AL-SHIFA SCHOOL OF PUBLIC HEALTH

HOSPITAL MANAGEMENT- HM 16
RAPID APPRAISAL OF HOSPITAL

Group Members

________________________ ________________________

________________________ ________________________

________________________ ________________________

Date:__________________________________________________

Hospital / Fecility name:___________________________________________

SECTION 1: Availability of specific health programs

1.1 Catchment

Area: ---------------------------;

Population: -----------------------;

Average walking distances from which most patients come: --------- Minutes; hours

Inpatient beds; -----------------------:

1.2 Services available

Offered

Yes No

Ambulatory care services consisting of:

- General curative services ____ ____

- Antenatal care program ____ ____
- Delivery care program ____ ____
 - Postnatal care program ____ ____
- Expanded program of immunization ____ ____
- Family planning services ____ ____
- Nutrition program ____ ____

Active outreach for:

- Midwifery ____ ____

- Health education ____ ____
- Family planning ____ ____
- Antenatal, natal, postnatal care ____ ____
- Nutrition surveillance ____ ____
- Curative care ____ ____

Offered

Specific inpatient (curative) services Yes No

- General medical care ____ ____

- General inpatient care ____ ____
- Intensive Care Unit ____ ____
- Trauma center
- OT services
Minor OT ____ ____
Major OT ____ ____
- Radiology Unit
CT Scan ____ ____
Ultrsound ____ ____
Color Doppler ____ ____
Mammogram ____ ____
X Ray Services
In Dept ____ ____
Ambulatory ____ ____
- Postmortem and mortuary services ____ ____
- Surgical care
Minor surgeries ____ ____
Major surgeries ____ ____
Laparoscopy ____ ____
- Cardiology unit
ECG services ____ ____
ETT services ____ ____
 Code blue ____ ____
Echocardiography ____ ____
Ventilator ____ ____
- Obstetric / gynecological care ____ ____
- Pediatric care ____ ____
Incubators ____ ____
- Trauma / orthopedic care ____ ____
- Medical procedures
Colonoscopy ____ ____
Endoscopy ____ ____
- Laboratory services
Serology ____ ____
Biochemistry ____ ____
Bacteriology ____ ____
Histopathology
Regular ____ ____
Frozen sections ____ ____
- Other: (________________) ____ ____

Specific preventive / health promotive services:

- Health education ____ ____

- Family planning ____ ____
- Environmental sanitation ____ ____
- EPI ____ ____
- Growth surveillance ____ ____
- Drug / alcohol education ____ ____
- Sex education ____ ____
- Breastfeeding / weaning promotion ____ ____
- Others : (_____________________) ____ ____

Specific organization and management support:

- Training and support ____ ____

- Program monitoring and evaluation ____ `____
- Drug supply system ____ ____
- Transport system ____ ____
- Repair and maintenance workshop ____ ____
- Other: (______________________) ____ ____
SECTION 2: Human Resource Profile

2.1 Medical Staff

Type of staff No. of posts No. vacant post No. present posts

Doctors: __________ __________ __________

Generalists _________ _________ _________

Surgeon _________ _________ _________

Obstetricians _________ _________ _________

Pediatricians _________ _________ _________

Other Specialists _________ _________ _________

Others (____________) __________ _________ _________

Others (____________) __________ _________ _________

Others (____________) __________ _________ _________

Others (____________) __________ _________ _________

2.2 Nursing Staff

Type of staff No. of posts No. vacant post No. present posts

Head Nurse __________ __________ _________

Charge Nurse __________ __________ ________

Postgraduate Student Nurse ___________ __________ _________

Student Nurse ___________ __________ _________

2.3 Paramedical Staff

Type of staff No. of posts No. vacant post No. present posts
Medical Assistant __________ ___________ __________

Laboratory technician’s __________ ___________ __________

Dental technicians __________ ___________ __________

OT technician __________ ___________ __________

Radiology technician ___________ __________ __________

Anesthetic assistant ___________ __________ __________

Dresser ___________ __________ __________

Midwifes ___________ __________ __________

LHVs ___________ __________ __________

Physiotherapist ___________ __________ __________

Others (_____________) ___________ __________ __________

Others (_____________) ___________ __________ __________

2.4 Administrative and Clerical Staff

Type of staff No. of posts No. vacant post No. present posts

Superintendent (unless __________ __________ _________

a physician/ clinically active)

Administrator __________ _________ _________

Finance dept Staff __________ _________ _________

Store manager __________ __________ _________

Clerks __________ _________ _________

Others (______________) __________ _________ _________

2.5 Support Staff

Type of staff No. of posts No. vacant post No. present posts

Ward master _________ __________ __________

Aya _________ __________ __________

Nursing attendants _________ __________ __________

Peons _________ __________ __________

Sanitary workers _________ __________ __________

Rereceptionists _________ __________ __________

Transporter _________ __________ __________

Drivers _________ __________ __________

Security personal _________ __________ _________

Food and nutrition staff _________ __________ _________

Laundry staff _________ __________ _________

Pharmacist _________ __________ _________

Pharmacist assistants __________ __________ __________

Maintenance staff _________ __________ _________

Drivers _________ __________ _________

Plumber ` _________ _________ _________

Housekeeping staff _________ __________ ________

Others (____________) _________ __________ _________

Others (____________) _________ __________ ___________

SECTION 3: Hospitals physical inventory

3.1 Buildings

General condition of building and paint Satisfactory Unsatisfactory

Administrative block
Emergency department
Outpatient department block
Operation theatre block
Inpatient block
Cleanliness of hospital
Suitable environmental temperature
Availability of utilities Continuous Available Intermittent Not available
- Water supply
- Electricity
- Standby electricity
- Gas supply
Waste disposal
- Incinerator
- Other waste
Functional washrooms
- Males
- Females
Availability of Refrigeration
Pharmacy
- Medical supply system
- Stock supply system
- Turnover
- Stock position (vaccines,sera)
- Special storage
Storage
Laboratory
Cafeteria

3.2 Furniture /utensils/supplies

Furniture / Utensils Present and in order Absent or non functioning

Stationary
Filling cabinets
Trash cans
Broom
Hand wash basins
Toiletries
Towels
Beds
Linens
Mattresses
Mackintosh / rubber sheeting
Chairs /benches/stools
Tables
Drinking water
Lockable cabinets/ cupboards
Kitchen supplies /equipment
Cleaning supplies/ equipment
Stretchers
Wheel chairs
Drip stands
Examination table / couch
Fully functional operation
Theater

3.3 Equipment and instruments

Present and in order Absent or nonfunctioning

Infant weighing scale
Adult weighing scale
Pulsometer
Cardiac monitor
Defibrillator
Blood pressure apparatus
Stethoscope
Fetoscope
Airway
Thermometers
Otoscope
Examination table / couch
Bed pan / urinal
Internal catheters
External catheters
Retractors
Vacuum extractor
Tape measure
Sterilizer
Instrument trays
Dressing forceps
Gauze / cotton
Needle holders
Suture needles
Injecting needles
I/V cannula
NG tubes
Scissors
Scalpel and blades
Forceps
Kidney trays
Surgical tape
Tongue depressors
Syringe pump
Torch
Hammer
Ambo bags
Face masks
Oxygen masks
Oxygen cylinders
Suction machine
Suction catheters
Sterile gowns
Sterile gloves
Surgical set
Equipment for anesthesia
Lighting equipment
Laboratory equipment
Pharmacy equipment
Physiotherapy equipment
Telemedia equipment

3.4 Drugs, medicines and sundries

- Essential drugs available Y/N

- Disinfectants available Y/N
- Emergency cart available Y/N
- Patients asked to bring medicines Y/N
- I/V fluids available Y/N
- Proper stocking of sera and vaccines Y/N

SECTION 4; Management and Organization

Activities Yes No
In service training and supervision
- Undergraduate students
- Postgraduate students
- Continuous education of staff
Availability of standing operating procedures
Availability of job descriptions
Availability of rules and regulations
Availability of Duty Roster
Meeting of Department’s staff
Internal Audit system
Epidemic monitoring and control system
Mortality review/reporting department
Medico legal coverage
Availability of stationary
Availability of computers system
Availability of wireless networking
Availability of telecommunication system

SECTION 5: Performance indicators

Indicators Number / Rate Comments

Bed Occupancy rate
Average length of stay
Death rate
Infection rate
Post graduate students trained in
one year
Staff bed ratio
- Doctors
- Nursing
- Para medical
- Support

SECTION 6: Initiatives of the hospital

Please use extra sheets if required.

- Revenue generation
 - Donations

- Special activities carried out by departments

- Research activities

- Emergency preparedness plan

SECTION 7: Suggestions