BACKGROUND AND OBJECTIVE

Proper documentation of patient safety events is important to be able to provide changes that can prevent events from occurring again. The Philippine General Hospital launched an online platform for reporting patient safety events in 2017. This paper aimed to describe the patient safety events, initial response to the event, and preventive actions done in the institution.

This is a retrospective descriptive study of patient safety event records from August 2017 to April 2022. General data of the patients, details surrounding the events, response to the event, and preventive measures done after the event were documented. Descriptive analysis was performed.

There was a total of 625 events reported with 525 total unique reports. There was an increased rate of patient safety event reports from 2021 to 2022. The average rate was 23.8 and 25.7 reports per month, respectively. Most reports were for in-patient cases and were type 3 preventable adverse events. The general initial response of healthcare personnel to the adverse events is to provide the appropriate clinical care. Preventive measures include re-orientation and event specific actions.

Documentation is crucial for patient safety events to provide solutions and prevent reoccurrence of these events that can cause harm to patients.

Human ; Therapeutics ; Patients ; Diet

BACKGROUND

The migration from classroom learning to real patient encounters during clinical clerkship is a transformative journey that carries with it many challenges which serve as rich sources of meaning. The actual patient interactions are pivotal opportunities that provide transcendental meanings which contribute to the well-rounded development of medical clerks, ultimately enhancing their ability to deliver better patient care.

Utilizing a qualitative phenomenological approach, the study allowed exploration of intricate layers of meaning embedded within the encounters of three female medical clerks in a medical university hospital in Manila, Philippines. The gathered narratives were analyzed and meanings were derived from these statements. The identified meanings were then organized into themes and essential insights that represented the core essence of the phenomenon being studied.

The reflections extracted from narratives revealed the emergence of 10 significant major themes stemming from medical clerks’ patient encounters. These encounters were consistently described as a sacred responsibility, providing opportunities for profound connections, resilience, deepened faith and comprehensive personal and professional development within a caring and compassionate environment.

The transformative journey was marked by profound personal and spiritual growth among medical clerks. Beyond developing their clinical skills, they experienced a transcendence that spoke to human desire for meaning beyond the material world. This "spirituality of encounter" fostered deeper connections with patients and enriched their perspectives on clinical practice that can further enhance their holistic development as medical students.

This essay laid out the development of a nurse's identity from clinical practitioner to developing researcher, with a focus on the importance of patient-centered and nurse-centered care as the cornerstone pillars of nursing research. Through narrative and application of qualitative and participatory research approaches, the author showed the intersection of everyday experience, philosophical inquiry, and scholarly pursuit along the path toward becoming a nurse researcher. The article examined how emotional experiences within the perioperative environment have instigated research questions aimed at improving patient and nurse well-being. Through the incorporation of academic models and theoretical perspectives, the author presented an emerging investment in health equity, social determinants of health, and collective inquiry, framing this individual path within the greater nursing science mission.

Background: In 2008, the Department of Health (DOH) issued Administrative Order 2008-0023 that called for an “effective and efficient monitoring system that will link all patient safety initiatives”. However, there are still no explicit and harmonized targets to measure effectiveness and to provide benchmarks that assess whether previous efforts were helpful. Objective: The study aimed to describe the status of patient safety performance measures and indicators on the international patient safety goals (IPSGs) in select hospitals in the Philippines. Methods: Descriptive, cross-sectional design was used to investigate currently used performance measures and indicators. Data collection included administration of a Hospital Patient Safety Indicators Questionnaire (HPSIQ) that summarized the currently used patient safety measures and indicators in the sampled Level 2 and level 3 hospitals and triangulation by review of documents such as hospital databases, protocols on reporting, and manuals for information gathering regarding patient safety. Performance measures were categorized using the Donabedian framework. Core indicators were identified through review of standards that cut across the six IPSGs and evaluation of overarching processes and concepts in patient safety. Results: Forty-one level 2 and 3 hospitals participated in the study. Most performance indicators were process measures (52%), while structure (31%) and outcome measures (17%) accounted for the rest. There is an obvious lack of structural requirements for patient safety in the hospitals included in this study. Less than half the hospitals surveyed implement risk assessment and management consistently. Reporting of events, near- misses, and patient safety data are widely varied among hospitals. Data utilization for quality improvement is not fully established in many of the hospitals. Patient engagement is not integrated in service delivery and performance measurement but is crucial in promoting patient safety. Conclusion Mechanisms to improve hospitals’ capacity to monitor, anticipate, and reduce risk of patient harm during the provision of healthcare should be provided. Having a unified set of definitions and protocols for measurement will facilitate reliable monitoring and improvement. Leadership and governance, both internal (e.g., hospital administrators) and external (e.g., DOH) that recognize a data-driven approach to policymaking and improvement of service delivery are crucial in promoting patient safety
Patient Safety ; Outcome and Process Assessment, Health Care

Background: Retinoblastoma is the most common intraocular cancer in childhood in the Philippines. Most data though on demographics, clinical profile, treatment options, and outcomes in the country are from the National Capital Region. Objectives: This study aimed to describe the demographics, clinical profile, treatment done, and outcomes of retinoblastoma patients seen in a public tertiary referral center in Davao from 2011-2020 to make available literature more representative of the status of retinoblastoma in the Philippines. Methods: An analytical cross-sectional study was conducted using the records of retinoblastoma patients seen in a tertiary government hospital located in Davao Region from January 2011 to December 2020. Results: There were 157 patients included in the analysis. Seventy-three (46%) were female with 44% coming from the Davao Region. One hundred seven (69%) patients had unilateral disease. Median age at initial consultation for patients with unilateral disease was significantly older than those with bilateral disease (p<0.003). Tumors were extraocular in 82 (40%) eyes. In the intraocular group, 36% of the eyes belonged to International Classification of Retinoblastoma (ICRB) Groups D and E. Enucleation was the most commonly performed treatment. Survival rate was 28%. This is the first report to provide epidemiologic and clinical data on retinoblastoma in the literature, including survival data, from Mindanao. Advanced stages and extraocular cases of retinoblastoma remain high. Delay of consultation contributed to the prognosis and clinical outcome of the disease. Conclusion. Advanced stages and extraocular cases of retinoblastoma remain significantly high in the country, even in Mindanao.
Retinoblastoma ; Therapeutics ; Survival Rate

It is just fitting for the oldest medical school in the Philippines, the UST Faculty of Medicine & Surgery, which just celebrated its sesquicentennial year, to initiate this trailblazing stethoscope tagging ceremony for 418 second-year medical students belonging to USTFMS Batch 2026. This activity is aligned with enhancing the Thomasian identity (one of the strategic directional areas [SDA 2] of the university) once they graduate, the Thomasian Physician identity. The stethoscope remains the symbolic representation of physician and patient care. The innovative and pivotal activity, completely different from other international medical schools’ rite of passage, was marked with meaningful symbolisms unique to USTFMS. This rite also involved a pledge to the patroness of the Department of Medicine, Mary Untier of Knots, who would thus qualify for a robust faith formation program of the university (key result area [KRA 1]). Indeed, this would be the beginning of an annual celebration of strengthening faith, hope, and charity (patient care advocacy), TRIA HAEC, the three virtues of St. Paul that comprise the core values of Thomasian education.
Schools, Medical ; Students, Medical ; Stethoscopes ; Patient Care

Leprosy presents diversely, making diagnosis challenging. Histoid leprosy is a rare variant with atypical features. We present a case of a 40-year-old Filipino male with multiple erythematous to flesh colored, well demarcated hypoesthetic nodules primarily on his back and abdomen. Dermoscopy revealed features of granulomatous disease. Fite-Faraco stain showed globi formation. Skin biopsy showed epidermal atrophy, dense histiocyte infiltrates and collagen trapping. While histoid leprosy is uncommon in patients without a prior history of leprosy and treatment, this case highlights the importance of maintaining a high index of suspicion, especially in endemic regions. Early diagnosis and prompt multidrug therapy are crucial for preventing transmission and improving patient outcomes.

Client feedback is an integral part of the health care system’s quality and effectiveness. In health care operations, it is paramount as it serves as a vital tool for continuous improvement, ensuring patient-centric care delivery, and fostering trust and accountability within the health care system. Client feedback helps shape up new and existing policies and is, therefore, highly valued, considered, and acted upon. In health care institutions such as the Southern Philippines Medical Center (SPMC), incorporating client feedback into policy-making enhances health care operations and aligns services with patient needs and institutional goals. In SPMC, the Hospital Client Experience Survey is the primary feedback mechanism by which clients, both internal and external, can voice their opinions, concerns, and suggestions regarding its personnel, processes, and structure. Through directives from the Anti-Red Tape Authority (ARTA)1 and the Department of Health (DOH),2 SPMC uses the Hospital Client Experience Survey Tool (HCES) to enhance service delivery. Public Assistance and Complaints Desk (PACD) Officers conduct monthly surveys across 200 hospital areas. Each area expects 5 to 30 responses, based on a calculation by the HCES Online Report Generator (ORG). PACD officers actively engage staff within their designated areas, encouraging their participation in survey distribution per transaction and motivating clients to provide feedback during specified survey days. Highlighting the significance of these surveys, PACD Officers emphasize the invaluable insights gained from diverse client responses, which ultimately shape and validate the impact of service delivery initiatives within the hospital. At the end of each quarter, PACD officers analyze data using the HCES-ORG, collate comments and commendations, verify the accuracy of HCES results, and then post them for viewing by the different departments within the institution. Exceptional staff commendations are documented in the quarterly HCES results publication, prominently displayed within the hospital. These commendations contribute to individual performance evaluations. If a staff member receives negative feedback on the HCES form, their unit manager receives a photocopy of the form and may implement disciplinary action or enroll the staff in customer service seminars hosted by the Professional Education and Training Department (PETD). Consistent negative feedback over three consecutive months may trigger appropriate improvement plans or corrective actions among individual staff or even entire departments. The infographic displays the reports from the HCES for the first to the fourth quarters of 2023. Clients’ feedback comprises three domains: personnel, processes, and structures. Personnel covers attitude and character, processes involve system and organization, and structures include facilities and equipment. The feedback includes both positive and negative comments, with recommendations also identified. The HCES consists of statements rated on a scale from 1 (strongly disagree) to 5 (strongly agree). For this infographic, we computed the mean satisfaction scores for each domain and the proportion of clients who reported satisfaction with the service and timeliness of service they received. To summarize the recommendations from the HCES, we utilized the artificial intelligence (AI) chatbot-powered search engine Perplexity AI. We uploaded the recommendations in spreadsheet format and prompted Perplexity AI to "Summarize, in bullets, the recommendations into three categories: personnel, process, and structure," and then to "Count the times each of those summarized comments were mentioned in the file." We used the response of Perplexity AI to illustrate the results as a word cloud, with the sizes of the words in the cloud proportional to the frequency of mentions. In the HCES, the most frequently mentioned suggestion was to provide additional staff. Other suggestions included maintaining clean and functional restrooms, and improving overall cleanliness and sanitation. Infrastructure-related suggestions focused on better ventilation, air conditioning or fans, expanding wards and watchers’ areas, adding more hospital beds and chairs, ensuring a consistent water supply, and providing necessary diagnostic and therapeutic equipment and medicines. Process-related recommendations focused on reducing service delivery turnaround time, prioritizing senior citizens, PWD, and pregnant patients, improving billing and laboratory services, optimizing operation scheduling, and enhancing staff communication and coordination between and among offices. Personnel-related suggestions included improving staff interaction with patients, providing staff training, ensuring staff safety, and performing diligent patient checks. Client feedback helps SPMC retain positive responses, optimize health care delivery, and serve clients better through ongoing renovations, reorganizations, and transformations, affirming its vision of quality service.
Feedback ; Patient-Centered Care

BACKGROUND

In Family and Community Medicine (FCM) residency training, the biopsychosocial approach to care was translated to a teaching strategy and cognitive framework called patient-centered, family-focused, and communityoriented (PFC) lens. However, the PFC lens documented in a matrix has no evidence of its implementation acceptability and appropriateness for the users in the FCM training program.

To determine the acceptability and appropriateness of the integration of the PFC lens in the Ortho- Geriatrics Fracture Liaison Service (OG-FLS) in applying the family medicine principles and achieving family practice required competencies of the residents in a tertiary hospital FCM training program.

A cross-sectional survey was conducted using a 15-item self-administered pre-tested online questionnaire to gather feedback and experiences on the PFC lens integration. Answers to open-ended questions were coded and analyzed with MaxQDA and synthesized into themes while numerical rating scales were analyzed with Microsoft Excel into means and standard deviation.

Nineteen residents answered the questionnaire. There were 47 OG-FLS patients referred to the service. Overall, the acceptability of the approach among FCM residents had an average score of 9.26 (SD ± 0.99) while appropriateness was rated 9.26 (SD ± 1.09) with 10 points as the highest score. The competencies achieved reported by residents were communicating effectively, collaborating with interprofessional teams, demonstrating clinical competence, and practice of biopsychosocial approach.

The PFC lens integration in OG-FLS is acceptable and appropriate in the practice of multidisciplinary care in the in-patient setting among FCM residents. Its integration is aligned with the expected competencies of a family physician that trainees can apply in future practice.