Graduate School of Business

School of Medicine and Public Health

Mental Health Project Proposal for Year Level 8 Psychiatric Rotation

April 15 to 28, 2024

In partial fulfillment of the requirements for

Doctor of Medicine-Masters in Business Administration (MD-MBA)

Submitted by

DELOS SANTOS, Leivanne S.

DERIJE, Heather Marie U.
NALUPTA, Rafael Adriano P.
QUEROL, Zachary Ivan G.
SALITA, Maxine Andrea C.
SAMONTE, Gianella Bianca C.

Date Submitted
April 25, 2024
 Rxercise: Physical Health for Mental Wealth

I. Introduction
In the Philippines, mental health issues are not given much attention because of the
false belief that mental health problems are not medical in nature and do not necessitate
treatment. Therefore, a lot of patients with mental health conditions remain undiagnosed.
Unfortunately, the risk factors for mental health diseases include stress, which is most often
experienced by doctors and other medical professionals. Chronic stress may eventually lead to
mental health conditions such as depression, anxiety disorders, and many more.
Physical activity has evident benefits for physical health, as well as a positive influence
on mental well-being. Typically, exercise therapy is recommended to address these issues and
promote mental wellness. Research has shown a positive correlation between physical activity
and mental health. The most notable impacts of physical exercise are observed in
self-perception and body image (Mahindru, Patil & Agrawal, 2023).
Regular physical activity enhances the functioning of the hypothalamus-pituitary-adrenal
axis (HPA axis). Evidence suggests that physical activity aids in improving sleep and managing
various psychiatric conditions. Overall, engaging in exercise is associated with better mood and
an enhanced quality of life. Aerobic activities such as jogging, swimming, cycling, walking,
gardening, and dancing have been demonstrated to alleviate symptoms of anxiety and
depression. These mood enhancements are believed to stem from the increased blood flow to
the brain triggered by exercise, as well as its impact on the HPA axis. This thereby influences
the body's response to stress. This physiological effect is likely mediated through the interaction
of the HPA axis with various brain regions, including the limbic system responsible for regulating
motivation and mood, the amygdala which processes fear during stressful situations, and the
hippocampus which plays a significant role in memory formation, mood, and motivation
(Sharma, Madaan & Petty, 2006).

II. Problem Statement/Rationale

Medical clerks and interns, while dedicated to caring for others, often face constraints
when it comes to prioritizing their own health and well-being due to the demanding schedules
and high levels of stress from their line of work. Therefore, we should find a way to make
physical exercise more accessible and convenient to doctors-in-training.
III. Objectives
A. General Objective
To promote the physical and mental health of medical clerks and interns through
the provision of accessible hospital gym facilities and through the promotion of a culture
of wellness within the hospital environment.

B. Specific Objectives
1. To provide medical clerks and interns with access to an exercise facility to
encourage regular physical activity
2. To provide educational resources aimed at raising awareness among
medical clerks and interns about the importance of regular exercise in
maintaining optimal health and preventing burnout and mental health
issues
3. To conduct ongoing evaluation and feedback mechanisms to assess the
effectiveness of and satisfaction with the exercise facilities

IV. Methodology
A. Overview
1. The methodology involves establishing a hospital-based gym facility
dedicated to providing medical clerks and interns with convenient access
to exercise equipment and amenities, aiming to support their physical and
mental well-being.
B. Needs Assessment and Planning
1. Conduct surveys and interviews to assess the exercise needs and
preferences of medical clerks and interns.
2. Analyze space availability and logistical requirements for setting up the
gym facility.
3. Develop a plan based on identified needs and available resources.
C. Stakeholders
1. Key stakeholders include hospital administration, facilities management,
and potential gym users. Identification of and collaboration with
stakeholders is important to secure support, allocate resources, and
ensure alignment with institutional goals.
D. Financial
 1. Initiate a donation drive, sponsorship drive, and connect with potential
partners to establish the financial, and likewise logistical support that the
this proposal may offer in exchange for the projected additional utilization
of the gym facilities.

V. Activity Design and Preparations

A. Location and Logistics
Given the nature of the program, a hospital-based gym facility is needed to have
a dedicated space for exercising. The Medical City has a newly-opened gym in the
Lower Ground Floor dedicated to doctors, nurses and staff. For our proposal, we would
like to not only improve the current roll-out of the gym but also widen the scope so that
medical clerks and interns are able to have access to this gym. After conducting
interviews with some residents, many of them have been unable to use the gym due to
the limited open hours and lack of awareness. Additionally, the Department of Advanced
Medical Education can be partnered to allow the gym access to clerks and interns. To
track the attendance of the users of the gym, a logbook (either handwritten or electronic)
can be used. This then can be used to assess number and rate of attendance, and
assess if the clerks and interns regularly use the gym for their exercise.

B. Recruitment and Outreach

The gym facility can be promoted through various channels including internal
communications and signage for medical clerks and interns. For example, posters about
the new gym can be posted in bulletin boards around various department offices and the
sleeping quarters of clerks and interns. This can be supplemented with information about
the benefits of regular exercise for physical and mental health.

C. Training and Support

For the gym facility, exercises and training can be facilitated by a hired gym
trainer to supervise and guide those who need assistance in their exercise or with
equipment operation. Nearby local gyms can be contacted or referrals can be made to
find an appropriate gym trainer. Next, a manager or head can be placed in the gym to
oversee its daily operations, as well as check and report for maintenance of the gym and
its equipment.
VI. Implementation
Once the hospital gym has been established, ensuring the regular usage of the
gym by medical clerks and interns is the next crucial step and requires sustainable and
feasible strategies to overcome challenges such as limited free time and competing
priorities.
To encourage utilization, the following strategies may be done:
A. Flexible operating hours
○ To accommodate the varying schedules of medical professionals and staff,
offering extended operating hours or possibly even being open 24 hours may
encourage the use of the gym on any available moment or free time that the
hospital workers have
○ To ensure security, implementing a 24/7 access system that uses biometric
authentication or keycards may allow staff and students to use the gym at their
convenience
B. Integration with department work schedules
○ Promote and encourage department heads to incorporate exercise breaks or
programs into their regular working schedule (e.g., one hour every week), which
will allow them to prioritize their physical and mental health alongside their
responsibilities in the hospital
C. Promotional Campaigns and Education
○ Health promotion campaigns may be launched to remind doctors, medical
students, and hospital staff of the benefits of regular exercise to their physical
and mental health
○ Guest trainers and exercise experts may be regularly invited to facilitate
workshops and educational programs on exercise strategies, and stress
management techniques.
D. Ensure convenience
○ Amenities such as locker rooms, showers, and provision of clean towels may
encourage more people to use the gym and to ensure quick and convenient
workouts during breaks or before/after shifts
VII. Monitoring and Evaluation
A. Attendance rate
1. Assess how many medical clerks and interns are able to go to the gym
B. Length of time spent per workout session
1. Check if each participant is able to spend at least 150 minutes in the gym
per week, which is the recommended length of exercise per week in
adults
C. Feedback Forms
1. Collect feedback from users through an online survey or suggestion
boxes to identify areas for improvement and ensure that the gym facility
meets the needs of medical clerks and interns.
2. Conduct surveys and interviews to assess the exercise needs and
preferences of doctors and medical clerks and interns

Table 1. Sample gym evaluation form.

TMC Gym Evaluation Form (Please 1 2 3 4

encircle your rating with 4=most
satisfied and 1=least satisfied)

Gym design

Adequate workout equipment

Gym operating hours

Music selection

VIII. Adaptation and Sustainability

The project’s adaptation would largely depend on the approval of the hospital’s
administration. With this a proposal letter would be submitted to The Medical City’s
administration highlighting the importance of this project in promoting the well-being of medical
interns and clarks not only as part of the hospital's commitment to excellence in healthcare
delivery, but also in the smoother flow of work inside the hospital.
 After this, the sustainability of this project would entail working closely with hospital
administrators, and the management of the exercise facilities to continuously maintain a gym
facility that is accessible to and compatible with the needs of the hospital's medical interns and
clerks. In addition, the sustainability of the access of the medical interns and clerks to the gym
facility may be supported through the exploration of potential partnerships with sponsors and
donors to supplement resources and limit the financial burden on the hospital.
Another way to ensure the sustainability of this project is to promote the regular usage of
the facility by the medical interns and clerks. This could be done by regularly obtaining feedback
from medical interns and clerks through surveys, or interviews, which could help identify their
specific preferences, challenges, and expectations regarding the designated gym facility. The
findings from the surveys and interviews to assess the exercise needs and feedback of doctors
and medical students would be regularly reviewed and considered in making necessary
adjustments to the facilities and program, which would help ensure the continuous utilization of
the gym facilities by the medical interns and clerks.

IX. Scope and Limitations

Limitations may include budget constraints, space limitations, and potential challenges in
coordinating with multiple stakeholders. Efforts will be made to address these limitations through
careful planning, stakeholder engagement, and ongoing evaluation of the gym facility.

X. Assessment and Evaluation

After the implementation of this proposed mental health project, the following measures
may be utilized for the evaluation of the projects as well as its ability to align with its
objectives:
1. Usage data analysis
a. Baseline data such as the hours spent exercising by hospital workers,
doctors, and medical students before the implementation of the hospital
gym is a useful benchmark for tracking the effect of the project on the
target population’s behavior
b. Usage data such as attendance rate as well as the length of stay in the
gym may be used to assess the success of the project implementation
and may also be used for monitoring trends in usage over time. Changes
in trends may be analyzed and possible problems and issues identified
are helpful for the improvement of the project
 2. Surveys and feedback
a. Survey and feedback forms collected before and after the project
implementation should include questions related to physical and mental
health and wellbeing which may include perceived stress levels, mood,
and overall satisfaction and impact on their health in order to evaluate if
the gym has been successful in serving as an avenue for increased
exercise leading to decreased stress
3. Alignment with objectives
a. Perceived outcomes from the implementation of a hospital gym must be
compared with the project’s initial general and specific objectives in order
to assess whether or not the project was successful in achieving its
expected objectives and outcomes

XI. Finances, Funding, and Resources

In order to finance the expenses related to this project, the following possible sources of
funding is outlined by the group:
● Donations
○ A donation drive focused primarily towards the key stakeholders,
especially those that are connected with both the hospital and the clerk
and intern population.
● Partnerships and Collaborations
○ Partnering with organizations connected with mental health programs,
physical exercise, and/or healthcare professionals’ welfare are important
to create activities, events, and/or educational opportunities in order to
maximize the utility of the venue to be made available.
● Corporate Sponsorships
○ Offering sponsorship opportunities for monetary, or logistical support from
different organizations, especially those that can offer equipment to add
or maintain the currently available equipment in the gym, in exchange for
marketing opportunities is an appropriate initiative to increase financial
capabilities for the added maintenance, and logistical necessities in
collaboration with the hospital which has already been managing the
facilities mentioned in this proposal.
XII. Recommendations
A. Assessment
1. To assess if having gym access is being utilized by the clerks and interns,
a monthly attendance check can be conducted. This to verify if the gym
will be highly used after having access to it, as well as track the rate of
attendance of its users.
2. To assess the impact of having access to the hospital’s gym facility
amongst medical clerks and interns, a monthly survey can be done. The
ASMPH Student Wellness Team can be contacted to facilitate the
creation of an online questionnaire. This can be then made into a project
to monitor the sustainability of the exercise program as a means of mental
health support.
B. Tailored Programming
1. In order to improve the gym facility in the future, the gym can create
different exercise programs. With a bigger staff of gym trainers, programs
such as circuit training, yoga, Zumba classes can be suggested to add
variety to the exercise program and regimen of its users. These classes
can also promote a healthier lifestyle between peers and colleagues.

XIII. References
Mahindru, A., Patil, P., & Agrawal, V. (2023). Role of Physical Activity on Mental Health
and Well-Being: A Review. Cureus, 15(1), e33475. https://doi.org/10.7759/cureus.33475
Sharma, A., Madaan, V., & Petty, F. D. (2006). Exercise for mental health. Primary care
companion to the Journal of clinical psychiatry, 8(2), 106.
https://doi.org/10.4088/pcc.v08n0208a