1

ANNUAL
REPORT

2020
LUNG CENTER OF THE PHILIPPINES
The Covid-19 Journey

Quezon Avenue, Quezon City 1100

lcp.gov.ph [email protected]
1
Metro Manila, Philippines
 LCP Annual Report
2020

CONTENTS
Table of Contents

MESSAGE FROM THE EXECUTIVE DIRECTOR........................................................ 3

ORGANIZATIONAL FRAMEWORK ............................................................................. 5
TOP MANAGEMENT ..................................................................................................... 5
MANAGEMENT TEAM .................................................................................................. 5
V I S I O N ...................................................................................................................... 6
M I S S I O N .................................................................................................................. 6
CORE VALUES ............................................................................................................... 7
MANPOWER COMPLEMENT ....................................................................................... 9
INTRODUCTION ......................................................................................................... 10
OVERALL PERFORMANCE OVERVIEW ................................................................... 11
CATCHMENT AREAS ................................................................................................. 15
STATISTICS, FIGURES AND SERVICES ................................................................. 16
RESEARCH OUTPUT ................................................................................................... 30
NEW SERVICES ............................................................................................................ 37
Health Advocacy and Promotional Activities ........................................................... 37

Other Services: Programs, Projects, Activities and Status ................................... 41

The Operating Room Complex .................................................................................... 46

CUSTOMER SATISFACTION ..................................................................................... 48

HIGHLIGHTS ................................................................................................................ 49
DOH Advisory designating LCP as COVID-19 referral Center ............................ 49
THE INCIDENT COMMAND SYSTEM (ICS) .............................................................. 50
ICS – SAFETY AND SECURITY ............................................................................... 54
FUTURE DIRECTION ................................................................................ 81
ACHIEVEMENTS .......................................................................................................... 82
FINANCIALS ................................................................................................................. 86
ACKNOWLEDGEMENT ............................................................................................... 94

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 LCP Annual Report
2020

MESSAGE FROM THE EXECUTIVE DIRECTOR

As we look back to the year 2020, it has been filled with challenges and upheaval as we are
thrust to fight this relatively unknown COVID disease which has taken the world by
surprise, mostly unprepared on what to expect, disrupting plans and turning the whole
healthcare system upside down, scrambling for control of the unknown.

But as the year passed, we now know more

about this disease and we are able to curb it if
not totally eradicate it. And slowly but surely,
we are able to continue with our hampered
plans as we continue our journey.

As we all know, The Lung Center of the

Philippines (LCP) has embarked on its initial
stage of its development plan covering the
period 2020 to 2025 as can be reflected in this
year’s 2020 Annual Report.

This 5-year plan remains anchored on the

original mandate of the institution provided by
law in 1981, specifically Presidential Decree
No. 1823, with the view of “meeting the
anticipated health problems of respiratory nature on a national coverage as a coordinated
effort of the Ministry of Health, other government agencies and the private sector
committed to health.”

This plan as we begin this 2020, is also cognizant of Lung Center’s new role in the context
of the implementation of the Universal Health Care (UHC) Act of 2018, wherein the
Department of Health has designated the LCP as the Apex or End-Referral Hospital for lung
care in October 2020. As Apex or End-Referral Hospital, it is expected to provide
performance mentoring and technical assistance to health care provider networks in the
areas of medical service, training and research. This new mandate has given a clear
direction to the future for the Lung Center for the next 5 years, as the institution applied
for accreditation and recognition from the Institute for Solidarity in Asia through its
program for the strategic approach to transforming the public sector – the Performance
Governance System (PGS).

The areas for development remain the same 3 pillars of Service, Training and Research,
with the addition of Advocacy and Linkages, in the new context of UHC. Over the next 5
years, we shall endeavor to provide quality specialized services for early diagnosis and
optimum management of lung and chest diseases; enhance the competencies of medical,
nursing and allied specialists to augment human resource of health; undertake
institutional research to support priority procedures and policy advocacy; and enable a
network of regional lung centers to deliver specialized services for lung and chest diseases.

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 LCP Annual Report
2020

For the Lung Center to achieve all its plans, it has to expand its physical infrastructure, as
the main building remains a shadow of its original structure which was gutted by fire way
back in 1998. The reconstruction of the West Wing will be the centerpiece of the 5-year
plan, and will pave the way for the expansion of specialized lung care services, including
lung transplantation and interventional pulmonary procedures; initiation of several
fellowship programs in pulmonary medicine, radiology, pathology, thoracic surgery and
anesthesia, and pediatrics, and production of more relevant research that will provide vital
information that can be translated to public health policy and programs.

Of course, the realization of these plans are made with the raging COVID pandemic in the
background. While the implementation of the plans may be hampered by the pandemic,
we are strong in our resolve to proceed with it using all available resources inside and
outside of the institution. We will continue to expand our existing services, while rolling
out newer and more advanced ones. We will continue to dialogue with PhilHealth to
ensure that payments due to us are promptly processed and paid, considering that the
PHIC is a major source of revenue for the hospital. We hope that assistance from the DBM
and DOH, through their subsidy and donations, will continue in the coming years so that
we can realize the vision of the LCP to be a regionally competitive institution for the
management of lung and chest diseases, leading a network of regional lung centers in the
country.

With focus and determination, we will overcome all these obstacles and come up a winner.

More power to the Lung Center of the Philippines.

VINCENT M. BALANAG, JR., MD

Executive Director

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 LCP Annual Report
2020

ORGANIZATIONAL FRAMEWORK
TOP MANAGEMENT

MANAGEMENT TEAM

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 LCP Annual Report
2020

VISION

THE PREMIERE INSTITUTION FOR LUNG AND OTHER CHEST

DISEASES, PROVIDING QUALITY HEALTHCARE THROUGH
EXCELLENT SERVICE, TRAINING AND RESEARCH.

MISSION
We provide quality health care
through state-of-the-art
facilities and highly competent,
compassionate staff for the
improvement of the Filipino
people's quality of life.

We provide immediate
attention to every
individual in need
regardless of creed,
color, sex, socio-
economic status and
political affiliation.

We endeavor to achieve
financial stability and
long-term sustainability.

We are dedicated to lung

health promotion and
advocacy.

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 LCP Annual Report
2020

CORE VALUES

The first to put up a SARS-COV-2 GeneXpert Lab in

the Philippines using the TB-Lab facilities at the KOICA
Building. The test boasts of same day results, leading
to faster clinical decisions.

Lung Center of the Philippines in

collaboration with Philippine Heart Center
Chinese Experts visits LCP, Apr 9, 2020

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 LCP Annual Report
2020

LCP STRATEGY MAP 2020 – 2025

The Lung Center of the Philippines (LCP) position itself for the
next five (5) years as the National Apex Center for the treatment and
prevention of lung and other chest diseases enabling regional lung
center network. Visible in its Strategy Map and Balanced Scorecard
having key indicators and targets that will measure the organization’s
performance and reflect its strategic initiatives, priority projects, and
annual targets covering the period 2020-2025.

excellent service, training, and research

nhance competencies of nderta e ins tu onal

rovide uality specialized nable regional lung centers
medical, nursing and allied researches on respiratory pearhead advocacies for
services for early diagnosis to increase access to
health personnel to and advanced lung diseases ealthy Lungs and ealthy
and op mum management specialized care of lung and
augment human resource that impact on na onal nvironment
of lungs and chest disease chest diseases
for health policies and guidelines

rovide state of the art rovide stateof the art

Assure engaged employees romote a culture of safety
hospital facili es and informa on technology to
with excellent safety and and excellent pa ent
e uipment to support support op mal opera onal
sa sfac on experience
programs and pro ects e ciency
p mize corporate powers to provide resources for
Assure e uitable health nancing for all
sustainability
C R AL

N C R AL
Customer focused Commitment
Compassion Crea vity Collabora on
Customer focused, Commitment, Compassion,
Crea vity, Collabora on

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 LCP Annual Report
2020

MANPOWER COMPLEMENT

The Lung Center of the Philippines (LCP), has a total authorized plantilla positions
of 1,589 approved by the Department of Budget and Management in April 2018.

Nonetheless, the challenges brought by the COVID-19 affected the operations of

government agencies. The existing policies on the engagement of Contract of
Service (CoS) and Job Order (JO) workers have changed to ensure smooth and
efficient delivery of service to the public. Hence, by virtue of COA and DBM Joint
Circular No. 2 s. 2020 dated Oct. 20, 2020 instead of December 31, 2020, Job
Order will continue until December 31, 2022.

Presidential Proclamation No. 922, s. 2020 issued by President Rodrigo Duterte,

also known as Bayanihan to Heal as One Act, declaring state of public health
emergency entire the Philippines due to Corona Virus Disease 2019 was enacted
under Republic Act No. 11469.

The Department of Health (DOH) is authorized to engage temporary human

resources for health (HRH) to complement and supplement the current health
workforce for COVID-19 response, and LCP is among the selected facilities.

MANPOWER COMPLEMENT

DOH
Augmentation
Plantilla/Regul
364,32%
ar, 612
54%

Job Order LCP

162, 14%

Out of the 1,589 approved plantilla of regular positions for 500 bed capacity,
612 were with original positions/plantilla, 162 JOs with CoS, 364 for 2020 under
the Human Resource for Health (HRH) Augmentation Program of the DOH.

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2020

INTRODUCTION

The Lung Center of the Philippines (LCP) had a clear 2020 vision of what it
wants to accomplish for the year. Celebrating its 38 th year Anniversary in January
23, 2020 with the theme: #Soar high LCP @38: “Honoring the past, embracing the
present and building the future.” LCP is optimistic and ready to continue the gains
of 2019, determine to carry out the plans for 2020.

However, LCP, the country and practically the entire world is not ready as
we plunged into a pandemic brought about by the novel corona virus, the Covid-
19.

Notwithstanding the pandemic, there were other forces and pressures we

need to address like governing rules on healthcare and other public policies. But
what encouraged, strengthened and inspired the LCP management, our frontliners
and other healthcare workers, to withstand all these challenges is we have to make
a difference in the lives of the Filipino people.

This is manifested by delivering excellent service, as we carry our mission

with the overwhelming support and intensified assistance of donors and sponsors,
from both the government and the private sectors.

This annual report is LCP’s journey through the 2020 COVID-19 PANDEMIC.

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2020

OVERALL PERFORMANCE OVERVIEW

A. Hospital Capacity
ACTUAL BED CAPACITY
• LCP's authorized bed capacity
remained at 210, actual 242 253 210
average monthly bed capacity 300
has increased from 242 200
(2019) to 253 (2020) to 100
accommodate Covid patients 0

• Based on the average authorized

bed capacity, the authorized
occupancy rate has decreased from
81% in 2019 to 53% in 2020.

B. Admissions and Discharges

• There were 3,996 total admissions

and 4,024 total discharges in
2020. An average of 11
admissions and discharges each
day.

• Average number of patients per

day is 112 and average length of
stay is 10 days.

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2020

C. Mortality

• Total deaths increased from 782 in

2019 to 819 in 2020, however, gross
death rate (20%) and net death rate
(17%) increased compared to 2019,
(11%) and (8.7 %) respectively.

• Public health emergency (Covid-19) 5 Leading Causes of Death

was the leading cause both
mortality and morbidity for 2020. Year 2019 - 2020

400
• Year 2019 showed Malignant
2020
neoplasms of the trachea, bronchus 200
and lung as leading cause death 0
2019

Malignantneoplasmof PublicHealthEmergency Pneumonia Respiratorytuberculosis PublicHealthEmergency

trachea,bronchusandlung ofInternationalConcern ofInternationalConcern
(COVIDConfirmed) (Non-Covid)
2019 180 0 146 77 0
2020 98 259 52 62 127

D. Hospital Infection

• The overall Hospital Acquired Infection Rate increased for 2020.

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2020

E. Patients Served

• A total of 14,710 patients

Service Patients Served 2020 were served by the Medical Social
Service Division, 1,715 and 8,898
Admitted…
for admitted patients and OPD
patients, respectively.
Out-Patients, 8,898 ,
84% • There were about 244 re-
admitted patients and 3,853
referred patients.
Admitted patients Out-Patients

Quantified Free Service

• Quantified Free Service for
Out-Patients, admitted patients amounted to
₱49,963,283.65 P164,684,476.64. A total of
P49,963,283.65 was extended for OPD
patients.
Admitted Patients,
₱164,684,476.64

F. Socio-Demographic Data
Distribution of Patients
MSS Classification for New Patients:
C – without discount
C1 – 25% discount
C2 – 50% discount
C3 – 75% discount
C3-D – donation
D – hospitalization charged to LCP

Most patients served by the Social

Services were classified under
category D; meaning, patients had no
counterpart from the total hospital bill.

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 LCP Annual Report
2020

• Most patients were admitted at

the Covid Ward area, 48%.

• A very high percentage of the

populations (patients) of the
hospital are already PHIC
members, 99%.

• The total Number of Inpatients INPATIENT NETWORKING REFERRALS

referred to other hospital 600
through Networking have the 529

highest in the month of 500

440
462 470
431
February, 31% and December, 400
14%. 313
292305
300 260 248

200

80
100
23
5 8 1 6 0 0 0 0 2 1 0 3
0
Number of Referrals to other hospitals Total Number of Referred Patients
Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec

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 LCP Annual Report
2020

CATCHMENT AREAS
Lung Center of the Philippines
Primary and Secondary Catchment Areas
(IN-PATIENT DEMOGRAPHIC DATA 2020)

Most of the patients are residents of Quezon City followed

by Region IV-A.

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2020

STATISTICS, FIGURES AND SERVICES

A. Emergency Medicine & Out-Patient Department

Despite a difference of -43% of the total number of patient’s consult at the

OPD and ER in 2020 due to Covid-19 pandemic as compared to 2019 data,
still 2.9% increase in the income was recorded. This maybe brought by
setting-up of another hemodialysis unit launched in January 23, 2020 with
licensed to operate in March 23, 2020.
Just in time for the 38th LCP Foundation day, the new building of the
Outpatient Department was inaugurated, January 23, 2020.

Income (in million pesos) 2019 2020 % Change

Emergency Room 21,044,856.38 21,626,636.65 0.028
Out Patient:
General OPD/Specialty 1,794,065.00 3,378,083.50 0.883
Health & Fitness 1,779,210.00 1,309,190.00 (0.26)
Executive Check-up 102,210.00 52,500.00 (0.486)
Hemodialysis 1,273,045.77 57,970,650.00 44.54
Gross Income 25,995,406.15 84,339,080.15 2.244

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 LCP Annual Report
2020

The PHDU sustained its services at 100% for 2020 as compared to 93% (2018, and
94% (2019) respectively by its effort of reaching patient through telemedicine and
social media network.

LUNG CENTER OF THE PHILIPPINES

PUBLIC HEALTH AND DOMICILIARY DIVISION
Quezon Avenue Extension, Quezon City
2020 ANNUAL REPORT
A. PATIENT REFERRED DURING THIS REPORTING PERIOD 1st Q2020 2nd Q2020 3rd Q2020 4th Q2020
1. Total no. of referrals (Presumptive TB/ TB patients) to hospital TB team 395 114 147 220

2. Total no. referrals from the wards 101 66 47 86

3. No. of TB patients admitted at the ward (Source: Hospital Discharge
Census 101 56 47 86
4. Intrahospital referral rate (ward_ (No.2/No.3 x 100) 100% 100% 100% 100%
5. No. of bacteriologically confirmed cases referred to the hospital TB
team 147 58 86 123
6. No. of bacteriologically confirmed cases detected by laboratory
(Source: Hospital Laboratory Register) 124 40 32 63
7. Laboratory referral rate (No. 5/ No. 6 x 100) 119% 145% 269% 195%
8. "Internal referrals" that were confirmed as TB cases (by TB Clinic) 394 114 147 220
9. No. of TB cases, all forms 394 114 147 220
369 108 138 164
10. TB cases referred to peripheral DOTS facilities (external referral)
(94%) (95%) (94%) (75%)

11. TB cases registered by TDPH (managed by the TB clinic) 25 (6%) 5 (6%) 9 (6%) 56 (25%)
12. No. of TB cases started treatment at the ward 101 56 47 86
B. REFERRAL OUTCOME OF PATIENTS REFERRED DURING THE
4th Q 2019 1st Q 2019 2nd Q 2019 3rd Q 2019
QUARTER PRIOR TO THIS REPORTING PERIOD
13. Total no. of TB cases referred to peripheral DOTS facilities during the
511 369 108 138
quarter prior to this reporting period
14. No. of accepted and registered (with TB case number) at the
477 360 103 130
peripheral DOTS facility
15. External referral acceptance rate (No. 14/N0.13 x 100) 93% 98% 95% 94%

The core principles of DOTS Therapy designed to ensure compliance and the concept that revolve around a patient-centered approach.

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 LCP Annual Report
2020

B. Pathology and Laboratory Medicine

A decrease of 30.25% for the usual basic procedures in the total workload
of the laboratory medicine services was noted. With the GenXpert and SNL-
EREID, it has helped to immensely increase a promising income of 120% as
compared to 2019.

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2020

C. Radiology & Radiotherapy

Number of Procedures Served

60,000

58,752
50,000

40,000

19,736
30,000
31,517

10,046

7,562
6,826
4,801

20,000
3,850

642
269

162
10,000
0

-
2020 2019
Diagnostics Ultrasound CT Scan Radiotherapy MRI Nuclear Medicine

There was a decrease of 46% in the number of patients for all procedures/services
as well as a decrease of 32% for the gross income of 2020 of the department as
compared to the data of 2019.

Gross Income
60,000,000.00 (in million pesos)
50,000,000.00

40,000,000.00

30,000,000.00

20,000,000.00

10,000,000.00

-
Diagnostics Ultrasound CT Scan
Radiotherap MRI (Sep- Nuclear
y Dec 2020) Medicine
2020 19,662,063.0 5,669,548.75 28,550,348.0 34,318,680.0 1,835,980.00 -
2019 24,534,993.8 9,647,273.94 40,048,740.0 54,611,190.0 4,309,820.00 684,967.50
2020 2019

Collective expenses inclusive of repairs, office/medical supplies and preventive

maintenance showed a very modest +26.8%, due to the restrictions brought about
by the Covid-19 pandemic.

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 LCP Annual Report
2020

D. Thoracic Surgery and Anesthesia

Operating Room Procedures 2020

846

352
227 103 124 56 17 1 1 46 1 1

There was a variance of -38% in the number of operating room procedures

done in 2019, (2864) vs. 2020 (1775 that affects overall income of -36%.
Surgery mortality rate was best maintained at 1.79% for the year.

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2020

E. Thoracic Oncology

NUMBER
Chemother
OF PROCEDURES-AMOU
apy, 1830

Blood
Transfusion
Bone
IVAD Flushing, Marrow
SQ/IM Biopsy

Chemotherapy administration remains to be the most common procedure

performed at the AMOU showing (1830), 89% among the other procedures.
The number of pay patients declined by 21%, Service patient by 29.34%.
Over all, the AMOU attends to approximately 173 patients on a monthly
basis.

On income, there was a 1.64% reduction in the pay AMOU earning a monthly
average of Php362,640.33. Service AMOU’s income for 2020 was Php
451,520.00 approximately decreased of 35.33% from that of 2019, all due
to Covid-19 lockdown. Further, as the LCP was dedicated to COVID-19
referral, the hospital resources and manpower was re-allocated in the care
of COVID patients, hence the oncology service limited the number of service
patients who were treated at the AMOU.
Gross Income (in million pesos)
4,412,096.00 4,339,684.00
5,000,000.00 3,895,684.40
4,000,000.00
3,000,000.00
2,000,000.00
698,139.40 451,520.00
1,000,000.00 386,197.20

-
Pay Service 2018 2019 2020

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 LCP Annual Report
2020

F. Pediatric Pulmonology and Critical Care Medicine

Most of the services and procedures of the department were reduced.

However, transformation in patients consult still improved the services
through VIRTUAL CONSULTATION and TELEPHONE CONSULT THROUGH
LCP’s Quitline system to reach out patients and has earned an over-all
rating of 96% in customer satisfaction and delight.

Almost all of the staff of the Pediatric Pulmonary and Critical Care Medicine
Department also devolved and dedicated themselves in professional growth
and development by attending technical training.

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2020

G. Pulmonary, Critical Care and Sleep Medicine

Most of the services dropped by 36% on all the procedures and services, due to
temporary closure of OPD at the height of the pandemic.

Total Services/
2019 2020 % change
Procedures
Sleep Medicine 491 134 -0.73
SRS 93,391 64,117 -0.31
CVU 11,522 10,168 -0.12
PT 11,479 424 -0.96
Hyperbaric Medicine 206
Pulmonary, Critical Care
116,883 75,049 -36%
& Sleep Medicine

However, a modest 26% approximate earnings in terms of income generation from

these procedures and services was noted with a great reduction in its projected-
calculated targets supposedly for the year.

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2020

The NURSING SERVICES

The department serves as the frontline service that caters to the healthcare
needs of the patient. The goal is to provide a culture of safety and excellent
patient experience.

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2020

With the increasing number of referrals and patients admitted, big adjustment
was made to accommodate COVID-19 patient. At the same time, the nursing
staff still cater to the existing respiratory cases which are non COVID related.

Use of plastic barrier to isolate Covid-

19 patients from the frontliners Designation of 48 Critical Beds

Forty-eight beds in the ward were designated as critical beds.

Four areas were converted to COVID ward and rooms were retrofitted.

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 LCP Annual Report
2020

Staffing was augmented through the DOH Augmentation Program (HRH). The
nurse-patient ratio is 1:5 to provide optimal nursing care to COVID patient. The
schedule of duty was divided into 2 shifts, 7am-7pm and 7pm-7am (12hour duty).

Conducting the Orientation and briefing of nursing support staff from the DOH-
HRH Augmentation program.

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 LCP Annual Report
2020

The nursing department will continue to serve with high level of competence,
coupled with compassionate and caring service even in the face of fear and
concerns about safety.

Provision of Donning Areas in all COVID WARDS

Provision of Doffing Areas in all COVID WARDS

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 LCP Annual Report
2020

Personal Protective Equipment (PPE) for Personnel

Nursing Trainings and Updates

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2020

KNOWLEDGE MANAGEMENT: Sharing Of Best Practices & Benchmarks

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2020

RESEARCH OUTPUT

Covid-19 was expected to adversely affect research activities in 2020 due to

limitations brought about by the nationwide lockdown. However, the novelty of
Covid-19 and the uncertainties regarding its clinical presentation, treatment
options and hospital outcomes provided the impetus for numerous researches,
and actually resulted to more protocol submissions and conduct of institutional
and collaborative studies.

Protocols submitted to TRB 18

36
Study Launches 11
8
n going instituional… 15
26
2019
n going collaborative… 7
14 2020
On-going sponsored trials 28
23
Completed Researches 11
10

0 10 20 30 40

Ethics Board: Types of Ethics Board: Types of

Study Review

26
30
8, 11%

18, 26%

11 1
2

44, 63%
Biomedical Studies
Operations Research
Sponsor-initiated Clinical trial
Researcher-initiated Clinical trials
Full Review Expedited Review Exempted
Resubmisions

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 LCP Annual Report
2020

Collection of Research Fees:

The collection of research fees, however, was markedly decreased due to reduced
number of studies sponsored by pharmaceutical companies and funding agencies
that were reviewed and launched

Collection of Research Fees

9,000,000

8,000,000 7,819,531

7,000,000

6,000,000

5,000,000

4,000,000
3,290,970

3,000,000

2,000,000

1,000,000 655,000
446,000

0
2019 2020

Technical Review & Management Fee Ethics Review

Other Research Impact

  Research studies on COVID are being done by the fellows-in-training

for future reference of succeeding trainees as well as clinical practitioners

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2020

A. Research Publications and Presentations:

There were a few research papers presented in international conferences and these
were mainly conducted virtually or on-line due to the COVID pandemic.

TITLE Author Publication Presentation

VATS biopsy of an Adult Kathy Jane Journal of Visual Virtual CHEST

with Pulmonary Tripole, MD Surgery; Congress 2020;
Langerhans Cell
Histiocytes: Case Report June 2020 June 26, 2020

Advanced Lung Eleanor dela CHEST Journal Virtual CHEST

Carcinoma and Genetic Pena, MD ;June 2020 Congress 2020
Mutation in a Very Young
June 26, 2020
Adult

Accuracy and Treah Mayo Journal of United States and

Reproducibility of Intra- Sayo, MD (Co- Thoracic Canadian
operative Assessment on investigator) Oncology Academy of
Tumor Spread Through Pathology Annual
Air Spaces (STAS) in Lung December 2020
Meeting 2020
Adenocarcinoma
March 2, 2020

Froze Section Does Not Treah Mayo For Publication United States and
Reliably Detect Tumor Sayo, MD (Co- Canadian
Spread Through Air investigator) Academy of
Spaces (STAS) in Lung Pathology Annual
Adenocarcinoma Meeting 2020
March 1, 2020

Cryotherapy Portia Maria Chest Annual

Recanalization of Primary Tanyag, MD Convention
Tracheal Squamous Cell and Joven
Roque October 2020
Carcinoma
Gonong, MD

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2020

B. 2020 Training Output

Clinical Fellowship Training Programs continued although were adversely affected
in terms of number and types of cases seen during the period. Most of the cases
admitted were COVID-related and there were fewer non-COVID cases, especially
those requiring special diagnostic procedures and surgery.

Thoracic Surgery Thoracic Anesthesia

New Appointments 1 1

Promotion to 2nd Year 2 0

Promotion to 3rd Year 3 0

End of Training 1 1

Graduated 0 1

TOTAL 7 3

Pulmonary Medicine Sleep Medicine

Level 1 12 2

Level 2 13 *

Chief Fellow 1 *

Graduated 8 2

TOTAL 37 4

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 LCP Annual Report
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UNDERGRADUATE AND POSTGRADUATE PROGRAMS: No. of Trainees

Undergraduate practicum, senior high school immersions internships and
postgraduate externships were markedly reduced due the lockdowns and
suspension of face-to-face interactions in schools and universities.

2019 2020

Practicum/On-the-Job Training 19 4

Senior HS Work Immersion 33 3

Internship 173 30

Externship 10 2

TOTAL TRAINEES 235 39

But total Training and Services provided and coordinated by the Education &
Training Department in 2020 continued to increase.
50 47
45

40
35
35

30 28

25

20

15

10
4
5

0
Training & Services Provided Training & Services Assisted/Coordinated

2019 2020

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 LCP Annual Report
2020

C. MENTAL HEALTH INITIATIVES DURING COVID-19

Description

Our healthcare providers and other frontliners

serve as first line of defense when it comes to
protecting our general safety and well-being.
However, in their day-to-day encounters in
battling COVID-19 pandemic, they are not
spared from harm to their overall well-being.
The objective of this webinar is to learn effective
ways to take care of the physical and mental
health of frontline health workers.

Date: June 05, 2020

Venue: EMG Auditorium
Number of participants: 19

In the day-to-day battle against the COVID-19

pandemic, frontline health workers also battle
with the stigma attached to the disease. They
face judgments from the public not only on how
they provide care but also are often tagged as
carriers of the virus themselves. This can lead
them to feel socially isolated and vulnerable to
mental health concerns.
The objective of this webinar is to help
frontliners understand and handle the
stigmatizing treatment from other people, and
help them create non-judgmental space among
themselves. The Philippine Mental Health
Association, Inc. (PMHA), in partnership with
Give2Asia and Johnson & Johnson, sponsored
this webinar session for hospital/health center-
based frontline health workers.

Date: June 11, 2020

Venue: EMG Auditorium
Number of participants: 29

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 LCP Annual Report
2020

Description

The sudden emergence of COVID 19 pandemic,

has caught many health workers unprepared.
“ D D
COVID-19 This has led to uncertainty leading to serious
C ” questions regarding survival.

Resource Speaker: The objective of this webinar is to discuss the

Dr. Benilda Galvez important details on COVID 19 that can help
protect and reassure health workers.

Date: June 2, 2020

Venue: EMG auditorium
No. Of participants; 75

To provide holistic mental support to

employees, face-to-face group processing
sessions were organized by the LCP Pastoral
Care Committee in coordination with the
Education and Training Department every
Tuesdays and Thursdays from August to
November 2020.

The objectives of the sessions include sharing

with the group, coping strategies, lessons
learned, present concerns and tips on dealing
with this pandemic.

Date: August 20 & 25

September 1, 3, 8, 10, 15, 17, 22, 24 & 29
October 1, 6, 8, 13, 15, 20, 22, 27 & 29
“ PP C ” November 19 & 26
Resource Speaker: Fr. Placido De Jose
Venue: EMG Auditorium
No. Of participants: 243

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 LCP Annual Report
2020

NEW SERVICES
Health Advocacy and Promotional Activities

1) The SLEEP MEDICINE

• Expansion of the sleep lab services by offering the portable Alice

PDX system for HOME SLEEP APNEA TEST. The device can be used
at the comfort of our patients’ own homes.

• Also offering the use of HOME AUTOCPAP TITRATION capable of

remotely adjust and monitor the amount of pressure delivered to
the patient with Obstructive Sleep Apnea.

• During pandemic, consultation for the health concerns of Sleep

patients is via Telemedicine.

Clinic consults is via Zoom or chat in Messenger and other flat

Forms including training the trainees done through teleconferencing.

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 LCP Annual Report
2020

2) The SUB-NATIONAL LABORATORY (SNL-EREID)

The LCP-EREID started operations solely for Covid-19 testing by
coordinating and sending out samples for RT-PCR testing to RITM.

• April 3, 2019 was a milestone for LCP-EREID. The facility was licensed
as a subnational laboratory (SNL) of RITM to operate on its own, with
full capability to process swab samples, validate test results, perform
quality control and deliver laboratory reports of RT-PCR testing for
Sars-Cov-2 to different sending health facilities.

Drafting the plans for the subnational

laboratory (SNL) with the draftsman in
action. The SNL-EREID

SWAB TESTING

SNL-EREID, 80,076,
94%

Gen Ex,
5,030, 6%
ONE STOP SWAB
The one-stop-swab caters to patients
• A total of 80,076 or 94% patients
were served by the SNL-EREID,
typically clients/referrals from DOH
and 5,030 equivalent to 6% of the
and DOLE for Overseas Workers
patients have undergone the
Employment for an-hour waiting of
GenXpert testing for 2020.
results for faster clinical interventions.

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2020

3) The NUCLEAR MEDICINE

The Nuclear Medicine Section, under the Radiology Department, officially opened
with a ribbon-cutting ceremony held in January 20, 2020. The launching of the
newly renovated and restored service expands armamentarium in biomedical
imaging, as well as radioactive therapeutics.

Dr. V. Balanag, Jr, with Dr. S. Naval and Dr. J. L Obusan during the launching of the Nuclear Medicine
Section, Jan 20, 2020 located at the north wing of the LCP Radiotherapy Building.

• The facility prides in the acquisition of the latest state-of-the-art Siemens

Symbia Intevo BoldTM SPECT-CT Dual Head gamma camera as LCP’s answer to
meet the growing needs of its patients.

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 LCP Annual Report
2020

4) The HEMODIALYSIS

• The Hemodialysis Unit was initially

launched June 18, 2019. It caters to
2020 Hemodialisys Unit
both pay and service in-patients with 150

acute and chronic renal failure 100

requiring renal replacement therapy 50

often accompany and may occur for 0

Jan Mar May Jul Sep Nov
and inconjuction with pulmonary and
other medical conditions. Another Male Pay Male Svc
Female Pay Female Svc
unit was inaugurated last January 23,
2020 with licensed to operate as of March 23, 2020.

• Blessing of the Unit

(additional new) of the
2020 Hemodialisys Unit
Hemodialysis, January 23,
2020 at the newly built 140

OPD facility. 120

100
80
60
40
20
0
Jan Mar May Jul Sep Nov

Male Pay Male Svc

Female Pay Female Svc

• A total of 1,024 patients have

undergone hemoperfusion,
78% mostly are in the service
wards and 22% are paying;
66% of which are female and
34% are male.

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 LCP Annual Report
2020

Other Services: Programs, Projects, Activities and Status

PROGRAMS, PROJECTS, ACTIVITIES STATUS OF IMPLEMENTATION

1) Smoking Cessation Program
• On its 29th year of successful
implementation, the program has
helped smokers remain tobacco
free after quitting smoking in 3
ways:

> Face-to-Face counselling at

the LCP clinic;

> Via the Quitline Program; and

On-line over the official >
Facebook Page of LCP “Bawal
Mag-Yosi.”
“Red Orchid” DOH Hall of Fame Awarde

• As of February 2020, it has

2) Quitline Program
received 1,298 calls and
• Lung Center of the made 5,163 follow-up calls.
Philippines launches 155225 LCP-OPD  406 enrolled in the
hotline PLDT Enterprise launched the Lung program.
Center of the Philippines' emergency OPD  92 are currently engaged in the
consultation number dedicated for COVID- program.
19-related concerns and cases.  64 are tobacco free
 13 have quit smoking in less
than 6 months.

#ONEwithYOU • May 13, 2020

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 LCP Annual Report
2020

3) Healthy Lungs Program

• Conducted 8 batches of
seminar / workshops.

• Conducted 4 sessions of
community outreach
activities.

• Conducted 9 batches of
organizational meetings.

• Continuous collaboration
with the different sectors
of society and the private
organizations.
The Healthy Lungs Program and LCP staff conducting
community outreach/medical mission held at Barangay
Apolonia Samsom, QC, Jan 24, 2020.

The Gender and Development (GAD) Advocacy 4) Anti-Air Pollution Program

Walk for “Healthy Lungs: Healthy Environment”,
January 18, 2020. • Program has temporarily
been stopped pending
availability of funds but
negotiations for this are still
being pursued.

• Some of its activities have

been consolidated into the
Healthy Lung Programs.

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 LCP Annual Report
2020

5) Comprehensive Asthma Clinic

• LCP has established the Asthma
Club since the early 1990’s.
The program is continuously
reaching-out patients with
Bronchial Asthma remotely
through the use of technology
despite the pandemic.
• The Comprehensive Asthma
Clinic is essentially a CENTER
FOR EXCELLENCE IN ASTHMA
EDUCATION AND
MANAGEMENT staffed by a
multi-disciplinary Asthma Care
Team.

6) Chronic Obstructive Pulmonary • The COPD and the

Disease & BRONCHIECTASIS Support
7) Bronchiectasis Support Group
Group is both a program
offered under the Section
of Pulmonary Rehab and
Physical Therapy.

• Sustained its services even

during crisis, the COVI-19
pandemic involving its
patients remotely at their
own home through
advancement in
technology

LCP COPD Support group joined the challenge and won the World COPD
Virtual Olympics Gold contest held in November 18, 2020

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 LCP Annual Report
2020

8) Lung Cancer Early Detection

• Implementation phase with the
Program following documents developed:

Protocol and Algorithm Phase I

Eligibility Questionnaire and Forms

9) LCP Wellness Gym • On the 9th year of implementation,

(Fat loss Program) there is now a total of 496
enrollees who have availed of the
program.

• 2,432 clients have utilized the

wellness gym in 2019. However,
due to the pandemic, the gym was
repurposed as stockroom for
supplies and a partly a temporary
shelter for the nursing staff.
10) Pain Management On the 21st year of implementation,
the program has been offering the
following services:

• Individualized Treatment Plans

in the form of oral medications,
injections, nerve blacks,
physical therapy, psychological
support and counseling,
acupuncture and surgery;
• Symposia.

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 LCP Annual Report
2020

11) Critical Airway and Initial stage of full implementation

Interventional Pulmonary Unit has already been carried out

Pulmonary Fellows-in-training conducting the ECMO procedure, supervised by the head of

the Pulmonary Medicine Interventional Unit.

12) Esophagus and Swallowing Formulated plans, policies, and

Center standard operating procedures for
the Program Implementation.

13) Lung Transplant Program • Finalization of MOA between LCP

and
• NKTI
• LCP Lung Transplant Manual
finalized
• Medical and Surgical Teams for
Lung Transplant Formation
• Formation of Paramedical Support
Groups:
> Rehabilitation
> Dietary and Nutrition
> Psychologist
• Collaboration with PHILNOS for
recipient listing.
• Collaboration with Pharma
company for the importation of
preservative (PERFADEX)
• Acquisition of necessary medicines
and equipment planning stage.

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 LCP Annual Report
2020

The Operating Room Complex

First ECMO for COVID-19, Lung

Center of the Philippines (LCP) in
collaboration with Philippine Heart
Center (PHC).

During a regular equipment disinfection.

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LCP Annual Report
2020

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 LCP Annual Report
2020

CUSTOMER SATISFACTION

For 2020, the ratings here include the months of January and February
pre-pandemic and then June until December during the
pandemic/lockdown or 9 months. No data was collected in March, April,
and May, 2020.

As a summary: Despite the challenges met and changes made by the

hospital staff in 2020, all departments were still able to reach or maintain
very high Net Approval Ratings.

Professionalism and Helpfulness, all departments obtained a net approval

rating of less than 90%. Moreover, the ICU, Bronchoscopy, OR, Radiology,
Pathology, PT and Doctor’s Clinic maintained 100% approval ratings for
2019 and 2020.

For Net Delighted ratings of professionalism and Helpfulness of staff

where at 60% score would be the minimum desired, almost all
departments reached it and higher in both years, 2019 and 2020.

Technical Skills of competence, carefulness and thoroughness, all

departments maintained high ratings of no less than 90% for both years.

For delighted ratings, most departments reached the minimum of 60% in

2019. However, they all obtained lower scores in 2020.

Facilities: With regards to the Quality of Facilities on cleanliness, comfort,

completeness, all facilities in 2019 and 2020 reached the minimum of 80%
and higher except for the Cafeteria in 2020. This may be due to the
Cafeteria’s closure during the lockdown.

None of the facilities were able to reach the desired 60% minimum in
Delighted. However, Parking and Patient Rooms reached 58% in both years.

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 LCP Annual Report
2020

HIGHLIGHTS

The LCP’s COVID-19 Journey

DOH Advisory designating LCP as COVID-19 referral Center

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 LCP Annual Report
2020

THE INCIDENT COMMAND SYSTEM (ICS)

• The World Health Organization (WHO) declared a pandemic last March 11,
2020. Lung Center of the Philippines (LCP) since January has started its
preparation for this respiratory disease by laying its plan conveyed through one
of the Management Committee meeting. The center responded to this
pandemic by activating the Incident Command System (ICS).

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 LCP Annual Report
2020

The hospital’s LCPPA’s parking lot –

turned into a makeshift board room
every day at 9:00 in the morning to
discuss different issues and concerns
on the COVID-19 pandemic for
immediate recommendations and
actions.

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 LCP Annual Report
2020

ICS - PLANNING

I. Balance Scorecard for Covid-19

• Aligned with LCP’s Strategy Map, a separate Balanced Scorecard for Covid-
19 was structured to separately evaluate and monitor processes related to
this health emergency.

LCP’s Balance Scorecard for Covid-19

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 LCP Annual Report
2020

II. Covid-19 Surge Plan

1. Activate the Incident Command System (ICS).

2. Identify Trigger Points based on Case/Disease Development.
3. Coordinate with other government and private agencies for collaborative
operational plans (e.g. Emergency Operation Centers, Epidemiologic
Surveillance Units, QC government and other LGUs referring to LCP).
4. Conduct Periodic Situational Analysis and activate Mitigation strategies as
needed.
5. Evaluate logistics support and adjust continuity and contingency plans
periodically.
6. Monitor non-Covid related processes (e.g. compliance to government
requirements, financial status, HR processing of regular hiring
requirements) to maintain organizational stability amidst the crisis.
7. Identify Demobilization Trigger Points based on Case/Disease
Development.

III. Forecasts

Cases

Based on the past trends in Covid cases, and assuming that all patients
come from Quezon City, about 20% of the total QC Covid cases are seen at Lung
Center. As of April 21, 2020, there were a total of 1062 cases in QC, and a total
of 222 Covid cases were seen at Lung Center (20.9%).

The current attack rate in Quezon City without standardizing for age is 36
per 100,000 population, which increased from 25 per 100,000 for the past 2 days.
This suggests that cases in QC will continue to rise. The number of cases reported
is not totally reflective of the actual or real-time data due to the delay in reporting
of results and the selective testing per barangay in QC.

There is an average of 29 LCP Covid related consults for the past 7 days
(lowest is 17 and highest is 58). The case range is wide and the trend is variable
(increasing or decreasing based on previous days).

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2020

ICS – SAFETY AND SECURITY

The committee denotes addressing the overall safety and security of the whole
hospital relating to health and wellness of the patients, healthcare workers,
frontliners as the most important resources. This includes not only the physical
well-being of patients, hospital staff but also of the facilities.

The Zoning Map: Identifying safe and hazard areas

Displaying flyers and posters at the Main Lobby and Point Areas on the
occasion of Patient Safety Day Celebration, Sept 27, 2020

Continued exposure to create awareness among patients safety.

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 LCP Annual Report
2020

PERSONNEL SAFETY

55
 LCP Annual Report
2020

To ensure safety and protection not only of the staff but also the public as a whole, ingress and
egress points were specified with corresponding Zoning maps for proper identification.

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 LCP Annual Report
2020

Several measures were instituted to ensure safety and protection of all hospital
personnel. They are made aware through the issuance of memoranda, center
orders, notices, lectures using advances in technology and all sort of social
media such as: FB page, Viber, What’s Up, Messenger, Zoom and Webinars, etc.
This is to ensure that all information and guidelines have been understood not
only reached and conveyed to all LCP personnel.

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LCP Annual Report
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LCP Annual Report
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 LCP Annual Report
2020

PERSONNEL CENSUS

Medical Task Force Covid-19 Census

Total Admissions
Since early February 2020 – January
2021, a total of 1,688 patients seen 345319
294
269
were confirmed to have Covid-19 188214 203212
diseases. Of the confirmed cases, 103128
2 12
there were 585 recoveries recorded.
JanFebMarAprMayJun JulAugSepOctNovDec
ADM 2 12 103128188214345319269203212294

A total Covid-19 confirmed

admissions of 807 from March- COVID+ Admissions
December 2020, of which
peaked in July to August 2020. 345
319
269
214 216 203212
188 193
128 104
103
56 50 38 57 39
25
0 12
2 0
Ma Ma Au No
Jan Feb Apr Jun Jul Sep Oct
r y g v
Admissions 2 12 103128188214345319269203212
Covid+ 0 0 56 25 50 38 193216104 57 39

Covid-19 deaths likewise

peaked during July-August Covid+Death
2020 with 84 mortalities last 400
August, 254 mortalities for
300
January-December 2020. A
mortality rate of 31.5% for 200
84
admitted patients. 100 0 0 17 16 9 5
47 40 17
8 11
0
JanFebMarAprMayJun Jul AugSepOctNovDec
Admissions 2 12 103128188214345319269203212294
Covid+ 0 0 56 25 50 38 193216104 57 39 29
COVID+DEATHS 0 0 17 16 9 5 47 84 40 17 8 11

In March, there was a

bimodal peak of 16.5% and
26.4% before it tapered to
3.7% in December 2020 for
mortality and morbidity.

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 LCP Annual Report
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There was an increase in the

number of patients who were
intubated and placed on
mechanical ventilation that
peaked in August 2020 and
subsequently tapered.

A parallel increase in the usage of

High flow nasal cannula in August
2020 was noted but continued to
be used for the succeeding
months, perhaps replacing
invasive ventilation.

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 LCP Annual Report
2020

The census for personnel diagnosed with Covid also reflected the peak of
cases during August but extended until September. It was also during May
that routine screening of personnel in the Covid Wards assisting in the
detection of asymptomatic cases.

LCP MONTHLY COVID-19

MARCH to DECEMBER 31,2020
CASES
( N=149)
38 37

24

15

7 7 8 8
2 3
MARCH APRIL MAY JUNE JULY AUGUST SEPT OCT NOV DEC

For the breakdown of cases, the nursing staff had the most cases followed
by the medical & interestingly the janitorial staff, and also in the non-
COVID areas.

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 LCP Annual Report
2020

More than half of the 54% were symptomatic or presymptomatics. These

are detected mostly through routine NPS/OPS Covid RTPCR swabbing
done for the staff. Majority though or 88% had mild disease, with only 1
critical case and 100% recovered.

Clinical Course of Healthcare Personnel

with Coronavirus Disease 2020

The most common possible exposure source was the community at 47%
and patient exposure at 27.6%. 52% only had low risk exposure.

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ICS - PUBLIC INFORMATION

Public information is vital, either during the day-to-day non-emergencies or

during a public health disaster such as the coronavirus pandemic. To keep track
emergency and disaster operations running smoothly, public information have an
extreme importance in sharing critical information with communities in order to
save lives and protect property. It is the forefront, tasked in communicating to the
public for health awareness, advocacy and promotional activities of the hospital.

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2020

ICS – LIASON OFFICERS

The Infection Control Nurse represents the hospital as HESU and RESU and tasked
to coordinate with the Local Government Unit (LGU) relative to the disposition of
personnel with mild to moderate symptoms for quarantine and isolation.

The Patient Business Division and Admitting Section were assigned as responsible
to collaborate with the LGU and MMDA relative to the management of overstaying
as well as unclaimed Covid confirmed and positive cadaver within specified period
of time, provided in the AITF protocol.

ICS – OPERATIONS

Months before COVID 19 became a pandemic, LCP was already admitting persons
under investigation (PUIs) in the Saint Therese Isolation Unit. However, as cases
began to surge, the LCP was quick to adjust –transforming its private 2A and 2B
into COVID wards. All major non-Covid services were either decreased or put on
hold temporarily.

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2020

Making Room for a Different Kind of Patients

In March 2020, there was a noted increase in numbers of patients affected and
seeking consult. It signaled the putting-up in place a screening/triage area,
consultation area and emergency room extension area.

By the end of December, there were just 70 designated COVID beds. There were
34 COVID ICU beds, 14 COVID isolation beds, and 14 COVID cohorted beds.
Ward 3B which used to have only 4 critical care beds now have 9 beds in the
MICU extension and 12 beds in RICU.

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 LCP Annual Report
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A hospitainer was constructed near the ER complex and eventually functioned as

the main transition area.

Along with the installation of plastic barrier in the different COVID

wards to limit exposure of patients to the frontline clinical staff,
installation of telemetry and CCTV surveillance camera to strictly monitor
activities of patients remotely were necessary.

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Designation of the Covid-19 Team

Pulmonary consultants went on COVID rotation for one week then break for the
next 2 weeks for quarantine. The COVID Rapid Response Team (CRRT), aside from
the Pulmonary team, also had an anesthesiologist to perform rapid sequence
intubation, paralysis and intubation, a surgeon for IJ catheter insertion; and a
cardiologist and nephrologist to co-manage. The IJ catheter insertion for critical
patients was helpful in avoiding frequent IV insertions hence reducing contact time
for staff and also facilitated immediate hemoperfusion or hemodialysis if
warranted.

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Formulation of Covid-19 Management Protocols & Policies

Triage: Setting up of the triage area and developing protocols for

triaging patients at the emergency room as well as coming in for OPD
consult were initiated in January.

The new OPD Building as designated COVID Triage Area and the Emergency Room

The new OPD building was designated as the COVID triage area and an
ER extension for COVID suspects was set up at the OPD complex to
attend to unstable patients in April.

It was only in September 15, 2020 that the OPD was able to resume
consults for non-COVID patients.

Outpatient telemedicine consultation area

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2020

Diagnosis:

Chest CT scan was very helpful in

identifying probable COVID cases because of
its characteristic findings on CT. It became
part of protocol for plain chest CT scan to be
performed aside from chest X-rays to facilitate
identification of probable COVID cases and
initiate management while waiting for their
swab results. We were also able to maximize
the use of point of care ultrasound at the ER level to aid in the diagnosis of
COVID and its complications such as pleural and pericardial effusions and
cardiac dysfunction.

By April 1, the LCP Subnational Lab was already able to process our own
Sarscov2 RTPCR tests and this resulted in the fast-tracking of management of
our patients.

Serum ferritin, C-reactive protein, procalcitonin were made readily

available and this assisted in the management and prognostication of cases.

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2020

Treatment

Investigational drugs:

Since this is a novel coronavirus, no definitive management is established and we

had to rely on the experiences from the reports of other physicians with a big
number of cases worldwide. We made use of investigational drugs such as
hydroxychloroquine/chloroquine, Lopinavir + Ritonavir based on early studies
from China. The Solidarity trial started in April 26 and we were able to have easy
access to these drugs, aside from Remdesivir and Interferon-B that were later
added to the trial in May 11 and July 15, respectively. Tocilizumab was given for
severe to critically ill patients with cytokine storm. Studies recommending the
benefit of Dexamethasone in reducing the 28-day mortality of severe to critical
COVID 19 led to its use as a standard of care starting May 2020, and is
continuously used as of present. Favipiravir was also given for mild to moderate
COVID patients in July. Low molecular weight heparin was given for severe to
critically ill patients for venous thromboembolism prophylaxis.

Investigational Interventions

Sepsis, ARDS and organ damage in

COVID 19 is modulated by “cytokine
storm” caused by dysregulated
inflammatory response led to
incorporation of hemoperfusion as an
adjunct treatment in June.

Convalescent plasma as a passive immunotherapy method has been used

previously with SARS and MERS and has been suggested for treatment of
COVID-19. From May 2020 to August 2020, there was gradual increase using
Convalescent plasma (CP) as an adjunct treatment for severe and critical COVID,
however, use of CP was limited due to availability of blood product.

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2020

Convalescent plasma

Top
Convalescent Plasma (CP) Team
Right
A radiology technologist who recovered
-1 from
and was one of the first donor of

Prone positioning is proven to improve PaO2/FiO2 in patients with ARDS in

general and it has been incorporated in clinical practice in managing ARDS in
COVID 19. As an established respiratory maneuver, prone positioning is advised
to patients without contraindications.

High Flow Nasal systems has provided the advantage of delivering close to 100%
FiO2 without intubating and avoiding mask or noninvasive ventilation all
together. We were able to acquire donations for HFNC and had a total of 24
units. This has greatly helped in reducing intubation rates and had reduced
mortality based on our data.

High Flow Nasal Cannula vs Invasive ventilation

6
High Flow 15
NC

94
Invasive ventilation 50

0 10 20 30 40 50 60 70 80 90 100
Mortalityrate Total Death

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Extracorporeal Membrane oxygenation (ECMO) was also performed for patients

in hypoxic respiratory failure (ARDS) with a high mortality risk despite optimal
care. There were 3 ECMOs performed for critically ill COVID patients but
unfortunately, none of them survived.

Management algorithms and protocols were developed for these interventions

such as hemoperfusion, convalescent plasma, proning, high flow nasal
cannula, sedation and intubation protocols and ECMO.

The Unified Covid 19 Algorithms and The Interim Guidelines on COVID-19 RT-
PCR Testing and Criteria for Recovery/Release from Quarantine were utilized to
constantly update our management algorithms.

ECMO training during COVID-19 Pandemic

Elective surgical procedures were cancelled and those needing immediate

intervention were done in the dedicated operating theater. COVID testing
became a requirement before a patient can undergo non emergent surgical
procedure. Two negative results are required for surgical procedures while one
negative result for bronchoscopic procedures. Resumption of procedures and
activities in the pre COVID era with strict adherence to physical distancing and
protection through wearing of masks were being undertaken slowly by mid-
May.

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EVOLVING TREATMENT REGIMENS

Shows the treatment options for managing COVID 19 pneumonia which evolved since
the start of COVID pandemic from March 2020 to August 2020. Initial treatment
regimen as early as January 2020 suggested the use of Remdesivir,
Hydroxychloroquine, Ritonavir/Lopinavir and Interferon. Discontinuation of
hydroxychloroquine and combination ritonavir/lopinavir July 2020 due to little to no
improvement when compared to standard of care. As these studies proved no benefit in
using Lopinavir/Ritonavir and Oseltamivir in managing COVID 19 and was withdrawn
as treatment options. These data coincides with this graphical representation of evolving
treatment where oseltamivir, ritonavir/lopinavir and CQ/HCQ was discontinued latter
part of April and not included from May to August for COVID 19 management.

EVOLVING TREATMENT COMBINATIONS

The treatment combination used from March to August 2020, statistically significant
combination were extracted from a total of 68 combinations used for 6 months duration
in COVID 19 management at LCP. From March to August, there is a decreasing trend of
mortality rate of admitted severe to critical COVID 19 pneumonia. Standard of care plus
Invasive ventilation was a predominant management strategy throughout this period.

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2020

ICS - LOGISTICS

The hospital immediately coordinated with the DOH and other donor agencies to
acquire the necessary personal protective equipment (PPE) for its front liners.
The Lung Center of the Philippines Physician’s Association was quick to respond
by assisting to solicit and receive donations from the different sectors. A system
was set in place to monitor PPE usage in the different areas and ensure that they
are adequately stocked and replenished.

OTHERS
SUPPLIES UTILIZATION PER AREA
70,000
RAD

60,000

PULMO

50,000

PATHO

40,000
ER

30,000
OR
HEMO
20,000

PEDIA
MICU 10,000
STU
3D
3C 0
3B/RICU
3A
2B
2A

Distribution of Supplies in different Zones Areas with W3A as top user.

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2020

The necessary level of PPE protection was specified for the different areas
according to the personnel’s level of exposure.

TYPES OF PPE's USED PER AREA OF EXPOSURE

40,000

30,000

20,000

10,000

0
FACE MASK FACE MASK N-95 FACE MASK KN95 FACE SHIELD

2A 2B 3A 3B/RICU 3C 3D
STU MICU PEDIA HEMO
OR ER PATHO
PULMO
RAD OTHERS

Types of PPE’s for the different zoning areas.

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 LCP Annual Report
2020

Free Accommodations were provided particularly for the clinical and

nursing frontline staff.

SUMMARY OF STAFF STAYING IN

TEMPORARY SHELTERS
STAYING IN
DPWH 15%
STAFF STAYING IN STAFF STAYING
PREFAB INSIDE LCP
14% (Functions)
44%
STAFF STAYING IN
OASIS
14%

STAFF STAYING
OUTSIDE LCP
13%

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2020

Free shuttle services to ferry LCP personnel from pick-up point to

LCP and vice-versa in the absence of public transport
Total Number Employees availing
Free Shuttle Services
Staff
Staff on Free staying
Shuttle, 369, 40% out/shelte
r, 273, 30%

Staff
staying in
LCP, 276,
30%

Different Route Within Metro Manila

NORTHBOUND WESTBOUND

EASTBOUND SOUTHBOUND

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It is also a part of LCP’s responsibility to ensure provision of nutritional support to

its workforce. LCP was blessed to receive free food and meal packages from
generous volunteers, donors and sponsors. This has helped uplift and boost the
mental and physical strength and stamina of the health care workers.

Provision of food packages from donations and free meals to all LCP employees.

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FUTURE DIRECTION

It has now been recognized that COVID-19 will stay until we find drugs to
cure this disease or an effective vaccination program is already in place.
The Lung Center of the Philippines would continue to be part of COVID
drug and vaccination trials to this end. The risk for a new surge of cases
is ever present hence provisions for resurgence should be in place.

The critical capacity numbers that when breached would necessitate the
conversion of non-COVID wards to become COVID areas again had been
identified. The alternating duty schedules and the COVID Rapid Response
Team remain in place to make sure that there are enough staff to manage
patients at any time without compromising personnel safety.

The most important challenge would still be to ensure that there is an

adequate workforce to serve in case there is another surge. Provision of
adequate supply of Personal Protective Equipment (PPEs) should always be
a priority.

Close communication and engagement with the hospital frontliners and

personnel, assuring personnel safety and commitment to provision of
quality patient care should be continuously pursued.

So far, the Lung Center of the Philippines with a total of 800 employees has
reported a total of 19 employees who contracted COVID 19 –although some
had severe disease, all survived.

The long battle with COVID-19 is far from over, but true to its mission the
LCP community has proven its ability to adapt and deliver consistent, quality
healthcare to those who need it most.

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ACHIEVEMENTS

PROCUREMENT

➢ During this time, the procurement process has been streamlined to

purchase necessary Covid-related materials and equipment. The
purchase of equipment and medical supplies were conducted under
Bayanihan to Heal as One Act (RA 11469) see appendix.

INFORMATION TECHNOLOGY

➢ Computerization and automation were largely devoted to the Subnational

Laboratory. A portion of a Laboratory Information Management System
software was donated to augment the processing of COVID-related tests
and results.

INFRASTRUCTURE AND EQUIPMENT

➢ The beds dedicated to COVID cases have increased in 4 months. Some of

the wards were repurposed to serve as additional wards for critical COVID
patients.

➢ Several equipment and medical supplies were donated (see appendix).

Acknowledgement Receipts of Donations are issued to the donors and
pictures taken to document the receipt of donated items.

➢ Temporary shelters were built within LCP premises. These were donations
from private and government agencies including the Office of the Vice
President and DPWH.

FUTURE PLANS & MAJOR PROJECTS 2021

➢ Retrofitting of the 4th Floor for in-patient admissions
➢ The West Wing Project with the Department of Public Works & Highways

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OTHER ACCOMPLISHMENTS

GENDER & DEVELOPMENT ACTIVITIES GENDER & DEVELOPMENT ACTIVITIES

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GENDER & DEVELOPMENT ACTIVITIES

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In 27 July 2021, a town hall “Management Dialogue with Employees” was held at
the EMG-Auditorium. One of the agenda focused on the Civil Sesrvice
Commission’s (CS) Revised Guidelines for Alternativew Work Arrangement (AWA)
Programs like Work from Home (WFH), Slide (Flexi) Time, 4-days Week Work, etc.
Employees Benefits were presented including among others the following:
• COVID-19 Hazard Pay • Phil Health Sharing
• Special Risk Allowance (SRA) • Accommodation, Meal and
• Salary Differential Transporation Allowances
• GSIS Loan Refund

Awards & Citations

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FINANCIALS

FUND SOURCES

GROSS REVENUE
2020 844,286,208.09 188,573,113.99
100%
90%
80%
70%
60% 2019
697,427,564.24
50% 115,620,292.32
40%
30%
20%
10%
0%
GROSS REVENUE Service and Business Income Shares, Grants and Donations

Gross revenue increased to 0.27% for 2020 compared to 2019

sourced from grants and donations from both the government and
private institutions during the crisis.

BUDGET UTILIZATION RATE

1,200,000,000.00
1,000,000,000.00
800,000,000.00
600,000,000.00
400,000,000.00
200,000,000.00
-
(200,000,000.00)
2019 2020 VARIANCE
CAPTIAL OUTLAY 95,239,729.33 96,199,259.00 0.01
PERSONNEL SERVICES 430,007,997.38 473,642,304.81 0.10
MOOE 525,184,740.37 448,623,504.29 (0.15)

A variance of 0.15% was noted for the year 2020 in comparison with
the year 2019 data for Maintenance and Other Operating Expenses

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LUNG CENTER OF THE PHILIPPINES

DETAILED STATEMENT OF CASH FLOWS - REVISED
AS OF DECEMBER 31, 2020

STATEMENTS OF CASH FLOWS

For the Years Ended December 31, 2020 and 2019
(In Philippine Peso)
2019
2020
(As restated)
CASH FLOWS FROM OPERATING ACTIVITIES
Cash inflows
Proceeds from sale of goods and services 9,656 222,580
Collection of revenue 154,945,274 144,506,269
Receipt of assistance/subsidy 435,681,500 290,282,459
Collection of receivables 249,667,412 467,395,972
Trust receipts 693,953,933 219,773,092
Other receipts 34,060,763 111,868,581
Total cash inflows 1,568,318,538 1,234,048,953
Adjustments 285,920,918 380,224,701
Adjusted cash inflows 1,854,239,456 1,614,273,654

Cash outflows
Payment of expenses 584,384,369 486,368,339
Purchase of inventories 168,072,749 231,234,488
Grant of cash advances 18,992,897 12,976,510
Remittance of personnel benefit contributions 125,286,825 117,942,080
Other disbursements 443,947,870 321,616,646
Total cash outflows 1,340,684,710 1,170,138,063
Adjustments 263,821,411 376,738,176
Adjusted cash outflows 1,604,506,121 1,546,876,239

Net cash provided by operating activities 249,733,335 67,397,415

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LUNG CENTER OF THE PHILIPPINES

DETAILED STATEMENT OF CASH FLOWS - REVISED
AS OF DECEMBER 31, 2020

LUNG CENTER OF THE PHILIPPINES

STATEMENTS OF CASH FLOWS
For the Years Ended December 31, 2020 and 2019
(In Philippine Peso)

2019
2020
(As restated)
CASH FLOWS FROM INVESTING ACTIVITIES
Cash outflows
Purchase of property, plant and
equipment 89,285,081 106,838,826
Total cash outflows 89,285,081 106,838,826

Net cash used in investing activities (89,285,081) (106,838,826)

Net increase (decrease) in cash 160,448,254 (39,441,411)

Cash, January 1 253,556,934 292,998,345

Cash, December 31 414,005,188 253,556,934

The Notes on pages 11 to 42 form part of these Financial Statements.

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LUNG CENTER OF THE PHILIPPINES

STATEMENTS OF FINANCIAL PERFORMANCE
For the Years Ended December 31, 2020 and 2019
APPENDICES (In Philippine Peso)

Procurements 2019
Inventory of Equipment and Medical Supplies
Note 2020 (As Restated)

Acknowledgements: List of donors

REVENUE
Business income 18 844,286,208 687,120,463
Share, grants and donations 19 188,573,114 115,620,292
TOTAL REVENUE 1,032,859,322 802,740,755

CURRENT OPERATING EXPENSES

Personnel services 20 493,399,220 442,405,193
Maintenance and other operating expenses 21 484,490,269 493,500,358
Financial expenses 22 1,919,577 4,444,542
Non-cash expenses 23 135,421,058 120,906,423
TOTAL CURRENT OPERATING EXPENSES 1,115,230,124 1,061,256,516

SURPLUS (DEFICIT) FROM CURRENT OPERATIONS (82,370,802) (258,515,761)

Assistance and subsidy 24 435,681,500 290,282,459
NET SURPLUS FOR THE PERIOD 353,310,698 31,766,698

The Notes on pages 11 to 42 form part of these Financial Statements.

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STATEMENTS OF FINANCIAL POSITION

As at December 31, 2020 and 2019
(In Philippine Peso)

2019
Note 2020 (As Restated)

ASSETS

Current assets
Cash and cash equivalents 6 414,005,188 253,556,934
Receivables - net 7 706,760,575 300,423,896
Inventories 8 92,725,696 53,998,752
Other current assets 9 2,574,587 5,370,308
Total current assets 1,216,066,046 613,349,890

Non-current assets
Investment property - net 10 26,090,199 -
Property, plant and equipment - net 11 4,850,923,342 4,718,890,995
Total non-current assets 4,877,013,541 4,718,890,995

TOTAL ASSETS 6,093,079,587 5,332,240,885

LIABILITIES

Current liabilities
Financial liabilities 12 307,741,279 191,991,047
Inter-agency payables 13 34,931,502 82,926,413
Trust liabilities 14 419,023,766 123,834,418
Deferred credits 15 26,169,265 23,357,235
Provisions 16 189,391,251 171,843,824
Other payables 17 346,310,271 322,086,393
Total current liabilities 1,323,567,334 916,039,330

TOTAL LIABILITIES 1,323,567,334 916,039,330

NET ASSETS (TOTAL ASSETS LESS TOTAL LIABILITIES) 4,769,512,253 4,416,201,555

NET ASSETS/EQUITY 27
Accumulated surplus 1,403,110,947 1,049,800,249
Government equity 3,366,401,306 3,366,401,306
TOTAL NET ASSETS/EQUITY 4,769,512,253 4,416,201,555

The Notes on pages 11 to 42 form part of these Financial Statements.

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Continued in next page please

LUNG CENTER OF THE PHILIPPINES
COVID-19 CASH DONATION
AS OF DECEMBER 31, 2020
DATE DONOR AMOUNT REMARKS
Lung Center Physician's Procurement of medical
3/27/2020
Association (LCPPA) 10,000.00 supplies/medical equipment
Surveillance camera, monitor
3/30/2020 OKADA Philippines for the Wards with approved
24,999,850.00
P.R.
Procurement of medical
3/31/2020 LCPPA
10,000.00 supplies/ PPEs
FBM Technology Procurement of medical
4/6/2020
Solutions Inc. 4,999,850.00 equipment/medical supplies
Covid related expenses for
4/8/2020 Senator Bong Go
100,000.00 patients and employees
Procurement of medical
4/13/2020 Monteguado
500,000.00 supplies
Procurement of medical
Monteguado
500,000.00 supplies
Procurement of medical
4/16/2020 Bayer Philippines
1,999,850.00 supplies
Medical Assistance
(laboratory, diagnostic
4/17/2020 PCSO
35,000,000.00 procedures, drugs and
medicicines
Procurement of medical
4/21/2020 Elaine Duran
50,000.00 supplies, food, PPEs
Covid related expenses for
4/23/2020 Dingo Smart Innovation
375,000.00 patients and employees
Procurement of medical
Senate Economic
4/27/2020 30,000.00 supplies, medical equipment,
Planning Office
40,000.00 food, PPEs
LCPPA - Globe Rewards Procurement of
4/29/2020
Fund 10,000,000.00 medicalsupplies/equipment
National Transmission
4/30/2020 Procurement of testing kits
Corporation 7,500,000.00
For employees transportation
4/30/2020 National Labor Relation
608,000.00 services

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LUNG CENTER OF THE PHILIPPINES

COVID-19 CASH DONATION
AS OF DECEMBER 31, 2020
DATE DONOR AMOUNT REMARKS
Procurement of medical
Manila Broadcasting
5/6/2020 supplies, medical
Company 57,000.00
equipment, food, PPEs
Procurement of PPEs and
5/12/2020 Wyeth Philippines other items for healthcare
699,850.00
workers
Covid related expenses for
5/15/2020 Arch Capital Group Ltd
1,249,850.00 patients and employees
Covid related expenses for
5/22/2020 Dr. Joselito Chavez
36,000.00 patients and employees
Philippine Cable For computer sets with
5/22/2020 Television Association printer for Emergency Roo
200,000.00
Inc. (ER) use
Covid related expenses for
5/21/2020 Anonymous/Unknown
140,000.00 patients and employees

5/26/2020 Usana Philippines Procurement of PPEs

350,000.00
Philippine Cable For computer sets with
7/10/2020 Television Association printer for Emergency Roo
10,000.00
Inc. (ER) use

8/3/2020 Teamreal TV Procurement of PPEs

40,000.00

Total
Php89,505,250.00

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“May Bagong Umagang Darating” #LabanLung

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ACKNOWLEDGEMENT

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