What’s in a name? Jeevanti Healthcare takes its name from an indigenous medicinal plant to signify its commitment to bringing a fresh and localized approach to secondary care through its new hospital chain. This is, of course, in contrast to two well-established hospital chains, Care and Apollo, which made their Western-sounding names - and Joint Commission-certified reputations - decades ago and have since helped to professionalize the Indian health market.
During a June visit to Jeevanti Healthcare headquarters in Thane, 40 minutes northeast of central Bombay, I met with Arun Diaz and Deepa Chandrasekhar, the charismatic and well-connected leaders of the young but promising company. A former banker, Diaz joined his old friend Chandrasekhar some seven to eight years ago to run an Apollo franchise clinic. They learned the business and decided they could make a bigger impact by improving the quality, availability and affordability of secondary health care.
With two hospitals and a third one set to open soon, Jeevanti serves people in Ambernath and Bhiwandi, small cities 60-80 kilometers from Mumbai. While the venture-funded company is still small, Jeevanti aspires to create a chain of 25 50-bed, secondary-care, multi-specialty hospitals in small, underserved cities in Maharashtra and Gujarat. The existing hospitals currently offer gynecology and obstetrics, pediatrics, general medicine and surgery. Between March 2012 and July 2013, the two hospitals served 30,000 people (27,736 outpatients and 2,264 inpatients).
Diaz, Chandrasekhar and their colleague Amruta talked with me over delicious dosas about their process and vision. Here are a few interesting themes:
Serving railroad suburbs with busy working people
People commute to work in Mumbai via railway from Ambernath and Bhiwandi. But health care options in these communities are largely limited to “mom and pop” businesses with one doctor. To keep their costs down, these shops tend to hire unqualified staff members and train them themselves. According to the Jeevanti team, many nurses working in the area can’t read or write. By contrast, Jeevanti’s nurses must have three-year diplomas or four-year bachelor’s degrees in nursing and two-three years of experience.
A brownfield approach to converting hospitals
With land acquisition being one of the biggest obstacles to setting up new hospitals in India, the Jeevanti team has taken a radical new approach. They scout for existing hospitals in densely populated towns with a diversified economy. The hospital must have an independent building and usable space.
The conversion process by which the old facilities become a Jeevanti hospital takes less than a year. According to Diaz, since Jeevanti does not buy property, capital expenses are low. They focus upgrades on installing infrastructure and equipment required by the National Accreditation Board for Hospitals for secondary hospitals: operation theaters, ICU wards and emergency services. They also purchase equipment for new services they are bringing online, like gynecology and orthopedics.
Physical conversion is a small part of the upgrades required to transform a brownfield hospital into a Jeevanti hospital. Here are some of the important steps related to human resource management they undergo in a conversion:
- Jeevanti offers jobs in the converted facility to all current employees, although they sometimes shift people to lower-tier jobs if they are unqualified to serve in their current role - for example, an unqualified nurse would become a nurse assistant.
- They hire a hospital administrator from outside the hospital (since existing management capacity is usually poor).
- The team meets with staff individually to listen to their career goals and support their growth, then instructs staff in important new skills like typing on computers.
- Jeevanti sets up standard operating procedures which include infection control practices and use of their hospital management information system.
Attracting and retaining talent
Many startup health care businesses struggle to fill their management positions. Diaz said, “For mid-career paramedicals, our ability to attract good candidates appears to be related to the location - considering that we are located in the peripheral towns adjoining Bombay, what seems attractive is the time and money they potentially save on commuting to work.”
He said even with these benefits, Jeevanti must “live with” some attrition and focus on continuously recruiting talent, especially within the junior doctor community and the early-career nursing staff. “A constant recruitment funnel supports us in providing the service and quality care that we aspire to deliver,” said Diaz.
Jeevanti employs social media to build its brand in order to reach young recruits on platforms including Twitter, Facebook and LinkedIn. Recruits also hear about Jeevanti through word of mouth from current employees.
Creating a memorable brand
Jeevanti worked with Elephant Design in Pune (a referral from the huge bookstore chain Crosswords, leaders of which sit on Jeevanti's board) to create a bright and modern logo featuring a multi-colored tree (see photo above). Elephant and Jeevanti developed the logo and brand attributes using market research, including a series of videotaped interviews with patients queried about why they chose to use a specific hospital. But the brand permeates beyond the logo at Jeevanti. Diaz described the brand as focusing on delivering patient-centered care and good value: “Our focus is on bringing back into the system care and concern, transparency and consistent high quality at value for money prices.”
In search of new partners
Jeevanti’s website includes a pitch for new partners:
“We are looking for small hospitals or nursing homes in tier 2 or tier 3 towns of Maharashtra and Gujarat. If you would be interested in working with us to upgrade to a multi-speciality secondary hospital, please do contact us. We would be happy to talk to you about how we might be able to join hands for our mutual benefit. Join Us Today!”