KNH NEWSLINE EDITION 26

More than just health

Christmas Edition

Christmas at the Hospital

Editor’s note

Editor’s note p.2

CEO’s Christmas Message p.3 Christmas at the Hospital p.4 Congratulations message for award p.5 ‘Tis the season! p.6

My journey with Keloid pain -breaking the silence p 7- 8

Positive mentions from KNH socials p.8 Effective policyp.9

To scaling greater heights: Dr. Idris Chikophe P.10

Intern’s Experience p.10

Exploring Professional Healthcare Chaplaincy at KNH p.11 Arise and Shine p.12

Hygiene saves lives p.13

The bull’s eye: setting targets the right way p.14 -15

Our story in Pictures p.16

KPCC spreads festive cheer p. 17 - 18

The steady growth of the Pharmacy and Manufacturing Unit at KNH p. 18 - 19 Comic zone p. 20

ON THE COVER

Christmas at the Hospital p. 3

Marketing & Communication Department

Design Concept Team: Dave Opiyo, Edel Q. Mwende, Yvonne Gichuru & Collins Cheruiyot

Editorial Team: Dave Opiyo , Edel Q. Mwende, Yvonne Gichuru, Luke Kung’u, Winfred Gumbo, Verah Mugambi, Priscah Angwenyi & Melody Ajiambo

Stories: Philip Etyang, Moses Njomo, Marian Moraa, Shiphrah Njeri, Verah Mugambi, Melody Ajiambo, Cynthia Cherono, Edel Q. Mwende, Linnette Leyi, Petterson Njogu, Yvonne Gichuru, Carol Langat, Neema Kemunto, Dr. Jane Gwaro & Samira Yusuf

Design By: Collins Cheruiyot

Photos: Nicholas Wamalwa, Doreen Nyaboke, Linnette Leyi & Aaron Mulama

Tel: +254 20 2726300-9 Ext. 43121 or 43969 Fax: +254 20 272572

Email: caffairs@knh.or.ke knh.caffairs@gmail.com

The festive season is here

Dear Colleagues, It’s that time of the year again. The holiday season is here. This is the most celebrated time of the year in Kenya and globally. There’s so much to adore about this month. Family, love, gifts, the beautiful decorations, shopping and of course quality time spent with family and friends raising glasses and watching fireworks explode in the sky.

Even if you are going through tough times, take a deep breath and enjoy the blessings surrounding us. I hope we celebrate every day like a holiday and that 2023 brings good health, inspiration and intentional acts of kindness as we serve our patients. Whichever way you choose to enjoy the festive season, stay safe and do not overdo it. Merry Christmas and cheers to a Blessed and successful 2023!

All the Newslines and Newsletters can be accessed online at: https://bit.ly/3uQGCcI

Ms. Verah M. Mugambi Editorial Officer, Marketing & Communication Kenyatta National Hospital.

CEO’s Christmas Message

Season’s Greetings,

And just like that, another year is ending! Christmas is around the corner again. What a tremendous amount of work has been done in 12 months! Sometimes, in the midst of the daily craze, one does not realize how many decisions were made, how many projects completed, how many changes implemented, the thousands of patients cared for and the amount of energy committed, day in day out. Thank you for your unwavering support this year in serving our patients and the institution. It is greatly appreciated. The gift of love, the gift of peace, and the gift of happiness; may all these be yours this Christmas.

Merry Christmas!

Dr. Evanson Kamuri, EBS Chief Executive Officer Kenyatta National Hospital

Christmas at the Hospital

By Linnette Leyi & Marian Moraa

What is Christmas like at Kenyatta National Hospital (KNH)-Pediatric Oncology Ward?

We understand that no family expects to be spending their Christmas at one of our wards. Unfortunately, this can be inevitable when illness or injury occurs at that time of the year.

For children with cancer, they end up spending long periods of time within the confines of the hospital as they receive treatment. However, staff at the Pediatric Oncology Ward at KNH try to make the season magical and colorful for the children who are eager and cannot wait to be well and back home.

Christmas festive period is a time for people to come together to celebrate and spread love and happiness and KNH is no exception. KNH has been privileged to have regular visits from willing and philanthropic donors who despite coming with heart-warming donations, have also gone out of their way to introduce various entertainment activities like dressing up as Santa Claus and Christmas Elves so as to put a smile on patients’ faces.

Therefore, the Christmas festive period at KNH is a time to uplift the spirits of patients especially those in the Pediatric Oncology wards. This plays a critical role in not only putting a smile on patients’ faces but leaving a lasting mark of care in their lives.

Also, KNH participates in the tradition of putting up string lights or candles and Christmas cards and trees across different Pediatric

Oncology wards to give these rooms a festive feeling that one can easily relate to if they were at home. Therefore, the hospital during this period does not only strive to provide quality health care services but also socio-psychological boost to the patients which goes a long way in uplifting patients’ health care and well-being.

Decorating the walls of the Hospital with special items that are Christmas themed like balloons and ribbons give a more familiar festive environment. Sharing homemade holiday treats, meals, wrapping presents, playing holiday movies, plays like magic shows, dancing competitions and musical activities to cheer-up patients. Most importantly, do not give up! keep going.

Godrey C. Wadu, a medical officer based at Ward 1E has been part of the Pediatric Oncology Ward since 2020 and over the years he has seen how important the festive season has always been to the patients. Therefore, the festive period in KNH is an integral moment for patients.

Decorating the walls of the Hospital with special items that are Christmas themed like balloons and ribbons give the Hospital room a more familiar festive environment.

PHOTO | STEVE ARWA

Santa Clause with christmas decoration at ward 1E giving the ward a festive mood

The Manager, Marketing & Communication- Ms. Edel Quinn Mwende was feted as a Rising Star in Marketing during the 5th African Marketers Conference & Awards 2022

‘Tis the season!

Christmas messages from KNH staff

By Verah Mugambi & Yvonne Gichuru

“I wish my clients, colleagues and other therapists a Merry Christmas and a Happy New year. I wish that you keep safe so that we see each other in the new year.” - Sylvester Wakulwa - Occupational Therapist, Outpatient Services, KNH

“I wish you a Merry Christmas and a happy prosperous 2023. May the excitement of this season stretch into the New Year for all of you.” - Florence Apiyo - Clerical Officer, Finance Department, KNH

“Hello Colleagues, I would want to take this opportunity to wish all of you Merry Christmas and a happy new year as you enjoy this season with your family and friends. Thank you and God bless you!” - Kilivua Joel Stephen MukayaSenior Principal Medical Laboratory Technologist, KNH

“I wish you all a Merry Christmas and a prosperous new year 2023. Remember to stay safe and sending lots of peace and joy to you and your family this Christmas season!”Christine Thuranira - Clerical Officer, Finance Department, KNH

“I would like to wish all my colleagues at Kenyatta hospital including the Management and our patients a Merry Christmas and Happy New year. Stay safe and may God bless you!”- Emily Kosgei - Physiotherapist, KNH

“I want to wish everyone a wonderful Christmas! Kindly remember the vulnerable in the society during this season. Share something with them too and may God bless you all.”

- Margaret Auma Ogolla - Health Information OfficerHaematology Lab, KNH

“May the sweetness of Christmas carols and cakes fill your life with happiness... But remember to keep walking to burn the calories. Wishing All a Merry Christmas!” - Dickson Okumu, HoD - Rehabilitative services, KNH

me

golden,

an Occupational Therapist working with

with special needs and talents! May your Christmas be filled with joy and your new year inclined to good health. God bless!”Mikie Baron - Occupational Therapist, Sensory Integration specialist, KNH

“It has always been a pleasure to work with you all. Enjoy a well-deserved rest and time with family this Christmas. Have a healthy and happy holiday season!” - Steven ArwaPhotography Intern, Marketing & Communication, KNH

“It’s quite humbling that KNH gave

this

precious rare opportunity to serve as

children

My journey with Keloid pain -breaking the silence

Taking a leap of faith

By Cynthia Cherono

It is early morning, just about 6:30 a.m. as I entered the Kenyatta National Hospital (KNH) gates with a referral letter. I hoped and prayed in my heart that I had entered my final treatment destination. This is a story of pain and suffering from benign keloids, a story of stigma, courage, resilience and hope. It is a journey that began many years ago as a class 7 pupil, which looked like a simple cosmetic earlobe shoot but ended up being a serious medical issue. I underwent a minor surgery of the ears and several injections at Tenwek Hospital as a 13-year-old.

At KNH, I was ushered in by my sister who is an employee of the Hospital and is familiar with its operations. She read the referral letter and immediately lead me to Surgical Clinic 24, where a plastic surgery clinic runs every Thursday, but the clinic was full.

We then registered at the Health Information Department No.19 and I was scheduled to see Dr. Jowi (a plastic surgeon specialist) who examined me, and decided that an incision was to be made. She then gave us an insight of what Keloids are, the primary causes, symptoms and treatment as well as prevention options.

Keloids are benign (noncancerous), fibrous skin tumours. They are most common in people with darker skin and usually develops between the ages of 10 and 30. Men and women are equally likely to have keloids. Keloids may also run in the family lineage.

Causes

Keloids usually occur at the site of skin damage (acne, burns, chicken pox, cuts, insect bites, piercings, surgery, tattoos, vaccinations). They can occur spontaneously. Whether or not a keloid will form is not determined by the severity of the wound - even a minor skin abrasion can result in keloid formation. Keloids are the result of abnormal wound healing. Normally, there is a balance

between the production and the breakdown of collagen, which is a protein that makes up the fibers in the skin. With keloidal scars, the cells in the skin called fibroblasts produce excessive amounts of collagen. The collagen fibres are also thicker and wavier. This leads to the thick, raised appearance that is characteristic of keloidal scars. It is unclear what prompts this unusual healing process. Possible causes include genetic factors, skin tension, and the presence of a very high number of fibroblasts in the skin.

Symptoms and complications

Keloids are usually firm, raised, shiny, and smooth. They are often pink or red, or much darker or lighter in colour than the surrounding skin. Keloids always extend beyond the limits of the original wound, sometimes by many centimeters. The colour, shape, and size of the scars may change with time. They are generally not painful, though they are

often itchy.

Keloids are more likely to develop on the arms, back, ears, lower legs, mid-chest, and neck. They may form as a wound heals, or they may take several months or even years to develop. Rarely, they will continue to grow indefinitely. There are generally few complications from keloidal scars. Depending on their appearance and location, they can cause some psychological distress, as keloids can be quite prominent. Keloids can also interfere with movement, especially if they are on a joint. Very rarely, keloids may become cancerous.

Making the diagnosis

Keloids can be diagnosed by your doctor or dermatologist. Diagnosis is based on the location and appearance of the scar, and how it progresses over time. Your doctor may do a physical exam and look at your medical and personal history to rule out any other possible diseases or conditions. A skin biopsy may be

PHOTO| STOCK A Kleloid and Scars on human skin

performed to confirm the diagnosis and to rule out any malignant tumor. Diagnosis for keloids includes a

“ Keloids are more likely to develop on the arms, back, ears, lower legs, mid-chest, and neck. They may form as a wound heals, or they may take several months or even years to develop.,”

simple physical exam of the scarred area. Your doctor may also collect a tissue sample for biopsy to rule out the possibility of skin cancer.

Treatment and services

You will probably prefer to remove the keloids, especially if they appear on an area of the body that is usually exposed, due to their unattractive appearance. There are several treatment options available starting from topical applications of creams, gels, injections in the tissue and cryotherapy, surgical removal

combined with radiotherapy.

Please note that if you have a history of keloid formation and are having surgery, discuss with your surgeon any strategies to prevent keloid formation. Also, those with a tendency to form keloids may want to avoid any unnecessary piercings or surgeries.

This is just a glimpse of part one keloid management, Watch out for part two on the Journry and recovery in the next Newsline Edition

Positive mentions from KNH socials

Evangelist Peter Mwaura

Kenyatta National Hospital is ISO9001:2015 certified, continuous improvement is the conversation we need to engage in.

Gerald Ngao

God bless KNH.

Fayrouz Winnes

KNH is simply the best.

Don Mendez

KNH is simply the best.

Cyprian Owino

KNH is very good.

Nyeri Pundit

Good facilities, I like them.

Jackson Ke Kazi nzuri.

Kimutai Meli

Keep up the good work.

Solomon Okoth Great Job KNH.

Bildad Jnr

KNH are always the best.

Eric M. Musau

We are all behind KNH.

Kevin Negaga Exemplary.

PHOTO |STOCK A Kleloid and Scars on human skin

Effective policy management

By Neema Kemunto (Principal Monitoring & Evaluation Officer)

Policies and procedure manuals are the heart of an organization that lay the foundation for operational excellence.

Policy and procedure are two terms that are sometimes used interchangeably, and while they do go hand in hand, they are not the same. But what is the difference between a policy and a procedure? Simply put, a policy is a guiding principle that gives the direction or basis for decisionmaking in an entire organization, a section of the organization, and down to every individual employee.

It simply indicates what needs to be done. A procedure, on the other hand, clearly gives the step-by-step outline of how to do what needs to be done. A good procedure document also gives the reason for doing things a certain way.

Kenyatta National Hospital (KNH) has over the years developed over 32 policies to govern its operations in a bid to attain operational excellence in healthcare delivery. While this is highly commendable, the Hospital has in the past failed to meet the intended objectives due to a poor policy management system. This has been characterized by a weak policy enforcement system, disorganized or outdated policies and lack of policies where required.

To alleviate these challenges, the Hospital through the Planning, Monitoring & Evaluation department embarked on the process of developing and reviewing polices to enhance policy adoption, implementation and effectiveness, and to ensure the policies are up-to-date and relevant to the business environment the hospital operates in.

To this end, the Hospital has reviewed 17 policies and developed 5, and is in the process of reviewing and revising the outdated policies. This has been done in line with the formulated guidelines that govern the whole spectrum of policy management.

According to the Senior Director Corporate Services, Mr. Job Makanga, OGW, this was instigated by inconsistency in the style and format of the policies; poorly written policies, inaccessibility of the Policies by all staff and out of date policies. To avoid these and other hitches, Mr. Makanga added that it was necessary for the Hospital to activate a systematic look at its policy-management process.

“Effective policy management is

necessary to enable governance, risk management, and compliance at every level in the Hospital. To ensure effective policy management, the Hospital has undertaken measures in creating, communicating, managing and maintaining policies, to ensure the gap between those who set the policies and the employees who are expected to know and follow these policies is bridged,” stated Mr. Makanga.

In its quest to streamline the policy management system, the Hospital through the Planning, Monitoring & Evaluation department has developed a Hospital-wide Policy Management Guideline that provides a clear roadmap on the formulation, implementation, monitoring and Evaluation of Hospitalwide policies.

This will ensure policies conform to consistent writing style and language, and are clearly written and understood. “All hospital Policies shall be developed under the guidance of the Planning Monitoring and Evaluation Department using the standard policy format,” said Mr. Felix Kilumbi, Manager, Monitoring and Evaluation.

He added that using a standard format for all hospital policies will make it easier for staff to read and retain information, as well as scan the documents later for specific guidelines and rules. Having policies centrally developed, monitored and evaluated at the department will circumvent the challenge of opposing policies emerging from various departments.

To achieve effective policy management, it is vital that all the hospital policies are accessible to employees at all levels of the hospital, and readily available for them to interact with. To this end, the Planning, Monitoring and Evaluation Department has developed a database of the Hospital policies that will

be integrated in the Hospital repository. This will ensure employees never have to guess where to look for information. New employees will be required to read, comprehend and sign up the key hospital policies upon recruitment.

Increasing Awareness of our policies and regulations across the Hospital through regular policy expositions is another step that the hospital has undertaken towards effective policy management. In this Financial Year 2022/2023, the Planning, Monitoring and Evaluation Department has held two policy expositions in the 1st and 2nd quarter respectively.

The virtual sessions have seen 10 policy presentations which are; Admission and discharge, Credit, AntiCorruption and Whistle blowing, Housing, Equipment and Machinery, Marketing and Communication, Road Safety Mainstreaming, Disability Mainstreaming and Security and Safety being presented.

Monitoring and Evaluating policy compliance is a step that the hospital has undertaken to ensure compliance, manage risk and protect the Hospital from Litigation.

The Hospital has included the implementation matrix and M&E Framework in the Policies to aid in the monitoring of the polices compliance and hold employees accountable while providing a direction for decisions. Quarterly reporting of policy implementation status to Executive Management Committee for review and further decision making will begin in the third quarter.

In addition, the Hospital will be carrying out Policy impact evaluations to establish as to whether the policies are meeting the set goals and objectives. With effective policy management, KNH will be on track to being a world class patient-centered specialized care hospital

To scaling greater heights: Dr. Idris Chikophe

By Linnette Leyi and Dr. Jane Gwaro (Anaesthetist)

We spend a greater part of our adult lives at work, climbing up the career ladder. Sometimes, we grow so fond of our colleagues that our colleagues even feel like a second family, such that when we have to leave the work place permanently for whatever reason, we feel like we are losing a part of ourselves.

This is what nurses and doctors from the Department of Anaesthesia and Critical Care felt when they had to bid goodbye to their colleague Dr. Idris Chikophe who had to leave the Hospital for greener pastures.

They shared their nostalgic memories during the surprise party they held for him at a restaurant in Upper hill.

Dr. Chikophe joined Kenyatta National Hospital in 2016 where he worked as a consultant anaesthesiologist, specialized in paediatric cardiac anaesthesia and intensive care.

His colleagues all said one thing that stood out: he was passionate about intensive care. “He trained Medical Officers (MOs) on Intensive Care. This really helped build capacity for the Hospital because these MOs can now work at the different ICUs where there are no registrars,” said Dr. Jane Gwaro.

He was very critical in Intensive Care as the department only had two intensivists. In addition to his professionalism, his colleagues described him as friendly, easy-going, very knowledgeable and dedicated.

Dr. Betty Owure, Medical Specialist, eulogized him as a go-to person for consultation. “He was always ready to help whenever we called him. I hope we can still do that even if we are not working in the same institutions,” she further added.

Dr. Patrick Olang’ Chair of Department within the juniors, available to supervise

The event was also attended by “Dr. Chikophe’s impact was felt by everyone. department. We miss him,” said

The intern’s experience

By Samira Yusuf Meet: Mercy Koech Department: Paediatrics

Roles: Receiving medical reports, administering medication to patients, dressing wounds, assisted feeding etc.

Your learning experience: It has been great gaining experience from medical practitioners within the hospital, they were receptive and gave me the chance to implement what I had

The nurses from the Critical Care Unit noted that he was a good mentor, research coordinator, a resource person, kind hearted, social, humble, refined, vibrant, passionate in-patient management especially the paediatric patients, had tremendous skills (for instance for central line insertion in children), implemented evidence-based medicine and was always within reach even when off duty.

Dr. Chikophe was overwhelmed by this gesture. During his speech he mentioned that he always loved science and he had achieved a lot working in KNH enjoying every minute from clinical practice, imparting knowledge and even recording lectures that were later useful to all the staff; to developing apps to aid in data collection and analysis. He would miss working in this environment and the KNH staff.

All those present at the event wished him well in his next endeavor.

learnt in school.

What you love about KNH: I have gained a lot of exposure to work environment as well as the ability to handle complex situations and patients who need extra care considering that KNH is a referral hospital.

Future plan: I want to further my studies by pursuing my Master’s degree abroad.

Parting shot: KNH has played a pivotal role in moulding my career and I look forward to making the most of my opportunity here.

PHOTO | LINNETTE LEYI Nurses and Doctors from the Department of Anaesthesia and Critical Care Unit join Dr. Chikope in a group photo during his farewell party

Dr. Idris Chikophe - Consultant Anaesthesiologist, specialized in paediatric Cardiac Anaesthesia and Intensive Care.

Exploring Professional Healthcare Chaplaincy at KNH

By Moses Njomo

The Newsline was privileged to catch up with Rev. Jecinta Kiugi and John Kanyi both who are professional health care chaplains and extracted the following interview.

In health care institutions such as the Kenyatta National Hospital (KNH), the role of chaplaincy is to enhance holistic care to the patients leading to positive outcomes. Holistic care entails physical, mental, and spiritual care since all human beings have a body, mind and spirit which are all interdependent; you cannot ignore either and this commitment is reemphasized in our social media hashtag, ‘KNH Inakujali’.

The chaplain, therefore, is a part of the healthcare multidisciplinary team since spirituality helps the patients in expressing their human despair, find meaning in life’s struggles, and transcend their own emotional distress.

A hospital chaplain is a professionally trained clergy member who supports patients and staff with spiritual and religious concerns. He or she is clinically trained to help navigate the healthcare experience.

Healthcare chaplains are specially trained to support belief systems across faiths and cultures. In order to better meet the needs of patients, chaplains receive more than 1,600 hours of training focused specifically in healthcare settings and are certified by specific international institutions.

KNH Health Care chaplain, Rev. Jecinta Kiugi, explains that Healthcare Chaplains are key personnel and clinically trained, to play a pivotal position in

contributing to the achievement of the hospital’s vision and mission. The caregivers and staff face harrowing and stressful situations and thus chaplains have an evolving role in spiritual support to healthcare teams towards; improved clinical outcomes, influencing better decisions about care and enhancing staff morale.

She further explains that there is a thin but profound line between religious care and spiritual care. It is therefore prudent to clearly distinguish between religious care and spiritual care in a hospital setup. What patients need is spiritual healing to support their physical and mental healing.

“In professional chaplaincy we say that all religious care is spiritual but not all spiritual care is religious,

mandate of quality patient care.

“The chaplain explores the patient`s situation to identify the needs, hopes and resources of the patient that can help them cope and make meaning out of their situation. All care must be recorded and where professionalism is upheld the chaplain should also chart like all the other medical practitioners,” said Rev. Kanyi.

The duo summarizes reasons as to why Healthcare Chaplaincy is paramount;

They highlight that Professional healthcare chaplains help the patient, loved ones and staff to find meaning and comfort in their struggles. Spiritual struggles are real and we all can tell when we feel rejected, lonely and many other feelings.

It is also evident that most patients have a sense of abandonment and loneliness while receiving medical care, the chaplain intentionally listens to the patient and makes spiritual interventions.

PHOTO | STEVE ARWA Professional Healthcare Chaplain, Mr. John Kanyi attending to a patient in the ward

PHOTO | STEVE ARWA Professional Healthcare Chaplain, Mr. John Kanyi

Arise and Shine

By Moses Njomo

Kenyatta National Hospital’s (KNH) 17th Annual Prayer Day was held on the 14.12.2022. The open space on the second floor of the iconic Tower block hosted this year’s event.

This year’s theme was ‘ARISE AND SHINE’ drawn from Isaiah 60:1-3. Despite the challenges in our work place and in our personal lives, the commands in the verse are meant to be transformative. The downcast can become uplifted, failure can turn to success, weeping can be changed to joy and the sick can be healed. In fact, any situation that is identical to darkness can be reversed when the light of God shines through that situation.

Both these words ARISE and SHINE are indicative of positive change. They both connote improved standard of life, particularly in line with God’s plan as described in Jeremiah 29: 11 ‘For I know the plans I have for you, declares the Lord, ‘plans to prosper you and not to harm you, plans to give you hope and a future’.

HOU Chaplaincy, John Kariba in his remarks, welcomed all attendees and acknowledged the presence of the senior management representatives; he did not forget to appreciate the prayer day committee for organizing

and coordinating the event.

Led by the Mr. Gyviria Odhiambo, the KNH-choir chairperson, in their melodious harmony enriched the programme by churning out beautiful tunes.

Representing Director Nursing Services, Mrs. Rose Wafubwa, reminded staff that despite of the tides and storms that have rocked the year 2022, it’s only by Gods unmerited grace and love that the hospital has withstood. She encouraged the staff to exemplify greatness in their duty as a thanksgiving to God for seeing the institution through. “Colleagues His love is 100% for us she concluded her remarks.

Representing Senior Director Clinical Services Dr. Irene Inwani, Director Health Care Quality, Dr. Lydia Okutoyi, acknowledged the role of the Chaplaincy Unit for their contribution in holistic care. She encouraged the staff to anchor their hope and trust in God. ‘It is common for health care workers to experience compassion fatigue but it is only God who can equip us with the strength to continue” she concluded by reminding the staff to reflect and acknowledge that it is indeed God who has enabled us To reach this far.

Representing the Chief Executive Officer, Dr. Alfred Birichi,

Director, Pharmaceutical Services reiterated the previous speakers by acknowledging that God has been the hospital’s anchor despite of the challenges. He mentioned the central role of God in our lives as he referenced the Kenyan National anthem and the Kenyan constitution which have emphasized that. He appreciated the Chaplaincy Unit for their contribution in holistic and for care and reassured them of management’s commitment in supporting such initiatives. “Despite of the advancements in medicine, God has an apex position in the healing process” he said. He concluded by reminding the audience that God works through people and that is how we can impact the love of God to those in despair.

In summary, though as a hospital we have challenges since the COVID-19 pandemic and our personal finances are strained due to the hard economic times and occasionally we experience downtime in our spiritual lives we should be reassured that God’s power supersedes all situations if only we align to his teaching.

The event culminated with a benediction from Bishop Tobias Oloo, from the book of Numbers 6:24-26

PHOTO | AARON MULAMA

Representing Director Nursing Services, Mrs. Rose Wafubwa (L), Director Health Care Quality, Dr. Lydia Okutoyi (C) and Director Pharmaceutical Services Dr. Alfred Birichi (R) in attendance during the 17th KNH prayer day

PHOTO | AARON MULAMA Guest preacher Bishop Tobias Oloo from Bethel Ministries International

Hygiene saves lives

Lessons learnt from COVID-19 prevention measures

By Melody Ajiambo

Health experts have constantly advised that good hygiene habits; the simple practice of hand washing with soap and clean water, is one of the most effective ways to prevent the spread of germs and viruses.

In fact, the Global Hand washing Day celebrated on 15th October every year, was founded by the Global Hand washing partners, and is an opportunity to design creative ways to encourage people to wash their hands with soap at critical times.

During the COVID-19 outbreak, the importance of hand washing with soap to reduce the spread of the SARS-CoV-2 virus was overly emphasized. The ‘Komesha Corona’ national campaign by the Ministry of Health saw Kenyans eagerly advocating for hand hygiene and other health preventive measures like wearing a mask properly and social distancing. They disseminated that information through main stream media, wall art (especially in slums) and social media platforms.

The government, through the Ministry of Health, donation groups, philanthropists, business owners, and individuals stepped up to provide clean water and soap as the first line of defense against the virus. Public spaces, including those in rural areas had access to clean water and soap. This bore good results.

According to the journal published by BMC Public health, the trajectory of COVID-19 pandemic and hand washing adherence are wildly interdependent. Their findings from 14 countries indicated that higher numbers of covid-19 infections and resulting deaths were related to lower levels of hand washing adherence and vice versa.

Yet, preventing and reducing the spread of COVID-19 was not the only positive outcome of observing hand hygiene. Mr. Gideon Ndambuki, an officer from Kenyatta National Hospital IPC (Infection Prevention and Control) Department explains that the spread of other infectious diseases was significantly reduced. He states that the hospital witnessed a decline

in the number of hospital acquired infections (HAIs) and multidrug resistant organisms (MDROs) during the COVID-19 era.

To add to this, diarrheal diseases; the leading cause of death in children in Kenya, was lower in comparison to previous times. The economic survey data 2021 shows that diarrheal diseases dropped by 23.6 percent in 2020. This could be directly linked to the heightened adherence to hand

hygiene.

The COVID-19 era saw frontline health workers in KNH do their best to save as many lives as possible. This could be seen with how they played a critical role in advocating for hygiene behavior change and adherence to the COVID-19 prevention protocols put in place by the government. How we laud and appreciate all who worked to ensure the hospital ran smoothly and efficiently.

The economic survey data 2021 shows that the number of registered deaths in 2020 was the lowest recorded in five years. Could this be as a result of observing hand hygiene? We cannot positively link the two factors, however, what we know for sure is that we can draw lessons from the COVID-19 era as we have seen above. It is proof that good hygiene practices can save lives.

Ndambuki

“ The hospital witnessed a decline in the number of hospital acquired infections (HAIs) and multidrug resistant organisms (MDROs) during the COVID-19 era”

Mr. Gideon

The bull’s eye: setting targets the right way

By Carol Langat (Senior Strategy and Performance Officer)

“Aim for the moon. If you miss, you may hit a star.” Goes the adage by Clement Stone. Setting the right metrics cannot be over emphasized. Metrics are used to track and assess performance over a certain period.

They indicate how well you are doing towards achievement of the set goals. In today’s data rich and dynamic environment, it can be tempting to measure broadly, then cherry-pick the results that seem most captivating. But just because data is widely available doesn’t mean everything in it has meaningful insights.

In fact, the scale of data accessibility is precisely why organizations and individuals need to be more specific and perceptive when choosing what to measure to improve outcomes. It may sound simple, but people often struggle when it comes to measuring performance.

Kenyatta National Hospital has an elaborate Performance Management System (PMS) that is aimed at achieving the organizational vision, mission, and objectives by enhancing performance. The PMS entails a three-tier cascading framework, well defined reporting criteria and performance measures.

The Hospital has been implementing performance contracting from the year 2005 as the main performance measurement tool. Performance Contracting is part of the broader public sector reforms aimed at improving efficiency and effectiveness in the management of the public service. This result-based management tool emphasizes on

improving performance and ensuring activities achieve the desired results.

The Hospital has adopted a cascading model that breaks down its strategic imperatives into actionable plans. Performance Contracts are cascaded from the Board of Management to the various functional areas who in turn cascade them to individual through the staff performance appraisal system.

This system enhances linkage between organizational strategic objectives, work plans and individual performance targets. Individual staff are required to set targets which are mutually agreed with their supervisors based on the

departmental performance contract, the core functions, job description and work assignments.

Gains and pains

The Hospital has made huge strides in as far as target setting and performance management and measurement is concerned. There has been an increase in the number of staff appraised from 3,193 (68%) in the financial year 2015/16 to 4,994 (96%) in 2021/22.

According to Mr. Job Makanga, OGW, the Senior Director Corporate Services “This can be attributed to the relentless effort by the various technical teams, support from various stakeholders and the top management good will and passion for result-based performance,” he said. This can further be demonstrated by the significant improvement in the Board Performance Contract composite score trends as well as the staff performance appraisal scores.

However, the Hospital has experienced a myriad of challenges in its effort to implement performance management. The elephant in the room has been target setting. This has compromised the quality of the end results thus making it difficult to link the actual performance of an individual staff to the reported performance.

Mr. Vincent Chagara, Chief Manager Strategy and Performance reiterates the critical role target setting plays he says, “A well designed performance management system utilizes appropriate performance measures that supports the achievement of the overall goals and objectives of the hospital. Essentially it enhances better communication between the various levels of management, leads to increased productivity, and increased efficiencies as well as improved job satisfaction for the supervisors and individuals.”

Setting meaningful targets

Observe the following key guiding principles when setting targets:

• Begin with the end result in mind. Understand what you are trying to achieve. The quality of the output is dependent on quality of targets set at the beginning of the cycle. Measure the right things, after all, what gets measured gets done.

• Cover all the significant

performance areas i.e the targets set should be relevant to the functional area, individual’s job description and work assignments as well as the hospital strategic objectives.

• Should NOT be arbitrary. Base targets on current knowledge; existing baseline data; Best practice results and the required level of performance by the organization.

• Consider stretch targets to achieve high level of performance.

• Aligned to departmental objectives and is linked to hospital goals.

• Should be SMART: Specificsetting specific goals with clear expectations; Measurableeasy to track, monitor and measure; Achievable- realistic and attainable; Relevantrelevant to a functional area, to the individual job scope and supports the achievement of hospital goals. Timeboundhave a certain target date or a timeframe in which they have to be achieved.

• Understand the nature of targets you are dealing with; Targets that are constant throughout the period; Targets that are divisible among the four quarters and those measured by implementation of activities.

• Cascading of targets. Cascading occurs in three ways.

o Performance indicator: measurable value by which performance is assessed ie absorption of allocated funds, reduce average length of stay.

o Target: The desired level of performance for performance indicator

o Initiatives: Planned activities towards the desired level of performance

• Allocate weights appropriately to each target. Weights should be distributed to the various performance targets in negotiated proportions based on the relative importance that is attached to each indicator.

The Hospital, with the understanding the critical and indispensable role performance measurement plays in the overall realization of the strategic aspirations, has adopted a raft of measures to ensure that performance management is enhanced.

“Continuous Staff training and sensitizations on target setting through various platforms is ongoing. Further, in a bid to streamline target setting for employees who perform similar duties, the hospital has developed standardized appraisal tools to guide the process.” says Mr. Henry Karuti, Senior Strategy and Performance Officer.

Our story in pictures

PHOTO | DOREEN NYABOKE

Director Facilities and Services Engineer Richard Binga on behalf of CEO KNH Dr. Evanson N. Kamuri, EBS planted a tree at the Administration Block grass lawn area in commemoration of this year’s International Anti-Corruption Day on the 9th December, 2022.

PHOTO | STEVE ARWA

Rotary Club of Nairobi South visited KNH where they donated gifts as part of their Chrismass festive outreach. KNH appreciates your donations

PHOTOS | MOSES NJOMO

PHOTO | STEVE ARWA Nissan Patrol Club, Kenya visited KNH Paediatric Wards where they interacted and distributed Chrismass goodies to patients.

PHOTO | STEVE ARWA

Head of Mental Health Dr. Ian Kanyanya (C) celebrates a fruitful year with colleagues during the departmental end year party held on 16th December, 2022.

Directors, Heads of Departments and Units under the Division of Corporate Services pose for a photo after a meeting to review the years activities at SDCOS Job Makanga’s office on Monday 19th December 2022

KPCC spreads festive cheer

By Edel Q. Mwende & Petterson Njogu

Celebrating Christmas in a hospital is generally not a pleasant experience for patients. The KNH Prime Care Centre (KPCC) however, has made this a season to spread festive cheer and raise awareness about KPCC services through a Christmas campaign themed #12DaysOfChristmas. It was officiated by KPCC Senior Director, Dr. John Ngigi and will run from 14th December to 25th December 2022.

Senior Director’s Staff Appreciation

On 14th December 2022; the first day of KPCC 12 days of Christmas, Dr. Ngigi appreciated five (5) staff for their outstanding performance in 2022. They include Mr. Lawrence Muthiani and Ms. Cynthia Vwenda (Nursing), Mr. Mike Ayienga (Housekeeping), Ms. Josephine Ngila (Finance) and Ms. Ann Wanja (Catering).

“We issue this token to these few employees who are a representation of us all. This appreciation portrays hard work and excellence at KPCC and everyone should feel a part of it,” said Dr. Ngigi while issuing the five with recognition certificates and shopping vouchers.

Additionally, he commended the Manager, Marketing & Communication-Ms. Edel Mwende for being feted as a Rising star in Marketing during the 5th African Marketers Conference & Awards 2022.

Dr. Ngigi donates a vein viewer to ward 9A (Paediatric ward)

The Senior Director, KPCC sacrificed a portion of his salary towards more vein viewers for the KPCC paediatric ward. A vein viewer is a hand-held device that projects a map of the patient’s veins on the surface of the skin.

“This vein viewer will go a long way in aiding pediatric cannulation at the facility,” said Dr. Ngigi.

While handing over the equipment to ward 9A, he also went ahead to give a rallying call to everyone to embrace the spirit of giving during this festive season. “Let’s give the little we have to people out there who

truly deserve it,” he added.

Celebrating inpatient at ward 10A admitted for 486 days

Mr. Kennedy Nyabuto is an inpatient who has been admitted in ward 10A KNH Prime Care Centre (KPCC) for 486 days. He has been on treatment since 16th August 2021. In the spirit of #12DaysofChristmas, the KPCC Customer Care Committee together with his family, held a surprise birthday for him on his birth date; 14th December.

Kennedy was admitted to the Prime Care facility after a horrifying accident a little over a year ago.

Seeing his children for the first

time since admission, Kennedy could not hide his delight and joy. He was joined by his family in expressing deep gratitude for the excellent care he has received from the Private Wing team since admission.

“I’m lost for words for the wellplanned birthday surprise, I would also want to thank all the doctors, nurses, nutritionists, physiotherapists, and all the support staff for taking care of me this far. Thank you so much and may God bless you,” Mr. Kennedy concluded.

Managers & KPCC staff sing “We wish you a merry Christmas”

To show appreciation towards their clients, the KPCC team sang a

PHOTO | STEVE ARWA Senior Director,KPCC-Dr. John Ngigi addresses staff during the 2022 final consultative meeting with representatives from various KPCC sections

PHOTO | STEVE ARWA

KPCC staff L-R ; Ms. Cynthia Vwenda, Ms. Josephine Ngila, Mr. Mike Ayienga and Mr. Lawrence Muthiani hold their appreciation certificates & vouchers for their exemplary performance in 2022

Christmas carol to them to elevate their spirit this festive season.

Festive messages from various KPCC service areas

Various KPCC service points (Pharmacies, 10C-Surgical Women’s, 9A- Paediatric ward, 10B-Medical Men’s ward, 9B-Oncology ward, Zarina Merali Day Care Centre-

Oncology outpatient, New Born Unit, Staff Clinic, KPCC Corporate Outpatient Clinic (COC), 10D-Medical Women’s ward, 9C/theaters and 9D-Maternity ward will be sharing festive messages within the #12DaysofChristmas campaign theme targeting patients, relatives, staff and the general public.

History Check:

The steady growth of the Pharmacy and Manufacturing Unit at KNH

By Philip Etyang

The growth and development of pharmacy in Kenya is closely linked to the development of the Native Civil Hospital, now Kenyatta National Hospital (KNH).

In the beginning, KNH Manufacturing Unit was compounding various combinations to come up with medicines. However, a 2015 Business Monitor Report on Pharmaceutical industrial base in Kenya, claimed that the country plays host to the largest pharmaceutical industrial base in the East African region.

The main unit was to compound various combinations because at that time there were very few, if any factory prepared drugs. All prescriptions were given with instructions on how to compound and mix different ingredients in a particular prescription.

The production of pharmaceuticals requires a broad range of packing

and raw materials. This was a challenge during the pre and postindependence period for Kenya and therefore, the industry started relying more on imports as opposed to locally produced pharmaceuticals which were much more expensive

than their imported counterparts.

Since Latin was the lingua franca of scientific work in the West during the Middle Ages, it was the language of the prescriptions used as well at the KNH Manufacturing Unit. Majority of the ingredients used were plant

Kenyatta National Hospital

PHOTO | STEVE ARWA

Senior Director KPCC-Dr. Ngigi hands over an appreciation certificate to Ms. Ann Wanja (Catering) during the Senior Director Staff Appreciation event.

PHOTO | STEVE ARWA Dr. John Ngigi donates a vein viewer to ward 9A in the spirit of #12DaysOfChristmas

PHOTO | STEVE ARWA Inpatient oncology pharmacy at KNH

derived and hence the use of Latin for descriptions for example;

Oleum Gossypii semis (cotton seed oil), Aurantii Gortex Siccatus (dried bitter orange peels).

Records at KNH indicate in the early years, the pharmacy personnel included one European Dispenser and one Hospital Compounder, both very important agents in the manufacturing process.

The then Kenya Medical Training Center (K.M.T.C) which was spearheaded by the British during the advent of colonialism at the Medical Training Depot situated in Kabete in the early 1920s and eventually becoming the Buller Camp for military personnel is indeed the cradle of pharmacy training in Kenya. By 1960, training of pharmacists intensified and dispensers were now being trained at the facility.

Between 1950 and 1969, the Pharmacy Department at KNH which was made up of the Main Pharmacy, Sterile Preparations Unit, and the Drug Store were situated at the present Supply Chain Department block which also houses the biological parents of this great production ‘Newsline,’ the Marketing and Communication Department as

well as the Central Registry. The main Pharmacy mainly dispensed pharmaceuticals to the wards as well as the issuing of drugs classified as dangerous drugs. Out-patients on the other hand, were being served at the present incinerator site near the old bus terminal.

Sterile preparations Unit/ Manufacturing Unit (SPU)

The Sterile Preparation Unit at KNH has been in existence since its inception in 1972 when it moved to its present site. The main objectives of the unit upon set-up were:

- To provide creams, simple syrups and suspensions, IV fluids and injectable drugs to the Hospital where possible.

- To sell the excess drugs to outside markets and hence generate income for the hospital.

- To assist the ordinary Kenyan who cannot afford expensive drugs to acquire them more cheaply where possible.

In the 1970s, the Unit was operating on a small-scale basis, yet there was increased demand from government

hospitals for Intravenous Fluids (I.V) from SPU. By the late 1980s, the equipment that was in use was old, dilapidated and inefficient with a tendency to breakdown at inopportune times leaving staff idle and the hospital buying vital I.V fluids. The Unit also faced problems in the importation of rubber stoppers and infusion bottles.

During the Rehabilitation Project, SPU received new equipment. With the delivery of the long-awaited distiller and the Unit went into full time production and therefore, meeting the increased demand from its production line. Pharmaceutical manufacturers face constant competitive and regulatory pressure to upgrade their technological capabilities, and therefore the arrival of the distiller at KNH revolutionalised pharmaceutical production not only at the facility but in the country as a whole.

Currently, Kenya is the largest manufacturer of pharmaceutical products, supplying around 50% of the products, in the COMESA (Common Market for Eastern and Southern Africa) region.

PHOTO | STEVE ARWA

The KNH Drug store

By Edel Q. Mwende

Comic Zone

Santa’s disease

What does Santa suffer from if he gets stuck in a chimney?

Claus-trophobia!

Snowman temper tantrum

What is it called when a snowman has a temper tantrum? A meltdown.

Inspirational Quotes

1. My idea of Christmas whether old-fashioned or modern is very simple: Loving others. Come to think of it, why do we have to wait for Christmas to do itBob Hope 2. Peace on earth will come to stay when we live Christmas every day- Helen Steiner Rice 3. Gifts of time and love are surely the basic ingredients of a truly merry Christmas-Peg Bracken 4. Nothing seems to bring people together like Christmas-Steven Dodrill 5. Christmas isn’t a season. It’s a feeling-Edna Ferber 6. Christmas will always be as long as we stand heart to heart and hand in hand- Dr. Seuss 7. To cherish peace and goodwill, to be plenteous in mercy, is to have the real spirit of Christmas-Calvin Coolidge 8. Christmas magic is silent. You don’t hear it — you feel it. You know it. You believe it-Kevin Alan Milne 9. At Christmas play and make good cheer, for Christmas comes but once a year-Thomas Tusser 10. He who has not Christmas in his heart will never find it under a tree-.Roy L. Smith