central hospitals - department of health...
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Central Hospitals
Progress, Opportunities, Challenges and Way forward
National Annual Review 2073/74
22 September 2017
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Central Hospitalsincluding Academia & Centers
1 Bir Hospital 12 Paropakar Maternity and Women’s Hospital
2 B P Koirala Institute of Health Sciences 13 Tribhuvan University Teaching Hospital
3 Patan Hospital 14 National Trauma Center
4 Karnali Academy of Health Sciences 15 Civil Service Hospital
5 Kanti Children’s Hospital 16 Nepal Police Hospital
6 Manamohan Cardiothoracic Vascular and Transplant Center
17 Birendra Army Hospital
7 Shahid Gangalal National Heart Center 18 Armed Police Force Hospital
8 Shukraraj Tropical and Infectious Disease Hospital
19 Bharatpur Cancer Hospital
9 HOTC Bhaktapur 20 Bhaktapur Cancer Hospital
10 Central Jail Hospital 21 Pokhara Academy of Health Sciences
11 Mental Hospital 22 Netra Jyoti Sangh
Regional/Sub-Regional
Hospitals
Zonal Hospitals
District Hospitals
General Hospitals
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% change in OPD visits by hospitals compared to previous year
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% change in in‐patient admissions by hospitals compared to previous year
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% change in bed occupancy rate by hospitals compared to previous year
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% change in infection rate by hospitals compared to previous year
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% change in hospital death rate by hospitals compared to previous year
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% Beruju clearance by hospitals
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Opportunities Specialized hospitals: Gangalal hospital, Human Organ Transplant Center, Man Mohan cardio‐thoracic centre, Cancer hospitals etcCan collaborate with hospitals for expansion of specialized services in all Provinces Can develop as training sites to produce quality human resources
Collaboration with other expertise:For improving quality services e.g. Bio‐medical engineering
Self‐sufficient healthcare waste managementRevenue from waste is sufficient for overall waste management
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Challenges: Infrastructure Inadequate space and land in most hospitalsNAMS, HOTC, PAHSNewer buildings are required
Old buildings needing repair and maintenance (including toilets)
Retrofitting:Causing service disruption
Hospital bed availability vs. sanctioned bedsDifficult to plan manpower and patient care
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Challenges: Human ResourcesRapid turnover of hospital chief
Hospital bed availability vs. human resources (No O & M
survey for many years)
Irrational allocation of Human Resources in existing
organogram
Management of Govt. staff vs. Hospital Development
Committee staff vs. Academic Staff
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Challenges: Human Resources
Salary discrepancies among public hospitals a major
cause for staff turnover
Specialized hospitals require sanctioned post for
specialists
(e.g.. Mental, Kanti Hospital)
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ChallengesOTHER ISSUES
Pharmacy
Difficult to manage as prescriptions are in trade name,
Procurement process difficult
Increasing demand for rehabilitation services
Increasing burden of Non‐Communicable Diseases (e.g. Mental health)
Sickle‐cell Anemia vs. Thalassemia
Identification of bipanna nagarik still not clear
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Challenges
Semi‐autonomous OR Fully autonomous OR Fully Government
run hospitalsDiscrepancies in HR management
Equipments
Old needing repair and maintenance
Inadequate budget for Procurement of new ones
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Way forward Infrastructure development
Utilization of nearby facilities and other govt. health institutions,
Expansion of service sites
Integrated approach
Maximizing the use of existing physical infrastructure
• e.g. Land pooling and construction of multi‐storied building for Human
Organ Transplant Center, Bhaktapur Hospital and Cancer Hospital
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Way forward
Human resource
O & M Survey on the basis of hospital functionality & national standards
Increase number of scholarship schemes and rational utilization of health
professionals
Develop performance based contracts for health professionals (min. 2
years)
Develop uniform facilities and incentives for HR throughout all public
facilities
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Way forward Develop the concept of umbrella university
• for Specialized/ Super Specialized Medical Sciences with multiple
faculties/specialization affiliating existing super specialized public hospitals
One year fellowship course on super specialized medical studies like kidney,
heart etc
Curative Service Division to initiate discussions for resolving issues
regarding Hospital Development staff and academic staff
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Way forward
Implementation of strict generic prescriptions by
MoH/NMC in govt. institutions for better pharmacy
management
Strengthen public health wing at all hospitals
Mass public awareness/motivational campaigns on
human organ transplantation
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Way forward
Promote hospital based research
Budget allocation for initiation of waste management
Recruitment of bio‐medical engineers
Promote optimum use of trade unions in hospital
management
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Thank you