Analysis and Evaluation of a Primary Hospital

IMMACULATE CONCEPTION HEALTH CENTER – Operated by Kaayong Lawas Foundation, Inc. , A Primary Hospital located at Bandung Village, Barangay VII, Victorias City about 34 kilometers to the North of Bacolod City, the capital of the Province of Negros Occidental. It is a 24 Bed Capacity composed of Male Medical Ward with 6 Beds, Female Medical Ward with 5 beds, Pedia Ward with 6 beds, 6 Private Rooms, 1 Labor Room, Delivery Room, OPD and Emergency Room. The Hospital is a licensed Primary Hospital with a Licensed Secondary Laboratory.

This is run by a Foundation, a non-government organization composed of the Board of Trustees. Their target clientele is the neighboring towns of EB Magalona and Manapla and they are more concentrated to provide services in the city itself, Victorias City. The ICHC provides Integrated Medical Services Program comprising the following service components: In-Patient services, as in house service catering to the needs of patients admitted for treatment and Emergency services that provide first aid treatment and medical attention to emergency calling for immediate medical and surgical assistance.

In cooperation with the City of Victorias, ambulance service is made available when called for. At the community level, Mobile Health Clinic which delivers basic health services to residents in remote sugarcane plantations and barangays is also undertaken. Another important component of ICHC medical services is Referrals of high risk and special cases that the medical staff identify to be beyond their capacity to care for or hence, referred for admission to private or government hospital in Silay and the capital city of Bacolod.

Victorias City has a projected population of 92,000 spread over 13, 392 hectares of the land area. It has 26 barangays, 8 of them situated in the poblacion, 10 are situated within the Victorias Milling Company, Inc. (VMC) compound and the rest are situated in the rural areas. Majority of the residents are Catholic while the rest belong to various sectarian denominations. Sources of income are mainly from development with the sugar industry (haciendas and sugar central), fishing, agricultural production, and entrepreneurial activities.

EXPERIENCE IN THE WARD AND PRIVATE ROOM OBSERVATION: Immaculate Conception Health Center (ICHC) is a 24 bed capacity Primary Hospital, the Chief Nurse with a dual role, also stand as the Head Nurse is responsible with the arrangement and scheduling of the staff on duty. Most of the time the Head Nurse together with her staff were assigned in both Wards and Private Rooms, in the Labor Room and Delivery Room, OPD and ER.

In one setting a group of staff mix composed of Nurses and Nursing attendant assigned in each shift and together with them is a 24 hour contractual doctor on duty assigned in each day. In each shift they see to it that there is (1) Regular staff Nurse, (1) Casual Nurse and (1) Nursing Attendant on duty plus there are also nurse volunteers on duty. In case of absences the Head Nurse will either arrange the schedule of the recently nurse on duty to stay on an extended hours or contact the other casual or regular nurse to fill in.

In this kind of set up they adopt the Functional Nursing as a model of care or approach. During the weekdays the set up would be the volunteer nurse will act as the medication nurse, the regular nurse will be the charge nurse of the Wards, Private Rooms, Labor Room and Delivery Room and sometimes the Head Nurse Helps the Charge Nurse and she is the one who goes with the Doctors during rounds. The Contractual Nurse will be assigned in the ER and OPD. The other volunteer nurse will do the bed side nursing.

The Nursing attendant will be in charge of the vital signs and monitoring of Input and Output and sometimes assist the Bedside nurse, the nursing attendant coverage of work were the wards, private rooms and ER/OPD. You could easily identify the nurses who are wearing printed scrub suit uniforms, the nursing attendants wearing plain blue scrub suit as their uniform and the volunteer nurses are wearing the white uniform. The same set up the whole week except on a Sunday in which the Head Nurse will take her 1day off and her regular time would be 7am to 3pm.

In terms of the decision making as long as the Head Nurse is around she is the one who decides but in lieu of her the charge nurse or the regular staff nurse is in charge of everything. Meanwhile, when we talk about the Labor Room and Delivery Room they seldom receive patients for delivery when the doctor on duty is not an Obstetrician – Gynecologist or most of the time the patient is a regular patient of the on call Obstetrician – Gynecologist of the Hospital.

In this kind of picture they might be overloaded with work but there is one thing I learned from this experience is that because of the small number of staff and patients working and living in the same community most of the people knew each other and they could work harmoniously, disregarding differences and working in a diversified personnel and team work is very visible in the area.

They say they seldom encountered arguments/misunderstandings both with co-workers and patients. Nursing personnel have a quarterly meeting and sometimes when a problem arises they call emergency meetings. They provide enhancement programs in collaboration with the City Health Office of Victorias they join training and seminars provided by the DOH and they allow their nurses to attend seminars conducted by private entities.

In terms of benefits and incentives, the Health Personnel receives 13month pay, Cost of Living allowance, Night Premiums, entitled for a 20% off to medicines and hospitalization including dependents (mother, father, husband and children), with Phil Health Profit sharing and a member of SSS, PAG-IBIG and Phil Health. Each health personnel are entitled of 15days sick leave and 15days vacation leave and render a 40 Working Hours per week and for the Head Nurse, she renders 48 hours per week. The Chief Nurse/Head Nurse conducts her Performance Appraisal/Evaluation for Nurses and Nursing Attendants Quarterly.

She use the Performance Appraisal/Evaluation Form and afterwards she meet her staff individually and talk regarding the performance and listens to the suggestions/ comments of her staff and most of the time they agreed to deliver health care services to the patients the best that they could. Any suggestions/comments the Chief Nurse/Head Nurse received from her staff she raised and open it to the Medical Director as well as the necessary improvement needed in the clinical setting such as repairs or additional equipment, medicines and other concerns in terms of nursing services.

In Regards to the budgetary requirement of the Nursing Service, the Chief Nurse is the one who prepared their annual appropriation. Though ICHC-VKLFI is paying a hospital and true to their motto “Health Care for the Poor” sometimes they agreed for waivers to patients in exchange of the emergency treatment or hospitalization of the people and they even accept NOCHP (Negros Occidental Comprehensive.

Health Program) clientele, this is a Health Insurance provided by the 3rd District Congressman in which you can use it after you already consumed the Phil Health the NOCHP will accommodate the rest of the Bill and you will end up paying nothing.

They also honor 20% discount for Senior Citizens in compliance of Expanded Senior Citizen’s Act or R. A. 9257 and 20% discount is also applicable to the Physically Challenge Person .

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