Nephrocare Health Services – Best Use of HR FINALIST– 2018


India’s largest network of dialysis centres with 135 sites in 85 cities and 18 states, it operates under the brand NephroPlus.

India suffers from a dearth of skilled technicians and nurses for Dialysis, making recruitment difficult and expensive. To counter this, NephroPlus created an in-house training academy for dialysis technicians. Eligible candidates are offered a guaranteed job, but students will also be qualified to work as a dialysis technician outside of NephroPlus. To meet high demand, NephroPlus has franchised its training academy with 7 currently operational and 8 to open in 2018. With the ability to meet increased demand, it has also developed an optimal staff mix ratio to eradicate wasted spending.


Briefly describe the organisation giving number of facilities, staff, revenue numbers.

Nephrocare Health Services Pvt Ltd (NephroPlus) was founded in 2009 by a dialysis patient Mr Kamal Shah and former McKinsey & Company consultant Mr Vikram Vuppala. In a short span of just 8 years, NephroPlus has grown to become the largest network of dialysis centres with 135 operations centres (as on Jan 31, 2018) spread across 85 cities in 18 states. With our motto of “Guest Care Comes First”, our topmost priority is to enable people on dialysis across the world lead long, happy and productive lives. We strive to provide the highest quality dialysis in an affordable setting. All our teammates undergo hours of rigorous training and certification before they are inducted to handle patients, who are referred to “Guests” in our ecosystem. We have also introduced for the first time in India, innovative concepts like “Holiday Dialysis” which help our patients lead enriching lives without any boundaries. As of 31st Jan 2018, NephroPlus has ~103 centres with Private Hospitals, ~29 centres with Government Hospitals and 3 Standalone centres with combined 1,450+ beds under operation. Some of India’s top hospitals including Max Group of Hospitals, Jehangir Hospital, Medica Hospitals, IVY Hospitals and Sahyadri Hospitals have partnered with us to provide quality dialysis service to their patients. NephroPlus is also the preferred dialysis partner for various Indian government agencies and state governments. In FY17 (Apr’16 to Mar’17), NephroPlus achieved its target of ~USD 15 MM in revenues and is enroute to cross USD 21 MM in FY18 (Apr’17 to Mar’18). NephroPlus currently has a staff strength of about 2,000 employees. In addition, more than 75 of leading Indian Nephrologists are our partners who help us develop the best quality protocols.

Please briefly describe the medical service, which the organisation is delivering in where there has been HR innovation.

We are providing quality dialysis at a cost currently unmatched by any other dialysis players in India. The typical consumer is a person with Stage V CKD (Chronic Kidney Disease) and has been recommended maintenance / regular Dialysis by a nephrologist.
Till date we have served over 1,46,000 patients with nearly 11,000 active patients currently dialyzing with us. Each patient typically has 10-12 dialysis sessions in a month. NephroPlus is currently doing 3,300+ dialysis sessions per day.
Dialysis services are provided by NephroPlus, through the dialysis units outsourced by Hospitals to NephroPlus.

Please describe the HR changes the organisation has made which have led to better services.

There are likely to have been several changes to practice. This could include a transfer of processes from, say, doctors to nurses, which cuts costs and saves time. It could be a cultural change programme, which dramatically improved patient or resident care or treatment. Or it could be a training programme that led to big skill improvements. Please list the changes separately.

Change 1 : There is a dearth of skilled technicians and nurses for Dialysis in India. This posed challenge for us in terms of finding skilled staff at economical costs to meet our ever increasing demand. To bridge this very important gap in the value chain of dialysis market and helps us control costs, we established our own, In-house training academy “Enpidia”. Through our own training academy, we are able to meet our ever increasing requirement of skilled technicians and nurses. As the training curriculum is designed in-house too, we are able to maintain a high level of skill, quality and service required amongst our technicians. Enpidia has tied up with BONENT, the reputed certification agency for dialysis technicians and nurses in the US. Additionally, we are empanelled with Bharat Sevak Samaj, Chennai and offer dialysis courses in association with this Government-recognized University. We are also empanelled with Healthcare Sector Skill Council (HSSC) under the Government of India, which helps our students get certified according to a standardized skill framework developed by HSSC. This gives our student flexibility as a dialysis technician, to work across any organization outside of NephroPlus too. This coupled with job guarantee for eligible candidates has helped make ‘Enpidia’ a success. To meet the high demand of technicians, we made ‘Enpidia’ franchise based. Franchisee model helps Enpidia to expand and at the same time maintain its quality standards. The franchisor focuses on its core competency of delivering knowledge whereas the franchisee undertakes the student mobilization activities. We have so far signed 15 franchise agreements. As of 31st January 2018, we have 7 operational training academies, with at least 8 more targeted to be operational in 2018.

Change 2 : Optimal Staff Mix and Ratio: Through our constant focus on process improvement, we have arrived at an optimal staff mix and ratio for smooth functioning of a centre under any given conditions. Maintaining this optimal mix and ratio has helped us in controlling costs and delivering highest value at our centres Merit driven Growth Opportunities: Unlike the current structures in the market, we provide our clinical staff a growth ladder to move up from centres across all teams. This helps us in retaining our most experienced and best performing staff members, while giving us an ability to evaluate all staff members across centres

When did the HR changes start affecting service delivery?

Month : June
Year : 2014

What are the main key performance indicators? How does the organisation measure the success of the project?

Clinical Indicators

Clinical IndicatorsPatient outcome is the highest priority area at NephroPlus. Employing skilled technicians from our academy ‘Enpidia’ coupled with our HR initiatives have helped in gradual improvement of patient outcome over the years. Below is the table showing improvement of quality in patient outcome as testedMetrics Jan’15 July’15 Jan’16 July’16 Jan’17 July’17 Jan’18% Kt/v in satisfactory range 72% 72% 79% 80% 80% 84% 86%
%Kt/v in range demonstrates the effectiveness of Dialysis process. Our focus on quality of dialysis has helped us increase this factor significantly.

Another key metric of quality is cross-infection (sero-conversion) rate, which is close to 0 for NephroPlus, with the market at around 30% sero-conversion over 3 years

Growth Indicators:
Our HR innovation have helped us in controlling our costs, increase retention of deserving candidates and maintain highest standard of quality in Dialysis while allowing us to grow at exponential growth rate.

In FY 15 (Apr’14 – Mar’15), we conducted ~200 Thousand dialysis sessions whereas we are en-route to conduct ~1 MM sessions in FY18.

In addition, we were able to add about 1300 machines in the network in the same time period.