After searching for six months, Senani Hegde, Krupakar and Joseph Raja almost gave up their quest for the Indian wolf in south-central India. Put on the trail of the elusive animal by a wildlife enthusiast, the trio set out to document the life of the wolf but could find no signs of it on the arid plains. However, when they changed tack and started following nomadic tribes, they not only saw the wolf but also uncovered an unusual belief that has possible helped keep the Indian wolf alive.
“Wolves are generally hated by everybody,” said Raja. “But initially, the nomads seemed over-protective of the wolf.” After half a year looking for wolf tracks and observing the wandering tribes, the filmmakers finally saw an old male wolf with one of its ears bent. Obviously, they called him Bent Ear.
The film they made over the next three years became Walking With Wolves, whichthis weekwon the wildlife conservation film award this year at the Centre for Media Studies' Vatavaran festival. The filmmakers show how Bent Ear survived many years in the Raichur area, where wilderness has been taken over by farming and grazing and where wolves are regularly hunted or poisoned to protect domestic animals.
The filmmakers were in for a series of surprises while working on the project. First, they realised that Bent Ear had a female partner and sub-adult children. In the absence of prey, the wolf family fed on berries and bananas. The filmmakers learnt from the nomads that wily Bent Ear knew how to penetrate their sheep pens. They observed his son learning to do the same. They saw Bent Ear avoiding food too conveniently placed, as though he suspected it might be poisoned. They filmed the death of the cubs by poisoning but also the birth of a new litter.
But the biggest surprise came to them in the attitude of the nomadic people towards the wolf. Unlike local farmers and herders, the nomads never chased, hunted or hurt the wolves. The filmmakers soon uncovered a legend of three brothers, one of whom is cheated out of his share by the other two. He leaves but not before bestowing a curse that he would come back to claim his due. The tribesmen consider the wolf to be that brother, returning to take what’s rightfully his. It’s possible that this fraternal feeling between tribe and wolf saved Bent Ear and his family.
Despite its importance as an apex predator in the central Indian ecosystem, the Indian wolf is one of the least-studied animals. It is one of two species found on the Indian subcontinent, the other being the Himalayan wolf. Yadvendradev Jhala, a scientist at the Wildlife Institute of India, has studied wolves for decades now but even he can only make an educated guess that there are between 2,000 and 3,000 Indian wolves in peninsular India. Few people know anything about the animal. Protecting it is almost impossible.
“The wolves don’t live in forests, they live outside forest areas,” Jhala said. "They are endangered and on Schedule I but it is very difficult to enforce the law because they are outside the protected area network."
Ashwin Aghor can only guess at the number of wolves in the Ahmednagar district of Maharashtra where he works. Aghor is the director of projects at EnviroCare Welfare Society that has conducted work to reduce animal conflict with humans. The projects include like building water holes for animals. Aghor has no doubt that the wolf population has crashed in the last 30 years or so.
“From conversations with shepherds, we find that the sightings of wolves were very frequent and now they are very rare,” he said. “A person who is 70 years old will say that when he was 30 years old he would have seen 20 wolves in a day. Now he doesn’t even see 20 in a month.”
According to Jhala what the wolf desperately needs are refuges across the agro-pastoral landscapes of India. These might be a few square kilometers that haven’t yet been touched by people, like the sacred groves in Rajasthan and Gujarat. They could turn into safe sights for breeding and rearing wolf pups. “But these refuges are fast vanishing because of extractive uses by people and encroachment by agriculture,” he said.
Walking With Wolves might only be the beginning of an investigation into the lives of wolves in India. The film discovered another animal with a wolf-like appearance hanging around Bent Ear's den and playing with his new litter. Was letting another adult into his family Bent Ear’s new survival strategy? “That’s a mystery,” said Raja. “That animal came at the end of our work. It just showed us one aspect and we said ‘now we have more questions.’”
What hospitals can do to drive entrepreneurship and enhance patient experience
Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.
At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.
Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.
At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.
Getting the best from collaborations
Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”
Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.
There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.
When intrapreneurship can lead to patient centric innovation
Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.
Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.
Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:
Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
Help for non-English speakers: Iconography cardstohelp non-English speaking patients express themselves and seek help in case of emergencies or other situations.
As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.
According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.
Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, 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.