Challenges and potential improvements in the admission process of patients with spinal cord injury in a specialized rehabilitation clinic – an interview based qualitative study of an interdisciplinary team | BMC Health Services Research

All eight of the invited health professionals agreed to take part in the interview process. Two leading professionals from each of the four predefined disciplines were interviewed, 5 of them male. The interviewees work in different wards and have worked at the SPC for varying lengths of time (range: 3.5 – 20 years). All interviews were conducted between November and December 2014 and lasted between 50 and 70 min. The admission process was described as a situation where the new patient meets the structures and processes of the specialized clinic. During this process, challenges and potential improvements are encountered that can be broken down into the five themes and sub-themes illustrated in Fig. 1 and described below. The characteristics of the patient and his/her family play a special role, as they may lead to other challenges.

Fig. 1

Results of the thematic analysis. Developed sub-themes and themes of challenges and potential improvements in the admission process of spinal cord injury patients at the Swiss Paraplegic Center

Theme 1: Characteristics of the patient and his/her family

The interviewees described different patient factors that can be challenging during the admission process. Different diagnoses, different rehabilitation phases, individual situations, ages and occurring co-morbidities differ from patient to patient and complicate the admission process. This complexity of the patients was described as the main difficulty to standardize the admission process for SCI patients because the patient’s specific situation presupposes an individual set of assessments to identify all relevant patient needs. Further discrepancies were found regarding decision-making capacity and responsibility as part of autonomy. The shared decision-making of professionals and patients was described as a very important but challenging aspect in the admission process. Although some of the interviewees felt that the current integration of the patient’s wishes and thoughts into the decision-making process is high, others felt that overly optimistic expectations of patients complicate the process. Besides the patient’s ability to make decisions, hospital limitations, including time and money, can also hinder the ability of health care professionals to attend to the patient’s individual desires and concerns. A more efficient and timesaving admission process was described as a potential solution to allow health professionals to better take into account the decision-making capacity, wishes and expectations of the patient.

I can imagine that some patients would like more therapy, but we have to say, “no, at the moment we can’t cover that for financial reasons”. (occupational therapist 1)

I think we are so busy with administrative tasks and paperwork that we don’t ask the easiest question. We don’t have the resources to ask, “what does the patient want?” (medical doctor 1)

Further challenges may also arise due to the family environment of the patient. Because of their severity and long-lasting repercussions, SCIs also have a serious effect on the patient’s family. It was described that negative relationships between patients and their family members and discrepancies between professional goals and the goals of the family members are very challenging, as they can affect the rehabilitation success. To be more aware of potential negative social relationships of a patient, it was proposed to graphically document them with a genogram. This could support the health professionals to actively integrate the family in the admission process and to reduce negative influences of the family. Another way for a better integration of family members could be achieved with supporting peers for family members, which could assist the health professionals and reduce the stress of the patient’s relatives.

Relatives who have had family members here as patients for four, five years for rehabilitation could be recruited to act as supporting peers. Because they are already familiar with the clinic, our staff and the rehabilitation process, they can help the family members of new patients. They are in the best position to say, “I know what you’ve been through, so I know where you are now. This helped me/us”. (…) I think this sort of peer support program should be a central part of the admission procedure. Both the patient and the patient’s family are welcome here. (nurse 1)

Theme 2: Information exchange between hospital and patient

Better patient information prior to their hospital admission was described as possibility for improving the admission process. It was described that health professionals often need too much time to explain how rehabilitation in the SPC takes place. To reduce the stress of the patient and the patient’s family, better information should be given about the expected treatment procedure and about the purpose of the hospital stay.

For me, it’s important that the patient is informed in advance about why he is here. For example, a urological patient should know why he is at this clinic, and which issues will be treated here. We just do not have time to explain this to each and every patient. It shouldn’t be our job to tell him why he’s here; he should be informed in advance. (occupational therapist 2)

Other challenges identified during the interviews include issues concerning pre-admission information, which is helpful for simplifying the admission process and the rehabilitation planning. Different sources of pre-admission information were described. One source are the forms completed during the pre-admission investigation, which is done by specially trained rehabilitation coordinators of the SPC. However, some interviewees stated that the accuracy of the pre-admission information forms with regard to the patient’s actual situation is low.

In part, there are also goals [recorded on the pre-admission forms] that don’t coincide with the goals the patient describes on the day of admission. The goals may have changed, or were never even understood by the patient to be goals. (occupational therapist 2)

It was mentioned that rehabilitation coordinators should have more experience in the rehabilitation of SCI patients, or should be better trained in how to conduct pre-admission investigations with SCI patients. More detailed questions concerning various aspects of the patient (previous treatment, social situation, current pain and mobility, wheelchair information) should be asked, as this information could save time during the admission process.

It would be super if you had a lot of information in advance [laughs] about the patient, such as about their social situation, for example. Then you could shorten the assessment. (nurse 2)

Further, stronger collaborations with external institutions were also cited as a potential means for improving the amount of available pre-admission information in the form of status or transfer reports. Measures are needed to increase the amount of sent reports from smaller hospitals or care institutions.

We get almost nothing from Spitex [external home care institution]. Perhaps we could give them the transfer reports so that they could send them to us filled out. (nurse 2)

Theme 3: Rehabilitation planning

The interviewees also mentioned challenges in the admission process related to rehabilitation planning. Pre-admission information, the rehabilitation phase and diagnosis, patient desires and the initial goal-setting process were described as the basis for rehabilitation planning. The goal–setting process influences subsequent medical examinations and interventions and defines professional responsibilities. However, misunderstandings between the patients and the clinic staff can occur because acute somatic goals are easier for the patient to understand than complex SCI goals of the health care providers. Complex, long-term goals are also often difficult to determine because the rehabilitation progress and neurologic recovery of SCI patients is uncertain. Thus, a careful balancing act between maintaining hope and not causing false hope is required. To optimize the goal-setting process, goals must be communicated with the patient as transparently as possible.

The first step is just telling the patient systematically and repeatedly if the objectives have changed or what the overall goals of the team are. And it can be quite simple things, such as paper printout on the wall. (….) That is actually a great example of communication because the patient, doctor and nurse look at exactly the same information. (….) Perhaps we also have electronic options on the patient’s iPad or through Twitter. (medical doctor 1)

The interviewees noted that context factors, such as changing conditions in the health care sector, also create challenges in the planning a patient’s rehabilitation. For example, increasing financial pressure reduces the time available per patient, which ultimately reduces the amount of therapy that can be planned.

Theme 4: Organization of the admission process

The interviewees pointed out that although every professional discipline has its predefined time slot to see the patient on the admission day, adhering to this time schedule is often difficult. Simultaneous admissions, for example cause time conflicts that could be resolved by better distributing admissions over the course of the week. Delayed admissions of the patient shift the whole time schedule and make it difficult to conduct all planned examinations of the admission day. Surgery preparations, unexpected examinations by doctors, sudden emergencies or required and parallel planned health professional education programs also disrupt the admission process and make it difficult to keep the time schedule.

Mostly, they are registered by half past ten. If a patient comes a bit late, we have a scheduling problem. Then (…) the therapist sees the patient later in the day and the whole process is delayed because all the other evaluation appointments have to be rescheduled. (physical therapist 2)

Sometimes there are also other things that are expected of us, like further education or professional development, and then we don’t manage in this period to also see the patients. (medical doctor 2)

Both of the interviewed medical doctors suggested adapting the order of the examination in order to optimize the admission day. The core team (medical doctors, nurses, physiotherapists, occupational therapists) should have priority over specialists from the surgery or radiography departments, and medical doctors should always be the first to examine the patient due to potential emergencies. Several interviewees pointed out the problem of double questions, as patients often get asked the same question several times. This could be reduced through organizational adaptions like collective examinations, in which various health professionals examine the patient at the same time. Although some of the interviewees felt this would be feasible, others felt that the organizational challenge and the different professional foci would make this impractical.

First comes the occupational therapists and asks, “What is the problem?” Then the physiotherapist comes and asks the same question [laughs]. Then the doctor and the nurse come and ask again, “What is the problem?”, so the patient has to explain four times that he has a pressure ulcer. (physical therapist 1)

The problem of double questioning can be solved by only asking the question once [during a collective examination]. To schedule this time-wise is difficult for us, though. It is also not possible resource-wise, I think, because you just need to be short one person because of illness or any other reason. (physical therapist 2)

Theme 5: Interdisciplinary work

Various interdisciplinary meetings are held during the admission process. The interviewees proposed to implement more meetings, where goals are set together with the patient in a group of different disciplines. The interviewees agreed that more meetings of this nature would help ensure that the patient is well informed, that professional responsibilities are clear and that discipline-specific goals are communicated among the health professionals. It was also suggested that the meetings should be adapted to ensure that health professionals who are directly involved with the patient can attend the meetings. In some meetings, professionals are represented only by their group leader, which makes direct communication with the responsible persons difficult.

It would be good if the nurses could be present [at the meetings], but the timing is bad. Some meetings are held in the early morning, when we [nurses] have to care for the patients. It would be better to hold the meetings during the day so the nurses can participate. But I doubt this is possible because it would require changing too many structures. (nurse 2)

Communication between various medical disciplines was also mentioned as a challenge. For example, delays in the communication of a prescription between doctors and nurses create inefficiencies. Prescriptions for blood samples, for example, should be communicated immediately so that nurses can include the blood collection in other assessments, which would save time. Others cited the poor availability of health professionals as another communication challenge.

If I need information about the patient, then I must first ask the doctor, but they are often not available [because they] are in a consultation. (…) You usually also can’t reach the responsible nurses because shift changes have taken place. (occupational therapist 1)

Different clinical documentation systems were mentioned as further communication challenges, because they can interrupt the flow of information. Access issues and unfamiliarity with the documentation systems of other disciplines were described as challenges. Using a common and central system, which combines all professional-specific systems, was suggested as potential improvement.

It is sometimes the problem that we (…) stationary therapists don’t get the background information from the outpatient doctors or physios because the [information] isn’t stored in the same place. (physical therapist 1)

Within the clinical documentation systems, challenges occur because the SPC tries to structure some documentation systems based on the ICF. This ICF implementation was described as very time-consuming because the structure of these ICF-based documentation systems has become very complex. A simplified structure of these systems was proposed as potential improvement.

If you simply color code the text [in the documentation systems], then you know, ok, blue is for physio things, where you can write physio things. Green is for things that concern the occupational therapist and (…) red is for things that concern the nurses. All of this is with the goal of finding the information better and more quickly. (physical therapist 2)

Regarding a further ICF implementation, most of the interviewees described the common language, the target-oriented and structured working with the ICF as advantages for the interdisciplinary work. But they also described a danger, as the ICF tends to be too theoretical and not applicable in the practice. Some health professionals argued against implementing ICF further because they thought that many of the ICF assessments about functional impairments were not actually been proved in practice or validated.

The ICF must become better. I mean, the ICF is really just a word that describes the psycho-social approach to a person. And if you look more closely, the ICF is a red book with items inside. Unquantified items, items that are in version 1.0. (…) ICF, you realize clearly, is at version 1.0 and is therefore not applicable in practice. (medical doctor 2)

Results of check for theoretical saturation

Although the analysis of one additional interview with a medical doctor had no effect on the themes developed from the eight original interviews, it provided additional insights. In particular, the interviewee suggested making a clear agreement with the patient regarding the admission time instead of simply informing them about the importance of punctuality. The interviewee also argued in favor of double examinations as a way to detect issues that may have been missed during the initial examination.

Hospital Admission Procedure – Nursing

Admission Procedure

DEFINITION

Admission of a patient means
allowing and facilitating a patient to stay in the hospital unit or ward for
observation, investigation, and treatment of the disease he or she is suffering
from.

1.       
Purpose of admission procedure

ü  To provide immediate care.

ü  To provide comfort and safety to
the patient.

ü  To receive the patient in ward for
admission according to his condition.

ü  To be ready for any emergency.

ü  To assist the patient is adjusting

ü  to the hospital environment.

ü  To obtain information about the
client so as to establish therapeutic nurse patient relationship.

ü  To involve patient and family in
care.

ü  To assist proper discharge
planning of care.

 

Types of Admission

·          
Routine   Admission:  
clients are 
admitted  for  investigations and planned treatments and for
surgeries. eg. diabetes, hypertension.

·          
Emergency Admission: Patients are admitted for acute, an emergency condition which requires
immediate treatment like burns, drowning, road accidents, fall, heart attack.

 

Admission, Observation, Charting

Responsibilities of the admission department

1.       
Gather patient information (name, age, sex, address, mobile no
etc)

2.       
Prepare medical record

3.       
Prepare patient identification bracelet

4.       
Consent form signed

5.       
Initial orders obtained

6.       
Inform
to floor ward nurse

 

Responsibilities of the nurse Prepare room

·          
Prepare
a clean and neat admission room with all the necessary items as per the need of
the patient.

·          
Prepare
an appropriate type of bed with adequate adjusted height of the bed

Identify self

·          
Welcome
patient and his family with warm approach.

·          
Make
the patient comfortable in bed and provide him with hospital clothes and ensure
adequate privacy.

·          
Alleviate
anxiety/fear

Orient patient

·          
Location
of nurses station

·          
Room
boudaries

·          
Clothes
storage

·          
Call
light

·          
Bed
controls

·          
Light
switches

·          
Telephone
policy

·          
Tv
controls

·          
Meal
times

·          
Visitng
hours

·          
Diet

·          
Safety
measures-side rails

·          
Time
for doctors visit

·          
What
tests are scheduled

Gather information related to:

·          
Medical
Orders

·          
Treatments

·          
Lab
Results

·          
Tests

·          
Diet

·          
Activity

 

Charting

·          
Record
all the basic information in patients record.

·          
Clearly
mention admission date, time patients details, complaints of the clients, any
allergies, patients mental status.

·          
Record
in admission register, treatment book, report book, medical legal case (MLC) register,
update ward census and nurse’s notes.

·          
Physical
Assesment

·          
Patients
Comfort

·          
Collect
information for database

·          
Perform
initial Admission Assessment

·          
Obtain
physician order for the Lab, Tests, Medical activity

·          
Identify
data

·          
Chief
complaints

·          
Present
history

·          
Past
health history

·          
Review
of body system

Observation:

What to look for in newly admitted
patients

·          
Anxiety

·          
Loneliness

·          
Increased
privacy

·          
Loss
of identity

 

Admission Assessment

Do a good assessment of his
physical condition in order to plan his care. If his physical state needs
immediate treatment report to physician and prepare your patient for physical
examination and carry out the treatment, which the physician prescribes after
the physical examination.

 

Admission Process – Calvary Hospital

Welcome to Calvary Hospital

Calvary is proud to welcome adult patients of all backgrounds and beliefs. A person may be a candidate for admission if they are diagnosed as having advanced cancer or other life-limiting illness and need an acute care medical setting.

Admission Process (En español)

For admission to Calvary Hospital, an application needs to be completed and submitted for review. Admission Application and descriptive brochures are available through the Community Outreach Department.

Social Workers, Case Managers, and Discharge Planners at referring facilities can initiate the referral process by faxing a single page referral to Community Outreach Services (fax: 718-518-2670). The Outreach Nurse Liaison can complete the full application on-site at the facility if requested. Applications can also be initiated via telephone from community physicians, home care agencies, hospices, nursing homes and directly by patients or family.

The completed admission application is promptly reviewed by the medical/clinical staff to determine if the clinical criteria for admission is met. Once the application is determined to be acceptable, the Admitting Department will contact the referrer or family to verify insurance and schedule admission.

Download the admission application.

For assistance, please call: 718-518-2000, ext. 2300.

Admissions To Home Care and Hospice

For admission to Home Care or Home Hospice, a referral is made by calling the Home Care Coordinator.

For assistance, please call the toll-free number at: 866-888-6680

Insurance Information

Calvary Hospital accepts patients participating in Medicare and Medicaid programs, Blue Cross and other private insurance carriers.

Some insurances do have limits to their coverage; therefore, an admitting representative may discuss with the family what benefits may be obtained by applying for Medical Assistance (Medicaid) and also provide them with information related to Calvary’s Financial Assistance Program.

For assistance, please call our Community Outreach Services Team: 718-518-2000, ext. 2300

Chapter 1 – Preventive Law in the Medical Environment

Chapter 1 – Preventive Law in the Medical Environment – The Admission Process

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The Admission Process

What does the hospital need to find out before I am admitted?

* Your name, address, and next of kin.

* Whether you may consent to your own care or whether the hospital must contact
your parent or guardian. If you have appointed someone else to be your agent,
you should give the hospital a copy of the power of attorney.

* How you will pay for the hospitalization. The hospital will want evidence
of insurance or a cash deposit. Even if you have insurance, the hospital may
demand a cash deposit.

What forms will I be asked to fill out?

* Consent forms. The hospital will ask you to sign a general consent form
for hospital treatment. If this form does not specify your treatment in detail,
it gives them permission to do only routine hospital care. You or your agent
are the only people who may sign this form. The hospital has no legal right
to demand that your spouse sign the consent form, but they may deny your admission
in nonemergency situations. If your spouse attempts to “veto” your treatment
by refusing to sign the form, such a veto is legally ineffective, and the hospital
should not honor it.

* Records release forms. These forms allow the hospital to give your records
to your insurance company. You may limit this release to authorize release only
of the itemized bill. You should write this on the form and send an accompanying
letter to the hospital’s medical records department. If you are paying for the
hospitalization yourself, you may refuse to sign the form.

* Insurance assignment forms. These forms give the hospital the right to collect
payment from your insurance company. If you are paying for the hospitalization
yourself, you should not sign the form.

What if I do not agree with something on the admissions forms? You should
mark out or change any parts of a form that you feel are inappropriate. If the
nurse refuses to let you do this, you should ask to see the hospital administrator.
Any changes or additions should be in ink.

What if the form is not completely filled out? You should not sign any forms
that are not completely filled out.

What are my rights in the hospital? You have certain basic rights in the hospital.
These rights, however, may be limited to qualified when there is a valid medical
reason to do so.

* You have a right to know what medications and treatments you are given.

* You have the right to refuse any treatment (although the courts may intervene
to order life-saving treatment.

* You have the right to speak with anyone you want, including friends, relatives,
physicians, or an attorney.

* You have a right to special diets that are prescribed by your religion,
except when your doctor has determined that there are compelling medical reasons
to change such diets. This should be discussed with your physician if a question
arises.

To whom do I complain if I feel that I am not being properly treated? If you
are concerned about anything involving your medical treatment, you should first
discuss this with your physician. If you have a problem with the nursing care,
diet, room, and so on, you should speak to hospital administrator. It helps
if you make a written record of your complaint.

What if there is no administrator on duty? If the problem is urgent, ask for
the administrator’s home phone number.

What if the nurses refuse to let me speak to the administrator? Ask for the
nursing supervisor and tell the supervisor that you want an “incident report”
filed. Make a written complaint to be included in this report.

What legal preparations should I make before entering the hospital?

* You should authorize someone, usually your spouse if you are married, consent
to medical care for you.

* If you do not want to be maintained as a “human vegetable” if something
goes wrong, you should sign a “living will.” A living will is a document that
authorizes the physicians to let you die in peace when there is little hope
for your recovery. You may want to consult an attorney about the details of
this document.

* If you are a single parent or guardian, you should authorize, in writing,
someone to consent to medical care for your child or ward while you are hospitalized.

* You should have a regular will prepared and signed. You should consult with
an attorney if you are not sure whether your will is in order.

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Admission Process – Columbia Asia Hospital

Admission: 
Both emergency and routine admissions are facilitated through customer care at the reception. On deciding the preferred room type, you will be required to fill in the inpatient consent form. All clarifications regarding the concent form will be addressed by customer care. After signing the consent form and completing admission formalities, you will be escorted to the room. Admissions are open 24 hours a day, seven days a week.

Pre-Surgical Evaluation:
The pre-operative anesthetic check-up is done for all patients undergoing any procedure, to ensure safety and fitness for the surgery.

A doctor will discuss with you about your health and give you pre-operative instructions. The nurse will carry out the pre-operative care, as per directions from the surgeon and anesthesiologist. 

In some cases, the patient may need to come to the hospital a few days before surgery for all tests. During this visit, the patient will be fully evaluated by the surgeon and anesthesiologist and certain laboratory/radiology tests would be conducted. The information obtained at this visit is important to provide the safest possible care during surgery.

Admission Kit:
An admission kit is available in the room for use. The kit contains basic toiletries that is required during the stay at the hospital. 

Insurance:
Please get in touch with the insurance desk to avail cashless facility through the Third Party Administrator (TPA). 

Deposits:
The finance counselor will share an estimate of your treatment and also the initial deposit amount. The customer care department will keep you appraised on the necessity to ‘top up’ your deposits as and when required. Deposits can be made in cash or by credit card. Please note that personal cheques will not be accepted.

Personal Belongings and Valuables:
Pack lightly when you come to the hospital for admission. You will be required to wear appropriate hospital attire, which will be provided to you during your stay. Please do not carry excess cash and valuables with you. The hospital will not bear any responsibility for loss of personal belongings or valuables. 

Room Assignment:
You will be provided the room type that you have requested for. In case the room type specified by you is not available, we will allot the best alternative room available. You have a choice of the following room types:

• Ultra deluxe single bedded room (available at select hospitals)
• Single bedded room
• Two bedded room 
• Five bedded room

(Please check individual hospital pages for the room details)

Room transfers subsequent to admission are possible subject to availability. For any such requests, please inform the nurse station. 

Policy on Patient Companions:
As a policy, only one companion is allowed per patient. Patient companion will not be permitted overnight stay in the five bedded rooms. Patients admitted in the ICU, Labour ward, OT recovery and other critical areas, will not be allowed to have a companion stay with them. However, companions may visit them periodically at specific times. Please ask the Customer Care for details of visiting hours.

Once the patient is shifted from room to the ICU / OT / Labor wards, the patient’s attendants will have to vacate the room with immediate effect. The customer care department will assist your companion with accommodation near the hospital. 

Admission Process

At The Mission Hospital, Durgapur we believe in the immortal saying of Swami Vivekananda- Service to man is service to God. We believe that each patient has the right to get best treatment and best attention from each member of The Mission Hospital family each time, every time.
 
Our passion for perfection has inspired us to document the usual hospital routine services and standard procedures for understanding of all patients, their family members, casual visitors and even each hospital staff for seamless functioning of each department, leading to world-class service to each patient as end product. 
 
 
REGISTRATION:
 
For initiating any medical treatment with OPD or Indoor, Registration at Reception located at ground floor is a must on payment of Rs. 100/- only once for all. Reception remains open round the clock. However, each time the patient has to carry his registration document and show it at the Reception for 
proceeding further.
 

ADMISSION:

• 
  · Based on advice from Consultant, if you require admission, then you need to complete required formalities at “Admission Counter” at ground floor.
• 
  · Reception is open round the clock but still in case of exigency admission is done through Emergency Department also. The Medical Officer in the Emergency may recommend and advise admission accordingly.
• 
  · During admission, you are usually asked a few questions and your cooperation is solicited only to help you better.
• 
  · The treating consultant shall specify the tentative duration of your stay in the hospital and based on that an advance payment has to be made in the Admission Desk.
• 
  · The admission procedure covers some formalities to avoid future complications and should usually take 30 minutes.

Admission of Corporate/Insurance Patients:
 

If your account is to be settled by any empanelled companies / organizations / Third Party Administrator (TPA), you must bring with you an authorization letter from the company clearly indicating that they have taken the financial responsibility for all medical treatment. Your treatment will be in the category specified by your organization. Separate direct bill will be made for any deviations from whatsoever has been allowed by your company. Such an order can also be faxed to the CEO of The Mission Hospital directly. The hospital will invite you for detailed discussion in case any ‘Package’ has to be finalized. Further, you should feel free to enquire about approximate cost of treatment, hospital charges, cost of investigations etc., either during admission or earlier from our Reception for efficient time management and decision taking. 
 

TYPES OF ACCOMMODATION:
The choice is wide and the per day room rent tariff (for cash patient) at present is as follows:

• 
  · General Bed
• 
  · Semi Private Rooms
• 
  · Private Rooms
• 
  · ICU/CCU/CTVS/ITU
• 
  · Deluxe Rooms
• 
  · Deluxe Suites

(Private/Deluxe/Deluxe Suites are provided with TV, Refrigerator, Telephone, and Internet & Personal Attendant Services)The Hospital is having centralized air-condition.  However, all beds and rooms / suites are given on first come first served basis subject to availability. Request for room change, if any, has to be made at the Admission Desk /Floor co-coordinator, who will try to accommodate your request as soon as possible, subject to availability.
 

BILLING AND PAYMENT:

• 
  · After the advance payment, as treatment progresses, it is better to go on making interim payment in consultation with the concerned people in the billing section. This updating of payments, periodically, helps smooth progress of entire procedure.
• 
  · Final payment has to be made at the time of discharge of patient for which the bill section will consolidate all charges for medicines/ consumables / services availed during hospitalization. The Billing department should be allowed some reasonable time as soon as the doctor signs the order for discharge.
• 
  · Bills for Insured / Corporate Clients are handled separately, but the “No Due”/ “Gate Pass” has to be collected from Billing Department before discharge.

Some other important information:

• 
  · Check Out Time 12:00 Clock (Noon) applicable.
• 
  · Mode of Payments
• 
  · Cash
• 
  · Credit Card (Master/Visa)
• 
  · Debit Card (Master/Visa/Maestro)
• 
  · Demand draft In favor of “The Mission Hospital”
• 
  · Cheque: Received Only for Corporates having MOU with us. (Not by personal cheque).
• 
  · Online Fund Transfer” (For Details Please Contact In- Charge Billing at 6th Floor.)
• 
  · For Availing “Online Service” please contact billing personnel at the billing department.
• 
  · Our contact No. For 24 hours billing information is :0343-398241,9002000736 ,Ext No 609 Fax No-0343-2532550
• 
  · For Medical Insurance/ TPA information please contact insurance desk at ground floor( from 10 am to 6 pm except Sunday & holiday)
• 
  · For corporate query or sanction please contact Corporate Desk at ground floor ( ext no-130)
• 
  · After admission all the financial transaction for indoor patient will be made from “Billing Department” at 6^th floor.
• 
  · Please check the entire document properly before leaving the counter.
• 
  · Minimum discharge process time: 3 / 4 hours after the advise for discharge by the consultant (except corporate & TPA or insurance patient as it subjected to receiving the authorization from the TPA).
• 
  · Please donate/replace the blood/blood product before the settlement of final bill which is used for your patient (if any) during the hospitalization period..
• 
  · The ‘Visiting Card” has to be submitted to billing department at the time of final payment which was issued at the time of admission.

 
SURGERY PACKAGES
 
The Mission Hospital offers very reasonable and competitive packages for different surgeries like Cardiac surgery, Uro-surgery, Orthopedics, Spine, ENT as well as Angioplasty, etc. Full advance payment is must for such planned surgeries as per mutual agreement. The unique aspect of the packages of The Mission Hospital is that once the deal is done no escalation is there, even if actual cost goes up considerably. In emergency cases, the payment has to be made within 24 hours of admission or earlier.
In general, outstanding amount beyond Rs. 5,000/- is not permissible.
Smooth payment of bills in time optimizes every body’s interest.
As Inpatient – “You are Our Guest”.
 

FACILITIES & MUTUAL RESPONSIBILITIES
 
Your quick discharge after a sound recovery being the objective, highly skilled and dedicated team of personnel is at work round the clock to ensure your stay as Inpatient pleasantly comfortable. But your spontaneous cooperation makes their task easier.

MEDICAL TREATMENT
 
Your treatment as Inpatient is the responsibility of your admitting Consultant. He will arrange for your laboratory/radiological tests, medications, diet and all special treatment, deemed necessary. But if you are already on any kind of medications, before admission never forget to inform your Nurse or Resident Doctor for guidance. During the period of your hospitalization, your Consultant has to approve the use of those medicines.
 

TEAM OF PROFESSIONALS
 
In addition to your treating Consultant, you will be looked after by a team comprising In-house RMO’s to ensure your proper treatment round the clock. They are the most important link in between the service providers on one hand and the Consultant on the other. RMO’s execute the instructions given by the Consultant.
We are proud of our team of highly skilled and competent Nursing Staff who will ensure professional care with smile and enthusiasm. They work in tandem with all for your quick recovery. She will ensure administration of medicine and execution of treatment. In case of any emergency, she will take required action.
Push the CALL BUTTON to draw Nurse’s attention, if required. Ward personnel are responsible for cleanliness, your movement by stretchers/wheel chair, if required. Kitchen staff caters you the prescribed diets. They serve better with mutual co-operation and understanding.

CONSENT OF PATIENT
 
In addition to the consent taken from you at the time of admission, you need to give further consents for Special Procedures to be undertaken during treatment as advised by your Consultant. Nursing staff will bring the form to you for the same.
 

HOUSE KEEPING & LINEN:
 
Clothing and linen for daily change will be provided. Using them is compulsory and a part of Inpatient protocol. In case of any problem please contact sister-in-charge or co-coordinator of the respective floor who will take care of your need regarding linen.
 

MONEY & VALUABLES
 
Hospital does not take any responsibility for your money or any other valuables. The less is better and welcome.
 

MOBILE PHONE
 
Use of mobile phone by the patient is strictly prohibited. Visitors should also restrict use of mobile phones near patients.
 

MEDICINES & CONSUMABLES
 
Medicines, Surgical and other consumables prescribed by your Consultants for your treatment shall be supplied from in-house pharmacy for which you need to sign a memo for inclusion in the bill.
 

“SMOKING IS SIMPLY ILLEGAL AT HOSPITAL AS PER THE LAW OF THE LAND.”

AT YOUR SERVICE: MAINTENANCE
 
For your maintenance/service requirements for TV, AC, Power Points, Push Button for calling Nurse, plumbing’s in toilets, telephone and the like, our maintenance staff are available on call. Preventive maintenance is done every day as a part of standard procedure.
Please inform the nurse about your specific requirement with a lead-time of, say, 45 minutes.
 

WASTE MANAGEMENT
 
Keeping the hospital neat and clean and highly disinfected is a part of our organizational culture. The waste is segregated into biodegradable and non-biodegradable categories and disposed to its right destination.
Let us all help to keep the quantum of waste as less as possible.
 

PARKING
 
Management has kept enough space in parking lot at the backside of the hospital by paying the requisite parking fees. Keep cars in orderly manner. To facilitate movement of ambulances, parking of Cars / Vehicles in front of the hospital is prohibited. For any help contact the security personnel posted outside.

How one group of hospitalists helped streamline the admissions process

Published in the March 2004 issue of Today’s Hospitalist

Program: Collaborative Inpatient Medicine Service at Hopkins Bayview

Hospitals served: The Johns Hopkins Bayview Medical Center, Baltimore, Md.

Year started: 1996 (with one doctor and two nurse practitioners)

Staffing: Seven hospitalists (and hiring an eighth) plus eight NPs/Pas

Services: Inpatient care provided to the 700-bed, teaching hospital’s 72-bed Zieve Medical Unit 24 hours a day/seven days a week. Hospitalists triage all potential medical admissions that come through the ER. They are responsible for all general medicine consults.

Average daily census: 25 patients a day

Like most U.S. hospitals four years ago, the emergency room at Baltimore’s Johns Hopkins Bayview Medical Center was overloaded. Patients who were scheduled to be admitted to the medicine floor spent an average of two and a half hours in the ER waiting to be moved, frustrating physicians and patients alike.

Perhaps most frustrated of all were the ER doctors. While they watched patients wait to receive the care they needed, admission delays were also crippling the ER’s ability to take care of “treat-and-release” patients. (From the time they walked through the door, patients were spending an average of six and a half hours in the emergency room.)

It just so happened that as the ER doctors were approaching their breaking point, hospitalists were flourishing in the department of medicine at this large, urban teaching hospital. So the two groups worked together to create an admission process that would shave several hours off patient waiting time.

“We were certainly not as frustrated as our colleagues in the ER,” recalls Eric Howell, MD, then a resident and now associate director of the seven-doctor hospitalist service at Bayview, “but it was very important to them, and it was very important to the hospital administration.

Because the department of medicine admits 60% of all ER admissions, we knew we would have to be a huge part of the answer.”

Leap of faith

The new process required a leap of faith on the part of the hospitalists, who would have to trust emergency physicians’ medical judgments. It also required the emergency room physicians to take the responsibility for writing admission orders.

The revamped admission system combines an “admission pager,” which one hospitalist carries each day, and cell phones, which both groups of doctors carry. The leap of faith requires hospitalists to “trust, but not confirm with their own eyes,” the emergency physicians’ assessment that a patient needs to be admitted.

Under the old system, the emergency department would call the medicine department, and a doctor on call would walk to the ER. The physician would work up the patient, decide to admit the person to medicine, and then write up the admission orders. All of this occurred while the patient waited in the ER.

Now, instead of finding one of the 50 residents on call, an ER physician who wants to admit a patient pages a hospitalist using the special “admission pager.” The hospitalist then uses a cell phone to call the ER doctor’s cell phone, and they discuss the case briefly.

Once the hospitalist accepts the admission over the phone, the ER physician writes very brief admission orders that include only the diagnosis, drug allergies and any one-time medications. The patient is then transferred upstairs to the medical floor, where the hospitalist begins a full work up.

Reduced waits

The system worked wonders, cutting the average two-and-a-half hour wait to 18 minutes during a two-month period studied between 1999 and 2000. Since then, the delay has crept back up “to about an hour. Dr. Howell attributes this to “a variety of other inefficiencies,” from paperwork to lack of beds. He says the group’s goal is to cut that delay to 15 minutes.

(Dr. Howell says an article on the triage program will appear in a future issue of the Journal of General Internal Medicine.)

A big advantage of the new system, Dr. Howell explains, is that procedures and treatments needed by these patients can begin right away. After all, an ER isn’t set up to care for inpatients like a medicine floor.

If a patient is experiencing a COPD exacerbation, for example, nurses can now give serial treatments with a nebulizer right away. In the ER, by comparison, nurses could deliver one treatment, but they were not set up to offer repetitive treatments.

“Not evaluating the patient with your own eyes can be a scary thing, but it has worked,” Dr. Howell says. Over the years, the medicine service decided that the admission was incorrect and scrambled to get the patient to the ICU in fewer than 1% of the cases.

“It’s a scary thought that you are going to have a patient who might crash on the floor, and people are resistant to that,” he explains. “But if somebody who was having trouble getting patients out of the ER in a timely fashion called me, I would absolutely suggest moving to this type of system.”

Feedback

A big reason the system has worked at Bayview is that from the beginning, the hospitalists and emergency physicians agreed to meet monthly to discuss how things were going and make changes as needed. As a result, the two groups have standardized key practices and procedures. Everybody now knows the acceptable ranges for blood pressures or abnormal electrolytes that make for a safe medicine floor admission.

“We are continually looking for ways to make patients’ care safe, but also to make the system more efficient,” Dr. Howell says. “The system would definitely fall apart if there wasn’t a way, like these meetings, to get feedback.”

Identifying hospitalists as the only physicians in the hospital who triage potential medicine admissions from the ER has also improved efficiencies in the hospital, he adds. The hospitalist’s job is to get the patient to the floor and then direct that patient to the appropriate provider in cases where there is another physician or a resident who will be following that patient through the hospitalization.

The system has also improved how hospitalists work with their ER colleagues. “Because we work so closely, we have developed a good rapport with them,” Dr. Howell says. “They know what to expect from each of us. Our relationship with the emergency department has become very solid.”

Deborah Gesensway is a freelance writer specializing in health care. She is based in Glenside, Pa.

90,000 1.1.1 Patient admission process to hospital. Development of an automated database for hospital

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CREATE PROCEDURE [update_ticket_patient_login] (@ patient_login varchar (50) …

Automated system for the operation of the polyclinic

4.1.8 View patient analyzes

CREATE PROCEDURE [patient_analize] (@ patient_id varchar (50))

AS

BEGIN

select visit.admission_date, direction_to_analysis.transmission_date, direction_to_analysis.analysis_type, direction_to_analysis.result

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BEGIN

select direction_to_analysis.delivery_date, direction_to_analysis.analysis_type, direction_to_analysis.result

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4.1.18 Information on prescribed medications for the patient

CREATE PROCEDURE [drug_for_patient] (@ patient_id varchar (50))

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BEGIN

select visit.adapt_date, medication.name, prescription.amount

from patient inner join visit on visit.patient_login = patient.patient_login

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BEGIN

select parcel. parcel_number

from parcel inner join street on street. parcel_number = parcel. parcel_number

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where @name = patient …

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4.1.22 Returns visit information for patient

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BEGIN

select visit.appointment_date, visit.time_of_ appointment, office.room_number, doctor_duration_of_ appointment, doctor.name, specialty.name_of_specialty, visit …

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4.1.30 Patient visits on a specific date

CREATE PROCEDURE [select_tickets_for_patient_id_and_date] (@ patient_id varchar (50), @ date date)

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BEGIN

select visit.admission_time, doctor.admission_duration

from patient inner join visit on patient.patient_name = visit.patient_name

inner join schedule on visit …

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4.year of receipt (disposal)

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90,000 What documents are needed and required for admission to a college or technical school – a list, a list and a package of necessary papers to enter a school: what needs to be collected

After the end of the 9th grade, the graduates will have to make a choice.They can continue their education at school or go to a secondary specialized educational institution (ssuz). The second option has many strengths. First of all, this is a shorter training period. There is no need to spend 2 years preparing for the Unified State Exam and waiting for the results. In addition, upon completion, you can take an accelerated program at the university. Many students, as well as their parents, are interested in various issues related to admission. For example, a list of documents that are needed or even necessary for admission to a college or technical school.They also ask whether it is compulsory to take the entrance tests and whether it is possible to choose several options at the same time. The procedure follows the established algorithm, which is set out in today’s article.

General description of the process

After the future student makes a decision about choosing a profession, you need to decide on a specific educational institution. As a rule, comprehensive information is posted on the official website of the school. To get an objective picture, it is worth carefully analyzing all the data.Then you can proceed directly to admission.

First of all, you need to prepare all the papers that are required. The set is the same in most situations. Additional certificates or certificates may be needed if the applicant applies for specific types of colleges. For example, related to art, physical education, pedagogy or medicine. A complete list can always be found on the official website.

It is convenient that, according to modern rules, it is not necessary to wait for the results of the OGE or the Unified State Exam in order to get your certificate for grade 9 or 11.This greatly simplifies the procedure and gives you more time to collect forms for admission to the school.

Immediately after preparing the necessary package of documents for admission to college, you can begin the main process. Papers are fed in different ways. Each has its own advantages and disadvantages. One of the more popular is to bring them to the admissions office. It is also possible to do this online in your personal account on the website or through the “Gosuslugi” portal. In addition, the package can be delivered using the Russian Post.

It is important to remember the timing of the introductory campaign. It is necessary to keep track of the dates on which enrollment to day, evening and correspondence departments begins and ends. It should also be borne in mind that the deadline is sometimes moved due to unforeseen situations. Therefore, it is important to constantly check for updates.

Who can apply

Any person who has a certificate of completion of the 9th grade of a comprehensive school is allowed to apply.There are no age restrictions.

What documents are required for admission to college

Lists of papers for educational institutions differ depending on how many years the applicant has attended school. The difference is insignificant, but it is worth remembering about it when going through the procedure.

After grade 9

In this case, the prospective student must fill out an application of the established form. An original or a copy of a passport of a citizen of the Russian Federation, a certificate of receiving incomplete secondary education is also required.It is necessary to attach 6 photographs with dimensions of 3×4. It is also mandatory to pass a medical commission and provide a certificate of Fo86 (for certain professions). It shows the general state of health of the applicant, the absence of contraindications for going through the training process. For males – additionally Fo25. It is filled in for the military registration and enlistment office and further registration.

After grade 11

For those who wish to enter after graduation, the set of required papers is practically the same.A military ID or certificate of registration for young men is added to the list. The rest of the list is the same.

Content of application for admission

The document must contain basic information about the applicant: name, surname, patronymic, as well as the date, month and year of birth. In addition, indicate the applicant’s citizenship and contact details.

It is required to indicate the name of the institution and whether the education will be the first or the second. After that, you need to note the name of the chosen specialty and the form of study: full-time or part-time.It is necessary to indicate whether a student enters a secondary school on a budgetary basis or under a contract for the provision of paid services.

The next step is to fill in the box with the number and series of the applicant’s identity document, as well as the date and authority of issuing the passport. In addition, it is mandatory to provide complete information about the education received before admission. It can be secondary (including incomplete) or higher.

If the applicant is a minor, the information about his legal representative is entered: parents or guardian.The name of the person, place of work and contacts are indicated.

The document notes whether the future student has a need to provide a hostel, create special conditions for training or admission due to health problems. The last step is consent to the processing of personal data, date and signature.

Sample application

In most cases, the papers are similar to each other. However, some points may differ depending on the requirements of a particular institution.The required forms are available for download on the official website in the appropriate section. It is enough to download them to your computer, print them using a printer and fill them in by hand. It is important to be careful and provide only reliable information. The candidate is responsible for her veracity.

How to Implement the Submission Process

After studying the list of documents required for admission to a college or technical school, and collecting a complete package, submit it to the admissions office. This can often be done in person.This option is still the most popular. However, there are also alternative methods. For example, order delivery by Russian Post to the specified address. Also, modern digital technologies allow you to scan all papers and download them via the Internet. It is only necessary to create a personal account on the official website of the school. This will save time and energy on the road. This option will be especially convenient for applicants from other cities. During the quarantine period, this method is the only possible one, since due to the restrictions introduced, the selection committee does not work normally.

How many educational institutions can you choose at one time

In addition to the question of what documents are needed to enter college, many are interested in the coverage of applications. Fortunately, the legislation of the Russian Federation does not impose any restrictions. The more places you choose, the higher the chance of success. However, the school may limit the number of majors available for selection at a time. This information should be checked on the official website and follow the updates, as they change every year.

Conditions of admission

After the applicant sends the application, the commission makes a decision on his enrollment or issues a refusal. There are a number of criteria that can influence the outcome of an admission campaign.

How to proceed without a certificate

Life situations are different. Therefore, instead of this paper, a certificate can be issued. This is due to insufficient student performance, failure on the OGE or other circumstances. Many do not want to spend a year retaking the exam.

A certificate of education for grade 9 or 11 is included in the list of documents that are required for admission to a technical school. However, there are institutions that accept children who have graduated from school for 8 years. They receive working professions: cook, machinist, seamstress, hairdresser and many others. Check the conditions of admission in each case. Also, some schools take on contract studies based on test results.

What to do without the exam

Often, schoolchildren do not have the ability or desire to take the Unified State Exam.It also takes a lot of time to prepare. And sometimes, for various reasons, the outcome is unsatisfactory. This will not be an obstacle. You can start studying without the appropriate paper, since they are enrolled on the basis of incomplete secondary education. All that is needed for admission to the desired college or technical school is to present to the commission a certificate of completion by the applicant of the ninth grade, along with other necessary papers. To study at a university after receiving a diploma from a secondary school, it is also not mandatory to pass the exam.

What they look at when receiving

Seats are limited on a budget basis. It often happens that there are much more applicants than a particular educational institution can provide.

Selection takes place according to the average score for the 9th or 11th grade. Also, in some cases, an additional competition of creative works is held, an audition, an interview or the delivery of physical standards. If the results are the same for several candidates, additional merit is taken into account.For example, participation or victory in school Olympiads, prizes in sports competitions, scientific conferences, the presence of publications in magazines.

Is it possible to enroll remotely

As mentioned above, it is not necessary to submit documents to the admissions office. Most educational institutions provide the opportunity to do this using the Internet. All that is needed to enter the technical school is scans of the necessary papers and a personal account on the official website of the school.Russian Post services also help to send documents while in another city.

There is also an opportunity to go to the correspondence course of study. Thus, you can master the program without attending a college on an ongoing basis. The student will need to be present only during the session to pass credits and checkpoints, attend lectures and defend coursework. The period lasts about 20 business days. This option is convenient for those who live in remote areas of the Russian Federation, combine education with work, or take care of a child or a sick relative.

How the exams will be held

In most cases, applicants are accepted according to the average score of the certificate. However, the MO defines a list of specialties that require entrance examinations. These are professions related to art – music, painting, stage skills. This list also includes: architecture, drawing, medicine, physical education and pedagogy.

The applicant is given 3 to 6 hours to complete the assignment. Depending on the chosen direction, you will have to perform different types of creative work.For example, creating a still life or building compositions on a sheet of Whatman paper. In some situations, exams are optional. This applies in particular to candidates with an art school diploma and an extensive portfolio with a large number of high-level drawings. All that is needed for admission to a technical school is to present it to the admissions office of the educational institution.

For students applying for specialties that are related to physical training, it is necessary to pass sports standards.These include: running long and short distances, push-ups from the floor, long jumps, lifting the body from a prone position, bending on the gymnastic bench and pull-ups. For females, it is possible to do the exercise on a low bar.

Future vocalists, musicians and actors will have to audition. Its content depends on the specialty chosen by the applicant. This can be a certification in vocal or musical instrument, as well as solfeggio. For a certain number of areas, an interview is provided instead of exams.As a rule, this is medical business, advertising and pedagogy.

Let’s summarize

School is an excellent solution for those who have decided on their future profession and do not want to spend two years getting a full secondary education at school. Students who graduate from this type of educational institution can enter and complete an accelerated program.

One of the most common questions of concern to applicants and their parents: what documents need to be collected when entering college.What did we find out:

• The package of papers is not too large. First of all, it is necessary to write applications of the sample established by the school or technical school.
• Templates are posted on the official sites. They need to be printed out and filled in by hand.
• There are places where you can go without having a lower secondary education diploma. Often this is a secondary school in which workers are trained.
• A number of educational institutions provide an opportunity to enroll on a paid basis based on the results of entrance examinations.
• Then you can start serving. This is done in several ways. The most popular is to personally take them to the admissions office. It is also allowed to send them by mail or via the Internet. An online operation is carried out using the LC on the official website or portal of “State Services”. Under quarantine conditions, this is the only option available.
• In most cases, prospective students are admitted without exams. However, some specialties require passing them.
• Also, the selection committee can take into account additional achievements of candidates.For example, prizes in competitions or olympiads.
• For applicants entering after the 11th grade of a comprehensive school, passing the Unified State Exam is not required. Without passing the exam, you can start studying at the university after graduating from the secondary school.

Based on all of the above information, it can be concluded that the procedure is not too complicated. The main thing is to choose the right institution and carefully study the rules for admission to it. It is also important to take into account the list of documents that are required for admission to the desired college, school or technical school, the timing of the entrance campaign.

PHILATOV HOSPITAL – official website

Appeal of the head physician

Dear parents and colleagues!

Chubarova Antonina Igorevna

Doctor of Medical Sciences, Professor, Chief Physician
Children’s City Hospital. N.F. Filatova,
Professor of the Department of Hospital Pediatrics No. 1
RNIMU them. N.I. Pirogova.

I am glad to welcome you to the website of our hospital!

Children’s City Clinical Hospital named after N.F. Filatova – “Filatovskaya Hospital” is a legendary institution, traditionally the leader of domestic medicine in the field of medical care for children.

Founded in December 1842, it is the first children’s hospital in Moscow. From the first days of its establishment, the hospital’s management and doctors have set themselves the task of highly qualified assistance to the children’s population. Leading doctors of that time worked at the hospital, cooperation with Moscow University immediately began, and since 1846 classes for medical students have been held in the hospital.

In 1922, the hospital was named after the first Russian pediatrician Nil Fedorovich Filatov. After that, the hospital in everyday life began to be called “Filatovskaya”.

After almost 2 centuries, the staff of our Filatov hospital remains faithful to the principles laid down at its foundation – put the health of the child above all else, provide not only treatment, but also the development of a small patient, create and disseminate new technologies, train future doctors on the basis of the unity of science and practices .

Now our hospital is a modern multidisciplinary medical institution, which includes a hospital, a day hospital, an outpatient surgery center, a city consultative and diagnostic center (level 3 outpatient care), a polyclinic (level 1 and 2 outpatient care) and an emergency trauma center. help.

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More details …

90,000 Catering unit of a medical institution.How are patients fed and how is the feeding process organized? We will tell and show

Catering unit of a medical institution. How are patients fed and how is the feeding process organized? We will tell and show

The employees of the catering department of the Khanty-Mansiysk District Clinical Hospital face a difficult task every day – to feed more than 700 patients with breakfast, lunch and dinner. In this case, it is necessary to ensure not only food safety, but also benefit.It is important for each patient to provide an individual menu, according to the medical diet prescribed by the doctor. Every day, in a responsible position – cooks, barmen, nutritionists, warehouse manager, kitchen workers: washers, loaders. Only 70 people.

Together with a representative of the Public Council and volunteers – doctors from the Medical Academy of Khanty-Mansiysk, we visited the catering unit of the hospital, saw the conditions for storing food, the cooking process, witnessed the well-coordinated work of the team, assessed the quality of the prepared dishes.

Food production is a complex, laborious and responsible process. Each company providing catering services is obliged to monitor the entire chain of the technological process, from the delivery of products to preparation and consumption.

In a medical institution in Khanty-Mansiysk, the “tablet-nutrition” system has been practiced for 20 years. This technology consists in the fact that food is laid out in portions in dishes and placed in special recesses on individual trays.Trays with meals are delivered to patients’ rooms by transport trolleys. The advantages of pill food are that the trays, like a thermos, keep food warm. Moreover, it is convenient, safe and comfortable.

When a patient is admitted to the hospital, the attending doctor prescribes a diet. Information in electronic form is transmitted to the dietitian every morning, it forms a nutrition register, a menu is drawn up, a therapeutic diet for the patient is determined, a clip is put on a tray with food indicating the table.The diet must include meat, fish, vegetables, fruits, dairy products and confectionery.

To control the quality of cooked food, there is a daily refrigerator, where sterile containers with prepared food are kept for 48 hours. This is necessary for regulatory organizations. Note that over the 20 years of the kitchen’s operation, there have been no cases of infectious diseases associated with the catering unit.

For many years, work here has been organized in accordance with the strictest international and Russian standards.For 5 years, the team of the catering department has been working in accordance with the HACCP quality control system. In 2013, a new regulation was adopted in Russia, according to which all companies in the food industry must introduce a new control system into production. At its core, HACCP is an innovative technology, which is a set of mandatory actions for every enterprise aimed at ensuring the safety of food consumers.

– The department is constantly updating equipment.We are closely monitoring this. We replaced all the spacing, updated the boilers, the electric stoves are working properly. We are planning a new blender, a washing machine for storing, buying new carts, – says the chief nurse Olga Karpova.

The team here is stable and friendly, knows and loves their job. There are elders. Since the founding of the catering department, the head Olga Zarudnaya and the senior nutritionist Lidiya Bashmakova have been working. Interestingly, the patients remember the kitchen workers.Especially inpatients love it when men feed. The children drew a portrait of one of the barmen and presented it as a keepsake.

Member of the Public Council Tamara Ovechkina and medical volunteers watched all the stages of the catering unit’s work – from checking the received raw materials to selling the finished product. Verdict – all conditions have been created in the medical institution that guarantee the safety and quality of products for the end user.

– This is a huge area of ​​responsibility.The patient’s health begins with the catering unit. The work of the team is no less important than the medical assistance of doctors. As a hospital patient, as a representative of the expert group and the Public Council of a medical institution, I want to say that the quality of food is beyond praise. Considering that this is a medical organization, and food is organized so as not to harm the process of recovery of patients, my assessment is excellent, – says Tamara Ovechkina.

As a suggestion, the experts advised finding an opportunity to organize meals for the hospital staff.No, not necessarily at the expense of the budget. It is important to provide for a separate room where medical personnel can safely eat, communicate, and relax. This is one of the ways to increase motivation, as well as to ensure maximum comfort and team cohesion.

Press Center of the District Clinical Hospital of Khanty-Mansiysk

M.P. Konchalovsky City Clinical Hospital

Administration of GBUZ “GKB named after M.P. Konchalovsky DZM “and the schedule of reception of the population

Chief physician – Yarotskaya Irina Anatolyevna
Education : higher. Graduated from the State Medical Academy in 2000, residency – in 2002, postgraduate studies – in 2005

Pirogov for additional
professional program “Therapy”, where she defended the final work
“Differential diagnosis of articular syndrome.”

In 2015, the Russian Medical Academy
postgraduate education “on the professional program” Organization
health and public health “.

Academic degree : candidate of medical sciences

Has the highest qualification category in the specialty “Therapy” with
2005, certificates in the specialties “Organization of health care and
public health “,” Rheumatology “,” Cardiology “.

From 2000 to 2008 – worked as a general practitioner at the City Clinical Hospital No. 81.

From 2008 to 2014. – worked at the post of deputy chief physician for the medical part in the city polyclinic number 65.

Since 2014.to 2020 – headed the consultative and diagnostic
department with day hospital GBUZ “GKB im. M.P. Konchalovsky DZM “.

In 2020 – she was appointed deputy chief physician of the State Budgetary Healthcare Institution “GKB im.
M.P. Konchalovsky DZM “on outpatient work.

April 16, 2020 – Head of GBUZ “GKB im. M.P. Konchalovsky DZM “

Total work experience – over 20 years.

Awards:

Certificate of honor of the Moscow Department of Health (2016)

Certificate of honor of the head of the administration of the Savelki district of Moscow (2017)

Certificate of honor of GBUZ “GKB im.M.P. Konchalovsky DZM “(2018)

Gratitude of the Minister of Health of the Russian Federation (2019)

Reception of citizens is conducted on Mondays – from 15:00 to 18:00
Registration by phone – 8 (499) 645-52-24
24-hour operational communication – 8 (925) 483-23-21

Deputy Chief Physicians:

Deputy Chief Physician for Medical:

Nikushkina Irina Nikolaevna
Education higher.Graduated from the First Moscow State Medical University. THEM. Sechenov with a degree in general medicine. Further training: therapy – 07.02.2009, cardiology – 27.06.2007, gastroenterology – 05.12.2011

Academic degree : Doctor of Medical Sciences

Total experience – 24 years.

Reception of citizens is carried out on Tuesdays – from 10:00 to 12:00

Office No. 349

Phone: 8 (499) 734-08-84

Deputy Chief Physician for Human Resources

Nikolaeva Marina Vyacheslavovna
Education: higher . Graduated from the Russian State Open Technical University of Railways, Faculty of Economics with a degree in Management (personnel management), 2001

Advanced training: in 2013 – heads of personnel services at the Center for Advanced Studies of the Ministry of Education, St. Petersburg, in 2016 – “Methods and technologies of university management in modern conditions” in the educational center for training leaders of the National Research University “Higher School of Economics”, in 2019- “Personnel work in the university in modern conditions” at the Peter the Great St. Petersburg Polytechnic University.

Total work experience: 25 years

Awards: Certificate of honor of the Ministry of Health of the Russian Federation (2014), Commendation of the Minister of Health of the Russian Federation (2018)

Reception of citizens is conducted by:

• Monday from 14:00 to 16:00,
• Wednesday from 10:00 to 12:00
• Friday from 10:00 to 12:00

Office No. 368

Phone: 8 (499) 735-64-29

Deputy Chief Physician for Economics:

Vinnik Nadezhda Grigorievna
Education : higher.Graduated from the All-Union Civil Engineering Institute (Moscow) in 1979 with a degree in economics and urban management.

Total work experience – 39 years.
Ranks : Honored Economist of the Russian Federation (2006), Full State Councilor of the Russian Federation of the 2nd class (class rank awarded by the Decree of the President of the Russian Federation of November 25, 2009)
Awards : Badge of Honor “For Merit in the Development of the Olympic Movement in Russia” ( 2010), Acknowledgment of the Ministry of Education and Science of the Russian Federation (2005), Acknowledgment of the President of the Russian Federation (2008), Certificate of Honor of the Department of Healthcare of St.Moscow (2013).

Reception of citizens is conducted on Thursdays – from 10:00 to 12:00

Office No. 351

Phone: 8 (495) 944-66-74

Deputy Chief Physician for Internal Quality Control of Medical Care:

Kuznetsov Evgeniy Nikolaevich
Education : higher. Graduated from the Moscow Medical Academy in 1996 with a degree in General Medicine. Co-author of the book “The Clinical Significance of 24-hour Blood Pressure Monitoring”.He actively introduced methods of multifunctional monitoring of blood pressure and ECG in the V.Kh. Vasilenko Clinic of Propedeutics of Internal Diseases, Moscow Medical Academy named after I.M. Physician of the highest category in functional diagnostics.

Total work experience – 25 years.
Academic degree: Candidate of Medical Sciences

Office No. 351

Phone – 8 (499) 735-64-29

Acting Deputy Chief Physician for Prospective Development

Korkeshko Vasily Valerievich 9000 Education …Graduated from the Smolensk State Medical Academy with a degree in General Medicine (2008). He was trained in clinical residency at the Smolensk State Medical Academy in the specialty “Therapy” (2008-2010).

Passed professional retraining in the following specialties:

“Ultrasound diagnostics” (2011), “Organization of health care and public health” (2014), “Functional diagnostics” (2016), “Cardiology” (2016), “Clinical pharmacology” (2017 ).

Member of the Moscow Regional Branch of the Interregional Public Organization “Association of Clinical Pharmacologists”.

Total work experience – more than 10 years.

Reception of citizens is conducted on Wednesdays – from 13:00 to 15:00

Phone: 8 (499) 735-62-91

Office No. 348

Deputy Chief Physician for Surgical Care

Vasilchenko Mikhail Ivanovich
Education : higher.1990 – the military medical faculty at the D.I. Ulyanov with a degree in General Medicine. 1994-1997 – clinical residency in military field surgery of the military medical faculty at the Siberian Medical University. 1990-2011 – passed military medical service in various positions, finished military service as chief surgeon of the 2nd Central Military Clinical Hospital named after P.V. Mandryka with the rank of colonel of the medical service.
1996 – defended his Ph.D. thesis on the topic: “Areflux jejuno-gastrostomy”.
2004 – defended his doctoral dissertation on the topic: “Optimization of methods for supravesical urine diversion and cystoplasty using the small intestine.”

Academic degree : Doctor of Medical Sciences

Awards : Honored Doctor of the Russian Federation

Certificate of honor of the Moscow City Health Department

Phone: 8 (499) 735-64-29

Deputy Chief Physician for Therapy:

Alexander Mikhailovich Gritsanchuk
Education : higher.He studied at the Russian State Medical University named after V.I. N.I. Pirogova (Moscow), GIUV MO RF
(Moscow), Military Medical Academy named after V.I. S. M. Kirov (St. Petersburg).
Cardiologist, arrhythmologist, anesthesiologist-resuscitator of the highest category. Supervisor
Regional Vascular Center. Assistant at the Department of Internal Medicine, Clinical
pharmacology and emergency medical care MGMSU them. A.I. Evdokimova.

Total work experience – over 10 years.

Phone: 8 (499) 734-05-39

Deputy Chief Physician for Anesthesiology and Resuscitation:

Muslimov Bagautdin Gusenovich
Education: higher.In 2006 he graduated from the Astrakhan State Medical Academy with a degree in General Medicine. 2006 to 2007 completed an internship at the Astrakhan State Medical Academy with a degree in Anesthesiology and Reanimation. From 2015 to the present, she has been working at the State Clinical Hospital im. M.P. Konchalovsky DZM “. Repeatedly passed refresher courses, thematic courses in various sections of anesthesiology and resuscitation. He is fluent in the practical skills of anesthesia, intensive care and resuscitation of various categories of patients.

Work experience over 10 years.

Reception of citizens is conducted on weekdays – from 9:00 to 16:00

Office number 339

Deputy chief physician for obstetric and gynecological care:

Vartanyan Elen Araevna
Education : higher. Graduated from the Faculty of Fundamental Medicine at Lomonosov Moscow State University in 2004 with a degree in General Medicine. In 2008 she graduated from the clinical residency in obstetrics and gynecology, specializing in obstetrician-gynecologist.She successfully completed a professional retraining course at the Department of Healthcare and Public Health Organization of the Russian Medical Academy of Postgraduate Education.

General experience: 7 years worked in the management staff of state budgetary institutions of the Moscow healthcare system.
Awards : thanks of the prefect of the Eastern Administrative District of Moscow (2012, 2013)M.P. Konchalovsky (Aleksandrovka St., 8), office building, office number 230

Phones: 8 (499) 729-30-31, 8 (499) 729-37-40

Deputy Chief doctor on epidemiological issues:

Gracheva Irina Yurievna
Education : higher. Graduated from the Moscow Medical Institute. IM Sechenov in 1989 with a degree in Epidemiology. Doctor-epidemiologist of the highest qualification category.

Total work experience – 26 years.
From 1998 to 2014 worked as a district specialist in epidemiology and organization of infection control of the Zelenograd Administrative District of Moscow.

Reception is conducted on Thursdays – from 10:00 to 12:00 (for medical examination of employees entering work)

Phone: 8 (499) 734-02-26

Deputy Chief Physician for Civil Defense and mobilization work of the ONP:

Manakov Nikolay Vladislavovich
Education : higher. Graduated from the Military Medical Faculty at the Saratov Medical Institute in 1987 with a degree in general medicine.Military Medical Academy with a degree in healthcare organization – in 1998.

Served in the Armed Forces of the Russian Federation from 1985 to 2014.
Total work experience – 31 years.
Rank : Retired Colonel of the Medical Service.
Awards : Commendation from the Head of the Moscow City Health Department (2017).

Phone: 8 (499) 734-34-86

Deputy Chief Physician for Clinical Expert Work:

Chistyakova Vera Petrovna
Education : higher.Graduated from the Moscow Medical Institute. IM Sechenov in 1993, specializing in general medicine.

Total work experience – 21 years.

Phone: 8 (499) 734-52-20

Deputy Chief Physician for Household Affairs:

Balashov Pavel Yurievich
Education : higher. Graduated from the non-state non-profit educational institution “Moscow Institute of Medical and Social Rehabilitation” in 2000 with a degree in General Medicine

In 2007.- Federal State Educational Institution of Higher Professional Education “Moscow State Academy of Physical Culture” with a degree in “Specialist in Physical Culture and Sports”.

In 2010 – State and municipal administration with a degree in “Manager”

Work experience in healthcare – more than 12 years

Phone: 8 (499) 734-20-20

Administrative building, 3rd floor

Deputy chief physician for outpatient work:

Titov Alexander Andreevich
Education : higher.

In 2006 he graduated from the Russian State Medical University of the Ministry of Health and Social Development of the Russian Federation.

In 2008, he completed an internship at the City Clinical Hospital No. 15 in Moscow, specializing in “Surgery”.
Completed advanced training courses in surgery.

In 2014, he underwent professional retraining in healthcare organization, and in 2017 – in physiotherapy.

Assigned to the specialties of surgery, healthcare organization and
physiotherapy, has the appropriate specialist certificates, the first
qualification category in surgery.

Phone: 8 (495) 011-02-37

E-mail address – [email protected]

Head of branch “Outpatient department No. 1”

Zakirova Nadezhda 9000

Phone: 8 (499) 735-44-30

Email address: [email protected]

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Head of the Polyclinic Department No. 2 branch

Tel. Veronika Georgievna Panferova

: 8 (499) 210-31-60

Email address – gkb-konchalovskogo @ zdrav.mos.ru

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Head of the Polyclinic Department No. 3 Branch

Yulia Vasilievna Glukhovshchenko

Phone: 8 (499) 735-55-80

E-mail address – gkb-konchalovsk.mos@zz. ru

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Head of the branch “Outpatient department No. 4”

Maltsev Kirill Aleksandrovich

Phone: 8 (499) 717-02-55

Email address – gkb-konchalovskogo @ zdrav.mos.ru

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Head of the Outpatient Department No. 5 Branch

Anton Germanovich Volvovsky

Phone: 8 (965) 390-28-28

Email address – gkb-konchalovsk.mogo@zd .ru

Acting as head of the branch “Perinatal Center”

Martynova Irina Viktorovna

Reception of citizens on weekdays from 12:00 to 16:00

Branch “Perinatal Center” GKB im.M.P. Konchalovsky (Aleksandrovka St., 8), office building, office No. 229

Phone: 8 (499) 729-37-41

Head of the antenatal clinic of the Perinatal Center branch

Saidova Elvira Anverovna

Reception of citizens is conducted on Mondays and Thursdays – from 15:00 to 16:30

Branch “Perinatal Center” GKB im. M.P. Konchalovsky (Aleksandrovka St., 8), KDO

Phone: 8 (499) 729-20-71

Procedure for issuing certificates of incapacity for work for doctors and policyholders – GU

FOR DOCTORS AND
INSURERS

Procedure for issuing leaflets
incapacity for work, approved by order of the Ministry of Health and
social development of the Russian Federation from 29.06.2012 No. 624n (hereinafter the Procedure)
as amended by order of the Ministry of Health and Social
development of the Russian Federation from 24.01.2012 No. 31n

The certificate of incapacity for work is financial and
a legal document confirming the temporary disability of citizens, and
also a document on the basis of which an allowance for temporary
incapacity for work at the time of illness of the insured person, instead of the lost
their earnings are 90,225.The certificate of incapacity for work can be filled out using
printing devices or manually in Russian in printed capital letters
black ink, using gel, capillary or pen
pens. Combined filling is possible.

1. On the issuance and extension of certificates of incapacity for work at outpatient,
inpatient treatment and if the patient is transferred to treatment from one
medical organization to another medical organization – a) from a hospital to
hospital, b) from hospital to polyclinic, c) from polyclinic to hospital, d) from
polyclinics to the polyclinic, as well as when referring or transferring to treatment in
another region (p.6, 18, 19, 58 Order).

p. 6 of the Order: – For outpatient treatment, the issuance and
the extension of the certificates of incapacity for work is carried out by the doctor after examination
citizen on the day of seeking medical help, with an entry in
medical documentation. Records on the extension of the certificate of incapacity for work in
the patient’s outpatient card must correspond to the entries on the sheet
disability. On the day of closing, a certificate of incapacity for work is issued for
appointment and payment of benefits for temporary disability, pregnancy and
childbirth (fill in the line “Get to work” or “Other”, put the signature
doctor and the seal of the medical organization).

In case of long-term treatment, the medical organization issues a new leaflet
incapacity for work (continued) and at the same time draws up the previous sheet
incapacity for work for the appointment and payment of benefits, in which the number is entered
of the issued continuation and the code “31” is indicated.

In case of inpatient treatment, a certificate of incapacity for work is issued per day
hospital discharge for the entire period of inpatient treatment. When
long-term incapacity for work with a hospital stay can be issued
certificate of incapacity for work for the payment of benefits.Moreover, the date of issue of this
the document coincides with the date of its registration and the date of stay in the hospital for
the moment of applying for a certificate of incapacity for work (for example, stay in
hospital from 08/01/2018 to 08/28/2018 and continues to be ill – date of appeal for
a certificate of incapacity for work, hospital stay and its registration –
28.08.2018) , the code “31” is indicated, and the continuation number is entered,
issued by on 28.08.2018

clause 18 of the Order: Citizen , who is
temporarily disabled, directed to
consultation (treatment, examination) to a medical organization,
located outside the administrative
district , by decision of the medical commission ,
who sent him, issued a certificate of incapacity for work per day
requests for the number of days required to travel to the place
finding corresponding to medical
organizations .The certificate of incapacity for work remains open. Renewal
(a new form is issued) and (or) closing the certificate of incapacity for work
carried out by the medical organization to which the citizen was sent
(applied) for treatment. If necessary
extension of sick leave medical organization
issues a new sheet (continuation ), which indicates
period of incapacity for work while treating a patient in this organization. Wherein,
a certificate of incapacity for work from the previous stage of the patient’s treatment is issued on
payment: empty lines of the table “Exemption from work” are crossed out by one
with a continuous line with the corresponding black handle, the code “31” is indicated,
the number of the extension of the certificate of incapacity for work, the doctor’s signature and seal are put
medical institution.

clause 19 of the Procedure: When a citizen is discharged after a stationary
treatment, a certificate of incapacity for work is issued on the day of discharge from the hospital for the entire
the period of inpatient treatment. With the continuation of temporary disability
the certificate of incapacity for work can be extended, if indicated, up to 10 calendar
days by the inpatient doctor, and the patient is referred for further treatment in
medical organization at the place of residence with an open leaflet
disability.

In the case when a citizen who is incapable of work on the day of discharge from the hospital,
is able to work in the medical organization to which he was referred
to continue treatment, the medical organization fills out in the form
disability line “Get to work” and closes it, put
the doctor’s signature and the seal of the medical organization.

Continuation of leaflet of incapacity for work in
other medical organization is issued for
new (!!!!) form of a certificate of incapacity for work with additional registration
the previous sheet for payment.

a) when transferring from hospital to hospital – sheet
incapacity for work is issued by the hospital on the day of transfer, indicating the period
hospital stay and the period of release from work, which, according to
the durations will be the same; the patient is sent to another hospital with
an open certificate of incapacity for work. On admission to the hospital, another
the medical organization is resolving the issue of further registration of the leaflet
disability.

With continuing treatment in another
hospital certificate of incapacity for work from the previous stage of treatment
the patient is issued for payment: empty lines of the table “Exemption from work”
are crossed out by one continuous line with the corresponding black pen,
the code “31” is indicated, the number of the continuation of the certificate of incapacity for work is indicated,
issued by this hospital, the doctor’s signature and the seal of the medical
institution to which the patient is transferred.On new form ,
issued in continuation of the previous certificate of incapacity for work, issued at
admission, during the period of hospital stay, the total duration is indicated
treatment (from the date of primary hospitalization to the present), and the period
exemptions in the table “Exemption from work” minus the days specified in
previously issued certificate of incapacity for work and to the present
time (for example, the period of inpatient stay and release from
work in the primary (previous) certificate of incapacity for work from 01.08.2018 to
08/28/2018, then in the continuation of the period of hospital stay is indicated from
08/01/2012 to 09/10/2018 (by the date of discharge from the hospital), in the table
“Exemption from work” period from 08/29/2018 to 09/10/2018) .

Issuance of a certificate of incapacity for work during treatment in a daytime
hospital “is carried out according to the rules established for registration
disability certificates for outpatient treatment.

b) when transferring from a hospital to a polyclinic
– certificate of incapacity for work is issued by the hospital per day
transfer, indicating the period of hospital stay and the period of release from
work.If the disability continues, the patient is referred to
a clinic with an open certificate of incapacity for work on the last day of release
from work in which the issue of further design of the leaflet is being resolved
disability.

If the patient is recognized as able-bodied (!) , then on the sheet
disability clinic fills in the line “Proceed to
work “ and it is closed, the doctor’s signature and seal are put
polyclinics.

If the patient is recognized as disabled , then on the sheet
disability hospital empty rows of the table “Exemption from work”
are crossed out by one continuous line with the corresponding black pen,
the code “31” is indicated, the number of the continuation of the certificate of incapacity for work is indicated,
the signature of the doctor and the seal of the medical institution (polyclinic) are put.The continuation of the period of incapacity for work in the polyclinic is drawn up in
in accordance with the established procedure on new form of the sheet
incapacity for work (!).

c) when transferring from a polyclinic to a hospital
– if you need to transfer from outpatient mode
inpatient treatment, the patient is sent to a hospital with an open leaflet
incapacity for work, which resolves the issue of its further registration.

If the patient continues treatment in the hospital , then in
outpatient disability certificate issued for payment, empty lines
tables “Exemption from work” are crossed out by one continuous line
the corresponding black pen, the code “31” is indicated, the number is indicated
continuation of the certificate of incapacity for work (hospital), the signature of the doctor is put and
medical institution stamp
(hospital). Continuation of the certificate of incapacity for work
drawn up in accordance with the established procedure on a new form of the sheet
disability (hospital) on the day of hospitalization.

g) when transferring from polyclinic to polyclinic
(for example, from the polyclinic at the place of contact to the polyclinic at the place of
registration) – to continue treatment in another clinic
the patient is sent with an open certificate of incapacity for work.

If the patient is recognized as able-bodied (!) , then on the sheet
disability clinic fills in the line “Proceed to
work “ and it is closed, the doctor’s signature and seal are put
polyclinics.Blank lines are crossed out by one continuous line.

If the patient is recognized as disabled , then on the sheet
incapacity for work empty rows of the table “Exemption from work”
are crossed out by one continuous line with the corresponding black pen,
the code “31” is indicated, the number of the continuation of the certificate of incapacity for work is indicated,
the signature of the doctor and the seal of the medical institution (polyclinic in which
continued treatment of the patient). Continuation of the period of incapacity for work in
the clinic is drawn up in accordance with the established procedure on a new form
certificate of incapacity for work (!).

2. Terms of extension of the certificate of incapacity for work and referral to
medical and social expertise (hereinafter MSE) in diseases, in the treatment of injuries,
conditions after reconstructive surgery, tuberculosis (p. 11, 13, 21, 27
Procedure) in accordance with Federal Law dated 21.11.2011 No. 323-FZ “On
fundamentals of health protection of citizens in the Russian Federation “(hereinafter FZ No.
323) .

In accordance with clause 11 of the Procedure for outpatient treatment of diseases (injuries),
poisoning and other conditions associated with temporary loss of citizens
ability to work, the attending physician single-handedly issues leaflets to citizens
incapacity for work for up to 15 calendar days
inclusive (part 3 of article 59 of the Federal Law No. 323).Extending days
incapacity for work, within the specified maximum period of sole
issuance, the attending physician conducts for a period until the next examination (attendance),
to assess the patient’s condition, the results of the prescribed examination, when
the need to prescribe an additional examination and adjust the treatment,
depending on the diagnosis, the severity of the condition, and in accordance with
medical and economic standards for the diagnosis and treatment of diseases, injuries and
other states.

For periods of temporary incapacity for work exceeding 15 calendar
days, a certificate of incapacity for work is issued and extended by the decision of a medical
Commission , appointed by the head of a medical organization. In the leaf
incapacity for work subsequent periods of release from work over 15
calendar days from the initial certificate of incapacity for work are certified by a signature
the attending physician and the chairman of the medical commission.

In accordance with clause 13 of the Procedure “… By the decision of the medical commission at
favorable clinical and labor prognosis, a certificate of incapacity for work can
be issued in accordance with the established procedure before the day of restoration of the ability to work, but
for a period not exceeding 10 months , and in some cases
(injuries, conditions after reconstructive operations, tuberculosis) – for a period not
more than 12 months , with renewal intervals
by decision of the medical commission at least 15 calendar
days. On the certificate of incapacity for work subsequent periods
exemption from work for more than 15 calendar days is certified by the signature of the treating person
doctor and chairman of the medical commission.

In accordance with clause 21 of Order in individual cases (complex
urological, gynecological, proctological and other complex, invasive
research methods, manipulations, procedures) for outpatient
treatment on the intermittent method, a certificate of disability may
be issued by the decision of the medical commission on the days of the
appropriate research (procedure).In these cases, the leaflet
incapacity for work, the calendar days of the research are indicated
(manipulations, procedures) and release from work is carried out on the days of the
research (manipulations, procedures). On the certificate of incapacity for work
the specified periods of release from work are certified by the signature of the attending physician and
the chairman of the medical commission.

In accordance with clause 27 of Order “For medical and social
examination (hereinafter referred to as ITU) is sent to citizens of with a favorable
clinical and labor prognosis no later than 10 months from the date
the onset of temporary disability in the condition after injuries and
reconstructive operations and no later than 12 months in the treatment of tuberculosis, or
a citizen is discharged to engage in labor activity. “

In accordance with Article 59 of the Federal Law No. 323 with obvious
unfavorable clinical and labor prognosis no later than 4
months from the date of the beginning of temporary disability patient
sent for a medical and social examination in order to assess
disabilities, and in case of refusal to pass
medical and social examination certificate of incapacity for work
closes.

Upon determination of disability, the period of temporary incapacity for work ends
the date immediately preceding the day of registration of documents at the institution
ITU.

Temporarily disabled persons who have not been identified
disability , a certificate of incapacity for work may be
issued by the decision of the medical commission, taking into account the days of passage
ITU, until the restoration of working capacity with the frequency of renewal of the leaflet
incapacity for work by decision of the medical commission at least 15
calendar days , or until re-submission to the ITU.

3. Drawing up a certificate of incapacity for work when referring patients to
treatment in clinics of research institutions (institutes)
balneology, physiotherapy and rehabilitation, spa facilities, in
including specialized (anti-tuberculosis) sanatoriums
institutions for follow-up treatment in specialized sanatoriums
(NS.25, 31, 60 Order).

In accordance with clause 25 of the Order to citizens sent
medical organizations and health authorities of the subjects
Of the Russian Federation for treatment in clinics of research institutions
(institutes) of balneology, physiotherapy and rehabilitation, spa
institutions, including specialized (anti-tuberculosis)
health resort institutions, a certificate of incapacity for work is issued by a medical
employee on the basis of the decision of the medical commission for the duration of treatment and travel to
the place of treatment and back.With appropriate medical indications, the leaflet
incapacity for work is extended by the attending physician of the indicated clinics,
health resort institutions.

The decision to close the certificate of incapacity for work to work may
accept the medical commission of the clinic, or the medical commission of the polyclinic for
the patient’s place of residence.

In accordance with clause 60 of the Order sheet
disability for follow-up care is drawn up in a medical organization,
directing a citizen to follow-up care.On a certificate of incapacity for work,
certifying temporary incapacity for work during treatment in a hospital, in
the line “Hospital stay” indicates the total length of stay
in the hospital, and in the table “Exemption from work” the period from the date of admission to
hospital and until the day preceding the transfer to sanatorium follow-up treatment (during
avoidance of duplication of extension days in the certificate of incapacity for work). For example,
hospital stay from 01.08.2012 to 09.09.2012, in the table “Exemption from
work “the period from 01.08.2012 to 08.09.2012, because from 09.09.2012 –
the date of the beginning of the sanatorium follow-up treatment, which is entered in the continuation of the leaflet
disability for follow-up care. The code “37” is entered into the “Other” column.
In fact, both certificates of incapacity for work are drawn up by a medical organization
to the patient in one day upon discharge from the hospital.

On the certificate of incapacity for work, drawn up for follow-up care, reason code
incapacity for work is indicated “08”, in the table “Exemption from work” in the column
“From what date” indicates the date of initiation of treatment.Further design of the leaflet
incapacity for work is carried out by the attending physician of the spa
institutions (departments): the line “Was in the hospital” indicates the terms
stay in a sanatorium, in the table “Exemption from work” in one line
the period of stay in a sanatorium-resort institution (department) is indicated.
The lines “Date 1” are also filled in – the date of the start of the tour, “Date 2” – the date
the end of the voucher, “voucher number” and “OGRN sanatorium or clinic research institute.”

This is important! On a certificate of incapacity for work with a code
reasons “08” in the table “Exemption from work” the period of incapacity for work is not
may exceed 24 calendar days.

4. Drawing up a certificate of incapacity for work when the injured are referred
in connection with a serious accident at work, at a sanatorium
treatment during the period of temporary disability (clauses 32, 60 of the Procedure).

In accordance with clause 32 of the Procedure: “When referring persons injured in connection with
an accident at work, for spa treatment during the period
temporary incapacity for work (before being sent to the ITU) certificate of incapacity for work
issued for the entire period of treatment and travel by decision of the medical commission in
in accordance with this Procedure “.

In accordance with clause 60 of the Procedure in the certificate of incapacity for work in the columns of the table
“Exemption from work” “From what date” and “To what date” in the line
the date of the start of treatment is indicated (similar to clause 31 of the Procedure) according to the direction
medical commission. Additional registration of the leaflet is carried out in a sanatorium
institution. In the line “was in the hospital, the length of stay in
sanatorium institution. With continued temporary disability
at the end of the spa treatment, the patient is referred to continue
treatment in a medical organization at the place of residence.

5. Drawing up a certificate of incapacity for work when referring patients
tuberculosis on vouchers to specialized (anti-tuberculosis)
health resort institutions for treatment in the case when the health resort
treatment replaces inpatient treatment, as well as aftercare after
inpatient treatment (clauses 33, 60 of the Procedure).

In accordance with clause 33 of the Procedure: “When directed by medical organizations
tuberculosis patients on vouchers to specialized (anti-tuberculosis)
health resort institutions for treatment in the case when the health resort
treatment replaces inpatient treatment, as well as aftercare after
inpatient treatment, a certificate of incapacity for work is issued by the decision of a medical
commission anti-tuberculosis dispensary and extended by medical
the commission of a specialized (anti-tuberculosis) sanatorium-resort
institutions for the entire period of treatment, follow-up treatment and travel in accordance with
this Procedure “.

In accordance with clause 60 of the Procedure: “When treating (aftercare) in
specialized (anti-tuberculosis) sanatorium-resort institution leaflet
incapacity for work is drawn up (opened) and signed by the attending physician
medical organization and the chairman of the medical commission before departure
citizen for sanatorium treatment (follow-up care). ”

In accordance with the explanations of the Social Insurance Fund of the Russian
Federation (letter dated 28.10.2011 3 14-03-18 / 15-12956): “As follows from p.33
Order, specialized medical commission (anti-tuberculosis)
health resort institution extends the certificate of incapacity for work for the entire
the period of treatment, follow-up treatment and travel. In the columns “From what date” and “To what date
number “of the table” Exemption from work “days of stay in a sanatorium
institution are indicated taking into account the days required to travel to the place of treatment and
back . The actual length of stay in the sanatorium (that is, excluding days
travel to the place of treatment and back) is reflected in the line “Was in
hospital “. After the end of treatment, follow-up treatment in a specialized
(anti-tuberculosis) sanatorium-resort institution when making a decision
a medical commission on the ability to work of a citizen, closing the sheet
incapacity for work is made by a sanatorium institution.

In case of continuing temporary incapacity for work for the period of termination
aftercare, treatment, the patient is sent with a certificate of incapacity for work to
treatment in a medical institution at the place of residence.

6. Issuance of certificates of incapacity for work instead of damaged ones
(p. 56, 57 of the Order).

If there are filling errors
on sheet of incapacity for work, it is considered spoiled
and instead of it a “duplicate” of sheets is issued
disability. On the certificate of incapacity for work in the line “duplicate”
the mark “V” is affixed. In the columns “From what date” and “To what date” of the table
“Exemption from work” the entire period of incapacity for work is indicated by one
line and certified by the signature of the attending physician and the chairman of the
commission.

If was spoiled sheets
disability primary then icon
“ V ” is put in the lines “Primary” and
Duplicate . If a previously issued primary sheet
incapacity for work was closed to work, then the remaining two empty lines
the tables “Exemption from work” of the “duplicate” are crossed out horizontally
continuous lines and the leaf is closed to labor.

If spoiled sheets
incapacity for work is a continuation of the previous
issued certificate of incapacity for work, in “duplicate” in the line
“Continuation sheet No.” indicates the number of the previous
certificate of incapacity for work (if the number is not known, then the sheet
incapacity for work can be printed without specifying it and without archiving in
electronic base, but only with registration in the registration form 036 / y on paper
carrier, number of the damaged certificate of incapacity for work in the “duplicate” not
is entered).”Duplicate” can be made in a handwritten version. In line
“Duplicate” is marked with “V”. In the columns “From what date” and “To what date
number “of the” Exemption from work “table for the entire period of incapacity for work
is indicated in one line and is certified by the signature of the attending physician and
the chairman of the medical commission. The remaining two lines are not filled in.
the tables “Exemption from work” of the “duplicate” are crossed out by one
a horizontal continuous line, and the sheet is closed to labor either
the corresponding image is filled in the column “Other” (for example, the code “31” in the case
continuation of treatment), the doctor’s signature and the seal of the medical
organizations.

If the registrar during the registration of a new form of the sheet
incapacity for work (primary, continuation) after filling manually or
printout on the printer, an error is immediately detected, then it is written off in the accounting
form 036 / y, for example, “025 634 000 015 – spoiled”, and the patient
another form is drawn up: “not a duplicate” – primary or continuation earlier
issued !!!

In clause 57 of the Procedure – in the line “place of work – name of the organization” “this
the information is indicated according to the words of the citizen. “Therefore, the resulting inaccuracies in
this line, filled out in a medical organization, are not a reason for
refusal to pay benefits.

The decision to reissue the sheet is not within the competence of the policyholder,
and the regional branch !!!

90,000 2,500 patients per week are admitted to the admission department of the Morozov hospital

A year ago, the admission department of the Morozov Children’s Hospital began work in a new building in accordance with the new standards of the admission departments of Moscow hospitals.

Today, the reception area is 1,755 square meters, while the old building was 1,238 square meters. Moving to a new building made it possible to introduce a new format of work on the principle of “doctor to patient”. The doctor’s workplace is located directly next to the examination room where patients are admitted. This allows specialists to conduct a direct examination of the patient at the second stage of triage in a matter of minutes after admission.In the event of a critical and life-threatening condition in a patient, the doctor can promptly make the right decision and immediately provide emergency assistance.

In addition, directly in the boxes there is the possibility of carrying out diagnostic procedures (ECG, ultrasound, radiography, laboratory tests) for children with signs of infectious diseases. Based on the results of examination and diagnosis, if there are indications for hospitalization, the patient is hospitalized in a specialized department.In the absence of indications for inpatient treatment, the doctor provides the necessary assistance in the admission department and gives recommendations.

“Every day, on average, the admission department of the Morozov hospital receives up to 500 patients, but on peak days, admission reaches 700 patients. If we talk about the structure of receipts, the largest share belongs to the pediatric profile – about 35% and the surgical profile – 20%, 10% each belongs to otorhinolaryngology and ophthalmology, a little less to traumatology, neurosurgery, gynecology and neurology.About 50% of the flow of patients arriving at the hospital is delivered by ambulance teams. The new admission department is, first of all, triage of patients depending on the severity of their conditions. Patients in critical and serious condition are treated immediately, and they are immediately sent to intensive care. The staying time of the remaining patients in the admission department varies from 20-30 minutes “, says Nikolai Kuleshov, head of the admission department of the Morozov hospital.

This is the only children’s hospital with short-term ambulance beds for 4-6 hours. All basic steps for primary diagnostics are performed in the admission department. An interdisciplinary team of doctors, consisting of eight specialists, is on duty around the clock. The capabilities of the new building made it possible to increase the number of receiving and examination boxes from 14 to 22. In a specially designated area for undergoing diagnostic procedures, there are two rooms for ultrasound diagnostics, a room for computed tomography and radiography, an anti-shock ward and two rooms for a clinical diagnostic laboratory.

A system of electronic registration of patients (SERP) has been created in the admission department: when a patient applies and is admitted, a serial number, time of treatment, specialty of the doctor, number of the receiving and examination box, where the patient should go, are assigned.

The capabilities of the SRP allow you to control the time of stay of patients from all workplaces, take into account the admissions of patients, rationally and evenly distribute them in the receiving and examination boxes, inform patients online and reduce the time of stay.

“The process of providing medical care to a patient begins from the admission department of the hospital. The transfer of the admission department to a new building allowed us to build a logical closed loop of comfortable patient routing. We managed to increase the level of comfort of staying in the clinic for accompanying relatives, reduce the queues at the offices and the number of patients moving around the admission department “, – noted Elena Efimovna Petryaykina, chief physician of the Morozov hospital.