CPAHS (HIM, MSS) AND RESEARCH INSTITUTE
Annual Performance Management Review 2024
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.
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.
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.
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.
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.
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.
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:
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.
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.
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.
LEARNING AND REFLECTIONS
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.
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 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.
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