Though the pandemic situation was new to all hospitals, it did not take long for Baguio General Hospital and Medical Center (BGHMC) to jump into strategy mode and immediately lay out a clear COVID-19 response plan that is driven by good governance and meaningful collaboration.
It has been months since the COVID-19 virus first entered our country and shook up our old ways of living. As Filipinos followed the news, we witnessed the many vulnerabilities of our social systems brought out in the open one after the other. Though some sectors continued to thrive with the new demands, many others were greatly weakened, bound by the difficult challenges to which there were several moving parts.
The local health sector is one of those that has been taking the brunt of the impact since the start. With delayed nationwide coordination, logistical constraints and capability limits weighed heavily on the hospitals’ COVID-19 response plans. Still, against the many hurdles thrown at them, Philippine hospitals have shown strength and resourcefulness under pressure.
One such hospital that was quick to adjust to the sudden changes was the Baguio General Hospital and Medical Center (BGHMC). Because of the discipline of governance that was already making waves in their institution even before the storm came along, BGHMC was able to keep their heads above water as they cared for the citizens of Baguio City and the Cordillera Administrative Region (CAR). Though their initial governance journey was shaken up by the pandemic, this only made BGHMC’s strategic management capabilities shine brighter as they responded to COVID-19 and geared their institution towards better, more crisis-ready specialty services.
BGHMC conducts a simple send-off for Healthworker Joel Junsay (3rd from left), the city’s first local COVID-19 transmission case and first patient to respond to Mayor Benjie Magalong (2nd from left)’s call for identity disclosure for transparency
Before the storm
Located at the center of Baguio City, BGHMC is an 800-bed capacity tertiary teaching and training referral hospital with specialty services catering to CAR and neighboring provinces. A few years ago, BGHMC realized that their capabilities as a hospital were not enough to accommodate the rising cases of lifestyle illnesses from the region. Rather than keep referring patients to higher-level institutions in Manila, BGHMC enrolled in ISA’s Performance Governance System (PGS) in 2018 to address their services’ limitations. Through this, BGHMC crafted a plan to become an end-referral hospital with sub-specialty centers for Brain, Heart, Trauma, Kidney, Eye, and Lung.
Since taking their first steps in the PGS pathway, BGHMC has garnered many milestones and awards. Dr. Gwynette Dizon, Head of the Office for Strategy Management, narrated some of the highlights, including: the alignment of their budget to their strategic deliverables; the implementation of around 20 clinical pathways (i.e. the outline of medical services needed for a specific health issue) for the top causes of morbidity in the hospital; and the active pursuit of 20 collaborative research projects. Their in-house digital innovations have also been lauded by other institutions, and at the beginning of 2020, they were already appointed as a subnational center for certain specialty services.
“Of course, we’re very proud of all our units because they’ve done a lot,” said Dr. Dizon, “Sometimes it’s difficult for us to let everyone understand this process in one sitting, but we can see that they’re really excited that at least there is a plan”
Spur into action
These plans, however, were momentarily knocked aside when the COVID-19 pandemic entered the country. Like many hospitals, BGHMC had to grapple through the uncertainty surrounding the virus, from many of the challenges stemmed.
Dr. Leamor Fangonilo, Head of the Public Health Unit of BGHMC, recalled the situation when the virus first came. According to her, the main source of the surge then was the influx of overseas Filipinos, locals, and foreigners coming to the city, coupled with the constraint of very limited mass testing.
It did not take long, however, for BGHMC to spur into action. As the only tertiary hospital catering to the region, BGHMC immediately coordinated with the City Government and the Department of Health (DOH) Regional Office in order to strategize their COVID-19 response plan.
“We adapted the Prevent-Detect-Isolate-Treat strategy of DOH wherein we have to intensify the Infection Prevention, Detection, and Control measures in our hospital,” said Dr. Fangonilo. “Early January to February, we already activated the Incident Command System. We designated a place for our operations center [for] all the communications.”
BGHMC was also able to intensify mass testing through generous donations of RT-PCR and RNA extraction machines and the training of medical technologists who could unload the burden of testing at the hospital. Aside from this, they followed stricter triaging to segregate COVID and non-COVID patients, and established an off-site quarantine facility.
(Left) BGHMC staff conducting COVID-19 testing; (Right) BGHMC Public Health Unit Head Dr. Leamor Fangonilo
Enablers and champions
For Dr. Fangonilo, what played a crucial role in their pandemic response strategy was communication and information, through which, they were able to address the fears and concerns of the staff and the negative treatment towards the healthcare workers who were received unpleasantly in their own communities.
Another factor that enabled their response was the Multi-sectoral Governance Council (MSGC). Part of the PGS elements, the MSGC is typically composed of external stakeholders who commit to contribute to the attainment of the institution’s goal. During this pandemic, the MSGC, chaired by Baguio City Mayor Benjamin Magalong himself, has proven to be highly effective in assisting hospitals, as attested by Dr. Fangonilo.
“We have seen [that] this Multi-sectoral Governance Council is very important during these times. Connections are very important and they helped us so much,” said the PHU Head.
Road of reinvention
With the pandemic seemingly here to stay, BGHMC’s now moves to readjust hospital operations and, in line with this, its budget.
“We have to have new guidelines for [COVID] response. The units are coming up with new clinical pathways to incorporate the COVID response so that when patients come in, we already know what to do,” stated Dr. Dizon. “[We’ll also do] tighter triaging in our hospital premises and monitoring in the use of PPEs, face masks and face shields. Our focus is prevention — to reduce the vulnerability of everyone, not only the patients but [also] the health workers,” she added.
Dr. Fangonilo also reiterated their pledge to continue their governance practices, saying, “We will make sure that our policies for response for pandemics like this are in place. We will also integrate Infection Prevention and Control policies in the culture of our hospital safety, and reinvent the new workplace environment.”
Indeed, reinvention seems to be the next move for BGHMC. Though the hospital’s PGS journey was delayed and its priorities modified, it only made them aim for more relevant goals as they now seek to include Infectious Diseases in their targeted specialty centers.
For BGHMC, even as the road presented new twists and turns and the conditions changed day by day, good governance remains at the driver seat, allowing them to navigate forward to rebuild the strength of the health sector.