citizens charter revised2013

7/25/2019 Citizens Charter Revised2013

1/43

LUNG CENTER OF THE PHILIPPINESCITIZEN'S CHARTER

DOH

VISION

The leader of health for all in thePhilippines.

MISSION

Guarantee equitable, sustainable andquality health for all Filipinos, especially

the poor and to lead the quest forexcellence in health

LUNG CENTEROF THEPHILIPPINES

VISION

The premier institution for lung and otherchest diseases providing quality healthcare through excellent service, training

and research.

MISSION

1. We provide quality health carethrough state!of!the!heart facilities byhighly competent and compassionatestaff for the improvement of quality of life

of the Filipino people.

". We provide immediate attention toevery individual in need regardless ofcreed, color, sex, socio!economic statusand political affiliations.

#. We endeavor to achieve financialstability and long term sustainability.

$. We are dedicated to lung healthpromotion and advocacy.

SERVICE PLEDGE

We, the officials and employees of the%ung &enter of the Philippines '%&P(,

pledge and commit to deliver quality publicservices as promised in the %&P &iti)en*s&harter and the +- //1"//0 standards.

We phold our shared values of concernand care forpatients, employees and

institution2 responsibility and discipline2commitment and dedication to excellence2respect for individual 3orth2 integrity and

honesty2 unity and team3or42 andcreativity and innovativeness.


2/43


SECTION OF RESPIRATORY SERVICES (SRS)ELECTROCARDIOGRAM (ECG)

STEP CLIENT ACTIVITY DURATION OFACTIVITY

PERSONRESPONSIBLE

FEES FORMSNEEDED

1 Patient 5eceives request

6 mins. &ler4 or 5T on duty Php #76.//

5equestfrom 8octor

" 5egisters patient

# Prints charge slip

$ Pays the corresponding fee atthe &ashier

6 Presents -fficial 5eceipt " mins. &ler4 or 5T on duty

7 Prepares the patient

Performs the procedure

End of Transa!"ons

9ote +f patient 3ants to borro3 :&G strip, lets patient;relative sign the


3/43

SECTION OF RESPIRATORY SERVICES (SRS)ARTERIAL #LOOD GAS (A#G)

STEP CLIENT ACTIVITY DURATION OF

ACTIVITY

PERSON

RESPONSIBLE

FEES FORMS NEEDED

1 Patient 5eceives request frompatient,,

6 mins.

&ler4 or 5Ton duty

Php 70/.//

5equest

from 8octor

" 5egisters patient and printcharge slip

# %ets patient;relative pay at thecashier

$ Prepares materials for >?Gextraction

1 min. 5T

6 Gives patient;relative print outof initial result for >P

# mins. 5T

7 +nstructs patient;relative to getofficial reading of result after #3or4ing days 'if pay patient,official result 3ill be for3ardedto >P(

" mins. 5T

End of Transa!"ons


4/43


PERSONRESPONSIBLE

FEES FORMS NEEDED

PULMONARY FUNCTION TEST $ SPIROMETRY

1 Patient 5eceives request form frompatient

6 mins. &ler4 or 5T Php 7#/.//to #,#0/.//

5equestfrom 8octor

" +nforms the patient aboutamount of test

# >s4s if patient had ta4enbroncho dilator

$ Performs orchedules Patient

STRESS $ E%ERCISE TEST

1 Patient 5eceived request form frompatient

1/ mins. &ler4 or leepTech

Php1,"//.//

5equestfrom 8octor

" +nforms the patient aboutprocedure and the amount ofthe test

# chedules patient


5/43


PERSONRESPONSIBLE

FEES FORMS NEEDED

SPUTUM INDUCTION

1 Patient 5eceives requisition from thepatient

6 mins. &ler4 of 5T Php 17/.// ;procedure @neb 4it Php1"/.// @cannister

Php 16.//each A Php7$6.//

5equestfrom 8octor

" 5enders patient in the cashtransaction

# Prints charge slip

$ %ets patient pay at the cashier

6 Prepare machine to be use 1 min.

5T7 Prepares nebuli)er 4it and canister

for use of the patient1 min.

B >fter payment, assist patient in thecollection area.

1 min.

0 +nstruct patient on ho3 to collectsputum

# mins.

Performs procedure 16 mins to1 hr

1/ >fter collection of sputum in the #canister, instructs patient to proceedto the laboratory for >F? smear

# mins.

& nd of !ransa!"ons &


6/43


PERSONRESPONSIBLE

FEES FORMS NEEDED

POLYSOMNOGRAPH $ SLEEP STUDY1 Patient 5eceives requisition form

from patient1/ mins. &ler4 or leep

TechPhp

0,///.// to16,///.//

5equestfrom 8octor

" +nform the patient aboutprocedure and the amount oftest

# chedule patient

D&ECHO

1 Patient 5eceives requisition formfrom patient

1/ mins. "8!echo TechPhp

",1B/.// to$,"#B.6/

5equestfrom 8octor

" +nforms the patient aboutprocedure and the amount oftest

# chedules patient

PRE&FLIGHT$HYPO%IA INHALATION TEST

1 Patient 5eceives request form frompatient &ler4 or 5T

Php",/"6.//

5equestfrom 8octor

" +nform the patient aboutamount of test

# Performs procedure $6 mins. 5T

$ Types of result for+nterpretation

# mins.&ler4 or 5T

6 %ets doctor sign result 1/ mins.

7 5eleases 5esults


7/43


LA#ORATORY SERVICES

STEP CLIENT ACTIVITY DURATIONOF

ACTIVITY

PERSONRESPONSIBLE

TIME *FEES FORMS NEEDED

1 PatientGet a number card in therac4 provided. 'Cumuhang numero na na4asabitsa harap ng bintana ngopisina.(

" seconds Ded. Tech.

Bam!6pm

chedule of

fees is locatedat the -P8%aboratoryWindo3

" PatientWait for the number to becalled. 'Eintayin namata3ag ang numero.(

16!"/

minutesDed. Tech.

# PatientPresent inquiry or submitlaboratory request orspecimen to thelaboratory staff.'magtanong o magbigayng laboratory request sa

laboratory staff lamang.(

" seconds Ded. Tech. 5equest fromthe attendingphysician

$ Patient&hec4 request;s forcompleteness of data.'suriin ang lab. *requestsa mga 4ina4ailangangimpormasyon.(

#!6 minutes Ded. Tech.

6 Patient+nspect specimen forquality and quantity.'uriing mabuti angspecimen base sa 4alidadat 4ung sapat para saexaminasyon.(

#!6 minutes Ded. Tech.

5endered5equest form


8/43


ACTIVITY

PERSONRESPONSIBLE

TIME *FEES FORMS NEEDED

7:ncode data in theEospital +nformation

ystem '?+?-(. 'itypeang impormasyon sacomputer.(

6 minutes Ded. Tech.

B>D !6PD

chedule offees is located

at the -P8%aboratoryWindo3

Transactionslip form

B PatientPay corresponding feesto the cashier .'Pagbabayad ng4au4ulang halaga sa4ahera.(

#!$ minutes Patient

0 Patient

Present -fficial 5eceipt

'-5( to the laboratory'upang maitala.(

1!" minutes Patient-fficial 5eceiptform

Patient:xtract blood forexamination. 'Cu4uhananng dugo ang mgapasyente na may requestng blood examination.(

1/ minutesDed. Tech.

Transactionslip form 3ithcorrespondingreceipt form

1/ Patient:ndorse all specimenreceived to the laboratory

section concerned.'Pagdala ng specimen saloob ng laboratoryo.(

16 minutes %ab >ide

* Schedule of fees is locaed a he OPD La!o"ao"# $i%do&


9/43


PROCEDURE& EMERGENCY ROOM

STEP CLIENT ACTIVITY DURATIONOF ACTIVITY PERSONRESPONSIBLE FEES FORMSNEEDED

1 Patient 8irects patient;companion totriage area

1 min.ecurity Guard

on!duty

" >s4s patient*s name, and chiefcomplaints

" mins.9urse ;

:5 Fello3:5 Patientervice

# :xamines ; >ssesses patient*scondition

6 ! 1/ mins.9urse ;

:5 Fello3

9ursing>ssessment;:5 Patient

ervice;5is4 Fall>ssessment

$ Prescribes medicines and;orrequests diagnostic procedures

# mins.9urse ;

:5 Fello35equestform

6 >dministers medications 1 min. 9urse :5 flo3 sheet

7 :valuates results of diagnosticprocedures

" mins. :5 Fello3:5 Patientervice

B :valuates disposition of patient'admission or out!patient( " mins. :5 Fello3

:5 Patientervice

0 Gives charge slip for :5 feeand other procedures

1 min. 9urse:5 fee H#"6.//

&harge slip

Presents official receipt '-5(6 mins.

Patient;&ompanion

-fficial5eceipt

1/ &hec4s and gives instructionson prescription, furtherlaboratory 3or4!up, referral Ifollo3!up

# mins.9urse;

:5 Fello3

5equestform;Prescription;>ppointmentslip


10/43

PATIENT TO #E ADMITTED

11 Gives admission notice toadmitting section

1 min. :5 Fello3>dmissionnotice

1" &oordinates and transports

patient to Ward 6 mins.

9urse;

9. >ide

>dmission

chart

PROCEDURE &OUT PATIENT DEPARTMENT & FOLLO&UP

FOR OLD PATIENTS*

STEP CLIENT ACTIVITY DURATIONOF ACTIVITY

PERSONRESPONSIBLE

FEES FORMS NEEDED

1 PatientGives -P8 card Iappointment slip

#/ mins. 9urse ; 9. >ide -P8 &ard

" Jerifies appointment 1 min. 9urse ; 9. >ide

>ppointment slip

#5egisters patient in thehospital database

6 mins. 9urse ; 9. >ide

-P8 &ard

$Prepares charge slip for the-P8 fee

1 min. 9urse ; 9. >ide &harge slip

6 Pays at the &ashier 6 mins.Patient;

&ompanionPhp 7/.// &harge slip

7>ccepts payment and issuesthe -fficial 5eceipt '-5(

1 min. &ashier -fficial 5eceipt

B5eturns to the -P8 andpresents -5 for -P8 fee

1 min.Patient;

&ompanion-fficial 5eceipt

0>ssesses and examinespatient

6 H 1/ mins. Dedical -fficer -P8 &hart

Prescribes or requestadditional procedures

1 min. Dedical -fficer 5equest form


11/43

1/

&hec4s and givesinstructions on prescription,further laboratory 3or4ups,referral I follo3!up

6 mins. 9urse5equest form;Prescription;>ppointment slip

REMINDER*

R+"s!ra!"on !", "s -!.n /*00a, !o 10*00a,

Cons23!a!"on s!ar!s a! 10*00a,

PROCEDURE & OUT PATIENT DEPARTMENT

FOR NE PATIENTS*


PERSONRESPONSIBLE

FEES FORMS NEEDED

1 Patient Gives out information slip #/ seconds 9urse ; 9. >ide +nformation lip

" Fills out information slip 1 min. Patient;&ompanion +nformation lip

# &ollects information slip 6 mins. Triage -fficer +nformation lip

$Prescribes or requestdiagnostic procedures

6 mins. Triage -fficer 5equest form

65egisters patient in hospitaldatabase

1 min. 9urse ; 9. >ide +nformation lip

7 Prepares charge slip 1 min. 9urse ; 9. >ide &harge slip

B Pays at the cashier 6 mins. Patient;&ompanion Php B/.// &harge slip

0>ccepts payment and issues-fficial 5eceipt '-5( to thepatient

1 min. &ashier -fficial 5eceipt

Proceeds to 5adiology 8ept.

and presents -5 for the &hest!ray

1/ mins. Patient;&ompanion 5equest form


12/43

1/nderta4eschest x!ray

115eturns to the -P8 andpresents -5 for the -P8 andervice &ard

1 min. Patient;&ompanion -fficial 5eceipt

1">ssesses and examines thepatient

6 H 1/ mins. Dedical -fficer -P8 &hart

1#Prescribes or requestsadditional procedures

1 min. Dedical -fficer 5equest form

1$

&hec4s and gives instructionson prescription, furtherlaboratory 3or4ups, referral Ifollo3!up

6 mins. 9urse5equest form;prescription;appointment slip

REMINDER*

R+"s!ra!"on !", "s -!.n /*00a, !o 10*40a, (Tr"a+)

Cons23!a!"on s!ar!s a! 1*005,


13/43


PROCEDURE& ADMITTING PATIENTS


PERSONRESPONSIBLE

FEES FORMSNEEDED

1 Patient Presents admitting order to>dmitting &ler4

1 min. Patient ; 5elative >dmitting -rder

" &hec4s availability of roompreferred by patient*s relative.+nforms Ward 9urse about theadmission

6 mins. >dmitting &ler4

# >ccomplishes admission sheetand related confinementrequirements

1/ mins. Patient ; 5elative

>dmissionheet

$ &hec4s data as accomplishedby patient or relative.5equest for credential;s li4e +8of person responsible foraccount.+nquires if patient is a member

of Philhealth -&>, ED-, etc.:xplains hospital policies andprocedures

6 mins. >dmitting &ler4 >dmissionheet

6 igns conforme regardingconsent of admission and theircorresponding responsibilities

1 min. Patient ; 5elative &onsent foradmission' Pay;ervice (

7 Prepares +8 tag and admission4it, encodes admission,itemi)ed bills and print Patient

8ata heet for referencepurposes.

6 mins. >dmitting &ler4 &harge lip,P8


14/43

B Proceeds to ocial ervice inthe case of service patients.For pay patients, they mayoffer voluntary deposit

6 mins. Patient ; 5elative

0 Patient Follo3s!up call to the 3ard and

chec4s readiness of bed orroom.5egisters patient in PhilhealthDandatory ledger and preparesname tag.

# mins. >dmitting &ler4

Patient Transport patient to the 3ardFor3ards patient data sheet tothe ?illing, credit and &ollection8ivision

1/mins. 9ursing >ide


15/43


PROCEDURE& DISCHARGING AND ISSUANCE OF CLEARANCE TO PATIENT


PERSONRESPONSIBLE

FEES FORMSNEEDED

1 Patient -rders dischage of patient 6 mins. Physician; 9urse!on!duty

" &lears patients from incomecenters

1/ mins. 9urse!on!duty &reditadKustments ifneeded

# Tags patients as discharge 1 min. 9urse!on!duty$ Prepares patient*s bill 16 mins. ?illing &ler4;

PE+& &ler4tatement of>ccount '->(

6 5eceives payment of bills 6 mins. &ollection -fficeron duty

>mount ofbill, 5eaders

Fee

->, 5eadersFee, &learanceslip from 8rs.

7 Presents completed clearance 1 min. Watcher ; relativeof patient

B &hec4s clearance ; patient*s

belongings, instructs patient onhome medication follo3!upconsultation

6 mins. 9urse!on!duty

0 ?rings do3n patient to exit 6 mins. 9ursing >ide

' Gives clearance to guard 1 min. Watcher ; relativeof patient


16/43

LUNG CENTER OF THE PHILIPPINESPHARMACY DIVISION

A6 OUT&PATIENT$AL7&IN$GENERAL PU#LIC


PERSONRESPONSIBLE

FEES FORMS NEEDED

1 Patient ; Patients5elative

Presents requisition slip orprescription

6 secs. Pharmacist!on!duty 5equisitionslip;Prescription

" 5eads and interpretsprescriptions

1 min. Pharmacist!on!duty

5equisitionslip;Prescription

# Prepares charge slip #/ secs. Pharmacist!on!duty

5equisitionslip;Prescription;

&harge lip$ Prepares medicine ;

Prescription filling1 min. Pharmacist!on!duty &harge lip

6 Presents -fficial 5eceipt'-5(

6 secs. Pharmacist!on!duty &harge lip ; -.5.

7 8ispenses Patient&ounseling

1 min. Pharmacist!on!duty &harge lip

B Files charge slip 6 secs. Pharmacist!on!duty &harge lip

.#6 OUT&PATIENT ITH CERTIFICATE OF MEDICAL ASSISTANCE (CMA)


Presents prescription and&D> form

6 secs. Pharmacist!on!duty Prescription;&harge lip

" 5evie3s &D> 1/ sec. Pharmacist!on!duty

&D> form

# 5eads and interpretsprescription

1 min. Pharmacist!on!duty

Prescription

$ Prepares of &harge lip #/ secs. Pharmacist!on!duty Prescription;

&harge lip


17/43


8ispenses ; &ounselspatient


7 Files &harge lip 6 secs. Pharmacist!on!duty &harge lip

C6 IN&PATIENTSTEP CLIENT ACTIVITY DURATION

OFACTIVITY

PERSONRESPONSIBLE

FEES FORMS NEEDED

1 9urse!on!duty;3ard5evie3ing of request from3ard

1/ secs. Pharmacist!on!duty

" 9urse!on!duty;3ard5endering of requisition 1/ secs. Pharmacist!on!duty

# 9urse!on!duty;3ardPrinting of requisition 1/ secs. Pharmacist!on!duty &harge lip

$ 9urse!on!duty;3ardPreparation of medicine ;Prescription filling


6 9ursing >ide!on!duty

8ispensing 1 min. Pharmacist!on!duty &harge lip

7 Filing of charge slip 6 secs. Pharmacist!on!duty &harge lip

D6 IN&PATIENT ITH CERTIFICATE OF MEDICAL ASSISTANCE


ACTIVITY

PERSONRESPONSIBLE

FEES FORMS NEEDED


Presentation of &D> form 6 secs. Pharmacist!on!duty &D> form

" 9urse!on!duty;3ard 5evie3ing of request from3ard

1/ secs. Pharmacist!on!duty

# 9urse!on!duty;3ard 5endering of requisition 1/ secs. Pharmacist!on!duty

$ 9urse!on!duty;3ard Printing of requisition 1/ secs. Pharmacist!on!duty &harge lip

6 9urse!on!duty;3ard Preparation of medicine ;Prescription filling



18/43


8ispensing 1 min. Pharmacist!on!duty &harge lip

B Filing of charge slip 6 secs. Pharmacist!on!duty &harge lip

E6 ARD$OTHER DEPARTMENT OR DIVISION

1 Presentation of5equisition and +ssue lip'5+(

6 secs. Pharmacist!on!duty 5+

" 5evie3ing of 5+ #/ secs Pharmacist!on!duty 5+

# Preparation ofmedicine;Prescriptionfilling

1 min. Pharmacist!on!duty 5+

$ 8ispensing 1 min. Pharmacist!on!duty 5+


19/43

I 8 F3o. for MDRTT# $ PMDT Sr9"s*

S!5 Pa!"n! $ C3"n! A!"9"!: D2ra!"on Prson "n&;ar+

Fs

creening D85T? uspect

Patient

>ssess;+ntervie3 patient

&ollect '"( putum specimens:ducate Patient re Preventionof pread!Give ac4no3ledgment letterbac4 to referring D8;8-Tfacility

16!#/mins. Physician;9urse Free

9on D85T?uspectPatient

! 5efer bac4 to referringD8;8-T Facility

"!6mins. ! Physician Free

:nrollment &onfirmed D85T?Patient

! &ollect '"( putum specimen!+nform the patient about thepossible diagnosis of D85!T?and the steps to be ta4en. GiveP>9>W> form

! "hrs to " days! 6!1/ mins.

! 9urse;upporttaff!Physician;9urse

Free

uspect is notseriously ill

Patient !>3ait laboratory results!5elease of results

8D

&ulture

8T

!+nform referring facility ofresults.

! $!6 days afterthe last specimencollection! #!#.6 monthsafter specimencollection! $!6 months afterspecimencollection! once result arereleased

! 9urse Free

uspect isseriously ill Patient 5efer to &onsilium for :mperictreatment >fter 1 3ee4 Physician Free


20/43

II& F3o. for !; Tra!,n! of Pa!"n!s ."!; MDR&T#

S!5 A553"an! $ C3"n! A!"9"!: D2ra!"on Prson "n&;ar+

Fs

&asePresentation to&onsilium

Patient &ase T& Physician Proposes drugregimen to &onsilium&onsilium approves drug regimen

L :very Tusedayonly

Physician Free

+nitial Patient+nformation atenrollment

Patient and Family L &ontact patient for enrollmentL +nform the patient on theenrollment proceduresL Give the pre!enrollmentchec4list &ompletionL >dministration of &ontract

L ocial &ase tudy 5eportL 5esidence Jerification

L #/ minutes

L a day afterenrollment '"hoursper visit(

ocial Wor4er Free

&ontact Tracing Patient and Family L &ontact Tracinginstructions;intervie3L &hest !ray for every householdcontactsL for positive &hest !ray, '"(sputum collection 3ill be done

L 8epends 3ith no.of householdcontacts '16!#/mins. Perhouseholdcontacts(

9urse &;o of8T !'Privatept.(

Patientenrollment

Patient and Family L 5equest baseline laboratorytestsL -rient the patient and family onD85!T? and on the proceduresto be done for enrollment afterL Provide drug education topatient

L #/ mins. ! 1 hour 9urse;upporttaff

Free

tart theTreatment

Patient L upervise the patient during theentire period of treatment

L 8irectly observe ecah treatment! >dministration of inKection! >dministration of drug

L 10!"$ monthsL 6/;B/ pts. Per day

L 1/!#/mins eachpt. 8aily 6!#/ minsper pt.

9urse;upporttaff


21/43

regimenL &ontinue providing informationabout T? and treatment decisionsL Donitors the patient for adversedrug reactionsL Donitors the progress oftreatment by follo3!upexamination of sputum,x!ray andbld. &hem..

L :very month

L daily

L sputum collectionmonthlyL x!ray H every 7mos.L bld.&hem H every7 mos. for belo3 6/yrs old! every # mos. Forabove 6/ yrs old Hor as needed

&harge'PrivatePatients(

D85!T?

patient ongoingtreatment

-ngoing patient L &ategory +J 5egister pdate

L 5evie3 &hartsL Preparation of 5eportL upport D85!T? patientseveryday as they come in forsupervised treatmentL 8istribution of :nablersL &onduct of Group 8iscussionL &onduct of General >ssembly

L >s 9eeded

L monthlyL monthlyL 3ee4ly

L 3ee4lyL 3ee4lyL every month

9urse

9urse9urseocial Wor4er

ocial Wor4erocial Wor4erPhysician ;ocialWor4er

;9urse ;upporttaff

Free

8efault Tracing -ngoing Patient L Trace and ta4e necessaryactions for a patient 3hointerrupts treatmentL Phone call ; home visit

L as needed ocial Wor4er Free

Patient8ecentrali)ation

-ngoing Patient L Trac4ing of confirmed patientready to be decentrali)e todifferent Treatment ites in DetroDanila I &>%>?>5-9L Give ocial Preparation forPatient 8ecentrali)ation 'PP8(

L monthly

L 1 hour lecture

9urse

9urse I ocialWor4er

Free


22/43

lecture for patient candidates forpatient decentrali)ationL chedule for monthly patientdecentrali)ationL Preparation of drugs and formsfor the Treatment sitesL +nitial Patient :ndorsement toTrained Eealth &enterL 8ispensing, 5ecording and5eporting of 8rug &onsumptionL Preparation of >dverse drugexperience reportL Donitoring and upervision

L monthly

L 1 day

L " hours ;endorsement

L every other 3ee4

9urse

Pharmacist

9urse

9urse IPharmacist9urse

9urse

+mplementtreatment

decisions

-ngoing patient L >dverse events! 8ose change2 drug change2

discontinuation of offendingagent2drug re!challenge2 holding offoffending agent temporarily2prescription of ancillary drug2medical referralL &hange in 8T patternL 8iscontinuation of drug2 drug ordoseL &hange to a more appropriate

drug or doseL 8rug change2 dose change2discontinuation of drug2continuation of present regimenL hift to &ontinuation PhaseL 8etermine treatment outcomeL Provide education at the end oftreatment

L as needed 9urse ;Physician

Free


23/43

I& F3o. for DOTS "n C;"3drn Sr9"s*

S!5 Pa!"n! $ C3"n! A!"9"!: D2ra!"on Prson "n&;ar+

Fs For,sNdd

1 Dother 3ith her child a. +nitial +ntervie3 ofmotherb. Get the demographicdata of the child includingthe vital signs and actualheight I 3eight of the childc. 5efer to the Pediatricianon duty for consultation Icomplete medical chec4!upM The Physician 3ill

prescribe appropriatediagnostic procedures li4e&hest !ray I or PP8.

"!# mins

"!# mins

"!# mins

1/!16 mins

9urse

9urse

9urse

Physician on

8uty

Free

Free

Free

Free

9TP8iagnosisForm forchildren/ H yrs old

!ray form

PP8 Test

" &hild a. 3ill do the request of&hest !ray 'P>%(

b. Will do the PP8 '6T(

1 min

" mins

9urse

9urse

#6/.//

#//.//

&hestx!ray request

PP8 request

# Dother L +ntervie3 for classificationand for social case study

6!1/ mins ocial Wor4er Free

$ Dother 3; her &hild L Follo3!up of child forPP8 reading after B" hours

1 min 9urse Free

6 Dother 3; her &hild L +f &hest !ray has an-fficial5eading, the mother isadvised for follo3!up

7 Dother;&hild L Follo3!up of child 3iththe Physician once all

diagnostic procedures arein.

1/!16 mins Physician Free Patient &hart


24/43

B Dother 3; &hild L +f child is diagnosed 3ithPrimary Coc4s +nfection'PC+(, the child 3ill beenrolled in the programprepare the Tx. &ard,register the name at the T?5egister for &hildren

1/!16 mins 9urse Free 9TPTreatmentcard forchildren9TP +8 &ardT? 5egistry

0 &hild L +f the child lives near toour center 'at least 1!"rides( she;he 3ill beenrolled.

9TPTreatmentcard forchildren9TP +8 &ard

&hild

Dother;&hild

L >n initial dose of >nti!T?meds 3ill be given, andthereafter.

L Eealth education 3ill bedone

6 mins

1/ mins

9urse

9urse

Free

Free


25/43

I8 F3o. for P3a"n DOTS Sr9"s*

S!5 Pa!"n!$C3"n! A!"9"!: D2ra!"on Prson "n&;ar+

Fs For,sNdd

5eferral from-P8, 8-T

Facility, 3al4!inor Private D8.

Patient a. +ntervie3 the patient, getthe result of sputum smear

if it 3as done.

b. +nstruct patient forsputum collection # times ifnot yet done '1 spotcollection;day(

"!# mins

"!# mins

9urse

9urse

%ab. &hargefor sputum at

cost orsociali)e'Private D&(

8one 3; -P8+ntra!Eospital

referral form'?lue Form(

%ab. request

For Positivemear 5esult

Patient9e3 &ase 3ithPhilhealthcoverage '1,6// H7 to 0 mos

L Day :nroll patient to ourfacility if 3ithin ourcatchment area or refer totheir nearest Eealth &enter.L Give Eealth :ducation onFacts about T? for ne3enrolled patient.

#!6 mins

#/ mins H1 hour

9urse 9TPtreatmentcard9TP+dentificationcard+f patient referto peripheral8-TEospitalreference

form 'Nello3form(

tart theTreatment

Patient L upervise the patientduring the entire period oftreatmentL 8irectly observed eachtreatment of daily doseL >dministration of inKectionif necessary.

L &ontinue providinginformation about T? andtreatment decisions

# !6 mins 9urse Free %aboratoryrequest forthe sputumfollo3!up


26/43

For 9egativemear 5esult

Patient M &ase is for T? 8iagnostic&ommittee 'T?8&(+f for Treatment! Day :nroll patient to ourfacility if 3ithin ourcatchment area or refer totheir nearest Eealth &enter.+f not for Treatment! 5efer bac4 to 8-Tfacility;D8.! nder surveillance

1 3ee4 after,to get thedecisionfrom T?8&.

T?8&&ommittee ;9urse

Free T?8& Form&laim slip forT?8&

+f refer patientto E& getEospitalreferral form'Nello3 Form(

>dmittedPatient in theWard

Patient L 5eferred to PE8 if T?caseL For approval of 9TP&oordinator

! if for treatment, give initialdose of T? meds.! -nce for discharge, referto Eealth &enter or maycontinue the treatment inour 8-T facility.

9urse Free +ntraEospitalreferral Form'?lue Form(

>F? smearrequest

-5 &hestx!ray

5ecording ofall T?8&decision on the%ogboo4

Patient L +f recommended fortreatment, for referral toEealth &enter.L +f for surveillance only, for

follo3!up every # months.

>fter T?8&everyDonday

9urse Free &hest x!rayrequest


27/43

L2n+ Cn!r of !; P;"3"55"ns

PHYSICAL THERAPY < REHA#ILITATION

Pro+ra,s S!5s C3"n! A!"9"!"s D2ra!"on

of A!"9"!:

Prson

InC;ar+

T", Fs For,s

Ndd

COPDS255or!Gro25

1. >ll patients shouldhave referral from theirpulmonologist

". Present the referralto the taff PT in

charge for filling andscheduling

#. >ll referrals shouldbe collated 'a minimumof 0 and maximum of1/ referrals per batch(

$. There 3ill be $batches in a year

6. Patients 3ill notifiedof their respectiveschedules

8iagnosed as&-P8 andcurrentlycontrolled andmedicallystable &-P8

patient

1. +nitial:valuation '7Dinute Wal4Test, tGeorgeOuestionnair

e for O-%(".+ndividuali)ed:xerciseProgram#. Post:valuation '7Dinute Wal4Test, tGeorge

Ouestionnaire for O-%($. %ectureson &-P8,TroubleDa4ers andDedicine,:xercise,8iet, and+ntimacy

7!3ee4:xerciseProgram'1"sessions(

taff in&harge>ssigned'5otation?asis(

T3ice a3ee4'TuesandThur(0#/ am

to 1"noon

Ouantified Freeervice'OF(

5eferral Formfrompulmonologist

5eferral form


28/43

In Pa!"n!Sr9"s

1. 5eferral from fello3sand consultants". PT in charge 3ill

evaluate and treat thepatient

Patientsadmitted in the&harity and

Pay Ward 3iththe follo3ing&onditionsPulmonarydiseases,urgical,9eurologic,Dusculos4eletal,-rthopedic,

ports +nKuriesand -therDedical&onditions

1. +nitial:valuation".

+ndividuali)ed?edside:xerciseProgram#. Ward+nstructions

8aily,From +nitial5eferral of

>ttendingPhysicianor&onsultantuntildischargefromEospitalservices.

taff inchargeassigned

'5otation?asis(

8aily eeeparateheet for

the5ecentPricelist

5eferral formfrom fello3sand

consultants

O2!Pa!"n!

Sr9"s

1. 5eferral from fello3sand consultants.". For :mployees,referral from:mployees physician.

#. PT in charge 3illevaluate and treat thepatient

Patientsreferred 3iththe follo3ing&onditionsPulmonary

diseases,urgical,9eurologic,Dusculos4eletal,-rthopedic,ports +nKuriesand -therDedical&onditions

1. +nitial:valuation".+ndividuali)ed:xercise

Program#. Eome:xerciseProgram

>sscheduledby staff inchargeand as

prescribedbyphysicianor 5ehabD8'>ppointment ?asis(

taff incharge>ssigned'5otation?asis(

8aily eeeparateheet forthe5ecent

Pricelist

5eferral formfrom fello3sandconsultants

5eferral from:mployeesPhysician


29/43

RADIOLOGY DEPARTMENTCITIZEN'S CHARTER

DIAGNOSTIC SECTION

REFERRAL FOR CHEST AND NON CONTRAST PROCEDURES


PERSON INC(AR)E

TIME FEES FORMSNEEDED

1 Patient 5eceives request from patient6 mins. Technologist;&ler4 at

x!ray reception

"$;Bcheduleof fees islocated attheradiologyreception3indo3

!ray request

" Prepares charge slip &harge slip

# Presents proof of payment -fficial

5eceipt$ 5egisters and prepares patient

+.8.!ray request

6 Performs the desired x!rayexamination

6!"/ mins. !ray Technologist !ray request

7 8evelops the exposed films " mins. !ray Technologist :xposed film

B +nterprets the films 5adiologist !ray resultform

0 ?rings in!patient bac4 to the3ard # mins. 9ursing >ide

+nforms out!patient of releasedate of x!ray result

1 min. -fficial receiptand +8


30/43


DIAGNOSTIC SECTION

REFERRAL FOR CONTRAST PROCEDURE

STEP CLIENT PATIENT

ACTIVITY DURATIONOF ACTIVITY

PERSON INC(AR)E

TIME FEES

1 Patient 5eceives accomplished referral'5equest( 6 mins.

Technologist ;&ler4 at x!ray

reception0am to6pm

cheduleof fess islocated at

theradiologyreception

3indo3

!ray request

Gives 3ritten instruction forpreparation of patient prior to theprocedure

chedule the date of patientsexamination! to 3ard nurse for in!patient! to patient ; relative for out!patient

Patientpreparation

" Proceeds to ; Transported to5adiology department onscheduled date of exam

6 mins. Patient !ray requestI patientconsent form

# Prepares charge slip on day ofexam5egisters patient name andprepares film +.8.

# mins. Technologist ;&ler4 at x!ray

reception

&harge slip

$ Presents proof of payment # mins. Patient;companion

-fficial receipt

6 Performs the desired specialprocedure

#/ to 1 hr. 5adiologist and5adiologist Tech.

!ray requestI patientconsent form

7 8evelop the exposed films 6 mins. 5adiologist and5adiologist Tech.

B +nterprets the films 5adiologist


31/43

0 ?rings in!patient bac4 to the 3ard # mins. 9ursing >ide !ray resultform

+nforms out!patient of releasedate of x!ray result.

1 min. Technologist ;&ler4

-fficial receipt

CT SCAN SECTION

REFERRAL FOR CT SCAN CONTRAST AND NON CONTRAST PROCEDURES


PERSON INC(AR)E


1 Patient 5eceives accomplished referral '5equest(

Gives verbal instructions forpreparation of patient prior to theprocedurechedule the &T can patientexamination! to 3ard nurse for in!patient! to patient ; relative for out!patient

6 mins. Technologist ;&ler4 at &T can

reception

0am to6pm

cheduleof fees is

located attheradiologyreception3indo3

&T canrequest

&T canschedule slip

" Proceeds to 5adiology 8ept. &Tcan section on scheduled dateof exam

6 mins. Patient &T canrequest

# Prepares charge slip on the dayof exam&hec4s that the consent,questionnaire and request areaccomplished properly

# mins. Technologist ;&ler4 at &T can

reception

&harge slip Iconsent form

$ Presents proof of payment # mins. Patient;5elativeor companion

-fficial receipt

6 &hec4s result of creatininePerforms &T can examination

#/ mins. To 1hr.

5adiologist ; 5.T. %aboratoryrequest


32/43

7 +nterprets &T can 5adiologist &T can resultform

B ?rings in!patient bac4 to the3ard

# mins. 9ursing >ide

0 5elease result of &T can

examination

1 min. Technologist ;

&ler4

-fficial receipt

CT SCAN SECTION

REFERRAL FOR CT GUIDED INTERVENTION PROCEDURES


PERSON INC(AR)E


1 Patient 5eceives accomplished referral'request(

Gives +f &T can films are3ritten ; Jerbal instructions forthe preparation of patient prior tothe procedure+f &T can films are available itis referred to radiologist

6 mins.

Technologist ;

&ler4 at &T canreception

0am to6pm

cheduleof fess is


chedule slip%&P Form

9o.#//B

" > schedule is given to the patient3ith 5>P+8 P>P-ut!patients ! &T cler4 sendnotice to laboratory+n! patients H nurse send noticeto laboratory

6 mins.Technologist ;


%ab form #&linicallaboratoryrequest

# Proceeds to ; Transported toradiology 8ept. &T can ectionon schedule date of exam&hec4s the consent, receivesresult of bleeding time andclotting timePrepares charge lip on the day

of exam5egisters patient name

6 mins. Patient

%ab form9o. $1!/1$&onsent forEospitaldiagnosis Icare

&harge slip


33/43

$ Presents proof of payment # mins. Patient;5elativeor &ompanion

-fficial receipt

6 Performs &T Guided ?iopsy #/ mins to 1 hr 5adiologist Patients chart

7 ends request ; specimen tolaboratory

6 mins. Technologist ;&ler4

%&P form #&linical

laboratoryrequest I %&Pform "1!1/#urgicalPathology


34/43

RADIOLOGY DEPARTMENTFRONTLINE ACTIVITIES

ULTRASOUND

REFERRAL FOR ULTASOUND PROCEDURESSTEP CLIENT ACTIVITY DURATION

OF ACTIVITYPERSON IN

C(AR)ETIME FEES FORMS

NEEDED

1 Patient 5eceives accomplished referral'request(Gives verbal instructions for thepreparation of patient prior to theprocedurechedule the ltrasound patientexamination! to 3ard nurse in!patient! to patient ; relative for!outpatient

6 mins.Technologist ;


0am to6pm

cheduleof fees islocated attheradiologyreception3indo3

!ray ;ltrasoundrequest form

" Proceeds to ; Transported to5adiology 8ept.ltrasound section on scheduleddate of exam

6 mins. Patient !ray ;ltrasoundrequest form

# Prepares charge slip on the dayof exam

5egisters patient name

# mins.Technologist ;


ltrasoundTransaction

form

$ Performs ltrasound procedures #/ mins to 1hr

5adiologist and5T

ltrasound5equest form H-utt Patient

Transactionform H +npatient

Patient*s chart


35/43

6 +nterprets ltrasound 5adiologist !ray resultform

7 ?rings in!patient bac4 to the3ard

6 mins. 9ursing >ide

B 5elease result of ltrasound

examination

1 min. Technologist ;

&ler4

-fficial receipt

REFERRAL FOR ULTASOUND GUIDED INTERVENTION PROCEDURES


PERSON INC(AR)E


1 Patient 5eceives accomplished referral'request(

Gives 3ritten ; verbalinstructions for the preparation ofpatient prior to the procedure> schedule is given to the patient-ut!patients!; Tech. endnotice to laboratory+n!patients!nurse send notice tolaboratory

6 mins. Technologist ;&ler4 at ;

reception0am to6pm

cheduleof fees is


!ray;ltrasound

request form

" &oordinates schedule 3ith 3ardfor in patient, patients relative for

out!patient

6 mins. Technologist ;&ler4 at ;

reception

!ray;ltrasound

request form

# Proceeds to ; Transported to5adiology 8ept.ltrasound ection on scheduledate of examination&hec4s the consent receiveresult of bleeding time andclotting time

6 mins. Patient

!ray; ltrasoundrequest form

&onsent form forEospital8iagnosis I &are

%ab request form-ut!Patient H -ut

Patient erviceForm


36/43

$ 5egister patient namePrepares charge slip on the dayof exam

6 mins. ; Tech. Transactionform or receipt

6 Performs ltrasound Guided?iopsy

#/ mins to 1hr 5adiologist +n Patient HPatient*s &hart

-ut Patient HProgress 9otes;-perative5ecord

7 end request ; specimen tolaboratoryPatient are device to follo3 upresult after five '6( 3or4ing days

6 mins. Technologist ;&ler4

%ab requestform

-ut Patient !ervice form I

Progress notes

+n Patient HPatient*s &hart


37/43


RADIOTHERAPY SECTION

REFERRAL FOR RADIATION TREATMENT PROCEDURESSTEP CLIENT ACTIVITY DURATION

OFACTIVITY

PERSON INC(AR)E


1 Patient 5eceives referral 9urse

Bam toBpm

5eferral form

" Gives information to the patientregarding his;her treatment andtreatment cost

1/ mins. 9urse Jerbal

# Ta4e vital signs 1/ mins. 9urse Patient*s chart

$ 5efer to 5ad. -ncologist for furtherevaluation

6 mins.!0mins.

9urse;5ad. Tech.

6 5egister patient data 5ad. Tech. Patient*s chart

7 Prepare charge slips and instructthe patient to pay at the cashier

#mins. 5ad. Tech. &harge slip

B Presents proof of payment # mins. Patient;5elativeor companion

-fficial receipt

0 Performs the x!ray simulation

planning

#/ mins. 5ad. -ncologist

and Ded.Physicist;5ad.

Tech.

:valuation form

Prepare immobili)ation 1/ mins. 5ad. Tech. 9;a

1/ Dar4 treatment site using tattoo " mins. 5ad. Tech. &T can request

11 +f &T!planning, proceed to &T!canroom

6 mins. Patient, 5ad.-nco. >nd Ded.

Physicist

1" Position the patient at the &T tablefor scanning # mins. 5ad. Tech.


38/43

1# Perform &T Planning #/ mins 5ad. -ncologistand Ded.

Physicist;5ad.Tech.

1$ Dar4 the treatment site using tattoo " mins. 5ad. Tech.

16 5eturn bac4 to radiotherapybuilding

6 mins. Patient, 5ad.-nco. >nd Ded.

Physicist

17 Prepare molding bloc4s #/ mins. 5ad. Tech.

1B &ompute daily dose;site usingcomputer planning

1/ mins. Ded. Physicist

10 Prepare the patient for irradiationtreatment

" mins. 5ad. Tech.

1 Position and set!up the patient atthe treatment table # mins. 5ad. Tech.

"/ 8eliver the desired treatment dose 0 mins.!16mins.

5ad. Tech.

"1 Give instructions for his;her dailytreatment

" mins. 5ad. Tech.

"" Patient chec4 up 6 mins. 9urse;5ad.-ncologist

"# Patient end of treatment, chec4!up 6 mins. 9urse;5ad.

-ncologist


39/43

CITIZEN'S CHARTER

PROCEDURE ON PROCESSING CLIENT'S COMPLAINTS

STEP ACTIVITY

PERSON$PARTY

RESPONSI#LE TIME FRAME

1 ubmits a complaint to the Patient*s 5elations&omplaints 8es4

&lient

1 3or4ing day ;3ithin "$ hrs.

" 5eceives complaint and chec4s if the complaintmeets the follo3ing requirements

1.( Written in vernacular of in :nglish".( &omplete name and mailing address

is clearly spelled out.#.( 8uly signed by the complaint

Patients* 5elationsDar4eting -ffice'P5D-( T>FF

# %ogs and refers the complaint to the concerneddepartment;section for 3ritten explanation.

$ubmits to the P2-3" R3a!"ons Mar=!"n+ Off"(PRMO) 3ritten explanation 3ith supportingdocument if and 3hen necessary.

&-9&:59:8 8:PT. ; :&T+-9 " 3or4ing days ; 3ithin $0 hrs.

65eceives and evaluates the 3ritten response ofconcerned department ; division ; section if theresponse is

1( A55ro5r"a! P5D- shall send it to thecomplaining client at his ; her mailing addressthrough registered mail or to e!mail address. 5eplyshould be signed by the head 3here the P5D- isunder.

"( +na55ro5r"a! P5D- may refer the complaintand 3ritten response to the +n!+r"!: D93o5,n!Co,,"!! (IDC).

P5D- 1 3or4ing day ; 3ithin "$ hrs.

7 &onvenes the +8&F Dembers. +8& &E>+5D>96 3or4ing days ; 3ithin 1"/ hrs.

B 8iscuss the complaint and 3ritten response. +8& &-DD+TT::

0Formulates final reply to complainant signed by +8&&hairman and for3ards to the P5D-

+8& &-DD+TT::


40/43

5eceives final reply P5D- " 3or4ing days ; 3ithin $0 hrs.

1/ ends;Dails final reply to the complainant P5D-

11 Furnishes copy of reply to the follo3ing offices a. 8irector*s -ffice b. Personnel

c. >rea concerned

P5D-

If ."!;"n fo2r!n (1>) .or="n+ da:s of no r53: fro, !; o,53a"nan! "!;r -: ,a"3 or &,a"3? !; r53: "s d,da55ro5r"a! and a5!a-36


41/43

CITIZEN'S CHARTER

MEDICAL SOCIAL SERVICE IN PATIENT PROCESS

UPON ADMISSION

STEP CLIENT ACTIVITYDURATION OF

ACTIVITYPERSON

RESPONSI#LEFEES

FORMSNEEDED

1 Patient;5elative

Presents Personal 8ataheet 'P8( from the>dmitting to Dedical ocialervice 'D(

" minutes5elative;

Patient 'pt(

9;>

Personal8ataheet

" Dar4s P8 3ith D+npatient stamp andschedules patient for anintervie3 3ithin "$ hoursupon admission

6 minutesDedical ocial

Wor4er 'DW(

Personal8ataheet

ARD VISIT < INTA7E INTERVIE

1Patient;5elative

&onducts room!to!room visit to #> I #? and calls D+&I T to update daily

admission

Dar4s P8 at patient*s chart 3ith D classification

stamp

chedules relative;s of ne3patient for an intervie3 atD -ffice

Follo3s!up Personal

8ataheet


42/43

" Goes to D office for the scheduled intervie3 " minutes 5elative;s

9;>

#

&onducts intervie3 to therelative;s of patient

+n case patient has norelative, DW conductsbedside intervie3

:xplains and advises tocomply D requirementsto be able to avail services

>ssess I classifies patientbased on the datagathered

"/ H #/minutes

Dedicalocial Wor4er

Photocopy ofpdated &edula

Photocopy ofany valid +8

?arangay&ertification

ocial &aseEistory

Treasurer*s&ertificate

:mployment&ertificate'if employed(

Photocopy ofPay lip

SU#MISSION OF RE@UIREMENTS < REFERRALS

1Patient;5elative

ecure the documents needed by D

ubmit completerequirements to DW

# H 6 days

16 minutes

5elative;s 9;>

Dedical>bstract

ocial&ase Eistory

Eospital ?ill

:ndorsementletter from

ocial Wor4er


43/43

"

5eceives I files submittedrequirements

Gives relative;s a list ofrequirements needed forreferral to funding agencies

#/ minutesDedical ocialWor4er 'DW(

9;>

Dedical>bstract

ocial&ase Eistory

Eospital ?ill

:ndorsementletter from

ocial Wor4er

#Patient;5elative

ubmits requirements forreferral to funding agencies 6 minutes 5elative;s

$ 5efers patient to different

funding agencies 16 minutes

UPON DISCHARGE

1 Patient;5elative

Presents discharge noticeissued by 9urse!on!duty'9-8( to DW

" minutes 5elative;s

9;>

8ischarge9otice

" >pply classification to discount patient*s hospital

bill

Dar4s classification to actionslip 3hich 3ill be attached tothe discharge notice

+nform the relative to presentthe notice and slip to 9-8,then to ?illing &ler4

"/ minutesDedical

ocial Wor4er8ischarge

9otice

citizens charter revised2013

Documents