The Daily Fix

The Daily Fix: Before India expands its nuclear programme, problems at current plants must be fixed

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

The Big Story: Nuclear woes

India on Wednesday embarked on the biggest expansion of its nuclear power footprint yet. The Union Cabinet cleared 10 new nuclear power plants, each with a capacity of 700 MW (mega watts of electricity). This will more than double India’s current nuclear power capacity of 6,780 MW.

The impulse for the expansion is obvious. In January, the draft national electricity plan of the Central Electricity Authority estimated that India’s peak power demand will increase to 690 GW (giga watts of electricity) by 2035 from the current 153 GW.

Nuclear power is widely regarded as a cleaner source of energy than fossil fuels like coal. Unlike renewable energy sources such as solar power which needs large tracts of land, nuclear plants work on a smaller area to produce larger amounts of power. They have been marketed as the cheapest alternative to coal-based generation plants.

However, the story of nuclear plants in India has been fraught with delays, opacity and large-scale local dissatisfaction. Nothing exemplifies this better than the Kudankulam facility in Tamil Nadu. The project was announced in 2002 and was supposed to produce electricity by 2007. Instead, the reactor began functioning only in 2012, five years behind its original schedule.

Not just this, the Kudankulam plant perhaps remains the most inefficient of India’s nuclear plants. As per official data, in 2014, the plant functioned for only half the potential hours it could have clocked up. Between April 2015 and January 2016, the plant worked at only 20% of its capacity. The performance of some other facilities has been equally poor.

In addition, India’s nuclear plants do not function transparently. Most technical information relating to the plants are beyond public scrutiny owing to security concerns. In 2016, for example, a leak was reported in the Kakrapar plant in Gujarat, but the extent of the leak still remains a mystery.

Finally, as witnessed in Kudankulam in 2011 , communities in many parts of India have rejected proposals to have nuclear plants constructed in their backyard. These protesters have been dealt with force and state action, with some even made to face sedition cases.

Without addressing the concerns about the safety and efficiency of India’s existing nuclear plants, the government’s large-scale nuclear expansion will only invite further distrust.

The Big Scroll

  • Nityanand Jayaraman writes on why India wants to import US reactors that even people in the US are not keen to use. 
  • Kumar Sundaram on the mystery surrounding the Kakrapar nuclear plant leaks in 2016. 

Punditry

  1. Nilanjan Ghosh in the Businessline says the lack of scientific data has hindered the Teesta water sharing accord between India and Bangladesh. 
  2. In the Indian Express, Khalid Anis Ansari explainswhy blanket reservations for Muslims in Telengana without considering the class differences within the community could be disastrous. 
  3. In The Hindu, Meera Srinivasan traces the history and political isolation of plantation Tamils in Sri Lanka – Indian migrants who crossed the water to work on tea plantations during British rule. 

Giggles

Don’t miss

Arunabh Saikia reports on how a rumour about spread of impotency through a vaccine caused panic in Assam.

“‘It turns out that the “news” Nooressa Begum watched was a video clip circulated via WhatsApp. ‘I received this video about an RSS injection on a WhatsApp group,’ said Samsul Haq, a resident of Hatigaon who works as a driver with an online cab service, referring to the Rashtriya Swayamsevak Sangh.

Haq claimed that everyone he knew had received the same video. ‘My neighbour’s two girls have stopped going to school because the parents are scared,’ he added.”

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

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.