The 200-bed Sancheti Hospital in Pune offers 14 distinctive super specialty services that cover the entire gamut of orthopaedics and trauma care. Sonal Shukla tracks the growth of the hospital, Pune, known for its academic heritage and thus fondly referred as 'the Oxford of the east', is also emerging as a healthcare destination. Any talk about the healthcare scenario in Pune is incomplete without a mention of Sancheti Institute for Orthopaedics and Rehabilitation (SIOR) in Shivaji Nagar. With its current bed strength of 200, SIOR has become one of South-East-Asia's biggest super-specialty orthopaedic hospitals.

Hub of Orthopaedic Care
It all started with the vision of orthopaedic surgeon Dr KH Sancheti, who established Sancheti Hospital as a modest 10-bed orthopaedic hospital way back in 1972. When the concept of super-speciality was in its infancy or nearly non-existent, Dr Sancheti dreamt of opening a hospital solely dedicated to one speciality— orthopaedics. "The aim behind this idea was to specialise in the vast array of super-specialities within orthopeadics. The other focus area has always been research, and getting all the orthopaedic patient under-one-roof has only given impetus to the research that we are doing in this area," shares Dr Parag Sancheti, son of Dr Sancheti, who has taken over the chairmanship of SIOR sometime back.

According to Dr Parag, initially, the orthopaedics specialty was only confined to trauma and accident cases. However, over the years there has been a radical change in the mentality of the patients, who now approach the hospital for advanced treatment procedures like joint replacement and arthroscopy. Today, the hospital offers 14 distinctive super specialty services that cover the entire gamut of orthopaedics and trauma care. Services are being offered in joint replacement, arthroscopy, trauma, spine surgery, shoulder surgery, hand surgery, paediatric orthopaedics and other such specialties. Each specialty among the 14 different orthopaedic specialties in the hospital has a separate team of consultants to avoid the duplication of work.

"Since one consultant is attending to one specialty, he gets more exposure to that particular sub-specialty, thereby mastering it," shares Dr Parag. Today, 40-50 per cent cases coming to the hospital are of accident and trauma nature, whereas 50-60 per cent are of joint replacement, paediatric orthopaedics, spine injury, etc.

The New Venture
The hospital has recently started a 55-bed Joint Replacement Centre with all the latest equipment and four state-of-the-art operation theatres. "With the growing incidence of knee arthritis in India and at least two lakh people requiring joint replacement surgery, we felt that opening a separate centre to cater this problem was important," says Dr Parag. Started in December, 2008, this centre has been conducting 40-60 operations per month and till date has done more than 500 joint replacements. The rooms of this centre are also tailormade according to the needs of the joint replacement patients.

	"I spent five years to design indigenous orthopaedic implant with my 40 years of experience as a surgeon"
	- Dr K H Sancheti, Founder, SIOR
	"We have been doing research in areas like knee replacement and arthroscopic surgery"
	- Dr Parag Sancheti, Chairman, SIOR

Sports Medicine
With sports medicine believed to be the upcoming speciality in medicine in the next few years, the hospital is already working towards becoming the preferred destination for it. The sports medicine division is rendering services to state and national level athletes. "This division is offering its services to various athletes who are training at Balewadi Sports Complex in Pune. It also renders its services during all sporting events held in Balewadi stadium," shares Dr Parag.

The hospital has been performing orthopaedic related surgery for over 40 years. "Our approach to treating patient's hip or knee arthritis focuses on the patient, and their unique, individual needs. They receive information before surgery, so they exactly know what to expect. After surgery, they get the help and care of specialised nurses and therapists who help speed their recovery. We look at these treatments as being philosophically different from a typical hospitalisation," says Padmashree Dr KH Sancheti. The facility is armed with an information desk for detailed guidance and assistance, a travel desk for the outstation patients which provide travel related support and a 24 hours pharmacy. The hospital has also built a guest house facility for the comfort of patients’ families.

The hospital is in process of establishing local area OPD for better administration and patient convenience. With this OPD, patients of different super specialities will get focused and quick attention.

Bullish about Technology

Lobby area in the hospital	The joint replacement theatre	Hyper baric oxygen chamber

SIOR has always shown a proactive approach towards adopting new technologies. Today, the hospital has highly advanced treatment facilities such as hyperbaric chambers with 100 per cent oxygen facility to heal the wounds faster— which is believed to be one of the first to be installed in India. It has a computer navigation system in place to perform joint replacement surgeries with perfection. The operation theatres at the hospital have incorporated a number of advanced features like powered and pneumatic instrumentation, high-tech image intensifiers (C- arms), and the latest equipment for joint replacement surgery, trauma surgery and spinal surgery.

The theatres boast of laminar airflows and HEPA filters for temperature-controlled air which is auto regulated for humidity and pressure and is completely bacteria free. The OTs are coated with patient-friendly special Corian material which is also hygienic and according to the international norm DIN EN ISO 846, is non-toxic and thermoformable. "The hospital has made approximately Rs one crore investment in the areas of Information Technology, infrastructure and medical technologies," shares Dr Parag.

Rich in Research
With the concept of evidence-based medicine gaining momentum in healthcare, the hospital has geared itself in the area of research. It has a well-equipped, in-house research and publication department, which has been conducting clinical trials for reputed international companies and has a dedicated team for the same. "We have been doing research in areas like knee replacement and arthroscopic surgery. With the US-based multinational company like Amgen, we are developing an injection which will heal the bones faster," shares Dr Parag.

Innovation in the Backyard
Dr KH Sancheti, who has now totally devoted himself to the research in orthopaedics, has designed an indigenous implant especially keeping in mind the needs of Indian patients. Osteoarthritis of the knees is a very disabling condition. Once the patient reaches a stage of intolerable pain and severe deformity, then Total Knee Arthroplasty (TKA) is the only solution. Till recently, the prosthesis that were available for TKA were all imported. The problem with these prosthesis is that they are made to suit the western lifestyle. They are designed for the bony architecture of the westerners. Moreover, they are expensive. Keeping this in mind, Dr KH Sancheti designed the Indus prosthesis, which is an indigenously manufactured monoblock, posterior stabilised design. This design, with minimal resection of the bone, offers high flexion, and the patient can squat too. Dr Sancheti studied the CT Scans of 500 male and female normal knee joints as his basic anthropological research and finalised five different sizes for the Indian knee. "Lack of affordability of the imported implants and their non-suitability for Indian bones made me spend five years to design indigenous components with my 40 years of experience as a surgeon," shares Dr KH Sancheti.

Socially Sensitive
The hospital is driven by the philosophy of Dr KH Sancheti, who believes doing his bit for the society by helping the less fortunate and for the past 25 years has been involved in charitable work. Dr KH Sancheti was one of the first ones to apply the concept of 'social orthopaedic' by carrying out mass polio and rehabilitation camps from 1976 onwards. During these camps, children with deformities are examined and operated upon. Till the year 2004, the hospital arranged 300 such camps in the states of Maharashtra, UP, MP, Gujarat, Andhra Pradesh and Karnataka.

The hospital has been conducting free polio and cerebral palsy camps for underprivileged in Anandpur, Sanawad, Amravati and Ahmednagar districts of Maharashtra. The camps include free diagnosis as well as surgery, and distribution of rehabilitation aid to the patients. "Until now, over 20,000 patients have benefited from this activity," shares Dr Parag.

	Medical Education
	The hospital has academic wings (College of post graduate studies in orthopaedics, college of physiotherapy, hospital management course) for continuous development of intellectual growth of the hospital. It is offering courses in MS (Orthopaedics), Diploma in Orthopaedics, Bachelors in Physiotherapy, Masters in Physiotherapy and Diploma in Hospital Management. It also has one year courses in Sports Medicine and Emergency Medical Services. "It is important to impart a teaching programme to train the budding talent, which, in the long run we can also cultivate for the patient care in the hospital. The courses like hospital administration conducted by SIOR has been churning out good managers for the sake of good hospital management," says Dr Parag.

Free plastic surgery camp is conducted on campus yearly in the month of January by famous surgeon Dr Sharad Dicksheet from US. "Correction of cleft lip, cleft palate, scars, and squints is carried out during this month. Over 500 surgeries have been done in this camp. Monthly arthritis camps are conducted in the Sancheti campus," says Dr Parag.

Challenge
The hospital is trying to attain the cost efficacy, one of the universal challenges faced by all the sectors. "To overcome this challenge, our administrative management is working on the process effectiveness by decreasing cost and reducing the patient stay," says Dr Parag.

Talent management is another area of concern. There is huge shortage of well trained staff to work in hospitals. Says Dr Parag, "With the current 350-plus staff strength, we are able to retain talent through our employee caring policies and well planned career paths for the people."

Medical Tourism
With its impressive infrastructure and world class facilities, the hospital has been referred patients from various parts of the world including the Middle East, Oman, Yemen, Tanzania, Kenya, Nigeria, UK, UAE, Nepal and Sri Lanka. The hospital has an official contract with the Ministry of Health, Oman for rendering services to the patients with orthopaedic problems. The hospital has also initiated the trend of arranging sight-seeing tours to various tourist spots for the medical tourism patients and has been providing few spa services too such as exclusive on-site beauty treatments for ladies. "We also have an in-house Arabic interpreter for easy communication with doctors and other hospital staff," shares Dr Parag.

Future Plans
Orthopaedic has many super-specialties in it such as trauma, joint replacement, sports medicine etc and the hospital plans to start centre of excellence for all such super-specialties in the near future.

Being a leading orthopaedic hospital in India, it is the referred centre not just within India but also in Middle-East countries. "We plan to capture this market. We already have tie-ups with few Middle-East organisations for patient management. We also plan to start our OPD in Dubai and Muscat," says Dr Parag.

When Pune city is expanding at a fast pace with many bigwigs in healthcare entering this emerging market, Dr Sancheti is clear that he wants to expand the hospital through the franchisee route. "I want to cash on the brand name of Sancheti in healthcare industry, where we will give our brand name to other hospitals and they can refer their complicated cases to us," he envisions.