The Daily Fix

The Daily Fix: What has the BJP done to set the CBI free from its parrot's cage?

Everything you need to know for the day (and a little more).

The Big Story: Cagey parrot

In the last few years of the corruption-tainted United Progressive Alliance government, it was not uncommon to hear complaints from Bharatiya Janata Party leaders about the ruling Congress’ willingness to use the Central Bureau of Investigation as a political tool. Congress Bureau of Investigation they called it. This impression was given additional ballast during Supreme Court hearings, in which Justice RM Lodha referred to the CBI as a “caged parrot”, forced to speak in its master’s voice.

Ironically, the same allegations are being leveled at the BJP government today. Just as West Bengal Chief Minister Mamata Banerjee raises the anti-demonetisation pitch, the agency has moved in to arrest her ministers in the alleged Rose Valley chit fund scam in which thousands are said to have been cheated. As Delhi Chief Minister Arvind Kejriwal’s battle with the Centre got louder, it was the CBI that shut down his office building and raided the Delhi Secretariat.

As former CBI director Joginder Singh told the Hindustan Times after Prime Minister Narendra Modi came to power, “All governments work towards keeping CBI and other investigative agencies under their control.”

In the Rose Valley scam, as in numerous cases against political leaders during the UPA regime, it was not the legitimacy of the investigations themselves that came into question. Many of those seemed like genuine matters that needed looking into. Instead it was the timing of CBI actions, with not much movement on files for months until it became politically expedient for the investigation to move forward.

Under BJP rule, another trend seems to have emerged. The role of the CBI, already under much pressure because of a lack of officers and far too many cases, has expanded to cover any investigation that the Centre deems important – like the matter of cheating PayTM customers. Why else would former Delhi Lt Governor Najeev Jung have to transfer several cases from Delhi Police to the CBI before his departure?

The agency, political tool as it may be, remains one of the more reliable investigating bodies in India and, as a result, it is important that its independence and image be protected. After all its complaints about the “Congress Bureau of Investigation”, the BJP has done little to address this question or that other worrisome matter of whether the agency even has legal sanction to exist.

Responsible governments don’t just govern responsibly, they also create the structures to build integrity into the system. If the BJP truly meant its criticism about the pliability of the CBI and the recognises the need for an independent agency, it needs to do much more to ensure the body does not continue to sing the tune of whoever is in power in Delhi.

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Punditry

  1. Aradhana CV in the Ladies Finger trawls through 45 High Court judgments in rape cases to discover that judges continue to conform to “archaic and gender insensitive and patriarchal precedents” instead of simply looking at consent.
  2. The Income Tax Settlement Commission seems to have its fastest order ever, according to the Indian Express, which points out that it has granted Sahara India immunity from prosecution over documents that listed alleged pay-offs to several politicians including a reference to a former Gujarat “CM”.
  3. Sidddhartha Singh and Bidudatta Pradhan in Bloomberg fall back on their sources to conclude that 97% of banned notes have been returned to banks.
  4. “Everyone likes to view Shivaji through their own prism, however much the image may get distorted,” writes Girish Kuber in the Indian Express.

Giggles

Don’t miss

Aarefa Johari takes you to Gujarat, where dairy farmers from milk cooperatives have not been got cash for more than 50 days.

“’Dairy farmers need cash to buy essentials for their cattle and their homes, and I usually pay them every 10 days for all the milk they have delivered,’ said Tejabhai Tamaliya, the secretary of a milk cooperative in Surendranagar’s Diksar village. Tamaliya’s cooperative has 150 members, whom he needs to pay at the current rate of Rs 5.9 per kilo fat of milk – the amount of milk that would yield 1 kilo of fat. Since most of them haven’t been paid in 50 days, Tamaliya now owes his members a total of nearly Rs 15 lakh.

‘I have the money in my account, but a withdrawal limit of just Rs 24,000 a week is too little – and it’s not like the cooperative bank is able to give us even that much cash each week,’ said Tamaliya, who has made numerous trips to the Surendranagar District Cooperative Bank head office since November 10 to introduce mandali members to the banking system.”

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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 cards to help 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.