Jesse Attachment Report

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MOUNT KENYA UNIVERSITY

School : Information Technology

Department : Enterprise and computing

Title : Attachment report

Name :Jesse Maina Thuku

Reg No: CBIT/2018/26993

Industry place: Thika Level 5 Hospital

Industry Supervisor- Ambrose Waita

University Assessor – Michael Nyoro

Date of submission-25/10/2019
AKNOWLEDGEMENT
First of all, I would like to thank the Almighty who is has been the most beneficial and merciful,

has given me confidence ,guidance and strength through my attachment period. This is a

knowledgeable and interesting experience to me. Completion of this attachment was not an easy

task but by the support and help of all my colleagues and employees of the hospital becomes

very simple to me .I would like to pay my gratitude to my respectful supervisor on the

cooperation during my attachment. I am especially grateful to my university for expanding my

knowledge and experience.


EXECUTIVE SUMMARY
My three months industrial attachment work terms was with Thika Level 5 Hospital in Kiambu
county.The purpose of industrial attachment creates the need for any discerning student to create
a clear picture of what has been done in the form of a report. Field attachment is a field of
practical training experience that prepares trainee for the tasks they are expected to perform on
completion of their training. This report contains information which I gathered during my
industrial training at Thika Level 5 Hospital for a period of three months. As a student, my
involvement in this attachment was to make sure I that I acquire new knowledge and practical
skills, improving my confidence in problem solving and to utilize the opportunity to relate with
different category of people likely to be met in real life situations. This report gives all the
activities I undertook, the experiences I gained, the practical skills acquired and the personal
inputs to the organization. My report gives a brief introduction about the hospital which is
committed to provide efficient and high quality medical services that are accessible equitable and
affordable to the patients , the system used which is the integrated Check Health Information
System and the work/duties of different departments in the organization. Services provided
include: laboratory services, health records, x-ray, consultation clinics and many more. These
departments use and Health Management Information System. The report also gives details of
the duties/functions of my host department. The information I am giving in this report reflects all
the achievements I achieved according to my objectives set herein. This report shows the
benefits, success, challenges encountered and how I was able to overcome the challenges. It also
shows my recommendations and the conclusion of my training.
TABLE OF CONTENTS

Contents
AKNOWLEDGEMENT.............................................................................................................................2
EXECUTIVE SUMMARY.........................................................................................................................3
ABBREVIATIONS.....................................................................................................................................4
1.0 INTRODUCTION.............................................................................................................................5
1.1 Brief history of the Institution........................................................................................................5
1.2 Main functions of the Hospital......................................................................................................6
1.3 Vision, mission, statement and core values of the institution.........................................................7
1.4 Organizational structure of the host institution..............................................................................7
1.5 Duties and responsibilities of the key personnel in the organization..............................................8
CHAPTER TWO.......................................................................................................................................11
2.0 HOST ATTACHMENT DEPARTMENT.......................................................................................11
2.1 Key functions/ activities of the Department.................................................................................11
2.2 Staff establishment of the Department.........................................................................................12
2.3 Student’s main objectives for the attachment exercise.................................................................12
2.4 Attachees’ assigned routine duties...............................................................................................12
CHAPTER THREE...................................................................................................................................14
3.0 EVALUATION OF THE ATTACHMENT PERIOD.....................................................................14
3.1 Success/ failure of the attachment exercise..................................................................................14
3.2 Challenges encountered by the student during the attachment period..........................................15
3.3 How the challenges were solved..................................................................................................15
3.4 Recommendations as how the attachment exercise can be improved by the university...............16
CHAPTER FOUR.....................................................................................................................................16
OTHER ISSUES LEARNED................................................................................................................16
4.1 Employees Code of Conduct.......................................................................................................16
REFERENCES..........................................................................................................................................17
ABBREVIATIONS
OPD-Outpatient department
CHIS-Check health information system
EMR-Electronic medical records
LIBS-Library information based system
CC-Child care
ENT-eye nose and teeth department
Ministry of Health, Disease Surveillance and Research Unit (DSRU)
CHAPTER ONE
1.0 INTRODUCTION
1.1 Brief history of the Institution
Thika level 5 Hospital began its operation in 1941 and is strategically located at Thika town
Kiambu county.It covers a land of 7.97 Hectares.The hospital is run by by a cohesive,highly
trained,dedicated and specialized human resource team of 550 members firmly anchored on the
pillars of teamwork and self-sacrifice.Thika level 5 Hospital provides health services to an
average of 20,000 inpatients and 350,000 oupatients annually.The hospital’s provision of quality
health services has blurred inter-county boundaries which have seen patience trickle in from
more counties including Nairobi,Murang’a ,Kirinyaga, and Machakos.Ever since the healthcare
devolution journey began in year 2010 until date ,the hospital has always pledged to relentlessly
pursue its objective of providing high quality and cost effective heathcare to its patients.Thika
level 5 believe in offering comprehensive care under a single roof.
Objectives of Thika level 5 hospital
I. To set the best practice standards in health care services
II. To continually improving the performance and exceeding expectations of patients
III. To cater for both inpatients and outpatients

1.2 Main functions of the Hospital


Treatment of patients.
Diagnostic of diseases.
Preventive measures for health protection.
Prophylaxis of relapses and comlications of diseases.
Medical and social rehalibilitation of patients.
Training of medical staff.
Improvement of qualification of medical staff.
Research work.
Thika Level 5 Hospital Services include the following:
Curative Outpatient Services
Family Planning
Growth Monitoring and Promotion
Immunization
Integrated Management of Childhood Illnesses
Antenatal
Antiretroviral Therapy
Basic Emergency Obstetric Care
Caesarean Section
Curative In-patient Services
Prevention of Mother to Child transmission of HIV
Radiology Services (e.g X-ray, UltraScan, MRI, etc)
Tuberculosis Diagnosis
Tuberculosis Labs
Tuberculosis Treatments

1.3 Vision, mission, statement and core values of the institution


Vision: To offer efficient and high quality medical services in Thika Level 5 Hospital that are
accessible, equitable and affordable for every citizen.
Mission: To promote and participate in provision of integrated Quality curative and rehabilitative
services to all clients in Thika District.
Core values: Efficiency, integrity, timeliness, transparency, confidentiality, professionalism and
quick response.
1.4 Organizational structure of the host institution

Medical superintendent

Health administrative officer (HAO)


Nursing officer in charge

supplies accounts
Heads of clinical departments
Support staff records (Medicine, surgery)
maintenance

Information
Technology
Department Ward nurse
Medical officers

Other departmental heads eg;

Physio, pathology, lab, ENT


MO interns
Clinical officers

Lab staff Ortho staff

Pharmacy staff Occupational Nurses CO interns


therapists

Pharmacy staff
1.5 Duties and responsibilities of the key personnel in the organization
The key personnel at Thika Level 5 Hospital are the Medical Superintendent, Health
Administrative Officer, Nursing Officer in-charge (NO i/c), Heads of Clinical departments (ie
Medicine, Pediatrics, Surgery, Obs/Gyn) and Ward Nurse i/c
The duties and responsibilities of the Medical Superintendent are:
1. Overall supervision of the working of the hospital.
2. Planning, development and budget monitoring of the hospital.
3. Interaction and assigning duties to immediate subordinate officers and Head of Clinical
Departments so as to ensure smooth functioning of the hospital Official spokespersons of
the hospital.
4. To discharge legal responsibilities pertaining to the hospital
5. Coordination and interaction with the Ministries, Police Directorate and other
Government departments.
6. Exercise of financial and administrative power delegated to him as ‘Head of Department’
manpower planning Appointing and Disciplinary Authority of Group C &D employees.
The duties and responsibilities of The Health Administrative Officer:
1. Staff hiring that is employing qualified people.
2. Coordination of business functions in the hospital.
3. Develop policies and procedures and ensure that they are followed or may implement
policies created by a governing board or body.
4. Managing patient records that is ensure medical histories, current health information, and
billing, insurance and legal documents are all being handled appropriately.
5. Maintain open lines of communication that enable the system to function swiftly and
efficiently.
The duties and responsibilities of Nursing Officer :
1. Managing, supervising and assisting the nursing staff.
2. Providing administrative support and patient care.
3. Provide guidance on administering care to new patients or those with special needs and
answer questions regarding to protocol.
4. Develop and implement training courses and organize seminars to help educate and train
new nurses and staff.
5. Frequently work with other nurses and patients to create a plan of care that is
individualized to a patient’s needs.
6. Document the performance of nurses, perform evaluations and counsel nurses on
unsatisfactory performance.
7. They meet with upper management to discuss personnel and administrative issues and
address and solve problems among staff.
The duties and responsibilities of Heads of Clinical departments (Medicine, Pediatrics, Surgery,
Obs/Gyn):
1. Monitor compliance to legal guidelines, internal policies and quality standards.
2. Evaluate performance and discipline employees when necessary
3. Assign cases and create schedules for all employees.
4. Plan and oversee all patients care or administrative operations and programs.
5. Coordinate and supervise staff providing constructive feedback.
6. Provide personnel with clinical training and opportunities for continuous development.
7. Devise strategies and plans for the clinical department according to standards for
excellent service and growth.
The duties and responsibilities of the Ward Nurse i/c:
1. Provide care and treatment for patients admitted in the hospital wards.
2. Providing day-to-day care and treatment for patients.
3. Provide information for patients and also their families to help them understand their
treatment and make informed decisions about their own healthcare.

Some of the partners that Thika Level 5 hospital works closely with
are:
● PEPFAR - An initiative by the government of the United States of
America that is behind the funding by USAID. Through the
President's Emergency Plan For AIDS Relief which was started by
George W. Bush, USAID is provided with funds, which it uses to
support Health under the IT field in achieving their goals and
missions.
● USAID - An independent agency of the United States of America
Federal Government that is the main source of funds for Health.
● Ministry of Health, Health Information Systems Division - A
unit at the Ministry of Health responsible for the maintenance and
support of various Health Information Systems that have been
employed by the Ministry.
● Afya Jijini - A 3 year, USAID funded project that started in 2015
and is expected to run up to 2018, whose goal is to improve
Nairobi City County institutional and management capacity to
deliver health services. Afya Jijini are responsible for support of
EMR systems i.e. IQ Care, and other Health Information Systems.
● Ministry of Health, Disease Surveillance and Research Unit
(DSRU) - A unit at the Ministry of Health responsible for disease
surveillance and medical research in Kenya.
The team at DSRU are responsible for using the IDSR system in
their daily activities.
● IntelliSOFT Consulting Limited - A Kenyan software
development and consultancy firm that specializes in the
healthcare industry, and whose primary focus is in the areas of
Health Management Information Systems and Health Research
Support Systems.
4. OpenMRS Community - A community of developers in charge of developing the free
and open source EMR system - OpenMRS (Open Medical Record System).

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CHAPTER TWO
2.0 HOST ATTACHMENT DEPARTMENT
 INFORMATION TECHNOLOGY DEPARTMENT
OTHER:
 HEALTH RECORDS AND INFORMATION DEPARTMENT
2.1 Key functions/ activities of the Department
 Information Technology Department functions include:
o Maintenance of computer hardware components in the hospital
o Networking facilitation(Cabling or otherwise)
o Maintenance of the software used in healthcare provided to the hospital
o Maintenance of the servers supporting the software
o Identifying rising issues/challenges in current systems in use and improvements
that can be implemented
o Managing users and the privileges they can access in the CHIS system
 Health Records and Information department activities were:
1. Data Management by collection of Daily Bed Returns (DBR) in each
wards and keying in the data in the computer system
2. Coding and Indexing of all the inpatient files
3. Central records keeping in the library of all the inpatient files after being
coded and indexed
4. Booking of consultant clinics that is the OOPC, GOPC, MOPC, HRC,
SOPC, POPC, Dermatology clinic, Ear Nose and Throat Clinic(ENT)
5. Maternity records
6. X-ray reception unit
7. CT Scan records keeping of all inpatients and outpatients
2.2 Staff establishment of the Department
The number of employees in the Information Technology Department are three (3).They are
employed by the county government. The department also offers internship (2) and attachés (4).
2.3 Student’s main objectives for the attachment exercise
1. To enhance knowledge and skills on what we learnt in class.
2. To be exposed to the actual working environment that is getting hands-on life experience
on what responsibilities should be done in an institution or an organization.
3. To understand work ethics, employment demands, responsibilities and opportunities.
4. To provide an opportunity to apply the principles and techniques theoretically learnt in
class into real-life problem solving situations.

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2.4 Attachees’ assigned routine duties
INFORMATION TECHNOLOGY DEPARTMENT
i) Setting up of the projectors for meetings
ii) Replacing malfunctioning computer components
This involved peripherals that were working improperly and those that seized to
work permanently
iii) Solving for networking issues
I got to terminate networking cables that had been damaged or replaced them with
new ones. I had to connect some of the computers to access internet connection
provided by the county government.
iv) Occasional record keeping of the computers in use and their corresponding
peripherals and other equipment e.g. printers. This was to keep record of all
working machines and to account for their numbers
v) Updating drivers, antivirus software on the computers. After tackling an issue, I
would take the chance and check whether these things were updated and working
properly to prevent unwanted viruses in the computers. This was recommended
by the supervisors.
vi) We were tasked to visit various departments that used the CHIS and other systems
to observe and assist where necessary in order to learn more on how they are
used.
vii) After becoming familiar with the CHIS system, an account was created by our
supervisor for the attaches to use. We were shown how to create accounts and
how to assign various privileges depending on the type of staff
viii) Once each week I was tasked with going to the reception to help register new
patients into the system in order to understand how it is done.
ix) Replacing older versions of operating systems with newer and stable ones.
x) Installing CHIS into computers that did not have one or those that failed to work
properly.
xi) Restarting the servers for the CHIS or LIMS systems from the server rom in cases
where complaints were made of slowed operation.
xii) Altering/editing biodata of patients from the outpatient departments whose
information had been entered incorrectly.
xiii) Backtracking patients information where asked for retrieval of important
information.
xiv) Creating templates of staff and interns/students identification cards using tools
like Microsoft Publisher.

HEALTH RECORDS AND INFORMATION DEPARTMENT

 Booking of consultant clinics.


- This is where we book the patients’ different consultant clinics eg, MOPC, SOPC,
HRC, GOPC, OOPC, Dermatology clinic and Ear Nose Throat (ENT).
- On the patients’ consultation form we include the time of arrival (7.30 AM), date of
the next appointment (if it’s after one week 1/52, one month 1/12 or after a day 1/7),
the room number (i.e. Room 30, Room 32 Female Filter, Room 6 for infant babies,
Room 27 Male filter)
- Disseminating information to patients by informing them the date of the next
appointment, the day and time for arrival
 Data management.
- Collection of Daily Bed Returns (DBRs) from each ward (Ward 1-6) and New Born
Unit (NBU) and admission registers
- Capturing the Inpatients patient’s biodata that are admitted in the hospital using the
Health Management Information System (HMIS)
- The inpatients from the wards data may include the Accumulation of Bed Duties
(ABD), Percentage Occupation of the beds, Turnover per Bed (TOB)
- Data collection of the DBRs consists of: Hospital number (56013972), Number of the
discharged home/died, Number of patients referred to another hospital, Previous and
Todays Physical Count Return wards consisting of patients eg 60 Patients,
Accommodated, Vacant beds and Total number of patients
CHAPTER THREE
3.0 EVALUATION OF THE ATTACHMENT PERIOD
3.1 Success/ failure of the attachment exercise
Successes
1. Able to understand the workflow of the various departments in the hospital.
2. Improved interpersonal skills with the patients.
3. Able to relate with the staff
4. Able to get through to the patients in some instances when the machine eg. X-ray
machine broke down.
5. Solving problems based on a department I was posted to
6. Build up trust with the staff such that they could assign us more responsibilities
7. Being confidential about the patients records and staff personnel files
8. Reduced turn-around times
9. Improved revenue collection
10. Reduced number of complaints from patients
Failures
1. I was not able to use the entire hospital management system (CHIS, LIMS, Accounts,
EMR). I was only able to access a part of the system.
2. Some departments are not yet integrated in the system so I was not assigned to work.
Example Diabetic and physiotherapy department
3.2 Challenges encountered by the student during the attachment period
1. Language barrier. In the booking and X-ray department when interacting with the
patients
2. Network failure leading to failure of Management Information System.
3. Workload
4. Unfriendly staff who are unwilling to assist where necessary
5. Misfiling of the inpatient files
6. Complaints from the patients about slowed services offered to them. Example, in the X-
ray department, there is no distinct organization in the order in which the patients
arrivedi
7. The medical terminologies used in the hospital were difficult to comprehend. Eg
MOH705A, MOH705B, ACD-10 etc.
8. Poor data intake loading to unreliable data being generated
3.3 How the challenges were solved
1. Checking and filing appropriately the files in the Central Records Department for
easy tracing and retrieval
2. Familiarized with troubleshooting techniques used in identifying and solving
network issues such as solving IP conflict, terminating new cables in case of
malfunctioning in an old one
3. Collaborating with other attachés with the assistance of the supervisor
4. Establishing a rapport with the staff to create a friendly working environment.
5. Seeking for help from other staff who are able to translate the language while
communicating with a patient
6. Establishing an understanding with the patient hence pleading them to be patient
as they wait to be served.
3.4 Recommendations as how the attachment exercise can be improved by the university
1. Referring students to organizations/ institutions that provide ample experience in their
particular course work, in this case; Information Technology.
2. Providing students particular objectives that are to be achieved during the attachment
period
CHAPTER FOUR
OTHER ISSUES LEARNED
4.1 Employees Code of Conduct
1. Act honestly and responsibly avoiding actual or perceived conflicts of interest.
2. Promote a safe, secure and healthy work environment for all.
3. Protect the hospital’s physical, electronic and intellectual property.
4. Uphold the policies of Thika Level 5 Hospital.
5. Uphold the values of the Hospital: Excellence and Innovation, Patient-Centered Care,
Teamwork, Collaboration, Respect and Diversity and Leadership.
6. Deliver patient care, research, education and support work with professional competence,
intellectual honesty and high ethical standards.
7. Respect and protect the privacy and confidentiality of all individuals and information
subject to relevant legislation and hospital policies.
8. Treat all internal and external members of the community with respect and dignity and
without discrimination.

REFERENCES
Head of ICT Department, Ambrose Waita
Head of Health Records and Information Department, Mr. Peter Muigai
i

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