IV. A DIRECTION

     After an assessment of the system, the GSI staff defined the  
direction   GSI  will  take.   Before  defining  the  goals   and 
objectives,  the staff reviewed the visions and missions  of  the 
Department  of  Surgery  and GSI and  the  problems,  needs,  and 
courses of action that came out from the systems analysis.

     After  having  identified  the root-cause  problem  and  the 
priority  need, the goal, therefore, is to develop  an  effective 
management system.

     The terminal performance objective is:

     At  the end of 2 years, the GSI staff, in  consideration  of 
the  financial and time constraints, must be able to  develop  an 
effective management system.

     The  management system shall be considered effective  if  it 
has promoted: 1) quality patient care; 2) quality staff training; 
3)  quality research; and 4) optimal participation of  consultant 
staff.

     The enabling objectives are:

     1.  The  GSI staff must be able to promote  quality  patient 
care.   Quality patient care is considered to be present  if  the 
following criteria are present:

          1.1 There is no  medicolegal suit filed against any  of 
               the GSI staff.
          1.2 There is no formal complaint  filed against any  of 
               the GSI staff.
          1.3 The  waiting  time for patient  management  in  the 
               outpatient  department  and  in  the  hospital  is 
               acceptable based on standards.
          1.4  The overall and disease-specific  mortality  rates 
               are acceptable based on standards.
          1.5  The overall and disease-specific  morbidity  rates 
               are acceptable based on standards.
          1.6  There   are   memoranda    of    cooperation   and 
               coordination  between GSI and services within  the 
               Philippine    General   Hospital, such as Sections 
               of  Medical Oncology, Endocrinology,  and  Nuclear 
               Medicine of the Department of Medicine, Section of
               Radiation Oncology of the Department of Radiology,
               Departments  of Otorhinolaryngology,  Orthopedics, 
               Dentistry, and Rehabilitation Medicine.

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     2.  The  GSI  staff must be able to  promote  quality  staff 
training.  Quality staff training  is considered to be present if 
the following criteria are present:

          2.1   There    is    no  formal   complaint    on   the 
                 effectiveness, efficiency, and humaneness in the 
                 management of any patient against any GSI staff.
          2.2   There   is   an  annual  GSI   multilevel   staff 
                 development program.
          2.3   There is at least one GSI consultant  development 
                 program per year.
          2.4   There  is  a  structured,  wholistic,   community
                 problem-based, self-directed educational  method 
                 for GSI fellows and residents.
          2.5   There  is  a  coordination  at  least  among  the 
                 general   surgery  divisions  on  the   training 
                 program of general surgery residents.

     3.  The GSI staff must be able to promote quality  research.  
Quality  research  is considered to be present if  the  following 
criteria are present:

          3.1  There  is  at least one  completed  and  published 
                quality  research output on patient care and  one 
                on staff training every year.
          3.2  The research will promote improvement  of  quality 
               patient care in GSI.
          3.3  The  research will promote improvement of  quality 
               staff training in GSI.

     4.  The management approach must be able to promote  optimal 
participation of all consultant staff.  Optimal participation  is 
considered to be present if:

          4.1 The participation of all consultant staff is within 
               the agreed upon minimum.
          4.2 There  is  coordination and cooperation  among  the 
               consultant staff of GSI.
          4.3 The  GSI  has  achieved the  standards  of  quality 
               patient care.
          4.4 The GSI has achieved the standards of quality staff 
               training.
          4.5 The  GSI  has  achieved the  standards  of  quality 
               research.

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