MAPÚA UNIVERSITY

School of Industrial Engineering & Engineering Management

Ospital ng Maynila Medical Center

Submitted by:
Cortes, Julius Gabrielle C.
Seneta, Joshua Adam O.
Pelayo, Reiner B.
Santos, Redrax Stephen A.

Submitted To:
Prof. Rene Estember

As a partial requirement for the course

SVM 151
Healthcare Systems

2nd Quarter S.Y. 2019–2020

Introduction

The Ospital ng Maynila Medical or OMMC is a 300-bed non-profit tertiary,

general and training hospital in Malate, Manila, Philippines. It is the laboratory hospital
of health science students enrolled at the Pamantasan ng Lungsod ng Maynila, one of
the Philippines' universities.

As hospital operated and maintained through taxes paid by Manila residents, OMMC
has for its primary concern the admission and treatment of patients who are bona fide
residents of the city. Furthermore, it is responsible for the provision of an integrated
community health program and research activities

The Ospital ng Maynila has been established to provide city residents, 80 of whom
have been classified as indigents, a better standard of medical care.

Studies reveal that an alarming number of city residents die without medical
attendance. During the year 1967, 16.45% of the total deaths in the city occurred without
medical attendance, and 14.43% with incomplete medical attendance. Added to this
problem was the fact all the four national hospitals located in the city cannot
accommodate all needy patients and even refuse some 8,000 patients a month.

The Objectives of the Hospital is to provide city residents quality medical care at
the lowest possible cost to the city of Manila, to provide a program of graduate and
undergraduate training in medical, nursing and paramedical disciplines, to serve as the
medical center of an integrated community health program and, to provide and maintain
an atmosphere of scientific excellence in order to stimulate and promote research
activities.

Mission and purpose of the hospital:

The hospital will function as an acute, non-profit, general hospital whose primary
concern is to provide free in-patient and out-patient medical care to all Manila residents,
regardless of social status, race or creed.
Background of the Study

The Health of the individuals in a nation contributes to the Wealth and

Good of the nation. Health care (or healthcare) is the diagnosis, treatment, and
prevention of disease, illness and other physical and mental impairments in human.
Quality in health can be explained as the difference between patient expectations and
perceptions; expectation means service provider performance during deliverance of
services whereas perception is measurement of delivery by the service provider.

A public hospital or government hospital is a hospital which is owned by

a government and receives government funding. In some countries, this type of hospital
provides medical care free of charge, the cost of which is covered by government
reimbursement.

The prime difference between a private hospital and a public hospital is the
ownership. A private hospital is one which is owned and governed by a person or many
people who are managing the whole finances on their own. A public hospital, on the other
hand, is completely and entirely run on the government’s funding and money.

The fees of a private hospital are higher than that of a public hospital. It should be
noted that most of the time public hospitals offer their services free of charge or for
reduced rates.

In a public hospital, since the services are mostly free, waiting time is longer. For
some operations patients must wait for years until they get their place. In a private
hospital, waiting time is less. If you have money, you can get you operation done very
quickly.

Private hospitals have the most modern equipment and the equipment last longer
too. Public hospitals have good equipment, but due to the extreme use they can get
damaged more often than those in a private hospital.

Number of patients per doctor is higher in public hospitals. It is not good as the
attention is too much divided. It is also exhausting for the doctor.
 Since private hospitals are a kind of a business, they earn a profit like any other
business. However, that is not the case with a public hospital. Governments operate
public hospitals for the health of their people, and not to earn a profit.

Role of Company in Healthcare

In providing healthcare services, the Government ensures that every Filipino would
have access to quality health care services. In the Philippines, population increases every
year, but it seems like the Government have not made any move regarding improving
their hospitals’ facilities, service process and man power.

The problem being faced by the Ospital ng Maynila Medical Center is their limited
capacity, low quality of health care services and low maintenance in their health-related
facilities especially in the public section. Ospital ng Maynila Medical Center is well known
to having a large volume of patients coming every day and it is their responsibility to
control and ensure that each one of them will receive high quality of health care services.

Objectives of the Study

 To provide alternative solutions for the problems encountered.

 To know the part of Ospital ng Maynila Medical Center in the healthcare industry
 To determine the products and services offered by Ospital ng Maynila Medical
Center.
 To know the procedures in availing the offered products and services by Ospital
ng Maynila Medical Center.
Importance and Relevance

The provision of high-quality, affordable, health care services is an increasingly

difficult challenge. Due to the complexities of health care services and systems,
investigating and interpreting the use, costs, quality, accessibility, delivery, organization,
financing, and outcomes of health care services is key to informing government officials,
insurers, providers, consumers, and others making decisions about health-related issues.

The field of health services research is relied on by decision makers and the public
to be the primary source of information on how well health systems in our country and
other countries are meeting this challenge. To provide information that will eventually lead
to improvements in the health of the citizenry. Drawing on theories, knowledge, and
methods from a range of disciplines, Healthcare system research is a multidisciplinary
field that moves beyond basic and applied research, drawing on all the health professions
and on many academic disciplines, including biostatistics, epidemiology, health
economics, medicine, nursing, operations research, psychology, and sociology.
 Pros and Cons of Private Hospitals:

Pros Cons

• Thanks to their smaller size, they are • They often only accept limited forms of
more equipped to offer personalized insurance.
care. • They have the right to refuse to treat
• Instead of being responsible for anyone who they don't think can pay.
dozens of patients, nurses usually • They also tend to be more expensive in
only have a few to care for at a time. general.
• They tend to stay on the cutting edge • Finally, they usually have very limited
of technology more easily than public numbers of beds.
hospitals, and they often have upscale
amenities that make them feel more
like nice hotels than hospitals.
• Wait times tend to be short, and
doctor-to-patient ratios are usually
excellent.
Pros and Cons of Public Hospitals:

Pros Cons

• Public hospitals can't turn • Their sheer size is a big one.

anyone away, so you're sure to • Although they have way more
receive treatment when you visit employees than private
one. hospitals, patient-to-doctor
• Because they are publicly ratios don't tend to be very
funded and not for profit, they good.
are usually a lot more affordable • You are almost certain to wait
than private hospitals. when visiting the ER.
Depending on the time of day
• Due to their size, they also and the nature of your
usually have a lot more beds emergency, you could wait for
than private hospitals. hours before being seen.
• There isn't e much in the way of
personalized care because
nurses are often overloaded
with patients. After all, public
hospitals can't refuse anyone.
METHODOLOGY

Data Collection

In order to gain knowledge about the process flow and the current system of the Ospital
ng Maynila Medical Center we conducted an ocular visit and toured around the different
sections of the hospital. We don’t allow to take a picture inside the hospital due to their
strict rules and regulations.

As we go around the hospital, we observed that some patients are situated along the
hallways of the building which proves the fact that Ospital ng Maynila Medical Center
cannot properly accommodate all their patients. The Cashier, Pharmacy, Radiology
department of the hospital has a problem in the queuing system.

We assessed all the details we could gather for us to formulate a problem

statement regarding the current status of the Ospital ng Maynila Medical Center. We also
interviewed one of the employees of the hospital but for private reasons we may not give
information about the interviewee and we cannot tape the conversation we had because
they have a strict protocol as a government employee.
Data Analysis

For Ospital ng Maynila Medical Center to optimize its capacity, provide high quality
health care services and preserve its facilities, a shift in its system or process flow must
occur by following the efficiency of this diagram:

Input Process Output

Existing Process Process Flow Assessment of the current

system

. By following the diagram, we defined and categorized their problems in the three
parts (Input, Method, Output) and by observing around the hospital and asking some of
the patients and staff there, the problem was verified.
CASE STUDY ANALYSIS

Presentation of Case Facts

During our visit to the Ospital ng Maynila Medical Center we found that many people
were waiting in line. Such situations are no different from what we Filipinos do. There
were workers on duty to support the patients inside the hospital, but the number of
staffs was not enough to serve their patients in abundance.
CONCLUSION

Alternative Courses of Action

Having stated that the Ospital ng Maynila Medical Center is a significant medical and
educational facility being administrated by the local government of Manila — OMMC
has the primary duty to cater in the admission and treatment of patients who are bona
fide residents of the said city; and thus have the responsibility in contributing in the
integrated community health programs and research program provisions that are being
implemented.

Essentially, the governing body of OMMC — the city government of manila — is liable
and must bear the accountability coupled with its reputation as a teaching hospital while
also maintaining top notch operation standards and industry protocols.
RECOMMENDATIONS

 Integrate healthcare service networks in line with the era’s developments in

mobile technology.
 Increase customer relationship and other primary and supplementary elements
that bolsters credibility and assurance.
 Being a public hospital in nature, transparency, honesty, and quality service are
supposed to be OMMC’s core.
 Ask the National Government to increase the hospital’s budget and provide
necessary breakdowns to justify all the cost
 Conduct employee trainings
 Purchase updated hospital equipment for the use of both the public and private
sections of the hospital
 Provide a better waiting area for patients and guardians
 Minor renovations are also needed in different areas of the hospital
 Expansion of their facilities
Related Review Literature

[1] Health services research is a significant field of scientific investigation that

encompasses several bailiwicks studying how technological aspects, organizational
processes and structures, socio-economic factors, financial systems, and distinctive
behaviours directly impacts the general welfare, costs, and accessibility of quality
healthcare University of Washington (2011)

Reference:

University of Washington (2011). Department of Health Services. Retrieved from

http://depts.washington.edu/hserv/hs-research-definitions#content

[2] Health research has found a comfortable definition as a process of systematically

investigating a single well-defined aspect of physical, mental, or social well-being
(Jacobsen,2012)

Reference:

Jacobsen, K. H. (2012). Introduction to Health Research Methods: A Practical Guide.

Retrieved from The University of Phoenix eBook Collection database.

[3] Conducting a research-based research is a common approach in fields such as

epidemiology, health services research, and public health research, and includes analysis
of patterns of occurrences, determinants, and natural history of disease; evaluation of
health care interventions and services; drug safety surveillance; and some genetic and
social studies (Lowrance, 2002; Lowrance and Collins, 2007).

Reference:

Lowrance WW, Collins FS. Identifiability in genomic research. Science. 2007; 317:600–
602.

[4] Economists have found that medical research can have an enormous impact on
human health and longevity, and that the resulting increased productivity of the population
contributes greatly to the national economy (Hatfield et al., 2001; Murphy and Topel,
1999) in addition to the individual benefits of improved health.
Reference:

Hatfield M, Sonnenschein HF, Rosenberg LE. Exceptional returns: The economic value
of America’s investment in medical research. 2001.

[5] Clinically rich information is now more readily available, in a more structured format,
and able to be electronically exchanged throughout the health and health care continuum;
hence, the information can be better used for quality improvement, public health, and
research, and can significantly contribute to improvements in health and health care for
individuals and populations” (NCVHS, 2007a)

Reference:

NCVHS (National Committee on Vital and Health Statistics). Enhanced protections for
uses of health data: A stewardship framework for “secondary uses” of electronically
collected and transmitted health data. 2007a

[6] The Virginia Commonwealth University 2004 Life Sciences Survey also found that
most Americans have a positive view of research. In this study, 90 percent of respondents
agreed that developments in science have made society better; 92 percent reported that
“scientific research is essential for improving the quality of human lives”; and 84 percent
agreed that “the benefits of scientific research outweigh the harmful results” (NSF, 2006)

Reference:

NSF (National Science Foundation). Science and Engineering Indicators 2006. Arlington,
VA: the National Science Foundation; 2006. Science and technology: Public attitudes and
understanding. Chapter 7.

[7] Ethicists have long suggested greater community involvement in health research
studies, including more communication about research results (reviewed by Shalowitz
and Miller, 2008a,b).

Reference:

Shalowitz DI, Miller FG. Communicating the results of clinical research to participants:
Attitudes, practices, and future directions. PLoS Medicine. 2008a May 13;5(5): e91.
[8] The healthcare data quality affects every decision taken along the patient care
process. The need for correct and reliable data has become very important. (Raheja,
Dubey, Chawda 2017)

Reference:

Raheja, K., Dubey, A., & Chawda, R. (2017). Data Analysis and its Importance in Health
Care. International Journal of Computer Trends and Technology, 48(4), 176–180. doi:
10.14445/22312803/ijctt-v48p132

[9] The reliability ensuring of a given healthcare data generally is based on the accuracy
and the completeness of the data recorded in the patient’s health record; therefore in
order to stay competitive and viable, healthcare organizations need to utilize the data to
positively affect the quality of healthcare, reduce costs, and to manage the patient
populations

Reference:

Santana, M. J., Feeny, D., Johnson, J. A., McAlister, F. A., Kim, D., Weinkauf, J., et al.
(2010). Assessing the use of health-related quality of life measures in the routine health
care care of lung-transplant patients. Quality of Life Research, 19(3), 371–379.

[10] Tactical planning requires convincing and an unbiased assessment. Transforming

healthcare organizations need to incorporate frequent changes to maintain the optimum
functionality — the strengths and weaknesses of the organizations are then determined
by their internal factors whereas the opportunities and threats usually are dependent on
the external factors.

Reference:

Velikova, G., Keding, A., Harley, C., Cocks, K., Booth, L., Smith, A. B., et al. (2010).
Patients report improvements in continuity of care when quality of life assessments are
used routinely in oncology practice: Secondary outcomes of a randomised controlled trial.
European Journal of Cancer, 46(13), 2381–2388.
The ultimate goal of health services research is to provide information that will eventually
lead to improvements in the health of the citizenry [11]; drawing on theories, knowledge,
and methods from a range of disciplines [12]. Health services research is a
multidisciplinary field that moves beyond basic and applied research, drawing on all the
health professions and on many academic disciplines, including biostatistics,
epidemiology, health economics, medicine, nursing, operations research, psychology,
and sociology [13].

References:

[11] Institute of Medicine. Improving information services for health services researchers:
a report to the National Library of Medicine. Washington, DC: National Academy Press;
1991.

[12] Ginzberg E, editor. Health services research: key to health policy. Cambridge, MA:
Harvard University Press; 1991.

[13] Institute of Medicine. Health services research: training and workforce issues.
Washington, DC: National Academy Press; 1995

[14] Quality of care is the degree to which health services for individuals and populations
increase the likelihood of desired health outcomes and are consistent with current
professional knowledge.

References:

Institute of Medicine. Improving information services for health services researchers: a

report to the National Library of Medicine. Washington, DC: National Academy Press;
1991.
Evaluation of the process of care can be done by applying the six goals for health care
quality. [15] Was the patient’s safety protected? Was care timely and not delayed or
denied? Were the diagnosis and treatments provided consistent with scientific evidence
and best professional practice? Was the care patient centered? Were services provided
efficiently? Was the care provided equitable? Answers to these questions can help us
understand if the process of care needs improvement and where quality improvement
efforts should be directed.

References:

Committee on Quality of HealthCare in America. Crossing the quality chasm: a new health
system for the 21st century Institute of Medicine. National Academy Press; Washington,
DC: 2001