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Development of the Concept for Jaffna Central Hospital

Development of the Concept for Jaffna Central Hospital. The Content. Feasibility The concept Strategy Project Way forward. Conceptual Feasibility. Demography Epidemiology Health Services Market Financials. Demographic. General population - 650,000

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Development of the Concept for Jaffna Central Hospital

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  1. Development of the Concept for Jaffna Central Hospital

  2. The Content • Feasibility • The concept • Strategy • Project • Way forward

  3. Conceptual Feasibility • Demography • Epidemiology • Health Services • Market • Financials

  4. Demographic • General population - 650,000 • Feeding population - 250,000 • Expected population – 900,000 Comment : Average market population for a private hospital in Jaffna – 360,000 Jaffna Province 1250 SqKm – Vadamarachi, Thanamarachi, Jaffna Islands, Valakama 84% Hindus , 99% Tamils , 79% more than O/L, 70% Productive population, 16% elderly, 44% employed - 15% Govt employees & 29% private /self

  5. Epidemiological • Communicable diseases • Non communicable diseases “ Multispecialty services with special focused specialties and high demand / revenue ”

  6. Health Services • Available hospital beds • Government - 1000 beds • JGH – Occupancy rate 110 / Turnover rate – 81 / ALS – 4.9 • Private - 100 beds – Mainly nursing homes • Out patient services “Main service provider are government hospitals & in the private sector CNH along with many small out door care services”

  7. Market • Middle income group • 44% employed : 15% Govt. employees & 29% private /self • Government servants , bankers , farmers • Elders and families with foreign support – 16 % • Foreigners , NGOs, construction company workers , new businessman • High patient migration to Colombo ( 15 % Col. Beds) “Most rapidly growing health market with no major player at the moment “

  8. Financial • Low capital infusion • Well planned medical services • Well controlled project management • High revenue services • Manageable model • High quality care • High asset utilization • Faster turnaround time • Project IRR - 25% / Equity IRR – 30% • Start as general services and expand on to focused areas most feasible model in Sri Lanka • BOI concessions - 08 year tax holiday

  9. External Environment Assessment

  10. Internal Environment Assessment

  11. The Strategy

  12. Selected Strategies • CORE STRATEGIES • Integration - MERGE WITH A FOREIGN HOSPITAL • Restructuring – NEW EFFECTIVE STRUCUTRE B. GENERIC STRATEGIES • Cost leadership – LOW COST & HIGH QUALITY • Value chain – ADD VALUE to EXISTING BUSINESS

  13. Vision “To be the best Patient Centric hospital in Sri Lanka “

  14. Services • Build a hospital for 30 years • Multi- specialty hospital – • Two stage development • 50 bed could upgraded to 100 beds • Service level • Match Colombo Standards • Services offered • Preventive / Investigative /Curative Rehabilitative care / Training development • Tie up with foreign hospital

  15. The Project

  16. Development plan • Two stage development • Stage 01 • New building of 50 beds • Renovate existing buildings as one unit • Stage 02 • Build 50 more beds after demolishing building 01

  17. Description 01 • New building - G + 3 – 24,000 sqft • Ground - Channel consultation, Pharmacy , reception, lobby , patient waiting • 1st floor - Patient rooms – Medical • 2nd Floor - Patient rooms –Pediatrics , /Surgical, Obstetric & Gynecology • 3rd Floor - OT, Baby delivery , ICU , neonatal unit • Service block at the back of new land • Use parking around the building

  18. Description 02 • Old buildings • Building 01 – current OPD and Wards • Ground floor - Use as a General OPD, ETU , Dental • 1st floor as a Administrative and doctors/ nurses rest room • Front doctors parking • Building 02 – current OT and wards • Investigation unit – Radiology , Laboratory , Cardiology , Eye , Audiology, neurology • Kitchen & canteen • Join old buildings with new building

  19. JCH Project Financials • Investment - 400 Mn • Equity - 200 Mn • Debt - 200 Mn • Gearing ratio 50 % • Cost of Debt 13.00% Term 6 Grace 2 • EQUITY NPV - 172 • EQUITY IRR - 30.7% • PROJECT NPV - 317 • PROJECT IRR - 25.5%

  20. Financial forecast

  21. Conceptual Project Costing – Stage 01 Description Cost Rs Mn. • Construction 199.0 • Equipments 102.0 • Start up cost 30.0 • Project cost 331.0 • Contingency 33.0 • VAT 36.0 • Total Project cost 400.0

  22. Description of Project Cost • Civil / M & E • Electrical / Solar Plumbing / Fire/ AC Generator / Medical Gas / Lifts /Data cabling / Transformer Nurse call / STP Incinerator / PA system / CCTV PABX / MA TV Mortuary /Laundry Landscape • Consultants • Architectural & Engineering Other Consultants Project Management • Equipment • Medical Equipment Kitchen Equipment Furniture & Accessories Computer Hardware & TV's EPBX Telephone System • Start up cost • Pre-Opening Employee Costs Training Cost Pre-Opening Marketing Costs GHC Pre-opening team & systems Preliminary Expenses Initial Supplies Software Installation

  23. Project Plan • Project completion in 24 months • Design built hospital • Project monitoring committee from the owner • Parallel development of HR, Systems, quality , image & brand building, networking , attracting consultants as for the preparation for the new building • Uplifting of current revenues

  24. Way forward • MOU with GHC/Micro - 02 weeks • Feasibility , project finance, forecasting - 02 weeks • Project planning – 02 months • Implementation – 12 months • Evaluation and start ups – 01 months • Inauguration - in 16 months Build Operate & Hand over

  25. Our Value Addition

  26. Hospital Projects • Project development • Site Management • Hospital design • Approvals • Construction - Civil, Mechanical & Engineering • Equipment Management • HR planning , recruitment and training • Supplies Management • Establishing systems - Policies and Protocols • IT planning , commissioning and training • Commissioning and Hand over of the hospital • Hospital Management

  27. Conceptualization management concepts logical assumptions Feasibility study demographic, epidemiological , economic regularity holistic financial Location Access Staff Supplies Environment disposals Medical Brief ( Medical Plan of Services) Financial feasibility project costing I financial forecast I Establishment of a company Fund Raising Initial Approvals MOH, Local Gov., UDA, BOI Appointments Consultants and related agreements Appointment of an Advisory Panel (AP)- Doctors , Nurses, Paramedics, Administrators Overall policies & Strategies Company formation A. Project Development

  28. Confirm Feasibility Survey plan Title search Soil, Water testing Approvals Survey plan UDA BOI Assessment of the site Water supply Electrical supply Effluent disposal Road access Weather pattern Work force Agreements Acquisition Fencing Security B. Site Management

  29. Confirmation of the Medical Plan Process Analysis of the respective services out put of services allocation Space, HR , equipments Confirmation of the policies and strategies Architects Brief 4. Schematic design Civil M & E Project Costing II 5. Detailed design Civil M & E Project Costing III 6. Functional design Process Systems Confirmation with AP C. Hospital Design

  30. Project Approval MOH Local Gov UDA BOI Site approval ( Survey Plan) Local Gov UDA BOI Approval Preparation and signing of agreement Submission and approval of the Equipment & the Building material and M & E List Submission of Detailed Plans and BOQs Building Plan Approvals Local Government UDA Atomic Authority Fire Department Traffic Impact Assessment Water, electricity & Telephone CEA MOH RDA Operational Approvals Certificate Of Conformity MOH registration D. Approvals

  31. E. Construction • Preparation of B.O.Q.s of Civil & M& E contracts • Preparation of agreements • Bonds and guarantees & signing of agreements • Initial payment • Mobilization • Initiation , monitoring of the construction • Project financial and logistic management • Commissioning and Hand over • Insurance

  32. Civil Piling Structural Masonry Interior decoration Crash bars Landscape Staff Quarters Service building M & E Electrical Plumbing AC Medical gas STP Incinerator Morgue Ceiling Flooring Fire PA IT E. Construction

  33. F. Equipment Management • Equipment Planning • Selection of the equipments • Project Costing IV • Layout & Process confirmation • Should be Completed before detailed civil construction • Tendering & Selection of Suppliers • Preparation of Agreements • Supply & Installation • Training • Servicing • Insurance • Importation • Installation • Training • Protocols for management • Commissioning & Hand over

  34. Confirmation of the process activities relation to HR Job Analysis - Planning of the Number , Profile and the Job descriptions Medical staff Doctors, Nurses and Para Medical and Medical assistants and Nurse Aides Technicians - Incinerator, CSSD, OT & ICU, Endoscopy, Radiology Facility staff PR, Security ,, Kitchen, Laundry, House Keeping Maintenance Civil , M & E (STP, electrical, Water supply, AC, Incinerator Administration Medical Administration Finance Marketing HR 3. Market Analysis & Preparation of packages Salary Perks Quarters Meals 4. Advertising & Recruitment 5. Training Basic organizational concepts , policies Special –protocols 6. Continuous training & Development plan G. HR Management

  35. H. Supplies Management • Confirming the Supplies aspect of the process analysis • organizing the supplies chain Management process • the process and policies • HR • Space and special requirements • Initial estimation through AP • Formation of the Supplies Management board • Drug regulatory committee • general supplies management committee • Selection of Items, quantity of the products • Negotiations and selection of the suppliers • Agreements • Purchase and storage

  36. I. Establishing Systems • Systems , Policies & Protocols • Medical Administration • Patient care services • General Administration • HR • Marketing • Financial Management • Facility Management • IT

  37. K. Commissioning and Hand over • Civil • M & E • Equipments • IT • Promotions

  38. J. IT System • Mapping patient care Process • Developing a system aligning with patient care process • Assess the IT equipment requirement • Testing • Training • Commissioning

  39. Discussion

  40. Thank you !

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