NAME OF HOSPITAL

ADDRESS:
TEL. NO.:
CONTACT PERSON:

CHAPTER 1
Socio – Demographics

Health Statistics and Epidemiological Indices

Introduction

The ABC Hospital (ABCH) was built in the year 1930 as a 250 bed provincial hospital. The hospital
beds are equally divided to medicine, pediatrics, surgery and OB-GYNE beds. Through the years, the
number of beds increased gradually to 348 beds (plus cot beds). In addition to this, ABCH has sixty (60)
extension beds in CDE Rehabilitation Center for psychiatric patients. This center was transferred by the
Philippine Mental Health Association (PMHA) to ABCH in 1994.

ABCH is unique, compared to other hospitals in the province. It serves as an end-referral provincial
hospital of Malipayon Province and at the same time the district hospital of Malusog ILHZ, which
includes municipalities of Mahinay, Maisog, Mahusay, matangkad, Masunurin. Because of its
geographical location, ABCH also serves patients from the island Province of Maganda, Northern
Malaya, Southern Maputi, and Southern part of Maykaya.

Patient Flow and Referrals

All government hospitals and RHUs in Malipayon Province and neighboring provinces refer their
patients to ABCH either for emergency surgery, obstetric and gynecologic care, or tertiary level care, or
for the diagnostic workup. Patients from the 2 private hospitals in the province refer patients to ABCH
once the patients could no longer afford to pay their fees.

CHAPTER 2
The internal Environment

Hospital Scope of Services

ABCH have specialist physicians and fellows who have undergone formal residency trainings in OB-
GYNE, surgery, pediatrics, medicine, anesthesia, nephrology, orthopedics, neurosurgery, adult
cardiology, radiology, ultrasonology, urology, rehabilitation medicine and psychiatry.

The OPD has the following OPD services:

1. Under-5 clinic
2. Diabetics Clinic
3. Family Planning Clinic/Pre-natal/Post-natal/Post-menopausal and Infertility
4. Surgery- for consultations and minor surgery
5. Physical therapy
6. Dental Section
7. Dialysis

ABCH also provides tertiary level laboratories, CT-scan, mammogram, special X-ray procedures,
treadmill, and ultrasonography.

The hospital pharmacy is open for 24 hours.

Hospital Management System

The hospital is led by the PHO 1 as Chief of Hospital. He is supported by the Hospital board, Dialysis
board and CDE Rehabilitation board, Administrative Officer, Chief Nurse, Department heads and Section
heads. There is a 3 year developmental plan of the present Governor as basis for hospital operations. This
was done during the 3 days ELA (Executive Legislative Agenda) last year.

The hospital only conducts an annual procurement plan once a year. Sometimes ABCH conduct an
emergency procurement for emergency drugs and supplies when these are untimely consumed.

Regular monthly staff meetings are done per department or section. Emergency meetings are also done,
especially when there is urgent need or problems to discuss or solve. Problem solving meetings are
participatory in nature to solicit compliance of the staff to the chosen solution.

The management information system is done manually however computerization has already started and
will be completed within this year. Financial reports are given to PHO 2, PHO 1, Hospital board and the
Governor every quarter. SDEX (Service Delivery Excellence for Health) is done monthly.

Housekeeping is done by Institutional Workers (IW) and supported by janitors on contract.

Security force is also composed of in-house security staff and at the same time by security guards on
contract. There is a maintenance staff for buildings and equipment. DOH maintenance personnel also
come regularly. ABCH has fire extinguishers and fire drills are done during fire prevention month of
March.

Solid waste is segregated and infectious and pathologic wastes are disposed after chemical treatment in
concrete vault. Liquid wastes pass through the septic tank for bacterial degradation. Within this year
ABCH will build its waste water treatment facility.

Middle Management

The Chief Nurse, Administrative Officer, Management board of different sections, Department heads and
Sections compose the middle management. They recommend new policies, rules and regulations to the
hospital board for approval and submit this to Sangguniang Panlalawigan for deliberation and approval
and finally to the Governor of the province for his signature. The different section heads supervise their
staff, inform and implement the new policies.

Quality and infection committees have been organized but needs to be reactivated.

There are many logistics, human resource and facility issues in the middle management level that need to
be discussed and addressed.
Personnel/Human Resources

Based on the present bed capacity, ABCH would need more health personnel i.e. Midwives, Nurses,
Doctors, Security Guards and Janitors. A stop gap measure is done through job orders and contractual
employees. Their salaries are funded from the hospital income. Unfortunately, there is a problem in the
availability of doctors which may worsen in the future. Most of the current doctors are already registered
nurses and have completed the requirements in the issuance of US visas. They are just waiting for their
clearance to travel.

For newly hired staff, orientation is done usually for a duration of 2-3 days. Each section head will have
30 min time slot. The last speaker is the Chief of Hospital. The last day is devoted to a hospital tour and
meeting staff in each section.

Financial Information/Accounting

The 2016 budget of the hospital was Php 140,038,317.08(PS, MOOE, CO). Of this 75% was allocated for
PS while 25% was allocated for MOOE. Of the MOOE, 41% was spent to purchase drugs and medicines.

The hospital income was generated from operations and diagnostic services amounting to Php
66,875,573.57 and from PhilHealth - Php 57,548,716.61. All hospital income was apportioned for
personnel services, MOOE including drugs and medicines, and for capital outlay through a Hospital
Board Resolution approved by the Sangguniang Panlalawigan.

Procurement, Supplies, and Drugs

The hospital formulated a Supply and Drug requisition procedure which was submitted to the Provincial
BAC for approval. The requisitioned items usually arrive 3 months after requisition. If there is a failure in
bidding, the items will arrive 6 months after requisition. The items that are delivered are usually not
according to the specifications (brand) and usually higher in price than those in the commercial outlets. In
some instances, supplies run out of stock.

Medical Staff

The Medical staff is not formally organized and there is no Medical Staff organization by-laws. However,
all doctors are members of MPPHA (Malipayon Province Public Health Association). MPPHA has by-
laws and registered by the Securities and Exchange Commission (SEC). The association members have
monthly dues, mortuary benefits, and meet regularly in a general assembly.

The present Provincial Health Officer I designate also performs functions of the chief of clinics.

The medical staff is composed of fellows, medical specialists, rehired retirees as part-time consultants,
resident physicians with permanent status, contractual residents under Residency Training Program in
general surgery and OB-GYNE, and graduating students of Merdeca University Medical School. All
health workers who are holding permanent status receive Magna Carta benefits (except Medico-legal
fees), night differentials and holiday pay.

The continuing medical education is done by attending Mid-year and Annual conventions of the different
specialties, local scientific meetings, round table discussions, mortality and morbidity reviews per
department, and case presentations. Some permanent residents are sent for a 6 month in-service training
to medical centers outside of Malipayon province.
Pharmacy

The pharmacy is located in between the main building and the south annex building. Staffing is adequate
and is headed by a pharmacist IV assisted by 8 staff (2 pharmacist III, 5 sanitary inspector I, 1 clerk 1).
Only 1 out 9 has plans for overseas employment.

The hospital pharmacy is licensed by the DOH to operate on a 24-hour basis following a 3-shift schedule.
Emergency drugs are available at the E.R., Nurses’ stations, O.R., D.R., and ICU/CCU.

The drug requisition is based on approved drug formulary. The requisitions are passed through the
Provincial Bids and Awards Committee. Because of the Generic Law, generic drugs usually win the bid
because of their low prices. However, ABCH checks for their bio-assay certificates and requires at least a
one year expiration date from the time of delivery to ensure quality of the purchased drugs. Emergency
requisition is done for emergency drugs when these run out of stock although on a limited basis.
Availability of essential medicines including the dangerous and regulated drugs are sometimes delayed
due tedious procurement process.

The pharmacy space is inadequate to accommodate the supplies and so with the stockroom. It has three
functional regular refrigerators. There are three computers to record all transactions. The air-conditioning
system needs repair. Some parts of the ceiling have leaks and vermin control is a problem.

Laboratory

Staffing is adequate because of hired job orders and contractuals to augment the plantilla items. The
laboratory operates 24 hours a day. ABCH performs hematology, urinalysis, fecalysis, blood chemistries,
cellular microscopy, blood banking, water analysis, blood and platelet separator, serum electrolytes, and
soon will operate a histopathology unit.

Sometimes due to late arrival of reagents, some procedures cannot be done.

The medical technology staff attends CME by PAMET and in-service trainings sponsored by DOH.

Dialysis Center

The ABCH has five (5) new hemodialysis units and 5 old machines operating on a 2- session schedule
from 7-12 noon and 1-5 pm serving ten patients a day. This center is managed by the Dialysis Board, and
Rotary Club of Malipayon Province.

Medical Records

This section is undermanned. There are delays in the production of reports and data. Sometimes there are
inaccuracies because some data do not match other entries.

In August 1, 2016, ABCH started the patient ID system following a chronological case numbering system
to identify patients before they are treated and managed. There are plans to fully computerize within this
year.

Food Service/Kitchen
The ABCH has 2 Nutritionist-dieticians. Marketing is done everyday. Food is cooked for breakfast, lunch
and dinner. Doctors on 24 hours duty are given free meals.

The ABCH has an employees’ cooperative canteen to serve the watchers and hospital staff.

At present, ABCH is constructing a new building to be used as a kitchen.

Radiology

This section’s staff is adequate. The radiology department operates 24 hours a day. The current machines
are ultrasound, CT scan, Mammogram, dry film processor, one stationary and one mobile X-Ray
machine. Few months from now, ABCH will acquire digital X-Ray machine.

Nursing

The nursing department is headed by the Chief Nurse and supported by nurse supervisors. Based on the
bed capacity, ABCH lacks nurses but this was solved by hiring job orders and contractual nurses. Aside
from this, ABCH has more than 100 volunteer nurses. Because of the promise for greener pastures, most
of the older nurses have already sought employment abroad. This limits the number of skilled nurses in
the hospital.

The nursing staff have their own monthly meetings to address problems and concerns, and brainstorm
possible solutions.

Building and Grounds

The main building has just been newly renovated. Most of the wards and private rooms were furnished
through the contribution of NGOs and private individuals. Repainting of the Emergency Room and OB
wards were done. The main building is located in the center of the compound and houses the OB-GYNE
ward, surgical ward, operating room, recovery room, nursing service office, and delivery rooms.

A 2-storey annex building is located north of the main building where the medical cases are admitted.

Another annex building, 2 storeys high is located south of the main building, of which the ground floor is
occupied by OPD (surgery, medicine, pediatrics, dental clinics, and OPD record section). The second
floor is occupied by the pediatric department.

The records section storeroom, supply room, maintenance room, male and female dorms, morgue, and
SARS building are located at east side of the building.

The hospital has a new 3 storey Admin building where the business offices, PhilHealth office, record
section, offices of the PHO 1 and PHO 11, administrative office, DOH Provincial Health Team Office
and the Technical section of the PHO are located. It also has three conference rooms.

The buildings and its grounds are generally clean. The water supply is from two deep well pumps and
from the Malinaw City Water District.

CHAPTER 3
Proposed Development Plan for the Hospital

The Abuyog District Hospital intends to develop into a level 2 district hospital and increase it
bed capacity to 100 beds.
Considering that it is currently a level 1 hospital, it will add the following licensing requirements
to become a level 2 hospital:

The Abuyog District Hospital will request assistance from the DOH for infrastructure, equipment
requirements. As for the man power, the hospital will seek to file an SB rolution to effect the manpower
requirements. We plan to accomplish this goal in 4years time.

1st year – We will DAED and schematic plans. Secure proof of land ownership. And propose this
for DOH funding. The new level 2 hospital with 100 beds will require an MOOE of (1700 x 100 x 365
days) 62 Million annually. Current MOOE is at 31 Million already augmented by PHIC reimbursement .
To address the gap of another 31Million, the hospital plan to ask the LGU to increase the budget for
another 15M and we estimate that the increase in PHIC reimbursement will cover the remaining
15Million.

In conclusion, Abuyog District Hospital will

Write what you intend to be in the next ten years (what is the developmental capability, bed
capacity, equipment, manpower, and infrastructure?)

CHAPTER 4
Financial Analysis of the Proposed Development Plan

Write the estimated cost (for capital outlay, equipment, manpower and MOOE) of implementing
the development plan and try to match with available funds. Is there a deficit? If so, what are the possible
sources of additional funds?

CHAPTER 5
Key Areas of Investment

If funds are not sufficient, what are the priorities of the development plan? How will the
investments be spread out in the next 10 years?