Certificate No.

AJA19-0226

Chapter I

Introduction

Effective and sustainable hospital-community partnerships are critical to

building a culture of health. Building a culture of health means creating a society that gives

all individuals an equal opportunity to live the healthiest life they can, whatever their

ethnic, geographic, racial, socioeconomic or physical circumstances may be. Though some

partnerships develop organically, a catalyst event such as the initiation of a community

health needs assessment process, new policies or payment models, or emerging community

health issues often brings organizations together or revitalizes long-standing partnerships.

The following study will prove that the information mentioned above is

effective. Citizens Memorial Hospital needed to find new ways to fill the nursing pipeline

due to an aging workforce, and they came up with a strategy worth replicating. The hospital

teamed up with Southwest Baptist University and Bolivar Technical College to expand

programs and train more nurses. The hospital serves as a training site for students and

provides financial resources for the program. The partnership has been successful in helping

us build our nursing and clinical staff. Plus, it’s great to see local residents going through

these training programs and choosing to stay and have a good career here in town.

Partnerships with local universities or technical schools can help hospitals train and recruit

quality staff, as well as strengthen community ties and fuel the economy. Beyond education

and training for health care workers, there are more ways health systems can partner with

the community to attract people and keep the economy strong. It starts with keeping
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people invested in rural areas so they have more reasons to stay. Volunteer programs

provide an opportunity to build momentum and positive energy, and they can also inspire

youth to get started on a career path in health care. At Citizens Memorial Hospital, it has

about 300 volunteers active now. It also offer a summer program for youth ages 15 and

older, where they can shadow employees to see if a health care career may be right for

them.

And as a new partnerships form, there is a need for increased structure and effective

operations for the partnerships. It is critical to define goals based on the community’s

health needs when building an effective partnership. When partners come together to

address an identified priority health need of the community, the goals and objectives of the

partnership should be agreed upon and understood by all partners. The most appropriate

governance and organization structure can then be developed, with all partners

understanding their distinct role in the collaborative approach to addressing their

community’s health needs. Shared governance can take the form of steering committees,

advisory boards, joint ventures, coalitions and a variety of more informal structures. With a

strong organizational structure and identified goals, objectives and roles, these partnerships

can effectively develop evidence-based interventions.

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Background of the Study

In the Philippines public hospital have different barriers and challenges, including

limited funding, lack of structure, disparate data collection and storage, limited operational

resources, and lack of personnel. Overcoming these barriers and challenges is necessary to

have a positive impact on the effectiveness and sustainability of the interventions.

Also, the Philippines in response to the Millennium Development Goals focus on

health, began the National Demographic and Health Survey to assess the effectiveness of

public health programs in the country, but the issue of ineffectiveness of these health

programs is caused by the inefficiency and lacking of personnel’s with knowledge with the

program. Also poor communities suffer a higher burden of disease due to inequities in

access to services and health status. Since financing for local government units often vary

and the benefits package for insurance plans may be unfavorable, some communities face

difficulties accessing public health services. Shifting the responsibility of healthcare from the

federal government to the local governments has increased local authority and has made

communities susceptible to lack of access to basic services. In addition, most healthcare

payments are made out of pocket, especially when receiving care from privately owned

institutions. Barangay health stations serve as primary public health facilities and are staffed

by doctors, nurses, midwives, and barangay health volunteers who in the long way resigned

or and stop rendering service because they were not paid already.

In Eastern Samar one of the poorest provinces in the Philippines suffers a big gap in

terms of government action in addressing issues on health care services and management
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of public hospitals. Llorente is one of Eastern Samar municipality who is in depth need of an

effective and sustainable hospital. This municipality has one public hospital but is very poor

in services, lack of personnel’s, lack of equipment such as medicines, beds and others. And

the nearest municipalities with hospitals are too far and too risky to travel especially to

those in critical conditions it may take one hour and thirty minutes before reaching the

hospital. That’s why at some point patients with critical conditions are not treated on time

that causes them to die. This lack of accessibility to effective public hospital and

management is what Llorentehanons problematized that needs immediate and proper

action.

Scope and Severity of the Problem

This policy paper will focus on the rehabilitation, improvisation of health care

services and management and building hospital community partnerships of a public hospital

in the Municipality of Llorente.

This problem is the concern of the people of Llorente, with regards to the

ineffectively and inefficiently hospital facilities and management. Also this problem are one

of the Llorentehanon’s concerned as to increasing numbers of mortality rate which most of

the caused are the lack of accessibility to a public hospital.

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Chapter II

Statement of the Problem

This proposed policy paper intends to determine the actions to be done by the LGU

of Llorente regarding the inefficient and ineffective health care services and management

rendered by the current public hospital in Llorente.

Specifically, the study sought to answers the following questions:

1. What are the different factors affecting the people of Llorente with

regards to lack of accessibility to public hospital?

2. What are the different policies to be implemented by the LGU of

Llorente?

3. Who were the different partnered organizations needed to be able to

implement the recommended policies?

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Goals and Objectives

Municipality of Llorente, is a 3rd class municipality in the province of Eastern

Samar, Philippines. According to the 2015 census, it has a population of 20,149 people. With

this number, a lot of people are suffering problematic fear and hopeless thought that when

they get sick unexpectedly they will not be cured quickly due to lack of accessibility to

hospital and money to pay for hospital bills for the nearest hospital is privately owned. With

this policy problem affecting the lives of Llorentehanon this study aims to achieve the

following goals and objectives:

1. To lobby to the LGU of Llorente to make the budget for

hospital rehabilitation as one of its priority.

2. Develop an informal or formal governance/steering group

(e.g., coalition, board, and committee) with individuals

representing each organization.

3. Develop succession plans with current and future leaders so

the partnership does not rely entirely on one person or

organization.

4. Draft any legal agreements or memorandums of

understanding to solidify the partnership structure, as

needed to the LGU.

5. Clearly define roles and responsibilities of each partner.

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6. Convene active workgroups and committees that focus on

execution and continually work to address challenges and

barriers.

7. Engage partners in collaborative problem-solving of jointly

shared problems.

8. Discuss lessons learned on an ongoing basis to modify and

strengthen partnership structure and processes.

9. Ensure transparent and frequent communication between

partners and other key stakeholders.

Significance of the Study

This policy paper is deemed significant to the people of Llorente. Specifically, this

will contribute to the improvement, effectiveness, and sustainability of public hospital

structure, facilities, personnel, management, and also to its relationship to the people who

will whole-heartedly helped which is the partner organization, also to all Llorentahanons. I

hope that this research will encourage the people of Llorente and also the civil society

organizations to be drawn to this new method of partnership and to adapt it as an effective

strategy that will benefit the whole constituency of Llorente

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Cause and Effect Analysis ( Fishbone Diagram)

Inefficient and Ineffective Public Hospital in

Llorente E. Samar
(EFFECT)
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Chapter III

Methodology of Analysis

Data Collection

In data gathering the researcher used the qualitative collection method and did in

depth face to face interview to fifteen respondents from different barangays of Llorente to

help generate evaluation hypothesis, strengthened and expanded or clarified evaluation

findings.

Data Analysis

After conducting series of data gathering the policy maker able to find out the

reason behind this problematic issue the people of Llorente are suffering. Majority of the

interviewed respondents answered the question that the LGU really need to make

rehabilitation of the Public Hospital and make it as its top priority projects. As the

respondents said they all deserved an effective, efficient, and reliable hospital no matter

what status you belong. And when the questioned asked if Hospital partnered with

organization would make it a much reliable, majority answered that it is. As what the

respondents said the more hand in the making the merrier and the healthier place. The

more inclined with knowledge on what to do the more chances of betterment of services to

be rendered.
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Chapter IV

Alternative Policy Solutions

The rehabilitation of the public hospital needs an immediate action to be taken by

the LGU by making it as its priority project. It must be funded by the government that’s why

during budget call the municipality needs to make it as its top priority projects and input

enough money to be funded. Integrate efficient structures, processes, communications and

documentation into a well-constructed partnership will lead to more optimal functioning.

The partnership should adapt formal written agreements and charters to document mutual

mission and vision statements, financial plans, action plans, and roles and responsibilities of

each participant, the collaboration can advance efficiently and effectively. The different

types of organizational partnerships to be tapped are Community organizations,

Educational organizations, Faith-based organizations, Housing and transportation services,

Government, Local businesses, Public health organizations, Health care organizations That’s

why during implementation of the project those partnered organization should also assess

and give hand for an effective output. Also to make this legitimate the LGU should make this

partnership with organizations as a municipal order. And to give these partnered

organization a public office in the municipal hall. These organizations should attend

seminars regarding for providing health care services to the people/patient, these

organizations should also have a proper collaboration to the personnel of the hospital that

in terms of emergency they can also be reached. The LGU should identify health needs

through a community assessment, with participation or input from key partners. Develop

programs based on prioritized community health needs. Ensure partners agree on the scope
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of the interventions Identify any evidence-based interventions and promising practices for

the identified need, and agree upon process and outcome metrics. Identify community

assets to determine all available resources (e.g., financial, time, facility space, staff, IT, in-

kind or other resources) and potential partners. Identify and apply for secure, sustainable

funding. Consider pilot grants if long-term funding is unavailable.

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Chapter V

Policy Recommendations

For further study in regards to creating hospital community partnerships following

recommendations are to be developed, implemented, and adopted. Many community

health needs identified by hospitals are aligned with those identified by other community

organizations, a prime impetus for collaboration. Hospitals and community should focus on

increasing access to care by providing free health services, increasing provider capacity, or

providing care in unique ways such as telehealth or in homeless shelters. Additionally,

hospitals and their partners should focus on better preventing and managing chronic

conditions and addressing socioeconomic insecurities. As the LGU has become more robust

and new community priorities have emerged, hospitals should developed traditional

partnerships focused on needs such as behavioral health and socioeconomic issues such as

food security, transportation and crime. More complex partnerships across multiple sectors

could be created to address the multifaceted and interconnected nature of community

needs, which will help in building a more reliable culture of health within the municipality.

And also LGU should enhance existing partnerships and initiate new partnerships
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Chapter VI

Summary of the Central Knowledge Gained from the Research

Developing and sustaining partnerships can be challenging, as hospitals and

community organizations may have differing organizational priorities and cultures and even

competing interests. It can take time to create relationships, build trust and generate

consensus among partners. Strong leadership and buy-in from the hospital and LGU on

addressing community needs including social determinants and their impact on health can

propel organizations to action. Leaders at hospitals and at community organizations all must

be committed to improving the health of the community; defining a shared mission, vision

and strategic objectives; making difficult decisions; and dedicating the necessary resources

for successful implementation. At some organizations, leadership is very integrated into the

community, with LGU engaged on various community boards, volunteering at community

events, or acting as facilitators or ambassadors in the community on specific issues.

Hospitals and community organizations may structure their partnerships differently

depending on the need being addressed. Before beginning to develop community programs

and interventions, the partners should adopt a partnership structure that enables efficient

functioning based on the mission and goals of the project. These structures can range from

informal ones such as ad hoc task forces and broad alliances and coalitions, to more defined

structures such as steering committees and advisory boards, to formalized structures,

including creation of a new backbone organization, not-for-profit company or joint venture.

Many organizations discuss governance and structure at the beginning of forming the

partnership so that all parties understand their roles and responsibilities. Hospitals and their
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partners provide resources, skills and expertise that are beneficial for a successful

collaboration. Partners can contribute a wide range of resources and roles, including:

Funding, Facility space and utilities, expanded staff and volunteers, Data sharing and

analytics, Increased access to care (e.g., diagnostic vouchers, clinic hours), Grant-writing

assistance, IT and technical support. Partners should make meaningful contributions not

just funding the effort or providing their reputation, but really driving the efforts forward.

Partners should not simply sign an agreement or attend a meeting. They must be actively

engaged, know what is happening in the community and in the partnership, and take an

active role in decision-making and implementation.

Implementation Plan

At first the LGU of Llorente should submit the list of its projects with public hospitals

at its most priority, for budgeting and funding. When the budget are already available the

LGU calls for any organizations shared with the same mission of improving health care

services in the municipality to give hand and be partnered with the LGU. With different

organization willing to help the public hospital could be started reconstructing. This time

during the ongoing reconstructing the partnered organizations with the LGU are also

starting its shared contributions and give each organization its roles and responsibilities.

The LGU also should make a municipal order legitimizing the partnerships. After the

construction of the public hospital the partnered organization must be given a public office

in the municipal hall for an easy communication. Also this partnered organization will take
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in charge for the management of the public hospital in case of issues arousal. The flow of

this proposal must be continuous as long as the mission, goals, objectives, of the partnered

organizations and LGU are still aligned.

Limitations and Unanticipated Consequences

The partnerships of the LGU and the organizations are limited only to its shared

vision of improving health care services and providing services for the benefits of the

constituents in the municipality of Llorente. Any reforms, alterations to be made of the

issued municipal order should be interrupted if it is not already aligned to the shared goals

and objectives. Unanticipated consequence like lacking of funds during the implementation

is possible. That’s why donations and grants are accepted.

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A POLICY PAPER ON IMPROVISATION, REHABILITATION OF HEALTH

CARE SERVICES AND MANAGEMENT, AND BUILDING A HOSPITAL-

COMMUNITY PARTNERSHIP OF PUBLIC HOSPITAL IN LLORENTE,

ESATERN SAMAR:

A BASIS FOR SOME POLICY RECOMMENDATIONS

Proposed by:

Presented To: