On Wednesday, the government announced it would decriminalise suicide. It is the rational thing to do: after all, those who attempt suicide do so for lack of social, economic and emotional resources. It will also ensure that young Indians under stress are not punished for cracking. After all, India has one of the world’s highest rate of suicides among people aged between 15 years and 29 years.
Each year, between 30 and 40 people per 100,000 Indians aged between 15 and 29 kill themselves. This accounts for about a third of all suicides in the country.
India's suicides are a result of its traditionalist middle-income residents transitioning to an increasingly globalised landscape, experts say. One striking fact when considering the suicide deaths per 100,000 people of that age-group is that the figures are higher in the better-off southern states and the lowest in the Hindi heartland.
The strains are obvious from this chart.
A common cause for concern is the pressure from parents to do well in the national board examinations, especially for Class XII, before finishing school. As scores in these exams often determine college admissions and subsequent employment opportunities, students aged 16-18 are often subjected to undue pressure at home to succeed. When they don't, suicide becomes a way out. In 2013 alone, 2,471 suicides were attributed to "failure in examination".
Moreover, the consequences of gender bias are among the leading cause of suicides among young women, say psychiatrists such as Rajiv Radhakrishnan of the Yale University School of Medicine and Chittaranjan Andrade of the National Institute of Mental Health and Neurosciences, Bengaluru.
Independent decision-making, wanting to postpone marriage and premarital sex are some factors that clash with traditional parenting styles, while physical and mental abuse and mental disorders could exacerbate suicidal tendencies.
The same study found that independent decision-making, rural residence and premarital sex were the strongest precipitators of suicidal tendencies.
Among men, however, the stories are different. As data from the National Crime Records Bureau shows, suicide is more prevalent toward south India, which has better economic indicators than the rest of the country on average.
According to data from the NCRB for 2013 and a World Health Organisation report for 2012, alcoholism among men between the ages of 15 and 59 years and suicide rates among men of the same age group rise and fall together. However, the data sets do not have an age-wise breakdown, so this covariance could be no more than indicative of other issues.
The same WHO report, released in September, noted that 75% of the world’s suicides happen in low- and middle-income countries. It also says that “suicide rates are highest in persons aged 70 years or over for both men and women in almost all regions of the world”. But this is not true for India.
There is an immediate explanation for why India’s elderly have it better than India’s young. Taking care of the elderly has been an important part of Indian familial traditions. Their needs are widely recognised and addressed, and they enjoy a measure of respect by virtue of their age.
The clash of values within families is an important factor for young people in their lives. As young Indians becomes more progressive, their traditionalist households become less supportive of their choices pertaining to financial independence, marriage age, premarital sex, rehabilitation and taking care of the elderly.
It is probably for these reasons that, according to the NCRB, the most common reason cited for a suicide was "family problems".
Putting the patient first - insights for hospitals to meet customer service expectations
These emerging solutions are a fine balance between technology and the human touch.
As customers become more vocal and assertive of their needs, their expectations are changing across industries. Consequently, customer service has gone from being a hygiene factor to actively influencing the customer’s choice of product or service. This trend is also being seen in the healthcare segment. Today good healthcare service is no longer defined by just qualified doctors and the quality of medical treatment offered. The overall ambience, convenience, hospitality and the warmth and friendliness of staff is becoming a crucial way for hospitals to differentiate themselves.
A study by the Deloitte Centre for Health Solutions in fact indicates that good patient experience is also excellent from a profitability point of view. The study, conducted in the US, analyzed the impact of hospital ratings by patients on overall margins and return on assets. It revealed that hospitals with high patient-reported experience scores have higher profitability. For instance, hospitals with ‘excellent’ consumer assessment scores between 2008 and 2014 had a net margin of 4.7 percent, on average, as compared to just 1.8 percent for hospitals with ‘low’ scores.
This clearly indicates that good customer service in hospitals boosts loyalty and goodwill as well as financial performance.Many healthcare service providers are thus putting their efforts behind: understanding constantly evolving customer expectations, solving long-standing problems in hospital management (such as long check-out times) and proactively offering a better experience by leveraging technology and human interface.
The evolving patient
Healthcare service customers, who comprise both the patient and his or her family and friends, are more exposed today to high standards of service across industries. As a result, hospitals are putting patient care right on top of their priorities. An example of this in action can be seen in the Sir Ganga Ram Hospital. In July 2015, the hospital launched a ‘Smart OPD’ system — an integrated mobile health system under which the entire medical ecosystem of the hospital was brought together on a digital app. Patients could use the app to book/reschedule doctor’s appointments and doctors could use it to access a patient’s medical history, write prescriptions and schedule appointments. To further aid the process, IT assistants were provided to help those uncomfortable with technology.
The need for such initiatives and the evolving nature of patient care were among the central themes of the recently concluded Abbott Hospital Leadership Summit. The speakers included pundits from marketing and customer relations along with leaders in the healthcare space.
Among them was the illustrious speaker Larry Hochman, a globally recognised name in customer service. According to Mr. Hochman, who has worked with British Airways and Air Miles, patients are rapidly evolving from passive recipients of treatment to active consumers who are evaluating their overall experience with a hospital on social media and creating a ‘word-of-mouth’ economy. He talks about this in the video below.
As the video says, with social media and other public platforms being available today to share experiences, hospitals need to ensure that every customer walks away with a good experience.
The promise gap
In his address, Mr. Hochman also spoke at length about the ‘promise gap’ — the difference between what a company promises to deliver and what it actually delivers. In the video given below, he explains the concept in detail. As the gap grows wider, the potential for customer dissatisfaction increases.
So how do hospitals differentiate themselves with this evolved set of customers? How do they ensure that the promise gap remains small? “You can create a unique value only through relationships, because that is something that is not manufactured. It is about people, it’s a human thing,” says Mr. Hochman in the video below.
As Mr. Hochman and others in the discussion panel point out, the key to delivering a good customer experience is to instil a culture of empathy and hospitality across the organisation. Whether it is small things like smiling at patients, educating them at every step about their illness or listening to them to understand their fears, every action needs to be geared towards making the customer feel that they made the correct decision by getting treated at that hospital. This is also why, Dr. Nandkumar Jairam, Chairman and Group Medical Director, Columbia Asia, talked about the need for hospitals to train and hire people with soft skills and qualities such as empathy and the ability to listen.
Striking the balance
Bridging the promise gap also involves a balance between technology and the human touch. Dr. Robert Pearl, Executive Director and CEO of The Permanente Medical Group, who also spoke at the event, wrote about the example of Dr. Devi Shetty’s Narayana Health Hospitals. He writes that their team of surgeons typically performs about 900 procedures a month which is equivalent to what most U.S. university hospitals do in a year. The hospitals employ cutting edge technology and other simple innovations to improve efficiency and patient care.
The insights gained from Narayana’s model show that while technology increases efficiency of processes, what really makes a difference to customers are the human touch-points. As Mr. Hochman says, “Human touch points matter more because there are less and less of them today and are therefore crucial to the whole customer experience.”
By putting customers at the core of their thinking, many hospitals have been able to apply innovative solutions to solve age old problems. For example, Max Healthcare, introduced paramedics on motorcycles to circumvent heavy traffic and respond faster to critical emergencies. While ambulances reach 30 minutes after a call, the motorcycles reach in just 17 minutes. In the first three months, two lives were saved because of this customer-centric innovation.
Hospitals are also looking at data and consumer research to identify consumer pain points. Rajit Mehta, the MD and CEO of Max Healthcare Institute, who was a panelist at the summit, spoke of the importance of data to understand patient needs. His organisation used consumer research to identify three critical areas that needed work - discharge and admission processes for IPD patients and wait-time for OPD patients. To improve wait-time, they incentivised people to book appointments online. They also installed digital kiosks where customers could punch in their details to get an appointment quickly.
These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott is working with hospitals and healthcare professionals to improve the quality of health services.
To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.
This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.