tagudin presentation anna input scenario
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BACKGROUNDER
Macro Environment Scan • Location: • Ilocos Sur
• (bounded on the west by the South China Sea)
• Industry:• Agricultural• Commercial
• Health Services• Ilocos Sur District Hospital• Pacencia Gonzales Memorial Hospital• Rural Health Clinic ( Tagudin)
General Location
The boundaries of Tagudin
Terrain of Tagudin
Welcome arch
Tagudin as gateway to Ilocos Sur from La Union; the church and public market
Some of the schools
The oldest sundials in the Philippines are in Tagudin.
Location of Tagudin General Hospital
Micro Environment Scan:• The Southern Ilocos Sur District Hospital is a level 2 primary
hospital with: 1000 square meters corner lot 50 bed capacity 1st floor - administrative offices, Laboratory, Radiology,
ER, OPD consultation, Pharmacy, • The Rehabilitation center, Billing and Cashier. 2nd floor houses the DR, LR, OR, LR, Nursery complex. 3rd floor are the patients rooms, where they
only have 1 private room. 4th floor is their dietary service and central supply room. •
Services: In-patient services Out-patient Services Surgical procedure Health programs Diagnostic procedures Emergency services Operative Services Dental services Intensive care serviceWorkforce: Doctors, nurses, midwives, administrative support, dentists, ancillary services staff
2-3 nurses are on duty per shift and 1-2 medical doctors are on duty.
• Accreditation: DOH and Philhealth
• Average daily census admitted patients:56
• Bed Occupancy Rate:112.2%
• Total Admissions: 8,557
• Total Discharges: 8,560
• Authorized Bed Capacity: 50
• Actual Beds: 86
Figure 2. TOP TEN LEADING CAUSES OF DEATH (2010)
External Stakeholder RoleDepartment of Health Governing body, financing,
accreditation; Licensing & regulation of hospitals; Policy & regulatory body for quality health care.
Philippine Health Insurance Corp. Institutionalization of programs of quality assurance at all levels of the health service delivery system; Provides health insurance to its members.
Local Government Unit Regular/Supplemental budget, Political influence and support
HMO Financing, accreditation
External Stakeholder RoleNGOs, Private Sector Other/additional budget
Dental, medical clinic Referral and outsource services
Community
Residents of Tagudin and nearby municipalities
Tax, beneficiary, income, possible source of manpower for TGH, clients of health services
Possible patients in the hospital; pays taxes to the LGU
External Stakeholder RoleIlocos Sur Electric Cooperative Power supply Tagudin Water District Potable Water supply Bank Loaning, deposit of income
Tagudin Multi-purpose Credit Coop, Inc.
Rural Bank of Santol
Rural Bank of Tagudin
Financial assistance to businessmen, farmers and others
Several medical and dental clinics
Pacencia Gonzales Memorial Hospital
Rural Health Unit of Tagudin
Attending to health needs of residents , Referral and outsource services.
Internal Stakeholder RoleMedical consultant Specialized careSurgeon Invasive treatment/ surgeryResident Physician General careNurse Supportive, bed side care;
assists physicianMidwife Provides care to childbearing
womenAncillary services
Administrative service & Maintenance
Engineering
Housekeeping
Facilitate the daily operation of the hospital;
Hospital maintenance and administration
Internal Stakeholder RoleDentist Oral care and prophylaxisPharmacist Drug dispensingMedical technologist Laboratory diagnosis and
screeningRadiologist Radioactive diagnostic test
procedures and treatmentMedical records officer Maintains patient file and
statisticsMedical social worker Services in medical issues
Scoring system for Impact of Issues in our Organization:1-4: Non-important- there is no significant impact in our organization.5-7: Important- Minimal impact but the hospital can still continue with its operation8-10: Vital- will completely/ immobilized our operation Scoring system for Probability of Continuing in next 3-5 yrs.:1-4: Can be easily corrected and will only last less than 3 yrs.5-7: Depends on the impact of the issue, it may last in 3- 5 yrs.8-10: 3-5 yrs. to recuperate from the impact of the issue is not enough and may need more time
List of Issues/ Trends
Classification (Political,
Regulatory, Economic, Social,
Competitive, Technological)
(O/T) Evidence Impact to Organization
(1-10)
Probability of continuing in next 3-5 years
(1-10)
1. Prone to flooding during the rainy months (June-Nov.) by virtue of its location
Political, Social
Threat: hinder access to and provision of healthcare services; Increased cases of water-borne and airborne diseases; Flooding may worsen during the wet months due to effects of climate change (PAGASA, 2011)
Exposed to typhoons from the west
Proximity to the great Amburayan River and the Chico River and their tributaries, which overflow during the wet season
Prone to storm surges from the South China Sea (PAGASA storm surge map)
Low elevation and relatively flat terrain
Inadequate drainage canals/infrastructures
7
10
Probability greatly affected by political will to address the impacts of flooding
List of Issues/ Trends
Classification (Political,
Regulatory, Economic,
Social, Competitive, Technological
)
(O/T) Evidence Impact to Organization
(1-10)
Probability of continuing in
next 3-5 years (1-10)
2. Prone to earthquakes
Political, Economic
Threat: Damage to hospital and town infrastructures; increased morbidity and mortality from injuries; spread of disease
Presence of numerous fault Lines in the region where Tagudin is located
8
10
Risks from earthquakes greatly influenced by political will and availability of funds to build earthquake resistant infrastructures
List of Issues/ Trends
Classification (Political,
Regulatory, Economic, Social,
Competitive, Technological)
(O/T) Evidence Impact to Organization (1-10)
Probability of
continuing in next
3-5 years (1-10)
3. Abundant/ rich water, aquatic, mineral and agricultural resources
Social Opportunity: the resources serve as source of food and income for residents, improving their health and increasing their capacity to pay for health services
Threat: Over-quarrying of the rivers can increase risks from flooding
Source of irrigation for farms
rich source of fish and marine plants, which are used for food
once a mining site for iron magnetite
Amburayan River being quarried for aggregates
One of the top rice producers in Ilocos Sur
Nutritional status of children in Tagudin better than the national average
9 9
List of Issues/ Trends
Classification (Political,
Regulatory, Economic,
Social, Competitive,
Technological)
(O/T) Evidence Impact to Organization
(1-10)
Probability of continuing in
next 3-5 years (1-10)
4. Unsafe and inadequate solid waste management
Political, Social
Threat: May cause flooding, increased airborne, water-borne and vector-borne diseases; air and water pollution
Open garbage dumps near the river
Practice of open burning of garbage
7 4
Collection system already in place; There is a proposed plan to build a landfill facility
5. Increasing urbanization and business opportunities
Economic, Technological
Opportunity: can lead to economic growth; increased clients and business tie ups for the hospital
Land conversion from agricultural to commercial and/or residential
7 7
List of Issues/ Trends
Classification (Political,
Regulatory, Economic,
Social, Competitive,
Technological)
(O/T) Evidence Impact to Organization
(1-10)
Probability of continuing in
next 3-5 years (1-10)
6. Presence of educational institutions
Social, Technological
Opportunity: Education could lead to improved health; source of manpower for the hospital
From pre-school to tertiary level (mostly vocational)
10 10
7. Presence of several commercial and light industrial concerns
Economic Opportunity Public markets, sari-sari stores, rice and corn mills, blanket weaving, wine and vinegar making
8 8
List of Issues/ Trends
Classification (Political,
Regulatory, Economic,
Social, Competitive,
Technological)
(O/T) Evidence Impact to Organization
(1-10)
Probability of
continuing in next
3-5 years (1-10)
8. Available financial institutions
Economic Opportunity 2 banks, 1 multi-purpose credit cooperative
9 9
9. Many available means of transportation
Economic Opportunity 15 transportation companies ply Tagudin to Manila; 4 companies ply Tagudin to Baguio; locally – jeepneys, mini-buses, tricycles
9 10
10. Convenient, fast and affordable access to communication facilities
Technological Opportunity Telecom companies: Bureau of Telecommunications, DIGITEL, PLDT, RCPI; reached by radio, TV, Cable-TV networks
9 10
List of Issues/ Trends
Classification (Political,
Regulatory, Economic,
Social, Competitive,
Technological)
(O/T) Evidence Impact to
Organization (1-10)
Probability of
continuing in next 3-5 years
(1-10)
11. Good electrification status (provided by ISECO)
Technological Opportunity 98% of total residential, commercial and institutional establishments have electricity
10 10
12. Relatively good source of potable water
Social Opportunity The Tagudin Water District serves the Poblacion; other areas have electric, jet-matic or pitcher pumps for water
9 10
13. Drainage facilities present but inadequate
Political Threat Overflows and clogs during the rainy months
5 6
List of Issues/ Trends
Classification (Political,
Regulatory, Economic,
Social, Competitive,
Technological)
(O/T) Evidence Impact to Organization
(1-10)
Probability of
continuing in next
3-5 years (1-10)
14. Relatively good implementation of Health and Nutrition Program by RHU
Competitive Opportunity for collaboration
Good accomplishment for “Operation Timbang” and Vit. A supplementation; improving nutritional status of children; But inadequate accomplishment for Iron and iodine supplementation programs
8 8
List of Issues/ Trends
Classification (Political,
Regulatory, Economic,
Social, Competitive,
Technological)
(O/T) Evidence Impact to Organization
(1-10)
Probability of
continuing in next 3-5 years
(1-10)
15. Low acceptors for the RHU’s Family Planning Program
Competitive Opportunity: As both government entities, the TGHCC and RHU could collaborate
Only 21% of total families are Family Planning acceptors
6 6
16. Presence of other health care and dental facilities
Competitive Opportunity for collaboration and referral
Threat as competitor
Pacencia Gonzales Memorial Hospital (private); RHU; several medical and dental clinics
7 9
INTERNALSCAN
Internal Factors Strengths WeaknessCLINICAL Ancillary Services
( Radiology, Laboratory, Dental, Pharmacy)
Conducts surgical procedures
0 deaths of obstetric patients
Lack of Manpower Specialized Medical
Services Health Programs
Promotion
GENERAL MANAGEMENT
Support of both government and private sectors
The only Capillariasis Center
Recording system Inappropriate/Ineffective
staffing & organization Infection Prevention and
control No internal audit/survey in
quality Underutilized of hospital
committees
Internal Factors Strengths WeaknessPHYSICAL FACILITIES Have adequate lighting Inadequate room for
communicable disease patients
Inadequate ventilation Underutilized areas No
elevator Inadequate facilities &
equipment Hygiene ad Sanitation
FINANCIAL Stable budget from Government’s subsidy
Top 2 boxes showed that there is a remarkable increase in income
Philhealth accredited
No accreditation from any HMO
There are more non-Philhealth members patients
Increase in HAMA Government subsidy is not
enough to sustain hospital expenses for expansion
Internal Factors
Strengths Weakness
MARKETING Increasing average daily census
Promotion of specialized medical services
Residency Program
ADMINISTRATIVE SUPPORT
Licensing of DOH and Philhealth
Hospital statistics updated
Ineffective staffing plan
Future Quadrant1.Expansion of Hospital & facilities2.Good referral system to other Health facilities & packages in specialized medical services
Internal Fix-It Quadrant1.Collaboration from other hospitals for best practices in hospital administration.2.Improve staffing & organization structure
External Fix-It Quadrant1. Implementation of a sound solid hazardous & liquid waste management2. Implement an Information, Education & Communication Program on good sanitation & hygiene
Survival Quadrant1. Implement an Emergency Preparedness Program
Tightened the Mission:Reason For Being
Primarily to serve the people of
Tagudin with safe, affordable,
effective health care services
delivered by highly qualified
healthcare practitioners and
well-trained support staff.
Restated the Vision:Where We Want To Be
To be the leading secondary hospital by
2015 and to be the first tertiary hospital in
Tagudin by 2020 providing excellent,
accessible and equitable medical services
in the areas of patient care, medical
training and research.
Staffed by highly trained and qualified
healthcare providers.
Values: Defining our culture
Compassionate Care
Respect
IntegrityService
Excellence
Professionalism
Social Responsibility
Consumer Mix
Priority target patients include those with some or all of the following qualities:
▫ Self Paying▫ Service patients▫ Covered by HMO ▫ Covered by Philhealth
Product Mix
▫ General/Family Medicine▫ Internal Medical▫ Pediatrics▫ Obstetrical and Gynecologic ▫ Surgical & Anesthesia▫ ENT/Ophthalmologic▫ Radiological/Laboratory services
Service Areas
▫ Ambulatory Surgical Clinic▫ Critical Care Units (ICUs, PACU, RR)▫ Dialysis Center▫ Newborn Screening Center▫ Trauma care▫ TB DOTS▫ Animal Bite Center
Goals and Objectives
• Goals and objectives▫ To ensure and sustain investments to provide equitable
healthcare▫ To improve health system performance through
continuous training and technological advancement▫ To ensure essential, accessible, quality and affordable
medical and surgical services.
Competitive Advantage
• Competitive advantage▫ The first and only government-subsidized
hospital in Tagudin providing affordable, holistic approach, and quality health services with financial stability than our private competitors.
Outside Relations
▫ Public-Private Partnerships HMOs Pharmacies Ambulatory services Philhealth DOH
▫ Referral System From rural and other local health units To provincial hospitals
Strategic Goals/KRA: Facility Enhancement
Plan
Adaptive Stabilization Strengthening of current specialty medical services and surgical procedures
Market Entry Joint Venture *Partnering with HMO and entrepreneurs to increase financial capital
Positioning Differentiation Creating *Health care packages that are affordable
Focus to Specialized medical services facility in the region
Implementation Facility and Equipment
Purchase of new radiologic equipments (e.g. ultrasound, ct scan)
Marketing Brochures, media events, newspapers with focus on gatekeepers (e.g., medical societies)
Control Monitoring and Review
Internal audit and external audit
STRATEGY FORMULATION
Strategic Goals/KRA: Capability Building
Plan
Adaptive Stabilization Creating and hiring new plantilla positions for additional hospital staff (e.g. Hospital director, specialist, nurses)
Market Entry Alliance *Partnership through affiliations with nearby medical schools
Positioning Focus to one Focus to the population of Tagudin needing high quality but affordable healthcare services
Implementation Organizational Structure
Inviting additional consultants/specialist practitioners
Human Resources Training and development for the hospital staff
Control Monitoring and Review
Internal audit and external audit
STRATEGY FORMULATION
TGH in
3-5 years
Scenario Building
THANK YOU!