ANNUAL HEALTH BULLETIN
2013
LADY RIDGEWAY HOSPITAL FOR CHILDREN
ANNUAL HEALTH BULLETIN
2013
Message from the Director The Lady Ridgeway Hospital being the premier children’s hospital in Sri Lanka providing free health care services to needy children of the nation serves as the national referral center for pediatric care in the country. It also serves as the local pediatric hospital for population in and around Colombo city for minor ailments. As this hospital acts as a premier teaching children’s hospital under the Ministry of Health, it is responsible for undergraduate and most of the postgraduate medical and surgical paediatric training provided by all units of the hospital affiliated to the faculty of Medicine, University of Colombo and postgraduate institute of Medicine. This Annual Health Bulletin testifies the quantity and quality of services rendered by LRH during the past year. It carries lot of information to policy makers and health planners for future development of health service in the field of child health in the country. Reliable statistics provide true basis for future planning. Students who are interested of doing studies, research and any publication can utilize annual statistics of Lady Ridgeway Hospital. The staff of LRH handles huge loads of work, we have to look forward to reorganize and facilitate this service provision to the public by going through this health information. To provide quality and productive services we have to introduce more sub specialties of general paediatric practice in order to achieve our goal of reaching the best health care center for children in South Asia by 2020. Most of the statistics are not second to any other paediatric facility in the world. It is our duty to look forward the yearly services for the satisfaction of the customer. I take this opportunity to thank who took initiatives to make this publication a reality. Dr. A.L.A LINTON PADMASIRI (MBBS,DCH,MSc,MCMA) Director Lady Ridgeway Hospital for Children (Teaching) Colombo 08
Lady Ridgeway Hospital for Children
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The Lady Ridgeway Hospital (LRH) is the largest public free of charge pediatric Hospital in the world. It serves as the National referral center for pediatric care for Sri Lanka . It also serves as local hospital for the population in and around Colombo city for minor ailments. The hospital has approximately over 900 beds and it treats children below 12 years of age from all over the country. It has all supportive services required to provide quality patient care. The total number of staff is over 2000 staff members. The medical staff consists of nearly 55 consultants and nearly 300 medical officers. They are organized as medical teams headed by permanent senior consultants who have international experience in that particular specialty. Nursing staff consists of nearly 700 nursing officers and are organized as teams in line the organization of Doctors.
Our Vision To make LRH the Best Health Care Centre for Children in the South Asia within this decade.
Our Mission Provision of consumer oriented comprehensive, best quality healthcare for children in Sri Lanka at all times through a motivated, efficient and trained team of health care staff to the maximum satisfaction of all health care seekers and to train undergraduates, post graduates and other health personnel in child care effectively.
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History of the Lady Ridgeway Hospital
The Lady Havelock Hospital 1910
During the period 1890-1895 when Sir Arthur Havelock was Governor of Ceylon, one of this greatest achievements was marking available many advances and new awareness in medical science to the island’s inhabitants. Until the 19th Century, children were treated as miniature adults before pediatrics emerged as a specialty. So one chief medical institution for which this Governor was officially responsible, although his wife proved the impetus, was a Children’s Hospital 17th January 1895 the Governor laid the foundation stone of what was to be called the Lady Havelock Hospital for Women and Children. It took over a year to build , by which time sir Arthur Havelock had been succeeded as Governor by Sir Joseph West Ridgeway, and so it was Lady Ridgeway who ceremonially opened the hospital on 12th October1896. 26th February 1910 Sir Henry Edward McCallum, the Governor of Ceylon Laid the foundation stone for Construction of a separate block for children. The building was erected with public subscriptions an the former first , Lady Ridgeway had been energetic in fund raising for this project. 27th September 1910 Ceremonial opening of the new section, the Lady Ridgeway block for the Children.1937 The qualified pediatrician for the hospital Dr. L.O Abeyrathne was appointed as the Physician and the medical Officer in Charge of the Hospital. 1950 -After independence in 1948 the Ministry of Health adopted plans to progressively reconstruct the LRH. The first wing of the new hospital containing new ward was opened in 1950.
Lady Ridgeway Hospital for Children
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ANNUAL HEALTH BULLETIN
Lady Lina Ridgeway
2013
The Lady Havelock Hospital ceremonially opened by Lady Lina Ridgeway
Lady Ridgeway Hospital for Children
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Directions of the Hospital Lady Ridgeway Hospital is situated near Borella town in Colombo District, Sri Lanka. There are two main entrances to the hospital via Maradana road & Baseline road. Entrance to the Accident Service, Orthopaedic clinic, Surgical clinic wards and administrative office is convenient through the Maradana road entrance of the hospital. Entrance to the Out Patient Department, Emergency Treatment unit, medical wards and most other clinics is convenient through the Baseline Road entrance of the hospital. Only authorized vehicles are allowed to enter the hospital expect for ambulances and vehicles caring critically ill children. Visitors to the inward patients need to produce valid pass given on admission and are allowed only during visiting hours.
Address- Lady Ridgeway Hospital For Children Dr. Denister De Silva Mawatha Colombo 08, Sri Lanka
Lady Ridgeway Hospital for Children
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Head of the Organization Hospital Director Dr. A.L.A LINTON PADMASIRI Telephone no 0112691521 rathnasiri@health.gov.lk General Information Telephones : 0112693711, 0112693712 Fax No : 0112686859 Email : directorlrh@yahoo.com Website: www.ladyridgewayhospital.lk Services offered
Accident and animal bite casualty care for children Out patients medical and surgical care for children General medical care for children General surgical care for children Heart (cardiology) care for children Eye (Opthalmolgy) care for children Ear, Nose, and Throat (ENT) care for children Skin(Dermatology) care for children Neurology care for children Kidney (Nephrology ) care for children Orthopaedic care for children Child Guidance /Psychiatric care for children Rheumatological care for children Cardiothoracic surgical care for children Plastic surgical care for children Cancer (Oncological) care for children Dental & Orthodontic care for children Child immunization services Occupational therapy service for children Physiotherapy service for children Language and speech therapy service for children Dialysis unit Endocrine Unit Laboratory services
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ANNUAL HEALTH BULLETIN
Hospital staff Category of Personnel 1 Medical Officers
Male
Female
Administrative Grade (Senior and Deputy)
01
Specialists (curative care) Grade Medical Officers Medical Officers (Blood Bank) Intern Medical Officers PGIM Trainees Post Intern MOO 2 Dental Surgeons Consultant Dental Surgeons Dental Surgeons 3 Registered Medical Officers 4 Nurses Matrons Ward Sisters Nursing Officers 5. Deputy Director (Finance) 6 Administrative Officer 7. Medical Records Officers 8 Pharmacists 9 Special grade MLTT Medical Laboratory Technologists 10 Radiographers 11 Physiotherapists 12 Speech Therapists 13 Occupational Therapists 14 Dental Technicians 15 Ophthalmic Technicians 16 Public Health Inspectors 17 ECG Recordists 18 EEG Recordists 19 Dispensers 20 Audiology Technicians 21 Orthopaedic Technicians 22 Boiler 23 Surgical Appliances Maker 24 Development Assistant 25 ICT Technician 26 House Warden 27 Perfutinist 28 Public Management Assistant 29 Physicist 30 Ward Clerk 31 Librarian 32 Lift Operator 33 Lab Orderly
26 123 01 15
26 192 06 22 105
10
20
01
01 09 03 05 28 687 01
01 10 11 12 03 03 03 01 02 01 02 01 01 01 04 02
06 04
12 04
03 19 01 20 01 10 04 05 01 03 04 10
03 02 04 01 18 01 01 01 06
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ANNUAL HEALTH BULLETIN
Category of Personnel Health Drivers Cooks KKS Limb Maker Prosthetist & Orthotist Telephone Operator Shoe Maker Plumber Welder Hospital Overseer Saukya Karyaya Sahayake Saukya Karyaya Sahayake(Subtitute) Diet Stewardess Seamstress
Male
Female
10 17 01 01
03 02 01
03 01 01 01 02
01 456 119 05 04
Distribution of Specialists Specialty Cardiologists
Cardiothoracic Surgeons Neurologists Dermatologists Rheumatologists Psychiatrists Pediatricians Pediatric Surgeons ENT Surgeons Eye Surgeons Orthopedic Surgeons Plastic Surgeons Anesthesiologists Histo- Pathologists/ Chemical Pathologists Hematologists Bacteriologists/Microbiologists Radiologists Pediatric Critical Care Resident Pediatrician Orthodontists Endocrinologists Nephrologists
Number of Consultants Male Female 02 03 01 01 02 01 02 03 06 04 01 02 01 01 03
01 01 04
03 02 01 01 02 01 01 01 01
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List of Consultants in LRH Name Prof. M. Senanayake Prof Shyma De Silva Prof Pujitha Wickrmasinghe Dr. Jithangi Wanigasinghe Dr. Ruwangi Dissanayake Dr. Samanmalee Sumanasena Dr. U.S. S. Waidyanatha Dr. Devan Mendis Dr. M.B.A.L.P Wijesooriya Dr. R. C. Ediriweera Dr. .P.M.G. Punchihewa Dr. W.D.J De Silva Dr. Srilal De Silva Dr. R.M.M.N.C Kithulwatta Dr. Y. Ramya De Silva Prof. Ranjan Dias Dr.Malik Samrasinghe Dr. Chandima Suriyaarachchi Dr. B.A.D Jayawardena Dr. A.K .Lamahewage Dr. (Mrs) U.A.R Ranawake Dr. A.D.K.S.N. Yasawardena Dr. K.D.R.A Kirihena Dr. Romesh Gunasekara Dr. Kanchana Singappuli Dr. Y.K.M. Lahie Dr. M. Munasinghe Dr. Sunil Wijesinghe Dr. (Mrs) Irugalbandara Dr. (Mrs)S.H.M De Silva Dr.(Mrs) N.A.V.C.T De Silva Dr.(Mrs) L Samraweera Dr. Ashoka Gunarathna Dr.(Mrs) Anoma Perera Dr. D. Jayawickrama Dr.E.M.J. Premarathna Dr. Jerad Fernando Dr. Kishani Pathirane Dr. R.A.N.K.K Samrasinghe Dr. (Mrs)C.S. Perera Dr. (Mrs) M.M. Jayathilake Dr. (Mrs) Iresha Jasinghe Dr.(Mrs) Kumudu Karunarathne Dr. S.N. Perera Dr.Duminda Samrasinghe Prof. J.K.K sennavirathne Dr. Janaka Akarawita Dr.(Mrs) S. Wijethunga Prof. Hemamali Perera Dr. A.S. Basnayake Dr. (Mrs) P. Rathnayake Dr. P.S.M.A.B Padeniya Dr.(Mrs) W.D.V.N Gunasekara Dr. (Mrs0 C.P Pethiyagoda Dr. Harris Pathirage Dr. U.S. Hettiarachchi Dr. Anura Jayawardena Dr. Merna Cabral Dr (Mrs) Navoda Attapattu
Designation consultant Pediatrician consultant Pediatrician consultant Pediatrician consultant Neurologist consultant Pediatrician consultant Pediatrician consultant Pediatrician consultant Pediatrician consultant Pediatrician consultant Pediatrician consultant Pediatrician consultant Pediatrician consultant Pediatrician Paediatric Critical care consultant Pediatrician consultant Pediatric Surgeon consultant Pediatric Surgeon consultant Pediatric Surgeon consultant Pediatric Surgeon consultant Pediatric Surgeon consultant Pediatric Surgeon Consultant ENT Surgeon Consultant ENT Surgeon Consultant Plastic Surgeon Consultant Cardiothoracic Surgeon Consultant Cardiothoracic Surgeon Consultant Cardiothoracic Surgeon Consultant Orthopaedic Surgeon Consultant Eye Surgeon Consultant Rheumatologist Consultant Anaesthetist Consultant Anaesthetist Consultant Anaesthetist Consultant Anaesthetist Consultant Anaesthetist Consultant Anaesthetist Consultant Radiologist Consultant Radiologist Consultant Radiologist Consultant Histopathologist Consultant Hematologist Consultant Chemical Pathologist Consultant Kumudu Karunarathne Consultant Cardiologist Consultant Cardiologist Consultant Dermatologist Consultant Dermatologist Consultant Psychiatrist Consultant Psychiatrist Consultant Orthodontist Consultant Neurologist Consultant Neurologist Consultant Nephrologist Consultant Paediatrician Consultant Paediatrician Consultant Paediatrician Consultant Paediatrician Consultant Paediatrician Consultant Endocrinologist
Ward/Unit 01 01 01 01 01 01 02 03 04 08 09 VP-OPD MICU MICU SCBU 5 05 07 10 11 VS-OPD 12 12 14 20 20 20 14 22 06 Operating Theatre(SICU) Operating Theatre(SICU Operating Theatre(SICU Cardiothoracic Unit Cardiothoracic Unit Cardiothoracic Unit Radiology Department Radiology Department Radiology Department Laboratory Laboratory Laboratory Laboratory 15 15 19A 19A Psychiatrist (clinic) 19B Orthodontic unit Neurology Clinic Neurology Clinic Nephrology Unit RP RP RP RP RP Endocrinology Clinic
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1 Out Patients Service 1.1 Out Patient care The Out patients Department (OPD ) and the Accident services department of this hospital is open for 24 hours a day for 365 days. Out patients clinics conducted by the relevant consultants of inpatient units and visiting consultants of the OPD maintain a continuous link with patients discharged from their units. There is also an emergency treatment unit, diarrhea unit and immunization clinic which operate in the OPD to improve the quality of care. * Here each patient gets multi services according to the need. Table 1.1 Performance of out Patients Department 2013 No of Patients No of First Visits No of Subsequent Visits No of Emergency Patients (Ward Admissions) Emergency Treatment Unit OPD Visits (Accident Service) Diarrhoea treatment unit Observation unit No of patients treated for injuries in the dressing room Rheumatic clinic Lactation Management unit Nutrition clinic Non Communicable diseases Total No of Patients Encounters
No of Specimen taken Mantaux test
391879 32078 87271 34695 39906 25340 8070 7841 995 2335 2244 1493 634147
47293 561
Table 1.2 Ward Admissions Emergency Treatment Unit Diarrhoea Treatment Unit Dengue Observation Unit
No of Patients 7856 144 2434
Table 1.3 Table 1.4 OPD Deaths No of Deaths Death on admission After admission
24 08
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ANNUAL HEALTH BULLETIN 2 Out Patients Services- 2013
Lactation Management center Referred from wards
referred from OPD
893
491
Direct
1st visits
94
2nd visits
1478
857
Total
Cleft palate & Lip
2335
207
Table 2.1
Nutrition Clinic 1st visits
Sub visits
Over 5 years
Total
782
1336
126
2244
Nutritional Stages 1SD 310
2SD 578
3SD 979
Median 38
Refered to MOH
Stu nte d
24
06
Wasted
Stunted & Wasted
72
59
Table 2.3
Non Communicable Diseases Control unit Diabetic Patients
Newly Diagnosed 61
Sub visits 523
Obesity Patients
Total 586
Newly Diagnosed 574
Sub visits 333
Total
Councelled adult Patient
Community Programme
Inservice Programms
41
38
01
Total 907
1493
Table 2.4
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3 Accident Service Department Accident service department at Lady Ridgeway Hospital provide emergency casualty care to children 24 hours a day, 365 days year. The department provides immediate attention to critical and life threatening casualties as well as minor urgent-care casualties following accidents and animal bites. There is separate 24 hour dispensary for accident service patients.
Performance of Accident service 2013
No of Patients Fall Trauma Animal Bite Foreign body Road Traffic Accident(RTA) Emergency Treatment unit Cut injury Burns Prick Injury Bicycle Spoke Injury Assault Deaths Crush injury Child abuse Electrocution Others Staff Total
15903 7361 4351 2123 1095 66 861 589 521 228 447 01 409 08 27 15 5901 39906
Table 3.1 OPD attendance of Accident service
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ANNUAL HEALTH BULLETIN
4 Immunization Immunization is the process whereby a person is made immune or resistant to infectious diseases, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or diseases.
Child Immunization Schedule Age
Vaccine
Remarks Before leaving the hospital, preferably within 24h of birth. (If a scar is not present 2nd dose could be offered after 6 months upto 5 years).
0-4 weeks BCG
2 months
Penta (D,T,P,HepB,Hib), OPV (1st dose)
4 months
Penta (D,T,P,HepB,Hib), OPV (2nd dose)
6 months
Penta (D,T,P,HepB,Hib), OPV (3rd dose)
9 months
JE
On completion of 2, 4 & 6 months. (For a defalter or for an un-immunized child, minimum 6 - 8 weeks gap between doses is adequate).
On completion of 9 months. st
12 months MMR (1 dose)
On completion of 12 months.
th
18 months DTP, OPV (4 dose) 3 years
On completion of 18 months.
nd
MMR (2 dose)
On completion of 3 years.
th
5 years
DT, OPV (5 dose)
On completion of 5 years.
12 years
aTD
On completion of 12 years.
Table 4.1 Schedule for Immunization
LRH Immunization clinic days:
Monday Tueseday Wednesday Thursday Friday Saturday BCG
Yes
-
-
-
-
-
Yes
Yes
Yes
-
Yes
Yes
-
-
-
Yes
-
MMR
-
Yes
Yes
-
-
-
ATD
Yes
Yes
Yes
Yes
Yes
Yes
Pentavalent / DPT / DT / OPV JE
Place / Time
Room No. 7 8.00am - 12.00noon
Table 4.2 Time table of Immunization
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ANNUAL HEALTH BULLETIN
Immunization services Age below 12 years Referral letter from a medical officer or as referred by the medical officer at OPD
Table 4.3 Performance of Immunization 2013 No of Patients
Type of Immunization (Vaccine) Polio
1st dose 2nd dose 3rd dose 4th dose Booster 5th dose Total 1st dose 3rd dose 4th dose Booster Total
DT
Tetanus Toxoid Hepatitis (B)
51 1st dose 2nd dose 3rd dose Extra Hep B Total 6 months 9 months 1.5 years 3 years 5 years Total
Vitamin A
Japanese Encephalitis Pentavalent
02 07 04 3 16 168 205 415 397 525 1710
1750 2 months 1st dose 4 months 2nd dose 6 months 3rd dose 4th dose Total
ARS (ERIG) ARV ARS (HRIG) Measles Rubella Mums(MMR) BCG ADT
472 374 418 556 769 2589 01 01 06 774 782
473 371 399 590 1833 99 6636 263 1234 242 917
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CLINIC CHART Specialty
Name of the consultant
Paediatric- Medical
Prof.M.Senanayake Dr.Shamya de Silva Dr.Pujitha Wickramasinghe
Ward - 01
Thursday 2pm-4pm (Renal) Saturday 8am –12noon
26 26
Paediatric -Medical
Dr.U.S.de.S.Waidyanatha
Ward 02
Monday 2pm-4pm
26
Thursday 8am –12 noon
26
Friday 2pm-4pm (Asthma)
28
Monday 8am-12noon
26
Thursday 2pm-4pm
28
Wednesday 8am-12noon (Renal Clinic)
35
Tuesday 2pm-4pm
28
Friday 8am-12noon
26
Tuesday 2pm-4pm
26
Wednesday 8am-12noon
26
Monday 2pm-4pm
28
Tuesday 8am-12noon
26
Friday 2pm-4pm
26
Paediatric -Medical
Paediatric- Medical Paediatric- Medical Paediatric Medical
Paediatric Surgical Paediatric Surgical Paediatric Surgical Paediatric Surgical
ENT
Dr. Devan Mendis
Dr.M.B.A.L.P.Wijesuriya Dr.R.C.Ediriweera Dr.P.M.G.Punchihewa
Ward no
Ward 03
Ward 04 Ward 08 Ward 09
Clinic days/Time
Place/Room no
Dr.Ranjan Dias
Ward 05
Tuesday 8am-12noon
28
Dr.Malik Samarasinghe
Ward 05
Wednesday 8am-12noon
28
Dr.Chandima Suriyaarachchi
Ward 07
Monday 8am-12noon
28
Saturday 8am-12noon
28
Tuesday 8am-12noon
28
Friday 8am-12noon
28
Thursday 8am-12noon
28
Saturday 8am-12noon
28
Monday, Wednesday, Saturday
31
Dr.B.A.D.Jayawardene Dr.A.K.Lamahewage
Dr.A.D.K.S.N.Yasawardene
Ward 10 Ward 11
Ward 12
8am-12noon Dr.K.D.R.A.Kirihena
Tuesday ,Thursday, Friday
8am-
12noon Plastic surgery
Dr.Romesh Gunasekare
Surgical OPD
Dr.U.A.R.S.Ranawaka
Cardio Thoracic
Dr.Lahee
Thursday 8am-12noon
35
VS – OPD
Ward 14
Monday to Thursday
30
WD – 20
Thursday 2pm-4pm
Acc.
Tuesday 2pm-4pm
Service.
8am-12noon Dr.M.Munasinghe Dr.Kanchana Singappuli Orthopaedic
Dr.S.wijesingha
Orthopaedic
Monday 7.30am-1.30pm
Unit
Tuesday 7.30am-12noon
Accident. Service
(Club foot Clinic) Wednesday 7.30a m1.30pm Opthalmology
Dr.D.Irugalbandara
Ophthalmology Unit
Rheumatology
Dr.Monika de Silva
Ward – 06
Monday to Saturday 8am12noon Friday 8am-4pm
23
Monday to Saturday 8am-12noon
Lady Ridgeway Hospital for Children
Wd-6
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ANNUAL HEALTH BULLETIN
Cardiology
Dr.Shehan Perera
Ward 15
Dr.Duminda Samarasinghe
Monday to Friday
62
8am-4pm Saturday 8am-12noon
Dermatology
Prof.J.K.K.Senavirathne
Ward 19A
Monday, Wednesday, Friday Tuesday,
(Skin Unit)
Thursday, Saturday 8am-12noon
33
Dr. Janaka Akarawita Child Guidance Clinic
Dr.S.Wijethunga
Room No.22
Monday & Friday
22
8am- 12noon Tuesday & Wednesday 8am-12noon Psychiatric
Prof.Hemamali Perera
Orthodontic
Dr.A.S.Basnayake
Psychiatric
Saturday -7am-1pm
Orthodontic
Monday to Saturday
Unit Neurology
Dr.P.Rathnayake Dr.Anurudda Padeniya
Nephrology
Dr.W.D.V.N.Gunasekare
Tuesday -1.00pm-4.oopm
(Clinic)
Neurology
22
8am-4pm
Wd 16
Monday 2pm-4pm
Clinic
Wednesday 2pm-4pm
Nephrology
Monday 8am-12noon
Room 32 Room 29
Thursday 2pm-4pm Haemophiliya Clinic
Wednesday 8am-3pm
New Wing 2nd Floor
Saturday 8am-12noon Monday to Friday 7am-4pm VP-OPD
Dr.Disna de Silva
VS-OPD
Dr.U.A.R.S.Ranawaka
Obesity Clinic
Dr.P.Wickramasinghe
Endocrinology Clinic
Dr.Shamya De Silva
OPD
07
Saturday 7am-1pm Monday to Thursday 8am-12noon
30
Wd 01
Thursday 8am-12noon
22
Wd 01
Monday 2pm-4pm
22
(3rd & 4th ) Child Development Clinic Cancer Clinic
Thursday 8am-12noon
WD 01
Dr.Damayanthi Pieris
Friday 8am-12noon
30
Dr.Lakshman Obeysekare
Monday 2pm – 4pm
30
Dr.Prasad Abeysinghe Dr.T.Skandaraja MDCC
Wd 14
2nd – 4th Friday 8am-12noon
35
FUC
Wd 14
1st & 3rd Friday 8am-12noon
35
Burns Clinic
Burns Unit
Tuesday 8am-12noon
35
PBU Clinic
PBU
Wednesday 2pm-4pm
26
Dental Clinic
OPD
Monday to Friday 8am-4pm
34
Saturday 8am-12noon
34
Monday to Friday 8am - 12 noon
36
Endocrinology clinic
Dr. Navoda Atapattu
OPD
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Table 5 Clinics by specialty 2013
Wards
No of clinics
Medical
01 02 03 04 08 09
VP /OPD RP/OPD Total Medical Surgical
05 07 10 11
VS/OPD Total Surgical ENT- Dr Yasawardena ENT- Dr. Kirihena Total ENT Skin Cardiology Rheumatology & Rehabilitation Neonatal Care unit Dental Orthodontic Orthopaedic Multidisciplinary CLAP (MCC) Child Guidance Total Child Guidance Speech & Language Child Development Renal Ward 01 Renal Ward 03 Total Renal Burns Eye Asthma Ward 02 Asthma Ward 09 Total Asthma Plastic Surgery Neurology - Dr. Piyara Rathnayake - Dr. Padeniya - Dr.Githangi Wanigasinghe Total Neurology
12 12
A B
No of Sub visits
Total visits
Average per clinics
48 95 96 98 96 97 291 290 1111 74 69 72 73 203 491 144 147 291 291 280 292 47 291 290 97 46 95 194 289 244 50 48 49 97 51 291 45 45
No of 1st visits 1428 2849 2252 2144 2743 2823 4720 4644 23603 961 720 1147 1250 4596 8674 4664 4514 9178 17642 9266 4333 30 13398 2033 5659 236 1296 2839 4135 2360 92 422 125 547 306 8861 104 39
2095 3387 4055 4312 3674 5097 7201 542 30363 4706 3752 3914 5131 6286 23789 7743 5477 13220 11412 16164 8232 46 3808 24278 5759 846 2380 7751 10131 4735 162 761 909 1670 667 10492 1076 333
3523 6236 6307 6456 6417 7920 11921 5186 53966 5667 4472 5061 6381 10882 32463 12407 9991 22398 29054 25430 12565 76 17206 26311 11418 1082 3676 10590 14266 7095 254 1183 1034 2217 973 19353 1180 372
73.4 65.6 65.7 65.9 66.8 81.6 41.0 17.9 48.6 76.6 64.8 70.3 87.4 53.6 66.1 86.2 68.0 77.0 99.8 90.8 43.0 1.6 59.1 90.7 117.7 23.5 38.7 54.6 49.4 29.1 5.1 24.6 21.1 22.9 19.1 66.5 26.2 8.3
50 166 125 48 339
599 876 709 155 1740
1274 5393 2936 2442 10771
1873 6269 3645 2597 12511
37.5 37.8 29.2 54.1 36.9
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Wards Nephrology Oncology Headache Intervention Obesity Endocrinology-
No of clinics
Dr. Shyma De Silva Dr. Navoda Attapattu
Total Endocrine Visual & Rehabilitation Diabetic Cardiothoracic- Dr. Munasinghe Cardiothoracic - Dr Singapuli Cardiothracic - Dr. Y.K.M Lahic Total Cardiothoracic Ketogenic Diet Myopathy Total
No of 1st visits 276 63 48 44 51 20 123 143 32 61 18 15 16 49 12 12 5819
No of Sub visits 500 83 570 220 268 166 303 469 92 61 94 89 78 261 52 17 115428
Total visits
Average per clinics
4567 55 1295 420 398 1022 709 1731 97 155 403 160 281 844 313 68 189171
5067 138 1865 640 666 1188 1012 2200 189 21.6 497 249 359 1105 365 85 304599
18.4 2.2 38.9 14.5 13.1 59.4 8.2 15.4 5.9 3.5 27.6 16.6 22.4 22.6 30.4 7.1 52.3
*** Visual & Rehabilitation clinic started to function from April 2013 ***Cardiothoracic Clinic data available from September 2013 *** Ketogenic Diet clinic started to function from January 2013 *** Myopathy clinic started function from January 2013
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6 Inpatients Services The In patients section of the Lady Ridgeway Hospital is at present composed of six general pediatric medical units, four pediatric surgical units, orthopedic unit , plastic surgery unit, cardiology unit, accident ,emergency care unit, pediatric ENT,Rheumatology & Rehabilitation unit, Child Psychiatry unit, Eye Unit Isolation unit, Burns unit, Catheter lab, Cardiothoracic, Dialysis, Dermatology unit and Special neonatal care unit. In addition to these Radiology, Pathology, Hematology, Microbiology, and Histopathology departments headed by senior consultants provide quality, assistance to both inpatients and out patients. The hospital provides in ward services to over 25000 children quarterly.
Special Units In this Hospital there are three Intensive care units Medical intensive care unit MICU Surgical intensive care unit
SICU
Cardio thoracic intensive care unit CTICU We also have one high dependency Unit HDU Table 6.1 Summary of the Inpatients Care Services 2013 No of Ward No of Special Units No of In patients beds Total no of patients Admitted Total no of Patients Discharges (including deaths) Daily Average Admission Daily Average Discharges Average Daily Sick Average Length of stay Bed Occupancy Rate% Hospital Deaths Turnover Rate
22 08 910 87271 87197 239 239 704 2.9 77.4 495 96 256943
Total Patients Days During the year 2013 Average length of stay in the hospital 2.9 dates and Bed Occupancy Rate is 77.4% both figures are in good range when compare to the other hospital in the region. Table 6.2 Hospital Deaths Deaths within 24 hours of admission Deaths within 48 hours of admission Deaths after 48 hours of admission Total hospital deaths
60 26 409 495
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6.3 Trends of Admissions during 2003-2013
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ANNUAL HEALTH BULLETIN Discharge Analysis Table 6.4 Paediatric -Medical 2013 Ward
Beds
Admission
Discharges
Transfer In
Transfer out
Deaths
Total Patents days
84 74 67 92 76 72 465
8568 7649 8082 7906 7624 8345 48150
8535 7549 7904 7731 7461 8301 47481
763 679 680 654 701 747 4224
771 747 841 810 853 761 4783
26 12 15 18 15 24 110
23553 20317 23743 20820 23318 22379 134130
01 02 03 04 08 09 Total
Average Daily Sick
64.5 55.7 65.0 57.0 63.9 61.3 367.5
Bed Occupancy Rate
Ave. Length of Stay
76.8 75.2 97.1 62.0 84.1 85.2 79.0
2.5 2.4 2.7 2.4 2.8 2.5 2.6
Bed Occupancy Rate
Ave. Length of Stay
95.5 55.5 61.6 75.9 72.1
3.0 2.4 2.1 2.2 2.4
Bed Occupancy Rate
Ave. Length of Stay
Table 6.5 Paediatric - Surgical 2013 Ward
Beds
Admission
Discharges
Transfer In
Transfer out
Deaths
Total Patents days
05 07 10 11 Total
39 40 39 43 161
3533 2628 3153 4423 13737
4048 3060 3834 4836 15778
931 719 1103 974 3727
437 259 436 542 1674
04 07 01 02 14
13597 8101 8764 11909 42371
Average Daily Sick
37.3 22.2 24.1 32.6 116.1
Table 6.6 Other Special Units-2013 Type of Specialty
Ward
Beds
Admissions
Discharges
Transfer In
Transfer out
Deaths
Total Patents days
Rheumatology & Rehabilitation
06
24
1088
1124
101
62
0
4533
12.4
51.7
3.8
ENT
12 15
38 26 08 13 11 22 19
4936 1708 0 0 0 1432 280
4939 1506 0 0 0 1605 263
221 290 651 396 663 863 73
208 457 598 360 620 676 35
0 25 50 34 45 02 53
9077 9449 2153 2057 2867 16320 4691
24.9 25.9 5.9 5.6 7.9 44.7 12.9
65.4 99.6 73.7 43.4 71.4 203.2 67.6
1.8 4.8 3.3 5.2 4.3 7.1 13.4
11 25 08 12 10 06 06 20 07
0 10289 583 1263 585 167 152 542 40
0 7680 515 1295 626 199 219 668 494
534 03 2 75 43 46 92 129 512
374 2602 70 42 05 12 25 02 54
161 0 0 0 0 0 0 01 0
3693 9449 377 2943 2181 792 1039 3282 2265
10.1 25.9 1.0 8.1 6.0 2.2 2.8 9.0 6.2
92.0 103.6 12.9 67.2 59.8 36.2 47.4 45.0 88.6
6.9 0.9 0.6 2.2 3.5 3.8 4.3 4.9 4.1
01 16 01
1415 861 43
1387 868 55
0 70 60
28 61 48
0 0 0
1387 1849 38
3.8 5.1 0.1
380.0 31.7 13.8
1.0 2.0 0.4
Cardiology SICU CTICU HDU Cardiothoracic
20
Neonatal care unit MICU Accident Service Day care Surgery Plastic Surgery Orthopaedic Skin Psychiatry
13A 13B 14A 14B 19A 19B
Burns Isolation
21
Hemophilia Eye DU
22
Average Daily Sick
*** Dialysis Unit started to function from May 2013
Lady Ridgeway Hospital for Children
Page 21
ANNUAL HEALTH BULLETIN
2013
Other Departments and Units 1 Radiology Department The unit consist of three Radiologists and seven Medical officers and thirteen Radiographers. They provide Services for the out patients, clinic patients referred from other organizations. Table 7.1 No of Radiological examinations performed 2013 Specility No of Special exams No of CT exams No of Routine exams No of total X-Ray exams No of US exams No of Nuclear Imaging exams Total exams No of Patients No of Films used
748 3044 67087 70879 12609 1962 85450 85450 64680
Electrocardiogram -ECG There are six Cardiographers in this unit. They provide services for OPD ,clinics and indoor Patients. This unit also provide 24 hours services for indoor patients. Table 7.3 No of ECG examinations performed 2013 In Patients 4866
Out Patients 1347
Total 6213
Electroencephalogram -EEG This unit provides services under administration of consultant Neurologist. There are four recordists. Table 7.3 EEG examinations performed 2013 In patients 1504
Out Patients 1511
Total 3015
Table 7.4 Psychiatric Unit In patients 223
Out Patients 1496
Total 1719
Lady Ridgeway Hospital for Children
Page 22
ANNUAL HEALTH BULLETIN
2013
Physiotherapy Department Pediatric physiotherapy is very different to treating adults. Helping children remain motivated and keeping a positive attitude towards their physiotherapy is essential to their progress. We ensure sessions are fun interesting and something to look forward to and enjoy. Physiotherapy is a clinical health science and profession that aims to rehabilitation and improve people with movement disorders by using evidence based, natural such as exercise, motivation adapted equipment and education. Our Institution has well organized physiotherapy department. The Physiotherapy Department was established in 1960 at LRH. Now it’s well equipped with all the necessary items. About 30000 registered patients are coming continuously to get treatment from this department for the diseases of Rheumatology, Neurology; Respiratory & Orthopaedic.There are many sections such as Gymnasium, Electrotherapy unit, Hydrotherapy unit and out door therapeutic play area etc. This physiotherapy department is conducted by Dr. Jaliya Uduwella (Chief Physiotherapist. The department of Physiotherapy provides services to the patients with in the institute as well as for the reference patients. The department of physiotherapy functions from 8.00am to 4.00pm every day except for Saturday. But Saturday also function from 8.00am to 12.00noon. Table 7.5 Performance of the Physiotherapy 2013 No of Patients OPD 1st visits OPD Sub visits Wards 1st visits Wards sub visits Total 1st visits Total sub visits Total visits Total treatments units
2601 8930 2860 23454 5461 32384 37845 158532
Lady Ridgeway Hospital for Children
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ANNUAL HEALTH BULLETIN
2013
Occupational Therapy services The purpose of occupational therapy is to help the child achieve or maintain their maximum level of independence and to develop practical life skills so that the child can participate to his/her full potential in the home environment. Occupational therapy can help children overcome physical or other difficulties in order that they can function and participate in their everyday environment. The department of occupational therapy provides services to the patients with in the institute as well as for the reference patients. The department of occupational therapy functions from 8.00am to 4.00pm every day except for Saturday. But Saturday also function from 8.00am to 12.00noon. Table 7.6 Performance of the occupational therapy 2013 No of Patients 1st visits Sub visits Total visits Total treated units
2374 13092 15466 77480
Table 7.7 Orthodontic Unit No of plate issued No of cleft lip & palate patients No of fix appliance patients No of feeding plates fitted
1638 176 3000 07
Table 7.8 Nephrology Unit Procedure
Numbers
LRH Ward Referrals Renal Biopsy Clean Intermittent Catheterization training Bladder Wash Blood Gas Subcutaneous Erythropoietin
3541 56 138 42 185 33
Lady Ridgeway Hospital for Children
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ANNUAL HEALTH BULLETIN
2013
Table 7.9 Department of ENT & Audiology Audiology Test (Total) Pure Tone Audiograms (PTA) Free-Field Tests Tympanograms Oto-Acoustic Emission tests (OAE) Brain-Stem Evoke Response(BSER) Hearing aids issue
Procedeous
8452 1871 2404 3444 21 522 14 3465
Lady Ridgeway Hospital for Children
Page 25
2013
ANNUAL HEALTH BULLETIN 8 Prosthetist & Orthortist Department (P&O)
Ministry of Health, Government of Sri Lanka & Handicap International (HI) are working together to address the physical rehabilitation needs of children with disabilities. Handicap established a Prosthetic & Orthotic (P&O) clinic in 2008 within the Lady Ridgeway Hospital for Colombo. The Prosthetic & Orthotic clinic provides prosthetic & orthotic devices, mobility aids , adaptive devices, advice/training to children with disability/family members, referral and follow-up services. Since the opening of the clinic in July 2009 up until June 2013, approximately 4100 children with disabilities have been provided prosthetic & Orthotic services.
Orter Assistive devices
U.E Orthoses
Spinal Orthoses
Lower Limb Orthoses
LE Prosthesis
Table 8.1 Performance of the Prosthetist & Orthortist 2013 Device P&O Devices Ankle Disarticulation Below Knee Knee Disarticulation Above Knee Orthoprosthesis
New
Repairs
0 01 01 02 01
01 01 0 01 0
S/Total L.E Prosth Ankle Foot Orthosis Ankle Foot Orthosis Night/Alluminium) CTEV Correction (DBNS) CTEV Correction (SFAB) Knee Ankle Foot Orthosis (Plastic Moulded) Knee Ankle Foot Orthosis (without Joint) Knee Orthosis (incl Mermaid splint) Hip Orthosis Pavlik haeness /Von Rosen Splint Any other (custom made) pl.mention the item S/total LE. Ortho TLSO Conventional Boston Brace(Moulded) Cervical Collar Soft (Custom made) Any other (custom made) Pl.mention the item S/Total Spinal Ortho Wrist Hand Orthosis (Custom made) Elbow Wrist Hand Orthosis (custom made)
05 190 71 99 553 28 277 132 27 128 04 1509 04 24 45 03
03 83 10 02 110 07 100 19 05 11 01 348 0 08 0 0
76 28 01
08 01 0
Total U.E Ortho
29
01
Other Assistive Devices FO and shoe modification(PF) L.S. Brace Cervical Collar Pelvic Binder Any other Prefabricated items Pl. Mention Sub Total other assistive devices
556 07 01 01 01 576
0 04 0 0 0 04
Lady Ridgeway Hospital for Children
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2013
ANNUAL HEALTH BULLETIN
Mobility and Adaptive device
Adaptive device
Mobility Devices
Elbow crutch Axillary Crutch walker walking Stick Posterior Walker Wheelchair Sub total mobility & Walking aids Special seating standing frame Toilet chair/wheelchair with commade Wheelchair modifications /special seats Sub total adaptive devices Total WA,MA and AD
Total Delivery of year
New 34 12 01 01 31 36 115 05 68 18
Repairs 0 0 0 0 0 04 04 0 0 0
109 224 2414
0 04 727
Lady Ridgeway Hospital for Children
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ANNUAL HEALTH BULLETIN
2013
9 Operations & Procedures Table 9.1 Accident Service Procedure Exchange Blood Extranfusion Bone Marrow Liver Biopsy Renal Biopsy Others Bortex Tenotomy Stapler Remover Total
01 121 20 49 20 38 85 05 339
9.2 Statistics of Cardiac Catheterizations done No of Patients
procedure ASD device closure PDA device closure PDA coilling Cardiac catheterization Septostomy Pericardial aspiration Pulmonary valvuloplasty Aortic Valvuloplasty COA dilatation RA Fistula Closure Flouros copy TOE PPM Insertion TPM insertion Coronary angiogram Aortic angiogram RVOT Perforation C/Cath+Baloon dilatation MAPCA Coiling Radiology Procedure AP window device closure Attempted PDA Device Closure AP window device closure Coronary Fistular closure Baloon dilatation of SVC obs Baloon dilatation of L.P.A Stenosis Attempted ASD closure Attempted PDA device closure C/Cath + BPV ASD closure + LPA dilatation Aortic Angiogram + Bronchoscopy ASD device closure + BPV A/P collateral device closure Total
314 58 85 399 31 14 31 05 26 02 04 46 15 06 07 24 07 08 02 26 02 02 01 01 03 01 02 01 01 01 01 01 1128
Lady Ridgeway Hospital for Children
Page 28
2013
ANNUAL HEALTH BULLETIN Table 9.3 Ophthalmology Unit Procedure Cyclo Refraction Refraction P.M.T (Post Medriatic Test) Convergence R.O.P Screening Laser treatment Colour Vision Visual Acuity
7124 2442 1480 228 2109 545 14 74
Table 9.4 Operation by nature Specialty - 2013 Specialty Genito urinary Ward No
Plastic Ward No
Abdominal Ward No
Major
Intermediate
Minor
Total
05 07 10 11 OPD BU Total
171 60 104 119 43
482 255 500 732 253 01 2223
152 23 73 30 50
805 338 677 881 346 01 3048
05 07 10 11 BU 12 14 14B OPD Total
1
20 05
02 04 01 02 15 0 18
05 07 10 11 OPD Total
497
01 43
23 09 01 12 79 02 346 04 02 478
98 142 78 87 16 421
11 04 06 03 0 24
250 225 204 278 18 975
03 03 08 11 01 173 199
11 16 17 20 06 149 219
14 20 26 32 07 440 539
48 24 34 44 07 03
01
54 27 34 48 08 03 01 10 185
213
10 54 02 126 04 01 224
141 79 120 188 02 530
10 202
328
Orthopaedic 05 07 10 11 14 14B Total Head Neck & Spine 05 07 10 11 12 14 14B OPD Total
01 01 01 118 121 05 03 04 01
01 01 14
09 169
02
Lady Ridgeway Hospital for Children
Page 29
2013
ANNUAL HEALTH BULLETIN
Specialty Thoracic
Major
Intermediate
Minor
Total
05 07 10 11 OPD Total
13 02 06 16 01 38
01 04
07 02 0 04
05
13
21 04 06 24 01 56
05 07 10 11 OPD Total
13 06 09 22 02 52
22 17 33 34 01 107
46 39 106 56 05 252
81 62 148 112 08 411
05 07 10 11 12 OPD Total
11 10 31 47 352 02 453
246 43 198 332 44 55 918
08 0 03 02 332 16 361
265 53 232 381 728 73 1732
12 11 Total
147 01 148
112
258
112
258
517 01 518
09 06 08 16 39
1022 1003 1056 1080 4161
1031 1009 1066 1097 4203
782 868 745 1027 81 121 92 144 01 3861
866 920 817 1142 150 162 98 210 07 4372
Rectal
Endoscopy
Specialty ENT
Traumatic 05 07 10 11 Total
02 01 03
Miscellaneous 05 07 10 11 12 14 14B OPD BU Total
04 02 02 03 02
13
80 50 70 112 67 41 06 66 06 498
22
71
55
388
517
Total Vascular 05 Total Total
71
55
388
517
01 01 2154
01 01 4969
9910
17033
EYE
Lady Ridgeway Hospital for Children
Page 30
2013
ANNUAL HEALTH BULLETIN
Table 9.5 CATAGORIES OF CARADIC & THORACIC SURGICAL PROCEDURES 2013 Open heart Major
Close heart Major
661 05 666
221 06 227
Routine Emergencies Total
Other Major
Other Minor
06 01 07
Minor Procedure
Thoracic
Minor Surgical Procedure
Anesthetic procedure
Total
34 05 39
48 187 235
01 257 258
972 464 1436
01 03 04
Minor Operations done at OPD
Table 9.6 Minor Operations Surgical Clinic
Umbilical Cauterization
Others
Suture Removal
Total
24
331
134
489
Skin Clinic
Skin Erxission
Electric Cortrization
Scraping
Skin biopsy
Skin Grafting
Skin Crayo
Others
Tissue Reduction
Total
15
78
290
2418
124
36
2971
Lady Ridgeway Hospital for Children
Page 31
ANNUAL HEALTH BULLETIN
2013
Hospital Laboratory Services The Laboratory services of this hospital consist of four Sections Bio-Chemistry, Hematology, Histopathology and Microbiology. Staff Consist of Consultant Hematologist, Consultant Microbiologist Five grade Medical Officers ,31 Medical Laboratory Technologists. Services are provided by main laboratory from 8.00am to 4.00pm and 4.00pm to 8.00am. Night lab for Inpatients. Out Patients and the Clinic patients are served by the OPD Lab. OPD lab performed routine hematological investigations such as WBC/Dc, Hb , UFR, ESR and FBC. Consultant’s Name
Biochemistry Section
Dr.(Mrs) Iresha Jasinghe
Microbiology
Dr.(Mrs) Kumudu Karunarathna
OPD
Dr. (Mrs)Shiromi Perera
Hematology
Dr.(Mrs) Mala Jayathilake
Histopathology
Dr.(Mrs) Shiromi Perera
Night Lab
Dr.(Mrs) Iresha Jasinghe
Table 10.1 Total Laboratory investigations performed 2013 Section
No of Tests 364349 96881 253331 312323 10190 163645 1200719
Biochemistry Microbiology OPD Hematology Histopathology Night Lab Total
Table 10.2 OPD Section Blood Test Blood -WBC/DC Blood Hemoglobin Blood Packed cell volume Blood platelets Blood ESR Blood picture Blood bleeding time Blood Clotting time Blood Malarial parasites Urine full report Urine ketone bodies Urine bile Urine sugar Urobilinogen Red Cell Indices Stool reducing substances Stool full report Reticulocytes Count Total
42651 42775 44195 44195 6702 5910 340 340 06 17500 106 188 2213 164 42692 1038 2152 118 253331
Lady Ridgeway Hospital for Children
Page 32
ANNUAL HEALTH BULLETIN
2013
Table 10.3 Biochemistry Section Blood Test Blood test Serum Electrolytes
1. Sodium 2. Potassium 3. Chloride
Serum total bilirubin Serum direct bilirubin Serum SGOT (AST) Serum SGPT (ALT) Serum total Protein Serum Albumin Serum total cholesterol Serum Alkaline Phosphatase Serum amylase Serum calcium Serum phosphates Serum Osmolality Serum Creatinine Serum urea Serum sugar+ CSF sugar Serum magnesium Serum uric acid Plasma Amonia CRP Plasma /CSF Lactase Urine test Urine calcium Urine phosphate Urine Creatinine Urine ketone bodies Creatinine Clearance Urine bile Urine PH Urine Cystine Urine Sodium Urine Potassium Urine chloride Urine Protein Urine osmolality Urine Nitrosonapthol Calcium /creatine ratio Urine Mucopolysaccharides Urine Haemocystine Urine reducing substances Protein / creatinine ratio Urine Fecl3 for phenylketonuria Urine uric acid Urine deposits Urobilinogen PO4 /creatinine ratio Uric acid creatinine ratio Urine magnesium creatinine ratio Urine magnesium Urine glucose strip test Urine DNPH Urine porphyrin Urine specific gravity 24hrs protein 24hrs phosphate 24hrs uric acid 24hrs electrolytes CKMB CK G.G.T Urine Myoglobin Amino acid Chromatography
32584 32584 32584 7832 6648 30520 31781 8015 24798 6223 7872 1250 15732 5280 481 33933 37404 12580 3319 1409 157 19975 110 913 664 2591 208 105 129 147 83 388 388 388 1265 471 103 442 183 26 177 638 54 246 42 31 128 53 11 104 127 43 09 27 22 30 12 05 236 256 255 01 132
Lady Ridgeway Hospital for Children
Page 33
ANNUAL HEALTH BULLETIN
Miscellaneous sweat test Water deprevation stone analysis Stool test Reducing substance Occult blood Total
2013
08 08 14 44 69 364349
Table 10.4 Bacteriology section Blood Test Blood culture ABST CSF Culture and gram stain Full report ABST Antigen test Pus, direct smear and culture ABST Throat swab/Nasal swab culture ABST Body Fluids / Aspirates D/S & Culture ABST Respiratory culture ABST MRSA culture ABST Urine culture ABST Urine full report Urine Reducing Substances Stool culture ABST Stool full report Stool reducing substances AFB
9634 1277 1236 1194 07 1205 3350 2949 220 95 114 450 2876 3266 3780 397 15072 2835 13731 135 1235 99 2237 483 119
Direct Smear Infection control sample culture API Dengue Antibody Dengue -Positive Total
24969 277 2420 1219 703 96881
Table 10.5 Haematology section Blood Test Hemoglobin White Blood cell/ Differential count Platelets count Packed cell volume ESR Malarial parasites Blood bleeding time Blood picture Inhibitor Screening Reticulocyte count Bone marrow Sickle test Iron stain Red cell indices APTT Factor IX correction Factor X correction Factoe XI corrections Factor IX Assay Factor VII Assay Factor VIII Assay Factor VII correction
55699 53968 54723 54473 8085 112 1408 7814 76 2310 211 84 90 55649 6605 72 02 07 60 09 154 15
Lady Ridgeway Hospital for Children
Page 34
ANNUAL HEALTH BULLETIN
Factor VIII correction Factor VIII inhibitor levels G6PD Rheumatoid factor Clot solubility Prothrombine test Urine Spectroscopy Thrombin time Urine Haemosidern Ham’s test Osmotic Fragility test Von Willibrand Riaf Activity Heinz Bodies Total
2013
101 34 38 147 35 8950 64 1186 73 45 09 13 02 312323
Table 10.6Histopathology section Blood Test Fine Needle aspiration cytology Direct Smears/ cytology Buccal smears Post Mortem Post Mortem slide preparation Special staining Surgical Biopsy slide preparation Total Table 10.7 Night Lab Blood Test Hemoglobin APTT Platelets CSF Full Report CSF Sugar Blood Urea Full Blood Count Blood Sugar WBC/DC Serum Bilirubin - Direct Serum Bilirubin - Total Urine full Report Ketone bodies Stool Full Report Stool Reducing Substances Bleeding time Clotting time Hematocrits values Prothrombin time Urine bile Aspiration Fluids Serum electrolytes ClSerum electrolytes Na+K+ Urine electrolytes ClUrine electrolytes Na+K+ Serum Cholesterol Serum Albumin Serum Calcium Serum Creatinine SGOT (AST) SGOT(ALT) Total
511 267 208 08 188 621 8387 10190
144 6214 303 327 887 7437 34611 2814 255 2590 2798 8263 160 297 231 357 357 34671 5046 100 37 106 16501 96 221 2508 6179 6228 7035 8356 85616 163645
Lady Ridgeway Hospital for Children
Page 35
2013
ANNUAL HEALTH BULLETIN
Blood Bank Analysis of RCC (450ML units) Component requests & issues 2013 For Patients in state Hosp. words Pediatric
RCC
FFP
PC
CSP
Plasma
R
C/M
I
R
I
R
I
R
I
R
I
17240
16799
10607
5589
3427
4978
4367
4048
1788
456
373
17
11
4048
1788
456
373
17
11
Other
1888
Total
Cryo
17240
16799
12495
R
I
1124 5589
3427
4978
5491
ANNUAL REPORT OF NOTIFICATION- LADY RIDGEWAY HOSPITAL 2013
04
03
March
01
02
02
Chicken pox
01
03
06
06
02
05
01
16 01
04
01
03
161
04
01
05
02
02
05
01
49
May
04
123
01
13
01
05
02
01
05
02
107
June
03
196
01
15
06
02
01
01
July Aug
04
336
01
21
02
03
02
01
02
187
03
23
03
09
04
01
Sep
04
119
01
09
01
05
01
02
Oct Nov
04
201
01
30
02
03
02
332
02
20
01
09
02
Dec
05
463
05
15
07
06
Total
31
2670
19
175
62
29
16
01
01
01 02
02
16 22
01
105
02
01
04
174
04
01
03
02
58
04
07
01
04
03
33
02
04
03
08
02
13
01
10
03
01
07
14
54
12
02
07
01
35
02
01
17
656
13
51
0 1 02
01
02
01
02
11
03
44
A- No of Notified cases B- No of Deaths
Lady Ridgeway Hospital for Children
0 1
02
01
03
13
07 02
02
01
02
48
April
02
01
JE
03
06
06
Herpes Simplex
06
01
02
Tetanus
02
168
01
Herpes Zoster Typhus Fever H. Influenza
165
06
H1N1
Feb
01
AEFI
03
Tuberculosis
04
Whooping cough like illness Measles
01
HFMD
13
Mumps
B 01
1
Encephalitis
Typhoid
Meningitis
Hepatitis A
Dysentry
AFP
Months
A 219
Jan
Food poisoning
Diseases DF/DHF
Page 36
01
01
0 1 01
2013
ANNUAL HEALTH BULLETIN
Summary of Hospital Statistics 1992-2001
Inpatients Services Total Patients Admitted Total Discharges (including deaths) Daily Average Admissions Daily Average Discharges Average Length of stay Total no of Beds Total Patient days Hospital deaths OPD Total no of OPD Patients Total no of Clinic Visits
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
44817 44379
44348 44140
49739 44456
48650 45087
56012 56072
54954 54789
55131 52900
55520 55601
62148 62072
66716 66637
77552 72567
123 122 4.1 635 180827 822
122 121 3.9 635 173625 701
136 122 4.2 635 186346 782
133 124 3.6 667 163147 696
153 154 3.4 667 189873 713
151 150 3.5 667 191215 683
146 145 3.5 667 186610 652
152 152 3.4 711 188269 576
170 170 3.1 733 193237 607
183 183 3.2 752 212661 620
212 199 3.2 768 228599 575
498626
597771
636105
673017
680298
685195
662954
647964
768951
816710
916638
108791
107015
117473
121286
123728
125449
121995
131378
144815
170934
203789
Summary of Hospital Statistics 2003-2013
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
Total Patients Admitted Total Discharges (including deaths) Daily Average Admissions Daily Average Discharges Average Length of stay Total no of Beds Total Patient days Hospital deaths OPD Total no of OPD Patients
64944 64819
73554 73468
63399 68001
62201 61561
66831 66065
69647 69805
83127 83078
85986 86104
84694 84665
87239 87279
87271 87197
178 178 2.8 780 207261 487
202 201 3.0 785 217603 516
174 186 3.0 806 206824 475
170 169 1.7 806 206349 530
183 181 3.3 873 220374 540
191 191 3.3 873 230162 617
228 228 3.1 873 259074 613
236 236 2.9 864 253242 613
232 232 3.0 901 257453 591
238 238 3.0 910 262041 531
239 239 2.9 913 256943 495
870475
894309
813100
870964
835821
779177
961139
835030
787360
645307
634147
Total no of Clinic Visits
225758
235449
259509
268003
295738
291817
285080
276222
288981
296518
304149
Inpatients Services
Lady Ridgeway Hospital for Children
Page 37
2013
ANNUAL HEALTH BULLETIN Hospital Finance -2013 Vote
Expenditure type Recurrent Expenditure
1.Personal Emoluments 111-1-8-1-1001 111-1-8-1-1002 111-1-8-1-1003 2.Travelling Expences 111-1-8-1-1101 3.Supplies 111-1-8-1-1201 111-1-8-1-1202 111-1-8-1-1203 111-1-3-0-1204 111-1-8-1-1205-(1) 111-1-8-1-1205-(11) 4.Maintennance Expenditure 111--8-1-1301 111--8-1-1302 111--8-1-1303 5.Contructual Service 111-8-1-1402 111-8-1-1403 111-8-1-1404 111-8-1-1405 6.Other Recurrent Expenditure 111-1-8-1-1506 111-1-8-1-1508 111-1-2-0-2103 7.PGIM/Intern 111-2-11-1-1001 111-2-11-1-1002 111-2-11-1-1003 111-2-11-1-1405 8.Blood Bank 111-1-8-9-1001 111-1-8-9-1002 111-18-9-1003
Salaries & Wages other allowances & H.P Other allowances Travelling Expences Stationary & Office Request Fuel & Lubricants Diets & Uniforms Medical Supplies Garbage Other Supplies Vehicles Repair Plant Machinary & Equipment Build & Structure
Amount Rs.
483,522,279.02 271,604,521.31 40,3652,220.28 103,072.00 2,305,720.17 3,120,191.8 36,533,335.70 102,990,390.52 4,987,322.00 5,458,167.98 1,971,363.74 1,743,060.82 1,836,969.13
Postal Charges & telecommunication Electricity water & gas Rates & Taxes Other contractual service
2,865,562.05 119,891,311.70 895,878.00 38,424,521.71
Property loan Other Custom duty
15,834,058.89 659,304.96 15,553.00
Salaries & Wages Overtime Allowance & H.P Overtime Allowance Training
48,342,058.93 28,259,946.45 114,000.00
Salaries & Wages Overtime Allowance & HP Overtime Allowance
4,282,726.80 1,846,967.52 4,267,072.12
Building & Structure Medical Equipment Repair Maintance & Repair (Electrical installation) Vehicle Repairs Medical air Supply Electricity repair Underground water tank Repair A/C Repair Lift Repair Lab Equipment repair
33,945,988.47 983,720.00 9,694,519.48 977,040.00 1,624,100.00 968,240.00 913,657.81 2,543,277.24 1,317,533.28 793,385.60
Furniture & office Equipment Telephone Repairs Medical Air Supply Medical Equipment Medical Equipment Air Conditions Supply & Instolation Lab Equipment Hospital Equipment
4,620,336.35 775,590.84
Rehabilitation & Improvements
111--2-13-1--2001(11) 111-02-13-1-2002(2) 111-2-13-1-2002(1) 111-02-13-1-2003 111-02-13-8-2103(11) 111-2-13-07-2103(11) 111-02-13-28 - 2104(1) 111-2-13-01-2002(11) 111-2-13-04-2103(1) 111-2-13-01-2002-11(06) Acquisition of fixed assets 111-2-13-1-2102 111-2-13-76-2103 (11) 111-2-13--08-2103(11) 111-2-13-11-2103 111-2-13-13 2103-11(1) 111-02-13-5-2103(1) 111-2-13-13-2103(11)4 111-2-13-13-2103(03) Total
10,137,325.00 5,429,671.49 2,714,382.38 3,699,835.00 28,672.00 1,667,083,931,.12
Lady Ridgeway Hospital for Children
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ANNUAL HEALTH BULLETIN
2013
Department of Pharmaceuticals The Institution has well organized pharmaceuticals department, which is the most expensive and important component of the hospital It provides services to the patient’s within the institute as well as for the special campaigns and for any situation of disasters. The department performs routine functions from 8am to 4pm every day, except for Saturdays. Where it functions from 8am to 12noon.It also functions for 24 hour throughout emergencies. The Chief Pharmacist is involved in administrative functions and there are 26 Pharmacists and 12 Dispensers. The institution obtain drugs from Medical Suppliers Department of Ministry of Health.
Local Purchase Ward No 01 02 03 04 05 07 08 09 10 11 14 15 19 Eye Unit MICU SICU Operating Theatre CTICU HDU SCBU OCC Burns Unit Skin clinic IDD Drug Stores DU 12 CHOGUM Total
Total Rs 869975.77 256932.96 251316.66 244.05 13707.00 12480.00 42268.92 114800.31 179327.50 85646.21 4985.00 121808.70 11680.00 26730.00 629403.61 117722.84 308460.00 33876.55 110674.62 37546.71 10900.00 18715.60 169393.50 614571.80 858344.00 4210.00 9972.80 1000.00 4937350.11
Lady Ridgeway Hospital for Children
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ANNUAL HEALTH BULLETIN
2013
Medical Records Unit
Main Functions of this unit Collection of information- Receiving BHTT & other documents Processing /sorting of information -Coding (according to International Classification of Diseases (ICD 10) Storing of Information -Secure of Medical Records retrieving for continuity of patient care, judicial purposes. Retrieval of Information - Research, Judicial & administration purposes as requested by patients and relatives .etc. Distribution of information -Collecting data and preparing statistical returns which will be sent to the Director Medical statistics unit and other relevant institutions. Value of the MEDICAL RECORD A good complete medical record is of value To the Patient As the medical record contains a complete report of a patient’s illness and results of treatment, it is of great value to the patient for Future care for the same or other illness, facilitating continuity and excellence of care and cost savings derived from not having to repeat diagnostic tests unnecessarily Informing them (by giving access) of their care ,treatment and as a legal documents to support claims for injury, To the Hospital, Clinic or other Health Facility The medical record may be used by the health facility to evaluate the standard of care rendered by staff and the end results of treatment. If adequate records are not kept, the facility cannot justify the results of treatment. The medical record is also of value to the facility for medico-legal purposes. Statistics derived from medical records can be used for evaluating and planning present and future hospital services. To the Doctor and other Health Professionals The medical record is of value to all health professionals caring for a patient. The patient may have been treated by them previously or by other health professionals. The medical records enable pertinent clinical, social or other relevant, information to be readily available for continuing patient care. In addition the medical record is of value for review of diseases, treatment and responses to treatment.(research, quality assurance, education and professional development of staff) To Researchers, Statisticians and Educators To scientific research the medical record has the potential to be an important tool. At its best, the information within a medical record supplies a practical and reliable source of material for the advancement of medical science. This information is Education also valuable in the collection of statistics on health care and the incidence of diseases, and for education of health professionals
Lady Ridgeway Hospital for Children
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ANNUAL HEALTH BULLETIN
2013
Education Programme for Lady Ridgeway Hospital Child Patients The government has decided to allocate diploma holder who join the ‘teachers’ service from the National Colleges of Education : for Sinhala medium and Tamil medium, to visit the Lady Ridgeway Hospital .These Diploma holders will keep the student patients engaged in educational activities. Children between the age group of 5-12 years from all parts of the country visit the Lady Ridgeway Hospital for medical treatment and some of them who warded in the hospital for several months for treatment purposes neglect their education by not being able to attend the school for a considerable period. The programme will enable child patients to continue their education while receiving treatment without any interruption. This will also prevent school drop outs due to illnesses.
Lady Ridgeway Hospital for Children
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ANNUAL HEALTH BULLETIN
2013
Patients Costing Programme The Ministry of Health is planning to present a statement of fees to patients that have undergone inpatient care when they are discharged from hospital. The statement would include fees for period of inpatient care and the cost of drugs given to the patients. Issuing statements of fees was commenced at Lady Ridgeway Children's Hospital on 1st April 2013. It has been decided to introduce the scheme first to the cardiology unit of the hospital and implement it to all other sections later. .
Lady Ridgeway Hospital for Children
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