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Thursday, March 7, 2019

Entry Level AAC2


AAC2: The SHCO has a documented registration, admission and transfer process
AAC2a: Process addresses registering and admitting outpatients, inpatients and emergency patients.
______________ Hospital has established following procedures detailing the steps involved in registering the patients. The data of each patient like name, address, telephone numbers, etc. are entered at reception in infinity software. ____________Hospital ensures that the personnel handling front office activities are aware of:
1.      Services of the Hospital
2.      Policies and procedures pertaining to admission and registration.
3.      Person or persons to be contacted when in need of clarification on the services provided.
4.      Specialty, Timing and Name of each Consultant.

OUTDOOR PATIENT DEPT
STEP 1: We have to attend the patient at front office within 5-7 minutes after his/her entry to our health care organization.
STEP 2:If patient is disabled or not willing to walk or move, we have to provide a wheel chair to the patient with the help of ward boy and patient attendant.
STEP 3: If patient is having past history of his/her treatment, ask him/her for a previous /past treatment file and ask him/her to sit in lobby.
Note – whenever we talk to any client or patient or relatives we have to be very calm.
Always maintain a smiling face as we are the front office executive.
STEP 4: Ask the patient for referral slip if the patients are from any doctor, hospital or any other source we have to take care that the corresponding patient, company or other source is empanelled with us.
STEP 5:Register them with OPD registration from front desk with ___________ software. All the details as per our OPD form.
STEP 5 A: We have to take registration charges from the patient
STEP 5 B: We have to give a receipt to the patient.
STEP 5 C: We have to register the patient on our software too.
STEP 6: By calculating the time from register & coordination with doctor we have to tell the patient the estimated waiting time, i.e. for how much time they have to wait for their turn to come.
We have also to tell the patient his/her OPD No. and the concerned doctor’s name.
STEP 7: When the patient’s turn comes to be examined by the doctor,call the name of patient by attendants.
STEP 8: with the help of ward boy or patient attendant move the patient from lobby to OPD chamber with the patient past treatment file and current OPD file.
STEP 9: we have to take care that, don’t interrupt between the patients or relatives while they having a conversation but also we don’t have to move from OPD chamber as we have to move from OPD chamber as we have to be the OPD attendant.
Note: we have to take care of privacy policy of patient, in that while examination of patient by the doctor only doctor, OPD attendant and OPD sister will only present in the chamber.
STEP 10: if the patient is a lady, then strictly no male is allowed to be present in OPD chamber.
Note:we are having a “do not disturb “board to hang on the door to avoid unacceptable disturbance to the doctor while they examine the patient.
STEP 11:if the doctor advises the patient for x-Ray, ECG, TMT, dressing, minor surgeries etc we have to shift the patient to relevant department /chamber/room.
STEP 11A: after completion of all the relevant treatment take the patient file to accountant and ask for total amount/fees of the patient.
STEP 11B: describe the charges i.e. OPD charge amount, pharmacy charge amount etc. to the patient and request the patient to pay the amount.
STEP 12:we have to admit the patient or his/her relative to pharmacy to purchase medication advised by the doctor.
STEP13: attach the receipt with the patient file signed by cashier or cash collection officer.
STEP 14:ask the patient for any query he/she might have, give answer the query with warmth and patience.
Note: don’t give consultant or any doctor or any higher authority person’s mobile number to any client or relative or patient without taking their permission.
Tell as date and time for review check up
Don’t talk loudly or in a rough language/manner with the patient or relatives or client as we create the first impression of hospital.




IN  PATIENT DEPT.
STEP 1: When we get confirmation that a patient has arrived with an emergency to our hospital campus, the first thing we do is give a call to ward boys and patient attendants to shift the patient from ambulance to stretcher.
STEP 2: Give a call to resident medical officer.
STEP 3: After the principal medical officer examines the patient, ask him where we have to shift a patient.
STEP 4: After counseling with the RMO/ CONSULTANT and permission of the same we have to do registration of the patient IPD registration register and in our software too.
STEP 5 :Make a file and fill the details of patient.
·         Name of patient
·         Residence address care taker of patient
·         Mobile digits
·         Address
·         Marital status
And the required or mandatory elements.
STEP 6: fill the patient’s consent form and after telling them the purpose and meaning of the form, get it signed by the patient’s relatives.
STEP7: send the file of patient to the corresponding ward where the medical officer has asked the patient to be shifted.
STEP8: we have to confirm that the file of patient is received by RMO of the corresponding ward by telephonic conversation or other source by visiting to the concerned dept.

AAC2b: Transfer or referral of patients who do not match the organizational resources       
Following is the process to deal with transfer of patients needing services that are not offered by ____________Hospital
·         Patients who do not match organizational resources, both in emergency as well as non-emergency situations transferred to other centers.
·         All patients reaching the emergency department in critical conditions are provided with first- aid and all available life saving measures.
·         In case of non- availability of beds in the inpatient care wards, patients are placed in the emergency ward or day care wards until beds are available.
·         In case of absolute non availability of beds, or if the patient’s medical needs are not within the scope of the services of ____________Hospital, the doctor on duty inquiries about the availability of beds in the nearest government facility or at other hospital of the patient’s preference and hospital with in 5 km area, and transfer the patient in the hospital’s ambulance or 108 ambulance. The patient is accompanied by the appropriate doctor or nurse if required.
·         Emergency patient receives life stabilizing treatment and if resources are not available, transferred to an organization that has the required resources.

SOP FOR REFERRAL OUT TRANSFER OUT:
S.NO
PROCESS FLOW
RESPONSIBILITY
SUPPORTING DOCUMENTS
1
Transfer out or referral out shall be done through opd or through emergency ward.
Admission Clerk
Register
2
The treating doctor shall decide transfer out/referral out and explain the reason and plan of transfer to the patient and relative.
Treating Doctor
Medical Record
3
Consent For Transfer Out/Referral Out Is Obtained From The Patient And Relative
Treating Doctor
Consent
4
The Order For Transfer Out Shall Be Written In The Transfer Out Register With The Patient’s Name, Date, Time

Treating Doctor
Transfer Out Register


Transfer of Unstable Patients
1. If a patient has not been or cannot be stabilized, the hospital may not transfer the patient unless either (a) or (b) is met:
  1. The patient, or legally responsible person acting on the patient's behalf, requests in writing that the transfer be effected, after being provided complete information pertaining to the transfer decision, including information concerning:
    1. The medical necessity of the transfer.
    2. The availability of appropriate medical services at both the hospital and the receiving hospital.
    3. The hospital obligation to provide screening and stabilization services without regard to the patient's ability to pay.
  2. A physician has determined and signed a certification to the effect that, based upon the reasonable risk and expected benefits to the patient and based upon the information available at the time of transfer, the medical benefits reasonably expected from the provision of appropriate medical treatment at another hospital outweighs the increased risks to the individual.
2. The patients who are unstable and/or are on ventilator support will be transferred in an ambulance with transfer ventilator and have to be accompanied staff nurse.

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