Whatever anyone says, a mother is the only true universal creator. Because a mother going through a black hole of pain creates life – the epitome of utmost creativity and a marvel of universal eternity. Thus, even though not given its due importance in a patriarchal society, childbirth is by far the most critical phase in every woman’s life.

Due to its complexity, during childbirth, a mother needs the most compassionate, advanced, and precise medical care that can be made available. Unfortunately, in the past, even a quarter of that care was never given to most child-bearing women.

All this resulted in almost all the developing countries, including ours, showing high maternal, neonatal, and infant mortality rates in the world. Yet, it might be due to our ever-growing population, but the majority kept blinking their eyes at the vital factors and utterly essential ratios. Ratios that are very crucial to a world-renowned and award-winning Neonatal Paediatrician like Dr Prof R. Kishore Kumar – whom Insights Success has crowned as ‘The Business Leaders Transforming Their Industries-2023.’

Changing Negatives to Prime Positives

In Dr Prof R. Kishore Kumar’s words, “I have been academic throughout, having worked only in teaching hospitals in the UK, USA and Australia throughout my career. I hardly saw any deaths–be it maternal or neonatal in those countries–India continued to see deaths – and whenever I asked my colleagues – they used to say this is INDIA! So, I wanted to change that. Hence, I studied the pattern of childbirths in India – in 2005, they had 144 maternal deaths/1,00,000 live births, 48 neonatal deaths per 1000 live births, 21% of women suffering silently due to pelvic floor damage, 4-10 % infection rates following childbirth and only 40% women successfully breastfeeding at six weeks of birth. Babies less than 28 weeks were not even being saved – and the ‘viability’ still is defined in India as 28 weeks and above.”

Dr Prof R. Kishore Kumar felt that he needed to change all the above, and that’s when he conceived the transformational Idea of Cloudnine Hospital. This was the beginning of his leadership in India in a different role, though he had been a leader all his life.

Today, due to the herculean efforts of a league of mighty leaders like Dr Prof R. Kishore Kumar, India’s present (2022) maternal mortality rate has declined to 103/1,00,000. At the same time, the infant mortality rate has fallen to 26.619 (2023) deaths/1000 live births and in comparison Cloudnine has 2/1,00,000 MMR and an infant mortality rate of 0.5/1000 live births.

A Multifaceted Leadership Persona

Dr Prof R. Kishore Kumar is a Neonatal Paediatrician qualified in India with a Gold Medal from Mysore University and left India in 1989 to specialise in Neonatology. In this branch, specialization was not available in India at the time. Initially, he worked in the UK, teaching hospitals for four years as part of his ‘accredited training’ and became a consultant Paediatrician there at the young age of 30 years–breaking the record those days being the youngest overseas Indian to become a substantiative Consultant–but soon wasn’t satisfied, hence went to USA after passing the toughest USMLE licensing exam to work there and subsequently to Australia where he further qualified/worked in saving extreme preterm babies less than 28 weeks (24 weeks onwards) – which was not even being thought of in India in those days and specialized in that. Dr Prof R. Kishore Kumar recalls, “I had become used to western working style, working atmosphere and even had become Head of the Dept. and Professor in Perth, Australia at a young age of 38 years after years of Globe-trotting,” he states. He was honoured by Bill Clinton, Former President of the USA, for his achievements in Neonatology and also for being one of the highest qualified Neonatologists in the world at that time– “In 2005, when my entrepreneurship was instigated in a conversation with Bill Clinton – who said the next century belongs to India,” adds Dr Prof R. Kishore Kumar, whose leadership skills are quite different and is constantly changing as per the need. He explains, “Because when I came back to India to establish Cloudnine – all the thoughts were in my mind – I needed to implement them – so I had to adopt a Lord Rama’s style – where I had to manage ‘lots of monkeys’ in a sense. Subsequently, I had to become Krishna – in a sense, direct the ‘army of trainers’ to perform with utmost perfection for execution.”

Three Cs of Cloudnine

In the process, Dr Prof R. Kishore Kumar had to adopt various leadership styles – accept responsibility and know that he would get the team where they wanted to go and no one else. Hence, transparency, hard work, a reward system, and praises were adopted from day one. “Despite the odds, we had to believe in ourselves as there were too many negative thoughts from too many people initially,” he shares.

Also sharing Cloudnine Hospital’s USPs, Dr Prof R. Kishore Kumar says that from the inception, there were three of them – Clinical Excellence, Customer Care, and Celebration, in that order.

*Clinical Excellence was targeted and achieved by the following –

1) Antenatal Classes for all couples undergoing pregnancy and childbirth are made compulsory where preparation for breastfeeding is explained.

2) Part of the antenatal classes taken by Obstetrician, Neonatologist, Anaesthetist, Physiotherapist, along with the Lactation Consultants and Dietitian.

3) Education was given regarding the changes the body goes through during pregnancy, how to preserve the body, nutritional requirements, pelvic floor exercises and preparation for breastfeeding, and the importance of the same.

4) Identifying the support person for the new mother.

5) Educating the support person and partner in the role they could/should play in childbirth and breastfeeding.

6) Allowing the partner into the Labour Delivery and Recovery (LDR), including if required in Operation Theatre (OT) and promoting golden hour breastfeeding.

7) Continued support of Lactation consultants and Nutritionists in the hospital and appropriate follow-up.

8) Duty doctors were Duty Obstetricians (Post MD), Duty Paediatricians (Post MD) and Duty Anaesthetists (Post MD) for efficiency and prompt services.

9) All staff were sensitized regarding the emergencies – including problems with breastfeeding and appropriate care periodically.

10) Nurses were recruited with five years of post-nursing experience and six months of in-house training in providing lactational support to ensure good quality services as lactational nurses.

11) Doctors were employed as Consultants only after five years of post-graduation experience to give credentials – and were periodically evaluated for their performance. Feedback was given to improve or sustain their performance.

12) Periodic debriefings were held as and when things were not as expected – to learn from what went well and what could have been done better within 24 hours of an event.

13) Newborn Screening was deployed for all babies from day one – despite opposition from various corners – this has been the standard in most developed countries for the last six decades.

14) “We also started our patented programme called Management of Baby Affairs (MBA) – allowing parents and grandparents to attain an MBA in looking after the babies,” informs Dr Prof R. Kishore Kumar.

*Customer Care – was focused on training the staff – from security, receptionists, nurses, paramedical staff, and housekeeping staff – about hospitality, hygiene and honesty (3Hs) and periodically recording their performance and review for improvements or reward system. Feedback was collected from the clients at every opportunity, and they acted on negative feedback within 24 hours for better outcomes without finger-pointing.

Dr Prof R. Kishore Kumar adds that they built the hospitals, too, as needed. “As we feel *Pregnancy is wellness and not an illness*, we have designed our hospitals–without the smell of the hospitals, not looking like hospitals, with a pleasing look and colours–more like malls–to make them welcome.

The infrastructure in all Cloudnine Hospitals caters for Pregnant mothers who would have lost centre of gravity with their body changes – so motorized beds to adjust the heights (rather than them needing to climb the standard beds in most hospitals), bathrooms/toilets – at the same level as floor for ease of walking when they are in labour pain/post epidural – so that they don’t need to struggle, chairs suited for breastfeeding or Kangaroo Mother Care (KMC) in all rooms to name a few.

*Celebrations – Most women nowadays have only one child or two children– “So we felt that the Childbirth should be celebratory–and accordingly, we celebrated and even arranged them a baby bounty packs to make the new parents feel elated.”

All these were ‘included’ in one transparent collective package without any hidden charges and were explained to the prospective parents during the antenatal period.

Accomplishing Near Perfection

Inspired to improve the maternal and neonatal statistics in India, Dr Prof R. Kishore Kumar reveals that they have achieved it in the last 16 years in multiple centres across India.

The Cloudnine Hospitals have had, unfortunately, three maternal deaths so far among 1,56,000 deliveries – accounting for two per 1,00,000 MMR and 99.8% survival for babies if only babies born >28 weeks are taken into consideration. But neonatal mortality of two per 1,000 live births suggests the highest survival despite the length of stay being reduced from five to seven days to three days with early mobilization for most mothers, thereby reducing their financial burden. The infection rates have been 0.6% – less than 2.6% accepted per CDC guidelines. Pelvic floor damages were virtually nil, and 95% were successfully breastfeeding at discharge – and are the only hospital chain from Asia to be part of VON (Vermont Oxford Network).

Dr Prof R. Kishore Kumar adds, “Our firm is offering a package – which is comprehensive – competitive – taking consideration of the clinical excellence offered for the better outcomes than any other hospital itself is a testament to our success.”

TEAM Mantra- Together Everyone Achieves More

Being an experienced leader, sharing his opinion on how the adoption of modern technologies like AI and ML impacts healthcare and how the Cloudnine Hospital Chain is adapting to the change, Dr Prof R. Kishore Kumar says that technology has been in their genes from inception. He says, “As I mentioned briefly, to provide customer care, we designed the hospital infrastructure with the best possible international architects to make it pleasing for the new parents.”

They have included technology at every step – be it in OPD beds (Electronic beds) or, foetal Doppler’s, or most modern NICU equipment to give the little one the best start in life even in unexpected situations wherein if your baby is born in extreme prematurity of being less than 28 weeks – needs technology at its best to have the best survival chances along with a TEAM (Together Everyone Achieves More) that is trained to look after tiny preemies.

They have used AI since inception to improve their standards of care – be it to train junior staff nursing staff, by identifying the ‘crunch markers’ for flagging high-risk patients, and so on.

Theirs was the first hospital to introduce LED phototherapy when it became available in the international market 12 years ago and phased out standard tube light phototherapy, which is still used in many hospitals – for reducing the length of stay and better performance.

Eliminating Issues

Considering the evolving industry scenario, there are challenges, accepts Dr Prof R. Kishore Kumar. The challenges they face are multiple:

• Any challenge the hospitality industry faces – they face similar challenges x5–since they are a healthcare company with hospitality built around 24/7.
• Quality care is to be provided 24/7, unlike any software companies require – constant supervision, wonderful implementation of SOPs and motivation of all employees.
• Nursing attrition is generally high – around 30%, though they have kept their nursing attrition to an all-time low of 15% – still, they lose many nurses to overseas markets.
• Quality of medical practitioners to provide the quality they have in mind requires constant motivation, accreditation, retention of the trained staff and so on.
• Multiple licenses are required for one facility – ex, 35 licenses are required to run a simple hospital like theirs–the cost of which in turn needs to be passed on to the consumer along with repeated renewals–which could be made simpler.

Embracing Positive Transformation

That is why, according to Dr Prof R. Kishore Kumar, today’s leaders must innovate, break the conventions, and become a transformational force positively. The leaders in the healthcare industry especially have to be innovative to provide quality care. They at Cloudnine have implemented SIMULATION training of all their specialists from day one – similar to the Airline and Defence Industry – which has reduced human errors to negligible status. Simulation training is something new in the Medical field that is less than ten years old and should be made mandatory and included in the Medical Curriculum in India. “Only through innovations like these can we break the conventions that medical errors are uncommon – and avoid unnecessary legal hurdles.” The transformation in a positive way could help reduce violence against doctors and the government’s serious prompt action to protect healthcare workers.

A No-TGIF Advise

In his advice, Dr Prof R. Kishore Kumar says that budding entrepreneurs should NEVER have a TGIF (Thank God It’s Friday!) attitude. ‘They should relax whenever they want and work when their mind is astute, which means you have your own timetable. Passion is essential for entrepreneurs who aspire to venture into this space.’

Flying on the Future Horizon

On envisioning Cloudnine Hospital’s operations and offerings in the future, Dr Prof R. Kishore Kumar divulges that they have been scaling their firm’s operations in multiple cities – with them now having 29 branches in 11 cities. They plan to have 50 branches all across India by March 2025. Still, there’s scope to open quality care institutions across India to make Maternal and Neonatal Health a top priority based on their model to make India a developed country. “Though we have multiple ‘Copy Cats’ – the quality care part is not being copied but only the business part!” the Dr Prof smiles.

According to him, transformational business leaders must work with what they have, not looking for ideal situations. Should have passion, motivate others, and ensure TEAM work is achieved to ensure GOALS are met.

Celebrating in the Raining of Awards

Dr Prof R. Kishore Kumar says that Cloudnine is a teenager having started life only in 2007 – so really a sixteen-year-old teenager – yet to attain adulthood. It has become the talk of the town and a big brand in a short time purely because of the various awards, including testimonials from multiple customers.

• The Most Influential Leader in Healthcare Award by Insight Success. Nov 2021. https://magazines.insightssuccess.in/The-Most-Influential-Leader-In-Healthcare-November2021/#page=22.
• Great Place to Work Award 2020 – Cloudnine. GPW in March 2021.
• Visionary Leaders at the forefront of Entrepreneurship 2019 – Insights Success Mar 2020. Accessible here: https://www.insightssuccess.com/dr-r-kishore-kumar-an-entrepreneur-par-excellence/.
• Dominant Leaders to Watch in Healthcare Industry – Insightscare Jan 2020, p 22-24. Accessible here: http://magazines.insightscare.com/Dominant-Leaders-Watch-Healthcare-Industry-January2020/#page=26.
• 100 Most Impactful Healthcare Leaders (Global Listing) Award Feb 2018 World Health and Wellness Congress & Awards.
• “India’s Most Admired Neonatologist 2016” was conferred by the Jury of the Annual Pharmaceutical Leadership Summit on 23rd December 2016 in Mumbai, India.
• Best Healthcare Brand, Mother & Child by Economic Times June 2016.
• Best PE/VC-backed Healthcare Company – Cloudnine VC Circle 2014.
• Mother and Child Care Service Provider Award by Frost & Sullivan Jan 2014.
• Member of the Management Board of the Indian Foundation of Premature Babies (IFPB) by invitation From June 2013 to present.
• Talent and Leadership Award issued by ET Now Jan 2013.
• Ten most innovative companies in India, issued by Fast Company Jan 2012.
• Forbes India – recognized Dr Kishore Kumar as the entrepreneur and Cloudnine as one of the 11 start-ups to watch out for in December 2011. https://www.forbesindia.com/article/special/11-startups-to-watch-in-2012/31622/1.
• ET Leaders of Tomorrow Award 2012 – given to Dr Kishore Kumar by Mr Anand Sharma, Minister of State for Commerce, Govt. of India on 17.12.2012.
• All India Achievers’ Award to Dr Kishore Kumar received from Mr. Anil Dhawan @ All India Achievers’ Awards in Bangalore, Nov 2012.
• Times of India – Legends Award in Paediatrics (Dec 2018).
• Pride of Karnataka Award in June 2015, Bangalore, India.
• Australian Service Excellence Award to Dr Kishore Kumar for Excellent Service in the Healthcare sector in 2014.
• Mother Theresa Excellence Award received from Integrated Council for Socio-Economic Progress in recognition of praiseworthy services, excellent performance and memorable contribution to the overall progress of the society – received in Bangalore on 25th November 2012.
• Best Maternal & Infant Care Hospital in Bangalore Award by Mr. Shashi Tharoor in 2011.
• Felicitated by former USA President Bill Clinton in Australia in Feb 2006.

*A Letter of Our Biggest Achievement – Giving and Saving Lives, Always and Forever*

Finally, Dr Prof R. Kishore Kumar concludes, “The letter below summarises the feelings of a family who had lost one of their premature twins in another hospital and transferred the surviving twin in a critical condition to our hospital – requiring lung resection and intensive care – eventually doing well is one of the best examples of the care given in Cloudnine.”

The post Dr Prof R. Kishore Kumar: The Most Compassionate Maternity and Child Caretaker at Cloudnine Hospital appeared first on Insights Success.