Brief History and Introduction

Mayo Hospital is the oldest and largest hospital of the country, serving the humanity since 1871.
Mayo Hospital was completed in 1870 and it started patient care in 1871. It was named after the Earl of Mayo, the then Viceroy and the Governor General of India.
Encompassing over 52.8 acres of land and the main building with boundary having 11 gates, the hospital is one of the largest hospitals in South East Asia and is a centre of excellence for public benefit. It had bed capacity of 300 beds on the Day of Independence (1947) but now is extended up to 2399 beds. The father of the nation, Quaid-e-Azam Muhammad Ali Jinnah also paid tribute to services rendered by this hospital on his visit to Mayo Hospital dated 19.03.1940.

Mayo Hospital is located in the heart of Lahore City and is surrounded by busy commercial and thickly populated residential areas with famous Anarkali Bazaar, Nila Gumbad, Urdu Bazaar and the Walled City of Old Lahore around it.

Earlier, after its construction in 1871, the Mayo Hospital was affiliated as a teaching hospital with the King Edward Medical College which came into being in 1860. The hospital was used to be managed by the Medical Superintendent under the administrative control of Government till 1999 when the whole setup was declared as Autonomous Medical Institution and the Mayo Hospital became Allied Hospital of King Edward Medical College. The Principal KEMC and the M.S. Mayo Hospital were placed under the administrative control of a newly created post of Chief Executive. In 2002, the Board of Governors took over the charge of the institution under PMHI Ordinance 2002, according to which the posts of Principal Executive Officer (PEO) / Dean and Deputy Dean were created. In the next year 2003, under another PMHI Ordinance 2003, the Board of Governors was replaced with the Board of Management under which Principal KEMC was declared Head of Institution consisting of KEMC & Mayo Hospital.

In year 2005, according to another Provincial Assembly of Punjab Act vide notification No. PAP-Legis– 2(19/2005 / 724), dated 12 May, 2005, the King Edward Medical University (KEMU) came into existence to which Mayo Hospital is to be declared as attached hospital for teaching purposes. The hospital so attached, however, has been placed under the administrative control of Govt. of the Punjab, the same administrative setup which existed since 1871 up to 1999.DEVELOPMENTAL STAGES

1871: Construction of the Main Building of Mayo Hospital

1891: Construction of Albert Victor Hospital (AVH) Block (Private Block)

1948: Pediatrics Block (Old) 1952: Out Patient Department Block

1974: Pediatrics Wards

1982: Institute of Ophthalmology

1984: New Accidents & Emergency Block & Pediatric Surgery Block.

2001: Department of Physical Medicine and Rehabilitation.

HOSPITAL POLICY

It is based on:

The effective implementation of Government commitment i.e. “Health for All”

Scalar Principle of Management

Command on communication

Decentralization of Authority (Finance and Administration)

PERT

Inculcating sense of social security through the availability of 100% commodities for 100% patients on 100 % occasions.

Consensus Formulary

CLIENT SATISFACTION RATIO (CSR)

Measures for the achievement of CSR:

1. Audiovisual Communication to attendants

2. Behavioral change towards the good of humanity, i.e., a new culture introduced, the patients and the attendants have been declared the guests of the hospital

3. Clinical / Surgical Audit on the feedback of all the cases admitted or entertained in Mayo Hospital to ensure that no patient is left unattended or at the mercy of indifferent, unprofessional or casual attitude.

FACILITIES AVAILABLE IN MAYO HOSPITAL

1. Central ICU with Central Oxygen (O2) & Suction System

2. Standard CCU Facilities

3. Angiography, Angioplasty, Cardiac Bypass, Heart Valves Replacement and all sorts of Cardiac Operations and procedures

4. Radio Isotope Cardiology / Thallium Scan / Echocardiography / ETT

5. Spiral CT, Color Doppler and Ultrasonography on latest machines

6. Renal Transplantation and Renal Haemodialysis

7. All Dermatological Procedures

8. Radiotherapy on latest machines

9. Latest Physiotherapy Equipment, Rehabilitation Center and Orthopaedic Workshop

10. Neuro-Angiography, EMG, EEG and all kind of sophisticated Neuro-surgical operations

11. Operations of Plastic Surgery and cosmetology

12. Operations of Fascio-maxillary, Jaw and Dental Surgery

13. All kinds of Orthopaedic Operations under competent consultants

14. All kind of Eye and ENT Operations

15. Surgical Operations of all kind for neonates, children, young and old patients

16. Radio Isotope Thyroid, Liver, Bone, Brain and other organs scanning, Hormonal Assays and Viral Markings are being done in Atomic

DATE WISE ACHIEVEMENTS AND THEIR CONTINUITY IN THE NEXT PHASE

Dates Achievements

24th May, 2003 100% Free Accident & Emergency Department

24th May, 2003 100% Free Pediatric Medicine Emergency Department

24th May, 2003 100% Free Pediatric Surgical Emergency Department

20th October, 2003 100% Free Three Units of Department of Ophthalmology

20th October, 2003 100% Free Eye Operation Theatre

14th April, 2004 100% Free Pediatric Surgery Operation Theatre

17th June, 2004 100% Free East & West General Surgery Operation Theatres

6th August, 2004 100% Free Diabetic Clinic

7th October, 2004 100% Free ENT Operation Theatre
100% free ENT operation theatre 100% free treatment and medicines in Tuberculosis & Chest Diseases Wards

4th January, 2005 100% Free Pediatrics Medical Ward

11th March, 2005 100% Free Cardiac Surgery Operation Theatre, Ward & ICU

1st April, 2005 100% Free Chest Surgical Wards

1st April, 2005 100% Free All the four units of surgical wards (Pre and post op care and medicines)

2nd June, 2005 100% Free Pediatric Surgery ICU

2nd June, 2005 100% Free Pediatric Surgery Ward

24th October, 2005 100% Free Dermatology OPD

14th November, 2005 100% Free Radiotherapy & Oncology Ward

24th February, 2006 100% Free Provision to All the Medical Wards
Achievements quarter 2, 2003 Provision of 100% commodities in Accident & Emergency

Department:

a) Main Accident & Emergency

b) Emergency Operation Theatre (COT/ NEOT)

c) Paeds. Medicine Emergency

d) Paeds. Emergency Operation Theatre

Achievements-quarter 4, 2003 Provision of 100% free services in the Institute of Ophthalmology (all the three Eye Units made free), even including the provision of Intra Ocular Lens (IOLs) This facility covers all the costly ophthalmic procedures like Vitreo-retinal surgeries, which in private sector may cost up to Rs. 80,000/-

Achievements quarter 4, 2003 100% free diabetic clinic with the provision of oral anti-diabetic agents & insulin injection like HUMULIN. The provision of 100% free medical coverage for both indoor and outdoor patients of Tuberculosis (TB) has been ensured. The entire equipment requiring repair has either been replaced or repaired. A kind of Repair Free Atmosphere maintained in the best interests of people including the Neuro-Angiography Machine recently repaired and installed.

Achievement quarter 1, 2004 Installation and commissioning of Angiography Machine in Cardiology Department including renovation of cardiac surgery Operation Theatre has been carried out. Angiographies are being performed on new machineInstallation and commissioning of Angiography Machine in Cardiology Department including renovation of cardiac surgery Operation Theatre has been carried out. Angiographies are being performed on new machine.

Achievements quarter 2, 2004 Pediatric operation theatres have been declared free for surgery with the provision of all medicines and surgical disposables including Shunts and all types of sutures Provision of 100% free surgical coverage to patients in ENT operation theatre Provision of shelter and overnight stay facilities for attendants of patients (initiation of service facilities for the above purpose in Quaid-e-Azam Musafer Khana)

Achievements quarter 2, 2004 Provision of 100% free operation facilities to all patients in main general surgery operation theatres of Mayo Hospital. East Operation Theatre, West Operation Theatre, North Operation Theatre and South Operation theatre

Achievements quarter 2, 2004 100% free medicine coverage extended to Pediatric Medical Ward including even providing anti cancerous chemotherapy, and third & fourth generation antibiotics in all sections of Pediatric Medical Units:,General Medicine (Nephrology), Oncology, Neonatal ICU, Isolation Ward, Diarrhoea Section, Paeds ICU

Achievement quarter 3, 2004 PC-1 approved, foundation stone laid down by Honorable Chief Minister for the construction of Multi-storey surgical tower. This will include state of the art operation theaters and wards including Helipad for trauma patients.

Achievements quarter 4, 2004 Establishment of state of the art Central ICU

Achievements in quarter 1, 2005 First time ever in the history of Pakistan in any hospital, cardiac surgery has been declared free

Up to April, 2006, 323 patients underwent cardiac surgeries like CABG and Valve replacement
Achievements quarter 2, 2005 All the four surgical units along with chest surgery (whole surgical floor) have been declared free of cost for all. Provision of 100 % free medicines to Pediatric Surgery Ward.

Achievement quarter 4, 2005 Provision of 100% free medical treatment in both the Dermatological Units. Provision of 100% free medical treatment in the Oncology Department.
Achievements quarter i, 2006 Provision of 100% free medical treatment in the four medical units (medical floor).

For this purpose a fully functional pharmacy has been established at medical floor.
Vision quarter 2, 2006 To declare following units free: Orthopedics & Urology

Vision quarter 3, 2006 To declare rest of the Hospital free for all patients

EQUIPMENT PURCHASED APRIL, 2003 TO Dec., 2005

UNDER GRANT 16 (12000)

DURING YEAR 2004-05

ALLOCATION Rs. 160.00 M

EXPENDITURE = Rs. 157.00 M

SEMS PROGRAM

DURING THE YEARS 2004-05
ALLOCATION Rs. 28.00 M
EXPENDITURE = 27.9918 M

UNDER ADP SCHEMES (997) MODERNIZATION OF UROLOGY OPERATION THEATRE”.

ALLOCATION = Rs. 10.00M
EXPENDITURE = Rs. 9.929 M

2004-2005 UNDER ADP SCHEME 999
COMPLETION OF CHILDREN’S MEDICAL SPECIALTY BLOCK
• ALLOCATION = Rs. 13.5 M
• EXPENDITURE = Rs. 13.217 M
• UNDER ADP SCHEME 996

UP-GRADATION OF RENAL TRANSPLANTATION AND HAEMODIALYSIS UNIT

• ALLOCATION Rs.10.00 MILLION
• EXPENDITURE Rs. 7.123 MILLION

UNDER ADP SCHEME 998-

PURCHASE OF RADIOTHERAPY EQUIPMENT
• ALLOCATION Rs. 74.825 MILLION
• EXPENDITURE Rs. 74.232 MILLION

HOSPITAL GOAL AND THE CONTINUITY OF ITS ACHIEVEMENTS

Sustainability of 100% Free of Cost coverage in Hospital will be ensured through Macro and Micro Financial Management Un-interrupted availability of resources and its rational utilization will be sought as hot pursuit. The essence would be to see through that this exceptional policy becomes natural to the hospital even in the future though a system of working.

ANALYSIS & CONCLUSION

Following factors are important:

• Commitment and desire of hospital administration to provide 100% free medical treatment to 100% patients at 100% occasions.
• Delay is harmful for the implementation of plans.
• Proper analysis of available resources, planning, documentation, implementation, management, monitoring, control and evaluation through feedback is essential.

The above said achievements have been made without incurring any additional expenses or demanding any further funds from the Government. It is all through better financial management, control and communication with all concerned. 1-3 monitoring / surprise visits in any time of day or night of different departments by the Medical Superintendent have made the difference.

Inspection by the Zonal Heads (Addl. Medical Superintendents, Deputy Medical Superintendents, Chief Pharmacist, Deputy Chief Nursing Superintendent and Nursing Superintendents) has been made mandatory.

Periodic meetings with Senior Registrars, Registrars, Nursing staff, Administrative staff in addition to Technical, Tender and different Hospital committees, have been scheduled on regular basis.
Through these meetings, concerned officials and staff are inspired and motivated. They are focused on ethical and moral values and the noble cause of their profession. Their refined attitude ensures quick and quality health services towards humanity in distress.

UNPRECEDENTED ACHIEVEMENT

The above achievement, an unparallel feat of any Government Department is the result of dynamic leadership of Chaudhry Pervaiz Elahi, Chief Minister, Punjab and the support of Dr. Tahir Ali Javed, Minister for Health, Government of the Punjab. It can not go without saying that it would not have manifested itself so glaringly without the fine piece of administration and management by Dr. Fayyaz Ahmed Ranjha, Medical Superintendent, under the able guidance of Prof. Dr. Mumtaz Hasan, Principal KEMC .

Major Constraints

137 years old building Infrastructure needs rebuilding New blocks to be built Increasing confidence of community on free treatment in Mayo hospital and the competency of health care providers is now pressing hard on the existing budget which needs revision and increase

Budget Allocation Yardstick Financial Year 2004-2005

Budget
Allocation
(Rs) (Expenditure / Bed / Day 1799 Beds
(Rs) Expenditure / Bed / Day 2399 Beds
(Rs)
Rs. 871, 828,000/- Rs. 1086 Rs. 1013
UTILITIES
Rs. 60,505,000/- Rs. 487 Rs. 454

Mayo hospital is 1799 bedded, tertiary care teaching hospital, where as 195 beds are available in the Accident and Emergency Department of Mayo hospital, Lahore. The hospital emergency services like diagnostic facilities, provision of medicines/equipment, Ancillary' services and manpower, (doctors and para-medical) staff are up to the mark. As a routine all the emergencies related to Surgical, Medical, Orthopeadic, EYE, ENT, pead Surgery, pead medicine, chest diseases; Neuro Surgery and maxillofacial Surgery cases are being given prompt emergency treatment and are managed accordingly. However due to certain constraints manpower in all the fields is deficient as compared to the workload in Accident and Emergency Department which requires uptime recruitment.

Emergency Block, Mayo Hospital, Lahore

IMPROVEMENT IN A&E DEPARTMENT

Accident & Emergency Department Mayo Hospital Lahore is the largest Emergency of the Pakistan. More then 800 to 1000 new patients get benefit from this emergency daily. Administrative staff of Accident & Emergency Department along with energetic and miraculous leader ship of. Medical Superintendent Dr.Fayyaz Ahmad Ranja, is working hard for provision of excellent services to the ailing humanity. Under the dynamic leadership of worthy M.S. a lot of improvements have been made. Main achievements are as under:-

PATIENT CARE.

Before the arrival of Dr. Fayyaz Ahmad Ranja Accident & Emergency Department used to provide 30 -40 % medicines but now, by the grace of Almighty Allah has enabled us to provide 100% Free medicines to all the patient attending in Accident &Emergency Department.

We have established a separate pharmacy in Emergency operation theatre with help of Almighty Allah; we are providing 100% free pre &operative medicine Isurgical items and diagnostic facilities.

CIVIL WORK

• Air conditioners of NEOT and COT have started working and now the work department is trying to increase its potential under the control and forceful grip of Medical Superintendent.
• By the efforts of worthy Medical Superintendent 03 brand new Air conditioners have been installed in the Emergency Ground floor.
• Sanitary work completed in Accident & Emergency Lab. with installation of new pipes and sanitary fittings.
• Freezers of Mortuary of A&E department were out of order for the last 6months, but now with personnel interest of Worthy Medical Superintendent both freezers are functional.

CARE OF EQUIPMENT.

• Exscinding equipment is constantly and routinely checked by the Bio-medical Engineer and keeps it functional by doing necessary service and repair.
• New instrument costing Rs.15, 00,000/- have been provided by the Medical Superintendent and in this way leparotmy and vascular repair, facilities have been enhanced in N.E.O.T. iv). New Oven of 4-liter capacity has also been provided the N.E.O.T. recently increasing sterilization capacity.

BETTER COMMUNICATION SYSTEM.

• Mike has been installed at the reception for announcement and better communication with the attendants of the patients.
• Process of initiation of computerized collection of data is under process.
• 05 new computer have been installed in Accident Emergency Department .Inshallah we will be able to computerize all the data of Accident Emergency Department very soon.

GENERAL CLEANLINESS.

All the bath room with new sanitary fittings have been tried to be made for time and neat clean. General bathroom of main ward are constantly watched by.
a. Two hour change over duty of all wards cleaner in three shifts.
b Responsibility of ward cleaner is to make the bath room neat and clean.
Banning of entries of outsiders in the bathrooms. To prevent sanitary fittings from theft.
All the beds, Trolleys, I/V stands, Almarah as and other tools/instruments have been painted after necessary repair in the whole department.

ORDERLINESS.

• Duty roster and attendance of all staff working in Accident Emergency Department are constantly watched. We are trying to maintain duty roster of Senior Registrars.
• Plastic chairs have been placed in front of OT's for sitting of attendants of the patients.

SURVEILLANCE /INTERVIEW OF THE PATIENT

Worthy Medical Superintendent has passed the direction to AMS(A&E) and DMS(A&E) for cross questioning to the Emergency patients/attendants time to time and assessment of the quality of service provided in Accident &Emergency Department. We have initiated this task and it has made marvelous improvement in patients' satisfaction rat

ACHIEVEMENT / ACCOMPLISHMENT

• Completion of canopy near Accident & Emergency Department, (ELLAHI MEHEMAN KHANA) where the patient's attendants are sitting.
• Deputed three ward attendant /Khidmat-Gar to facilitate the patient attendants and serving them with cold water round the clock.
• Deputed three Ward cleaner for sanitation in canopy & the vicinity round the clock.
• Reconstruction of passage from A&E to canopy to facilitate patient attendants & doctors.
• Construction of shed at reception.
• Opening of X-Ray door from surgical side, to facilitate seriously/dangerously injured patients for X-Rays.
• Successful implementation of 100% provision of free medicine & surgical items to all patients visiting in Accident & Emergency Department.
• Procurement of two new operation tables in NEOT.
• All air conditioners in Accident & Emergency, COT & NEOT made functioning.
• Web site of Mayo Hospital has been made functional on Internet for latest information.
• C.C.TV has been installed in Accident & Emergency department made functional to detect the mismanagement of the Medicine.
• First of all by the Grace of Almighty Allah, and after going through the day & night work hard by DR. FAYYAZ AHMED RANJHA, to provide the Image intensifier facilities to the Emergency patients, which is available for doing Orthopedic Operations to avoid blood loss of severely injured patients. We are heartily grateful to the Worthy Medical Superintendent, Mayo Hospital, Lahore for this grate achievement.
• Extension of NEOT & installation of two new operation tables to facilitate surgeon in Accident & Emergency/NEOT by increasing operation tables from 2 to 4.
• M.O.T. near New Casualty Emergency Operation Theater with well equipped new instrument & two new operation tables which are functioning round the clock.
• Two new X-Ray's machines have been launched and working for rendering services to the Emergency patients.
• New Bio-chemistry analyzer was also installed in A&E Lab and functioning .
• Shifting of blood Bank from 1st floor to Ground floor .
• Centralized oxygen supply in COD, Medical & Surgical ward on
• ground floor .
• Installation of curtain & accessories in female ward (COD) .
• Centralized Oxygen and other gases supply in COT & NEOT .
• Installation of new kits in Accident & Emergency& lifts .
• Renovation of DMS /AMS Office .
• Recruitment/selection of new energetic and dedicated staff for A&E Department .
• Training program for doctors/nurses & paramedics about quality Health Care, Interpersonal communication & evidence based medicine learning programme .
• Incentive, Reward and compensation program for Emergency staff.
BRIEFING OF A & E LAB MAYO HOSPITAL LAHORE

A & E Lab is working around the clock in three shapes. First shifts or 6 hours each, starting from 8.A.M in the morning by the night shift is or twelve hours i.e. 8. P.M to 8. A.M.
No. of Patients range is 100-125 within average of more than 100 patients per day. Total No. of tests ranged from 700, - 900 with an average of 100 per day. So an average per month is 23000 to 25000.
Test Description
All kinds of tests being performed including LFTs, RFTs, routine blood and
..
urine examinations, blood sugar, cerium electrolytes, currently we are performing the blood gases because of non-availability of the solutions and reagents.

Staff

1. Medical

1. Senior Consultant Pathologist 1

11. Bio••Chemist 1

1Il. Medical Officer 1

IV, Medical Technologist 1

2. Para Medical

I Lab Technicians 2

II. Lab Assistants 4

III Lab Attendants 7

IV. Ward Attendants 2

Lab Cleaner 1

Demand of Instrument is enclosed
Strong Points

An efficient and vigilant handling with the careful compiling of the results within minimum time limits regarding all quality control measures.

Generation of Income

All emergency tests are free of cost, so the income generating sources wards are in the same building, i.e. neuro-surgery, plastic surgery and (1)1) cases after the time limits of the main laboratory.

Future Development and Viable Plan for generating more income

Replacement of instruments by the latest . technologies based equipment.

Specify the time limit of the emergency patients.

Charges for every duplicate by the Lab.

Computers with a proper Receptionist in all the three shifts

Increase the qualified and trained staff.

Brief History & Introduction

Hospitals are functioning almost in every part of the country thought they are not as adequate and equipped as may be available in the advanced countries. But in spite of all pecuniary handicaps and many other draw backs we can safely assets and claim that in hospitals like Mayo Hospital, services and Jinnah etc. medical services are provided in a competitive manner and it is mainly due to the major contribution of the experts and staff and appropriate administrations running these functions. There is not very reach awareness among the successes that in hospital services including medical and surgical, there is another integral and essential part without which the main theme of the hospital can not be achieved is the segment of blood transfusion service.

I may give some details with a view to bring out to the awareness of the general public. So for as Mayo Hospital is concerned Blood Transfusion Service work under its our directionally presently headed by Prof. Dr. Yasmin Lodhi, In Mayo Hospital, two Blood Banks function round the block and for all concerned cases treating doctors make requisitions to obtain blood or its components to accomplish the treatment in operation. All blood bank services are free of cost for the inpatients and entitled ones.

Now I explain in brief the functioning blood, mandatory screening for transfusion transmittable diseases like Hepatitis B,C. and HIV blood grouping cross-matching, impotent preparation, safe storage and compliance of the hospital requisitions. Collection of blood is a difficult task because there is only one source and that is extrication from healthy human body. To motivate blood donors volunteer non (remunerated) non remunerated donors in itself need demagogue and oritation to prepare them mentally for donation. Apart from donor councelling, teaching and training of paramedical hospital and health service staff is also conducted here.

The existing position is quite encouraging as compared to the past. Planning work has enabled us to comply any genuine demand of the hospital and to meet any emergent situation in year 2005 statistics are as under and these excel all the previous records in respect of blood bank services.

Year 2005 Main Blood Bank Mayo Hospital, Lahore.

Annual Report Total Blood Grouping 34342.

Donors Bleeding 12032

Blood Screening 12032

Blood Components provided 702

(FFP, PVC, PLATLETS)

Non donor basis blood provision 200.