Aravind Eye Hospital Case Study Hbr Blog

Case | HBS Case Collection | April 1993 (Revised May 2009)

Aravind Eye Hospital, Madurai, India: In Service for Sight, The

by V. Kasturi Rangan


Starting as a modest 20-bed hospital, Aravind had grown into a 1,400-bed hospital complex by 1992. It had by then screened 3.65 million patients and performed 335,000 cataract surgeries, nearly 70% of them free of cost for the poorest of India's blind population. Aravind's founder, Dr. Venkataswamy, now 74 years old, had a goal to spread the Aravind model to every nook and corner of India, Asia, and Africa. The case sets the stage for developing such a plan of action.

Keywords: Developing Countries and Economies; Social Marketing; Service Delivery; Service Operations; Welfare or Wellbeing; Expansion; Health Industry; India;

“How do they do this?” Their approach differs on several aspects:

Way of working

-         Far-reaching standardization: everyone performs the same actions in the same manner. Individual preferences are subordinate to the interests of the whole.

-         Far-reaching task delegation: specialists are only doing specialist work. A cataract operation takes five to ten minutes (this varies indeed per surgeon). A specialist operates 60 patients in one morning.

-         Processes are being improved step by step and this refinement process continues. They reduced the time between the end of an operation and the start of the next operation to only a few seconds.

Planning and reaction

-         Strong anticipation: from previous experience (numbers) they know how many patients will come at what month and at what day of the week. They prepare for this by increasing capacity at busy days.

-         Strong reactive capacity: the planning processes are designed in such a way that it is immediately visible when demand is greater than predicted at a moment in time. The employee who sees this gives a signal to people from other departments who are asked to come and help immediately.


-         People are trained to work in different departments. People are constantly trained not only to deliver better quality care and to improve skills, but also to further increase flexibility.

-         Attitudes: people need to work together to ensure that the patients gets what he needs. Not self-interest, not their own department, but demand determines who works at what place (according to knowledge and skills).

An interesting case! I do not know if the methods, used at Aravind, could also be implemented in the , but I know no other hospital in the world that comes so close to flow as characterized by . Take a look at the thesis ‘Hospital system design’ for more information. Click here to contact Hanneke Molema.

P.S. my gratitude goes to Nieki Peerbooms for translating my Dutch blog

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