Rail trail

India's rail safety rests on the shoulders of 200,000 trackmen with 15 kilos of gear on their backs

As more than 130 people die in a train accident in Kanpur, discussion on modern safety systems has been revived.

More than 130 people have died in one of the worst railway accidents India has seen in years, after the Patna-Indore Express derailed in Kanpur Dehat district on Sunday. The incident saw 14 coaches coming off the tracks, leading to horrific scenes of mangled bogies and serious injuries, in addition to the death toll which authorities are concerned may still go up.

Since efforts are still on to rescue people at the site, officials have not yet spoken of the cause of the incident. One official said that another train passed through the route safely just nine minutes before the accident. Yet most seem to have concluded that the derailment was likely the result of a rail fracture – a crack in the tracks.

“A high-level probe has already been ordered and we will take strict action,” said Minister of State for Railways Manoj Sinha, who visited the spot on Sunday. “The engineers and experts will probe the cause of the accident, but it appears there was a rail fracture.”

Rail fractures

Rail fractures occur when a small crack turns into a larger one, usually because of the pressure of heavy bogies traveling over it. Indian Railways, which maintains 115,000 km of track around the country, is particularly prone to it in the season when there is a significant difference between the maximum and minimum temperatures in the day, since those cause the tracks to expand and contract. Poor maintenance and fitting could also be the cause of a small crack that over time could turn into a separation of rails. The result is a break in the tracks, which causes the bogey to go off the rails, affecting all the coaches behind it as well.

The Times of India reported that 50% of train accidents in the last three years have been due to derailments, of which 29% were caused by track defects. Accidents due to derailment have been up by 67% this fiscal year, up to November 15. Those numbers will be even worse once the Kanpur incident has been accounted for, especially since it came just days after another train derailed in Jodhpur.

The accident has also turned the spotlight back on passenger safety, with some claiming that the recent push to increase capacity and redesign business models for the railways has shifted focus away from core safety issues. The Hindustan Times quoted an unnamed senior ministry source saying “somewhere along the line, routine safety drills have taken a backseat and the 1 lakh-odd vacancies in the safety category have remained”. The report also quoted Sanjay Pandhi of the Indian Railways Loco Running Men Organisation saying that the business aim of the railways, running more and heavier trains, has led to a deterioration in the rail tracks.

Track monitors

Some of the focus might turn back to the physical way that Indian Railways actually maintains its massive track length. One of the world’s biggest employers, Indian Railways has an entire department of trackmen – formerly known as gangmen – whose entire job revolves around maintaining tracks. These 200,000 trackmen set out every morning carrying 15 kilos of equipment and walk along a 5 kilometre stretch of rail to check it for defects.

Play

The work is hard, as well as dangerous. Trackmen spend most of their day on tracks that still have trains plying on them, which leads to an average of more than 300 deaths every year. Added to the danger is the pressure of maintaining the tracks themselves, since mistakes by trackmen could leave trains vulnerable to incidents like the tragic derailment in Kanpur.

Play

For years, the authorities have promised to develop safety technology that will better alert trackmen when trains are approaching and giving them lighter toolkits.

In addition to the trackmen, Indian Railways uses ultra-sonic flaw detection machines, but these have to be taken out manually and are thus likely to only travel over high-density routes once every two months. The authorities are working with the Indian Institute of Technology-Madras to develop automated detection systems, but for the most part current monitoring is heavily dependent on the trackmen alerting engineers about potential dangers.

Earlier this year, Railway Minister Suresh Prabhu launched the Track Monitoring System, software meant to store information regarding temperature and track-maintenance activity across the railways. However, The Pioneer reported that the new system is not available to those in the safety wing. “As a result, the monitoring mechanism becomes a closely guarded secret defeating the very purpose of the launching of the software application,” an unnamed railway official told the paper.

We welcome your comments at letters@scroll.in.
Sponsored Content BY 

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.

Play

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.

Play

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.

Play

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.”

Play

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.