Document: OSPL/QM

OSPL Quality Manual

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CONFIDENTIALITY: The information contained in this document is the property of Octavo Solutions and or
its subsidiaries/ affiliates and are kept in strict confidence except with written permission of Octavo
Solutions. Such information shall not be published, disclosed to others, or used for sale or any other
purpose; and this document shall not be reproduced in whole or in part. This document is returned to Octavo
solutions upon request or completion of the use for which it was made available, or termination of
relationship with the recipient, whichever first occurs. Any recipient so agrees by acceptance of this
document.

OCTAVO SOLUTIONS
QUALITY MANUAL
CONTROLLED/ UNCONTROLLED
(Delete as applicable)

Date of Issue 8th November’10

Holder NABET
Copy Number 1

USER OF THIS DOCUMENT IS RESPONSIBLE FOR DETERMINING CURRENT

REVISION LEVEL BEFORE USING DOCUMENT

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TABLE OF CONTENTS
NUMBER SECTION PAGE
1. Scope 5
1.1. General 5
1.1.1 Vision , Mission and Value 6
1.2. Application and Exclusions 6
2. Normative Reference 7
3. Terms and Definitions 8
4. Quality Management System 9
4.1. General Requirements 9
4.2. Documentation Requirements 12
4.2.1 General 12
4.2.2 Quality Manual 12
4.2.3 Control of Documents 12
4.2.4 Control of Records 14
5. Management Responsibility 14
5.1. Management Commitment 15
5.2. Client Focus 15
5.3. Quality Policy 15
5.4. Quality System Planning 17
5.4.1 Quality Objectives 17
5.5. Responsibility , Authority and Communication 18
5.5.1 Responsibility and Authority 18
5.5.2 Management Representative 23
5.5.3 Internal Communication 23
5.6. Management Review 23
5.6.1 General 23
5.6.2 Review Input 24
5.6.3 Review Output 24
6. Resource Management 24
6.1. Provision of Resources 24
6.2. Human Resources and Training 25
6.2.1 General 25

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6.2.2 Competence, Awareness and Training 25

6.3. Infrastructure & Work Environment 30
7. Service realization 30
7.1. Planning of Service Realization 31
7.2. Client Related Processes 31
7.2.1 Determination of Service Requirements 31
7.2.2 Review of Service Requirements 32
7.2.3 Client Communication 32
7.4. Purchasing 32
7.4.1 Purchasing Process 32
7.4.2 Purchasing Information 33
7.4.3 Verification of Purchased Product 33
7.5 Coordination and Execution: Service Provision 33
7.5.1 Control of Coordination and Execution 33
7.5.2 Validation of Processes : Execution 33
7.5.4 Client Property 33
8. Measurement, Analysis and Improvement 34
8.1. General 34
8.2. Monitoring and Measurement 34
8.2.1 Client Satisfaction 34
8.2.2 Internal Audit 37
8.2.3 Monitoring and Measurement of Processes 37
8.3. Control of Non-Conforming Service 38
8.4. Analysis of Data 38
8.5. Improvement 39
8.5.1 Continual Improvement 39
8.5.2 Corrective Action 39
8.5.3 Preventive Action 39
Procedures
Procedure for Control of QMS Documents and Records 40
Procedure for Internal Audits 42
Procedure for Control of Non-conforming Products 44
Procedure for Corrective Actions 45
Procedure for Preventive Actions 46

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Rev Description of Change Author Effective Date

0 Initial Release Dr. Prashant Kulshrestha 25/01/2006

1 Revision – 1 Dr. Prashant Kulshrestha 24/02/2008

2 Revision – 2 Dr. Prashant Kulshrestha 02/09/2008

3 Revision – 3 Dr. Prashant Kulshrestha 19/02/2009

4 Revision – 4 Ms. Sheela Bhattacharya 15/05/2010

5 Revision - 5 Ms. Sheela Bhattacharya 8/11/2010

Reviewed & Approved By Issued By MR

MD
Name Dr. Bidhan Das Name Ms. Sheela Bhattacharya

Signature Signature

Date Date

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SECTION 1 SCOPE

To provide Consulting Services in the field of Healthcare Pan India

SECTION 1.1 GENERAL

Octavo Solutions is committed to provide highest possible standard of Consultancy and Training services
related to Quality Assurance & Accreditation of Hospitals and Healthcare Providers (Public & Private).
Octavo Solutions is a Private Limited Company (Established 2007) and has offices at following sites:
OSPL Offices Address Contact Person Contact details
TELEFAX:
Corporate B – 4/167, Basement, Safdarjung Mr. Sanatana Mishra & +91-11-41658335
1.
Office Enclave, New Delhi -110029 Mr. Alok Man Singh +91 - 9958196961
+91 - 9312758801
Registered 2/33, Third Floor, Sarvapriya Vihar Dr. Bidhan Das Tel:
2.
Office New Delhi -110017 (Managing Director) +91-11-26850512
Plot No-6, Guru Prasad Building, Mr. Bidhan K. Das &
Regional D-402 Lokhandwala Complex, Mr. Anup Mishra +91-9619671813
3.
Office (West) Andheri (West) Mumbai Technical Lead (West +91-9769775141
(Maharashtra) Zone)
Regional A/2, HIG, Baramunda Colony Mrs. N. Das Burma
4. +91-674-2550858
Office (East) Bhubaneshwar (Orissa) -751003 (Director)
B-5/332, Ghatprabha Block,
Regional
National Games Village,
5. Office Dr. Deepa Mehra +91-9740800877
Koramangla, Bangalore
(Karnataka)
(Karnataka)-560074
Regional Plot No.8, Old Vasavi Nagar, Near
Mr. S. Nazrul Islam
Office Adarsh Convent School,
6. Technical Lead (Andhra +91-8121167808
(Andhra Secunderabad (Andhra Pradesh)
Pradesh)
Pradesh) - 500015

Website: [Link]
E-mail: bidhandas@[Link]
[Link]@[Link]

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SECTION 1.1.1 MISSION , VISION & VALUE

MISSION
To become the Leader in Healthcare Consulting in India by providing value for money ; effective, efficient
solutions and hands on support.

VISION
To focus on continuous development of processes for understanding the needs and expectations of the
Clients; leading to continual improvement and achievement of real Client satisfaction.

To redesign (existing) and develop (new) quality healthcare institutions and hospital with competitive
process designs/ models matching national and international standards.

VALUE
Client Delight
Competent
Honest
Truthful
Ethical
Sincere
Disciplined
Teamwork
Focused
Integrity

SECTION 1.2 APPLICATION & EXCLUSIONS

The Quality manual documents the quality system of Octavo Solutions, to demonstrate the organizations’
ability to consistently provide services that meet Client and regulatory requirements and to continually
improve the effectiveness of internal processes. The manual establishes compliance with ISO 9001:
2008, Quality Management System – requirements. The QMS defined in this manual applies to all
activities carried out within Octavo Solutions that ensures quality at all stages – Designing & Planning,
Coordination, Execution, Control and Evaluation.

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Where any requirement of ISO 9001: 2008 can not be applied due to the nature of our organization, its
activities and its services, they are considered for exclusion. An ISO 9001: 2008 requirement may be
excluded only when the exclusion may not affect our ability, nor absolves us from the responsibility, to
provide services that meet Client and applicable regulatory requirements.
MR is responsible for identifying those requirements of ISO 9001:2008 that do not apply to our
organization or services, and to propose exclusions of such requirements from the scope of the quality
system. The Managing Director has the responsibility and authority for examining whether the proposed
exclusions are appropriate and for approving them.
Any exclusion taken is documented in this section of the Quality Manual. The excluded requirements are
precisely identified with reference to specific clauses and/or statements in the standard. There is also a
brief justification why the exclusion is taken and why it is appropriate.

1. Exclusion: ISO 9001: 2008 Section 7.3, Design and Development

Justification: Our organization does not need to design any product (service) since
we provide consultancy for establishment of NABH standards in Healthcare Organizations and no
additional design is necessary.

2. Exclusion: ISO 9001: 2008 Section 7.6, Control of Measuring and Monitoring Devices
Justification: Our organization does not use any instruments, equipment, or devices.

SECTION 2 NORMATIVE REFERENCE

ISO 9000: 2005 QUALITY MANAGEMENT SYSTEMS

Fundamentals and vocabulary

ISO 9001: 2008 QUALITY MANAGEMENT SYSTEMS

Requirements

ISO 9004: 2000 QUALITY MANAGEMENT SYSTEMS

Guidelines for Performance Improvement

NABET requirements for registration of Hospital and Healthcare organizations (NABH standards)

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SECTION 3 TERMS & DEFINATIONS

Quality Meeting or exceeding Client expectations

Client satisfaction The degree to which Client expectations of service are met or
exceeded

Health care All care, service, training, research, etc, to evaluate, diagnose,
treat and follow up on maintenance of required health, prevent
illness as well as improve health.

Service The non-material equivalent of good, it is claimed to be a

process that creates benefits by facilitating a change in
Clients, a change in their physical possessions, or a change in
their intangible assets.

Quality Management System System that outlines the policies and procedures necessary to
improve and control the various processes that will ultimately
lead to improved performance.

Audit It is an evaluation of an organization (system, process, project

or product) and is an independent assessment of the fairness
by which a company's financial statements are presented by
its management.

ABBREVIATIONS

QMS Quality Management System

OSPL Octavo Solutions Pvt. Ltd.
MR Management Representative
MD Managing Director
HRD Human Resource Department
RM Responsibilities of Management
ISO International Standards of Organization
QA Quality Assurance
OSQM Octavo Solutions Quality Manual
NABH National Accreditation Board for Hospital and Healthcare
Providers

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SECTION 4 QUALITY MANAGEMENT SYSTEM

PURPOSE
This Section corresponds to Section 4 of the ISO 9001-2008 Standard and is used to describe Octavo
Solutions overall Quality Management System and how it is effectively implemented and controlled.

SECTION 4.1 GENERAL REQUIRMENTS

Octavo Solutions has established, documented, implemented, maintained and is continually improving its
Quality Management System in accordance with the requirements of the ISO 9001-2008 standard. The
QMS is supplemented by Client-specific requirements. The company continually improves the
effectiveness of its QMS.
Senior Management identifies, disseminate, and maintain the spirit of excellence throughout the Quality
Management System. Octavo Solutions maintains control over and responsibility for all processes that
affect service conformance to requirements, regardless of whether the process is completed internally or
by an outsourced/empanelled agency/consultant.
For documentation purposes, the internal processes are split into two main types, those associated with
providing control, monitoring and improvement and those associated with Project Management. In reality
there tend to be substantial overlapping between the two types.
OSPL has no process which requires outsourcing; hence so consequential controls are necessary.
Process management
The process approach acknowledges that a desired result is achieved more efficiently when activities and
related resources are managed as a process. The advantage of the process approach is the ongoing
control that it provides over the linkage between the individual processes within the system as well as
over their combination and interaction.
The Quality Management System for Octavo Solutions has been established to comply with the
requirements of ISO 9001: 2008 and is based on the following guidelines in accordance with the general
requirements. Octavo Solutions has,
a) Identified the processes needed for the quality management system and their application.
b) Determined the sequence and interaction of these processes.
c) Determined criteria and methods needed to ensure that both the operation and control of these
processes are effective.
d) Ensured the availability of resources and information necessary to support the operation and
monitoring of these processes.
e) Monitored, measured and analyzed these processes.

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f) Implemented actions necessary to achieve planned results and continual improvement of these
processes.
The overall process model of the Quality Management system is operated by the application of the “Plan-
Do-Check-Act” method, described below,
Plan: Establish the objectives and processes necessary to deliver results in
accordance with Client requirements and the Company’s policies
Plan Do
Do: Implement the processes
Check: Monitor and measure processes and product against policies,
objectives and requirements for the product and report the results. Act Check
Act: Take actions to continually improve process performance.

THE ACCREDITATION PROCESS

Rules of procedure governing accreditation

Octavo Solutions provides consultancy in all forms to prepare healthcare organizations to be accredited

by NABH.

Octavo Solutions uses the accreditation criteria approved by NABH only to provide accreditation services

to hospitals and health care organizations. No single interest will predominate and balance of interests of

all the stakeholders is ensured.

Resources OSPL

Needs Operational Controls by Business

Process Management Development
(Services & Planning
Clients Delivery)

Satisfaction
Analysis of
Performance

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Enquiries and application

On application, interested hospitals and health care organizations, a set of documents outlining the terms,

and conditions of accreditation are sent by OSPL to allow the hospital to make a value judgment as to

whether to proceed with an application for accreditation. These documents include:-

• The application form

• The fees schedule of NABH and Octavo Solutions as a Consultant Organization

• Controlled copies of policies and procedures relevant to the accreditation programme.

The policies and procedures supplied to the applicant also outline the rights and duties of the applicant in

the following areas:-

• The use of the accreditation symbol of NABH

• Appeals and complaints

• Confidentiality

• The assessment process

• The accreditation process

An outline of the accreditation process

As a general rule the accreditation process follows NABH Guidelines for accreditation of hospitals and

health care organizations.

1. Application Receipt and Processing Formal application is received and processed.

A review of the applicants documentation is undertaken

2. Systems assignment against the appropriate accreditation criteria (Review of
self assessment report)

Onsite survey, witnessing of an applicants undertaking

3. Compliance assessment
activities for which they are seeking accreditation

The audit report given by surveyor panel is reviewed with

4. Approval of accreditation governing body decision on whether grant of accreditation
is to be recommended and of what grade.

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When accredited, the hospitals are subjected to

5. Surveillance audits surveillance audits to ensure ongoing compliance with the
current accreditation criteria.

The hospital is subjected to re-assessment where their

Re-Assessment quality system is comprehensively re-assessed. The
6.
periodicity is generally every 3 years.

SECTION 4.2 DOCUMENTATION REQUIRMENTS

SECTION 4.2.1 GENERAL

This quality manual defines Octavo Solutions QMS and the documented procedures necessary for its
implementation, maintenance and improvement. The Quality Manual also includes the quality policy and
quality objectives.
SECTION 4.2.2 QUALITY MANUAL

This Quality Manual provides the basis for analyzing Client requirements, defining the processes that
contribute to the achievement of a service delivery that is acceptable to the Client, and provisions for
keeping these processes in control.
The Quality Manual represents official policy and is used as a standard by all in developing and
administering systems for continual improvement and the control of Quality and reliability of services.

SECTION 4.2.3 CONTROL OF DOCUMENTS

Octavo Solutions operates a comprehensive document and data control system to control QMS
documentation and to ensure required approvals. The purpose of Documentation Control Procedure is to
define the controls needed,
a) To approve documents for adequacy prior to issue
b) To review and update as necessary and re-approve documents
c) To ensure that changes and the current revision status of documents are identified
d) To ensure that relevant versions of applicable documents are available at points of use
e) To ensure that documents remain legible and readily identifiable
f) To ensure that documents of external origin are identified and their distribution controlled
g) To prevent the unintended use of obsolete documents, and to apply suitable identification to them if
they are retained for any purpose.

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ISSUE AND CONTROL OF QUALITY MANUAL

Identification
Manuals are issued either as controlled or uncontrolled:
Controlled manuals are-
• Identified as controlled
• Individually numbered
• Kept up-to-date with any revisions.
Uncontrolled Manuals are-
• Clearly marked 'uncontrolled'
• Issued for information purposes only
• Not be updated with any revisions.
Manual Issuance
MR is responsible for the issue of all Quality Manuals. It is the responsibility of the holder to ensure that
all amendments are incorporated and that the Quality Manual is maintained up-to-date and is available to
all relevant staff.

Amendment and Re-issue

The Quality Manual is periodically reviewed to re-affirm its adequacy and conformance to internal and
Client requirements. Amendments to the Manual are carried out as required to reflect the current Quality
Assurance Programme. Each amended procedure is logged on the master Issue and Revision Status
index and is numbered consecutively until such time as an issue of a new Quality Manual incorporates all
amendments.
Issues of Quality Manuals are identified in Serial No. order. Each issue cancels and supersedes all
previous issues and amendments. Amendments are not implemented until the relevant section has been
rewritten, approved by the MR and countersigned by the MD.
The MR ensures that the pertinent issues of appropriate documents are available at all locations, where
essential to the effective functioning of Quality System. All documents are stored in a secure place so that
they are accessible only to authorized persons. All documents are verified by the concerned approval
authorities before release.

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SECTION 4.2.4 CONTROL OF RECORDS

Organizational Records which provide evidence of conformance to requirements and of the effective
operation of the companies Quality Management System is identified, stored, protected and retained.
The MR is responsible for identifying the records to be retained, retention time, disposal method, and for
arranging for their protection and controlled retrieval. Access to records is under control of MR
Removal of Records to a location other than the immediate area where the file is located is restricted to
authorized person - MR and MD. The following records are identified as Quality Records and these are
maintained for a period of minimum three years.
• Training Records
• Contract Review Records
• Project Proposals & Designs
• Internal Quality Audits
• Management Quality System Reviews
• Customer Feedback
• Corrective and Preventive Action Report
The records are periodically reviewed by MR & MD for the purpose of improving the product delivery.

PROJECT RECORDS
Project Records are stored in a suitable environment to prevent damage or deterioration and to prevent
loss. Responsibility for the accuracy and completeness of the Records is assigned to the respective
Team Leaders.

SECTION 5 MANAGEMENT RESPONSIBILITIES

PURPOSE
This Section corresponds to Section 5 of ISO 9001-2008 and its purpose is to examine the Management
System to determine if it addresses the key elements of the ISO 9001-2008 Standard. It includes the
management’s commitment to quality, its Quality Policy, Organizational planning to deliver quality
services, administration of the Quality Program, and Regular review of the system for improvement, Team
Member awareness about the Quality Policy, goals and objectives.

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SECTION 5.1 MANAGEMENT COMMITMENT

The management of Octavo Solutions is committed to implementing, and maintaining a documented

quality system.
This commitment includes: ensuring that Client, regulatory and legal requirements are understood and
appropriately addressed, the quality policy is understood and implemented at all levels of the
organization, quality objectives and plans are established as necessary and that the responsibilities of all
functions affecting quality are clearly defined.
Applicable legal requirements with respect to personnel, premises and Company Act’s, 1956 are all being
adhered to in full measures.
Management makes provisions for the necessary resources and personnel to maintain the system, which
ensures that the requirements of this manual are met.

SECTION 5.2 CLIENT FOCUS

Senior management ensures that Client requirements are determined and met with the aim of enhancing
Client satisfaction by adopting the following strategies:
1. Review of terms of reference and project objectives procedures to ensure compatibility.
2. Allocating trained and qualified staff resources to perform project tasks.
3. Scheduling and reporting progress in sufficient detail to control project cost.
4. Training personnel as required.
5. Maintaining the employee and of project activity records.

SECTION 5.3 QUALITY POLICY

Octavo Solutions’ Quality Policy reflects its commitment towards meeting Client expectations through
continual improvement of the QMS and focus on Quality services, Quality Processes, and Quality People.
Octavo Solutions accepts responsibility for meeting and exceeding Client satisfaction through adequate
training of its Team Members, adherence to proven procedures, and by maintaining an organizational
culture that fosters continuous improvement.
The organization achieves this by:
• Ensuring that every Team Member is aware of the importance of determining and fulfilling Clients'
expectations.
• Accepting projects that fall within its area of expertise and that will ensure Client satisfaction.

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• Focusing resources on fulfilling Clients’ expectations.

• Maintaining systems and processes that help to run all operations efficiently and effectively.
• Monitoring performance and acting to continually improve the effectiveness of the systems.
• Promoting the ‘Pursuit for Perfection’ throughout project development lifecycle: Quality services
• Resolving Client issues quickly and effectively: Sense of urgency
• Championing the formal process of continuous improvement and creative innovation
• Focusing on prevention rather than reaction
• Driving issues to root cause: Eliminating repeat problems
• Striving for zero defects: Getting it right the first time
• Building strong relationships in development processes
• Growing, developing and executing flawlessly by investing in training and development: Quality
People

The quality policy is communicated throughout the organization and is reviewed for continuing suitability
during the annual strategic development process. Quality, continual improvement and Client delight are
the personal responsibility of each Team Member. By focusing the resources on determining and fulfilling
Client's expectations, OSPL provides services of the highest quality, on time and with ever- improving
levels of Client satisfaction. It achieves this through the application of continual improvement, process
control, Team Member empowerment and management commitment.

DIAGRAMMATIC REPRESENTATION OF QUALITY POLICY

Management commitment

Pre-controls Concurrent Feed-back controls

(Policy & control (Analysis, Surveys &
Planning) Audits)

High Quality Timely Client Internal &

Service Delivery of Satisfaction External
Service Audit

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SECTION 5.4 QUALITY SYSTEM PLANNING

Quality system planning is carried out in order to meet the requirements of ISO 9001:2008 as well as the
quality objectives as described in Section 5.4.1. When conditions require change, the process is
controlled and integrity of the Quality Management System is maintained.
Quality planning consists of implementing, updating, and maintaining this Quality Manual and the
supporting QMS documentation.

SECTION 5.4.1 QUALITY OBJECTIVES

The objectives are established via the Management Review Procedure and communicated to all levels of
the organization for use in establishing each function's and Team Members' annual key objectives.
Quality objectives are measurable, and consistent with the quality policy including the commitment to
continuous improvement.
The current Quality Objectives are:
(i) To have the strong Team in OSPL
Measures –
• By following stringent Interview Process to recruit the members (detailed in Sec 6.2.2.)
• By proving 15 days training to the New Joinees before sending them to field (detailed in
Sec 6.2.2.)
• Regular Internal Audits by the Management so as to be updated about the Job Progress
(ii) To provide timely, high quality service to clients.
Measures-
• By preparing the complete DPR with deadlines before starting any project.
• By regularly updating the Client about the Project Stage.
• By receiving regular Client feedback.
• By having proper documentations of the projects.
• By regular performance audit of the Team Member who is onsite by the Management.
• Initial response to complaints & queries within 3 working days and maintenance of the
record of the same.
• Priority to be given to the Client’s Complaint and shall be resolving the same with in 7
days.

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SECTION 5.5 RESPONSIBILITY, AUTHORITY & COMMUNICATION

SECTION 5.5.1 RESPONSIBILITY & AUTHORITY

Responsibility brings the feeling of usefulness and pride. But when employees lack the authority to back
up their responsibilities, they may feel unable to meet them. This may create stress and dissatisfaction.
OSPL ensures that every team member as per their qualification & experience enjoy the responsibility
with authority.
In OSPL it’s the responsibility of the HR department to keep the team members informed about their
responsibility and authority.

ORGANOGRAM & JOB DESCRIPTION OF KEY PEOPLE

Board of Directors

Managing Director

MR

H R Head Technical Finance Head Admin Head Team Leader (Consultant /

Experts* Associate Consultant)

Assistant
Consultant

Junior
Consultant

*Consultants/ Technical experts include Medical & public health experts, Quality Gurus & non-medical
experts like architects, engineers & bio-medical engineers.

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Responsibility Matrix

Functionaries
Finance Tech. Admin Team Assist. Junior
MD HR Head MR
Head Expert Head Leader Const. Const.
Clauses
4.1 S P
4.2 S P
5.1 P P P T P S P
5.2 P T T P S P
5.3 P S S S P P
5.4 P S S S S S
5.5 P P S T S S S S S
5.6 P S S S S S S T P
6.1 P P P T S P
6.2 S P S S S S
6.3 S P
7.1 S P S P P P P
7.2 P P P P P
7.4 S S S P S P P P
7.5 S S S P S P P P
8.1 S P P P
8.2 P P S S P S P
8.3 S S S P P
8.4 S P P P
8.5 P S S S S P P

P = Primary Responsibility
S = Secondary Responsibility
T = Tertiary Responsibility

MANAGING DIRECTOR
The role of the Managing Director is broad but covers area such as,
(i) To approve all the policies
(ii) Ensuring provision of adequate services to allow the business to perform efficiently
(iii) Dealing with all matters of company business such as taxes, banking, insurance and legal
requirements
(iv) The formulation of general policies for pricing based on the current market position and to
direct effort toward new market sectors
(v) The identification of skills required to address new markets & to satisfy these new Clients

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(vi) Selection & promotion of senior members of staff and the over seeing of all appointments to
the workforce
(vii) Agreeing to remuneration of all Team Members
(viii) Adjudicating in all serious matters of discipline
(ix) Dealing with all major personnel problems
(x) Evaluation of new manufacturing and computing techniques and to allocate the necessary
capital expenditure
(xi) Ensures that every Team Member under his directions is properly trained and aware of their
role & responsibilities in carrying out the assigned quality that are defined in Quality policy
and applicable quality procedures in the periodic review of the QMS and the implementation
of any identified required improvements
(xii) Measures, monitors and analyzes actions necessary to meet goals and drive continual
improvement
(xiii) Ensures availability of information necessary to support the operation and monitoring of these
processes
(xiv) Ensures compliance with applicable safety, statutory and regulatory requirements

FINANCE HEAD
(i) Planning of the Accounting Systems
(ii) Accounts closure, preparation of Financial Statements.
(iii) Analyze and report monthly management accounts information.
(iv) Overseeing the production of monthly financial information
(v) Plan & manage the working capital of the organization and cash flow requirements.
(vi) Monitor all Capital Expenditure against budgets set individually.
(vii) Ensure effective control of costs and expenses
(viii) Present budget comparisons against actual (For operational expenses) every month.
(ix) Internal Audit
(x) Preparation of Project Financials – Financial Feasibilities & DPR
(xi) Dealing with banks to procure finance and day to day dealings
(xii) Insurance
(xiii) Internal Audit
(xiv) MIS Report Generation & Analysis
(xv) Planning of Application of Funds and their Control.

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TEAM LEADERS
(i) Manage and contribute to consulting assignments through project conceptualization and
delivery plan
(ii) Ensure practice growth by managing client project delivery
(iii) Contribute to the repository of consulting processes and knowledge bank
(iv) Develop practice depth/expertise by using market intelligence and developing networking in
the industry
(v) Ensure proper work allocation and engagement for the team
(vi) Set team targets/goals/assignments
(vii) Manage project budget and cost
(viii) Manage client relations, client calls and build business pipeline.
(ix) Guide and mentor the practice team and help them grow and deliver quality outputs
(x) Create market opportunities for all the services offered by OSPL.
(xi) Participate in industry forums/ Public speaking/ writing articles / conducting workshops for
clients and associates/ lecture at institutes we recruit from
(xii) Participate in training and development programs and sessions and conduct learning
sessions for members within the firm
(xiii) Identify, analyze, pursue and report on business opportunities with existing and prospective
clients
(xiv) Establish new lines of practice/service and plan new offerings
(xv) Build business pipeline, nurture and grow new client accounts
(xvi) Lead role in business development ,generating revenue with the help of team
(xvii) Achieve the revenue and receivable targets for the practice for attainment of company’s
business targets and profitability

HUMAN RESOURCES & TRAINING - HEAD

i) Formulation of Policies.
ii) Standardization of processes like Confirmation, Exit, Recruitment, and Joining.
iii) Handling Induction.
iv) To train and keep the relevant records
v) To generate the RL Bands for the division.
vi) Responsible for Employee Retention Plans.
vii) Responsible for Database Management .To ensure the maintenance and updation of all
employee records pertaining to hiring, promotion, and salary increments, etc.

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viii) To execute the entire performance appraisal exercise and to ensure confirmations & appraisals
are carried out on time.
ix) To handle grievances.
x) Responsible for staff welfare activities.

HEAD ADMINISTRATION
The formulation and maintenance of the Office work protocols in context of
(i) Purchase- equipments, consumables including stationery etc
(ii) Logistics- travel arrangements, accommodation arrangements, TA/DA etc
(iii) Telephone, Mobile, Internet, data card expenses etc
(iv) Communicate with clients, raise invoice, collect payments and acknowledge the same
(v) Keep all records pertaining to company's functioning
(vi) Arrange all trainings and keep the relevant records
(vii) Responsible for administer the arrangement of Air / Train ticket for the employees going for
training / meeting (official visit) as per their entitlement.
(viii) Responsible for organizing events, meetings, seminars, conferences, presentations,
trainings, workshops.
(ix) Responsible for proper negotiation with the vendor by involvement of finance department.
(x) Responsible for procurement of the materials for OSPL.

Assessor and Expert Pool

A pool of assessors and experts has been established by the Board of Directors - Annexure – I

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SECTION 5.5.2 MANAGEMENT REPRESENTATIVE

Role & Responsibility of Management Representative (MR)-

(i) Developing and upgrading the Quality Manual of OSPL as per the current ISO Standards.
(ii) Maintaining the account of Controlled and Uncontrolled copies of Quality Manual.
(iii) Responsible for keeping all the team members informed about the Quality Policy and it’s
Objective.
(iv) To ensure Quality Management System is implemented in OSPL.
(v) To Liaison with external parties on matters related to the Quality Management System.
SECTION 5.5.3 INTERNAL COMMUNICATION

The organization ensures the processes of the Quality Management System and their effectiveness are
communicated throughout the organization by:
• Sending circular (through e-mails / mails) to all the team members.
• Morning Meetings
• In-house Training programs
• Monthly Project Review meetings
• Notice Boards
• Management Review Meetings

SECTION 5.6 MANAGEMENT REVIEW

SECTION 5.6.1 GENERAL

OSPL Management reviews the Quality Management System at least once a year and more often as
needs dictate to ensure its suitability, adequacy and effectiveness.
The review addresses the Quality Policy, Quality Objectives and Quality Management System as well as
changing business needs, Client Satisfaction, Operational and Performance Results, Quality Trends,
Continual improvement, Assessment of Resources, corrective and preventive action activities.

To be updated about the Project Stage, Monthly Project Reviews are organized in which the Team
Leaders presents their Project Details to Management.

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SECTION 5.6.2 REVIEW INPUT

Management Reviews utilizes:

• Quality Manual
• Detailed Project Reports undertaken in the respective financial year
• Internal and External Quality Audit Results
• Feedback form from the Clients
• Monthly project reports for the respective Financial Year.
• Progress Reports of previous Management Review reports.
• Proposals for the New Projects.

SECTION 5.6.3 REVIEW OUTPUT

The output from management reviews includes actions related to,

i. Suggestions for improvising the Quality Manual
ii. Decisions on New Projects
iii. Clear understanding on Future Resource requirements.
iv. Policies for System Improvisations.
v. Expansion Plans

Results of Management Reviews are recorded and addressed as appropriate. Action items are followed
up at subsequent management reviews to ensure closure.

SECTION 6 RESOURCE MANAGEMENT

PURPOSE
OSPL ensures that the candidates becoming the part of its team are competent both technically and
physically to perform their assigned tasks. The primary aim of this approach is to enhance Client
satisfaction by meeting the explicit and implicit Client requirements.

SECTION 6.1 PROVISION OF RESOURCES

To meet up its Mission OSPL makes sure that it has a team which aspires for making OSPL the Leading
Consultancy in the Healthcare Sector. OSPL ensures that all the team members are aware of the

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relevance and importance of their activities and how they contribute to the achievement of the Quality
Results.
All team members carrying out tasks that require special skills, are identified, documented and remedied
with in-house or external training. A training log of all the team members is maintained and kept in the
personnel records.

SECTION 6.2 HUMAN RESOURCES & TRAINING

SECTION 6.2.1 GENERAL

The organization assigns competent personnel to the project on the basis of applicable education,
training, skills and experience. MD, MR are responsible to review the Agreement/Contract to determine
any specific requirements and the work scope to determine the competency level and final selection of
Project teams.

SECTION 6.2.2 COMPETENCE, AWARENESS & TRAINING

OSPL has outlined the basis for the evaluation, selection and continual monitoring of Consultants based
on their ability to provide services in accordance with the specified requirements.
OSPL receives its resource pool by-
• Campus Placement –
OSPL believes in nurturing the young candidates who have the zeal to learn.
• By Placement Agency
• Walk in interview

The criteria for selection followed in OSPL is –

Written Examination

Interview by HR /Consultant

Final Interview by the MD
At the time of interview OSPL informs the candidates about their Job Profile and the Career Path.

Criteria for selection of Consultants and Experts

Applications for registration of consultants are invited and screened based on established criteria’s which
is mentioned as below:-
• For clinician members – MBBS with 5 years of experience of which 2 years should be in a
hospital.

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• For hospital administrator – Graduate/ PG in management or hospital administration with

minimum of 2 years of work experience of being in the hospital administration/ allied health care
services.
• For Nursing Assessor – [Link]. / [Link]. Nursing with 5 years of experience or diploma in general
nursing midwifery with 7 years of Experience in both cases 2 years of supervisory capacity
experience in a hospital is a must.

OSPL Hierarchical Structure –

In OSPL the team members are placed in various Responsibility Levels (RL) Bands as per their
Qualification & Experience.
1. Junior Consultant /Executive ( Level I) –
a. BHM/ Graduate with 0-3 yrs. of experience.
b. PGDHA/ PGDM/ MBA in Health & Hospital Management with 0-1 year of experience
2. Assistant Consultant/Asst. Manager (Level II) –
a. BHM/ Graduate with 4-5 yrs. of experience.
b. PGDHA/ PGDM/ MBA in Health & Hospital Management with 0-2 years of experience.
c. AYUSH/BPT with MHA with 1-2 years of experience
3. *Associate Consultant / Deputy Manager (Level III)-
a. BHM/ Graduate with 6-9 yrs. of experience.
b. PGDHA/ PGDM/ MBA in Health & Hospital Management / AYUSH/BPT with MHA with 3 -
4 years of experience.
c. MBBS / BDS with MHA with 1-3 years of experience
4. *Consultant / Manager (Level-IV)-
a. BHM/ Graduate with more then 10 yrs. of experience.
b. PGDHA/ PGDM/ MBA in Health & Hospital Management / AYUSH/BPT with MHA with >5
years of experience.
c. MBBS/BDS with MHA with >4 years of experience
5. Director/ Managing Director
* Please note for these positions NABH Assessor Training from QCI/NABH is must

The Consultants working on Projects submits the Reports; this is maintained so as to fulfill -
a) Conformity to specified service requirements
b) On-time delivery
c) General factors affecting the ease to do assignments/projects
d) To understand the Project Status.

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Each Consultant’s personnel file is properly kept with HR Depart. The file contains the details of
employee, his/her academic and professional certificates, training log, offer letter and appointment letter
from OSPL.

The need for training is identified through a comparison of job skills with the job description, changes in
procedures, and nonconforming activity. When a need has been identified, training are scheduled and
completed. Human Resources Department has the responsibility of establishing, maintaining &
implementing organization wide training programs.

Quality Training
OSPL believes in Developed team members can only make developed Organization. To ensure that
there is an awareness of the importance of quality, everyone is given training in the fundamental concepts
of Hospital, IPHS and Quality Standards.
All empanelled consultants leading NABH consultancy assignments need to successfully complete NABH
Assessor Training Course. Their status will remain provisional till they do so. However, they may lead QA
projects.
For a newly appointed Team Member a 15 days Training Session is organized. The training for all Team
members includes understanding of the following Features –
• Introduction to the OSPL
• Introduction to the Hospital Departments
• Bio Medical Waste
• Essentials of Quality Management Systems
a) Primary Health Centre
b) Community Health Centre
c) Sub Centre
d) District Hospitals
• ISO 9001: 2008 Quality Management System – Requirements.
• NABH Standards for Hospitals and Health Care Providers
• National Health Programes
a) RNTCP
b) Pulse Polio
c) RCH
d) NMEP
• Gap Analysis

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• Developing Systems
• Implementation of the System
• Assessment & Evaluation

Team Members are made aware of all the internal and external training opportunities.
The effectiveness of a training program is expected to manifest itself through improvement in job
performance and / or service quality. Evaluations are conducted to verify this relationship.

INTERNAL AUDIT
Internal Audit is the one of the most important feature for an organization for the following reasons –
 To understand the awareness of the Team Member about his Job Profile.
 To understand the progression of the Team Member
 To understand the Training need of the Team Member.

To meet the above needs regular assessment of the Team Member is being done through –
 Receiving regular reports from the Team Members (through mail or telephone)
 Monthly Assessment Program – By receiving Feed Back Forms from their Respective Sites on
monthly bases
 By surprise visit to the Sites by the Management.
 Yearly Performance Appraisal

Code of Conduct
All consultants are obliged to improve the standing of the consultancy profession by rigorously observing
the code of conduct.
Consultant undertakes:
• Team Members shall safeguard OSPL’s goods and property; also see that all books, records and
articles belonging to OSPL are safely kept and maintained, are not removed without the
expressed permission of the relevant authority, or lost or damaged in any way. Team Member
recognizes and accepts that all materials developed by OSPL are considered to be OSPL’s
property/propriety.
• Every Team Member shall, in accordance with the laws applicable to OSPL and policy (including
service conditions) and procedures laid down by OSPL, perform the duties entrusted to her/him
from time to time.
• To judiciously use information provided by client and maintain confidentiality of information
received in connection with assignment.
• To avoid and or declare any conflict of interest that may affect the work to be carried out.

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• Not to accept any gift or any other favor from the clients and their representatives and also not to
allow colleagues to do so.
• Not to act in a manner detrimental to the reputation of OSPL, NABH and the client.
• Every Team Member shall during the tenure of her/his service devote her/his whole time and
attention to the affairs of OSPL in all respects, and fully confirm to directions and service rules of
OSPL.
• Every Team Member shall comply with the orders and instructions of OSPL and its nominated
functionaries, and shall conscientiously work to fulfill its functions and purposes. She/he shall
make her/his utmost endeavor to promote interests of OSPL and serve at such places and in
such capacity as may be required from time to time.
• Every Team Member shall maintain honesty and integrity.
• Every Team Member shall observe courtesy and politeness; and refrain from any riotous or
disorderly behavior, or any behavior not conducive to normal functioning of OSPL.
• Every Team Member shall present herself/himself at her/his place of work at the stipulated time,
and maintain punctuality in office and other work assignments.
• Every Team Member shall generally conduct herself/himself in a manner that is consistent with
office discipline and good reputation of herself/himself and OSPL.
• Disciplinary action are taken against a Team Member who commits any misconduct, or otherwise
acts in violation of the norms of disciplinary conduct by following the principles of natural justice
and/or the existing law applicable to OSPL.
• Disciplinary action may entail discharge from service with notice or pay in lieu of notice, or an
Team Member who is proved to have committed serious misconduct, or acted in violation of the
norms of discipline and conduct referred to above.
• Where a disciplinary proceeding against an Team Member is contemplated or is pending or
where any criminal proceedings against her/him are under investigation or trial and OSPL is
satisfied that it is necessary or desirable to place the Team Member under suspension, then
OSPL may in writing suspend her/him with effect form such date as may be specified in the order
and on such conditions as may be stipulated in the letter of suspension. A statement setting out in
detail the reasons for such suspension are supplied to the Team Member within a week from the
date of suspension.
• The suspended Team Member shall not be entitled to any further wages/salary for such period in
case the charge or charges against him are established in the course of an enquiry, or otherwise,
and if he is sought to be dismissed or discharged. In case the charges are not proved so as to
cause dismissal / discharge, the Team Member will get full salary/wages for the period of
suspension.

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SECTION 6.3 INFRASTRUCTURE & WORK ENVIRONMENT

OSPL defines, provides and maintains the infrastructure necessary to ensure that service delivery
conforms to established requirements. The work environment is suitable to achieve its Objectives and
satisfy project requirements.
OSPL has well documented and implemented both Travel Policy and Deputation Policy to take care the
Boarding and Lodging of its team members on site.

The features and amenities in OSPL office are-

• The space area is 2000 sq. ft.
• Work stations are available for the Consultants.
• Each work station is with net connection, which the Consultants can connect to their Laptops or
Computers.
• For the better understanding of the subject good numbers of books are available on Quality,
Hospital Planning as reference for the Consultant.
• Conference Room
• Proper storage facility.
• For refreshment Pantry with Tea and Coffee Facility is available.
• Appropriate light and cooling facility.
• Suitable cross Ventilation.
• Rest Room

SECTION 7 SERVICE REALIZTION

OSPL plans and develop its service realization processes in order to satisfy the Quality objectives and to
increase Client satisfaction. Service Delivery Control is established in accordance with Procedures for
Control and Monitoring of services delivery.
Human Resources Department issues adequately documented instructions. Human Resources
Department is responsible for issuing the instructions to the end provider and ensuring that the necessary
resource is available. Human Resources Department ensures that the correct Procedures are followed.
The management reviews the service realization plans in the light of changing business conditions such
that future requirements for new processes, manpower planning can be done.

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SECTION 7.1 PLANNING OF SERVICE RELIZATION

It is the responsibility of the Management to plan and develop the process for the Service Realization.
These processes are carried out in accordance with documented procedures. When ever proposal for a
new project comes to OSPL following steps are
(i) OSPL first of all conducts the market survey to understand about its client.
(ii) OSPL confirms that the deputed Consultants are at par with the Project Requirement.
(iii) DPR is prepared
(iv) Proper documentation is carried out for the Client including stages –

Customized Program Program Closure Post- Pre-

Gap Analysis Development & & prepared for Assessment
Implementation Pre- Assessment Gap Closure in
Process

NABH Final
Accreditation/ Assessment
Certification

(v) It’s the ethic of OSPL to maintain Confidentiality of the projects of it’s Client.

SECTION 7.2 CLIENT RELATED PROCESS

SECTION 7.2.1 DETERMINATION OF SERVICE REQUIRMENTS

Octavo Solutions determines:

• To clearly understand the specific requirement of it’s’ client.
• Sending the proposal and the planning on realization of Client’s requirements.
• OSPL determines that the Consultant maintains the Decorum onsite and presents the
deliverables as required and in framed time lines.

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SECTION 7.2.2 REVIEW OF SERVICE REQUIREMENTS

At every stage of Project, the Project is being reviewed by the Management to ensure that the Client is
ready to go for the Final Assessment. It’s mandatory for the Consultants to send the regular reports so
that the Management is updated about the Project. Management ensures that the Consultant bring any
raised query of its Client to its Management so that it can be addressed at the right time. Proper
documentation is maintained to help the Management to review the Project before handing over the Final
Output to its Client.

SECTION 7.2.3 CLIENT COMMUNICATION

Project MOU is signed between OSPL and the Client. OSPL ensure to keep its Clients updated about the
Project. All information’s are exchanged in a Client specified language and format. OSPL believes in
maintaining Transparency with its Client. At the ends of the project Feedback is taken from the Client to
get an understanding about its work and to work on improving the same for the Future Projects.

SECTION 7.4 PURCHASING

Octavo Solutions has established a controlled method for the purchase of materials and services and
assigned responsibility to Administration for actions in connection with the purchase of material and
services. Existing suppliers/ providers are subject to a regular review based on their ability to supply
product/ deliver services that fulfills the following requirements,
a) Conformity to specified requirements
b) On-time delivery
c) Cost (Economical & effective)
d) Business relations

SECTION 7.4.1 PURCHASING PROCESS

In OSPL mainly purchase is of Computers, Stationeries, Tickets and some miscellaneous items for
Pantry.
The Process Flow followed at OSPL is –
• Quotation is requested from at least three vendors.
• Based on the Pre-Set requirements as per Sec 7.4 purchase order is raised
• Product is received on the basis of Challan.
• The amount is cleared after receiving the final Bill.

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SECTION 7.4.2 PURCHASING INFROMATION

Purchase order placed with suppliers defines the product, the revision level and any additional quality
assurance requirements beyond those established by Octavo Solutions Resource Planning System for
Purchasing Requirements.

SECTION 7.4.3 VERIFICATION OF PURCHASED PRODUCT

Production suppliers are encouraged to ensure that their process are continuously capable of producing
within specified limits via appropriate method that will provide confidence in the quality and delivery of the
product at a competitive price.

SECTION 7.5 COORDINATION & EXECUTION : SERVICES PROVISION

Octavo Solutions ensures that service is delivered to clients within desired framework. File is created for
every single project and Project Consultant is designated. It is his/her duty to ensure that work
progresses within service design as per drawn up action plan and is acceptable as per requirements and
specifications. File closer takes place once agreed service has been delivered and Client satisfaction
feedback is taken.
SECTION 7.5.1 CONTROL OF COORDINATION & EXECUTION

The service delivery process is monitored throughout and all forms of controls are used to ensure service
delivered meet Client requirements and expectations. Pre-controls (i.e. action plan resource planning,
pre-project meetings), concurrent controls (i.e. periodic meeting, process mapping, instructions/
guidelines) and feedback controls (survey, audits) are used to achieve desired output.

SECTION 7.5.2 VALIDATION OF PROCESSESS : EXECUTION

Each step involved in service delivery goes through stringent internal audit criteria and is regular checked
from initiation to completions of the project.

SECTION 7.5.3 CLIENT PROPERTY

Client is assured of confidentiality and secrecy and the clause towards strict following of this principle of
practices is declared in agreement made between Octavo Solutions and the client. The following are
considered as Client’s Properties which have be in save custody –
(i) Tariff List
(ii) The data’s – Structure, Process Details.

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SECTION 8 MEASUREMENT, ANALYSIS AND IMPROVEMENT

PURPOSE
This section corresponds to Section 8 of ISO 9001-2008 and addresses the methods used to measure,
report and improve on both the performance and effectiveness of processes and the ability of these
processes to deliver services which satisfy the Client. It also addresses the need to collect and use data
on Client’s satisfaction, non conformances etc. to address improvement issues.
SECTION 8.1 GENERAL

OSPL has defined, planned and implemented the following measurement, monitoring, analysis and
improvement activities needed to assure conformity, and achieve improvement.
i. Internal Audits
ii. Client Satisfaction Surveys
iii. Complete Analysis of the Project after Completion

SECTION 8.2 MONITORING & MEASUREMENT

SECTION 8.2.1 CLIENT SATISFACTION

Effective arrangements for communicating with Clients and prospective Clients are being implemented
relating to provision of service information, enquiries, contracts, Project Design and Development and,
and Client feedback.
Methods involved includes-E-mails, Fax, mails, presentations, and other electronic forms of
communication.
Complaint Redressal Cell: -
OSPL has a Complaint Redressal Cell with Head – HR to hear complaints from the clients/customers at
the Octavo Office on First Tuesday of every month between 10 am to 1 pm. The complaints can also be
sent through E-Mail / Postal Mail. One can contact the following for Complaints –
Mrs. Sheela Bhattacharya
Octavo Solutions Pvt. Ltd.
Mobile – 9910275123
Email – [Link]@[Link]

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All queries are recorded and are appraised of remedial measures immediately over telephone and in
writing within 72 hours-

i) OSPL has documented procedures for handling the feedbacks from Clients within
reasonable time.
ii) OSPL tries its best to respond in minimal possible time but not more then 7 days.
iii) OSPL maintains records of all feedbacks, of their resolution and the corrective and
preventive actions taken.
Annexure - II CLIENT FEEDBACK FORM

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Description

Sl # Activities Responsibility
1.0 Receipt of Inputs
All issues are verbally/ in written format (either on page or via E-
mail) communicated to Office Administrator, who records all these in
1.1 the Complaint Book date wise, categorized along with possible/ Administrator
known causes of issues and solutions / resolution made, if any at
point of contact

2.0 Root cause Analysis / Fact Finding Exercise

Human Resources Department looks into the query, and where

required make note in the file and facilitate the resolutions after
2.1 Head – HRD
identifying the causes. He/She ensures that the above resolutions
are effectively implemented.
All logged complaints/ Issues are investigated for
 What exactly happened?
 Who were the involved parties and persons?
2.2 Head – HRD
 What were the contributing factors?
Where required, the records are referred to get the factual
information.
3.0 Resolution Action
Based on analysis of Para 2.0, or where necessary a discussions or
3.1 MD
interrogation is done HRD
An action plan is decided with clearly assigning the responsibilities
3.2 for action needed to be taken. Records of these are maintained. MD
Action to be taken within 7 working days.
4.0 Monitoring the Effectiveness
Effectiveness of the actions implemented is reviewed in next monthly
4.1 MD
review meeting.
Data of all complaints received and actions taken are discussed in
5.0 MD
Management Review meeting.
6.0 Records Generated
Client complaint Log
Head – HRD
Minutes of review meetings and action taken

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SECTION 8.2.2 INTERNAL AUDIT

The organization conducts internal audits at planned intervals for the following purposes:
i. To verify whether quality activities and related results comply with planned arrangements, ISO
9001:2008 and Quality Management System requirements.
ii. To determine the overall effectiveness of the quality management system as implemented and
maintained.
iii. To identify opportunities for continual improvement

OSPL has established, maintained and implemented an Internal Quality Audit Program to verify that
quality activities and related results comply with planned contractual arrangements and to determine the
effectiveness of their Quality Plan and associated procedures.

The internal audits are conducted by the Management to get clear understanding about the projects.

Every element or process of the quality management system is audited at a minimum of twice per year.

Only qualified personnel may perform internal auditing activities.

Audit planning takes into consideration the status and importance of the processes and areas to be
audited, as well as the results of previous audits. Auditors do not audit their own work. It is ensured that
management of the audited area takes actions without undue delay to eliminate detected non-
conformities. Follow up activities include the verification of the actions taken. Internal quality audit
recommendations and results are reviewed as part of management review.
Internal audits cover all quality management related processes. Internal audits are scheduled according
to an annual plan. When non-conformities or Client complaints occur, the audit frequency is appropriately
increased. Follow up audit activities verifies and record the implementation and effectiveness of the
corrective action taken.

SECTION 8.2.3 MONITORING & MEASUREMENT OF PROCESSES

Monitoring and measurement of processes demonstrate the ability of the processes to achieve planned
results.
These methods confirm the continuing ability of each process to satisfy its intended purpose. The results
of audits of the QMS, coupled with Client satisfaction and dissatisfaction is the primary indicators of QMS
effectiveness.

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The methods used in OSPL are as follows-

• Daily report (in future it would be weekly report)
• Monthly Report
• Surprise visit by the Management on site
• Regular Communication between the Management & the Client via E-Mail, Mail, Fax, by
Telephone.

SECTION 8.3 CONTROL OF NON-CONFORMING SERVICE

A further objective is to determine the cause of the nonconformity and to ensure that appropriate action is
taken to prevent a similar re-occurrence.
Octavo Solutions ensures that the Consultants are completing their assignments as per the dead lines.
The moment the Management comes to know about any non-confirming Services it immediately takes
action.

The flow followed is –

Reason for Non
Non Confirmation is Action taken by
Confirmation is
reported OSPL
found

Action Includes – removing the root cause for the non-Conformity like providing the facility absence of
which is leading to delay, counseling the deputed Consultant or in adverse case changing the Consultant.

SECTION 8.4 ANALYSIS OF DATA

Following Data are maintained –

• Feedback by the Client
• Daily Reports
• Monthly Reports

The analysis of data provides information relating to Client satisfaction, conformity to service
requirements, characteristics and trends of processes, positive and negative compliance including
opportunities for preventive action.
The analysis on all of the above determines the effectiveness of the QMS and highlights the areas that
need to be addressed for continual improvement of the QMS. MR is responsible for the effort and to
ensure closure where QMS improvements are warranted.

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SECTION 8.5 IMPROVEMENT

SECTION 8.5.1 CONTINUAL IMPROVEMENT

Continual improvement is measured against goals and objectives.

The Team Leaders shall promote and manage continual improvement in quality, productivity, service and
value in project teams.
OSPL continual improvement program consists of many activities such as:
• The on-going review of the Quality Manual and the supporting documents;
• Actions resulting from audits, management review, corrective action and preventive action;
• Analysis of Client provided information, such as satisfaction data, consultant performance reports
and data relative to the quality of our services;
SECTION 8.5.2 CORRECTIVE ACTION

OSPL has established a Corrective Action program to eliminate the cause of the nonconformity and thus
prevent recurrence. Appropriate actions are taken for all identified non conformities. This may include
notifying the responsible function in writing, issuing a formal corrective action request etc.
Corrective action plans is developed, recorded and reviewed with the function responsible for
implementation. A system is maintained to transfer any Client complaints to the respective Project team
such that issues may be resolved in a timely fashion as desired by the Client. Results of corrective action
and its effectiveness are being documented. All identified non conformities are being brought to closure.
This procedure addresses nonconformity identification (including Client complaints) cause determination,
action to prevent recurrence, identifying and implementing the corrective action, recording results,
determining if the corrective action was implemented and effective in resolving the nonconformity.

SECTION 8.5.3 PREVENTIVE ACTION

OSPL has a Program of Preventive Action which anticipates the potential causes of nonconformities
and works to reduce or eliminate the potential failure modes.
This procedure defines the requirements for,
a) Determining potential nonconformities and their causes
b) Evaluating the need for action to prevent the occurrence of nonconformities
c) Determining and implementing actions needed to eliminate or reduce the risk of occurrence.
d) Recording of the results of the action taken
e) Reviewing the effectiveness of the preventive actions taken.
Records of preventive action are maintained and included as an input for management review.

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OCTAVO
Quality Procedure Manual
Procedure for Control of QMS Documents and Records

Doc: OSPL/QP/4.2/01
Issue No. 01, Revision Status: 00, Date of Issue: 8th Nov’10
Approved by: MD Issued By: MR
This procedure addresses Clauses 4.2.3 and 4.2.4 of ISO 9001:2008
_____________________________________________________________________________
1. Purpose
• To ensure proper preparation and authenticated issuance of QMS documents
• To ensure that only current QMS documents are available at all user points bearing
authentication
• To ensure that all QMS documents are legible and readily identifiable.
• To ensure that the documents of external origin are identifiable and available for reference
• To prevent the unintended use of obsolete documents.
• To ensure that the documents are periodically reviewed and revised as per the need
• To ensure proper preservation of records as per the directives of the divisional heads and/or MR

2. Scope: Methodology for control of documents and records related to QMS.

3. Responsibility: MR and respective functionaries in OCTAVO

4. Procedure
4.1 Identification – The QMS documents shall be of two types as follows when they are on hard
copies:
• Controlled Copy - to be marked so, in each set of document.
• Uncontrolled Copy
QMS documents shall given an identification or designation number, after issuance.

4.2 MR shall issue all the documents to intranet of OCTAVO.

4.3 MR shall keep some copies of the obsolete document in archives for future reference, after it is
marked OBSOLETE COPY prominently on front page

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4.4 The contents of systems documents shall be kept on electronic medium for convenience of
modification but access to the same shall be to MD and MR only.
4.5 Storage, Protection and Retrieval - MR shall keep all copies of QMS documents safely,
protected against any damage from water, dust, fire, sunlight, attack from pests and insects, etc.
All these documents shall be stored in such a way that any one of them could be retrieved for
reference without any problem.
4.5.1 All QMS records shall be kept by the respective functionary/staff duly protected as per 4.5
above.
4.6 All Systems documents shall be reviewed and revised as per need (identified at MRs).
4.7 Any revision/modification in any of the systems documents shall be recorded in a table with the
following columns to indicate identification of the changes and the currency status of the
document.

Revision Revision
Doc: OSPL/ Changes made Signature of MR
No. Date

4.7 All documents of external origin (like legal references, governmental notifications and directives
and reference documents such as standards) shall be kept safely with the respective functionary
and shall be easily retrievable.
4.8 All QMS records shall be maintained by the respective functionary and shall be protected as
stated in 4.5 above. The retention time for each QMS record shall be decided as per the directive
of MD and/or MR.

5. Monitoring: MR shall periodically check the intranet to ensure that the QMS documents are in proper
health and shape.

6. Records: Hard copies of documents

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OCTAVO
Quality Procedure Manual
Procedure for Internal Audits

Doc: OSPL/QP/8.2.2/01
Issue No. 01, Revision Status: 00, Date of Issue: 8th Nov’10
Approved by: MD Issued By: MR
This procedure addresses Clauses 8.2.2 of ISO 9001:2008
_____________________________________________________________________________

1. Purpose: To determine whether the QMS in OCTAVO:

a. Conforms to the planned arrangements, the requirements of ISO 9001:2008 and the
policies and objective established / set by OCTAVO
b. QMS is effectively implemented and maintained for:
(i) Ensuring customer satisfaction
(ii) Effecting continual improvement
(iii) Legal compliance

2. Scope: All elements of Quality Manual and all Quality Procedures

3. Responsibility: Management Representatives

4. Procedure
4.1 Scheduling of Internal Audit shall be once in six months or earlier if considered necessary by the
management.
4.2 MR shall maintain a list of trained auditors of QMS or get its Internal Audit conducted by one of its
empanelled consultants/experts.
4.3 MR shall coordinate to ensure successful conduct of the internal audit.
4.4 MR shall coordinate with the audit team in the preparation of an Audit Report, indicating non-
compliances and observations as per format at Annexure-A.
4.5 MR shall evolve a Corrective Action Plan (CAP), complete with schedule, in consultation with MD,
concerned HOD, etc.
4.6 The appropriate functionary / functionaries identified at act on the CAP shall implement the CAP
within the same schedule (time over run shall be allowed only with the permission of MD).

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4.7 MR shall verify the correctness and successful implementation of the CAP and shall submit
Report to the MD. After MD’s approval, this report shall be included in the agenda for the next
MRM.

5. Monitoring: MR shall ensure the implementation of this procedure.

6. Records:
(i) Audit Reports

ANNEXURE – III
FORMAT FOR INTERNAL AUDIT REPORT

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OCTAVO
Quality Procedure Manual
Procedure for Control of Non-conforming Products
Doc: OSPL/QP/8.3.1/01
Issue No. 01, Revision Status: 00, Date of Issue: 8th Nov’10
Approved by: MD Issued By: MR
This procedure addresses Clauses 8.3.1 of ISO 9001:2008
_____________________________________________________________________________

1. Purpose: To eliminate the chances of non-conformance of products to the extent possible and
causes of a detected non-conformity (both existing and potential) and prevent its recurrence
/occurrence.

2. Scope: Method of dealing with detected non-conformities (both existing and potential)

3. Responsibility: MD assisted by MR

4. Procedure
4.1 Non-conformities (both existing and potential) detected in audits or otherwise shall be reviewed in
the light of the intent and content of the relevant clause(s) and the implementation of the
corresponding Corrective and Preventive Action Plans (CAP and PAP).
4.2 The MR shall modify the appropriate procedure incorporating the issues arising out of the
implementation of CAP and PAP and/or the situation at OCTAVO, without sacrificing the
requirements of the standard and without violating the stated policies and objectives of OCTAVO.
4.3 Appropriate deterrent action shall be taken and/or disincentives imposed, in the case of chronic
defaulters. Such punitive actions taken in respect of erring personnel can be kept confidential or
otherwise as per the discretion of MD.
4.4 The Quality Procedures for Corrective Actions and Preventive Actions are to be followed
adequately.

5. Monitoring: MR shall assist MD in reviewing the records of implementation of the above procedure.

6. Records: Records of non-conformities to the extent possible to maintain logically -

(i) Audit reports
(ii) Client feedback
(iii) Monthly Review Meeting Minutes

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OCTAVO
Quality Procedure Manual
Procedure for Corrective Actions
Doc: OSPL/QP/8.5.2/01
Issue No. 01, Revision Status: 00, Date of Issue: 8th Nov’10
Approved by: MD Issued By: MR
This procedure addresses Clauses 8.5.2 of ISO 9001:2008
_____________________________________________________________________________

1. Purpose: To eliminate the causes of a detected non-conformity and prevent its recurrence.

2. Scope: Method of dealing with detected non-conformities

3. Responsibility: MD assisted by MR

4. Procedure
4.1 Non-conformities detected in audits or otherwise shall be reviewed in the light of the intent and
content of the relevant clause(s) and the implementation of the corresponding Corrective Action
Plan (CAP).
4.2 The MR shall modify the appropriate procedure document (if necessary) incorporating the issues
arising out of the implementation of CAP and/or the situation at OCTAVO, without sacrificing the
requirements of the standard and without violating the stated policies and objectives of OCTAVO.
4.3 Recurring nonconformities, in spite of corrective actions shall receive top priority.
4.4 Appropriate deterrent action shall be taken and/or disincentives imposed, in the case of chronic
defaulters. Such punitive actions taken in respect of erring personnel can be kept confidential or
otherwise as per the discretion of MD.

5. Monitoring: MR shall assist Team Leaders in reviewing the records of implementation of the above
procedure.

6. Records:
(i) Audit reports
(ii) CAPs
(iii) Monthly Review Meeting Minutes.

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OCTAVO
Quality Procedure Manual
Procedure for Preventive Actions
Doc: OSPL/QP/8.5.3/01
Issue No. 01, Revision Status: 00, Date of Issue: 8th Nov’10
Approved by: MD Issued By: MR
This procedure addresses Clauses 8.5.3 of ISO 9001:2008
_____________________________________________________________________________

1. Purpose: To eliminate the cause(s) of potential nonconformity or other undesirable situation and
prevent its occurrence.

2. Scope: All elements of QMS – a proactive approach

3. Responsibility: MD assisted by MR

4. Procedure

4.1 The potential areas of non-conformities shall be identified and their cause(s) shall be diagnosed
through:
a) Periodic review of the various quality procedure documents and manuals and determining the
status of their successful implementation. In this context, any difficulty faced or the
probability of facing difficulties due to any or combination of the following changes (which
may hinder smooth and successful adoption and implementation of the procedure or manual
under review) shall be clearly identified:
i. methodology
ii. personnel (competency level)
iii. customer requirements
iv. legal or other requirements
The above shall be followed up by determination of possible training needs of personnel
and/or better understanding the new legal or customer requirements. Preventive Action Plan
(PAP) shall be chalked out to nip the potential non-conformity in the bud.

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4.2 Examining the various nonconformities already detected and the result of implementation of
CAPs in one or more divisions and deciding the strategies to adopt, so as to prevent
snowballing of nonconformities in other divisions in the implementation of the QPs individually or
in combination.
4.2.1 Counseling sessions with personnel who are deficient in their understanding of the QMS
4.2.2 Analyzing the lapses in the administrative areas, which may cause non- Conformities in
future.
4.3 Deterrent action shall be taken and/or disincentives imposed in the cases of chronic defaulters to
restrict the growth of potential areas of nonconformities.

5. Monitoring: The MR shall assist MD in reviewing the records of implementation of the above
procedure.

6. Records: Monthly Review Meeting Minutes

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