MAYO HOSPITAL, LAHORE

BRIEF HISTORY AND INTRODUCTION Mayo Hospital is the oldest and largest hospital of the country, serving the humanity since 1871. King Edward Medical University is the attached university which is Pakistan's second most prestigious and subcontinent's second oldest institution.

Mayo Hospital was completed in 1870 and it started patient care in 1871. It was named after the Earl of Mayo, the then Viceroy and the Governor General of India. Encompassing over 52.8 acres of land and the main building with boundary having 11 gates, the hospital is one of the largest hospitals in South East Asia and is a centre of excellence for public benefit. It had bed capacity of 300 beds on the Day of Independence (1947) but now is extended up to 2399 beds. The father of the nation, Quaid-e-Azam Muhammad Ali Jinnah also paid tribute to services rendered by this hospital on his visit to Mayo Hospital dated 19.03.1940. Mayo Hospital is located in the heart of Lahore City and is surrounded by busy commercial and thickly populated residential areas with famous Anarkali Bazaar, Nila Gumbad, Urdu Bazaar and the Walled City of Old Lahore around it. Earlier, after its construction in 1871, the Mayo Hospital was affiliated as a teaching hospital with the King Edward Medical College which came into being in 1860. In year 2005, the King Edward Medical University (KEMU) came into existence to which Mayo Hospital is to be declared as attached hospital for teaching purposes. The hospital so attached, however, has been placed under the administrative control of Govt. of the Punjab, the same administrative setup which existed since 1871 up to 1999.DEVELOPMENTAL STAGES 1871: Construction of the Main Building of Mayo Hospital 1891: Construction of Albert Victor Hospital (AVH) Block (Private Block) 1948: Pediatrics Block (Old) 1952: Out Patient Department Block 1974: Pediatrics Wards

1982: Institute of Ophthalmology 1984: New Accidents & Emergency Block & Pediatric Surgery Block. 2001: Department of Physical Medicine and Rehabilitation. Development is actively taking place and new buildings like Surgical Tower to meet the demands of the patients are being constructed.

HOSPITAL POLICY It is based on: The effective implementation of Government commitment i.e. Health for All Scalar Principle of Management Command on communication Decentralization of Authority (Finance and Administration) PERT Inculcating sense of social security through the availability of 100% commodities for 100% patients on 100 % occasions.

ORGANIZATION
Medical Superintendent heads the Hospital Management. STAFF 1. Medical Senior Consultant Pathologist 1 BioChemist 1 Medical Officer 1 Medical Technologist 1

2. Para Medical Lab Technicians 2 Lab Assistants 4 Lab Attendants 7 Ward Attendants 2 Lab Cleaner 1

SPECIALIZED UNITS WORKING IN MAYO HOSPITAL

Mayo Hospital, Lahore is the oldest and biggest hospital of Pakistan. It consisted of 2000 Registered beds. There are 24 Specialized units working in Mayo Hospital, Lahore. Cardiac Surgery Neurology unit Dermatology unit Neuro Surgery unit urology Unit Oncology Unit Orthopaedic Unit Psychiatry Unit Paeds Medical Unit Paeds. Surgical Unit Paeds. Preventive Unit Chest Disease Unity. E.N.T. Unit. Eye Unit. Plastic Surgery Unit Burn Unit Physically Disability Unit. Surgical Unit. Medical Unit Venerology Unit. Dental Unit Physiotherapy Unity E.C.G. Unit.

 Radiology

FACILITIES AVAILABLE IN MAYO HOSPITAL

Central ICU with Central Oxygen (O2) & Suction System
Standard Coronary Care Unit (CCU) Facilities

Angiography, Angioplasty, Cardiac Bypass, Heart Valves Replacement and all sorts of Cardiac Operations and procedures Radio Isotope Cardiology / Thallium Scan / Echocardiography / ETT Spiral CT, Color Doppler and Ultrasonography on latest machines Renal Transplantation and Renal Haemodialysis All Dermatological Procedures Radiotherapy on latest machines Latest Physiotherapy Equipment, Rehabilitation Center and Orthopaedic Workshop Neuro-Angiography, EMG, EEG and all kind of sophisticated Neuro-surgical operations Operations of Plastic Surgery and cosmetology Operations of Fascio-maxillary, Jaw and Dental Surgery All kinds of Orthopaedic Operations under competent consultants All kind of Eye and ENT Operations Surgical Operations of all kind for neonates, children, young and old patients Radio Isotope Thyroid, Liver, Bone, Brain and other organs scanning, Hormonal Assays and Viral Markings are being done in Atomic.

DEPARTMENTS
Main Accident & Emergency Emergency Operation Theatre (COT/ NEOT) Paeds. Medicine Emergency Paeds. Emergency Operation Theatre OUT-PATIENT DEPARTMENT

There are 42 out-patient departments comprising Medicine and Surgery and sub-specialties. Average patients per day in OPD: ~2000 INPATIENT DEPARTMENT Average surgeries performed per day: ~250 Total Beds: ~1600 Major Departments: 4 Internal Medicine and 4 General Surgical Departments. Total patients seen per year are ~8,35,136: ~2,25,653 in the Emergency and ~6,09,483 in the Outpatient Department. ACCIDENT & EMERGENCY BLOCK Mayo hospital is 1799 bedded, tertiary care teaching hospital, where as 195 beds are available in the Accident and Emergency Department of Mayo hospital, Lahore. It is the main emergency department, treats adults starting from 13 years. There are separate emergencies for children less than 13 years comprising Pediatric Medicine and Pediatric Surgery emergencies. Total Beds available: ~169 Patients seen per day in all Emergency departments (Adult and Pediatric): ~ 600 - 800 FACILITIES AVAILABLE IN EMERGENCY DEPARTMENT 24-hour in-house coverage by general surgeons and prompt availability of care in varying specialties such as orthopedic surgery, anesthesiology, emergency medicine, radiology, internal medicine, oral and maxillofacial surgery. Intensive care (ICU) & coronary care unit (CCU), fully equipped with central monitoring, central oxygen supply system, ventilators, defibrillators and sufficient stock of medicines. A burn unit for 10 patients, managed by Plastic Surgeons A well equipped clinical laboratory, performing 500 700 tests daily. Sufficient stock of blood of all groups.

 Ambulance service for transport of patients within hospital. IMPROVEMENT IN A&E DEPARTMENT Accident & Emergency Department Mayo Hospital Lahore is the largest Emergency of the Pakistan. More then 800 to 1000 new patients get benefit from this emergency daily. Administrative staff of Accident & Emergency Department along with energetic and miraculous leader ship of. Medical Superintendent Dr. Fayyaz Ahmad Ranja, is working hard for provision of excellent services to the ailing humanity. Under the dynamic leadership of worthy M.S. a lot of improvements have been made. Main achievements are as under: Patient care Civil work Care of equipment Better communication system. General cleanliness. Orderliness. Surveillance /interview of the patient

BLOOD BANK MAYO HOSPITAL, LAHORE

Dr. Muhammad Farrukh Sultan B.Sc., MBBS(Pb.) RMP. Blood Transfusion Officer BRIEF HISTORY & INTRODUCTION Hospitals are functioning almost in every part of the country thought they are not as adequate and equipped as may be available in the advanced countries. But in spite of all pecuniary handicaps and many other draw backs we can safely assets and claim that in hospitals like Mayo Hospital, services and Jinnah etc. medical services are provided in a competitive manner and it is mainly due to the major contribution of the experts and staff and appropriate administrations running these functions. There is not very reach awareness among the successes that in hospital services including medical and surgical, there is another integral and essential part without which the main theme of the hospital can not be achieved is the segment of blood transfusion service. All blood bank services are free of cost for the inpatients and entitled ones.

A & E LAB MAYO HOSPITAL LAHORE TEST DESCRIPTION All kinds of tests being performed including LFTs, RFTs, routine blood and urine examinations, blood sugar, cerium electrolytes, currently we are performing the blood gases because of non-availability of the solutions and reagents.

CORPORATE SOCIL RESPONSIBILITY

Free services in the Institute of Ophthalmology (all the three Eye Units made free),

even including the provision of Intra Ocular Lens (IOLs).

Eree diabetic clinic with the provision of oral anti-diabetic agents & insulin injection

like HUMULIN. The provision of 100% free medical coverage for both indoor and outdoor patients of Tuberculosis (TB) has been ensured.
Installation and commissioning of Angiography Machine in Cardiology Department

including renovation of cardiac surgery Operation Theatre has been carried out. Angiographies are being performed on new machine. Pediatric operation theatres have been declared free for surgery with the provision of all medicines and surgical disposables including Shunts and all types of sutures Provision of 100% free surgical coverage to patients in ENT operation theatre Provision of shelter and overnight stay facilities for attendants of patients (initiation of service facilities for the above purpose in Quaid-e-Azam Musafer Khana) Provision of 100% free operation facilities to all patients in main general surgery operation theatres of Mayo Hospital.
100% free medicine coverage extended to Pediatric Medical Ward including even

providing anti cancerous chemotherapy. PC-1 approved, foundation stone laid down by Honorable Chief Minister for the construction of Multi-storey surgical tower. This will include state of the art operation theaters and wards including Helipad for trauma patients. Establishment of state of the art Central ICU

 First time ever in the history of Pakistan in any hospital, cardiac surgery has been declared free
323 patients underwent cardiac surgeries like CABG and Valve replacement.

All the four surgical units along with chest surgery (whole surgical floor) have been declared free of cost for all. Provision of 100 % free medicines to Pediatric Surgery Ward.
Provision of 100% free medical treatment in both the Dermatological Units. Provision

of 100% free medical treatment in the Oncology Department.

Provision of 100% free medical treatment in the four medical units (medical floor).For

this purpose a fully functional pharmacy has been established at medical floor. To declare following units free: Orthopedics & Urology To declare rest of the Hospital free for all patients

PATIENTS WELFARE ASSOCIATION

Patients Welfare Association came into being in 1963 and Register on 11th January, 1964. patients Welfare Society, Mayo Hospital, Lahore is providing social, psychological and financial Assistance to poor needy patients. WORKING OF PATIENTS WELFARE ASSOCIATION. Patients Welfare Association is providing free medical assistance to the disabled persons. Patients Welfare Association Mayo Hospital, Lahore is providing free optical to the poor and deserving patients. Patients Welfare Association provides free of cost ambulance services to the poor and destitute deceases families. Patients Welfare Association, Mayo Hospital, Lahore is providing vocational training facilities for Women of the surrounding area of May Hospital, Lahore. Almost 15 to 18 Females getting vocational Training from this Center every month. Patients Welfare Association, Mayo Hospital, Lahore is providing Day Care Center facility to working families of the hospital.

 Patients Welfare Association, Mayo Hospital, Lahore is running a guide service to the patient coming for treatment from far flung areas of the country. For this purpose a guide is deputed by Patients Welfare Society to assist Patients. 30 to 40 patients are taking guidance daily. Patients Welfare Association, of this hospital is providing wheel chair with in hospital premises. Facility of photocopy of the documents of the patients and staff of the hospital. Patients Welfare Society is also bearing the expenses of stationary for Utilization of Zakat Fund. Patient Welfare Association is also providing services in search of attendance of Unknown Patient. FUTURE PLAN
Patients Welfare Association, Mayo Hospital, Lahore will construct a Welfare

Home for the un-known and un-attended patients of Mayo Hospital, Lahore. Patients Welfare Association, Mayo Hospital, Lahore intends to purchase its own Ambulance for needy patients.
Patients Welfare Association, Mayo Hospital, Lahore will shortly start a compute

training programme for the employee of the Hospital.

Patients Welfare Association of this hospital will also start a public call office for the

patient to provide them telephonic facility within the Hospital premises. Ultrasound facility for outdoor patients. BRIEF OF HEALTH WELFARE COMMITTEE MAYO HOSPITAL, LAHORE. Medical Social Officers are performing their duties for zakat fund utilization. They keep and maintain record of Zakat. About 350 to 400 patients per month getting free medicines from General Zakat Fund and almost 60 patients getting free medicines from Urology Fund of the Heath Welfare Committee of Mayo Hospital, Lahore.

HOSPITAL GOAL AND THE CONTINUITY OF ITS ACHIEVEMENTS Sustainability of 100% Free of Cost coverage in Hospital will be ensured through Macro and Micro Financial Management Un-interrupted availability of resources and its rational utilization will be sought as hot pursuit. The essence would be to see through that this exceptional policy becomes natural to the hospital even in the future though a system of working.

ACHIEVEMENTS AND ACCOMPLISHMENT

ACHIEVEMENTS

Starting from 24th May, 2003, following departments provide 100 % free[4] treatment (as long as the patient remains admitted in the hospital): Accident & Emergency Department Pediatric Medicine and Surgery Emergency, Inpatient Department and Intensive Care Unit (ICU) Department of Ophthalmology and Eye Operation Theatre General Surgical Operation Theatres and Inpatient Departments Diabetic Clinic Otorhinolaryngology Operation Theatre Tuberculosis & Chest Diseases and Chest Surgical Departments Cardiac Surgery Operation Theatre, Inpatient and Coronary Care Unit (CCU) Dermatology Outpatient Department Radiotherapy & Oncology Department Internal Medicine Departments
ACCOMPLISHMENT

Completion of canopy near Accident & Emergency Department, (ELLAHI MEHEMAN KHANA) where the patient's attendants are sitting. Deputed three ward attendant /Khidmat-Gar to facilitate the patient attendants and serving them with cold water round the clock. Deputed three Ward cleaner for sanitation in canopy & the vicinity round the clock.

Reconstruction of passage from A&E to canopy to facilitate patient attendants & doctors.

Construction of shed at reception. Opening of X-Ray door from surgical side, to facilitate seriously/dangerously injured patients for X-Rays. Successful implementation of 100% provision of free medicine & surgical items to all patients visiting in Accident & Emergency Department. Procurement of two new operation tables in NEOT.

All air conditioners in Accident & Emergency, COT & NEOT made functioning.

Web site of Mayo Hospital has been made functional on Internet for latest information.

C.C.TV has been installed in Accident & Emergency department made functional to detect the mismanagement of the Medicine.

First of all by the Grace of Almighty Allah, and after going through the day &

night work hard by DR. FAYYAZ AHMED RANJHA, to provide the Image intensifier facilities to the Emergency patients, which is available for doing Orthopedic Operations to avoid blood loss of severely injured patients. We are heartily grateful to the Worthy Medical Superintendent, Mayo Hospital, Lahore for this grate achievement.
Extension of NEOT & installation of two new operation tables to facilitate

surgeon in Accident & Emergency/NEOT by increasing operation tables from 2 to 4.

M.O.T. near New Casualty Emergency Operation Theater with well equipped

new instrument & two new operation tables which are functioning round the clock. Two new X-Ray's machines have been launched and working for rendering services to the Emergency patients.
New Bio-chemistry analyzer was also installed in A&E Lab and functioning .

 Shifting of blood Bank from 1st floor to Ground floor .

Centralized oxygen supply in COD, Medical & Surgical ward on ground floor .

Installation of curtain & accessories in female ward (COD) .

Centralized Oxygen and other gases supply in COT & NEOT .

Installation of new kits in Accident & Emergency& lifts .

Renovation of DMS /AMS Office. Recruitment/selection of new energetic and dedicated staff for A&E Department .
Training program for doctors/nurses & paramedics about quality Health Care,

Interpersonal communication & evidence based medicine learning programme. Incentive, Reward and compensation program for Emergency staff.

ANALYSIS & CONCLUSION

FOLLOWING FACTORS ARE IMPORTANT:
Commitment and desire of hospital administration to provide 100% free

medical treatment to 100% patients at 100% occasions. Delay is harmful for the implementation of plans. Proper analysis of available resources, planning, documentation, implementation, management, monitoring, control and evaluation through feedback is essential. The above said achievements have been made without incurring any additional expenses or demanding any further funds from the Government. It is all through better financial management, control and communication with all concerned.

They dont give any proper lecture and they dont develop any proper strategy to promote ethical behaviour in their organization but they give some trainings regarding ethical behaviour.

ETHICAL BEHAVIOUR:

CORPORATE SOCIAL RESPONSIBILITY:

Yes they show corporate social responsibility by treating people without charges. STRESS: Causes; There are following causes of stress in Mayo hospital; a) Employees dont have economic security b) Employees dont have health security Due to job security stress doctors held a protest on 07-07-07. Facilities; They provide them flexible time schedules. They provide job sharing.

THREATS:

Sometimes doctors and other employees go for strike because they have following threats; a) Economic threats b) Health threats c) Job threats Teamworking is promoted in this hospital because without team -working ,work cannot be done.It is important in daily operations and pther treatments. There are some problems which they have to face in team-working because people have different ideas,thinking and different personality traits and doctors can suggest juniors but cannot suggest seniors and colleagues. They dont give any training regarding team-working.

TEAM-WORKING:

PROBLEMS IN TEAM WORKING:

TRAINING OF TEAM-WORKING:

In Mayo hospital there is leg-pulling. ATTITUDES OF EMPLOYEES TOWARDS HOSPITAL: In Mayo hospital doctors and nurses want to leave because of economic stress. a) Discouraging male-domination; There is no issue of ma le domination,both of them are equally treated and they work on same level but sometimes women are more prominent. b) Flexible time schedules; Yes,there is flexible time schedule,Doctors work for 24 hours weekly.There are shifting times as following; 1) 6:00am-6:00pm 2) 6:00pm-12:00pm 3)12:00pm-6:00am c) Physical necessities for physically disable people;

HEALTHY RELATION OR LEGG PULLIN G:

MAYO HOSPITAL DIVERSE IN TERMS OF;

There are no physical necessities for physically disable people even parking facility is not available. d) Off days for religious activities; Yes, employees have off days in Mayo hospital for religious activities. e) Parental care hours; Parental care hours are only given to post graduate and house doctors.

There is following number of dotors,nurses and ward boys in Mayo hospital; Doctors: Nurses: Ward boys:

NO.OF DOCTORS,NURSES AND WARD BOYS:

FACILITIES PROVIDED TO MAYO HOSPITAL: As it is a government hospital so,government provide it many facilities.There are free health facilities .Patients entry fee is only 10 rupees and there are no extra charges even for operations and medicines.

BENEFITS OF MAYO HOSPITAL PRIVIDED TO EMPLOYEES FOR MOTIVATION:

It provides no facilities to motivate employees.

There is culture variation in Mayo hospital and it creates many problems.

CULTURE VARIATION:

Yes,child care facility is provided to doctors,nurses and other employees in Mayo hospital.

CHILD CARE FACILITY OR PERSONAL SUPPORT: