ANNUAL REPOrt 2017 KOMFO ANOKYE TEACHING HOSPItaL KUMASI A Center of Excellence DRAFT ©2018 Komfo Anokye Teaching Hospital, Kumasi Photgraphy: Book Cover/Layout: Bright Amoako-Attah TABLE OF CONTENTS List of Tables 4 List of Figures 5 Acronyms 7 Acknowlegdements 8 Preface 9 From the Desk of the Chief Executive 10 CHAPter 1 CHAPter 12 CHAPter 21 Introduction 12 Directorate of Transfusion EENT 64 Medicine Unit 104 CHAPter 2 Human Resource CHAPter 13 CHAPter 22 Performance 17 Directorate of Internal Audit Unit 108 Oral Health 70 CHAPter 3 CHAPter 23 Clinical Care CHAPter 14 Research and Services 23 Directorate of Development Unit 110 Anaesthesia and CHAPterDRAFT 4 CHAPter 24 Intensive Care 74 Quality Assurance Pharmacy Unit 113 CHAPter 15 Unit 38 CHAPter 25 Directorate of Supply Chain CHAPter 5 Obstetrics & Domestic Management Unit 115 Gynaecology 79 Services 39 CHAPter 26 CHAPter 16 Biostatistics Unit 120 CHAPter 6 Oncology Technical Services 41 Directorate 86 CHAPter 27 CHAPter 7 Social Financial CHAPter 17 Welfare Unit 122 Family Medicine Performance 42 Directorate 89 CHAPter 28 CHAPter 8 Information Collaboration CHAPter 18 Communication Diagnostics and Support 45 Technology 125 Directorate 94 CHAPter 9 CHAPter 29 Directorate of CHAPter 19 Public Health Unit 128 Trauma and Orthopaedics Medicine 47 Directorate 96 CHAPter 30 CHAPter 10 Security Unit 144 Directorate of CHAPter 20 Emergency Medicine CHAPter 31 Surgery 54 Directorate 101 Challenges CHAPter 11 and Mitigating Directorate of Strategies 146 Child Health 59 3 LIST OF TABLES TABle 1: Number of Doctors TABle 20: Expected and Actual TABle 39: Social Issues Handled and Related Personnel per Outputs of Other Services in in 2017 123 Directorate/Unit, 2017 18 EENT in 2017 65 TABle 40: Hardware Infrastructure TABle 2: Nurses and Midwives by TABle 21: Top ten causes of OPD (Equipment) 125 Directorates, 2017 19 attendance, Eye Unit, 2017 66 TABle 41: New Installation and TABle 3: Pharmacists and TABle 22: Top ten causes of Replacement of Equipment 127 Pharmacy Technicians by admission, EENT Unit, 2017 67 TABle 42: Summary of Expected Directorates, 2017 20 TABle 23: Outreach Activities by Outputs and Results 129 TABle 4: Allied Health Staff per Eye Department 2017 69 TABle 43: Trend of Vaccinations Cadre, 2017 20 TABle 24: Top ten causes from 2015 to 2017 at KATH 136 TABle 5: Staff Pursuing Further of admission, Oral Health TABle 44: Categories of Clients Studies per Directorate, 2017 21 Directorate, 2017 72 who Reported at the HIV Testing TABle 6: Top Ten Specialist OPD TABle 25: Types of Anaesthesia and Counselling Section 138 Attendance, KATH 2017 25 by Theatre. Directorate of TABle 45: ARV Facilities to Which Anaesthesia and Intensive Care, TABle 7: Top Ten Causes of HIV Positive Clients Were Admissions (KATH, 2017) 27 2017 77 Referred, January to December TABle 26: Trend in Obstetric 2017 139 TABle 8: Theatre Service services in Obstetrics & Utilization, KATH, 2017 27 TABle 46: Trend of EID Tests and Gynaecology Directorate, Results for HIV Exposed Infants, TABle 9: Top ten causes of death 2013-2017 81 2017 30 KATH, 2013 to 2017 142 TABle 27: Top Ten Causes of TABle 47: Categories of Exposure TABle 10: Number, condition and Maternal Deaths in Obstetrics & to Body Fluids Among Clients Operational Cost of Available Gynaecology, 2017 85 Vehicles, 2013-2017 39 who Received PEP in KATH, TABle 28: Outreach activities, Jan–Dec 2017 142 TABle 11: Infrastructural Oncology 2017 88 Development, 2017 41 TABle 29: Services by Family TABle 12: Internally Generated Medicine Directorate, Fund (IGF) Revenue Categories, 2015-2017 90 KATH 2017 42 TABle 30: Top Ten Conditions TABle 13: The 2016 and 2017 Seen in the OPD- Family Revenue Figures Compared 43 Medicine Directorate, 2017 90 TABle 14: Classification of IGF TABle 31: Summary of Activities of Revenue by Mode of Receipt 43 Physiotherapy Unit, 2017 91 TABle 15: 2017 IGF Expenditure TABle 32: Achievements 109 Budget Execution 44 TABle 33: Tendering Activities 116 TABle 16: Collaboration and Support 45 TABle 34: Trend Analysis of Achievement 117 TABle 17: Trend in OPD Services Utilization by Clinics 48 TABle 35: Activities Conducted Through Price Quotation 117 TABle 18: Haemodialysis and Renal OPD 49 TABle 36: Major findings of Ward Monitoring Report 118 TABle 19: Trend in OPD Sub- Specialty Clinics in Child Health TABle 37: Donations 119 (2013-2017) 60 TABle 38: Achievements 122 4 LIST OF FIGURES FIGURE 1: Category of staff FIGURE 20: Trend in Admissions, FIGURE 35: Top Ten Causes of by Professional Groups, KATH KATH (2013-2017) 50 Admissions in the Child Health 2017 17 Directorate, 2017 61 FIGURE 21: Top Ten Causes of FIGURE 2: Age Group of Staff, Admissions in the Medicine FIGURE 36: Trend in Mortality KATH 2017 18 Directorate-KATH 2017 50 Rates in Child Health Directorate from 2013 -2017 62 FIGURE 3: Separated Staff, KATH FIGURE 22: Trend in Mortality Rate 2017 21 (%) in the Medicine Directorate FIGURE 37: Trend in Mortality 51 Rates in Child Health Directorate FIGURE 4: Service Utilization 2013-2017 from 2013 -2017 63 (2017 Targets and Actuals) 23 FIGURE 23: Top Ten Causes FIGURE 38: Distribution of Out- FIGURE 5: Trend in OPD Service of Deaths in the Medicine Patients in EENT Directorate by Utilization, KATH 2017 24 Directorate, (2013-2017) 52 Department 64 FIGURE 24 FIGURE 6: Trend in Aggregated : Trend in various OPD Service Utilisation, Diagnostic Investigations in FIGURE 39: Trend in OPD service by Clinics in EENT Directorate KATH 2017 25 Medicine Directorate (2013-2017) 53 (2013-2017) 65 FIGURE 7: Trend in In-Patient Service Utilization, KATH FIGURE 25: Trend in Endoscopy FIGURE 40: Trend in Admissions in EENT Directorate (2013-2017) 66 2013- 2017 26 and ECG Investigations in Medicine Directorate (2013-2017) FIGURE 41: Surgical Operations FIGURE 8: Trend in Surgical 53 in EENT Directorate (2017) 67 Operations Performed, KATH 2017 28 FIGURE 26: OPD Clinics in the FIGURE 42: Trend in Surgical Directorate of Surgery, 2017 54 Operations in EENT Directorate FIGURE 9: Trend in Recovery Ward (2013-2017) 68 Admissions, KATH 2013-2017 28 FIGURE 27: Trend in OPD Attendance by Clinics in the FIGURE 43: Trend in Mortality FIGURE 10: Trend in ICU Directorate of Surgery (2013- Rate in EENT Directorate Admissions, KATH 2013 -2017 29 2017) 55 (2013-2017) 68 FIGURE 11: Trend in Total Mortality FIGURE 28: Trend of Total OPD FIGURE 44: Trend in OPD Rate, KATH (2013-2017) 30 Attendance in the Directorate Attendance, Oral Health FIGURE 12: Trend in Deliveries, of Surgery (2013-2017) 55 Directorate (2013-2017) 70 KATH 2013-2017 31 FIGURE 29: Trend in Admissions FIGURE 45: Trend in OPD FIGURE 13: Trend in Maternal in the Directorate of Surgery Procedures in Oral Health Mortality Rate per 100,000 Live (2013-2017) 56 Directorate (2013-2017) 71 Births, KATH (2013-2017) 32 FIGURE 30: Surgical Operations FIGURE 46: OPD Procedures FIGURE 14: Top Ten Causes of by Clinic in the Directorate of by Clinic at the Oral Health Maternal Deaths, KATH 2017 32 Surgery (2017) 56 Directorate (2017) 71 FIGURE 15: Trend in Emergency FIGURE 31: Trend in Surgical FIGURE 47: Trend in Surgical Services Utilization (2013-2017) Operations in Surgery Operations, Oral Health KATH 33 Directorate (2013-2017) 57 Directorate (2013-2017) 73 FIGURE 16: Trend in Diagnostic FIGURE 32: Trend in Mortality FIGURE 48: Trend in Pre-Operative Investigations (2013-2017) Rates in Surgery Directorate Cases in Anaesthesia Directorate KATH 34 (2013-2017) 58 (2013-2017) 74 FIGURE 17: Age of Vehicles, 2017 39 FIGURE 33: Trend in OPD FIGURE 49: Trend of Critical Care Attendance, Child Health, FIGURE 18: OPD Service Patients Managed in Anaesthesia 2013-2017 59 Utilisation by Clinics in Medicine Directorate (2013-2017) 75 Directorate, KATH (2017) 47 FIGURE 34: Trend in In-patient FIGURE 50: Trend in Anaesthesia Service Utilization, Child Health FIGURE 19: Trend of OPD Administration, Directorate of Directorate (2013-2017) 61 Attendance in Medicine Anaesthesia and Intensive Care Directorate, KATH 2013-2017 49 (2013-2017) 75 5 KATH Annual Report 2017 | LIST OF TABLES FIGURE 51: Trend in Number of FIGURE 69: Trend of OPD Services FIGURE 86: Clinical Use of Post-operative Cases, Directorate -Physiotherapy Unit, 2013-2017 92 Concentrated Red Cells in of Anaesthesia and Intensive Care Transfusion Medicine Unit, FIGURE 70: Comparative (2013-2017) 76 Analysis of In-patient Services 2017 106 FIGURE 52: Trend in Mortality (Physiotherapy Unit), FIGURE 87: Clinical Use of Fresh Rate, Directorate of Anaesthesia 2013-2017 92 Frozen Plasma in Transfusion and Intensive Care (2013-2017) 77 Medicine Unit, 2017 106 FIGURE 71: Trend in Diagnostics FIGURE 53: Trend in OPD Services Investigations in the Diagnostic FIGURE 88: Clinical use of Platelet in Obstetrics & Gynaecology Directorate (2013-2017) 95 in Transfusion Medicine Unit, Directorate (2013-2017) 80 2017 107 FIGURE 72: Trend of Aggregated FIGURE 54: Trend of Admissions Diagnostic Services in the FIGURE 89: Breakdown of Blood in Obstetrics & Gynaecology Diagnostics Directorate Discarded in Transfusion Directorate (2013-2017) 80 (2013-2017) 95 Medicine Unit, 2017 107 FIGURE 55: Trend in Deliveries FIGURE 73: Trend in OPD FIGURE 90: Distribution of Call Ins in Obstetrics & Gynaecology Attendance in Trauma and at the Drug Information Directorate (2013-2017) 81 Orthopaedics (2013-2017) 96 Centre 114 FIGURE 56: Distribution of Surgical FIGURE 74: Comparative Analysis FIGURE 91: Category of Staff, Operations in Obstetrics & of Clubfoot Cases in Trauma and Biostatistics