- Vision & Mission statement: Till 2009 the institution had no vision and mission statements. To develop these a committee was constituted comprising of professors from different specialties. The committee after several rounds of meetings and discussions with different stakeholders drafted Vision , Mission and Value statements for the institution which were presented before the Management Council in its meeting held on 5/1/2010. The MC unanimously approved the statements. These statements have been displayed on prominent positions within the premises of the institution and circulated to all stake holders for implementation.
- Business plan: The Annual business plan for HMC for 5 years (2010-2014) has been developed. This plan spells out our targets for the five years and the finances required to meet those targets. It also includes the integrated strategic implementation plan and the medium term budgetary framework.
3. Hospital budget: Special attention was paid toward generating funds for the institution. Under the provincial government policy the autonomous institutions are restrained from generating funds and becoming financially self sufficient by raising user charges, as this is against the governments’ claim of provide free health care to the masses. The institutions are therefore mostly dependent on the Grant in Aid from the provincial government.
HMC with the approval of the management Council slightly increased the rate of some user charges and through hectic negotiations with the Finance department managed to increase the budget from Rs. 278 million in 2007-8 to Rs. 600 million in 2010-11. The hospital receipts in 2010-11 were Rs. 50 million as against a target of Rs. 37 million. This became possible because of strict financial control, internal and audit introduced in the institution.
4. Growth, Eye and Foot Clinic: In the year 2009, the following three facilities were added to the Endocrinology and metabolic diseases unit of HMC.
- Growth Clinic
- Diabetic Eye Clinic
- Diabetic Foot Clinic
With these additions the Endocrinology department has become a state of the art and the only clinical unit in the province to provide specialist and latest care and treatment to diabetic patients. The Endocrinology unit has also been approved by the College of Physician and Surgeon Pakistan (CPSP) for training of FCPS. This is the first unit in the country along with one in King Edwards Medical College Lahore to have been done so.
5. Pain Clinic: The Anesthesia department of this institution started a Pain Clinic in September 2009 for out patients suffering from different types of chronic pains and backaches. Consultancies and minor procedures are carried out thrice a week. In 2009, 98 patients and in the year 2010, 543 patients were provided consultations/ treatment.
6. Thallasemia Clinic: The Pathology Department started a blood transfusion clinic for children suffering from hereditary blood diseases like Thallasemia etc. The clinic was started with six reclining chairs/beds in a chamber fitted with a television for children’s entertainment. Chelating therapy is provided to patients suffering from blood diseases free of cost. So far 47 patients have been registered in the clinic. These patients visit the clinic at regular intervals for Chelating therapy. Regularly sessions of Chelating therapy are run with blood transfusions in the Pathology department. The hospital management has allocated 5% of Zakat fund for free treatment of children suffering from Thallasemia.
7. Breast clinic:A Breast clinic was established in 2011 for a coordinated management of women with lumps in their breasts. The clinic is run jointly by specialists from Oncology and Surgery departments once a week. Other departments like radiology, Pathology and Gynae are involved if need arises as per protocols and SOPs established.
8. Swine Flu Laboratory: The hospital also established a Swine Flu laboratory in 2009 with the help of National Institute of Health Islamabad (NIH). In this laboratory latest machines including a PCR machine has been provided with all accessories and staff has been trained to work as per latest protocols. This laboratory has the state of the art facilities to diagnosis of some rare diseases like Swine Flu and Bird Flu etc for which HMC has been declared as a focal site for the whole province.
9. Isolation unit for Swine Flu: This has been established in the Private Rooms of HMC as this institution was declared by the Health department NWFP and World Health Organization (WHO) as the focal site for the whole province. The isolation unit has been equipped with all necessary machinery like suction machine, ventilators, oxygen cylinders and monitors. Staff at all levels including doctors, nurses and paramedics were provided extensive training to deal with Swine Flu patients. Personal Protective Equipment (PPE) and Tami flu Capsules were provided by the WHO through the Health department to this institution. In the year 2010, 178 patients with suspected flu were examined and screened at Swine Flu OPD at HMC. Nasopharyngeal swabs were taken from all suspected cases. Among these patients 14 samples were declared positive for H1N1 out of which 02 patients expired while the rest recovered without any complications.
10. Online Pathology & Radiology results: The management Information System (MIS) of the hospital was expanded and improved. It was the biggest IT reform program in the history of this institution. Through networking all clinical units, supportive departments like Radiology, Pathology, Pharmacy department’s central stores and the administration departments were connected to the central server. For all pathology investigations, bookings / demands are placed by the clinical units online while samples e.g. blood/urine etc are sent physically /manually to the central Laboratory. The tests results are uploaded by the Pathology laboratory and can be retrieved, viewed and printed by the units using their own computer and printer provided at the nursing counters in each unit. Similarly the result of X-rays and ultrasounds by the Radiology department are conveyed to the units using the same network.
11. Online Indenting: The pharmacy department has been fully computerized. The main pharmacy store is connected to the satellite pharmacies (04 in number) which are further connected with the individual clinical units through networking. The traditional manual indenting of pharmacy and store items was stopped in December 2009 and the online indenting started. Now the Head/Staff Nurse places the demands of medicines, disposables and stores to the satellite pharmacies from their nursing counters using the computer / network. The supply is made within 30 minutes by the satellite pharmacies directly to the units, saving their precious time.
12. ICD-10 coding was introduced in all the clinical units. Now all patients admitted and treated are coded under ICD-10. This computerized patient record keeping has made the institution more organized. At the click of button information like 10 most common prevalent diseases etc are available. This helps in good decision making and future planning. All patients at the time of discharge are issued computerized discharge slips and all data related to patients treatment and care is maintained vigorously along with manual data in the hospital’s record room.
13. Computerized Radiography (CR) machine: A CR-machine was installed in the Radiology Department on public private partnership (PPP) basis. This machine was provided free of cost by the private partner (Agfa). The maintenance is provided by the private partner whereas the hospital is only bound to purchase films from the company. This addition has not only improved the quality of services provided by the department but also would earn revenue for the institution despite the fact that the rates charged for the service by the hospital are the lowest in the country i.e. Rs. 130 per exposure. In the private sector the rates are between Rs. 250-350 per exposure.
14. Mammography machine in Radiology department: This was made functional in 2011, about eight years after it developed fault. Now ours is the only machine after IRNUM which provides mammography service to the female patients in the whole province. This machine also helps run our breast clinic.
15. Repair of Endoscopes: In the year 2011 six endoscopes of the gastro- enterology department were repaired at a cost of Rs. 42 lacs and made functional. The Gastroenterology unit of HMC is the only unit of its kind in KPK which provides emergency services to patients with gastro-esophageal bleeds and other problems related to livers and gut.
16. C–Arm machine:The C-Arm machine in the cardiology department went out of order in October 2009 as result of which a very specialized service i.e. “Electrophysiology cardiac” treatment that was available only in HMC was disrupted. The institution through advocacy and hectic efforts got Rs.18 millions from the provincial government and purchased a state of the art Phillips C-Arm machine, which are now fully functional and providing services to the needy patients.
17. Inventory of Stores:In the year 2009 special stress was given to streamlining the records available in the hospital. The inventory, which was non-existent, was prepared in a period of around three months. All unserviceable items were auctioned thus getting rid of junk and earning revenue for the hospital. Now the hospital has a complete record of the assets of its unit and specialties. Based on this information the hospital balance sheet and income statements are being prepared. The inventory is being revised and updated in 2011.
18. Orthopedic pharmacy: A pharmacy store was started in the operation theatres on public private partnership basis, where best quality implants and other disposables for orthopedic surgeries are provided on rates, which are less than half of the market prices. This has not only reduced the financial burden on the patients but has also drastically reduced the postoperative complications and complaints. During the year 2010, 479 implants were sold out of which share was given to the OT staff and the rest spent on the improvement of OTs. The Intra Ocular Lenses (IOL) are also being planned to be provided through this pharmacy in the next year.
19 Smile Train Project: The Plastic surgery department started a “Smile Train Project” during 2009. Under this project cleft palate / lip surgeries are carried out on weekly basis. Smile Train Italia, an Italy based NGO provides funding for this project. The infrastructure, human resource and equipment of HMC are used while the financial support provided by the NGO is distributed amongst the patient, surgeon, paramedic and anesthesia staff and the institution. Out of the institution share several Air Conditioners and some equipment was provided to the operation theatres. Moreover, because of this project the waiting list in the plastic surgery unit has come down from 6-7 months to around one month now.
20. Hospital patient safety committee: This committee was constituted in 2009 to safe guard patients against avoidable deaths / disabilities due to lapses in medical care. The committee is headed by a senior professor and works to identify threats to patient safety due to human factors and latent conditions which cause failure of treatment and also coordinate with all I/C units to prepare standard protocols / guidelines related to their specialties and ensure observance of these protocols.
21. Hospital Quality Control Unit:This was also constituted in 2009 and is headed by a senior professor. The Quality Control Unit has been assigned the task to assess and monitor on day to day basis “the structures and processes” of the institution according to the accreditation standards set by Pakistan National Accreditation Council (PNAC). It would also constantly endeavor to implement, upgrade and take timely corrective measures in case of any deviations.
22. WHO safe surgical guidelines 2009: HMC introduced WHO’s safe surgical guidelines in the year 2010. These guidelines specify the role of surgeon, anesthetist and nurses, before, during and after surgical procedures. These guidelines have been recommended by experts for all kind of economic settings, as they have proven to reduce mortality rates related with surgeries. HMC is the first institution in KPK to adopt and implement these guidelines. They have been placed on the walls of all operating theatres a circulated to all concerned staff members for implementation. This has had a good impact on the outcomes of our surgical procedures.
23. Pediatric & Vitreo-retinal sub-specialties: The Ophthalmology unit of this institution has been declared as “Centre of excellence” and is the prime focal site for the implementation of National Blindness Control Program in NWFP. With the help of Fred Hollows Foundation (FHF), an Australian NGO, specialized Eye Care Clinics for Pediatric and Vitreo-retinal sub-specialties have been constructed which started functioning recently. Equipments worth millions were also donated by Fred hollows for this centre. The institution created four positions of specialists to run these sub-specialties against which recruitment have been made.
24. Family Care Centre (F.C.C): With the assistance of UNICEF and Provincial AIDS Control Programme (PACP), the hospital administration has built a Family Care Centre to provide care to patients living with HIV AIDS. The project started in June, 2010 & completed in July, 2011. It is the only centre of its kind in the country. Here not only diagnostic and curative services are provided but also all rehabilitative services provided to people living with AIDS. This is also a research & resource centre where teaching, training and advocacy for AIDS is provided through the best people in the field.
25. Expansion of clinical units: This project from the provincial ADP was initiated during 2009.Under these project seven clinical units which includes Medicine, ENT, Surgery, Orthopedic, Gynae/Obs, Dermatology, Psychiatry and Hematology along with an Operation theatre and Intensive Care Unit and a labor room would be added to the existing facilities. 99% of the civil work has been completed, 100% of equipments have been purchased and in about 02 months period the units would be made functional.
26. Residential accommodations: Construction of hostels for doctors, nurses and paramedics under the Provincial Annual Development Program (ADP) schemes stared this year. These include 01 doctor’s hostel, 12 doctors’ flats, 02 nurses’ hostels and 01 paramedic’s hostel.
In addition to ADP schemes, the NWFP Workers Welfare Board approved construction of 05 residential units for which HMC has allocated land. These 05 units include 01 doctor’s hostel, 01 nursing Hostel, 01 Paramedics Hostel and separate married flats for Doctors and Nurses.
The work on all these units has started and half of them have been completed while the rest would be completed by Dec 2011.HMC had never witness development work on such large scale in its 20 year history.
27. BSL-3 TB laboratory: Due to the Special interest taken by the HMC management in running the TB Control Programme in the hospital, the Provincial TB Control Programme and the KFW (German development bank ) offered to construct a Biosafety level-3 laboratory for diagnosis of Tuberculosis in Hayatabad Medical Complex. This was welcomed by the institution and 03 kanals of precious land was allotted within the premises of HMC. The construction work started in December 2009 and the building has been completed.
BSL-3 will be constructed in phase-2 of the project in 2011. This is first and most sophisticated Lab of its kind not only in the province but in the whole region.
28. Burn and Trauma Centre: A 60 bedded Burn and trauma centre was approved by the Federal Workers Welfare Fund (WWF) for HMC for a cost of Rs.380 million. The work on the centre started in December 2010 and is expected to be completed by June 2012. This would be the first trauma and burn centre in the province, and would provide state of the art services to patients of this traumatized province.
29. School of Midwifery at HMC. In 2009 an MOU was signed with Maternal, Newborn and Child Health (MNCH) programme under which a school of Midwifery was to be established in HMC. A whole new floor has now been added on the roof of the existing nursing school building for training of midwives. This has provided additional classrooms, laboratories and examination hall to both the school. More than 80 midwives are being trained in this school at the moment.
30. Hostel for PICO. The Fred Hollows Foundation has agreed to fund the construction of a hostel for 100 students of PICO. HMC administration has earmarked land for the purpose. Construction is expected to start in Oct. 2011.
31. Bank and ATM machine: On the persistent demands from the staff a branch of Muslim Commercial Bank was opened in 2010. An ATM machine was added in June 2011. Now the staff, around 2000 in number more than half of which is females don’t have to go out of the premises for withdrawal or deposit of cash and other issues like depositing utility bills.
32. Cardiac Rehabilitation Centre (CRC): Due to hectic efforts of HMC administration this centre was approved by the Chief Minister KPK and was included in the ADP 2011-2012. The construction work on the building started in July 2011. His project would comprise of four stories and 200 beds and would cater for treatment of patients with chronic heart failure and also provide specialized facility of Cardiac Electro-physiology.
33. The Central Air Conditioning Plant was lying out of order was completely overhauled in 2009 at a cost of Rs. 3 million. The cooling tower was reconstructed and fins were imported from Thailand for the plant. The problems which were faced in the past have been rectified.
34. Improvement in OPDs: During the year 2009 televisions were provided in all the OPDs for the entertainment of the patients and also for providing them with health education. New sign boards were installed inside the hospital for the guidance and convenience of the patients and visitors and patient guides were deputed to in OPDs for helping and guiding patients.
35. Spine surgeries started: In the Orthopedics units, spine surgeries were started in the year 2010. This is the first hospital in KPK to provide this facility. Specialized equipments for the purpose were purchased. The department has now been renamed as “Orthopedics and spine surgery” unit. This renaming would create awareness amongst the public about the availability of this facility in HMC as before this patients used to go to Punjab for the treatment. Secondly this unit (if approved by PMDC and CPSP) would become a training centre for future specialists in the field of spine surgery.
36. Internet /video conferencing facility was made available in 2009-2010 between LRH and HMC, which is used both for the learning purpose (seminars, lectures, presentations) as well as for different events (world health day, child day etc). The Internet facility is already available in all clinical units and library of HMC.
37. Tele-medicinesystem was started in HMC in 2009-2010. The OTs have been connected to the HMC and LRH auditorium. The surgeries can now be viewed by the TMOs live in the auditorium. The recording facility for OTs is also available which can be utilized by the TMOs and doctors for learning purposes.
38. Length of stay & bed occupancy: .With our Management Information System till now only the statistics regarding the number patients in different specialties was maintained. Without spending any extra money from the same data since August 2009, two other important indicators of clinical performance namely: Average length of stay (ALS) and the Bed occupancy rate (BOR) are being calculated and used to monitor the performance of the different individual units.
39. Job description manual: A job description manual was prepared for the institution in 2010. The Hospital/ Institution never had a JDM since its inception. This manual is a handy guideline for every category of employees in the institution regarding his/her responsibilities. Things are more streamlined and complaints from the units and even from the public have reduced manifolds.
40. Standard Operating Procedures: An SOP manual for the institution was prepared and circulated to the clinical units to streamline the care of patients and reduce adverse events. The SOPs are general in nature and every unit has come up with its special/ peculiar SOPs. These have been printed in book form and circulated to all concerned.
41. Attendants waiting area: Till now there was no place at all for the attendants of patients to rest or stay overnight in the hospital. Through donations from philanthropists attendants waiting area was constructed in HMC with a cost of Rs. 12 lacs and officially opened in July 2011. This area provides facility for toilets, bathing, cool drinking water and sleeping. This facility is free of any charge.
42. Children Park: The designated Children Park in HMC gave a deserted look and had become a heap of filth. Massive refurbishment and renovation of the park was carried out in July 2011. Several swings, sea-saws, monkey bars and slides were installed for children playing besides installing benches and trash bins. The Park gives a very impressive look now.
43. Benches and Trash bins: Around 100 fiber- glass benches and trash bins purchased from Marks Company Hayatabad were installed in the parks and green areas of the hospital in 2011. The whole hospital was re-painted in 2011 both interior and exterior giving a new look to the entire building.
44. Hawa park
45. Hospital websitewww.hmcpeshawar.com.pk was developed. Separate websites for PGMI and KGMC already exist. The website is a very vibrant one and provides latest information about the institution and related subjects.
46. Free treatment for Blood cancer patients.
HMC in coordination with the Novartis Pharma and the health department of KPK has started provision of free medicines to patients suffering from Chronic Myeloid Leukemia. This program would be for a period of five years in which the Novartis Pharma would provide medicines to patients for 10months in a year while medicines for the remaining 2 months in a year would be provided by the government of Khyber Pakhtunkhwa. HMC oncology unit is the focal site for this project. The institution has provided separate space, staff and equipment for implementation of this programme in the hospital. The programme is underway satisfactorily.
47. Establishment of Bone bank.
A bone bank has been established in the hospital, where bone chips from donors would be stored and used for bone grafting of needy patients. This bank has been set up and run jointly by the Orthopedics and Pathology departments of the Institution and is the first Bone Bank of its kind in the province.
48. Water filtration Plant.A water filtration plant was installed in the hospital premises in Jan 2012 with the help of an NGO. This plant can provide 30,000 gallons of filtered water daily and is of great help to the poor patients, attendants and even the staff of the hospital
49. Khyber Girls Medical College: A component unit of HMC has proved to be one of the best public sector medical schools in the province. In 2010 and 2011 the academic results of KGMC were best in the province. Two hostels and an auditorium for the college was initiated in 2010 from the Provincial ADP and work is expected to be completed by June 2012.
In July 2011, PMDC inspected KGMC and approved it for postgraduation. It has become the first medical college in the province officially approved for M.Phil & other postgraduate courses.
50. Institute of Kidney Diseases: During 2009- 2010, development work was carried out in IKD and a new ward/ unit added raising the bed strength from 50 to 90. The number of Renal dialysis, Renal transplants and other specialized surgery has constantly been on the rise.