Mizan Tepi University Teaching Hospital Performance Report 2013 E.C.

MTU TEACHING HOSPITAL
2013 EFY
PERFORMANCE REPORT
Presenter - Teklemariam Ergat [Ass. Professor]
August 28/ 2021
Aman
By Teklemariam E [Ass. Professor] 1

OUTLINE
Background
Admin Performance
Clinical Service Performance
Problems Encountered
Next Focus Areas

Background
Mizan Tepi University TH
- Established in 1978 E.C.
- Incorporated in to MTU in 2008 E.C.
- Catchment population nearly 2 million
- Expansion 10 Hectares to 52 Hectares
- New organizational structure development
- JEG

Human Resource Profile
HR Profile
Clinical staff = 446
Supportive staff = 443
Total = 889

Staff profile

Admin activities
Health Science college inauguration ceremony

HSC inauguration ceremony

Students welcoming ceremony

Students welcoming …

I – CARE Planning
Lab session

I-CARE Planning ….. Lab session

I-CARE opening day

I-CARE open day … presentation

Ward Visit with state Minister MoH

Visit by gusts from MoSHE

Institutional reform & good governance
Compliant handling
Compliant collection – suggestion box
Client opinion survey

Human Resource Mgt
Plan for new employment 364
- Actually employed = 282 (77.5%)
- HSC supportive staff + Hospital staffs
Carrier structure – 26 HPs
Work time adjustment & follow-up
“Monthly staff forums”
Short & long term trainings

Budget & Finance
Allocate budget for 2013 EFY
Treasury 81,025,800
Internal revenue 12,000,000
Total allocated = 93,025,800
Expenditure
Salary = 81,680,855.16
Operating cost = 16,847,698.85
Drug & Medical supply = 17,140,049.40
Total expenditure = 115,668,603.41
Expenditure is
greater than
allocated
budget.
How? Why?

Internal revenue
Plan 12,000,000
Achievement 8,446,398.66
Performance 70.38%
Reasons for low performance
Free services / waived services
Poor medical debt collections
No additional IG activities
Suggested solutions
 Implement the new service fee
rates with GB revisions
Strengthen medical dept collection
Establish private wing & Model
Pharmacy

Procurement administration
Performance
Market survey done every
quarter (4x)
Public bidding done (2x) per
year
Total procurement amount in
Birr = 30,890,003.50
Problems identified
Un-planned procurement –
due to poor plan & COVID
related expenditures
 Problems with public
bidding – price escalations
over time
Budget shortages

Internal Audit & Inspections + “External Audit”
Performance
Financial audit 4X
Cash audit 12X
Medication – product audit 4X
Drug store inventory – 12X
Annual physical inventory –
done
“External audit – 4X”
Findings
Deficiency in transfer of
daily revenue to institutional
bank account
Un-planned & repetitive
small procurements

Other administrative activities
Annual pan was prepared
300 new ID cards to staffs
Broadcast by local media /HE
Assets registration – 580/600 = 97%
Labelling rooms & blocks
Campus greening & beatification

Campus greening & beatification

Campus greening …

Clinical Services Performance
HSTQ
Target 85%
Achieved 75%
EHSTG
Target 85%
Achievement 67%

Outpatient Service
OPD (new + repeat)
Plan = 57,000
Achievement = 50,987
(89.45%)
NCD screening & treatment
Plan = 8000
Achievement = 7800 (98%)
 Patient satisfaction
Target 85%
Achievement
62.25%

Discussion with Diabetic patients association
Health information
delivered to 500 individuals
with diabetes (by 6 rounds)

OPD waiting time
Possible solutions
Automate medical record
services
OPD expansions
Use electronic patient que
system

HIV/AIDS Counseling &Testing
PICT
Tested 11,528
Positive = 134(1.16)
VCT
Tested 1388
Positive = 22 (1.58%)
• All tested (+ve) were linked to
ART

Radiology and Imaging
Ultrasound service
Plan 4000
Achievement 4022
X-ray
Plan 3066
Achievement 2053 (67%)
Why low performance of imaging?
• X-ray was not-functional for a long time
Solutions taken
• New digital X-Ray machine was installed
& made functional
Way forward
Employ additional radiologist to operate
the new X-Ray
 Use security camera in the imaging
rooms
Agreement with companies for X-ray &
other imaging machines

Digital X-Ray with fluoroscopy

Color Doppler Ultrasound

Biomedical Engineering Services
New equipment Installation
& assembling = 27 ME
Preventive maintenance =
51ME
Training to HPs on 19 new
medical equipment
Medical Oxygen – ups &
downs + plant??
Medical equipment
inventory
Total # of MEs = 337
Number of functional
equipment = 160
Non-functional = 90
Repairable = 59
Obsolete = 28

Percentage of Non-Functional Model Medical
Equipment (Target < 4%)

Pharmacy & Laboratory
Pharmacy
 Drug dispensing
Plan113, 316 & achievement
114,565
 DTC meeting
 Expired drugs identification
 Use of bin card & stock card
*** Problems??
Laboratory
Planned investigation 53,580
#performance 46,688 (87.14%)
• Blood collection plan = 2500 Units
& collected blood = 1856 Units
(74.2%)
• Blood usage plan 1700 units &
actually used 1568 (92.2%)
• SLIPTA standard 221/275 = 80.36%

Pharmacy - store

Pharmacy ….

Laboratory

Laboratory…

Discussion with blood bank committee

Emergency Medical Services
Plan 18,403
Achievement 19,392
Emergency death target <
1%
Emergency death occurred
0.07% (#15deaths)
Out referral target 300
Out referred 702
Why large number of out
referrals?
oLack of specialty services
such as orthopedics
oLack of high level diagnostic
services such as CT-Scan &
MRI
oBlood shortages

ER Patient Triage within 5minutes of arrival
Why not 100%?
Shortage of working
space /Ambulance
Parking…?
Community behavior
Solutions
oSeparate Emergency
Building

Inpatient Services
oInpatient Plan 5706
oAchieved 5253 (92.1%)
oInpatient Mortality target
<1.5%
oRecorded IM 1.85% [97]

OR Performance
oMajor surgery plan 2070
oAchieved 2038 (98.5%)
• Minor surgery 2300
• Achieved 2406 (100%)
Improvements – 2 OR
Tables for CS & Renovation
of Major OR
Major Minor Total
2038
2406
4444

Gyn OR Tables

Maternal Health Services
Delivery services
• Plan 4468
• Achieved 3422 (77%)
oSVD 2321 + CS 946 + Inst
155
• Maternal death #5
• Still birth target < 1.5%
• Still birth recorded 5.2%
[179/3422]
Reasons for maternal death
• Delayed referrals
• Blood shortage/PPH
Reasons for still birth
oIUFD due to delay
oHypertension
oMalformations

Neonatal Intensive Care services
oPlan 1031
oAchievement 1243 (100+)
• Neonatal death target < 25%
• Death recorded 1.37%
[17/1243] – first 24 hrs
• Deaths recorded b/n 1 –
7days 5.8% [72/1243]
Reasons for Neonatal Death
oከወረዳ በሪፈር የሚመጡ ህፃናት አብዘኛዉ
በወቅቱ ስለማይላኩ እና በእናት ሆድ ዉስጥም
ደክመዉና የመዳን እድላቸዉ ቀንሶ
ስለሚመጡ፣
oጊዜአቸዉ ሳይደርስ ስለሚወለዱ፣
oከጤና ጣቢያዎች በሪፈር የሚመጡ ጨቅላ
ህፃናት ያለባለሙያና ያለበቂ ክብካቤ
ስለሚመጡ
oሲወለዱ ክብደታቸዉ አንሶ መሆኑ
(<2000gm)፣
oከወረዳዎች/ጤና ጣቢያዎች ሪፈር ሲደረጉ
ሙቀታቸዉና ስኳራቸዉ ቀንሶ ስለሚመጡ

Neonatal Deaths
17
72
89
First 24 hrs
b/n 1-7days
total

NICU services

Adult ICU

Major problems encountered
oBudget shortage
oMedication/drug and
medical supplies shortages
oInsufficient water supply
oBlood shortages
oComplaints on the newly
revised fees from MoH
Solutions taken
• Additional budget secured from
MOF
• Medication purchase EPSA &
markets
• Truck water from municipality
/Mizan
• Strengthen blood donation
committees & mobilization
• Hold some fees ---- but still full
of grievance from client side

Next Focus Areas
oExpand specialty services such as
orthopedics, dialysis unit,
dermatology center, psychiatric
clinics, dental clinics, ophthalmic
clinics
oEstablish diagnostic services
including CT-Scan & MRI
oSeparate emergency building
oExpand & standardize OPD
services
oAutomate medical services starting
from Medical Record Unit
oWater supply issue??
oEstablishing biomedical
maintenance agreement with
companies
oCompound fence construction
oSenior staff residence – speed up
the construction process
oModel pharmacy services – Mizan
& Aman
oReferral Hospital construction –
design work in the 2014 EFY
oStrengthen external links – VHP,
UC

Mizan Tepi University Teaching Hospital Performance Report 2013 E.C.

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