Ghana Adventist Health Services
(Quarterly Report Form for Hospitals/Clinics)
2025 QUATERLY REPORTING TEMPLATE
Name of Facility { }
[2025] ANNUAL – JAN 1ST to DEC 31ST, 2025
Submitted by:
Tel:
Email:
Date of submission:
1
1.0 Summary of Results to Date
Baseline Target for Q1 Q2 Q3 Q4
Indicators 2024 2025 Target Target Target Target
1. TOTAL NUMBER OF STAFF
ON GOVERNMENT PAYROLL
2. TOTAL NUMBER OF STAFF
ON IGF
3. TOTAL OPD ATTENDANCE
4. PERCENTAGE NHIS
COVERAGE
5. BED COMPLEMENT
6. TOTAL ADMISSIONS
7. TOTAL REFERRALS IN
8. TOTAL REFERRALS OUT
9. NUMBER OF MATERNAL
DEATHS
10. MAJOR SURGERIES
11. MINOR SURGERIES
12. PERCENTAGE C/S
CONDUCTED OVER TOTAL
DELIVERIES
13. NUMBER OF PLANNED
OUTREACH PROGRAMMES
CONDUCTED
14. TOTAL ANC ATTENDANCE
15. TOTAL DELIVERIES
16. TOTAL FAMILY PLANNING
VISITS
17. TOTAL MENTAL HEALTH
CASES SEEN
18. CHILD WELFARE CLINIC
REGISTRANTS
19. TOTAL IMMUNIZATIONS
20. PRESENCE OF A
FUNCTIONAL DRUG &
THERAPEUTIC COMMITTEE
(DTC)
21. RATIONAL USE OF
MEDICATION SURVEYS
CONDUCTED
2
Baseline Target for Q1 Q2 Q3 Q4
Indicators 2024 2025 Target Target Target Target
22. AVERAGE NUMBER OF
MEDICINES PER
ENCOUNTER
23. PERCENTAGE OF
ENCOUNTERS WITH
ANTIBIOTICS
24. PERCENTAGE OF
PRESCRIPTIONS WITH
DIAGNOSIS INDICATED
25. PERCENTAGE DRUG
INCOME OVER TOTAL
REVENUE
26. TOTAL LABORATORY
INVESTIGATIONS
27. PERCENTAGE LABORATORY
INCOME OVER TOTAL
REVENUE
28. NUMBER OF EVANGELISM
CONDUCTED
29. PRESENCE OF FUNCTIONAL
COST AND QUALITY
IMPROVEMENT UNIT (team
members, appointment
letters with terms of
reference, work plans,
minutes of committee
meetings, evidence of
management decisions on
quality recommendations)
30. NUMBER OF QUALITY TEAM
MEETING HELD
31. NUMBER OF QUALITY
IMPROVEMENT ACTIVITIES
COMPLETED PER SAFECARE
QUALITY IMPROVEMENT
PLAN
32. PERCENTAGE COMPLETED
AUDITS PER WORK PLAN
33. PERCENTAGE OF INTERNAL
AUDIT
RECOMMENDATIONS
IMPLEMENTED
34. NUMBER OF HIGH-RISK
AREAS AUDITED PER YEAR
3
Baseline Target for Q1 Q2 Q3 Q4
Indicators 2024 2025 Target Target Target Target
35. PERCENTAGE REVENUE
COMMITTED TO
INFRASTRUCTURE AND
EQUIPMENT
36. PERCENTAGE REVENUE
COMMITTED TO
INVESTMENTS (savings,
provident fund, Heritage
fund)
37. PERCENTAGE TOTAL
REVENUE COMMITTED TO
RESEARCH AND
PROFESSIONAL
DEVELOPMENT
38. PERCENTAGE OF
OUTSTANDING CMS DEBTS
COMMITTED
39. PERCENTAGE OF
OUTSTANDING GAHS DUES
COMMITTED
40. PERCENTAGE OF
OUTSTANDING CHAG DUES
COMMITTED
41. ACTIVE HEFRA LICENSE
42. ACTIVE NHIS
CREDENTIALLING
43. CLAIMS REJECTION RATE
44. NUMBER OF REPORTED
DATA BREACHES/
INCIDENTS
45. NUMBER OF STAFF
TRAINED ON DATA
PROTECTION
46. NUMBER OF PATIENTS
SATISFACTION SURVEY
CONDUCTED
47. NUMBER OF STAFF
SATISFACTION SURVEY
CONDUCTED
2.0 GENERAL REPORT
2.1 Background
Facility Name
4
Location
Operations (services offered by the facility)
Reporting Period
Any other event that impacted health during the quarter
2.2 Major achievements in the quarter in line with the work plan
Strategic priority 1: Improving health security (service delivery)
Strategic priority 2: Strengthening/investing in health systems (infrastructure, equipment, etc)
Strategic priority 3: Communicable and non -communicable diseases
Strategic priority 4: Addressing health determinants of the pro-poor
2.3 Enabling functions of the facility
Financial accountability
Resource mobilization
Analysis of the financial implementation of the work plan and related issues
Number of planned Number of Activity Approved Allotted Committed- Budget implementation
activities in the work Activités on track Budget Budget Expenditures rate
plan completed (1) (2) (3) (4) = (3)/(2)
Narration
Analysis of physical implementation rate of work plan (products and services)
Program area Products In Not Completed On hold Cancelled (Give
progress started reasons)
Communicable
diseases
Non-communicable
diseases
Maternal/child and
reproductive health
Community work or
outreach
Research
5
initiatives/proposals
Others(specify)
Total
2.4 Partnership and Collaboration
Major events that have taken place with the GAHS directorate including visits and meetings
Major events that have taken place with other GAHS institutions
Major events that have taken place with other health partners (MOH, GHS, CHAG, Teaching Hospitals,
Regulatory bodies)
Major events that have taken place with civil society/NGOs/the public and communities including durbars
Major events that have taken place with the Conference including meetings, church activities, etc
Analysis of quality of support received from the Conference and GAHS directorate
Period and Achievements Quality of Alignment with the work plan
purpose support
GAHS
Conference/Church
2.5 Human Resources
#New #Transfer –in # Transfer-out #Promotions submitted
recruitments
#Study leave #Retirements #Sick leave #Leave of absence
#Death Attrition rate
Narration
Total staff (end of the Doctors Nurses/Midwives Allied Health Administrative/Support Staff
quarter)
Narration
Pharmacists Physician
/Pharmacy Assistants/Medic
Technicians al Assistants
2.6 Other issues of importance to the facility not elsewhere captured
2.7 Quality Improvement Activities carried out as per the SafeCare Quality Improvement Plan
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3.0 THE PERSPECTIVE OF NEXT QUARTER
3.0 Success Stories/Lessons Learned
One Story Per Template
Instructions: Provide the information requested below.
* Facility Name and Type ___ (e.g. Kwadaso SDA Hospital) __________________
* Key Issues: _______ (e.g. Community Outreach Strengthening)
____________________
Title: _________________________________________________________
Department/Operating Unit: ____MCH____________
Please provide the following data:
* Headline (Maximum 300 characters): A good headline or title is simple, jargon-free,
and has impact; it summarizes the story in a nutshell; and includes action verbs that bring
the story to life.
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* Body Copy (maximum 5,000 characters): The first paragraphs should showcase the
challenge encountered and the context of the intervention. Presenting a conflict or sharing
a first-person account are two good ways to grab the reader’s attention. Continue by
describing what actions were taken and finally describing the end result. What changed
for the person or community? What was learned? How did this make a difference in the
community or the country overall? If this story is related to a "best practice", what were
the innovations in planning, implementation or partnering that made it different? If this
story is about an evaluation, what program adjustments were made?
* Pullout Quote (1,000 characters): Please provide a quote that represents and
summarizes the story.
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* Contact Information (300 characters): Please list the name of the person submitting
along with their contact information (email and phone number).
Note: The Results Performance Column depicts the achievement level expressed as the
Actual versus Planned percentage.
