Rapid_Assessment_Hospital_Management_Tool

8/7/2019 Rapid_Assessment_Hospital_Management_Tool

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Hospital Management

Rapid Assessment Tool

GTZ Health Service Management System ACEH


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Gedung Administrasi Lama Lantai II, Rumah Sakit Umum Dr. Zainoel AbidinJl. Tgk. Daud Beureueh No. 108 Banda Aceh 23126 ACEH-IndonesiaPO BOX 672 Banda Aceh 23001

www.gtz.de
http://www.gtz.de/http://www.gtz.de/


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1. General hospital information

1.1.Date (period) in which the assessment is being conducted:

1.2.Name of the hospital:

1.3.Location (District/City):

1.4.Population in catchment area: (Area from which population comes to seek services. Is therea predefined catchment area? Does this differ to the actual catchment area, for example:people from other regions come to make use of this facility?

1.5.Are the clients who actually attend the hospital in correspondence with the population in thecatchment area or the target population defined in the mission statement? If not please

specify where they differ. (For example: number, age, gender, religion)

1.6.Mission. What is the mandate of the health institution? What services is the institutionsupposed to offer to what population? Is this statement documented and where?

1.7.Vision. Medium to long term aspirations and plans for the health institution. What institutionaldevelopment is intended with owners and political decision makers? Is this statementdocumented and where?


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1.8.Type of Hospital. Please mark

Sub District hospital/health center

District hospital/general hospital

Provincial /referral hospital

Specialized hospital

Other (explain) __________________________________

1.9.Hospital basic indicators for given observation period (Preferable one full calendar year.Use the same observation period for all indicators and departments).

In-patients. Please fill out the following indicators forkeyin-patientdepartment of the hospital.Please also state the period of observation to which the data refers. Some key in-patients

departments are surgery, obstetrics and gynecology, internal medicine or pediatrics rather thanENT, ophthalmology, dermatology...etc.

Observation period__________________________________

Name of in-patientdepartment

Number ofbeds

Averagelength of

stay (ALOS)

Bedoccupancyrate (BOR)

#Admissionsper period


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Out-patients. Please fill out the following indicator for key out-patient departments of the hospital.Some key out-patient departments are XXX.

Observation period__________________________________

Name outpatient department/ policlinic Number of out-patients perperiod

1.10. Staff. Amount of medical and non medical staff employed in the whole medical facilityat the moment of the study.(Full time, part time, long term, short term or other type ofemployment. Not to include any outsource services staff).

#

Specializeddoctors

#

Generaldoctors

#

Nurses

#

Midwives

#

Administrative staff

#

All otherstaff

Total # Staff


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1.11.Available equipment

Please mark () which equipment is available in the hospital at the moment of the interview. Theinterviewer should adapt this list of equipments to the list of required medical equipment asdefined by local / national standards for the same type of facility. The type of hospital answerrefers to the possibility that the national health system for the country doesnt require that type of

facility to have certain equipments.

EQUIPMENTS (to beadapted according to

local standards)

Have it()

Dont have it because()

Have it, but does notwork because (short

reason)

Will have it,acquisition isplanned for

(date)

Fixed equipment forstandard X-Ray

Budget

Type of hospital

No request/ no need

Other reason

Electro cardiogram

BudgetType of hospital

No request/ no need

Other reason


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EQUIPMENTS (to beadapted according to

local standards)

Have it()

Dont have it because()

Have it, but does notwork because (short

reason)

Will have it,acquisition isplanned for

(date)

Multi bloodanalyzer

Budget

Type of hospital

No request/ no need

Other reason

Ventilator/respirator

Budget

Type of hospital

No request/ no need

Other reason

Electric Centrifuge

Budget

Type of hospital

No request/ no need

Other reason

Spectrophotometer

Budget

Type of hospital

No request/ no need

Other reason

1.12. Amount of services offered in the observation period in relation to specializedstaff. Please fill out the following indicators for the observation period (preferably previous year).The number of doctors and staff refers to the number of medical staff who is exclusively connectedto the provision of the mentioned service in that observation period. For example: 350 generalsurgeries per year with 5 general surgeons available. Use the same observation period for allservices.

SERVICES HOW MANY PER PERIOD

If such intervention is not available mark (-). # Doctors # Otherspecialized

staff

1. Surgery

a. Generalsurgery

# interventions

b. Abdominalsurgery

# interventions

c. Neurosurgery # interventions


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d. Traumatology # admissions

e. Specialsurgery

# interventions

2. Obstetrics / Gynecology

a. Deliveries # of deliveries

b. Cesareansection

# interventions

3. Pediatrics

a. Generalpediatrics

# admissions

b. Intensive care # admissions

c. Neonatologyintensive care

# admissions

4. Internal medicine

a. Generalinternal medicine

# admissions

b. Intensive care # admissions

c. Cardiology # admissions

d. Hemodialysis # procedure

e. Neurology # admissions

f. Oncology # procedure

5. Dental care # patients

6. Dermatology # patients

7. Ophthalmology # patients

SERVICES HOW MANY PER PERIODIf such intervention is not available mark (-).

# Doctors # Otherspecialized

staff

8. Ear-nose- throat # admissions

9. Laboratory

a. Lab Elisa

b. Bloodtransfusion

c. Blood bank

10. Radiology

a. CT Scan


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b. MRI

c. 24 radiologyprocedure

d. echography

11.Other specialized servicesBurn center/ stroke center/HIV-AIDS unit


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1.13. Support equipment and services

o Electricity

Do you have 24-hour electricity availability (generator)? YES NO

o Air conditioner/heatingDo you have air conditioner/heater in all operating theaters? YES NO

o Running water

Do you have running water available in the main treatment buildings? YES NO

o Sewage

Do you have sewage water treatment facilities? YES NO

o Waste management

Does the hospital have a professional waste management system? YES NO

If NO: explain why.If YES: Give details (type of incinerators, equipment used procedures...etc.)

Is the waste management done by an external party? YES NO

If YES by who and how?


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2. Human Resources

2.1.Qualifications. Does the Human Resourcesdepartment or the Staff TrainingDepartment assess the training needs of the hospital staff or the departments?

YES NO

2.2.Method. If YES describe the method for assessing the training needs and with whatfrequency they are assessed? Commonly used methods are: Request of thestaff/departments, internal decision of the HR department, based on the trainings givenin previous years.

Please explain the method used

2.3.How did the responsible unit for trainings respond to the training needs identifiedin the assessment? Describe (e.g. Systematic preparation and implementation oftrainings according to needs, taking advantage of offers by third parties according toneeds...etc.(Collect a copy of trainings curriculum for observation period)

2.4.Are training courses or further qualifications of staff registered in the staff /personal records?

YES NO


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If YES how? (Electronic personal records or physical records, describe the process)

2.5.Commonly do training courses or further qualifications of staff automaticallylead to better salary, improvement in position or other sort of remuneration?

YES NO

2.6.Are there mechanisms to monitor in how far trainings and qualifications contentsare implemented / applied / used in the daily work? Please explain.

2.7.Performance. How is staff performance assessed?Explain the method for assessingthe staff performance, the frequency and who is responsible for initiating theassessments.

Is the individual staff performance/evaluation system correlated to remunerationor other incentives?

YES NO

2.8.Please state how many persons were hired/fired/suspended during the last year inthe hospital.

How many personswere...

Hired


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Fired

Suspended

Please state the top 5 main dismissal reasons.


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100 %

3.2.Hospitals annual budget Expenditures. Break down the actual hospital expendituresin the last fiscal year using the following categories (roughly estimation). If the planningfigures for the same categories at the begging of the same year are available note themtoo. )

Budget line%

of the hospitalsbudget SPENT on

%of the hospitals

budget PLANNED tobe spent on

Staff(salaries)

Drugs (medicines for prescriptionand daily operations)

Energy (electricity bill)

Maintenance (equipments andbuildings)

Investment in equipments /infrastructure (new or replacement)

Other regular expenditure whichrepresent a considerable amount ofthe budget.

3.3.Billing. Please describe the current method of processing patients billing.

By hand or electronic spread sheet (excel)

Simple, stand alone electronic billing programme

Billing system as integrated part of HMIS

Other


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If Other please describe.

3.4.Is every payment accompanied by the production of a receipt? (Directobservation).

YES NO

3.5.Does the hospital have a cost accounting system?

YES NO

3.6.Is the accounting system Accrual Cash based Other

3.7.Financial reporting. Please state what kind of reports does the accounting departmentproduces and in what frequency.

Type of financial reportsYES/NO

Frequency

Balance sheetOnce a year

more frequent how often________

Cash flowOnce a year


Income statementOnce a year


Other ________________Once a year


3.8.Are these reports electronically produced? In this case this doesnt refer to thereports being produced using excel spreadsheets but more to integrated accounting


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systems.

YES NO

3.9.Please describe shortcomings and perceived problems in the financial management

and accounting process in the hospital? This also refers to budget related problems andto the procedures to manage/generate financial information.

3.10. Financial accountability. Does the hospital have regular internal audits (organized/conductedby the health institution itself)?

YES NO

If YES, how regular are they performed? ___________

When was the last one performed (date) ___________

3.11. Does the hospital have regular external audits?Conducted by an external party?

YES NO

If YES, how regular are they performed? ___________

When was the last one performed (date) ___________

4. Quality

4.1.Is there a quality management (Quality assurance) system established?

YES NO


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If YES please explain. Which system is being used? In which units?

4.2.Are key administrative, medical and support procedures defined by SOP?

YES NO

If YES please state some of those key procedures defined by SOPs.

4.3.Commonly who develops these SOPs for the hospital?

The hospital

The Ministry of Health

Other authorities

Others

If others please describe.


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4.4.Which services offered by the hospital are accredited and until when? Pleasewrite down the name of the services; in the column next to the name write down untilwhich date this accreditation is valid.

Services accredited Until when

4.5.Does the hospital have regular evaluations to assess the quality ofservices?

YES NO

IF YESwhich ones:

Client satisfaction

Quality assessment

Post surgical infections

Bed sore

Net death rate

Laboratory quality check

Other


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5. Maintenance

5.1.Please fill out the following information. The equipment list can be adapted to localstandards. The first group of equipments is considered basic and should be checked for

All Hospitals. Provincial hospitals should be checked for the equipment listed in AllHospitals but also for the equipment under Provincial hospital and specializedhospital and so on.

Equipment

Does thehospitalhave?

( )

Today is itfunctioning?

YES/NO

If it doesntwork, how long

has beenbroken?

Does the hospitalhave maintenancecontracts for hightech equipments?

All hospitals

X-rays

Echography

ECG

Blood analyzerElectric centrifuge

Spectrophotometer

Air Conditioned /Heater

24 hours electricity (genset)

Provincial hospital andspecialized hospital

CT Scan

Mammography

Echocardiography

ElectromyographyEEGElectroencephalograpy

Elisa

Western blot

Blood bank

Special hospital

Radiotherapy

Extra corporal bloodcirculation systemHyper baric chamber


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6. Pharmacy

6.1.Availability. Which are the main problems regarding the availability of drugs?

1.1.1 Fall short on certain drugs

The drugs are expired

Unacceptable delay between request and delivery

Cost of the drugs for certain categories of patients

Patient has to purchase the drugs outside the hospital

Other ____________________________

6.2.Please write down the number of prescriptions served in the hospitals Pharmacyaccording to the payment method used by the patient for a given period. Pleaseuse the same period for all data ( e.g. prescriptions per month / per year).

Type of patient # prescriptions served

Self paying patients

Patient with private insurance

Patient with public insurance

Other payment method

Total

7. IT/Information Systems

7.1.General information from the IT Department

Des the hospital have an IT department?

YES

NO


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Which % from the annual hospital budget is destined forthe IT department:

Capacity (Quantity of staffs) for:

Computer hardware

& softwareNetworking

Programmer

Database query

Are there regular maintenance contracts for ITequipments?

YES

NO

7.2.In general can the hospital information system be described as...

An integrated information system

Parallel stand alone information modules

Other _____________________________

7.3.Does the information generated by the information system allow key personnel to make

conclusions on the performance and quality of management and medical services?

YES NO

7.4.Does the current information system facilitate the production of required regularreports?

YES NO

7.5.Has some department or the whole hospital ever performed a time efficiency assessment?

YES NO

7.6.Please list the most important reports required by each department of thehospital.Name 1 or 2 reports that are required from each department

Department Name of the report How often / permonth, or year


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Rapid_Assessment_Hospital_Management_Tool

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