SLIDE 1:
Good day, fellow nursing staff of the Medical Cluster, I am
,
one of the head nurses and the Training Officer of the Medical Cluster. I
will be presenting to you the Performance Governance System of the
Medical Cluster. >>>>>>CLICK
SLIDE 2:
It was in the year 1987, >>>>>>CLICK through the efforts of its first
chairman, Dr. Efren SJ Nerva, that the Department of Medicine became
the first training program in Bicol to be accredited by the Philippine College
of Physicians. >>>>>>CLICK
In February 2020, the Medical Annex 2 or the ESRD Ward was
established and redirected patients with renal problems from the Medical
Ward and Medical Annex 1. The ward focuses on the provision of medicalsurgical and nursing care among renal patients. The ward is strategically
located adjacent to the hemodialysis unit. >>>>>>CLICK
In April 2020, amidst the pandemic, the Medical Ward transferred from the
Emergency Room and Medical Ancillary (ERMA) Building in the main
hospital building to the 6th floor of the 8-storey general wards building and
was among the very first clinical units to occupy the newly-built building.
>>>>>>CLICK
In July of the same year, RA 11478 increased the bed capacity of the
Medical Ward was increased from 50 to 140 beds, while the Medical
Annex and CD wards were decreased from 40 to 35 beds each.
>>>>>>CLICK
In October 2021, The Medical Annex and CD ward were renovated and
were temporarily relocated to the ERMA building and Old Surgery Ward.
>>>>>>CLICK
SLIDE 3:
The Medical Cluster of the nursing service comprises the 3 clinical nursing
units that cater to the patients of the Department of Internal Medicine that
works interrelatedly within the nursing scope of care.>>>>>>CLICK
The: Communicable Disease Ward, >>>>>CLICK………Medical Annex
>>>>>> CLICK and the Medical Ward. >>>>>CLICK
SLIDE 4:
The Medical Ward is a 140-bed capacity >>>>>CLICK situated on the 6th
floor of the 8-storey Building that caters to a variety of non-infectious
medical cases. It is divided into 4 stations: >>>>>> CLICK Station A ,
>>>>>> CLICK B with 30 bed capacity each , >>>>>> CLICK Station C
and >>>>>> CLICK D both with 40 bed capacity >>>>>> CLICK
SLIDE 5:
Each of which caters to the following services: >>>>>> CLICK Station A
– Cardiopulmonary cases>>>>>> CLICK Station B Neurology cases
>>>>>> CLICK Station C – Oncology and Hematology Casess and
>>>>>> CLICK Station D – Miscellaneous Cases such as endocrine,
toxicology, dermatology, and gastroenterology. >>>>>> CLICK
SLIDE 6:
In the main building, the Medical Annex Ward and CD ward are located at
the back portion with both having 35-bed capacity >>>>>> CLICK
The Medical Annex caters to patients to patients with infectious
Pulmonary, stable Toxicology , stable psychiatry, and endocrinology cases
for wound management. >>>>>> CLICK
The Communicable Disease Ward provides management to patients with
highly communicable medical cases which include but are not limited to
Pulmonary Tuberculosis, Central Nervous System Infection (CNSI),
Rabies, Tetanus, Dengue, and Leptospirosis. >>>>>> CLICK
SLIDE 7: CURRENT REALITIES:
A typical trend in the total patient census of medical clusters increasing in
range from >>>>>>CLICK
10,000 to almost 12,000 in 2018, 2019 & 2022. However, >>>>>> CLICK
year 2020 and 2021 marks a decrease in admissions due to the advent of
the Coronavirus pandemic. >>>>>> CLICK
SLIDE 8:
The Medical Cluster has always exceeded the occupancy rate>>>>>>
CLICK though an increase in bed capacity by 130 to 210 year 2021.
>>>>>> CLICK
SLIDE 9:
It is also interesting to note that the Medical Cluster attends greatly to
patients needing critical care due to the limited capacity of the ICU
Complex.>>>>>> CLICK
SLIDE 10:
With these current realities, the staffing of the medical cluster adds to the
growing challenge of providing Quality Patient Care. >>>>>> CLICK This
table shows the distribution of staffing requirements compliant with the
210 allocated beds to the medical cluster considering primary and high
dependency care. >>>>>> CLICK
SLIDE 11
The Nursing Service of the medical cluster strengthens the competency
development and adaptation program of the nursing staff wherein one
time or another will be transferred to the special areas and specialty
centers, and further trained and provided with opportunities for
professional growth and development consequent to the mandate and
>>>>>> CLICK
SLIDE 12:
strategic positioning of Bicol Medical Center. >>>>>> CLICK
SLIDE 13:
as well as the strategic position of the nursing service to have 100%
competent nursing personnel compliant with the required staffing pattern
for various clinical and specialized nursing units of the Bicol Medical
Center by 2028. >>>>>> CLICK
SLIDE 14:
However, due to the fast turnover, the composition of the staff, and the
trained nursing personnel in the area are tough to maintain. This
boundless challenge that the medical cluster must deal with, despite the
>>>>>> CLICK current 210-bed capacity and compliance with >>>>>>
CLICK 115 % standard staffing Pattern. >>>>>> CLICK
SLIDE 15: (STRATEGIC MAP)
To gain professional Maturity and mastery of the Nursing Practice, .
>>>>>> CLICK the workforce of the medical cluster needed to be taught
and guided to be more compassionate, competent, and be more
collaborative. Strengthening the skills and behavioral adaptations is the
top priority for them to be ready and be prepared to attain their personal
& BMC governance goals. >>>>>>CLICK
SLIDE 16
Together, with our VISION >>>>>>CLICK
MISSION >>>>>>CLICK
And CORE VALUES >>>>>>CLICK
SLIDE 17:
The medical cluster works hand-in-hand with other departments toward
the achievement of>>>>>>CLICK CORE & SUPPORT organizational
targets or deliverables. >>>>>>CLICK
SLIDE 18:
THE accomplishments of the medical cluster on the CORE PROCESSES
focusing on the Patients, staff Development, Research & collaborations
>>>>>>CLICK
SLIDE 19:
Patient Care is one of the major roadmaps regularly monitored
>>>>>>CLICK
SLIDE 20:
with its specific objectives set on 85% discharge-Turn Around Time, Zero
targets on Medication Error & 96% Accurate Documentation. >>>>>>
CLICK
SLIDE 21:
The medical cluster intensifies >>>>>> CLICK the health education
whereby head nurses closely coordinate with the different department of
the hospitals and initiates information dissemination to all admitted
patients on pertinent policy and regulations of the hospital regarding the
discharge process, Philhealth enrollment, discharge planning, and clinic
schedules. >>>>>> CLICK
Ward assistant deployment makes sure that all patients bill forwarded to
the billing section for discharge has a complete document requirement,
>>>>>>CLICK
Discharge Tracking makes use of the IHOMIS color coding, helps more in
the monitoring, and lastly >>>>>> CLICK
by adhering to the citizen charter posted for everyone's information and
guidance. >>>>>> CLICK
With these initiatives, we were able to achieve 98.74% Discharge
TAT.>>>>>> CLICK
SLIDE 22:
We have not been able to meet the target of 100% on the medication
process>>>>>> CLICK
SLIDE 23:
However, significant improvement has been noted over the last six
months with a result of 99.71%. >>>>>> CLICK For the reason of the
unmet target, the medical cluster implemented a collective strategy such
as organizing the Medication area, and improvement in the forms being
utilized concerning medication administration. The standard time of
medication administration was reinforced and through extensive
collaboration with the clinical pharmacist, this process improvement was
pilot-tested for three months and was shared with other units of the
hospital. >>>>>> CLICK
SLIDE 24:
100% OF discharged charts have been submitted to the HIMS, however
at least 47% of those charts are returned with 70% attributed to nurse
deficiencies. >>>>>> CLICK
SLIDE 25:
With these results, the assigned nurse on duty ensures the completion of
charts, every shift. The head nurse and/or charge nurse will do the open
and close chart validation to monitor compliance with chart completion.
Staff with deficiencies are noted and subjected to coaching and mentoring
consequently staff with accumulated deficiencies are subjected to an
eclectic approach.>>>>>>CLICK
SLIDE 26 (TRAINING ROADMAP)
Another core roadmap is training. We ensure that the staff shall be
provided with learning & development considering Clinical units are a
threshold of clinical practice. >>>>>> CLICK
SLIDE 27
Conduct of Training needs assessment. >>>>>> CLICK The training
officer assigned to the unit maintains an inventory of training that the staff
has attended. >>>>>> CLICK
SLIDE 28
The staff was able to attend the training conducted within and outside of
BMC such as mandatory, regulatory, advanced competency & competent
respectively. >>>>>> CLICK
SLIDE 29
The unit has its initiative to further strengthen the onboarding of the staff,
the clinical nursing unit works collectively to conduct a clinical orientation
for all new nursing personnel in the clinical areas. >>>>>> CLICK
SLIDE 30:
We value continuous education and self-development, encouraging head
nurses and staff nurses to pursue further studies. Now, we are fortunate
to have with us a head nurse, Emilio Antang Jr. who is on his way to
becoming a doctor after he finishes his dissertation. >>>>>> CLICK
SLIDE 31
To link every staff and foster solidarity and facilitate ease in
communicating important announcements and updates, the nursing staff
of the medical cluster are members of the BMC Nursing Service 139 or
95%% are members. >>>>>> CLICK
SLIDE 32
The Support Processes >>>>>> CLICK
SLIDE 33
We are grateful for the support of the Nursing Service; now we have 110
staff at 115% compliance with the standard staffing pattern. Hopefully,
with the continued hiring for the plantilla position we will address the
deficiency for permanent staff. >>>>>> CLICK
SLIDE 34
The regular Audit conducted by the Patient Safety Team through a
standard checklist is also valuable in ensuring that the staff complies with
set standards. We were able to improve the reporting on sentinel events.
>>>>>> CLICK
SLIDE 35
Medical Cluster was able to achieve an average rating of 86% from
January to June of this year. Continual application of Basic Courtesy
Practices, Patient Advocate as well and intensified health education
proved helpful in the attainment of the target. >>>>>> CLICK
SLIDE 36
Generate additional revenue to ensure the sustainability of current and
future hospital operations, the staff ensures devout utilization and prompt
charging of the medical supplies and procedures. The staff is also allowed
to attend resource management updates and training. >>>>>> CLICK
SLIDE 37
The Bicol Medical Center works towards the digitalization of the processes
of the hospital. The Medical cluster benefits from all these innovations
such as the IHOMIS application where patient records are updated and
readily accessible for charging, viewing of result and request for
medicines and laboratory procedure. On plan are application for Doctor’s
order and Nurse’s module which will make possible more time for Nurses
and Doctor’s to be at the patient bedside where they are most
needed>>>>>> CLICK
SLIDE 38
The organizational objective is being downloaded from the Top
Management down the line and the performance of the staff is being
monitored and evaluated semi-annually through the Individual
Performance Commitment Review. >>>>>> CLICK
SLIDE 39
All the plans, strategies, and monitoring of Unit performances and the
requirements of the standard. are being cascaded by the OSM. >>>>>>
CLICK The Nursing service created a PGS-ISO Team with its specific
duties and functions.
SLIDE 40:
The Medical Cluster is also Unit PGS-ISO Core Group responsible for
cascading to staff
>>>>>> CLICK
SLIDE 41:
TO SUSTAIN THESE GAINS, meeting with the teams and staff is of
valuable activity. >>>>>> CLICK
It is everyone's responsibility to keep updated on the status and activities
of the organization. At all levels of the organization, effective operation
and decision-making depend on accurate information. One effective way
of delivering a message is through meetings.
SLIDE 42:
Each unit of the cluster has its regular meeting, and the Medical Cluster
meets up with the Nursing staff at least once a month, during this time
important topics are discussed, and updates are also provided to the staff.
Aside from the monthly meeting with staff, the institution also schedules a
general meeting at least once a year. >>>>>> CLICK
SLIDE 43:
PGS cascading was given importance. >>>>>> CLICK
SLIDE 44:
The hospital has a Praise committee that is responsible for the awards &
recognition of the performance of the staff as well as the unit. The Medical
cluster recognized the staff's exemplary performance by giving a monthly
recognition aside from the initiative of the Nursing service. >>>>>> CLICK
SLIDE 45:
The Medical Cluster as discussed are venue for Clinical Instructor
Preceptorship as well as Training grounds for nursing student affiliates.
We have two Clinical instructors from Mabini College doing their Clinical
Instructors Preceptorship in the Ward. We also had 283 days of Clinical
exposure to at least 247 students from Nursing Schools doing their
Nursing Affiliation, such as the University of Nueva Caceres, Universidad
de Santa Isabel, CSPC, Naga College Foundation, and the University of
Saint Anthony. >>>>>> CLICK
SLIDE 46:
The need for equipment, facility improvement, training of the staff,
activities of the unit, and PLANS are being laid in the PPMP-WFP. >>>>>>
CLICK
SLIDE 47:
The nursing service highly encourages the staff to continue their
professional career through taking a master's degree.>>>>>> CLICK
SLIDE 48:
The medical ward station welcomed 35 DOH Scholars from DOH
Retained Hospital all over the Philippines to conduct their immersion as a
requirement in palliative care of geriatric patients. >>>>>> CLICK
SLIDE 49:
BREAKTHROUGH RESULTS>>>>>> CLICK
SLIDE 50:
The Medical Ward conducted an improvement on the Medication process
whereby the forms being used such as IV fluid form, Kardex, and
Endorsement sheet were revised as well as Reiteration on Standards in
Medication Protocol paved the way for it >>>>>> CLICK
SLIDE 51:
to be introduced to the entire Nursing Division and is being utilized at
present. Medical Ward came up with a Work Instruction on the conduction
of Health Education. >>>>>> CLICK
SLIDE 52:
Case Analysis were also some of the notable accomplishments of the
Medical Cluster. >>>>>> CLICK
SLIDE 53
Through attendance in the Training of Trainor, some of the Head Nurses
of the Medical Cluster were empowered to develop modules that are being
used in the training and orientation of new staff. >>>>>> CLICK
This was made possible because 11 out of the 18 head nurses of the
medical ward undergone Training of Trainers to become faculty nurses.
>>>>>> CLICK
SLIDE 54-55-56:
Because of the commitment and virtuous performance of the medical
cluster staff, >>>>>> CLICK
a well-deserved promotion from >>>>>> CLICK
Nurse I to Nurse VI was conquered>>>>>> CLICK
SLIDE 57:
The Medical Cluster will continue to provide basic and advanced training
to newly hired and appointed nursing staff through the immersion
program. kills are not only developed but also the confidence and belief in
oneself is further cultivated. With the direction of the specialty center,
Station B or the Neurology Ward will transfer to its new building.
Neurological cases will give way to the development of the specialty
center which is the Lung Care Center. As such, more patients will benefit
from this specialized care that the hospital will offer. Lastly to intensify the
need for highly dependent care to Internal Medicine patients, a plan to
extend the services in the ward is also a dream for the medical cluster.
>>>>>> CLICK
SLIDE 58: MARAMING SALAMAT PO.