Peter Sondergard said that information is
the oil of the 21st century, and analytics is the combustion
engine. The goal is to turn data into
information, and to turn information into insight. HEALTH INFORMATION MANAGEMENT SECTION (HIM). The Health Information Management Section, is
involved in:- the creation and maintenance of quality standardized health
records for every patient treated; and
- the improvement of accessibility of
the health record through digitization and digital transformation; in order for
- data collected to be maximally utilized not only for health facility
statistical reports, but also for research, continuous quality improvement and
policy development.
The
organizational structure involves one supervising administrative officer
overseeing five units, namely:- the outpatient health records management
unit,
- the ER and admitting health records management unit,
- the
inpatient health records management unit,
- the health data analytics and
- the health records processing and releasing unit.
The HIM has 98
employees: 59 regular employees, 26 job order employees and 13 institutional
workers, 70% female, 77% (76/98) are individuals aged 40 years and below with
40% (40/98) with 6 to 32 years of service under their belt. MEDICAL SOCIAL SERVICES SECTION.
On the other
hand, the Medical Social Services aims to be a proactive partner of patients
and their families in building self-reliance, free from social and physical
illnesses. Their mandate is based on
Republic Act 11223, the Universal Health Care Act stating evaluation as a
function of the medical social workers in the health facility. Administrative Order 44 series of 2021
provides guidelines in determining eligibility for social care, medical and
financial assistance and point of service.
Republic Act 11463, the Malasakit Center Act provides financial risk
protection. The
organizational structure involves one social welfare officer IV with four
units, namely:- the Special Programs Unit;
- the Eligibility and Assessment
Unit;
- the Case Management Unit, divided into general services and specialty
services; and
- the performance monitoring, research and technology development
unit.
The MSS has 99
employees: 84 social welfare officers, 14 social welfare assistants and 1
administrative aide; 87% female; 92% (92/99) are individuals aged 40 years old
and below; with 17% (17/99) having served in VSMMC for more than 6 years. VSMMC RESEARCH INSTITUTE. Although the VSMMC Research Institute was
originally created in 2021 by Hospital Order No. 2021-182, the VRI has become an independent
institute directly reporting to the Office of the Medical Center chief
effective last May 1, 2024 through HO No. 2024-62, dated April 22, 2024. This
is aligned with the DOH mandate for research and the medium-term goal of VSMMC
for Grow Deeper Go Higher 2024 and beyond. Currently the VRI
has 7 core staff under one medical specialist IV with three major units (patterned after the UP Manila Research Grants Administration Office) namely, - the Grant Application and Protocol
Development Unit (GAPDU) tasked with the overall approval of researches
submitted;
- the Fund Administration Management Unit (FAMU) designed for all
regulatory, fund, and fiduciary matters; while
- the Research Implementation
Support Unit (RISU) is tasked in
assisting researchers in all matters concerning the implementation of the
research.
The age of the staff ranges
from 25 to 58 years old; three males to 4 females; two of them are married, the
rest are still single. Aside from the
core group, the VRI was able to reorganize the VSMMC Technical Review Board
with 25 trained members. They help
technically review research proposals submitted by our researchers: our
residents and fellows in training, our non-physician employees, as well as
partners and stakeholders willing to collaborate on research projects and
clinical trials. The VRI also organized thirty five (35) department research
officers appointed by their respective
departments to be in charge of monitoring research activities of their
departments and offices. SCORECARD TARGETS AND RESULTS
For the HIM.
Of the five main
targets of the HIM, information capital on electronic health records have been
implemented in special clinics like the Women and Child Protection Center,
Child Survival, Renal and Lithotripsy as well as pilot runs in the ER thanks to
our Family Medicine ER team. For
training, 100% of the HIM staff have attended the basic health information
management (HIM) seminar and the medical certification of the causes of death.
Almost half of the staff have attended the ICD-10 coding seminar.
For the MSS.
To establish
specialty centers with advanced comprehensive services and expanding training
for healthcare professionals, the MSS has sent 12 medical social workers for
trauma-informed care (TIC); 9 medical social workers for 4Rs (Recognizing,
Reporting, Recording and Referring) for Women and Children Protection; 9
functional specialty social workers for advanced care and 1 functional
specialty social worker for basic care.
The MSS was also
able to send 3 medical social workers for cross training for comprehensive
exposure and training relative to case management of specialty areas.
As its
contribution to building resilient facilities, starting March 13, 2024 the MSS
totally banned the single-use plastics in all offices through an office policy.
For provision of
quality healthcare through improved service delivery, 99.99% of all admitted
patients under basic or ward accommodation were assessed for eligibility within
24 hours from admission. The MSS also
implemented the use of psychosocial assessment tool for pediatric and geriatric
patients, piloted to 44 elderly and 6 pediatric cases last May 2024 and fully
implemented by October 16, 2024 under seven departments and to ONCOLOGY and
transition clinic cases. 17 medical
social workers who were hired in 2022 participated in a case presentation
conference as part of their training.
For case management, the MSS is working on
operational guidelines in the conduct of ward visits, multi-disciplinary case
and family conference, grief work, kangaroo mother care case management, among
others. With the breakthrough of
discharging patients at the Center for Behavioral Sciences starting January 10,
2024, 80% of the 191 patients were successfully monitored post-discharge. Beginning July 2024, this was replicated by
other specialty social workers. Starting April 2024, at the emergency room, readmitted
patients within 15 days from discharge with social complications are managed by
the EAU social workers.
Utilizing technology to improve service delivery,
the MSS utilized an online assessment tool for inpatients under basic or ward
accommodation. This tool is processed
for privacy impact assessment. Starting
March 1, 2024, an inpatient general registry for ED, OB and elective clusters
provides real time contribution to the
digitization program.
To achieve core impact of financial risk
protection, 8,245 (102% of target) eligible patients were enrolled to POS; 100%
or all 20,852-hospital bill in excess of PHIC were charged to MAIFIP, CAF or
Quantified Free Service. To add
corporate service responsibility, the MSS conducted two dishwashing soap making
activities last June 18 and October 1, participated by 28 ONCO and 100 ORTHO
patients and their significant others.
This year, 499 ward classes were conducted,
participated by 10, 159 patients and their significant others. The MSS aims to continue strengthening social
service programs and services and are grateful for the recognition of its
efforts through the following awards:
● Best Office Award during PRAISE 2024,
● CSC Presidential Lingkod Bayan Award
during PRAISE 2024,
● Best Practice Award from HFDB in
celebration of World Social Work Day 2024
● Gawad Parangal Award for the Health of
Office Ms Mergin D Acido during the celebration of the Filipino Social Work Day
2024
● Cancer Assistance Fund Excellence in
Fiscal Management Award during the CSPMAP and CAD Access Site Forum
For the VRI. Despite its being a relatively young office
with overwhelming research submissions and recent transformations, the VRI
implemented reforms to commit to a 14-working day turnaround time for technical
review of research proposals and case reports.
The VRI cooperates with 25 research technical reviewers of the VSMMC
Technical Review Board headed by Dr
Reden Patalinjug to ensure timely release of reviews. On the average, technical reviews are
released in an average of 10 working days for 437 research proposals and 215
case reports; totaling 652 protocols from January 2024 to November 2024.
The VRI has recorded eighty (80) research
presentations to local and international conferences as of November 30, 2024;
47 research papers (36 local and 11 international presentations); 33 case
reports (16 local and 17 international presentations). 17 out of 47 research
papers garnered recognition and awards; while 6 out of 33 case report
presentations garnered the same; totaling 23 recognition and awards out of 80
presented research papers and case reports.
Anent to providing an enabling environment for
research, the VRI performed research consultations for 85 protocol versions and
statistical services for 35 protocol revisions.
With all these interventions, the VRI was able to recommend six (6)
researches (5 of which were completed in 2024; while the other 1 was last 2023)
to the concerned departments for policy adoption last October 2024. We are
still looking forward to the feedback from these departments regarding our
recommendations, and to conduct a policy brief writing workshop to assist in
policy development.
For the second
target “at least twenty (20) researches presented into a local/international
research forum or conference”, the VRI has recorded 80 presentations - a 400%
increase from the baseline. We
appreciate the passionate work of our department research officers for
encouraging dissemination of completed research papers.
For the third
target “at least ten (10) researches published in a peer-reviewed journal”, the
VRI has recorded 6 publications as of November 30, 2024.
The VRI was able
to release 437 technical review results for research proposals and 215 review
results for case reports, totaling 652 protocols technically reviewed and
endorsed to the VSMMC Research Ethics Committee from January 2024 to November
30, 2024.
OTHER SIGNIFICANT ACCOMPLISHMENTS
For the HIM. The HIM prides itself in its struggles
with close monitoring and timely reporting of patient census and hospital
statistics; improvement in issuance of medical certificates; online requisition
of patient health records; paperless certification of no pending charts for
completion and 2023 Compendium of Hospital Statistics.
Monitoring the patient census at the OPD,
as well as records retrieval and medical certificate issuances, trends can be
helpful to formulating programs and plans.
Consistently monitoring ER consults and
admissions help in logistics preparation and feedbacking to the ER healthcare
team. Establishing proper record-keeping at
SugBUCAS in Carcar and Bantayan also provides us with real time feedback on our
performance and the impact of the project. Serving 4,360 patients at SugBUCAS
Bantayan from April 2024 to October 2024, we identify that most common
admissions are for IM and Pediatric consultations. Likewise in SugBUCAS Carcar, we see that
out of the 15,999 admissions, majority are from IM, General Surgery, Pediatrics
and OBGYN.
HIM also closely monitors the turnaround
time for issuance of death certificates, medical certificates, and livebirth
certificates. There is a breakthrough in the increasing
number of medical certificates released and the decreasing turnaround time.
With digital transformation, one of the
breakthroughs for 2024 is the implementation of the online requisition of
medical documents which allow patients from geographically distant areas to
request their medical documents in advance.
To improve chart completion, the HIM
heavily relies on the department chairs and training officers to oversee
resident physicians. The HIM provides
feedback through paperless communication and clearances sent to the official
department email addresses.
With the importance of hospital
statistics in research, patient care, decision-making and administrative
control, the HIM launches the 2023 Compendium of Hospital Statistics as a
reference to data that can be useful for hospital management.
The best practices of the Medical Social
Service can be summarized into 4 points: Case Management Guidelines,
Post-Discharge Follow up within 7 days from discharge, monitoring and case
management of readmission within 15 days with social complications and conduct
of health education and wellness campaign
For the MSS. To patients, the Malasakit Center
provided improved access to healthcare, reduced financial burden, timely
medical intervention and improved patient satisfaction.
Services provided are in line with DOH
standards despite providing services distant from VSMMC such as the telesocial
services at SugBUCAS Carcar.
The General Inpatient Registry is the MSS
contribution to electronic health records mandate of the DOH. Considering that patients needing special
care also need case management, MSS provides post-discharge care services.
Initially piloted with the Center for
Behavioral Sciences, the number of patients provided post-discharge services
was increased to 1,933 patients.
We also take pride in consistently
meeting the QOP targets that we set, with all patients evaluated, managed and
provided with social work intervention. Streamlining process flows also make work
easier, such as utilization of standard forms and coordination for
pre-admission services.
In order to make sure that the MSS staff
are competent to deal with the difficult cases they face, training involves
case conferences with the training core.
Considering that the social determinants
of health are usually not medically-related, the MSS ventures into providing
two activities for health education and livelihood training for our patients
and their significant others. Not limiting these activities to the
hospital, the MSS partnered with community and school-based campaign for young
adolescents regarding relevant health topics.
In order to boost morale and give credit
where it is due, the MSS also recognizes best employee of the month based on
set criteria and performance measures. For the VRI. To summarize the significant
accomplishments and best practices of the VRI, it would be the following:- organizing and training the technical
reviewers of the VSMMC Research Technical Review Board (TRB) to help the VRI
core staff to achieve 14-working day turnaround time of technical reviews.
- The second would be the appointment of
the department research officers who are our coordinators to initiate, monitor
and report research activities within the different clinical departments and
specialty centers.
- Protected time with supervision of their
research mentors is what our resident physician trainees need to allow them to
focus on their research requirements.
- The VRI provides research consultation
and statistical services to assist researchers in improving their research
proposals, inevitably changing and creating a culture of research.
The VRI is one of the most collaborative
of offices, considering that with only 7 core staff, it is highly dependent on
the inputs of its research technical reviewers and the monitoring and reporting
of its department research officers. The VRI was able
to conduct its own research podium presentation, pitch to policy contest, case
report poster contest, and bioethics poster contests during the VSMMC Medicine
Week last September 2024. Furthermore, the
VRI also co-hosted, with the help of the Office of Strategy Management, with
the Nutrition Center of the Philippines the Nutrition and Multi-Morbidity
Symposium last October 2024, at the Marco Polo Plaza, Cebu.
The VRI identifies its provision of
protected time for research as one of its best practices. This activity
provides an avenue and opportunity for researchers to work solely on their
research every Wednesday, under the authority of Hospital Personnel Order.”
The VRI further identifies the research
consultation and statistical services provisions as one of its best practices.
Alongside this, the VRI also recognizes the efforts of the best-performing
Technical Review Board Members on a quarterly basis. Ultimately, the VRI
continues to inculcate the celebration of wins (may it be big or small) through
its salo-salo culture.
For the HIM. Teamwork makes the dream work. The most successful of all health programs is
the one that is inclusive and involves as many stakeholders as possible. This is true in the implementation of the
electronic health records with the need for interdepartmental collaborations
and communication, as well as training and continuing education.
For the MSS. It is also important to remain humble and to
accept that we are still a work in progress.
We accept both praise and complaints from our patients and stakeholders
in order to identify gaps where we can continue to improve.
For the VRI. We learn from past experiences. Knowing that research, the word itself, can
strike fear in any Sottonian, we hope to provide an enabling environment for
research by finding champions and enthusiasts, by providing ample opportunity
and time to engage in research activities, and by communicating with one
another how we can help researchers find their way.
TRANSFORMATION AGENDA
For the HIM. Digital transformation is the process
of using digital technologies like the hospital information system and
electronic health records, to change how the hospital operates and engages with
patients and other stakeholders. There
is a lot of work waiting for us to accomplish digital archiving of all
paper-based documents, logbooks, imaging and laboratory results, in order to
fully implement paperless electronic health records for the whole hospital.
For the MSS.
On the other hand, disruptive
innovation is the process of making our services more accessible,
affordable, and simpler for a wider audience, like tele-social services,
post-discharge monitoring and assigning our social workers where the patients
are, even to the point of utilizing social media and technology to reach out to
our indigent and financially incapacitated patients.
For the VRI. Transformational
change is a type of change that occurs when an organization makes a fundamental
change in how they operate. It's often
triggered by changes in an organization's environment. This type of change can
be challenging, but it can also lead to significant improvements in
performance. The VSMMC Research
Institute aims to provide an enabling environment for research, for a
transformational change in research culture. In CONCLUSION, Information may be the oil of the 21st
century, and analytics the combustion engine, but it is through digital
transformation and disruptive innovation that we effect transformational
change.
