Adia General Hospital Provide acute, Complex care,

Residential and Ambulatory Health Services

to Meet the Present and Future Needs
of the Community

In Partial Fulfillment of the requirement for the degree

Bachelor of Science in Nursing

Adia, Patricia T.

October 2016

Introduction
Each of us would like to hear these words when seeking health care assistance
for ourselves, for our families, or for others. It should not only be our wish, but our
expectation. Health care that implements a How can we help you today? philosophy is
care that is patient centered, takes full advantage of what has been learned about
systems strategies for matching supply and demand, and is sustained by leadership
committed to a culture of service excellence and continuous improvement. Care with
this commitment is feasible and can be found in practice today.
Patient waits have been a long-standing concern in health care. Waits occur
throughout the continuum of care and are built into and budgeted for within day-to-day
operations. The status quo is changing, however, as patient experience becomes linked
to provider payment, efficiency and service become differentiators between hospitals
and providers, and patient expectations evolve. While excellent clinical care remains the
expectation, health care consumers are now seeking health care and supporting
systems that are respectful of individuals.
Adia General Hospital is owned by Nurse Adia, Patricia, A Corporation sole and
is directed locally by a Board of Directors comprised of As-is residents. Within the
Province of Batangas health insurance system, and by an Affiliation Agreement with the
Bauan Health Authority, Adias General Hospital's mandate is to provide acute, complex
care, residential and ambulatory health services to meet the present and future needs of
the communities which it serves.

The Hospital's approach is to conduct such services in a Christian value based

atmosphere of "Care With Compassion" in the Catholic tradition of the Healing Ministry.
Adia's General Hospital began in 1995 when the Africa Company inquired of the Nurse
Adia whether an Order of Sisters could be found to provide care for their loggers and
their families. It was the Sisters of Adias general Hospital who responded to this
invitation, bringing Christian virtues and traditions. With the introduction of the Provincewide health insurance system in the 2014's, that invitation to now includes all residents
of As-is and specifically those residing in the Bauan.
Adia's General Hospital is a 300 bed (140 Acute Care and 160 Complex Care)
facility. It provides a full spectrum of services normally found in a facility serving a
population of this size with specialties in Anesthesia, Ear Nose & Throat, Emergency
Medicine; General Surgery, Gynecology, Internal Medicine, Obstetrics, Ophthalmology,
Orthopaedics, Mobile MRI, Pathology, Pediatrics, Psychiatry, Radiology and Urology, in
addition to a full complement of Family Practitioners, Midwives and Oral Surgeons, as
well as Dentists; all supported by a full spectrum of technology and staff in diagnostic
imaging, laboratory and rehabilitation medicine.
On behalf of the Adia Family, the Hospital's Board of Directors, the Hospital
Foundation, physicians, staff and volunteers we wish to extend our warmest welcome.
We hope you find within this website, evidence of our true "Care With Compassion" as
we assist you in your needs.

OBJECTIVES

Advance our work in patient and resident safety with a focus on medication safety
and infection prevention.
Further develop and implement a safety framework throughout the organization
with an emphasis on preventing injury and violence in the workplace.
Strengthen the continuum of care to support timely access to services and smooth
patient flow for all patients.
Provide an exceptional health care experience through the development and
provision of patient-and family-centered care.
Enhance our quality culture, processes and outcomes leading to exceptional
care and service that fully supports our Accreditation with Exemplary Standing.
Maintains quality care and supports a seamless transition of acute care services to
the new Hospital; Values and uses the talent and commitment of staff,
Create a respectful, safe and rewarding work environment for all.

ACKNOWLEDGEMENT

Foremost, I would like to express my sincere gratitude to Shernikkoli Africa the

president of the Adias General Hospital for the continuous support of the institution, for
patience, motivation, enthusiasm, and immense knowledge. His guidance helped me in
all the time of. I could not have imagined having a better president for my Institution.

I would like to thank the rest of my board committee: Dra. Jorita Buhay, Dra. Aj
Adia and Sweet Adia, for their encouragement, insightful comments, and hard
questions.

I thank my team in Adias General Hospital: Health Educators, Nurses,

Nutritionist, Pharmacists, Physician, Volunteers, and Other Team Members, for
providing care, for the sleepless nights we were working together. Also I thank my
partners in As-is General Hospital Sweet Adia, Lone Adia, Josh Banta, Arby
Camantigue, Men Aldea, Marco Banta, Alyssa Adia. In particular, I am grateful to Dr.
Africa

for

enlightening

me

the

first

glance

of

putting

up

this

institution.

Last but not the least, I would like to thank my family: my parents Donna Adia
and Jorge Adia, for giving birth to me at the first place and supporting me spiritually
throughout my life.

DEDICATION

The Members of the board humbly dedicate the excellence of this hospital to the
persons who love them, support them and gave them encouragement which inspired
them during the most challenging phase of their lives.
To the Creator, the Beloved Father for His light and providence, to their family,
whose hardships and sacrifices served as an inspiration and guidance in their work. To
their friends, health care team, family.
This institution is lovingly and heartedly dedicated to their loving parents,
brothers and sisters, who gave them the chance to share and support.

VISION

Our vision is to become ever more able to serve the needs of the community with care,
compassion
and skill.

MISSION
Adias General Hospital is a health care community that respects the sacredness of all
aspects of life. Our hospital embodies the Christian principles of health care in the
Catholic tradition.These principles of dignity of the individual and common good inspire
our staff, physicians and volunteers to dedicate themselves to service and to the
support of one another.

Objective

Advance our work in patient and resident safety with a focus on medication
safety and infection prevention.

Further develop and implement a safety framework throughout the organization

with an emphasis on preventing injury and violence in the workplace.

Strengthen the continuum of care to support timely access to services and

smooth patient flow for all patients.

Provide an exceptional health care experience through the development and

provision of patient-and family-centered care.

Enhance our quality culture, processes and outcomes leading to exceptional care
and service that fully supports our Accreditation with Exemplary Standing.

Maintains quality care and supports a seamless transition of acute care services
to the new Comox Valley Hospital; Values and uses the talent and commitment of
staff,

Create a respectful, safe and rewarding work environment for all.

ROLES AND RESPONSIOBILITY OF JOB

Community Health Worker:
Community Health Workers (CHW) can be broadly defined as individuals who
connect health care consumers and providers, promoting health particularly among
groups who have traditionally lacked access to care.
Dentist:
The general dentist (DMD or DDS) is a primary care professional for patients in
all age groups. Dentists take responsibility for the diagnosis, treatment management
and overall coordination of services to meet the oral health needs of patients.
Health Educators:
Health educators teach clients, both individually and in groups, about various
health topics.

Interpreters:
Interpreters are invaluable members of the healthcare team that assist other
healthcare professionals in communicating with the patients in their native language.
Mental Health Provider
Professional training for individuals who provide mental health services in
community health settings varies widely.
Nurses
Advanced Practice Nurses (APN) today are required to have a Masters degree.
The term APN is a descriptor that includes nurse practitioner (NP), clinical nurse
specialist (CNS), certified nurse-midwife (CNM), or certified registered nurse anesthetist
(CRNA). APNs must hold current RN/APN licensure in the state in which they practice.
In 29 states, APNs must pass a national certification examination to practice. State
Nurse Practice Acts detail legal authority, reimbursement, and prescriptive authority
under which APNs practice. In DC, APNs have full prescriptive authority and may
practice without any required collaborative agreement with a physician.
Vocational or practical nurses:
These nurses usually receive up to 12 months of basic nursing skills training.
They practice under the supervision of a registered nurse or physician. They must

practice a national licensing examination to become a licensed vocational nurse (LPN)

and must obtain a license in a state to practice.
Nutritionist:
The Registered Dietitian (R.D.) is a health care professional trained in the single
specialty of nutrition science. Their goal is to promote health and fight illness by
fostering the practice of proper nutrition to individuals and groups.
Pharmacists:
Pharmacists dispense drugs and medications prescribed by physicians,
physician assistants, nurse practitioners, and dentists. They also advise healthcare
professionals and patients on the use and proper dosage of medications, as well as
expected side effects and interactions with other prescription and nonprescription
medicines.
Physician (MD):
Physician training begins with a bachelors degree from a four-year college or
university. Medical school typically consists of two years of course work followed by two
years of clinical experience. Course work emphasizes pathophysiology, recognition of
signs and symptoms of disease, and application of scientific method to the
understanding of disease. Classes also include training in history taking and in physical
examination.
Physician Assistant (PA):

Physician Assistants must be licensed in the state in which they practice. In the
District of Columbia, PA authority is derived from the physician and requires agreement
with a physician-collaborator to obtain licensure. PAs have prescriptive authority under
this agreement and may be directly reimbursed under Medicaid. PAs have limited ability
to apply for reimbursement under Medicare. Board Certification examinations are
available in Primary Care and/or Surgery. Not all states require board certification for
licensure. Recertification requires 100 continuing education hours every two years and
by written examination every 6 years.
Social Worker:
Raining for professional social workers is at minimum a bachelors degree in
social work (BSW). Most social workers possess a master s degree in social work
(MSW). They provide counseling, and enable individuals, families, and communities to
obtain social services. They work with clients on issues of unemployment, illness,
disability, housing, abuse, and financial problems. Social workers specializing in
providing mental health services and counseling are called Clinical Social Workers.
Volunteers
Volunteers are individuals that that provide services in the clinical setting with no
monetary payment. They may be retired healthcare practitioners or citizens with a
strong desire to provide public service to the community.
Other Team Members:

Other members of the interdisciplinary health care team may include: Physical
therapists, occupational therapists, speech and language therapists, and art or music
therapists. The availability of these additional members of the health care team depends
on the community served and the health care services offered.
Scheduling in a Complex System
Scheduling of appropriate health care services is a complex issue that requires
the balancing of clinical criteria and acuity; patient needs; and organizational resources,
structure, and culture. The science of optimizing access and wait times is still evolving,
with little comprehensive measurement of wait times for appointments, and with targets
that are often pragmaticreflecting practitioner, staff, room availability, and costas
opposed to evidence based. While these components are measurable, many other
confounding factors influence the capacity of health systems to offer appointments in a
timely manner.
Looking beyond the challenges in the ambulatory primary and subspecialty
environments, hospitals and rehabilitation experience have their own struggles with
scheduling and prolonged wait times causing patient and provider irritation, operational
inefficiencies, and increased cost. The system complexities can be overwhelming to
unbundle and the multiple improvement efforts that have occurred in clinics, hospitals,
and rehabilitation centers may be uncoordinated, and opposing incentives often
scheduling and Wait Time Metrics.
A noted opportunity lies in the metrics used to assess wait times that measure
the key components of access, scheduling, and outcomes. The commonly used
measure for outpatient appointment wait times in current use is based on the IHI

recommendations for third next available appointment, that is, an organizations goal
for their performance with respect to patient access should be to achieve a TNA of zero
for primary care and of 2 days for specialty care (IHI, 2015c).

Applicant: any jobseeker who 1) submits an application via Vanderbilt's online

application process, and 2) meets the basic qualifications of the job as determined by
the Recruiter.

Candidate: An applicant who has been referred by a Recruiter for consideration by a

Hiring Officer for a specific position.
Hiring Official: Manager or other Vanderbilt employee with the authority to make a
hiring decision.

Recruiter: Human Resources staff member who supports the outreach, screening, and
presentation of candidates to Hiring Officials.
Requisition: An electronic document filled out by a Hiring Manger or their designee on
Talent Central when they want to initiate recruitment for an opening.

Posting: Placing information about an opening on the Vanderbilt University job board to
notify the public and VU staff of employment opportunities.
Regular Position (full time, part time): An ongoing position that has no defined end
date. Ongoing does not mean that the position cannot end, just that there is no current
expectation that the position will end at a defined time.

Term position (full time, part time): A position expected to exist for a period longer
than six months, but generally not beyond one year. A term hire may be appropriate
when the departments need is expected to last less than one year. Hires who are in
term positions could receive notice of employment ending at anytime in advance of one
year. Hires in term positions are bound by all Vanderbilt policies and procedures and
must successfully complete an initial orientation period. Staff members in term positions
are eligible for certain benefits.

Full time: The status of a position in which the standard work schedule requires a
minimum of 30 hours per week and offers eligibility for Vanderbilt benefits (such as
health care, PTO, etc.)
Part time: The status of a position in which the standard work schedule requires less
than 30 hours per week. Part-time positions do not offer eligibility for most employment
benefits (with the exception of PTO and in some cases retirement).

Temporary position: A specific position limited to a duration of no more than six

months which does not offer benefits (there may be some benefit exceptions). /benefits/
PRN position: PRN is an acronym that stands for the Latin phrase pro re nata or as
the situation demands. PRN positions should not require a standard work schedule and
are utilized on an as needed basis. PRN positions are budgeted positions; however,
they are considered temporary and do not offer benefits (retirement may be an
exception if all other requirements are met).

HIRING POLICY

Recruitment activity shall be in accordance with Equal Employment Opportunity

policies and with all Federal, State and local laws, hospital regulations and applicable
executive orders pertaining to hospital employment procedures.

The Manager of Human Resources Services and Administrator of Compensation

and Labor Relations, in collaboration with the hiring manager, shall formulate position
requirements to accommodate a broad-based search for high quality candidates with
the most suitable education, experience, skills, knowledge and abilities to perform the
job responsibilities outlined in an approved position description. Such collaboration shall
occur prior to posting the vacancy. Applications for hospital staff positions shall be
reviewed by the Human Resources Generalist to determine if the applicant meets the
minimum qualifications of the vacancy.

Management may consider substitutions for relevant requirements in some

instances where applicants may possess exceptional qualifications, but years of related
experience or educational degree may not completely align with the stated preferences
of the job description. Final selection of candidates is solely at managements discretion
and shall be based upon assessment of the candidates knowledge, skills and abilities
and such other criteria as management may deem appropriate.

PROCEDURE

1. Prior to initiating recruitment, an approved Staff Position Transaction Form for

the vacant position must be provided to the Compensation Section of Human
Resources. An up-to-date job description approved by Compensation must accompany
each requisition.

2. The Human Resources Generalist shall contact the hiring manager to review
the job specifications to be certain that the position description accurately reflects the
essential functions of the job before initiating appropriate recruitment activity, including
listing the vacancy on the hospitals Career Opportunity website, print advertising or
other recruitment methods.

3. All regular full and part-time positions shall be posted on the hospitals Career
Opportunity website and may also be advertised. Temporary vacancies may be listed on
the website at the discretion of the hiring manager and in collaboration with the Human
Resources Generalist.

4. The hiring manager and the Human Resources Generalist shall ensure
compliance with hospital policies and procedures relating to all collective bargaining
agreements, layoff, recall, promotion, transfer, hiring or posting requirements.

5. Internal and external applicants must apply online through the hospitals
Career Opportunities website. Online applications shall be accepted as long as the
position is posted.

6. The Human Resources Generalist shall review the online applications

identifying candidates with the most suitable education, experience, skills, knowledge
and abilities and shall electronically forward qualifying applicant resumes to the hiring
manager.

7. The hiring manager shall review the referred applicants by accessing the
hospitals web-based candidate referral, screening, selection and placement system.
The hiring manager shall select the applicants who will be interviewed, schedule
interviews and inform the Human Resources Generalist of his/her top candidate choice
by completing the web-based Vacancy Information and Candidate Assessment Record.

8. Individuals hired in positions at Grade 23 and above require approval by the

hospitals Manager. Leaves and Labor Relations before an offer of employment may be
made.

9. The Human Resources Generalist shall notify the unsuccessful candidates

who were interviewed, and for who email addresses were provided,

HIRING
1 Offers: When the Hiring Official has made the final selection of the candidate to
hire, the Recruiter will provide a pay recommendation taking relevant factors into
consideration. The department may prepare an offer letter and once accepted,
Human Resources will prepare the offer confirmation letter of record (LOR) to the
incoming employee.
2 Under certain circumstances, it may be necessary to rescind a contingent offer of
employment. These circumstances include, but are not limited to the following:

A candidate fails to comply with established timelines associated with the

pre-employment screening process;

A candidate does not pass the pre-employment screen;

A candidate omits or falsifies information on the application or related

documents;

Reference information is unfavorable or inconsistent with information

provided by the candidate.

3 In the event that it is appropriate to rescind an offer, Human Resources will notify
the Hiring Officer as well as the candidate in writing.
4 Work Eligibility: New Hires will be required to complete Section I of the I-9
electronically upon accepting an offer of employment; but no later than the first day
of employment. Documentation that establishes eligibility to work in the United
States must be presented no later than the 3rd day of employment. Individuals who
hold citizenship in countries other than the United States are subject to special
conditions related to employment. Hiring Officials who are considering hiring a
foreign national applicant must contact the Office of International Services to make
sure that all legal and policy requirements are met before any job offer is made.
5 Temporary Employees: Hiring of employees for temporary positions should also
be conducted through Vanderbilt Temporary Service (VTS). Temporary and PRN
positions are created for a limited period of time, but no more than six months or on
a situational basis as needed.

To ensure consistency in hiring processes and adherence to compliance

requirements, VTS is also responsible for contracting with and managing all
outside temporary employment. The Clinical Staffing Resource Center is
responsible for contracting with and managing all outside temporary agencies
as approved secondary vendors for nursing positions.

Arrangements with individuals providing services with the intent to pay

through accounts payable or other procurement processes should be

reviewed and approved by Human Resources. The department should
contact their human resources consultant for a determination of whether a
Consultant/Independent Contractor relationship exists. Those who do not
meet the IRS eligibility requirements may be considered for hire as VTS
temporary employees.
Rehires and Bridging: A former employee may be considered for rehire if the separation
from prior employment was voluntary and appropriate notice was provided and if the
employee worked through the notice period as required by the department. (Hourly paid
employees who resign are required to provide a two-week written notice and exempt
employees who resign are required to provide at least one month written notice.)

The Recruiter will review the personnel file of the former employee who has applied for
reemployment and verify eligibility for rehire before forwarding the application. The
Hiring Manager will be advised of the former employee's eligibility for rehire and the
requirement to check references.

Some benefits can be bridged if an employee has completed at least two consecutive
years of service in a regular or term full-time and/or part-time position immediately prior
to their last separation or changes to temporary work-status and returns to a regular or
term position in less than one year. Temporary positions are not counted when
determining whether two years of service has been completed.
6 Transfers: Employees must have successfully completed the orientation period
and have remained in the current position to allow for a six-month evaluation period
to be eligible for a transfer. Vanderbilt encourages employees to establish a longterm, stable working relationship before seeking other career opportunities within the
Vanderbilt system. Individuals who are not meeting performance expectations must
disclose any formal performance counseling to the Hiring Official to be eligible to
transfer within the Vanderbilt system.
7 Employment of Minors: Vanderbilt does not employ individuals under the age of
18 in regular positions. It may be appropriate to hire individuals who are under 18
years of age in temporary positions available through Vanderbilt Temporary Services
(VTS) or in defined programs. Due to safety concerns, minors may not work in
certain types of laboratories or operate certain types of machinery/equipment.
Minors are also generally prohibited from positions requiring patient contact or care.
8 Employment of Family Members: Family members can be employed at
Vanderbilt. However, one family member may not have direct influence over the
others conditions of employment (i.e., salary, hours worked, shifts, etc.). For the
purpose of this policy, family member may be defined as spouse, domestic partner,

son, daughter, parent, grandchild, sister, brother, mother-in-law or father-in-law or

someone in a close personal relationship. Disclosures are expected to be made
through the conflict of interest process upon hire and on an annual basis.
S. Volunteers: All volunteer opportunities must be coordinated through Volunteer
Services. Individuals interested in volunteering can contact Volunteer Services or go to
the website at www.vanderbilthealth.com/volunteerservices/ for more information.
Volunteer opportunities may also require background screening.

DESIPLINARY POLICIES
1. Engaging in conduct as an employee of the Hospital specific to the workplace which
violates any state or federal criminal statute./Termination.
2. Failure to report conduct by an employee or agent of the Hospital specific to the
workplace which a reasonable person should know is a criminal offense./Termination.
3. Failure to report another employee's or agent's violation of any duties under the
Hospital's compliance standards or policies (other than criminal conduct)./Discipline
may

range

from

written

warning

up

to

suspension or termination of employment on the first offense.

4. Negligently providing incorrect information to the Hospital or to a government agency,
consumer, third party payer, vendor or similar person or entity (footnote 1)./Discipline
may
suspension

range
or

from

termination

of

written
employment

warning
on

the

up
first

to
offense.

5. Knowingly (footnote 2) or willfully providing false information to the Hospital or to a

government agency, consumer, third party payer, vendor or similar person or entity or
falsifying

any

document

or

Hospital

record, including without limitation, any record required to obtain reimbursement for
services provided by the Hospital or its employees or agents (footnote 3)./Termination.
6. Failure to comply with any provision of the Hospital's compliance standards or
policies or state or federal statute or regulation (other than a knowing or willful violation
or violation of a criminal statute)./Discipline may range from a written warning up to
suspension or termination of employment on the first offense.
7. Knowingly or willfully violating any provision of the Hospital's compliance standards or
policies or any state or federal statute or regulation (other than violation of a criminal
statute)./Discipline may range from a written warning up to suspension or termination of
employment on the first offense.
8. Failure to detect conduct by an employ or agent of the Hospital which a reasonable
person should know is criminal or a violation of the Hospital's compliance standards and
policies and reasonably could be expected to detect./Discipline may range from a
written warning up to suspension or termination of employment on the first offense.
9. Intentional or reckless disregard or encouragement of conduct by anemployee or
agent of the Hospital which a reasonable person should know is criminal or a violation
of the Hospital's compliance standards and policies and reasonably could be expected
to detect./Termination.
10. Failure of a manager, director, or other supervisor to properly supervise employees
under his or her direction, which failure results in a violation of law, regulations, or the
Hospital's compliance standards or policies./Discipline may range from a written
warning up to suspension or termination of employment on the first offense.
11. Intentional or reckless disregard or encouragement (by a director, manager or other
supervisor) of conduct by employees or agents of the Hospital, which conduct
constitutes a violation of law, regulations, or the Hospital's compliance standards or
policies./Discipline may range from a written warning up to suspension or termination of
employment on the first offense.

12. Failure to comply with the Hospital's record retention policies (other than intentional
or willful destruction of records)./Discipline may range from a written warning up to
suspension

or

termination

of

employment

on

the first offense.

13. Intentional or willful destruction of Hospital records or of any evidence relevant to an
investigation of a suspected violation of law or of the Hospital's compliance standards or
policies./Termination.
14. Impeding or obstructing an investigation regarding a suspected violation of law or of
the Hospital's compliance standards or policies./Termination.
15. Retaliation against any employee or agent who has made a bona fide report to the
Hospital or to any regulatory or government agency with respect to violations of
applicable

laws,

regulations

or

Hospital

compliance

standards or policies./Termination.
16. Engaging in any other conduct or wrongdoing which has the potential to impair the
Hospital's status as a reliable, honest and trustworthy health care provider./Discipline
may

range

from

written

suspension or termination of employment on the first offense

warning

up

to