Lung Center of the Philippines

Annual ReportAnnual ReportCY 2012CY 2012

HIGHLIGHTS OF PERFORMANCE

CY 2012

LUNG CENTER AWARD

The Lung Center of the Philippines through the Smoking CessationProgram won and was awarded the “RED ORCHID AWARD” on May 29,2012 at the Philippine Trade and Training Center. This is a national searchfor a 100% Smoke Free Environment. This was a program adopted/initiatedby Department of Health.

PEDIATRIC PULMONARY

The Center being a recipient of FY 2011 Disbursement AccelerationProgram (DAP) in the amount of P105, 000,000.00 for purchase of medicalequipment for Pediatric Pulmonary Program and the Bio-regenerativeTechnology Program in which ninety percent (90%) has been released hascontributed much to said program. The Pedia Out-patient and EmergencyRoom is already in full operation. Pedia Ward of 14 bed capacity has 328admissions while the service ward of 6 bed capacity has 74 patientsadmission.

HOSPICE AND PALLIATIVE CARE

Hospice care is a medically directed “end of life” care for the terminallyinjured patients. It is a “model quality”, loving and compassionate care evergiven to patients by highly professional and spiritually oriented workers.Close to 70% - 75% of admitted patients at the Lung Center of thePhilippines are cancer cases and an additional percentage of terminally illCOPD and PTB cases will also die in six (6) months’ time or less. The LCPhospice shall cater to all terminally ill and injured patients from NKTI,PHCA, EAMC, Philippine Children Medical Center, likewise, will acceptreferrals from other institutions. The hospice and palliative care section orunit will also accept rotation of hospice subspecialty fellows from familymedicine training hospitals mainly the UP-PGH. The SM Foundation hasdonated the hospice equipment and fixtures necessary for the hospicefacility.

RADIOTHERAPY SECTION

On March 2011, the Radiotherapy Section opens its services to the publicand can be seen with sharp acceleration in the number of services andpatients.

The Section has contributed a remarkable increase in the number ofpatients by 40% from 2011 to 2012. The newly acquired Linear AcceleratorMachine has greatly contributed to patients with lung cancer on theradiation therapy on the following procedures/treatment: 2D, 3D,Conformal Treatments and the Intensity Modulated Radiation Therapy(IMRT) with Simulation planning.

STEM CELL

The Molecular Diagnostics and Cellular Therapeutics Laboratory (StemCell Unit) offers a promising area of hope for the amelioration of manydiseases for which there has been no cure and minimal hope of prevention.The Stem Cell provides quality, autologous dendritic vaccines and otherautologous adult stem cell-based therapies. For active immunotherapy,dendritic cell are used to trigger the immune response against diseasesincluding cancer. For regenerative purposes, autologous adult stem cellsare administered to mediate repair of affected tissues. For the periodJanuary 1 to December 21, 2012, the Molecular Diagnostics and CellularTherapeutics Laboratory had a total of 32 patients. Out of the 32 patients,23 of which availed the immune cell therapy, 6 of which availed theCirculating Tumor cell analysis for patients, the regenerative therapy and 1patient the Tumor Collection and Culture.

LCP MAJOR PROGRAMS AND PROJECTS

1. CRITICAL AIRWAY & INTERVENTIONAL PULMONARY UNIT - the Critical Airway Management and Training, will make significant improvement in the areas of patient safety, team communication, equipment availability and response efficiency. It will also offer training to other specialties to be more competent in handling patients with critical and difficult airways. Airway management is a procedure and essential skill necessary not only for the anaesthesiologist but to all physicians. Optimal resuscitative treatment of medical and trauma patients often revolves around timely and effective airway interventions that can be challenging in the acute setting, especially in critical patients.

Objectives / Goals :1. To ensure safety of all patients with critical/difficult airway by the application of advanced

knowledge, skill, techniques and devices.2. To educate and update Clinicians of the Lung Center of the Philippines and other

specialties from all other hospitals with the current knowledge on airway management and the use of advanced airway devices.

3. To establish the Lung Center of the Philippines Difficult Airway Algorithm.4. To conduct research activities pertaining or related to critical / difficult airway

management.5. To establish links with different centers / hospitals in the entire Philippines for ready

access and consult of their own critical / difficult airway problems.6. To conduct surveys and gather factual information related to critical/difficult airway

cases. Thus, will establish The Philippine Critical/Difficult Airway Registry.7. To collaborate with International Airway Societies for the advancement of our knowledge

and skills.8. To establish The Lung Center of the Philippines Critical / Difficult Airway website.

2. THE ESOPHAGUS & SWALLOWING CENTER - will be in the forefront in the care

and management of patients with esophageal diseases and swallowing disorders.

Objectives :1. To provide excellent service in the diagnostic evaluation and corresponding

management of patients with esophageal diseases and swallowing disorders.2. To engage in the progressive application of appropriate and most recent surgical

treatment modalities specially in the field of minimally invasive esophageal surgery and offer better service to our patients.

3. To provide a venue for the training and development of thoracic surgeons/specialists dedicated in the diagnosis and treatment of patients with esophageal disease and/orswallowing disorders.

4. To record and evaluate data gathered from the diagnosis, medical and surgical treatmentof patients with esophageal disease as well as swallowing disorders for the purpose of research and development of new or refinement of current management.

5. To share our experiences and establish collaborative activities with local and international centers with the same interest in order to ensure our patients’ safety and anupdated management of esophageal disease and swallowing disorders.

3. COMPREHENSIVE ASTHMA CENTER - this is a center that is at the forefront of asthma care and is committed to the comprehensive management of patients with asthma of all ages, races, religious beliefs, educational, and socio-economic levels.

Mission :1. To enable asthma patients to breathe and live normal lives.

Objectives / Goals :1. To reduce and prevent asthma symptoms and acute asthma attacks that require

emergency room visits and hospitalizations2. To provide patient and family education about asthma3. To provide 24-hours-a-day emergency access to asthma treatment4. To return stabilized patients to the primary health care providers5. To provide additional access to education and care with our asthma van6. To provide professional (for health care providers) and community education7. To network with other agencies in providing access to asthma care

Services available :1. Ambulatory Asthma Control Clinic - is where patients and their families can have

access to asthma education, diagnosis, evaluation and treatment.2. Urgent Care Asthma Unit - a 24-hour-a-day emergency access to asthma treatment

for patients with acute asthma who require urgent and emergency care and hospitalization.

4. AVIATION MARITIME & TRAVEL MEDICINE

Objectives/Goals :1. To provide medical assessment and fitness evaluation for individuals or groups for flight,

diving and travel.2. To establish a specialty referral-based unit that deals with medical problems related to

flight, diving and travel.

Action Plans :1. Finalize the Program and seek formal approval.2. Generate resources and funds for personnel training, equipment, facilities.3. Finalize personnel line-up4. Commence personnel training5. Prepare materials and complete equipment and facilities6. Create vital linkages with relevant sectors7. Work for certification8. Launch and commence program9. Conduct promotional/marketing activities10. Perform periodic evaluation

5. PAIN MANAGEMENT AND PALLIATIVE CARE UNIT - is a hybrid multidisciplinarypain clinic and a tertiary palliative care unit. Multidisciplinary Pain Clinic is a health care delivery facility manned by physicians of diverse specialties and health care providers who specialize in the diagnosis and management of patients with chronic pain.

Objectives/Goals :1. To evaluate, diagnose, and treat chronic pain.2. To treat patients in a humane, compassionate and ethical manner.3. To assist in goal setting and pacing4. To engage in research5. To develop the staff to be responsive to the needs of the patients in terms of pain

management and related aspects of patient’s care.

6. DEPARTMENT OF THORACIC ONCOLOGY

Objectives / Goals:1. To provide service in the diagnosis, management, treatment and follow-up care of

individuals with intrathoracic malignancies.2. To develop specialist through the ongoing acquisition of knowledge regarding

established and evolving biomedical, clinical and similar sciences, with the subsequent application of that knowledge in a professional, compassionate, multidisciplinary and effective form of treatment to persons with underlying intrathoracic oncologic problems.

Vision :1. To establish a world class center for training specialist in intrathoracic malignancies.2. To be a repository site for tumor specimens.3. Center for research for intrathoracic malignancies.4. To be a member of an international referral center specializing in intrathoracic

malignancies.

Summary of Accredited Physicians

Visiting - 387

Referral - 80

Plantilla - 46

Fellows in-training - 30

537

SERVICES OFFERED

Outpatient Department

- Emergency Room Services

- General OPD Clinics

- Health and Fitness

- Pre-flight Assessment

- Asthma Clinic

- COPD Support Group

- Smoking Cessation

- Specialty Clinics

- TB

- Lakas Baga Club

- Asthma Club

- COPD

- Outpatient Thoracic Surgery

- Pain Clinic

- Lung Transplant Program

- Ambulance Services

Public Health and Domiciliary Unit

- Cancer Support Group

- Directly Observed Therapy for TB (DOTS)

- Samahan ng Lusog Baga (Support Group)

- Lung Cancer Early Detection Program

- TB in Children

- MDRTB Control Program

- TB Control Program

- A (H1N1) Swineflu

- Infectious Disease Awareness Program

- Avian/Birdflu

Radiology Department

- Diagnostic

- CT Scan

- Interventional Radiograpy (Biopsy, Aspiration, etc.)

- C-Arm Fluoroscopy

- Ultrasonography, 2-D echocradiography and Doppler Studies

- Digital Radiography

- Therapeutic (Radiotherapy)

- Linear Accelerator

- Brachytherapy

- Simulator

- Radiation Oncology Services

Pulmonary Medicine Department

- Section of Respiratory Services

- Aerosol Therapy

- Arterial Blood Gas (ABG)

- Electrocardiography (ECG)

- Fiberoptic Bronchoscopy (FOB)

- Mechanical Ventilation

- Oxygen Therapy

- Polysomnography (Sleeplab)

- Pulmonary Function Test (PFT)

- Pulse Oximetry

- Stress Test

- Sputum Induction

- Respicartory Care Institute (RCI)

- Bronchoscopy

- Intensive Care Unit

- Intermediate Care Unit

- Isolations Unit

- Cardiology Services

- Thoracic Oncology Services

- Pulmonary Rehabilitation (PT)

- Musco-Skeletal Pain Management

- Pre and Post Operative Rehabilitation

- Orthopedic Rehabilitation

- Geriatric Rehabilitation

- Chest Physiotherapy

- Electrical Muscle Stimulation

- Hot and Cold Pack Modalities

- Infrared Diathermy Manual Therapy

- Muscle and Gait Retraining

- Paraffin Wax bath

- Transcutaneous Electrical Nerve Stimulation (ENS)

- Therapeutic Exercises

- Ulrasound Diatherm - Weight Reduction Exercises

Pathology / Laboratory Department

- Blood Banking

- Clinical Chemistry

- Clinical Microscopy

- Cytology

- Hematology

- Immunology

- Immunopathology

- Microbiology

- Surgical Pathology

- Immunohistochemistry

- TB Laboratory

- National Reference Laboratory (NRL)

- Stem Cell Program

Thoracic Surgery & Anesthesia Department

- Ambulatory / Outpatient Surgery Services

- Esophageal Service

- Thoracic Endoscopy

- Thoracic Surgical Oncology

- End-stage Diseases

- Operating Room Theater

- Pain Management

- Recovery Room

- Surgical Intensive care units

- Post Anesthesia care unit

Hospital Support Services

1. Pharmacy Division

2. Central Supply and Services

3. Personnel Division

4. Patient Business Division

5. Procurement, Property & Supplies Division/Material Management Division

6. General Services Division (Housekeeping, Communication, Motorpool)

7. InformationTechnology Services Section

8. Budget & Accounting Division

9. Social Service

Lung Center of the Philippines

Annual Report 2012

Fiscal Year 2010 2011 2012

Total Bed Capacity 250 258 258

Total Admissions 6,062 6,067 6,275

Total Discharges 6,048 6,069 6,301

Total Outpatients 63,162 54,227 56,599

Occupancy Rate 65% 62% 61%

Statistical Data Admissions VS Discharges

Admissions Discharges

2010 6062 6048

2011 6067 6069

2012 6278 6338

2010 2011 20125900

5950

6000

6050

6100

6150

6200

6250

6300

6350

6400

Statistics : Admissions vs Discharges

Admissions

Discharges

Total Number of Procedures In-patient vs Out-patient 2012

Sections In-patient Out-patient

Clinical Chemistry 34,454 14,729Hematology 34,192 18,801Clinical Microscopy 2,868 1,384Immunology 1,427 739Blood Bank 8,049 17,518Microbiology 23,836 29,814Histopath 3,838 2,910Total 108,664 85,895Total No. Of Patients 194,559

Chemistry Hematology CM Immunology Blood Bank Microbiology Histopath

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

Comparative Procedures of Inpatient vs Outpatient 2012

In-patient

Out-patient

COMPARATIVE ANNUAL WORKLOAD REPORT

Laboratory Services

Clinical and Anatomic PAY SERVICE QFS Total

CY 2011 176,319 86,880 33,557 296,756

CY 2012 185,468 97,470 34,787 317,725

Pay Service QFS

0

20,000

40,000

60,000

80,000

100,000

120,000

140,000

160,000

180,000

200,000

Comparative Chart of Workload

2011

2012

RADIOLOGY DEPARTMENT

Procedures:

− A 1.72% decrease in the number of Diagnostic Radiography procedures / patients from 2011 (41,604) to 2012 (40,888).

− A 5.1% increase in the number of Ultrasound procedures / patients from 2011 (3,221) to 2012 (3,397).

− An 18.48% increase in the number of CT Scan procedures / patients from 2011 (2,629) to 2012 (3,225).

− A 40% increase in the number of Radiotherapy procedures / patients from 2011 (8,410) to 2012 (14,125)

− All procedures were dominated by pay patients by 3:1

Total Number of Procedures In-Patient vs Out-Patient 2012

Procedures/Services In-Patient Out-Patient

Diagnostics 10,207 30,681

Ultrasound 1,938 1,523

CT-Scan 975 2,250

Radiotherapy 376 15,882

Total 13,496 50,336

Over-all Total 63,832

Diagnostics Ultrasound CT-Scan Radiotherapy0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

Procedures Inpatient vs Outpatient 2012

In-Patient

Out-Patient

DEPARTMENT OF PULMONARY MEDICINE

Total Number of Procedures / Admissions

2011 2012

Section of Respiratory Services 99,593 94,289

Physical Therapy 6,358 7,791

Medical Intensive Care Unit 306 288

Intermediate Care Unit 67 17

Sta. Therese's Isolation Unit 155 120

Number of Fellows in Training 18 17

OUT-PATIENT DEPARTMENT

10 Leading causes of OPD Consultations

Causes No. of Cases

1 PTB 5,183

2 Bronchiectasis 2,337

3 COPD 1,730

4 New Growth 716

5 Bronchial Asthma 650

6 CAP 553

7 Pleural Effusion 497

8 URTI 157

9 MDRTB 135

10 Destroyed Lung 90

PTBBronchiectasis

COPDNew Growth

Bronchial AsthmaCAP

Pleural EffusionURTI

MDRTBDestroyed Lung

0

1,000

2,000

3,000

4,000

5,000

6,000

Chart Report of OPD Consultation

Total number of OPD Consultations 2010-2012Patients

2010 631622011 611572012 64035

59500

60000

60500

61000

61500

62000

62500

63000

63500

64000

64500

Total Number of OPD Consultations 2010-2012

Patients

2010

2010 2011 2012

Department of Surgery and Anesthesia

Report of OR Procedures

Procedures In-patient Out-Patient Total

Major Thoracic Surgery 387 387

Major General Surgery 244 6 250

Minor Thoracic Surgery 335 66 401

Minor General Surgery 326 131 457Bronchoscopy 320 125 445Rigid Bronchoscopy 24 1 25Gastroscopy 35 11 46Laryngoscopy 2 2Colonoscopy 15 8 23Tracheoscopy 1 1Proctosigmoidoscopy 9 4 13

Total 1,698 352 2,050

0

100

200

300

400

500OR Procedures Inpatient vs Outpatient

In-patient

Out-Patient

Pedia UnitTotal Number of Admissions

Pay Charity

2011 369 40

2012 328 74

2011 20120

50

100

150

200

250

300

350

400

Total Admissions of Pedia Unit

Pay

Charity

Pedia UnitTotal Number of Pediatric OPD Consultation

Patients

2011 10792012 1996

2011 20120

500

1000

1500

2000

2500

Comparative Number of Pedia Consultations

Patients

NURSING DEPARTMENT

A. Administrative

• Implemented the RN Heals Program of the Department of Health with 50 candidates who were graduates of the Post Graduate Course in Pulmonary Nursing.

• Implemented the wearing of white uniform among nurses.

• Launched the “Best Ward Award” based on Quality Assurance/Nursing Audit results.

B. Training/Research

• Basic IVT Program - 20 conduction

• Pulmonary Nursing Program – 6 conduction

• Critical Care Training Program – 7 conduction

• IVT – Update – 4 conduction

• Accreditation of Lung Center of the Philippines Nursing as Provider for NCP-Pulmonary Nursing Levels 3,4, and 5

• Sent Staff nursesto PCMC for Pediatric Intensive Care for the LCP-PICU opening

• Research Work – 10 complete Documents (Book Bind)

Philhealth : Total Number of Claims filed

2010 2011 2012

Pay 3038 2958 3098

Service 734 678 685

2010 2011 20120

500

1000

1500

2000

2500

3000

3500

Philhealth Total Number of Claims filed

Pay

Service

FINANCIAL REPORT

Fiscal Year 2010 2011 2012

Gross Hospital Income 453,701,145.45 411,062,237.16 541,505,017.00

Operating Budget 578,160,000.00 590,100,000.00 644,427,000.00

Quantified Free Service 97,739,489.24 86,548,590.26 86,281,054.00

Total Expenses 512,959,005.74 481,614,673.25 633,992,200.00

Government Subsidy 157,560,000.00 157,560,000.00 333,308,248.00

Net Income 562,650.97 459,973.65 154,540,011.00

2010 2011 20120.00

100,000,000.00

200,000,000.00

300,000,000.00

400,000,000.00

500,000,000.00

600,000,000.00

700,000,000.00

Comparative Financial Report 2010, 2011,2012

Operating Budget

Total Expenses

Government Subsidy

Net Income