2. Matron Roberts Polyclinic II (MRPC II) is the only polyclinic that operates with the benefits of a dual system in Belize City, which is administered by the Government of Belize in partners with National Health Insurance. MRPC serves a population of over 40,000 inhabitants on the Southside of Belize. MRPC II is assigned a total amount of 12,000 registered patient with a payment of $6.30 per member per month. Opening hours: Monday – Friday 7:00a.m. – 8:00p.m. Saturday – Sunday 7:00 a.m. – 12:00noon

4. Key Areas of Service 1. Use of the Health Information System Management (Includes BHIS, RAWA and Medical Records) 8. Outreach/Mobile services 2. Management of outpatient clinical services 9. Laboratory service 3. Pharmaceutical supplies10. Quality assurance (NHI, MOH and USAID Audits) 4. Health Education / Health Promotion11. Infection Control 5. Referral12. Staff Development /Continuous Medical Education/Protocol Revision 6. Surveillance13. Family and Community Health 7. Dental Service14. Specialist Services – Nutritionist, Gynecologist, Pediatrician, PNP

5. YearTotal EncountersDifference Percentage (comp. to prev. yr.) 200930583 2010434251284230% Increase 201141084-23416% Decrease 201246993590913% Increase 2013 54263727013% Increase 2014 54071-1920.4% Decrease

6. Total registered patients seen 11,490 Total non-registered patients seen 13,412 Total doctors’ consultations 24,902

7. Staff of Matron Roberts Polyclinic II, 2015 Total Number of Employees52 Permanent Established13 Open Vote7 Contract – Clinic, Pharmacy & Lab13 Sessional Staff3 Specialists3 MRPC II - NHI Funds10 Cuban Brigade 3

8.  Utilizing the tools Facility Evaluation Pharmacy Evaluation Medical Audit Evaluation  Work on recommendations from previous audit  Self assess facility and plan how to meet standards  Regular revision of medical files  Monthly updates of KPI’s and discussions on plans to achieve targets – Core Team

9.  Monthly Staff Meeting – includes updates, operational plan, future plans, patient complaints, etc..  Department meetings  Weekly Core Meeting – Operational Plan Core team: Administrator Medical Coordinator Nurse In-Charge Nurse Specialist II  Monthly reports by each unit – includes targets, achievements, challenges and recommendations  Annual reports by each unit compiled into collective annual report

10. Category Percentage allocated Staff Distribution60% Staff Trip10% Clinic30% 100%

11.  Who will be eligible to bonus: Must have more than three months working in facility  Note: Any staff that resign or is terminated will not be eligible to bonus Each staff will be assessed to determine quantity of bonus assigned to their category  Criteria to meet by staff to earn bonus amount: 1. Punctuality 2. Patient Complaints 3. Customer Service 4. Team player 5. Productivity

12.  Commenced the piloting of the NCD passport with a sample size of 50 patients  Infrastructural improvements such as partition for outpatient, MCH triage area, repair to roof, installation of water pump, etc.  Achieved to become a baby friendly clinic  Continuous weekly core meeting with Administrator, Medical Coordinator, Outpatient Nurse In-Charge and Nurse Specialist I  All nurses and doctors were certified in BLS and ACLS  Upgrade of medical equipment  13 schools were visited twice for the year as part of the iron supplementation program  100% coverage for prenatal first test  Full implementation of the RAWA system – assist in billing, reporting and monitoring of caps  Effective and efficient reporting is being made for Pharmacy and Lab due to RAWA (Registration of Clinical Activities Web Application)  Meet all MOH/NHI key performance indicators with high scoring  Held staff retreat

13.  Dual System used in the clinic  Waiting time remains a challenge  BHIS does not compliment NHI medical records  Patient information not updated in BHIS  Patients neglect to bring proper identification when visiting clinic, causing errors in information entry in BHIS  Documentation in the BHIS  Patients refuse to use the clinic within their area of residence, thus overcrowding this facility  Shortage of Medical Officers and Nurses  Counter referrals  Classification of staff due to dual system  Approval for expenditure of $3,000.00 delays at the ministry level  Shortage of medications and lab service – we cant have the 100% of proper management of these patients due to unfilled referrals  Ministry of Health have losses of income due to shortage

14.  Improving access and reducing inequity by: 1. Reduction of waiting time 2. Ensuring all services are provided daily 3. Increase human resource 4. Strengthening of the triaging process  Improve management of chronic conditions by: 1. Improvement in monitoring and evaluation 2. Improving nutrition in chronic disease patient 3. Strengthening of in-house mental health program 4. Hiring of an internist 5. Strengthening of structured training 6. Improving home visits to chronic patients

15.  Increase the focus on prevention, screening and early intervention by: 1. Focusing on health education and promotions 2. Improvements in the screening 3. Emphasis on IMCI and PMTCT protocols 4. Meeting MCH targets 5. Emphasis on baby friendly initiative  Improving quality, safety, performance and accountability by: 1. Meet the standards of NHI/MOH 2. Meet standards of the capacity project 3. Implement and adhere to MOH infection control protocols 4. Improve/strengthen internal security system 5. Improve collaboration with agencies and support service

16.  Effective use of the BHIS for health planning by: 1. Regular updating of patients’ demographic and medical information 2. Strengthen the usage of immunization, postnatal and nutrition information 3. Integrate BHIS with NHI medical records  Improvement in health workforce by: 1. Continuous capacitation activity for staff 2. Hire human resource according to population needs 3. Develop criteria for the employee of the month 4. Develop staff manual

17.  Adequate Infrastructure: 1. Expansion of the MCH and Doctor’s area 2. Purchase and install of UV lights in all areas of the clinic 3. Remodel of parking lot 4. Purchasing for necessary upgrade of furniture and equipment  Ministry of Health to develop a guideline for the management of NHI funds  Ministry of Health to hire all supporting staff under the ministry  Invest in more internal extension within the clinic  Develop a preventive maintenance program for computers and medical equipment with respective Director

19. Entrance to the clinic Front Desk OPD Waiting Area

20. Triage Area Doctors’ Area Consultation Room Triage Room

21. MCH Waiting Area MCH Triage Room MCH Consultation Room MCH Rooms

22. Asthma Bay Observation Room

23. Pharmacy Area Pharmacy Waiting Area Inside of Pharmacy