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St. mary’s catholic general hospital, eleta ibadan - hospital annual report 2008ST. MARY’S CATHOLIC GENERAL HOSPITAL
Hospital Annual Report 2008
The hospital has recorded modest achievements in terms of process re-engineering, leading to effectiveness in our operations owing to turnaround time of patients and efficiency leading to higher We are constantly scanning the environment to ensure that opportunities are embraced while taking urgent steps to combat threats. Our slogan in terms of service delivery is always ‘Quality Service Excellence’ which means maintaining customer loyalty. This goes beyond the usual rhetoric’s of ‘Customer Satisfaction’ in the sense that a dissatisfied patient could stop patronizing the hospital.
Maintenance of patient loyalty can make patient see the hospital as his own and wanting progress for same. Such patients offer advice in areas where deficiencies are noticed by them and would want certain changes to be made. These patients are reluctant to abandon the hospital. We are proud that suggestions from such patients have helped in our effort at achieving our service slogan.
While noting that the hospital still has excess capacity, we are on the verge of entering into collaborations with some financial institutions who have promised to get some of their customers to Professor Albert Ainstein, a German Philosopher once said “I shall pass through this way but once. Every good deed l have to do, let me do it now, let me not defer, for l shall pass through this way but The effort to prosecute our service slogan is derived from this maxion as we see our current role in the hospital as a journey which providence has devolved on us.
2.0. NATIONAL HEALTH INSURANCE SCHEME (NHIS)
The scheme has various Health Maintenance Organizations (HMO) and the hospital has about nineteen of them that pay in their capitation every month, so as to affect prompt health care services to all enrollees of the scheme. So far only two of the HMO’s defaulted in the payment of the capitation and steps have been taken to get across to the concerned HMO’s.
2.1. Achievement: The scheme has served as source of income to the hospital as well as creating
publicity for the services that we render and we equally enjoy more patronage.
2.2. Problems: The problem encountered is the non-availability of doctors to give prompt medical
2.3. Solution: The hospital will pay more attention to the scheme by making provision for doctor’s
availability and to provide computer for the NHIS desk for proper records to always update information on the enrollees. This will help to give prompt health care services to the enrollees of the scheme as well as prompt information to the health maintenance organization. 3.0. RESIDENCY PROGRAMME
The hospital continues to offer residency programme for the doctors.
Dr. M.A. Daramola who is a senior resident passed his part 1 examination of the West African
College of Physicians in Family Medicine in 2007. He is preparing for his part 11 examination.
Dr. M. Egbele was a senior resident having passed her part 1 examination in the West African
College of Physicians in Family Medicine. She was preparing for her part 11 examination when attention was called to a misdemeanor by her in October 2008. She resigned her appointment with Dr. Innocent Umeakunne was a junior resident in the beginning of the year. He passed the part 1
examination of the National Postgraduate Medical College in Family Medicine in November, 2008, so Dr. Mrs. A. Adebayo is interested in family medicine but has not passed her primaries yet. She will
be in the residency programme after passing her primaries.
Dr. O. A. Durojaiye is also interested in family medicine and preparing to take the examination for
Dr. F. A. Ajayi and Dr. T. Ojo are medical officers who are not interested in family medicine and are
here temporarily. They were employed in November and December 2008 respectively.
Dr. A.O. Akinola was employed in 2007 as part time family medicine consultant and trainer for the
residents in family medicine. He works three times a week, Mondays, Wednesdays and Fridays.
Dr. A. G. Ayandipo continues to be the surgical specialist for the hospital. Dr. A. Arije is the
consultant in internal medicine for the hospital and Dr. A. O. Adeyanju is the Consultant Obstetrician
and gynaecologist for the hospital. The three consultants work part time. Dr. F. F. Fadero who
suffered a stroke in 2007 was able to join the hospital again in May 2008. He is a Paediatric Consultant who works part time. Professor A.O. Folami is still the Medical Superintendent. He
supervises the paediatric department also and works full time. 4.0. RESEARCH ACTIVITIES
4.1. Ethical Committee
The hospital has always depended on the ethical committee of University College Hospital and University of Ibadan when researchers apply to us. It was decided to form an ethical committee for the hospital. This has been formed but the formal inauguration has not been done yet. However, some research projects continued in the hospital. The hospital has finished its part of the misoprostol study early in the year. The genetics of severe malaria study continued. The organizers of this later research donated a colour television to the Children’s ward. Smaller research projects are ongoing.
5.0. GLOBAL FUND MALARIA PROJECT
On 13th March 2008, the Society for Family Health organized a workshop on malaria control update for health providers, in aid of global funds phase 2 implementation. Dr. A.O. Akinola attended the workshop. Shortly after this, the global fund malaria project came to the hospital with highly subsidized Artemisinin Combined Therapy (ACT) anti-malarial drugs for children under 5 years, sulphadoxine pyremathamine for pregnant women and insecticide treated net for children under 5 6.0. CLINICAL POSTING TRAININGS AND EXPERIENCE
In addition to other institutions that come to the hospital for their clinical training postings and experience, we went into collaboration with the Department of Nursing, University of Ibadan (U.I) in July 2008. Their BSc. Nursing students now come to our hospital for their clinical postings and experience. This collaboration took effect from 1st July 2008. The Oblates of St. Joseph students (Seminarians) came to us in the month of July for one month The TULSI CHANRAI Foundation Health Assistants were in our hospital for one month training.
7.0. HIV AND AIDS ACTIVITIES
In March 2008, the hospital started carrying out confirmatory tests and CD4 Count for all patients both pregnant and non-pregnant, who tested positive. 7.1. Creation of Awareness and Voluntary Counselling and Testing (VCT)
The hospital has extended its services of awareness creation on HIV and AIDS and voluntary counseling and testing to private hospitals, Local Government Health Centres, Traditional Birth Attendants (TBAs) both in the churches and in the mosques. The places visited include; 1) CAC Olugbode Odo Ona, 2) CAC Oke Irapade Odo Ona, 3) CAC Oke Lapeda, 4) CAC Oke Isegun Oniyarin, 5) CAC Oke Iyanu Agbokojo Ogunpa, 6) CAC Agbala Itura Odo Oba, 7) CAC Arogungbogunmi Olomi, 8) Christ the Saviour Oke Ado, 9) Christ the Saviour Olorunsogo Molete, 10) Ogunse mosque Odo Oba, 11) Sheu Maternity Centre Bode Igbo, 12) Faith Home Olomi, 13) Anu Oluwa Maternity Centre Odo Oba, 14) Primary Health Centre Olomi, 15) Primary Health Centre Orita Aremo, 16) Sarat Maternity Centre Oremeji and 17) Awoyelomo clinic and Maternity Centre.
During the visit to these centres, health education was also given. The clients who tested positive were brought to the hospital for confirmatory test, CD4 count and for AntRetroviral Drugs.
Creation of awareness and Voluntary Counseling and Testing are now done at the Out Patient Department (OPD) of the hospital on daily basis.
7.2. Anti-Retroviral Clinic
The Anti-Retroviral Clinic was started in the hospital on the 15th of April 2008. This clinic runs once a week. In this clinic, those who are HIV positive, both pregnant and non-pregnant, and exposed babies 7.3. Training Workshops
The staff have benefited from series of capacity building trainings and workshops organized by APIN/ PEPFAR and are more equipped to manage our patients and give quality care. 7.4. Home Based Care
The hospital continues to offer this service to our patients. They are visited and treated at home. Those who need hospitalization are encouraged to come to the hospital for proper care and management.
7.5. Support Group
The support group for those who are HIV positive is very much alive. We have 80 clients in this group including pregnant women, orphans and other people living with HIV and AIDS (PLWHA) and they meet once a month to share and to support one another. At this gathering, they are given some food items and vitamins to boost their immunity and to prevent opportunistic infections. They get financial 7.6. Challenges
• Inadequate counseling rooms• Need for extension of the waiting area and a room for the nurses• Need to have Anti-Retroviral clinic twice a week to reduce congestion • Need for a permanent Doctor at the Anti-Retroviral clinic Our Collaboration with AIDS Prevention Innitiative Nigeria (APIN) and President’s Emergency Plan for AIDS Relief (PEPFAR) has brought about an improvement in the services offered to patients, in our income generation and in free services and ART to HIV and AIDS patients. Our laboratory has been upgraded by them and internet facility (V-SAT) installed for on-line dissemination and access to A team from HARVARD PEPFAR USA, USAID USA, USAID Nigeria and APIN/PEPFAR UCH, Abuja and Lagos visited the hospital on the 18th of July to see how the programme was going. They were quite impressed with the progress the programme had made.
STATISTICAL DATA OF HIV/AIDS ACITIVIES FOR THE YEAR 2008
IN THE HOSPITAL
TESTEDTotal ANC Received Test Result & SUMMARY OF ACTIVITIES OF HIV/AIDS FOR THE YEAR 2008
8.0. PRIMARY HEALTH CARE (PHC)
8.1. Target Areas
Onigambari, Ope- Agbe, Olunde, Agric Olomi and Eleta.
To increase awareness amongst mothers on the importance of immunization.
To increase good health through health Education 8.3. Activities:
Referral of serious illnesses to hospital Facility.
The community’s poor economic status remains a problem hence many of our clients will only seek health care when they are not able to go to the farm or market.
Many of our clients seek free treatment. Different Religious activities affect our programme, for example, Islam fasting period.
The number of PHC out reach visits are determined by the community leaders. 8.5. Achievement
We have been able to get 12 volunteer health workers who are still under training.
Health Education was extended to St John’s Catholic School Eleta and Kajola Primary School Agric Olomi.
POLIO POLIO POLIO POLIO DPT DPT DPT HBV HBV HBV MEASLES
YELLOW TETANUS TOTAL
9.0. TUBERCULOSIS / LEPROSY (TBL) CONTROL UNIT
This centre was opened in the year 2006, with the help of Damien Foundation Belgium representative, Ibadan, Oyo State. The centre creates awareness to Tuberculosis /leprosy prevention, screening of TBL suspects and Direct Observation Treatment (DOT) Short Course for those with sputum positive TB. The Damien Foundation Belgium representative Ibadan continues to sponsor the programme which had made treatment of Tuberculosis free of charge.
Number of clients from January To December 2008.
Positive cases Died before Sputum smear Follow-up defaulters 10.0. STAFF TRAINING AND DEVELOPMENT
In addition to APIN/PEPFAR organized workshops, the nurses, doctors, pharmacist, laboratory personnel, accounts staff and data manager attended series of workshops, seminars and conferences during the year. These have enhanced both professional and personal development of staff and ultimately better and quality health care to patients.
11.0. FINANCIAL REPORT
11.1. Income Statement
Result showed total income of N111, 410,400 while expenditure was N111, 261,766 giving a marginal Various strategies evolved at achieving our target income paid off in the year as we exceeded the budgeted figure. However we battled with high expenditure profile noticeable mostly on maintenance and repairs having to be carried out, and some running costs like diesel in view of the near total breakdown of electricity supply in the country. We have however made progress at reducing these expenditures. The result will however be more visible in year 2009.
11.2. Collection on Receivables
Out of the over N900,000 owed by Total Health Trust, a Health Maintenance Organization, only the sum of N56,000 has so far been received from them. We have resurrected the matter of the indebtedness and steps are on to achieve recovery of the balance.
Sum of over N450, 000 remain outstanding at the ward.
Most of the debts crystallized as a result of financial distress suffered by the patients. On some occasions, corpses were abandoned by indigent relatives of diseased patients and hospital had to take urgent steps to make them shoulder responsibility of burial.
11.3. Payment to Suppliers
Suppliers were paid on due date. Payment dates are 14th and 28th of each month or the next working day where payment date falls on a weekend or a public holiday.
We have added the sum of N3, 000,000 to our funds at Kakawa Discount House in Lagos. We are enjoying an interest rate of above average while total sum invested is N8m with roll over period of 90 days. Interest is used for working capital purposes.
We equally invested in shares to the tune of over N3m. We have however not been fortunate with the investment in view of the global recession which affected our capital market. Foreign investors divested of shares in our capital market to reduce their exposure to risky assets and meet redemption needs in their home countries. We are however leaving the current investments in the belief that the bearish nature of the stock market will become bullish in no distant future.
11.5. Other Accounts
We maintain current accounts with United Bank for Africa PLC and Union Bank PLC. The accounts were operated on credit basis only and are used for transactions to facilitate smooth running of the 11.6. Donations Received
Donations totaling N2,173,000 were received during the year. The amount was used to upgrade our 11.7. Drug Revolving Fund
The fund really took off in March 2007 with the sum of N2m obtained from Medical Missionaries of Mary (MMM) Mission fund sent to us as donation. We are happy to report that the fund has grown by over 200% during the year 2008. Suppliers are paid on due dates with a credit period of just two weeks. Sum of over N6.0m is on account.
11.8. Procurement Committee
This is a sub-committee under the Drug Committee. The committee work involves purchase of drugs from suppliers at competitive prices. Activities are reported to the Drug Committee. The Sub- 12.0. HOSPITAL STATISTICS
STAFF NOMINAL ROLL AS DECEMBER 2006
STAFF NOMINAL ROLL AS DECEMBER 2007
SECURITY MEN (NIGERIAN LEGION)SECURITY MEN GRAND TOTAL
ST. MARY’S CATHOLIC GENERAL HOSPITAL ELETA IBADAN
STAFF STRENGTH AS AT MAY 2008
TOTAL SERVING DOCTORS
13 + 1 NYSC Doctor
TOTAL NURSING PERSONNEL
TOTAL OTHER PERSONNEL
ST.MARY’S CATHOLIC GENERAL HOSPITAL, ELETA, IBADAN.
STATISTICAL DATA OF PATIENTS ATTENDANCE FOR THE YEAR 2008
TOTAL DEATH RECORDED 287
The department’s statistics are as follows: NUMBER OF
Out of the 4857 patients screened for HIV this year, 199 were positive. The total number of Hepatitis screened was 755 for both Hepatitis “B” and “C”, 55 were positive 13.0. LITIGATIONS
13.1. Litigation Re: Baby Lawal
The hospital received a letter from Kola Olawoye & Co. (Legal Practitioners) on 1st August 2008 stating that they had sued Ibadan Central hospital on behalf of their clients – parents of Karimat Lawal who suffered automatic amputation of four fingers of the left hand. The Ibadan Central hospital lawyers had replied that the amputations were due to the professional negligence of St. Mary’s Baby Lawal was referred to St. Mary’s hospital Eleta on 25th February 2008 by Ibadan Central hospital where she was born on 24th February 2008, because of respiratory distress. Baby was seen in our hospital ten hours after birth with swollen and blue left hand with evidence of impaired circulation of blood to the hand. She was treated in this hospital for impaired circulation of left hand and possible generalized infection. The left hand did not improve looking gangrenous. On 28th February 2008, she was referred to the University College Hospital, Ibadan.
We got the file of the baby in this hospital and summarized it and made copies of parts of the case file. The case was reported to our lawyer, Mr. Alli-Balogun who replied to Kola Olawoye & Co.
Since then we have been in contact with our lawyer and there has been no new development on the 13.2. Litigation Re: Mr Azeez Aderinoye
On 29th August 2008, Mr. Azeez Aderinoye was admitted into the hospital, unconscious with stroke. He recovered consciousness after a few days and disappeared from the hospital without formal discharge on 4th September 2008. The family said they did not know his where about and reported to the police who came to the hospital. A doctor form the hospital went to the police station to make statements. Search was organized for him in the hospital premises but was unsuccessful. The Board and the Health Coordinator are aware of this case. The hospital lawyer, Barrister Alli-Balogun was This case appeared on the Sunday Tribune of 14th December 2008. The article described his admission into the hospital and his disappearance with his where about not known neither to the hospital nor to the family. The hospital lawyer studied the article and advised that we need not worry but to exercise greater care in the future with regards to safety of patients.
14.0. OTHER CHALLENGES
Inadequate electricity supply from Power Holding Company of Nigeria (PHCN). The hospital relies on the use of generators for power supply.
High cost of maintenance of hospital facilities.
Hospital vehicles are old and need replacement. 15.0. PROJECTIONS FOR 2009
Start Ear, Nose and Throat (ENT) clinic Purchase of an electricity transformer for hospital use Purchase of new vehicles for hospital 16.0. APPRECIATION
The hospital management team wishes to express a profound gratitude to His Grace, Most Rev. Dr. Felix Alaba Job, the Medical Missionaries of Mary, the Board and benefactors who supported the Hospital Administrative Head / Director of Nursing Services ST. MARY’S CATHOLIC GENERAL HOSPITAL
HEALTH INFORMATION/MEDICAL RECORDS DEPARTMENT
STATISTICAL REPORT FOR THE MONTHS JANUARY-DECEMBER, 2008
TOTAL OPD ATTENDANCE
TOTAL PRIVATE OPD ATTENDANCE
IDENTIFICATION DATA: A 78-year-old male. REASON FOR CONSULTATION: The patient is scheduled for total hip replacement, who has hypertension, hypercholesterolemia, possible peripheral vascular disease, previous smoker. He is a patient of Dr. John B. Luster. Surgery is scheduled for August 1, 2006. HISTORY OF PRESENT ILLNESS : I saw the patient today, who is scheduled for total hip re