WHEN THE SUN RISES

WE WORK HARD TO DELIVER

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Hospitals and District Health ServicesWeekly Reporting Template 2015/16

(Weekly Monitoring Tool)

Name of Hospital/Facility: ___________________

Month: ___________________Week: ___________________Date: ___________________

2

Maternal and Child Health Issues

Week: _______________

OBJECTIVE NAME OF HOSPITAL

NUMBER REASONS/COMMENTS

Maternal Deaths

Still Births

Neonatal Deaths

Under Five Mortality

3

Maternal and Child Health Issues

Week: _______________

OBJECTIVE NAME OF HOSPITAL

NUMBER REASONS/COMMENTS

Cervical cancer screening

Child under 5 years severe acute malnutrition case fatality rate

Child under 5 years pneumonia case fatality rate

Child under 5 years diarrhoea case fatality rate

4

HIV/AIDS, STIs and TB (HAST)

Week: _______________OBJECTIVE HOSPITAL INDICATOR reasons/comments

Prevention Of New HIV,STIs and TB Infections

Number of clients tested for HIV (including ANC)

Number Of Male condoms distributed

Number Of female condoms distributed

Number of Medical Male Circumcisions performed

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HIV/AIDS, STIs and TB (HAST)

Week: _______________

OBJECTIVE HOSPITAL INDICATOR REASONS/COMMENTS

Sustain health and wellness of the citizens of Mpumalanga

Number of HIV positive clients initiated on ART - Adults

Number of HIV positive clients initiated on ART - Children

Total Number of clients remaining on ART(TROA)

Number of HIV positive clients initiated on IPT

6

HIV/AIDS, STIs and TB (HAST)

Week: _______________OBJECTIVE HOSPITAL INDICATOR REASONS/COMMENTS

Prevention Of New HIV,STIs and TB Infections

Number of Antenatal clients tested HIV positive

Number of Antenatal clients initiated on ART

7

HIV/AIDS, STIs and TB (HAST)

Week: _______________

OBJECTIVE HOSPITAL INDICATOR REASONS/COMMENTS

Prevention Of New HIV,STIs and TB Infections

Number of TB suspect 5 years and older tested for TB

Number of TB suspect tested positive and initiated on TB treatment

Number of patients diagnosed with MDR TB

TB hospitals Number of MDR patients initiated on MDR TB treatment

8

Major Adverse Events

Week: _______________INSTITUTION DATE OF THE

EVENTDESCRIPTION CORRECTIVE MEASURES IMPLEMENTED CONSEQUENSE

MAMANGEMENT

9

Medicine Availability

Week: _______________INSTITUTION % MEDICINE

AVAILABLESTOCK OUTS OF ARV

STOCK OUTS OF TB DRUGS

STOCK OUTS OF VACCINES

STOCK OUTS OF HYPERTENSIVE DRUGS

STOCK OUT OF DIABETES MELLITUS DRUGS

COMMENTS

(Tracer Med)

10

Consumables Availability

Week: _______________NAME OF FACILITY

% CONSUMABLES AVAILABLE

STOCK OUTS OF MAJOR CONSUMABLES (SYRINGES, GLOVES ETC) STOCK OUTS ON MAJOR IV INFUSIONS

COMMENTS

- -

11

Environmental Health Services (Waste Management)

Week: _______________

OBJECTIVE HOSPITAL /

PHC FACILITIES

INDICATOR REASONS/COMMENTS

Effective managing of medical waste at hospitals and PHC facilities

Waste officers appointed / delegated and trained

Availability of waste management plans

Records of waste categories collected

Availability of dedicated / suitable lockable waste storeroom

Monitoring tick lists available to ensure SP compliance

100% availability of waste containers

All waste collected as per schedule

12

Health Facilities Management

Week: _______________

NAME OF FACILITY

STATUS/NEEDS FOR INFRASTRUCTURE NEEDS

STATUS/NEEDS OF MECHANICAL EQUIPMENT

(BOILERS, BACK-UP GENERATORS, AUTOCLAVES, MEDICAL GAS PLANTS ETC)

STATUS/NEEDS OF KITCHEN, LAUNDRY & MORTUARY EQUIPMENT

MAINTENANCE PROJECTS & PROGRESS

CAPITAL PROJECTS & PROGRESS

CHALLENGES

13

Equipment Maintenance

Week: _______________

INSTITUTION AUTOCLAVES

MAINTAINED WELL?

DATE OF MAINTENANCE

INCUBATORS

MAINTAINED

DATE OF MAINTENANCE

MORTUARY

CLEANED WITH APPROPRIATE MATERIALS

DAILY CLEANING RECORD KEPT

AIR CONDITIONERS

MAINTAINED

DATE SERVICED

KITCHEN EQUIPMENT

MAINTAINED .

DATE OF MAINTENANCE

REMOVAL OF HEALTH CARE RISK WASTE

DATE DONE

DAILY REGISTER AVAILABLE

COMMENTS

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Equipment Maintenance

Week: _______________

INSTITUTION ELECTRICITY SUPPLY

CONSTANT

GENERATOR

TESTED THIS WEEK? DATE & TIME

PIPED WATER.

ANY LEAKS NOTED

TELEPHONES AVAILABLE AND WORKING

COMPUTERS WORKING AND LINKED

REMOVAL OF HEALTH CARE RISK WASTE

DATE DONE

COMMENTS

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Planned Maintenance – Medical Equipment

Week: _______________

DISTRICT PLANNED FOR THE MONTH (according to maintenance

plans)

PROGRESS REASONS/COMMENTS

Ehlanzeni

Nkangala

Gert Sibande

16

Unplanned Maintenance (Repairs) - Medical Equipment

Week: _______________

DISTRICT DESCRIPTION OF OCCURENCE

PROGRESS REASONS/COMMENTS

Ehlanzeni

Nkangala

Gert Sibande

17

Procurement of Major Medical Equipment

Week: _______________

PROGRESS /STATUS COMMENTS

EHLANZENI

GERT SIBANDE

NKANGALA

18

Human Resource Issues

Week: _______________NAME OF FACILITY LABOUR RELATION

CASES REPORTED CASES FINALISED EMPLOYEE ASSISTANT PROGRAM (EAP)

- (Psychosocial and Health Related issues )

(Psychosocial and health related workshop conducted)

19

Human Resource Issues

Week: _______________

NAME OF FACILITY INJURY ON DUTY AND OCCUPATIONAL

DISEASES REPORTED

EMPLOYEES MEDICAL SURVEILLANCE (initial, periodic , exit medical and special medical

examination

OTHER

- - -

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Human Resource Issues

Week: _______________

NAME OF FACILITY MAJOR TERMINATIONS

TYPES

MAJOR TRANSFERS

LEAVE DISCOUNTING

/LEAVE GRATUITY

TYPES OF LEAVE TAKEN

GRADING /TRANSLATION

LONG SERVICE AWARD

- IN OUT - VA

SL

TIL

LTD

PD

ML

STL

FRL

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Human Resource Issues

Week: _______________

NAME OF FACILITY NO. OF POST ADVERTISED

RECRUITMENT AND SELECTION PROCESS

FOLLOWED

NO. OF POST(S) FILLED PER CATEGORY

REMARKS /REASONS FOR DEVIATION

YES NO Category NO.

Professional Nurses

Medical Personnel

Finance Support

Admin Support

Allied Health

22

GP Contracting

Week: _______________NAME OF PHC FACILITY

NUMBER OF VISITS BY A DOCTOR PER WEEK

(NO. OF VISITS AND NO. OF HOURS

ON CONTRACT / SESSIONS /OUTREACH

COMMENTS

NUMBER OF VISITS NUMBER OF HOURS PER VISIT

23

Non Negotiables

Week: _______________NAME OF FACILITY

TYPE OF NON-NEGOTIABLE

BUDGET EXPENDITURE NON-FINANCIAL INFORMATION

(E.G. AVAILABILTY OF CLEANING MATERIAL, TOILET ROLLS, ETC )

COMMENTS

- - -

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Ideal Clinic

Week: _______________NAME OF FACILITY

BASELINE SCORES COMPONENT SUBCOMPONENT ELEMENT ACTION TAKEN TO ADDRESS GAP

IDENTIFIED

COMMENTS

- - -

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Six Priority Areas on Extreme &Vital Measures (NCS)

Week: _______________NAME OF FACILITY

PRIORITY AREA QUALITY IMPROVEMENT

PLAN

PROGRESS BUDGET EXPENDITURE COMMENTS

Cleanliness -

Waiting Times

Staff Attitude

Patient Safety

Infection Prevention and Control

Availability of Medicine

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AG Findings / Recommendations

Week: _______________

INSTITUTION FINDING ACTION PROGRESS REPORT

Various institutions

Various findings

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Finance

Week: _______________DATE NUMBER OF

INVOICES RECEIVED

NUMBER OF INVOICES PAID

WITHIN

30 DAYS

NUMBER OF INVOICES PAID

WITHIN

60 DAYS

TOTAL AMOUNT REASON

FOR NON-PAYMENT

CORRECTIVE MEASURES

TAKEN

PLANNED PAYMENT

DATE

MUNICIPALITY ACCOUNT

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Finance

Week: _______________DATE NUMBER OF

INVOICES RECEIVEDNUMBER OF

INVOICES PAID WITHIN

60-90 DAYS

NUMBER OF INVOICES NOT PAID WITHIN

60-90 DAYS

REASON CORRECTIVE MEASURES

TAKEN

OUTCOME PLANNED PAYMENT DATE

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Finance: Payment Tracking

Week: _______________

DATE INVOICES NOT PAID WITHIN

60-90 DAYS

INVOICE NUMBER PAID AS PLANNED

Y=1

N=0

REASON CORRECTIVE MEASURES

TAKEN

OUTCOME 2nd PLANNED PAYMENT DATE

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Infrastructure Finance: Payment Tracking

Week: _______________DATE INVOICES NOT PAID

WITHIN

60-90 DAYS

INVOICE NUMBER PAID AS PLANNED

Y=1

N=0

REASON CORRECTIVE MEASURES

TAKEN

OUTCOME 2nd PLANNED PAYMENT DATE

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Infrastructure Finance: Payment Tracking >90 Days

Week: _______________DATE INVOICES NOT PAID

WITHIN

>90 DAYS

INVOICE NUMBER PAID AS PLANNED

Y=1

N=0

REASON CORRECTIVE MEASURES

TAKEN

OUTCOME 3rd PLANNED PAYMENT DATE

32

Infrastructure Finance: Accruals > 90 Days

Week: _______________DATE INVOICES NOT PAID

WITHIN

>90 DAYS

TOTAL AMOUNT REASONS FOR NON-PAYMENT

CORRECTIVE MEASURES

TAKEN

OUTCOME 3rd PLANNED PAYMENT DATE

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Finance: Payment Tracking >90 Days

Week: _______________DATE INVOICES NOT PAID

WITHIN

>90 DAYS

INVOICE NUMBER PAID AS PLANNED

Y=1

N=0

REASON CORRECTIVE MEASURES

TAKEN

OUTCOME 3rd PLANNED PAYMENT DATE

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Portfolio Committee Recommendations

Week: _______________

FINDING CORRECTION PERFORMANCE

CORRECTED =1; NOT CORRECTED =0

ACTIONS TAKEN TO ADDRESS ISSUE

NOT CORRECTED = 1; NOT CORRECTED =0

- -

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AG Recommendations

Week: _______________

FINDING CORRECTION PERFORMANCE

CORRECTED =1; NOT CORRECTED =0

ACTIONS TAKEN TO ADDRESS ISSUE

NOT CORRECTED = 1; NOT CORRECTED =0

- -

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Highlights

Week: _______________

DEPARTMENT OF HEALTHMPUMALANGA PROVINCEREPUBLIC OF SOUTH AFRICA

Thank You