ACADEMIC DEPARTMENT

STUDENT GROUP DISCUSSIONS GUIDE

DEPARTMENT: ORTHOPAEDIC AND TRAUMA

Theme : HEALTH SYSTEM MANAGEMENT

Hours: Theory Hour 44

Unit of competency MANAGING AN ORTHOPAEDIC AND TRAUMA UNIT

Broad-objective : 1. The trainee should be able to competently manage an Orthopaedic and

(Learning Trauma unit through effective resource management, infrastructure
Outcome) maintenance, and strategic service planning in accordance with the
Kenyan health system, workplace policies, and quality standards.

Group Discussion- Q1
A busy Level 5 County Referral Hospital frequently experiences delays in operating on
closed ankle fractures due to missing specific plate sizes and calcaneal traction sets.
In your groups discuss:
The internal and environmental factors affect resource planning in the hospital.
Task:
Formulate three actionable strategies that the Orthopaedic Departmental Management
Team can implement to ensure uninterrupted stock availability during high-demand
periods.

Group Discussion: -Q2

A Level 4 Sub-County Hospital attempts to procure specialized pediatric traction frames,
but the process stalls for three months due to administrative delays between the facility and
the County Department of Health procurement office.
In your groups discuss:
 Analyze the most common procurement bottlenecks in Kenyan public hospitals under the
Public Procurement and Asset Disposal Act (PPADA).
Task:
Recommend practical measures to enhance efficiency, transparency, and accountability
when making emergency requisitions for high-demand trauma items.

Group Discussion -Q3

A consignment of POP rolls delivered to a Level 5 Referral Hospital is inspected and found
to be expired, damp, and lacking proper manufacturing batch numbers.
In your groups discuss:
How do quality, quantity, and technical specification discrepancies directly impact patient
outcomes ?
Task:
Draft the standard corrective action procedure (including writing a Rejection Note and
notifying the Hospital Tender/Procurement Board) required by MoH guidelines.

Group Discussion -Q4

An audit of the orthopaedic theatre stock in a County Referral Hospital reveals a large gap
between recorded inventory and physical stock of titanium trauma plates.
In your groups discuss:
Describe the inventory control methods (such as First-In, First-Out [FIFO], First-Expired,
First-Out [FEFO], and periodic physical stock-taking) in managing expensive medical
devices.
Task:
Develop a Departmental Inventory SOP that prevents stock-outs of basic emergency
supplies while curbing commodity pilferage.

Group Discussion -Q5

A Level 4 hospital is converting a standard outpatient room into a full Plaster Room.
However, the drainage frequently clogs, and the space lacks radiation shielding for mobile
X-ray machines.
In your groups discuss:
How does an improperly designed facility layout compromise infection prevention, worker
safety, patient dignity, and clinical efficiency?
 Task:
Recommend infrastructure adjustments to optimize workflow and align the room with
Kenya Quality Model for Health (KQMH) standards.

Group Discussion -Q6

During a routine infection control and infrastructure audit at a Level 5 hospital, the team
finds that the Plaster Room lacks running water, two Balkan frame pulleys on Ward 3 are
rusted shut, and the emergency call buttons in the trauma ward are disconnected.
In your groups discuss:
How should an Orthopaedic Trauma Officer systematically evaluate and document
infrastructure functionality using standard checklist tools?
Task:
Develop a prioritize corrective action plan detailing immediate, short-term, and long-term
fixes for the identified infrastructural deficiencies.

Group Discussion -Q7

At a Level 4 Sub-County Hospital, the main plaster sink becomes totally blocked due to
missing plaster traps, completely halting cast applications over a holiday weekend.
In your groups discuss:
What are the primary institutional challenges affecting the maintenance of orthopaedic units
in Kenyan public health facilities?
Task:
Design a proactive Departmental Preventive Maintenance Schedule covering all
mechanical, electrical, and plumbing assets in the unit.

Group Discussion -Q8

A County Health Management Team (CHMT) is reviewing annual budget allocations.
They note that the orthopaedic unit spent an exorbitant amount on piecemeal repairs for an
outdated, 15-year-old portable X-ray unit.
In your groups discuss:
How can an Orthopaedic Trauma Officer use structured maintenance reports to justify a
budget request for new capital equipment?
Task:
 Draft a formal Maintenance and Asset Status Report for the hospital Medical
Superintendent advocating for the replacement of a faulty equipment item in orthopedic
unit.

Group Discussion -Q9

Waste management handlers at a Level 5 facility report several needle-stick and pin-prick
injuries caused by K-wires protruding from overfilled yellow garbage bags in the operating
theatre.
In your groups discuss:
Analyze the legal, occupational, and safety risks associated with improper segregation of
sharp orthopaedic hardware and contaminated plaster dressings.
Task:
Propose a departmental IPC enforcement strategy to ensure 100% compliance with waste
segregation guidelines at the point of generation.

Group Discussion – Q10

Monthly casualty data indicates a 60% spike in motorcycle-related open tibia fractures
along a newly constructed highway near a Level 4 Sub-County Hospital.
In your groups discuss:
What epidemiological and socio-economic trends influence the shifting demand for
emergency orthopaedic services across Kenyan counties?
Task:
Using the data scenario above, formulate three evidence-based operational interventions to
present to the Sub-County Health Management Team (SCHMT).

Group Discussion – Q11

A baseline assessment at a Level 5 Hospital reveals an average wait time of 5 days for
closed fracture reductions due to a bottleneck in Plaster Room staffing and X-ray processing
times.
In your groups discuss:
How does benchmarking current performance against national standards help identify
system gaps and clinical inefficiencies?
Task:
 Develop a Quality Improvement (QI) Project outline (using a PDSA - Plan-Do-Study-Act
cycle) aimed at reducing wait times for emergency orthopaedic surgery from 5 days to
under 24 hours.

Group Discussion – Q12

You are part of the departmental committee tasked with drafting an expansion proposal to
build a modern, dedicated Level 5 Emergency Trauma & Orthopaedic Center complete with
an expanded Plaster Unit and dedicated Orthopaedic Operating Theatre.
Task:
Structure an evidence-based Facility Expansion Plan Proposal to be submitted to the Chief
Officer of Health / Hospital Management Team (HMT).
Your proposal should cover:
i. Problem Statement
ii. Infrastructure Needs
iii. Resource & Equipment Requisition
iv. Human Resource Requirements
v. Expected Outcome