Dona Remedios Trinidad Romualdez Medical Foundation

Graduate School
Bliss Calanipawan Road, Tacloban City, Leyte 6500

In Partial Fulfillment of the Requirements in

Nursing Administration IV

A Hospital Study
Mother of Mercy Hospital
Benigno Aquino Avenue, Tacloban City, Leyte

Accomplished by:
Ms. Carleen Roan S. Delloro, R.N.
Ms. Junalyn L. Doncillo, R. N.

Submitted to:
Professor Irma Roasa R.N., M.A.N.

June 2011
Chapter I

Hospitals are very important institutions for the economic and social well-being of
society. The Hospital Licensure Law, Republic Act 4226, defines the term hospital as “a place
devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment, and
care of individuals suffering from illness, disease or deformity, or in need of obstetrical or other
medical and nursing care.” The term shall also be construed as any institution, building or place
where there are beds, cribs or bassinets for use by patients for twenty-four (24) hours or longer,
in the treatment of diseases, diseased conditions, injuries, deformities, and all institutions such as
those for convalescence, sanitorial care, infirmaries, nurseries, dispensaries and such other names
by which they may be designated. Their curative and rehabilitative functions enable them to
restore individuals to being productive members of society and for those individuals to enjoy the
benefits that can be derived from it. A hospital's performance is difficult to measure because of
the high degree of subjectivity. In general, it may be said that the objective of a hospital is to
provide quality patient care while maintaining the financial viability of the organization. There
are, of course, other objectives related to other activities of specific hospitals such as research
and training. Hospitals, like most other organizations, do not operate in isolation. Various
factors surrounding the hospital and even within the hospital affect its degree of success or
failure in attaining its objectives. These factors include the nature of its resources (capital,
human, technology, etc.), competition, markets (consumers), and government regulations and
incentives.
Nurses play a big role in the success of a hospital especially that the nursing service
comprises the major population of the workforce. Nursing is a healthcare profession focused on
the care of individuals, families, and communities so they may attain, maintain, or recover
optimal health and quality of life from conception to death. Nurses utilize the nursing process
which  uses clinical judgment to strike a balance of epistemology between personal
interpretation and research evidence in which critical thinking may play a part to categorize the
clients issue and course of action. It has 4 phases namely: Assessment, Diagnosis, Planning,
Intervention and Evaluation. In the assessment phase, the nurse completes a holistic nursing
assessment of the needs of the individual/family/community, regardless of the reason for the
encounter. Nursing diagnosis represent the nurse's clinical judgment about actual or potential
health problems/life process occurring with the individual, family, group or community. The
accuracy of the nursing diagnosis is validated when a nurse is able to clearly identify and link to
the defining characteristics, related factors and/or risk factors found within the patient’s
assessment.  For each problem a measurable goal/outcome is set. For each goal/outcome, the
nurse selects nursing interventions that will help achieve the goal/outcome. The nurse
implements the nursing care plan, performing the determined interventions that were selected to
help meet the goals/outcomes that were established. Delegated tasks and the monitoring of them
is included here as well. The nurse evaluates the progress toward the goals/outcomes identified
in the previous phases. If progress towards the goal is slow, or if regression has occurred, the
nurse must change the plan of care accordingly. Conversely, if the goal has been achieved then
the care can cease. New problems may be identified at this stage, and thus the process will start
all over again. The nursing process is a cyclical and ongoing process that can end at any stage if
the problem is solved. The nursing process exists for every problem that the
individual/family/community has. The nursing process not only focuses on ways to improve
physical needs, but also on social and emotional needs as well.

Nursing service is a general concept referring to the organization and administration of

nursing activities. It is the hospital department, which is responsible for the organization and
administration of nursing activities.

Leadership in nursing administration is lived at the corporate level by the chief nurse
executive, at the middle management level by directors of nursing and at the practice interface by
nurse managers. Corporate and middle management exist to support the nurse manager at the
practice interface. This is where the most important work is carried out to ensure that a quality
practice environment exists to support nurses' practice, the education of students and the conduct
of research, all ultimately supporting patient-centered care.

The management process is composed of four major functions, namely, planning,

organizing, directing and controlling. While planning is the first function, one must recognize
that it permeates into the other functions, which are dependent on it. By forecasting one can
estimate the future; by setting objectives the results to be achieved can be determined; by
developing and scheduling programs, the activities needed within a set time frame can be
defined; by preparing the budget, tools and resources can be allocated while establishing policies
and procedures that will define the course of action and standards.

Organizing establishes formal authority. It sets up the organizational structure by

identifying groupings, roles and relationships within the agency. This is depicted in an
organizational chart. Job descriptions define the qualifications and scope of responsibilities, the
relationships and authorities of personnel. Staffing includes determining the staff needed, thus
developing and maintaining a staffing pattern, The process covers recruiting, selecting, orienting
and developing personnel to accomplish the goals of the organization. The selected personnel are
then distributed in the various areas of the agency where they are qualified to belong. Staffing
schedules are made to meet the needs of clients, personnel and agency.

Directing or leading actuates efforts to the accomplishment of goals. This includes

utilization of various modalities of nursing care through the nursing process; updating policies
and procedures; supervising personnel to harmonize work through adequate guidance and
leadership; coordinating personnel and services toward a common goal; communicating via
various routes to ensure common understanding; developing people by providing staff
development programs; and making sound decisions.

Controlling leads to the assessment and regulation of performance of workers. To ensure

the attainment of objectives, certain standards are utilized to measure performance, monitor and
evaluate nursing care, including the utilization of resources. Control promptly reveals deviations
from set plans and standards necessitating immediate corrective measures, actions and/or
discipline.

The success of hospitals in their mission is therefore important. This success is highly
dependent on the hospitals' managerial capability as well as the hospital’s physical set-up, work
force, supplies and equipment. An understanding of how hospitals are managed will contribute
immensely to future successes in hospital management and towards the enhancement of their
roles in society.
Chapter II

Description:

The Mother of Mercy Hospital (MMH) is the newest four-storey General Hospital that
provides ultra-modern facilities, high-technological equipment, and professionally competent
medical staff who will attend to the patient's needs. Presently, it has a 50-bed capacity.

Geographical Location:

Benigno Aquino Avenue, Tacloban City, Leyte, Philippines 6500. A few meters apart
from Holy Infant College. Taking the road of Real Street, Mother of Mercy Hospital is at the
back of Leyte II Electric Cooperative.

History and Background

Mother of Mercy Hospital is currently a 50-bed capacity tertiary hospital run by

Religious Sisters of Mercy, the same congregation that run Holy Infant College. According to
research and reading the institution filed a license to construct as a specialized hospital focused
on “Mother and Child”, since they cannot initially apply as a General tertiary hospital due to its
proximity to Bethany Hospital. According to law, a hospital will not be given a license to
construct if it is only few kilometers away from another hospital that offers the same service.

The construction of the hospital started during the first quarter of the year 2008. An
organization called Os Mercy; members are scholars of Religious Sisters of Mercy congregation
in Australia, visited Tacloban City as part of their Asia Pacific Region developed to link with
Religious Sisters in the Philippines. They knew that RSM are planning to build a hospital with
two (2) purposes:

 training centre for nursing students; and

 a base for health care & promotion to the disadvantaged people of the region.
 This is so, because Holy Infant College provides courses such as Bachelor of Science in
Nursing, Practical Nursing, Radiology and Midwifery. Initially the construction needs
1,000,0000 Php to start ordering the hospital supplies such as bandages, gauze, gloves, etc., this
was made possible thru fundraising of Os Mercy. Currently, this fundraising program is still
ongoing since the fourth floor is still under construction. Local donors via blogs and websites of
the aforementioned organization do the fundraising.

Although 4th floor is still under construction, the hospital had its blessing on June 18,
2010 and opened its services to people on September 24, 2010. PhilHealth Insurance accredited
them for Center of Safety last January 2011-April 2011. Presently, they had applied for Center of
Quality and application is still on the process. The opening of the Out Patient Department will be
this coming June 8, 2011. This institution is just presently making a history to be one of the
excellent tertiary hospitals that will provide quality healthcare to patients of Eastern Visayas.

Programs:

MMH is a non-stock Tertiary General Hospital owned and administered by the Religious
Sisters of Mercy of the Roman Catholic Church that offers the following services:

- 24-hour Emergency Room and Ambulance Services

- 24-hour X-Ray service
- 24-hour Clinical Laboratory Tests
- Histo-Pathology
- 24-hour Pharmacy
- Accommodations for Suites, Executive Private Rooms, and air-conditioned wards
- NICU, ICU, 2 Major Operating Rooms, 2 Minor Operating Rooms, 2 Delivery and
Recovery Rooms,
- In-House Consultation Room
- Out-Patient Department
 - Ultra-Sound Services

*Soon to open new equipment:  16-slice CT Scan

Purpose:

Mission Statement:
To provide the highest quality of patient care through holistic and competent nursing care
with efficient management of the health team. It also commits itself to continuously develop its
staff and affiliates towards excellence.

Vision:
Dedicated to the Mother of Mercy and responding to the general health care needs of the
people of God, the Mother of Mercy Hospital is committed to:

 Deliver excellent health care through highly competent staff utilizing innovative

technology and research;

 Ensure well-being through spiritual support;

 Serve as training hospital primarily for Health Sciences students of Holy Infant College,
and collaborate with other health care institutions on training needs;

 Promote and protect LIFE as ministry of the Roman Catholic Church;

 Create an atmosphere that is caring and compassionate within the hospital system with
special program for the poor.
Philosophy of the Division of Nursing:

The Division of Nursing is one of the most vital support pillars in the optimal functioning
of the hospital. It holds primordial functions essential in the attainment of the vision, mission and
objectives of the Mother of Mercy Hospital.

Recognizing that nursing care is the paramount reason for its existence, it embraces the
professional responsibility to provide utmost quality of patient care through the implementation
of international standards of nursing practice in its delivery of patient care.

Essential to the Division of Nursing is the scientific knowledge, skills, and attitudes of its
personnel. The promotion of research and its utilization is the primary tool to assure and enhance
quality nursing care. It commits itself to always practice in the bounds of high professional ethics
to ensure ethical values.

The Division of Nursing recognizes the client as a spiritual being with unique special
needs for the attainment of optimum level of functioning. Therefore, it should constantly
maintain a patient-centered care with the nursing process as its framework of health care
delivery. It is aware that the client it serves is the economic force that helps sustain the hospital,
as such the Division of Nursing staff shall at all times observe good customer care, cost
efficiency and competent nursing care.

Lastly, the Division of Nursing shall advocate for the personal and professional growth of
the staff. This shall be attained through regular self-survey, continuing education program and
training that will pave the way for its recognition and respect as leader of health care always
inspired by values of mercy charism.
SITUATIONAL ASSESSMENT BASED ON THEORIES LEARNED AND DATA
GATHERED IN ACUAL SITUATION: A FILED STUDY OF MOTHER OF MERCY
HOSPITAL

1. Agency Purpose

Mission Statement:
To provide the highest quality of patient care thorugh holistic and competent nursing care
with efficient management of the health team. It also commits itself to continuously develop its
staff and affiliates towards excellence.

Vision:
Dedicated to the Mother of Mercy and responding to the general health care needs of the
people of God, the Mother of Mercy Hospital is committed to:

 Deliver excellent health care through highly competent staff utilizing innovative

technology and research;

 Ensure well-being through spiritual support;

 Serve as training hospital primarily for Health Sciences students of Holy Infant College,
and collaborate with other health care institutions on training needs;

 Promote and protect LIFE as ministry of the Roman Catholic Church;

 Create an atmosphere that is caring and compassionate within the hospital system with
special program for the poor.
Philosophy of the Division of Nursing:

The Division of Nursing is one of the most vital support pillar in the optimal functioning
of the hospital. It holds primordial functions essential in the attainment of the vision, mission and
objectives of the Mother of Mercy Hospital.

Recognizing that nursing care is the paramount reason for its existence. It embraces the
professional responsibility to provide utmost quality of patient care through the implementation
of international standards of nursing practice in its delivery of patient care.

Essential to the Division of Nursing is the Scientific knowledge, skills, and attitudes of its
personnel. The promotion of research and its utilization is the primary tool to assure and enhance
quality nursing care. It commits itself to always practice in the bounds of high professional ethics
to ensure ethical values.

The Division of Nursing recognizes the client as a spiritual being with unique special
needs for the attainment of optimum level of functioning. Therefore, it should constantly
maintain a patient-centered care with the nursing process as its framework of health care
delivery. It is aware that the client it serves is the economic force that helps sustain the hospital,
as such the Division of Nursing staff shall at all times observe good customer care, cost
efficiency and competent nursing care.

Lastly, the Division of Nursing shall advocate for the personal and professional growth of
the staff. This shall be attained through regular self-survey, continuing education program and
training that will pave the way for its recognition and respect as leader of health care always
inspired by values of mercy charism.
2. Agency Programs

 24-hour Emergency Room and Ambulance Services – facilitates patients going to

the hospitals and referral 24 hours a day 7 days a week.

 24-hour X-Ray service

 24-hour Clinical Laboratory Tests
 Histo-Pathology
 24-hour Pharmacy
 Ultrasound Service
 Accommodations for
o Suites- currently there is only one suite room, fully air-conditioned,
television, refrigerator and DVD player.
o Executive Private Rooms- available in the OB PED ward and MED
SURG, fully air-conditioned with television and refrigerator.
o Wards- fully air-conditioned. We have available OB wards, PEDIA ward,
Medical Male ward, Female medical ward, Male surgical ward and
Female surgical ward. Each ward can accommodate five patients.
 Special Units/Departments
o NICU (Neonatal Intensive Care Unit) Consists of three (3) specific areas:
Outborn area (babies born outside of the hospital but was admitted)
which can accommodate at least five patients. Well babies area babies
receiving antibiotics or phototherapy that will stay in the NICU for at least
5 days. Pathologic area babies admitted to this area needs close
monitoring i.e. premature babies. There are two incubators and one
mechanical ventilator.
o ICU (Intensive Care Unit) consists of four beds and 1 bed in the isolation
room. 2-infusion pumps, 2-syringe pumps, 2 mechanical ventilators are
 available as well as cardiac monitors and pulse oximeter, machines needed
for patient who needs focus nursing care.
o There are three Major Operating Rooms, 1 room exclusive for OB cases
i.e. CS, TAHBSO etc. 2 major rooms are for General Surgery (1 of which
is for “dirty” cases i.e. explore laparotomy for ruptured appendix,
evacuation of pus from a certain body area and etc)
o 2 Minor Operating Rooms, one minor room is for OB cases i.e. Dilatation
and curettage, the other is for general surgeries.
o 2 Recovery Rooms, one is for OB cases, which can accommodate 2
patients. The other is for General surgery, which can accommodate 3
patient at one time.
o 2 Delivery Room tables and a Labor Room with five beds.
o In-House Consultation Room, there is one available family consultant.
Clinic is open Monday to Friday 8am to 5 pm and Saturday from 8am –
2pm.
o Out-Patient Department currently opened up the ENT clinic which can
cater to all patients.

 This institution also addresses programs of DOH:

o Unang Yakap Program- NICU nurses makes sure to achieve the first crawl
of newborn on their mother’s womb, before the baby is subject for any
therapeutic intervention. This is implemented for mother and baby
emotional bonding.
o Exclusive Breastfeeding (Executive Order 51) – colostrums is the most
important gift a mother could provide his baby, MMH ensures to provide
that gift. Formula milk is strictly prohibited in the NICU department. The
area has a breastfeeding room, where mom and baby can spend time
together.
3. Agency Support

The Mother of Mercy Hospital was established by the Religious Sisters of Mercy
Congregation and supported by Os Mercy, an organization under Religious Sister based
in Australia. Appliances and other technological equipments donated by High School
batch 1959 of Holy Infant College and AnWaray Partylist donated the hospital’s
ambulance.

4. Agency Client

The Clients are people who seek Health Services, May it be for Preventive,
Curative or Rehabilitative management regardless of race, economic status and religion.
This institution opens its services to the people of Eastern Visayas, most patients are
referral from Hospitals in Samar. Since, this hospital has not yet reached its peak point,
for the month of May there were approximately less than 100 admissions.

5. Agency Workforce

The following are the people behind the organization:

Administrators:
o Board of Trustees: 1
o Hospital Administrator: 1
o Finance Officer: 1

Medical Staff:
o Medical Director: 1
o Chief of Clinics: 1
o Chairman, Department of Pediatrics: 1
o Chairman, Department of Obstetrics: 1
o Chairman, Department of Surgery: 1
 o Chairman, Department of Internal Medicine: 1
o Resident Doctors: 6

Nursing Service:
o Nursing Director: 1
o Nurse Supervisor/Quality Assurance Officer: 1
o Nurse Unit Manager: 6
o Staff Nurses: 30
o Midwives: 3
o Nursing Attendants: 2

Laboratory Staff:

o Pathologist: 2
o Chief of Medical Technologist: 1
o Medical Technologist: 2
o Laboratory aide: 1

Pharmacy Department:

o Pharmacist: 2

Dietary Department:

o Dietitian: 1
o Dietary Personnel: 2

Radiology Department:

o Chairman: 1
 o Radiologist: 2
o Supervisor Radiology Technologist: 1
o Radiology Technologist: 1

Billing Department:

o Billing Department Personnel: 2

Medical Records:

o Medical Records Clerk: 1

PhilHealth Office:
o PhilHealth Officer: 2

Social Worker Office:

o Social Worker: 1
Institutional Workers:

o Central Supply Room Personnel: 2

o Orderly: 7
o Laundry: 1
o Maintenance: 2
o Driver: 2

Safety and Security:

o Security Guards: 3
 6. Agency Strengths and Weaknesses

Strengths Weaknesses
- Equipped with Technological facilities - An obvious understaffing, MMH
and innovative workforce utilizes Primary Nursing which has a
- Offers General Services: Obstetrician ratio of 1 nurse is to 8 patients
Gynecology, Pediatrics, Medicine, - There is only 1 Resident Doctor on
Surgery duty for 24 hours
- Medical Services are cheaper compared - There are still no Physicians for
to other Private Tertiary Hospitals consultation in the Out Patient
(Medicines, Room rates, Diagnostic Department
exams etc.) - Operating Room Instruments, Stocks
- The institution offers packages that and Supplies still are not enough to
may lessen patient’s expenses during supply in case of multiple operations in
hospitalization (Normal Delivery a day
Package, C/S Packages etc.) - Presently, there are only 58 beds on
- Accredited by PhilHealth Insurance as operation, 4th floor still under
Center for Safety during the First 6 construction.
months of Operation - Presently, there is no available elevator
- Utilizes primary nursing which operating in the institution.
promotes quality patient care. Transporting of patients pass through a
ramp located at the back area of the
hospital
- Diagnostic examination, CT Scan Unit,
is not yet available in the institution
Opportunities Threats
- Because of its isolated geographical  The Mother of Mercy Hospital have threats
from hospitals within Tacloban City
location, it suits best for patients who mainly from 2 private hospitals which are
wish to have more privacy and a quiet in the same locality providing almost the
same level of Healthcare services. If MMH
environment. does not adopt the advance technology,
these hospitals become the major threats.
- Arrival of new technologies  Due to understaffing leading to long work
hours of staff, unrest among employees
may pose as serious threat to the
institution.
 Competitor hospitals having superior
access to clients.
 Financial position of the hospital has not
been well during the year.
7. Agency Future

In the Next few Years of Service the Mother of Mercy Hospital:

o Established an excellent Healthcare through highly competent staff utilizing

knowledge on research and technology.

o Accredited by PhilHealth Insurance as Center for Excellence

o An excellent training Hospital primarily for Holy Infant College students and
other affiliated health care institution/colleges.

o The Mother of Mercy Hospital is the foremost provider of compassionate and

professional health care service in Eastern Visayas.

o This institution can compete with any tertiary hospital accredited as center for
excellence with its competence and maturity over years of service. Staff had been
trained to be globally competitive, and therefore competency is measured through
knowledge, skills and attitude.

o The Mother of Mercy Hospital will have techniques and highly technological
equipment that would be first in Eastern Visayas more than enough to provide
holistic care to patients regardless of race, economic status and religion.
CONCLUSION:

The data obtained revealed the history, purpose and physical assessment of the Mother of Mercy Hospital
as well as the strengths, weaknesses, threats and opportunities of the newly-opened tertiary hospital in
Tacloban City. As a starting hospital in its beginning phase, a lot of things still have to be worked on in
order to match up with its competitor established hospitals. With less than one-year of operation and
counting, the Mother of Mercy Hospital continues to strive for excellence in patient care and continues to
develop and equip itself with effective policies, management strategies, the latest technological
advancement in patient care and wellness. The operation of the institution is slow because of inadequate
funds thus the reason for understaffing and unavailability of modern high technology equipment. If the
number of patients continue to increase which at the same time will also increase the hospital’s revenue,
the hospital will be able to level with other tertiary hospitals within the city. Armed with competitive
administrators, medical and nursing leaders and staff, the hospital has the capacity to reach its vision of
becoming the foremost provider of quality healthcare in Eastern Visayas.
RECOMMENDATIONS:

On the basis of information provided by the Mother of Mercy Hospital, the recommendations are:

 Provide excellent quality nursing care and services in generating “customer loyalty” through
word-of-mouth publicity.
 Coordinate with the LGU in providing easy access routes towards the hospital.
 Strengthening partnerships with different organizations.
 Provide in-house trainings to staff so as to improve/enhance their craft.
 A key challenge is to convert weaknesses into strengths. For every perceived threat, the same
change presents an opportunity for institutional success.
 Match strengths with opportunities.
BIBLIOGRAPHY:

Lydia M. Venzon, RN, MAN, FPCHA and Jennifer V Nagtalon, BSN, RN. - Nursing
management towards quality care, Third Edition, 2006, C&E publishing Inc.