Sri Sathya Sai Institute of Higher Medical Sciences Whitefield, Bangalore.

Project Report on What makes an Organisation?

PGP 2012-14

Group 2: Anusha Subramanian Jasti Preethi Belinda Jitendra Laldhari Yadav Mudavath Swetha Naman Kumar Shaivya Sonkar

Table of Contents
1. 2. Objectives ............................................................................................................................ 1 Introduction and History ..................................................................................................... 1 2.1 2.2 3. Introduction ............................................................................................................. 1 History ..................................................................................................................... 3

Mission, Goals and Strategy ................................................................................................ 3 3.1 3.2 3.3 3.4 Mission ..................................................................................................................... 3 Guiding Principles .................................................................................................... 4 Strategy .................................................................................................................... 4 Expanding the reach of the hospital and its services ................................................. 6

4.

Structure of the Sri Sathya Sai Central Trust ...................................................................... 7 4.1 4.2 Structure .................................................................................................................. 7 Organizational Type Professional Bureaucracy ..................................................... 8

5.

Culture of SSSIHMS Emergence and Purpose ............................................................... 11 5.1 Interpreting culture ................................................................................................ 11

Conclusion ................................................................................................................................ 15 References ................................................................................................................................ 15 Questions .................................................................................................................................. 15

Table of Figures
Figure 1 : SSSIHMS Strategy: Porter's Matrix........................................................................... 5 Figure 2 : SSSIHMS: Telemedicine Centre ................................................................................. 6 Figure 3 : Sathya Sai Trust: Structure ........................................................................................ 7 Figure 4 : SSSIHMS: Organisational Chart................................................................................ 8 Figure 5 : SSSIHMS: Organisational Type - Mintzberg model ................................................... 8 Figure 6 : Hierarchy in Operational Core ................................................................................... 9 Figure 7 : SSSIHMS: Cultural Artefact 1 ................................................................................. 13 Figure 8 : SSSIHMS: Seva Dal at Work ................................................................................... 14 Figure 9 : SSSIHMS: Organizational Symbols ......................................................................... 14

ii

1. Objectives
Study the goals of Sri Sathya Sai Institute of Higher Medical Sciences and analyse how the strategy of the organization helps in achieving its goals. Analyse the structure and the arrangement of reporting relationships in the hospital. Explore the various aspects sustaining the culture of SSSIHMS.

2. Introduction and History

2.1 Introduction

Sri Sathya Sai Babas Medical Mission reads as follows: Hospitals that treat patients with love and care, with dedication and devotion, are a rarity. There are hospitals with costly equipment and expert doctors, huge buildings and spic and span interiors, but they indulge more in profiteering than affording relief This hospital is being started so that expert advice and treatment can be rendered to them in a loving atmosphere of reverence and devotion. No charge will be levied here for any service It is with these noble intentions that Bhagawan Sri Sathya Sai Baba started his healthcare mission, which is now over five decades old. Sri Sathya Sai Healthcare Mission is based on a utopian ideal, ingrained in the millennia-old culture of India, where the society takes the responsibility to meet the basic needs of its members. The institutes founded by this organization attract the cream of doctors, who understand the true spirit of their noble profession and heed their calling to practice it in these institutes, where they are given the freedom to do all that is required in the best interests of the patient and his health. Medical care today is beyond the reach of the very people who are most vulnerable to disease. The poor in India are resigned to a reality in which they neither have knowledge of prevention of disease nor access to medical care. The hospitals established under the guidance of Bhagawan Sri Sathya Sai Baba provide complete medical care including consultation, diagnosis, comprehensive treatment and follow-up to all patients totally free of charge. Sri Satya Sai Medical Care Mission is one of the many social welfare projects taken up by the Sri Satya Sai Central Trust. Under the aegis of Sri Satya Sai Seva Organization, the Sai Global Health Mission has touched and transformed lives in more than 120 countries. Sri Sathya Sai Institute of Higher Medical Sciences, Whitefield, Bangalore, is the second high-class, super-specialty facility devoted to the practice of ideal healthcare, where treatment is offered totally free.

Sri Sathya Sai Institute of Higher Medical Sciences has two specialities- Cardiac and Neuro Sciences symbolically reiterating Bhagawans quote, In the human body there are two important organs. One is the heart and the other is the head. Many of the assistance/services areas of the hospital are supported by volunteers from the service wing of the Sri Satya Sai Organization on rotation, who consider an opportunity for self-elevation in the spirit of Love All Serve All. The Seva Dal can be identified by the blue scarves for men and orange & yellow scarves for women. The guidelines on which the organization functions are: Treat patient and not just the disease. Every patient should be given the best available treatment Medical care must be administered with love and care Sri Satya Sai Medical Trust is the only charitable trust in India, to offer complete medical care including consultation, diagnostics, comprehensive treatment and follow-up, at the primary, secondary and tertiary levels to all patients free of all charges. The institute mainly focuses and participates in cutting-edge research in the areas of preventive health and in areas where by treatment costs can be drastically reduced, without compromising on the quality of care. It is also the first Indian hospital in india to have image guided neuro navigation system for Brain Surgery. Sri Satya Sai Institute of Higher Medical Sciences, Whitefield,Infrastructure: 333 beds Operating rooms : 8 ICUs : 6 Cardiac Cath labs: 2 24 Hour Emergency Unit

Specialities Cardiac sciences Neuro sciences

Clinical services: Radio-diagnostics Laboratory Blood bank Telemedicine

2.2 History

Starting in 1956 with a 8 bed general hospital in the village of puttaparthi, the sri sathya sai health care mission has grown to offer secondary and tertiary care through two super speciality hospitals (1991 and 2001) and has now taken healthcare to the doorstep of the rural poor through its mobile hospital initiative (2005), all offering medical care totally free of charge to all patients. Though it was established on a smaller scale with just 80 beds and 2 operation theatres, it offered both primary and secondary care. Sri satya Sai Institute of Higher Medical Sciences Whitefield, Bangalore, was established in January 2001, inaugurated by the then Prime Minister of India, Sri. Atal Behari Vajpayee to serve the medical needs of the poor and needy who could not afford costly cardiac and neurosurgical care. It is spread over 3,54,000 sq ft, constructed within 12 months and is the first tertiary care hospital to have a comprehensive, post Discharge patient Rehabilitation Program. In the first step it was constructed in the record time of 6 months with a built-up area of 1, 53,000 sq feet, it is the first super speciality hospital in india to offer world class tertiary care through state-of-art medical technology, totally free of charge. This temple of healing was placed among the 50 best hospitals in the world and received the accolade-best fusion of form and functionality. In the past fifty years over 4 million patients have benefited from free healthcare services at this hospital.

3. Mission, Goals and Strategy

3.1 Mission

The Sri Sathya Sai Medical Trust is mainly driven by the values and vision of Bhagawan Sri Sathya Sai Baba. He has been the cynosure for all the activities undertaken by the trust. Moved by the plight of the millions of this country for whom affordable healthcare is a distant dream, Sri Sathya Sai Baba envisioned the foundation of the hospital in Whitefield area of Bangalore which would provide all the modern infrastructure that is need for implementing efficient and effective healthcare facilities for those who need them the most. The main principle which marks the foundation of the hospital is Health is a natural right of an individual. The principle is deeply imbibed in the day-to-day operations of the hospital. This also defines the mission statement of the Trust which saysSri Sathya Sai Central Trust (Medical Care Division) provides free medical care to the sick and ailing with the dedication, commitment, love and the best of skills, so that they will be
3

cured in body, mind and spirit. Or mission is to provide high quality medical care free of charge to all irrespective of caste, creed, religion and financial status in an atmosphere of love and compassion.
3.2 Guiding Principles

The hospitals run by the Trust follow the guiding principles laid down by Bhagawan Sri Sathya Sai Baba. 1. Universal Healthcare: Healthcare should be available to all, irrespective of caste, religion, nationality, or financial status. 2. De-commercialized Healthcare: Healthcare should be delivered free of charge. The hospitals provide the entire range of medical services investigations, surgery, medicines and in-patient care absolutely free of cost. In fact, there is no billing counter in the hospitals at all. 3. Human Values in Healthcare: Healthcare should be administered with Love. The doctors, the caregivers and the hundreds of Seva Dal (service volunteers) are inspired by the ideal Service to Man is Service to God 4. Spiritualisation of Healthcare: The aim should be to heal the patient in body, mind and spirit, not merely to cure disease. These are followed as the main guiding principles in all the hospitals set up by the trust. They provide the framework to carry out daily operations in the hospital. These tenets are followed by the employees and volunteers of the hospital while performing their duties. Competitive advantage Sri Sathya Sai Institute of Higher Medical Sciences is a unique hospital quite different in its aims and operations from other hospitals. It is a charitable organization that provides world class healthcare completely free of cost. Patients from all over the world seek treatment here and are not differentiated based on religion, gender, caste, income or sect. Therefore, from a business perspective, the hospital strives to serve a large number of those in need while minimizing cost. This sets the organization apart from other hospitals providing the same service. 3.3 Strategy The organisation strategy does not focus on competition with other hospitals. Their strategy is in line with the mission and operative goals of the organization as defined by Bhagavan Sri Sathya Sai Baba. The hospital follows a Focused Low Cost Leadership model described by Michael Porter to define its strategy. In order to achieve its goal of treating as many patients as possible within the limited budget allocated to each department, SSSIHMS strives for efficiency in its processes. All the incoming patients are diagnosed and their need for treatment is assessed. Subsequently, preference is given to the patients who need the treatment the most.

Low Cost

Uniqueness

Broad

Low cost Leadership

Differentiation

Integrated Cost Leadership/Differentiation

Narrow

Focused Low cost Leadership

Focused Differentiation

Figure 1 : SSSIHMS Strategy: Porter's Matrix

Reasons for Focused Strategy The hospital avoids cases which have legal implications (eg: accident victims). Since it is a super speciality hospital covering only two areas, namely cardio and neuro sciences, the scope of treatment is narrow. Thus, the hospital has very focused approach on the type of patients treated. The hospital does not treat patients above the age of 60.

Reasons for Low cost Leadership The hospital uses systematic procedures and exercises tight control to provide healthcare services efficiently at low costs within the allocated budget. Their best cost reduction strategy is the employment of Seva Dal members as part of the administrative support staff. The Seva Dal members are inspired volunteers of the Sri Sathya Sai Organization who come with a willingness to serve humanity.

Salient features of SSSIHMS according to the Miles and Snow Strategy Typology The hospital maintains efficiency in its processes and is less focused on innovation and differentiating itself from other hospitals. Decision making is restricted to the upper levels in the organizational hierarchy. All departments work on stringent budgets, therefore making cost control a top priority.

Keeping these features in mind, SSIHMS can best be classified as following a Defender strategy. This is in line with their goal of treating as many patients as possible within the given budget constraint. 3.4 Expanding the reach of the hospital and its services Since the hospital runs a tight ship with respect to budget constraints, a cost effective and innovative way to increase the outreach of the hospital was by building a telemedicine facility. The department of telemedicine, SSSIHMS, Whitefield is part of the Sri Sathya Sai Tele-health Network that includes both the sister institutions at Prasanthigram and Whitefield. Need for Sri Sathya Sai Telehealth Network: Due to the quality and nature of treatment provided at SSSIHMS, the hospital receives patients from all over India and neighbouring countries like Nepal and Bangladesh. A large number of these patients are below poverty line and some cannot afford the travel to avail the free and quality services of SSSIHMS. The telemedicine facility at SSSIHMS aims at reaching out to these patients in their geographical areas providing both diagnosis and counselling without them having to traverse the distance and incur avoidable expense.

Whitefield

Prasanthigram

Nodal Location - West Bengal, Orissa

Figure 2 : SSSIHMS: Telemedicine Centre

Aims of the project: Sri Sathya Sai Telehealth Network seeks to extend its neurosurgical expertise to remote areas through the nodes established at select locations across several States. SSSIHMS looks forward to utilize it telemedicine network to: Streamline the flow of revisit/Outpatients from pre-identified locations (States) Schedule appointments for face-to-face consultation and surgery Minimize unnecessary investigation, and travel for patients who can be advised remotely Provide follow up for post-operative patients Counselling of the patients Guide patients requiring support from other medical specialties presently not provided by SSSIHMS-WFD Conduct and participate in online CME's, training of DNB's and exchange of best practices and expertise in neurosurgery.
6

Through successful integration of telemedicine services in its routine clinical care, SSSIHMS expects to achieve right service mix that is both timely and distance insensitive ensuring maximum efficiency and effectiveness in optimal utilization of its resources.

4. Structure of the Sri Sathya Sai Central Trust

Sri Sathya Sai Central Trust was founded by Bhagawan Sri Sathya Sai Baba on 2nd September, 1972. Under his guidance, the Trust has been undertaking a number of welfare activities such as providing free education at school and university levels, delivering quality medical care at primary, secondary and tertiary levels completely free of charge, supply of pure drinking water in various regions of the state of Andhra Pradesh and the metropolitan city of Chennai. Other activities of the Trust include preservation and propagation of the rich culture and heritage of India through construction of museums, convention centers, community halls etc.

Sathya Sai Trust

Healthcare

Education

Services

Heritage

Figure 3 : Sathya Sai Trust: Structure

4.1 Structure A hospital is a very complex entity. Success here depends not only on the skills of the doctors, but also on the efficiency and interlinking of support services, infrastructure and engineering services for the treatment to be successful. There are three key components in the structure of an organization- Hierarchy, departmental grouping and systems for coordination across departments. These concepts can be applied to SSSIHMS in the following manner. Hierarchy- The director serves as the apex and chief decision making authority in the organization. Various department heads (HODs) report to the director frequently. In addition, there is a strict hierarchy followed within each department. Departmental grouping- The organization is divided into five clinical and three administrative departments. The functional structure ensures that similar activities are
7

grouped together into a single department. The eight department heads are at the same hierarchical level under the director. Horizontal linkages for information sharing - Employees communicate using intranet and email. There are periodic meetings within each department and also between the HODs and the director. The Seva Dal members play a pivotal role in providing horizontal links.

Figure 4 : SSSIHMS: Organisational Chart

4.2 Organizational Type Professional Bureaucracy The structure of SSSIHMS can be placed into the Mintzberg framework as follows:

A-Top Leadership, B-Middle Management, C-Operating Core, D-Technical Support, E-Support Services Figure 5 : SSSIHMS: Organisational Type - Mintzberg model

A. Top Leadership The Director is the functional head of the organization. He is responsible for coordinating among all department heads and planning activities such that the goals of the organization are
8

met. The Sri Sathya Sai Central Trust takes the responsibility of hiring the director after doing a thorough background check. The Director is most often chosen from the senior staff in clinical departments at SSSIHMS. B. Middle Management There are three administrative and five clinical departments. Each department has a head (HOD) who reports to the director. The HODs make up the middle management and are responsible for handling operations, finances and coordination within their departments. The administrative division consists of Human Resources, Engineering and Finance (Purchases and budget allocation) departments. The clinical division primarily covers two specialities Cardiac Sciences and Neuro Sciences. There are five clinical departments Cardiology, Cardio Thoracic and Vascular Surgery, Neurology, Neuro surgery, Anaesthesiology. C. Operating core The hospital currently employs 460 permanent staff and a few honorary staff members. Doctors have the option of residing on campus. Nurses and interns are provided hostel accommodation. At any given time, there are a maximum of 150 patients each in the Cardio and Neuro Sciences blocks. In the clinical departments, the doctors follow a hierarchical structure as shown below:

Figure 6 : Hierarchy in Operational Core

The senior consultant reports to the HOD of that department. In addition to these roles, nurses and medical student interns assist the doctors in their activities. Doctors across all levels execute the primary responsibility of SSSIHMS to provide quality healthcare to everyone who approaches them.
9

There is a hierarchy in place in the administrative departments too, although not defined formally. The admin departments are smaller in size compared to the clinical departments. They are responsible for handling all logistics in the hospital and ensuring that there are no roadblocks in its functioning. The retirement age for doctors in SSSIHMS is fixed at 58 years. It is extendable subject to mutual consent and performance. E. Support Services There are several supporting departments in both administration and clinical areas that form an important part of the functioning of the organization - Anaesthesia, Physiotherapy, Dietary Services and Laundry and Human Resources. The clinical support staff provides services across the six clinical departments. HR handles the hiring process, annual employee appraisal reviews, organizing trainings for doctors and nurses and addressing employees grievances. Perhaps the most distinguishing feature of this hospital is its service unit Seva Dal comprising of 50 men and 50 women volunteers. In periodic cycles of three months each, the Sathya Sai Seva Organization ensures that all districts in Karnataka take turns to send their member volunteers to serve in the hospital. Each batch of volunteers works for a period of one week at the hospital. The Seva Dal can be identified by the blue scarves for men and orange and yellow scarves for women. The incoming Seva Dal members are trained in different administrative support functions through a handholding program by the outgoing workers. There is a detailed three hour orientation session held every Sunday to apprise the incoming volunteers of their responsibilities. The Seva Dal members work under various capacities. Maintaining cleanliness, guiding patients, manning the gate, supporting the kitchen staff, aiding security staff and handling patient information flow across departments are some of the functions the Seva Dal members carry out. Since it is a voluntary service, it also helps the organization to reduce costs incurred to run all support services. The organization maintains a sizeable support services division. This is essential for its smooth running and high level of coordination within the operating core. D. Technical support staff: The organization uses Hospital Management Information Systems (HMIS) to store computerized patient information. The HMIS are indispensable to collating patient data and provides solutions for many operational requirements of a smoothly running healthcare. This infrastructure makes it possible for the healthcare staff to retrieve all aspects of patient information with a single click. The hospital is almost completely a paperless environment. Doctors have to authorize clinical tests for patients before the tests can be performed, ensuring accountability. These results are stored permanently in the patient database. Biometric ID scanning is going to be implemented in the future to record employee attendance in all hospitals under the Sri Sathya Sai Trust. These records will be stored and
10

monitored centrally. All doctors are familiarized with the use of patient management software, thereby minimizing the size of the technical support division. There is also a small engineering support team to help manage the sophisticated equipment in the hospital. Organizational Type Professional Bureaucracy The hospital has a large and efficient operating core consisting of highly skilled professionals. The technical support staff forms a very small part of the organization. Large administrative support staff aids the professionals and runs the routine administrative tasks of the organization. There is some level of formalization, but HODs and senior employees have a good degree of autonomy. There is a high degree of specialization and emphasis is on quality and effectiveness. Although there is a strict multi-level hierarchy within each department, it can be inferred from all the other features of the organization that the hospital follows a professional bureaucracy.

5. Culture of SSSIHMS Emergence and Purpose

Bhagawan Sri Sathya Sai Baba was quoted as saying, Nara seva is Narayana seva. Service to man is service to God. Service to the lord in the form of the poor and forlorn can never go waste. Man is the product of society and service to society is real service. Such service should be rendered without regard to caste, creed, race or nationality. Sri Sathya Sai Organization was founded in the 1960s with service to mankind as its primary underlying objective. This is strongly reflected in the value-based culture of all its child organizations. Bhagawan Sri Sathya Sai Babas teachings established the identity and beliefs of the Sathya Sai Organization and Trust. As his followers grew in number, the culture became more firmly established and correlated strongly with the vision and strategy of all the member institutions. 5.1 Interpreting culture SSSIHMS has a very strong, symbolic culture that all its members identify with. The passing away of Bhagawan Sri Sathya Sai Baba had little impact on the culture and functioning of the organization. Seva Dal members in particular continued to lend their support. Some of the noticeable aspects of the culture in SSSIHMS are: Rites and ceremonies Rites of passage Induction program for new employees: The induction program is a 2-day long program split into 3 stages. Stage 1 (Day 1): Employees are briefed about the background and history of the Sri Sathya Sai Medical Trust.

11

Stage 2 (Day 1): Employees are given an overview about the hospitals under the trust and the structure of SSSIHMS. Stage 3 (Day 2): Employees are taken to their respective departments of work and given a detailed appraisal of their roles as well as the overall functioning of the department.

Seminars and trainings Doctors are allowed to participate in seminars and conferences within the country twice a year. Based on annual appraisal reports, HR recommends and arranges training programs for employees.

Rites of enhancement There are no awards given to employees in any public forum. Rewarding select employees would go against the principles of the service oriented organization, where everyone is expected to work selflessly without expecting any recognition. However, there is an annual performance appraisal system in place. Extraordinary medical accomplishments are published in the monthly publication Sanathan Sarathy.

Rites of integration An annual sports meet is held to foster a sense of solidarity among all employees.

Stories and legends The hospital carries huge boards of display with certain stories and legends which are placed in the central hall of the hospital campus. Mother Easwarammas three wishes Though illiterate and coming from a simple, rural background, Mother Easwaramma had a vision for the village of Puttaparthi which lacked even basic amenities. She therefore made three requests to Bhagawan: Build a small school for the village children as they had to walk long distances to attend schools in the neighboring village. As there were no good medical facilities in Puttaparthi, a hospital needed to be built. People struggled to obtain drinking water in the summer when River Chitravathi dried up. Therefore, wells needed to be dug in the village. This incident inspired the three major endeavours of the Sathya Sai Trust of providing free healthcare, free education and free clean drinking water. Bhagawan Sri Sathya Sai Babas life history Two sections of the Central Hall are occupied with boards that take one through the life story of Baba and his service to mankind. Achievements The hospital administration puts up stories of unique achievements of the hospital on the notice boards and also publishes them in the newsletters regularly.

12

Symbols Perhaps the most visible element of the culture of this organization is the rich spread of physical artifacts throughout the hospital premises. There are several photographs of Bhagawan Sri Sathya Sai Baba on display. In some locations, there are chairs draped in yellow or orange cloth to symbolize Babas presence.

Figure 7 : SSSIHMS: Cultural Artefact 1

The most striking symbol that represents the culture of SSSIHMS is the Central Hall. It consists of a large, open space at the conjunction of the Cardio and Neuro blocks. There is a big portrait of Baba and a chair beneath at the center. There is minimal activity in this area, making it a calm and serene location.

This is in stark contrast to what one would expect to see in a typical hospital buzzing with activity. Moreover, every Thursday morning, patients and devotees alike congregate in the Central Hall to sing Bhajans. Along the walls, there are notice boards lined up which narrate stories about Baba and showcase the history and activities of the Sathya Sai Trust and its offshoots.

13

The Seva Dal members are dressed in white and have scarves draped around their necks, making them easily recognizable.

Figure 8 : SSSIHMS: Seva Dal at Work

Symbols of the organization The Hospital shares the symbol of its parent organization. The symbol depicts the teachings and principles of Baba. The logo embodies symbols from five major religions of the world and the five cardinal principals. Shri Sathya Sai Samithis comprise of members of different ethnic groups and different religions, all pursuing their respective religions, but joining together for the service of Mankind with the conviction that service to Man is service to God.

Figure 9 : SSSIHMS: Organizational Symbols

14

Languages All employees and Seva Dal members working in the hospital greet each other and outsiders by invoking the chant Sairam. This not only gives a distinctive feel to the atmosphere in the hospital, but also serves as a means of identification for the members with the Sathya Sai Organization. There is a white board at the entrance where patients come in, with a Thought for the Day on display. The notice boards in the Central Hall carry several quotes and slogans by Baba emphasizing the importance of service to mankind.

Conclusion
Sri Sathya Sai Institute of Higher Medical Sciences is a unique organization in the realm of non-profit entities. The basic principles on which the hospital runs are firmly established by the parent Trust. The organization has developed a structural form that helps it to achieve its goals using a sustainable business model. It has created a niche for itself in the world of healthcare by adopting a very different strategy. By fulfilling its mission without compromising on the underlying culture and values, the organization has set an example for other charitable institutes to follow.

References
1. 2. 3. 4. 5. 6. 7. Face-to-face interview with Mr. P. Mohandas, Senior Personnel Officer, SSSIHMS, Whitefield, Bangalore Face-to-face interview with Mr. Raghuram, Senior Manager HR, SSSIHMS, Whitefield, Bangalore http://wfd.sssihms.org.in/pages/telemed-dept-01.html http://wfd.sssihms.org.in/pages/speci-home.htm http://www.sssmt.org.in/pages/guiding.htm http://www.srisathyasai.org.in/Pages/Service_Projects/Introduction.htm Brochures provided by SSSIHMS

Questions
1. 2. 3. 4. Since yours is a non-profit organisation, what differentiates the processes in your organisation with respect to any other healthcare organisation? Is the budget constraint applied to the entire firm or the individual departments separately? How is the budget divided across departments? Are the individual doctors allowed to make their own decision regarding the number of patients to be treated? Is there a documented organizational chart describing the hierarchy of different levels of organization?
15

5. 6. 7. 8. 9. 10. 11. 12. 13.

What are the various administrative & clinical departments? How is the information flow across clinical and administrative departments? How strictly is the hierarchy enforced within each sub-department of each of clinical and administrative groups? What changes have been employed in the structure of the organization and functioning of Seva Dal, after Bhagwan Sri Satya Sai Baba passed away? What are the awards/recognitions given to employees? What is the measure of performance of employees? Are there any ceremonies like induction programs for new employees (other than Seva Dal members)? How does the culture of the organization manifest itself in observable artefacts? What is the relationship with other organizations, hospitals, government? How is technology helping in achieving the strategy and aims of the organization?

16