekeeping related services to facility management companies is slowly catching up with the new age hospitals, thus providing an opportunity for the service providers in the hospitality sector with a new business avenue.

Apollo hospital New Delhi, which has recently been accredited with Joint Commission International(JCI) for its quality of care in a safe environment is one of the few hospitals in India having standard facility management, safety and other management expertise. “Safety, Quality of care and various auxiliary services including proper F&B services have become extremely important for any healthcare service provider.” claims Apollo hospital.

Facility planners believe that in future hospitals will have malls attached to them. Because of amalgamated services, so that attendants and friends of patients can spend free time.

Role of Dietitian in Hospital diet Service

Hospital offers nutrition counseling on inpatient or outpatient basis. With a referral from physician, a registered dietitian is available to assess your eating habits and educate you on the best diet for your individual health needs.

Doctors Hospital Nutrition services is comprised of clinically trained dietitians who are a part of our hospital-wide multidisciplinary network including physicians from various specialties’, registered nurses, physical therapists and registered pharmacists.

Services and functions

Nutrition Services offers personalized individual counseling tailored to your unique health care needs. The benefits from nutrition therapy in a number of circumstances include:-

1) Heart disease including high blood pressure and high cholesterol.

2) Diabetes

3) Cancer and cancer prevention

4) Gastrointestinal and Digestive disorders.

5) Optimal nutrition for growing children.

6) Women’s health issues (e.g. pregnancy, menopause and osteoporosis)

7) Fatigue, depression, low energy

8) Arthritis/autoimmune diseases

9) Healthy vegetarian eating

10) Compulsive eating disorders

11) Food allergies and intolerance

12) Kidney disorders

Dietetics is the interpretation and communication of nutrition science to enable people to make informed and practical choices about food and lifestyle in health and disease.

Role

  1. Dietary services is one of the most important hospital supportive services contributing to the recovery of health scientifically prepared diets and educating the patients regarding the use and utility of different funds and balanced diet.
  2. Dietetics department provides:-

Diet plan and consultation

Indoor diet service

  1. Hospitals cater a number of patients with nutritionally balanced and hygienic therapeutic diets. Its purpose is to maintain good nutritional status, to correct deficiencies and to prevent a number of diseases and to maintain body ability, to metabolize the nutrients and thereby to reduce complications in patient life.
  2. The dietitian increases the awareness and understanding the importance of diet and physical activities regarding the good health.
  3. Overall the dietitian helps in developing, strengthening and implementing some effective health policies to improve diets and encourage the regular practice of keeping good health.

Additional Services

In certain medico-legal cases for notarizing the healthcare related documents a patient can contact the nurse who in turn will contact a notary public in the hospital. The signature of the concerned should only be done in the presence of the notary public as a witness.

On special occasions like Birthday or a marriage anniversary, the hospital staff can prepare a cake as a surprise gift to the patient and celebrate the occasion.

Etiquettes and Manners

The hospital staff is trained to treat patient as a guest and make him/her comfortable as much as possible. Etiquettes and manners play an important role while dealing with the patient and the visitors. Few of the points that need to be focused are:-

  • Facial expressions-Always smile, maintain an interested and helpful expression, maintain eye contact.
  • While talking to the Guests-Distance, speech, Gestures. Maintain distance of at least 2 feet, speak softly and clearly.
  • Posture-Stand erect at ease; weight balanced on both the feet,shoulders straight,chest out/stomach in
  • Hands-Keep hands on the sides or behind your back.
  • Do not keep hands in pockets or on the hips
  • Do not cross arms across the chest.
  • Do not lean against the counter

While standing

If the guests are not around

1) Maintain your poise always

2) You may be in view of the guest, even if you are not interacting.

3) Do not huddle together in groups

Pace

Walk at even pace in guest areas without sound of footsteps. Do not run in guest area.

In corridors

If guests are approaching get aside and give them first right of way. If near a door, open the door for the guest to pass through.

Which side

1) Walk on the left hand side

2) If accompanying guest, walk on his/her right hand side and open the door of the guest.

3) Walk erect and maintain the pose.

Speech

While talking to colleagues and patients

1) Speak softly and politely

2) Language should not be abusive or absurd

Courteous behavior

Open the door for the guests before he/she reaches out. Hand him/her a pen.

Reach out for the bag that he/she is carrying

Do not get familiar with the guests even if he treats you like a friend

Remember your relationship with the guest is a professional one.

Treating patients courteously and then turning to colleagues and talking improperly tarnishes the image.

Treat the guests with as much respect as your personal local guests.

When on duty-Handle equipments without banging, stay calm, do not get nervous or create panic. Calm down the patient and visitors as they may be fearful, anxious, apprehensive, confused or in mental shock or agony.

Do not talk loudly or hold lengthy discussions in guest areas. Do not come/visit the guest/patient areas when not in uniform.

Words like Thank You, Sorry, please, may I… really play a part on patients mind while talking.

IMPORTANCE OF PATIENT CARE

  • Greater profitability
  • Improved compliance
  • Greater patient retention
  • Word of mouth publicity
  • Better productivity
  • Better staff morale
  • Reduced staff turnover

 

India is a developing country. Healthcare industry is really playing a major part in every sector. Privatization has really changed the scene of healthcare industry and its relation with hospitality. Recently with the FDI stepping in the Insurance in health sector, the competition in hospital quality care services has increased. With facilities like TPA services offered to patients and EMI facilities also available, the direct/indirect role of hospitality can be seen increasingly.

Assistant Professor
Mandeep Narang
MHA Department