Service Development Program, 2001-2003
Philosophy
We believe that service should be:
The reason for existence of a department of surgery.
Rendered to the highest possible number of clients seeking assistance from a department of surgery.
Of the highest possible quality, with quality being loosely defined as client’s satisfaction and specifically defined as highest percentage possible in the resolution of the health problems of the clients with the least incidence of death, complications and disability and in such a manner that the clients are satisfied and will not file any complaint.
An effective and efficient provision of highest quality of medical care at the lowest possible cost.
Of the highest possible quality that is constantly promoted and improved by effective governance, continuous training of staff, and continual research.
Goal
To continually provide highest possible quality services to all clients of the department of surgery.
Performance
Objectives (Targets)
|
Parameter |
Target |
How derived |
|
|
Ideal |
Realistic |
||
|
Admissions/year |
based on 80% occupancy rate |
10-20% better than previous year |
[no. of bed-day per year / ave. length of stay ] x 80% bed occupancy rate |
|
Bed occupancy
rate |
80% |
10-20% better |
|
|
Average length of
stay |
4 |
1 –2 days better |
|
|
Elective
inpatient operations |
Based on existing facilities and capability |
10-20% better |
no. of OR rooms/slots per week (3) x ave. no. of operations per OR day (6) x 52 weeks |
|
Emergency
inpatient operations |
|
10-20% better |
|
|
Ambulatory
operations |
|
10-20% better |
|
|
Ambulatory clinic
consults |
|
10-20% better |
|
|
Emergency room
consults |
|
10-20% better |
|
|
Recovery rate |
90% |
|
|
|
Mortality rate |
<1% |
5% |
|
|
Operative
mortality rate |
<% |
5% |
|
|
Morbidity rate |
<5% |
|
|
|
Cancellations |
<10% |
Better than previous year |
|
|
Complaint |
Zero |
Not more than 3/year |
|
|
Preoperative
visits |
2 |
3 |
|
|
Medical expense
for major operations |
|
Cost of essential needs (P 5,000) |
|
|
Tissue review
(unnecessary operations) |
10% |
Better than before |
|
|
Fibrocystic
changes |
|
Better than before |
|
|
Normal
appendectomy rate |
|
Better than before |
|
|
Disaster
Preparedness Program |
|
|
|
Strategies (General)
Effective leadership from chairperson down
Effective in promoting achievement of performance objectives
Effective in promoting achievement of the other strategies
Leadership by training and coaching
Leadership by example
Situational leadership – innovativeness and resourcefulness
Consultant-guided and assisted services from chairperson down
Structured departmental service development program with clear philosophy, directions, and policies; realistic short- and long-term targets; doable strategies; regular weekly and monthly monitoring; and continual quality improvement measures
Continuing education, training, and coaching of resident staff
Motivation-provision for resident staff
Donor-enticement or donor-development program
Strategies (Specific)
Computation of the highest possible number of services that could be rendered to clients of the department of surgery.
2001- Computation of targets based on existing facilities and based on ideal standards and benchmarkings
2002 and 2003 – Computation of targets based on existing facilities and based on ideal standards and benchmarkings with adjustment to performance in the previous year.
Mandatory vs selective work-up of patients for elective operations
Sudden cancellation of scheduled elective inpatient operations
Tissue review on unnecessary operations
Reduction of unnecessary fibrocystic changes operations
Reduction of unnecessary appendectomy rate
Reduction and prevention of morbidities and mortalities
Reduction of complaints
Support from top
management
Lack of equipment
Lack of nurses
Multisectoral
problem-solving and collaboration
With anesthesiologists
With nurses
With pathologists
With other departments
Donor development
program
Operasyon Pinoy
Funds for indigent patients
Electrocautery machines
Surgical equipment
Volunteer
parasurgical staff program (medical secretary-clerk, nurse)
Outcome
|
Parameter |
Target |
2001 |
2002 |
2003 |
|
Admissions |
|
Better than 2000 |
Better than 2001 |
|
|
Bed occupancy
rate |
80% |
Better |
Better |
|
|
Average length of
stay |
4 |
6 |
5 |
|
|
Elective
inpatient operations |
|
Better |
Better |
|
|
Emergency
inpatient operations |
|
Better |
Better |
|
|
Ambulatory
operations |
|
Better |
Better |
|
|
Ambulatory clinic
consults |
|
Better |
Better |
|
|
Emergency room
consults |
|
Better |
Better |
|
|
Recovery rate |
90% |
Better |
Target reached |
Target reached |
|
Mortality rate |
<5% |
Target reached |
Target reached |
Target reached |
|
Operative
mortality rate |
<5% |
Target reached |
Target reached |
Target reached |
|
Morbidity rate |
<5% |
Target reached |
Target reached |
Target reached |
|
Cancellations |
10% |
10% |
8% |
6% |
|
Complaint |
Not more 3 per year |
6 |
1 |
1 |
|
Preoperative
visits |
|
6 |
2 |
2 |
|
Cost of major
operations |
|
P 10,000 to P5,000 (Sept) |
P 5,000 |
P 5,000 |
|
Tissue review
(unnecessary operations) |
10% |
Baseline |
Better |
Better |
|
Fibrocystic
changes |
|
Baseline |
Better |
Better |
|
Normal
appendectomy rate |
|
Baseline |
Better |
Better |
|
Disaster
preparedness program |
|
|
|
Formulated |
To sustain and institutionalize the service
development program
To improve further on certain service
parameters that still need and can still be improved
To market the department of surgery so as to
increase the present service capacity