Kisiizicentre ofexcellenceStaffmotivated, professional, competentManagement & GovernanceSustainability High quality trainingChristian WitnessCare for the vulnerableIntegrated health system“Life in all its fullness” John 10:10STRATEGIC PLAN 2015– 2019 (approved by Board of Governors March 2015)

Mission: “bringing holistic healthcare and life in all its fullness to the staff, patients, clients and visitors in the Hospital and community.”

“Kisiizi Hospital is in fact a God-ordained work and as long as it is run with Him in the centre of every part, then He will continue to use it for His glory.” Doreen Sharp

Integrated Vision:To further develop an integrated holistic Health System involving COU Kisiizi Hospital and the surrounding region linking Churches, Health Insurance Groups, Schools and Communities to provide high quality health promotion, screening and care for people’s needs – body, mind, spirit and community – to the glory of God that all may find “life in all its fullness”.

Overall the purpose of this strategic plan is to:

1. Explain our motivation and goals to our stakeholders 2. Explain in detail what Kisiizi intends to accomplish in the next five years 3. Guide our operations to ensure optimal utilization of resources4. Serve as a tool for resources mobilization5. Explain the steps we plan to achieve our goals

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Key objectives:

1] To become a centre of excellence in S.W. Uganda, without compromising access for the poor and vulnerable.

High quality Staff offering Preventive, Educational/Promotional, Curative, Palliative and Rehabilitative health care services that are accessible to everybody

High quality training of health care workers in various disciplines

2] Improve Hospital human relations and Staff confidence including universal job descriptions and appraisals, improved communication & vision sharing with Staff

adequate, productive, well motivated and qualified personnel able to provide quality health care services with competence and compassion

3] Improved Governance, Management and Accountability Systems Effective Board and Management structures (Governance and Leadership)

and accountability systems in place and assured Well documented, organized and up-to-date record keeping, managed

systems and practices for effective planning and decision making Improved Storage of Medical Supplies and General Facilities & Estate

Management Well developed, equipped and maintained infrastructure Enhancing Leadership by identifying who is responsible for what

(including Deputies for Senior Managers) and ensure availability of regular management information, particularly financial information

4] Strengthen both Internal and External relations Greatly enhanced image, visibility and brand as a caring C.O.U faith-

based Organisation High quality Community programs including the Insurance Scheme, Child

Sponsorship, Mental Health, Rehabilitation, Hope Ministries and outreach clinics.

Integrating health systems to maximise health benefits and health promotion

Strengthen links with the Diocese in health promotion, evangelism, care for the vulnerable

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Strengthen links with Kisiizi Partners and other stakeholders and donors Increase the national and international profile of Kisiizi as part of our Christian witness and to enhance our ability to recruit high-

quality Staff and to obtain funding support

Key objectives:

1] To become a centre of excellence in S.W. Uganda, without compromising access for the poor and vulnerable. High quality Staff offering Preventive, Educational/Promotional, Curative, Palliative and Rehabilitative health care services that

are accessible to everybody High quality training of health care workers in various disciplines

a) Clinical Services:Topic Achieved Planned / Vision Comments / timescale

Out-Patient / Accident & Emergency

Department

Opened new rooms. Eye clinic to current KHPL room. Emergency lighting installed.Oxygen saturation monitor installed.

Creation of Accident & Emergency central area for stabilisation of seriously ill patients prior to their transfer to the wards.Streamline flow of patients, increased registration, one-way system, triageImproved “customer care” of out-patients

By April 2015.Training for registration staff in care for patients

Medical & Paediatric Interns in OPD MO’s more flexible, Consultant physician supervision.Ante-natal & Child welfare clinics Add post-natal clinic; create new space by reorganising stores 2015 ? support from Banyakigezi

Colposcopy services, especially for women with HIV at risk of cancer 2015Mental health opd to avoid stigma – room identified 2015

HIV clinics – greater space for consultation & counselling

Shaded waiting area for patients 2015

Stre@mline IT system to be piloted then rolled out Improved patient safety featuresMaternity care Consultant Obstetrician in post;

Uganda Maternal & Newborn Hub links with visiting UK anaesthetist Jan 2015.Mothers’ Waiting Home opened.

Obstetric anaesthesia training upgrade. Aim to recruit more midwives.Expand labour ward to 10 beds, Maternity unit to 60 beds; separate labour ward staff

Long term building plans, no funding yet identified. 2018 maybe related to 60th Anniversary celebrations?

Neonatal care Small unit but some good results Designated proper unit with 15+ cots and facilities and space Long term building plans, no funding yet identified. 2017 - 2019

Mental health Community outreach vehicle obtained.District Engineer approved building plans.

Build new ward and day unit, Further develop community networks. Upgrade to a Consultant led service. Psychiatric nurse training in Kisiizi.

Phase 1 foundations started by March 2015.Potential UK consultant in contact.

General Medicine

Consultant Physician in post August 20142 intern doctors

Upgrade chronic diseases clinics e.g. hypertension, diabetes with multi-disciplinary comprehensive service

Visiting specialist drs from UK March 2015 for 1 month to facilitate this improvement

Reconfigure Medical Ward HDU etc. 2015Recruit Ugandan Consultant Sponsor MO for training 2015-2018

Rehabilitation Develop service for children with special needs e.g. cerebral palsy 2016 summer construct classroomTrain special needs teacher Funding obtained, in progress

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Patient Safety Full time Patient Safety Nurse appointedAPPS / SUSP programmes going well

Integrated Patient Safety programme establishedFacilitate APPS programme in Rugarama Hospital, Kabale 2015-16

Surgery Second Surgeon. New theatres, upgraded anaesthetic equipment, new diathermy, refurbished ward area.

Visiting expertise for Ophthalmology, Plastics, Fistula, ENT etc. ENT specialist from Kampala visit 2015Repeat successful AMREF camps for cleft palate

Dr Robert 2 weeks training in orthopaedics in CorSU hospital

Further training Dr. Robert in specialty orthopaedicsNeed improved imaging equipment e.g. mobile x-ray machine

Apply for Commonwealth Fellowship 2015

Dr Gabriel 1 month UK training in endoscopy and urology

Introduce upper-gastrointestinal endoscopy serviceDevelopment of day suite for endoscopy etc. (in old theatre building)

Start by Feb 2015By June 2015

Introduce bone marrow aspiration (samples to be assessed in Mbarara or Kampala)

By December 2015

Paediatrics RCPCH Global Links registrar partnershipProvision oxygen saturation monitor for high-dependency area.

Upgrade Paediatric early-warning score chartsHealth education sessions and videos in Rukiga on ward & paediatric opd

2015

Intensive Care High dependency beds in wardsSome dedicated equipment for HDU beds

Aim for basic ICU, maybe situated next to theatres to provide recovery area support 1 adult & 1 child ventilator

ITU 2016-2018

Introduce peritoneal dialysis for acute renal failureCommunity 5 general clinics a month.

Helpline to Dr in charge PHCIncreased health promotion via insurance groups, churches, schools.Eye safaris linked to Ruharo Eye Hospital, Mbarara

Chaplaincy / Palliative care

Chaplain and Deputy in post, new Chaplains’ office opened, visit of Archbishop; successful mission

Multi-disciplinary teams, link with Africa Palliative Care AssociationStronger links with Diocese

b) Support Clinical Services:Laboratory Microbiology lab opened.

Upgraded lab equipmentImprove quality assurance. Introduction of HbA1c monitoring for diabetes.(further lab technician currently sponsored for training)

Established regular media preparation for culture & sensitivity service

Further visits for training and quality assurance from Microbiology Consultant, Chester

Recruitment degree-holder in-charge Quality Assurance programme fully functionalIntroduce gene expert analysis for multi-resistant TB screening

Imaging Chester radiology link active. Second Sonographer in place. Radiographer/sonographer [4 years]training sponsored and underway.

Need mobile x-ray or image intensifier.

Aim for echocardiogram service. Potential regional service.Pharmacy In-charge Pharmacy Technician appointed Develop IT and support systems for prescribing safety Stre@mline April 2015 onwards for OPDBiomedical engineering

Technician appointed, new workshop opened, inventories being set up

Tight maintenance and repair schedules, staff training to ensure best use of equipment

Send technician for 1 month training in Chester on Commonwealth Fellowship

IT / Data ERP system in pharmacy Pilot Stre@mline integrated patient system in OPD then wards. If successful then pilot in Rugarama Hospital, Kabale. If works well then publish and distribute via UPMB, WHO etc.

OPD pilot April 2015Paed. Ward discharge pilot Sept 2015Surgery theatre pilot May 2015

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c) Health promotion & screening:Health education

Pilot videos trialled, screens in OPD waiting area

Focused videos for specific conditions e.g. diabetes to be made in KisiiziIntroduce screens in other clinical areas e.g. Mothers Waiting Home for health promotion

2015

Use videos in health insurance community groups plus archdeaconries, schools, neighbouring hospitals and health centres.

Mid-2015 onwards

Basic family planning; Rukiga video made Develop new worker to lead on Family Planning programme 2015Health screening

Potential use of questionnaires related to lifestyle e.g. alcohol consumptionWeight / obesity / bp / visual acuity screening etc.

2016

d) Training, Audit& Research:Facilities Opened new Staff Centre for multi-

disciplinary training sessions, library and IT area etc. January 2015

School of Nursing female dormitory new build (partial funding currently available)

2015 - 2016

Nurses / Midwives

School of Nursing & Midwifery certificate and diploma level courses. School bus purchased. Visit by Midwifery Tutor from UK. Further tutor completed training and returned to Kisiizi.

Nurse interns; Tutor : Student ratio 1:30; increased teaching on wards by school staff. Potential link to Uganda Christian University.Potential expansion of courses: Theatre assistants, anaesthetic CO’s etc.Aim to integrate multi-disciplinary continuing medical education for hospital and school of nursing staff.

See detailed report from School of Nursing and workplan

mhGAP Mental Health awareness for general staff Provide training for diploma nurses currently requiring them to go to Butabika. mhGAP training for staff and community health workers.

mhGAP 2015 then annual

Physios Link with University College Dublin established

Pilot link with Mbarara physiotherapy training school 2015

Potential link to London School of Hygiene & Tropical Medicine diploma course placement October 2015

Interns 8 in post from August 2014 on one year rotation

Develop reputation as top-quality intern training centre

Medical Students

From Uganda and overseas Aim to improve follow up to keep in touch with those who have visited ongoing

Other units Amplification training for WHO Further train up local hospitals / health centres in WHO APPS mattersAudits Weekly mortality audit Pharmacy prescribing audit

Insurance scheme health promotion effectiveness auditResearch WHO / Johns Hopkins University Surgical

Unit-based Safety Programme (SUSP) underway

Analysis of SUSP data including economic aspects SUSP programme to end mid-2015

Well woman research; Head injury

e) Access for the poorKH Community Insurance

Manager appointed Jan 2014 Increase membership, target 40,000 initiallyIncrease publicity

ongoing

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Scheme Balance financially, strengthen health promotion. Consider screening.Mothers waiting home

Opened and in use. Consider free use of waiting home by insurance scheme members.

Ambulance Collects pregnant mothers from HC’sHelpline 24 hr Available for public to enquire for adviceChild sponsorship

Dorcas & Kisiizi Partners programmes

f) Primary SchoolStaff Full complement of staffFinances Previous big loss significantly reduced Boys dormitory poor, aim to replace. UCD 2015Disability friendly

First wheelchair bound pupil taken on; special needs teacher in training

Develop special needs classroom and programmes integrated with main school

University College Dublin link, 2016

g) Estate support services& infrastructure:Clinical areas Surgical ward first half refurbished Refurbish second half of surgical ward area 2015 – 2016 ? help from CMS

Covered waiting area for lab & pharmacyNew pathways linking opd to wards

Offices New chaplain’s office in in-patient area Refurbished Accounts office with enhanced security 2015New refurbished Child Sponsorship office 2015New refurbished Records & Data office New Pharmacy Store area in current staff room with loading bay at rear 2015Refurbished HIV clinic Offices for Consultant Specialists By 2016

Laundry Industrial washing machine in operation Potential move site if develop Maternity / Children’s WardVehicles new pick up; School of Nursing bus Pick up from IRCU, KH paid taxesCarpentry Supermarket ----------------- Potential benefit to quality of life and reduced cost of livingBakery ----------------- “Tourism PM launch Dec 2014 Visitors Centre, toilets, parkingForests Pilot harvesting of 19 trees successful Harvesting plan in progress Start felling by end of March 2015Farm Goat project supporting very poor families

Cows providing milkAccommodation New Staff Accommodation Unit planned Start by May 2015

2] Improve Hospital human relations and Staff confidence including universal job descriptions and appraisals, improved communication & vision sharing with Staff

adequate, productive, well motivated and qualified personnel able to provide quality health care services with competence and compassion

Topic Achieved Planned / Vision

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HR records JD’s updated for a number of posts, commenced appraisal process

Complete JD’s Complete annual appraisals

Terms & Conditions

Reviewed with all Staff, lawyers & Mx Board to finalise and ratify

Communication Staff meetings; Audit sessions; website; CAG. Department meetings commenced

Multi-disciplinary meetings with Hospital Staff and School of Nursing Staff will enhance communication and team working

2015

3] Improved Governance, Management and Accountability Systems Effective Board and Management structures (Governance and Leadership) and accountability systems in place and assured Well documented, organized and up-to-date record keeping, managed systems and practices for effective planning and decision making Improved Storage of Medical Supplies and General Facilities & Estate Management Well developed, equipped and maintained infrastructure Enhancing Leadership by identifying who is responsible for what (including Deputies for Senior Managers) and ensure availability of

regular management information, particularly financial information

Topic Achieved Planned / VisionMedicines Appointment of 2nd Pharmacy Technician Stre@mline Computer system; increased storage capacityEstate Foreman role / Estates mx upgrade; recycle where possibleMeetings Weekly prayer meeting includes review of

forthcoming dates and plansStrategic planning days away April 2014

Consider annual strategic planning retreat for a day to review implementation progress of the strategic plan

April/May 2015

Finance Sub-committee meeting; new auditors; on-line access to UK bank account

GSF expenditure; widen support baseInternal Auditor visits from District

Leadership In-house training on appraisal etc. Comprehensive Leadership Training courses for in-charges Wards & Depts Chester faciliatation tripPosts Appoint Deputy Administrator 20154] Strengthen both Internal and External relations

Greatly enhanced image and visibility as a caring C.O.U faith-based Organisation High quality Community programs including the Insurance Scheme, Child Sponsorship, Mental Health, Rehabilitation, Hope Ministries

and outreach clinics. Integrating health systems to maximise health benefits and health promotion Strengthen links with the Diocese in health promotion, evangelism, care for the vulnerable Strengthen links with Kisiizi Partners and other stakeholders and donors Increase the national and international profile of Kisiizi as part of our Christian witness and to enhance our ability to recruit high-

quality Staff and to obtain funding supportTopic Achieved Planned / Vision

Visit supporters St Paul’s, Dublin; University College Dublin Physiotherapy school

Establish Friends of Kisiizi in Australia, Singapore as well as in UK and USA

Publicity Web site updated, radio. MS gave presentation at Uganda Medical

Increased publications and publicity

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Association National Conference Nov 2014Friends Day MS spoke 6/2014 Reading, UK Friends Day 2015 liaison with supporters UK; visit to Dublin supportersWHO Links APPS; SUSP; UHC-PSQ

WHO Country Rep visited December 2014Integrated programme and spread. Country Representative to visit Kisiizi November 29th 2014

Banyakigezi PM launch visit Dec 2014 Explore developments and supportChurch hospitals

Visits from Kagando, Kabale, Mbale, Kabarole, Kiwoko

Trip to Kagando HospitalPhysician clinics at RugaramaRukungiri and Rugarama Hospital Kabale

2015

Signed: Bishop Patrick Tugume, Chairman of the Board of Governors Approved 12th March 2015

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