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PROFILE OF THE DR. JOSE FABELLA MEMORIAL HOSPITAL (FABELLA)

 EXISTING HOSPITAL

  •  A 700-bed capacity (authorized -ABC) Level III (specialty and end-referral) teaching and training hospital for Obstetrics, Gynecology, Anesthesiology, Newborn Medicine, and Pediatrics;
  • Located at the Old Bilibid Compound (OBC), Sta. Cruz, Manila, adjacent to the Manila City Jail;
  • Census:
2015 2016 2017 2018 2019
1.     Authorized Bed Capacity (ABC) 700 700 700 700 700
2.     Bed Occupancy Rate based on ABC
-       Including Newborn 184.58% 83.60% 138.89% 124.30% 157.87%
-       Excluding Newborn 67.58% 39.41% 53.03% 81.04% 73.22%
3.     Implementing Bed Capacity (IBC) 501 465 466 466 496
4.     Bed Occupancy Rate based on IBC
-       Including Newborn 257.90% 125.86% 208.64% 186.72% 222.80%
-       Excluding Newborn 94.43% 59.33% 79.65% 121.73% 103.33%
5.     Total Admissions 42,573 30,610 29,922 35,077 32,927
-       OB 21,475 15,132 14,655 16,996 15,671
-       Gyne 758 678 648 780 719
-       Pedia 1,581 1,642 1,741 1,915 1,984
-       Newborn 18,759 13,158 12,878 15,386 14,553
·         Pathologic 9,892 7,646 7,755 9,422 8,840
·         Non Pathologic 8,867 5,512 5,123 5,964 5,713
6.     Total Inpatient Days Care 471,603 214,194 354,870 317,597 403,364
-       Excluding Newborn 172,672 100,968 135,483 207,054 187,069
7.     Average Inpatient per Day
-       Including Newborn 1,292 585 972 870 1,105
-       Excluding Newborn 473 276 371 567 513
8.     Total Discharges 42,451 30,213 29,455 34,656 32,822
-       Excluding Newborn 33,920 24,704 25,090 30,581 27,985
9.     Average Length of Stay
-       Excluding Newborn 5.06 4.07 5.33 6.68 5.65
10.  Deliveries 18,677 13,103 12,808 15,333 14,516
11.  Average Number of Deliveries per day 51 36 35 42 40
12.  Cesarean Section Rate 31.99% 38.21% 41.46% 40.97% 40.61%
13.  Forceps Rate 1.05% 1.01% 1.01% 0.98% 1.04%
14.  VBAC Rate 0.11% 0.05% 0.03% 0.03% 0.08%
15.  Abortion Rate 4.68% 4.49% 5.02% 4.66% 3.63%
16.  NICU Morbidity Rate 53.05% 58.11% 60.22% 61.24% 65.39%
17.  Total Deaths (inpatient) 677 419 539 684 703
-       OB 8 7 3 7 7
-       Gyne 1 2 3 0 1
-       Pedia 33 42 54 62 53
-       NICU 634 368 479 615 642
-       Newborn 1 0 0 0 0
18.  Gross Death Rate 1.60% 1.39% 1.83% 1.97% 2.14%
19.  Net Death Rate 1.11% 0.93% 1.34% 1.46% 1.62%
20.  Maternal Mortality Rate per 1000 Live Birth 0.43 0.53 0.23 0.45 0.48
21.  Neonatal Mortality Rate per 1000 Live Birth 33.85 27.97 37.2 39.97 44.11
22.  Perinatal Mortality Rate per 1000 TB 50.2 44.45 51.85 56.41 60.13
23.  Fetal Mortality Rate per 1000 TB 16.93 16.95 15.22 17.12 16.76
24.  Autopsy Rate - - - - -
25.  Total OPD Consultations 88,999 78,169 87,481 99,818 94,322
-       OB 34,993 28,873 33,508 41,137 38,841
-       Gyne 8,743 8,179 9,002 7,952 8,573
-       Pedia 18,737 17,692 21,062 25,874 21,568
-       Family Planning 8,999 7,798 6,971 7,354 6,409
-       Dental 12,671 11,160 11,024 10,922 12,608
-       Medical 4,759 4,391 5,706 6,321 6,032
-       Surgical 97 76 208 258 291
26.  Average Number of Outpatient per day 377 318 366 411 388
27.  Total ER Consultations 7,268 6,325 8,017 10,243 11,049
-       OB 5,306 3,897 4,006 5,927 7,230
-       Gyne 257 212 261 269 344
-       Pedia 1,705 2,216 3,750 4,227 3,475
28.  % Distribution of Inpatients by Risk
-       OB
·         High Risk 55.11% 65.55% 67.23% 68.86% 68.93%
·         Low Risk 44.89% 34.45% 32.77% 31.14% 31.07%
-       Hospital Wide
·         High Risk 72.13% 79.42% 81.28% 86.94% 82.57%
·         Low Risk 27.87% 20.58% 18.72% 13.06% 17.43%
29.  Rate of PhilHealth Inpatients 69.67% 90.84% 90.29% 97.22% 93.74%
30.  Nosocomial Infection Rate 1.64 2.40% 4.32% 1.98% 1.98%
  •  It has an annual budget for CY2019 of P695,191,000.00 for Personnel Services, P80,027,000.00 for MOOE and P7,500,000.00 for Capital Outlay); CY2018 (P692,283,000.00 for Personnel Services, P89,165,000 for MOOE and P77,700,000 for Capital Outlay)
  • It generated an income of P190 Million in CY 2016;CY2017- P218 Million; CY2018 P235 Million; CY2019 – P201 Million
  • Performance Budget Utilization Rate (PBUR) as of December 2018:
  GAA Utilization   SAA Utilization
CONAP 2017 Current 2018 CONAP 2017 Current 2019
None 100% None 99.90%
  • It has a staff complement of 1,436 at present (300 employees short of the 1,706 required for a General Hospital of 500 bed capacity);

  • It has accredited training programs in Ob-Gyn, Pediatrics, and Anesthesia as a well as Fellowship Programs in Newborn Medicine, Perinatology, Ob-Gyn Ultrasound and Family Planning;

  • It is a National Center for training in Basic Emergency Obstetrics and Neonatal Care (BEMONC), Essential Intrapartum and Neonatal Care (EINC), Lactation Management including Human Milk Banking, Visual Inspection with Acetic Acid for Cervical Cancers, National Certification Program for Maternal and Neonatal Nursing, and Family Planning;

  • Other programs: Voluntary Blood Donation Program, Dental Obturator Program and Infant and Young Child Feeding Program, Mother-Baby Friendly Hospital Initiative and Health Emergency Management;

  • It is actively providing services to the entire nation (thru Outreach Missions) in Gynecologic surgeries and Family Planning;

  • It operates a School of Midwifery since 1922 and has been offering BS Midwifery since 2012;

 History:

  • Nov 9, 1920: Dr Jose F. Fabella, Chairman of the Public Welfare Board, founded a six (6) bed maternity clinic in Isabel St., Sampaloc, Manila, called the “The Maternity House”.
  • 1951: Relocated (for the 5th time) to the Hospital facility of the Old Bilibid (erected in 1898) in Sta. Cruz, Manila and called the “Maternity and Children’s Hospital”.
  • 1968: Renamed “Dr. Jose F. Fabella Memorial Hospital” (13 years after his death).
  • 2000: Mandated as the “National Maternity Hospital” by virtue of DOH Administrative Order No. 11 series 2000;
  • 2000: The OBC was conveyed to the Home Guaranty Corporation (HGC) by the Development Bank of the Philippines (DBP), for disposition. The proposed OBC Urban Renewal and Infrastructure Project did not push through.
  • November 6, 2009: The Lung Center of the Philippines (LCP) and Fabella entered into a usufruct agreement of a 121,463 square meter lot for the transfer of Fabella at the LCP compound.
  • 2012: The 3-storey Satellite Outpatient Department building costing P 47.2 million was completed at the LCP compound. The building and its equipment, costing P 8.6 million, is presently being utilized by Administrative, Finance, and Training offices as well as the School of Midwifery of Fabella.

RATIONALE FOR THE TRANSFER AND REDEVELOPMENT OF THE DJFMH

  • The present area is limited for expansion to cope up with the increasing demand for hospital services, always criticized for being overcrowded, flood prone and with overly rehabilitated electrical and structural fixtures.

  • Surrounding informal settlers pose as a fire hazard, and threaten the security of the hospital patients, personnel, and the general public.

  • The hospital is to be transformed into an Apex Center for Reproductive Health and Neonatal Health to meet the demand of the region and the entire country;

  • DOH is being asked by the HGC to vacate the site immediately due to the planned sale of the lot. Latest demand letter from HCG for Fabella to vacate the OBC was in September 4, 2015.

  • Moreover, a structural investigation conducted by ESCA, Inc. (a private construction firm) in January 2016 revealed that the buildings require immediate strengthening to avoid damage to life and property in the event of a major earthquake.

    • Overall, 76% of columns and 80% of beams exceeded the capacity requirements, thus any planned retrofitting will be too costly (around P300 million for 3 buildings as computed by structural engineers), would take time to complete (2-3 years) and would require occupants to vacate areas while being renovated. Retrofitting will be an issue for HGC to tackle in as much as the National Historical Institute calls for the preservation of the buildings as heritage structures.

IMPLEMENTATION ARRANGEMENTS

  • The expansion into a Level 3, 6-floor, 800-bed capacity teaching and training hospital includes the construction of a new building inside the DOH Compound, Rizal Ave., Manila, procurement of new equipment, and hiring of new hospital personnel.
  • Total Project cost: P 2.00025 billion
    • Infrastructure: P 1.617 billion
    • Medical Equipment: P 383.25 million
  • Construction of the new building is in phases

Floor

Floor Area (in m2)

Phase I

Phase II

Ground/First Floor

6,737

2,884

3,853

Second Floor

6,830

6,830

 

Third Floor

6,830

6,830

 

Fourth floor

8,409

 

8,409

Fifth Floor

8,787

 

8,787

Sixth Floor

5,257

 

5,257

TOTAL

43,287

16,544

26,743

Phase I Total Contract Cost –P 742,888,888.88

Phase II Approved Budget for the Contract – P 742,800,000.00

  • Timeline of Phase I implementation:

ACTIVITIES

PLANNED

ACTUAL

Invitation to Bid

June 4, 2013

June 4, 2013

Pre-Bid Conference

June 11, 2013

June 11, 2013

Opening of Bids

June 25, 2013

June 25, 2013

Bid/Post Qualification Evaluation

July 3, 2013

July 3, 2013

Notice of Award

August 3, 2013

October 10, 2014

Contract Approval*

September 5, 2013

December 23, 2014

Notice to Proceed

September 8, 2013

January 23, 2015

Date of Completion (28months)

January 2016

May 2017

The awarding of the contract for Phase 1 was delayed due to the preliminary injunction issued by the Makati Regional Trial Court. 

  •  Negotiated contract for the Phase II was awarded in December 2015, after clearance from the Government Procurement and Policy Board.
  • Construction of Phase I and II was delayed, a first 6-month (until November 11, 2017) and a second 2 month extension (until January 11, 2018) had lapsed. The contractor posted a more than 30% slippage in February 2018 which equates to termination of contract, unless remedies are instituted.

Current Hospital Officials:

Esmeraldo T. Ilem, MD, FPOGS

Medical Center Chief II

Romeo A. Bituin, MD

Chief, Medical Service

Lourdes C. Mendoza

Chief, HOPPS

Alma Mina S. Enrile

Chief, Finance Service

Edna E.Solis

Chief, Nursing Service