political play

With Bihar in their pocket, Narendra Modi and Amit Shah have conquered the Hindi heartland

Up next: The south and east.

Bihar was the only big outlier. In a sea of saffron from Jammu and Kashmir to Maharashtra, Gujarat to Jharkhand, Bihar was the only state to resist the spread of the Bharatiya Janata Party. It even managed to deliver a crushing defeat to the BJP, at a time when Prime Minister Narendra Modi and Party President Amit Shah were pulling off resounding victories or canny takeovers across the land. That is now in the past. Nitish Kumar’s decision on Wednesday to join hands with the BJP to return as Bihar chief minister, less than 15 hours after stepping down from the same post and ending an anti-BJP alliance, means the saffron party now controls almost the entirety of India’s heartland.

In some ways, this should not be surprising. The BJP’s massive Lok Sabha victory in 2014 suggested the party could expand far beyond its traditional strongholds, on the back of Narendra Modi’s popularity. In the state elections that followed in 2014, it has methodically gone about this task, winning outright in many cases and ensuring it would be in the driver’s seat even without a majority.

The following year, 2015, seemed to halt this expansion, with the BJP being routed by the Aam Aadmi Party in Delhi and defeated by a coalition of Opposition parties in Bihar. But the saffron party did not just pick up the pieces and move on, it continued to work on unsettling the governments in those states where it had lost. In Delhi, that meant making it difficult for the AAP government to function. In Bihar, it focused on attacking the weakest links in the Rashtriya Janata Dal-Janata Dal (United) alliance.

Hook or crook

In 2016, the BJP got a breather, since it was not a major player in most of the state elections, although it did manage significant vote-share gains in Kerala and West Bengal. In Assam it managed its very first victory, opening up the North East.

Meanwhile, the party was also hard at work on coming to power without elections. It first tried this gambit in Uttarakhand and Arunachal Pradesh, building up support and allegedly using money to attract lawmakers over to the BJP camp. Though both efforts initially seemed successful, they ended up being overturned following Supreme Court scrutiny. But that did not stop the BJP from pushing further. By December 2016, Arunachal had turned saffron and elections in Uttarakhand a few months later led to the same result.

Early elections in 2017 saw the same two-pronged approach. In Uttar Pradesh, the BJP managed a resounding victory, giving it a huge national boost and confirming its position as the pole of Indian politics. But in Goa and Manipur, despite finishing with fewer seats than the Congress, the BJP still cobbled together enough support to form the government in both states.

In Bihar, as with those two states, the government is now primarily run by two parties, neither of which won the most seats in the 2015 election.

Congress leaders attempted to pass this off as a “failure” of Indian democracy, but whatever the moral dimensions of the move may have been, the BJP’s successful efforts only confirm the impression that it is dominant. All other political parties are forced to react.

Up next

Now that the Hindi heartland has nearly been conquered – a resounding BJP victory in municipal polls in Delhi suggests even AAP is under the gun – the saffron party is looking further afield. It has already pushed its way into several North Eastern states and is continuing to throw its weight, and central funds, around there. North Eastern states have traditionally backed the government at the Centre, so this may not be surprising. The party will spend some of the next few years hoping to ensure it is re-elected, in states like Gujarat, or winning over states like Himachal Pradesh where it seems ready to take over.

The real challenge lies in the south and east

In the crosshairs:

  • Karnataka was the BJP’s first big win in South India in 2008, and it was supposed to be a gateway to the rest of the region. But the party lost the state to the Congress in 2013, thanks to infighting and allegations of corruption among other things. Karnataka is up for elections in 2018, and there is much talk of anti-incumbency against the Congress government. The BJP has a real shot at repeating its success from 2008, and then looking further south to states where its presence is minimal but growing.
  • Odisha is the BJP’s brightest hope in the east, in the short-term at least. The party has never won in the state, but after four terms of Biju Janata Dal’s Naveen Patnaik at the helm, there is a feeling that voters are ready to choose an alternative. Traditionally that would have been the Congress, which ran the last non-BJD government in the state in the late 1990s. But the Congress local unit has failed to keep up, and some now believe the BJP will be the principal beneficiary of any anti-incumbency in elections in 2018. Will that be enough for a victory?
  • West Bengal may not be an immediate prize for the BJP, but it is hard at work in the state. Three decades of communist rule gave way to the Trinamool Congress’ Mamata Banerjee in 2011. Banerjee has dominated the state since, but the BJP sees the potential for West Bengal to fit the BJP vs ‘secular’ party formula that now exists in many other states. Elections are not due till 2021, and even then few expect the party to unseat Banerjee, but the saffron party is steadily making inroads – and working to polarise voters in the process.
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.