Healthcare Settings Classification PDF

TRIGGER 1 HEALTHCARE SETTINGS Classification of hospital shall be based on Administrative Order No. 2012–0012, dated July 18, 2012, "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines" They shall be classified according to...

TRIGGER 1 HEALTHCARE SETTINGS Classification of hospital shall be based on Administrative Order No. 2012–0012, dated July 18, 2012, "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines" They shall be classified according to the following: According to Ownership Government The hospital is created by law. A government health facility may be under the National Government, DOH, Local Government Unit (LGU), Department of Justice (DOJ), State Universities and Colleges (SUCs), Government-owned and controlled corporations (GOCC) and others Private Owned, established, and operated with funds from donation, principal, investment, or other means by any individual, corporation, association, or organization According to Scope of Services General Hospital A hospital that provides services for all kinds of illnesses, diseases, injuries or deformities It provides medical and surgical care to the sick and injured, maternity, newborn and child-care It shall be equipped with the service capabilities needed to support board certified/ eligible medical specialists and other licensed physicians rendering services in, but not limited to the following: Clinical Services (Family Medicine, Pediatrics, Internal Medicine, Obstetrics and Gynecology, Surgery) Emergency Services Outpatient Services Ancillary and Support Services (Clinical Laboratory, Imaging Facility, Pharmacy) Specialty (Iya iya na doctor sa inana nga sakit chuchu) Specializes in a particular disease or condition or in one type of patient A specialized hospital may be devoted to the treatment of the following: Treatment of a particular type of illness or for a particular condition requiring a range of treatment Treatment of patients suffering from a particular diseases of a particular organ or group of organs Treatment of patients belonging to a group such as children, women, elderly or others EXAMPLES Particular disease Particular organ Particular group of patients National Orthopedic Hospital Lung Center Philippine Children’s Medical Center National Center for Mental Health Philippine Heart Center National Children’s Hospital According to functional capacity Level 1 General Hospital - OK LANG WALA MOBILE XRAY AS LONG AS NAAY IMAGES OR RADTECH A level 1 General Hospital shall have as minimum: 1. A staff of qualified, medical, allied medical and administrative personnel headed by a physician duly licensed by the PRC ( PROFESSIONAL REGULATIONS COMMISSION ) 2. Bed space for its authorized bed capacity, in accordance with DOH Guidelines in the Planning and Design of Hospitals 3. An operating room with standard equipment and provisions for sterilization of equipment and supplies in accordance with: DOH Reference Plan in the Planning and Design of an Operating Room or Theater DOH Guidelines on Cleaning, Disinfection, and Sterilization of Reusable Medical Devices in Hospital Facilities in the Philippines 4. A post-operative Recovery Room - (after surgery na patients thats need to be monitored and care cared immediately after nila mag under go og surgery) 5. Maternity Facilities consisting of Ward(s), Room(s), a Delivery Room, exclusively for maternity patients and newborns. 6. Isolation facilities with proper procedures for the care and control of infection and communicable diseases as well as for the prevention of cross infection 7. A separate dental clinic 8. Provision for blood donation 9. A DOH-licensed secondary clinical laboratory with the services of a consulting pathologist 10. A DOH licensed Level 1 imaging facility with the services of a consulting radiologist 11. A DOH licensed pharmacy Level 2 General Hospital As minimum, all of Level 1 capacity, including but not limited to: 1. An organized staff of qualified and competent personnel with Chief of Hospital/Medical Director and appropriate board certified Clinical Department Heads 2. Departmentalized and equipped with the service capabilities needed to support board certified/ eligible medical specialties and other licensed physicians rendering services in the specialties of Medicine, Pediatrics, Obstetrics and Gynecology, Surgery, their subspecialties, and other ancillary services 3. Provision for general ICU for critically ill patients (adult) 4. Provision for NICU (new born) 5. Provision for HRPU ( high risked pregnant unit) 6. Provision for Respiratory Therapy Services 7. A DOH licensed tertiary clinical laboratory 8. A DOH licensed level 2 imaging facility with mobile X-ray inside the institution and with capability for contrast examinations Level 3 General Hospital (IR) As minimum, all of Level 2, including but not limited to: Teaching and/or Training Hospital with accredited residency training program for physicians in the four major specialties namely: Medicine, Pediatrics, Obstetrics and Gynecology, and Surgery Provision for physical medicine and rehabilitation unit Provision for ambulatory surgical clinic ( is a healthcare facility where surgical procedures are performed on patients who do not require an overnight stay in the hospital. ) Provision for dialysis facility Provision for blood bank A DOH licensed level 3 imaging facility with interventional radiology Specialty Hospitals As described above Trauma Hospitals The trauma capability of hospitals shall be assessed in accordance with the guidelines formulated by the Philippine College of Surgeons Trauma Capable Facility is a DOH licensed hospital designated as a Trauma Center Trauma Receiving Facility is a DOH licensed hospital within the trauma service area which receives trauma patients for transport to the point of care or a trauma center MENTAL HEALTH FACILITIES ▪ Psychiatric patients have been cared for in long-stay mental health facilities, formerly called asylums or mental hospitals. ▪ Majority of large general hospitals have a psychiatric unit, and many individuals are able to maintain their lives as regular members of the community. ▪ The hospital stay of many persons with chronic mental illness has been shortened by modern medication and better understanding on the part of the public. LONG-TERM-CARE FACILITIES ▪ Long-term facilities were homes for the elderly, the infirm, and those with chronic, irreversible, and disabling disorders, especially if the patients were indigent. ▪ Some facilities are transitional from an acute hospital setting to the community, some have residents who have a need for professional healthcare but do not need intensive care. EX: REHAB TRIGGER 2 1. Why did the doctor advise her to be admitted in hospice facility? THE HOSPICE - Historically a hospice was a guesthouse intended for pilgrims and was often closely, connected with a monastery and supervised by monks. From the beginning it had a strong religious connection and exemplified the Christian insistence on compassion and care for the aged, the infirm, the needy, and the ill. In modern Britain the hospice movement developed gradually from its beginning in 1905, when the Sisters of Charity founded the St. James Hospice in London. St. Christopher's Hospice, also in London, founded in 1967, soon became known for its peaceful environment and expert medical and nursing care. In 1974 the first hospice in the United States, the New Haven Hospice (now Connecticut Hospice), was established in New Haven, Connecticut. The hospice movement later spread to many countries worldwide. Hospice is specialized type of care for those facing a life-limiting illness, their families and their caregivers. Hospice care addresses the patient's physical, emotional, social and spiritual needs. Hospice care also helps the patient's family caregivers. Hospice care takes place in the patient's home or in a home-like setting. Hospice care concentrates on managing a patient's pain and other symptoms so that the patient may live as comfortable as possible and make the most of the time that remains. Hospice care believes the quality of life to be as important as length of Life. 2. If Mrs. R refuses to be admitted in hospice facility, do you think her family can provide a home health care? Extended health care With the advance in medical science and the ever-increasing cost of hospital operations, the progressive-care concept is more attractive, both for outpatient and inpatient care. Progressive care can be divided into five categories: (1) intensive care, (2) intermediate care, (3) self-care, (4) long-term care, and (5) organized home care. 1) Intensive care - those with a variety of critical conditions are provided the highest level of care by trained medical personnel. 2) Intermediate care - An Intermediate Care is a vital part of the healthcare system, serving as an essential link between a hospital's Intensive Care Unit (ICU) and the general ward. Intermediate care units are designed to provide an intermediate level of care that's not long-term. They are designed to provide close monitoring and support for patients who are critically ill, injured, or who require intensive medical intervention. However, they are not as intense as an ICU. 3) Self-care facilities are organized into separate units in which ambulatory patients who require only diagnostic or Convalescent care are given accommodations similar to those of a hotel. The patients are free to wear street clothes and to go to the hospital cafeteria. Such a ward or wing of a general hospital requires much less costly equipment than the intensive or intermediate-care units and can be staffed with far fewer nurses and aides. 4) Long-term care - Long-term care involves a variety of services designed to meet a person's health or personal care needs during a short or long period of time. These services help people live as independently and safely as possible when they can no longer perform everyday activities on their own. Long-term care is provided in different places by different caregivers, depending on a person's needs. Most long-term care is provided at home by unpaid family members and friends. It can also be given in a facility such as a nursing home or in the community, for example, in an adult day care center. 5) Home-care programs are for patients who need some health services but not all of the treatment facilities of a hospital. The patients are provided with a range of individualized medical, nursing social, and rehabilitative services in their own homes, coordinated through one central agency. Patients can be considered ready for home care when: (1) diagnosis and a plan for treatment have been established; (2) inpatient hospital facilities are no longer required for proper care; (3) the nursing service has found that the physical environment of the home is such that the patient receives adequate care; (4) the patient is too ill to visit an outpatient clinic but does not need hospital care; (5) the family environment would have a therapeutic effect, and family members or others can be taught to provide the necessary care; and (6) the family and the patient prefer that care be provided at home. Home care conserves expensive acute-care beds, and most patients on home care do as well as or better than expected. 3. What is telemedicine as recommended by her doctor? TELEMEDICINE Telemedicine refers to the provision of remote clinical services, via real-time two-way communication between the patient and the healthcare provider, using electronic audio and visual means. In primary care, telemedicine is usually in the form of phone calls, where the patient seeks the doctor's advice about non-emergency medical problems which don't require the doctor to see the patient. It doesn't replace face-to-face consultation when it is needed, but complements it. The real role of telemedicine at present lies in the convenience it offers to patients and practitioners by obviating the necessity for a physical visit to get medical advice or treatment. It is cost-effective, in comparison to the process of waiting to see a doctor or other practitioner. It can help select urgent calls after a doctor’s office is closed. It is of immense value in the follow up of patients with chronic diseases such diabetes, high cholesterol or high blood pressure. Such patients have no regimens, prescription refills, or even just access to group support. An added convenience is that telemedicine consultations can be so arranged as to follow all needed laboratory investigations or vital sign monitoring system. Benefits of telemedicine Telemedicine requires no significant outlay other than two things: a web camera, and a secure patient portal that connects the doctor to a secured electronic medical records, and connectivity. This ensures safety, the ability to store necessary medical records, connectivity. In addition the physician needs a medical license in the same state as the state where the patient receives his prescription. Those who support the use of telemedicine, point to the convenience, the lower waiting time for a consultation, the access it provides to high-quality medical diagnosis and treatment, and the lesser cost of most consultations. In addition, the ready availability of patient records online has the potential to make patient prescriptions more reliable and accurate. By providing second opinions more easily and faster, it can also make the patient and physician experience better. Finally, it produces improved health outcomes, which should be the primary goal of all health services. Studies which drew direct comparisons between telemedicine and other approaches to patient management mostly show that the benefit lay with telemedicine. TRIGGER 3 Developing a vision and mission statement is crucial to the success of community initiatives. These statements explain your group's aspirations in a concise manner, help your organization focus on what is really important, and provide a basis for developing other aspects of your strategic plan ORGANIZATION - An organization is any collection of persons, materials, procedures, ideas or facts arranged and ordered that the combination of parts makes a meaningful whole that works towards achieving organizational objectives. The process of organization implies to the arrangement of human and non-human resources in an orderly fashion to make a meaningful whole that accomplishes organizational obiectives. MISSION STATEMENT A mission statement defines the hospital's business, its objective and its approach to reach those objectives. Sample of Hospital Mission To provide high-value, patient-centred care; To advance hospital care through research and quality improvement; To provide rigorous training for the next generation of physicians. VISION STATEMENT Describes the desired future position of the hospital. Sample of Hospital Vision A community in which all people achieve their full potential for health and well-being across the lifespan. We work to be trusted by patients, a valued partner in the community, and creators of positive change. HOSPITAL PHILOSOPHY Strive to maintain balance in our pursuit of excellence in clinical care, quality improvement, research, and education. Seek out well-trained physicians with excellent clinical skills as well as academic interests. Support those interests through hands-on mentorship, and tailored opportunities for professional development. The result is a diverse and exceptional group of faculty that will enjoy successful academic careers in Hospital Medicine. HOSPITAL ORGANIZATION 1. Board of Trustees 2. Executive Administration 3. The Medical Staff 4. Nursing Service 5. Allied Health Services 6. Clinical Support Services 7. Administrative Support Services 1. BOARD OF TRUSTEES The "board of trustees," or governing board operates the hospital in trust for the community and has a fiduciary duty to protect the assets of the hospital through efficient operation. The trustees are responsible for establishing the hospital's mission and establishing its by laws and strategic policies. Trustees select the administrative leader of the hospital and delegate the hospital's daily operations and budgeting to the appointed executive. EXECUTIVE ADMINISTRATION The chief executive officer (CEO) reports to the governing board and provides leadership in implementing the strategic goals and decisions set by the Board The CEO also represents the hospital to the external environment and the community. In these tasks, the CEO must coordinate the collective effort of the hospital's personnel. 2. THE MEDICAL STAFF The physician is the leader of the clinical team and the major agent working on behalf of the patient. The physician's responsibility is to diagnose the patient's condition accurately and to prescribe the best and most cost-effective treatment plan. The medical staff is a formally organized self-governing unit within the hospital, primarily comprised of physicians, but may also include other doctoral level health care professional such as dentists or psychologists. NURSING SERVICES Nursing services employees are responsible for carrying out the treatment plan developed by the physician. Nursing services, also called patient care services, is the largest component of the hospital. ALLIED HEALTH SERVICES A number of departments perform support functions that help with diagnosis and treatment. The clinical laboratory is a diagnostic centre that performs a variety of functions, including autopsy, clinical cytology and clinical pathology. Also medical technologists, radiology department and rehabilitation services. CLINICAL SUPPORT SERVICES The hospital pharmacy purchases and dispenses all the medications used to treat patients in the hospital. The pharmacist works directly with the medical staff in establishing a formulary, the listing of drugs chosen to be included in the pharmacy. Other important administrative and business functions may include marketing and planning, public relations, plant and materials management, fund-raising, housekeeping and security. A health information system (HIS) refers to a system designed to manage healthcare data. This includes systems that collect, store, manage and transmit a patient's electronic medical record (EMR), a hospital's operational management or a system supporting healthcare policy decisions. Hospital Organization Based on the CHED CMO Course Outline: Administrative services - a program that prepares individuals to develop, plan, and manage healthcare operations and services within healthcare facilities across healthcare systems. 1. Governing board - a committee of officers who have general supervision over the welfare and conduct of staff 2. Hospital Administrator - responsible for the smooth daily operation of their facilities. - duties include making wide ranging decisions about finances, personal medical policies, and community relations 3. Admissions Emergent Admission - usually happens when a patient seen in the emergency department is subsequently admitted to the hospital. Elective Admission - occurs when a doctor requests a bed be reserved for a patient on a specific day. 4. Information system - a computer system that can manage all the information to allow health care providers to do their jobs Medical services - maintenance or improvement of health via the prevention diagnosis and treatment of disease, illness injury and other physical and mental impairments in people 1. Physicians Radiologist - specialized in diagnosis and treatment of injuries and diseases using medical imaging Family Physician - sees patients of all ages Internal Medicine - physician provides primary care to adult patients Pediatricians - provides primary healthcare to children Obstetrician/Gynecologist - specializes in women's reproductive system/health Surgeon - can be trained in general surgery or in more specialized areas Psychiatrist - treats emotional & behavioral problems through a combination of counseling psychoanalysis, hospitalization and medication Cardiologist - focus on treatment of the heart and its blood vessels. Dermatologist - specializes in treating the skin, hair, nails and mucous Endocrinologist - specializes in endocrinology (hormonal glands) Gastroenterologist - specializes in the disorders of the digestive track Nephrologist - specializes in kidney health and diseases  Otolaryngologist - focuses on the diagnosis and treatment of medical conditions of the ears, nose and throat Pulmonologist - specializes in the diseases of the respiratory tract Neurologist - specializes in the field of neurology includes brain, nervous system and spinal cord Anesthesiologist - administer anesthetics to induce temporary loss of sensation of consciousness Oncologist - specialize in the diagnosis and treatment of cancer. 2. Clinical services 3. Clinical support services TRIGGER 4 Purchasing of medical supplies CLINICAL SUPPORT SERVICES: a. The hospital pharmacy purchases and dispenses all the medications used to treat patients in the hospital b. The pharmacist works directly with the medical staff in establishing a formulary, the listing drugs chosen to be included in the pharmacy. Allotment of hospital budget and hiring healthcare personnel ADMINISTRATIVE SUPPORT SERVICES Non-medical administrative services are necessary to the hospital's business and physical plant management. The CEO leads these administrative services and is directly responsible for the day-to-day operations of the facility. Business services manages the hospital's admitting and discharge functions, records charges to a patient's account, and handles accounts receivables with third-party payers such as insurance companies. The finance department advises the CEO on financial policy and long-range planning, establishes procedures for accounting functions, receives and deposits all moneys received by the hospital and approves the payments of salaries and other expenditures. Accounting is central to the hospital's financial business. Detailed and sound accounting practices are fundamental to maintaining important organizational statistics for administrative decision-making. Admitting services is often where the patient first has contact with hospital. The sensitivity and efficiency of this department can greatly influence the patient's perception of the quality of care received. Information services and medical record maintenance are core functions of hospital management. The human resources department interacts with all departments in the hospital to ensure the quality and motivation of personnel working at the hospital. Other important administrative and business functions may include marketing and planning, public relations, plant and materials management, fund-raising, housekeeping and security. Providing indirect support services among patients? Financing Because hospitals may serve specific populations and because they may be not-for-profit or for-profit, there exist a variety of mechanisms for hospital financing. Almost universally, hospital-construction costs are met at least in some part by governmental contributions. Operating costs, however, are taken care of in different ways. For example, funds may come from private endowments or gifts, general funds of some unit of government, funds collected by insurance carriers from subscribers, or some combination thereof. In some countries, operating costs may be supplemented in part by public or private sources that pay charges on uninsured or inadequately insured patients or by out-of-pocket payment by these individuals. In many countries, and in Europe in particular, the financial support of services in hospitals tends to be collectivized, with funding provided through public revenues, social insurance, or a combination of the two. Thus, the costs of hospital operation are covered infrequently by payments made directly by patients. Details vary somewhat from country to country. In Sweden, for example, most hospital operating costs are financed by public revenues collected by regional governments. Many other European countries follow a similar model, with operating costs for hospitals paid out of national insurance funds; such is the case in the Netherlands, Finland, Norway, and elsewhere. In contrast, other countries, such as the United States, rely heavily on private insurance funds. Private health insurance corporations or agencies exist in many countries. These entities. may offer different or more services relative to national health insurance, although generally at additional cost as well. Private insurance funds offer an alternative mechanism of hospital financing.