Administrative Order No. 2020-0019 - Service Delivery Design of HCPN_feec13ef7dae6ff1459c04ab1fd25df6.pdf

Service delivery system

1. RepublicofthePhilippines
DepartmentofHealth
OFFICEOFTHESECRETARY
MAY142020
ADMINISTRATIVE ORDER
No.2020—_0014
SUBJECT:GuidelinesontheServiceDeliveryDesignofHealthCareProvider
Networks
I.RATIONALE
TheUniversalHealthCare(UHC)ActorRepublicAct11223isanchoredonan
integratedandcomprehensiveapproachforthehealthsystemtoensurethatallFilipinos
arehealthliterate,providedwithhealthylivingconditions,andprotectedfromhazards
andrisksthatcouldaffecttheirhealth.
Section18oftheUHCActprovidestheformationofhealthcareprovidernetworks
(HCPNs)thatensureintegrationandeffectiveandefficientdeliveryofpopulation-
basedandindividual-basedhealthservices.HCPNsmaybecomposedofintegrated
localhealthsystems(theprovince-wideorcity-widehealthsystems),networksof
privatehealthcareproviderstocomplementthehealthservicesprovidedbypublic
healthfacilities,ormixedpublic-privatenetworksofhealthserviceproviders.In
addition,theDOHismandatedtoidentifyapexorend-referralhospitalsforpatients
needingspecializedcarenotavailablewithintheHCPNs.
UHCImplementingRulesandRegulations(IRR)inSection18providesthatHCPNs
shallreceiveperformancedriven,closed-end,prospectivepaymentsfromPhilHealth
basedondiagnosis-relatedgroupings.Apexorend-referralhospitalsmaybecontracted
asstand-alonefacilitiesbyPhilHealth.
TosupporttheimplementationoftheUHCActanditsIRR,andtoensurethatall
Filipinoshaveaccesstoqualityhealthcare,thefollowingguidelinesareherebyissued.
II.OBJECTIVES
A.GeneralObjective
ThisOrdershallsetthestandardsofHCPNsandapexhospitalstoensurethatthe
continuumofcareisdeliveredthroughapeople-centeredandintegratedhealthsystem.
B.SpecificObjectives
ToprovidetherequirementsoftheHCPNs;
Todevelopthemechanismforafunctionalreferralsystem;
Toestablishguidelinesforthedesignationofapexhospitals;and,
Toprovideguidelinesfortheestablishmentofpublichealthunitsinhospitals.
BYNES
Building1,SanLazaroCompound,RizalAvenue,Sta.Cruz,1003Manila
@TrunkLine651-7800local1113,1108,1135
\
DirectLine:711-9502;711-9503Fax:[phone]eURL:http:/Avww.doh.gov.ph;e-mail:{[email protected]
Syne

2. III.
Iv.
SCOPEOFAPPLICATION
ThisOrdershallapplytoallDepartmentofHealth(DOH)offices
andall
itsunitsand
instrumentalities,includingtheCentersforHealthDevelopment(CHDs),hospitals,
PhilHealth,andotherattachedagencies.Likewise,thisshallalsoapplytoallpublic
andprivatehealthfacilities,LocalGovernmentUnits(LGUs),andotherrelevant
stakeholdersonestablishingHCPNs.
DEFINITIONOFTERMS
A.ApexorEnd-ReferralHospital
—Thetermsapexandend-referralhospitalareused
interchangeablyintheseGuidelines.Itreferstoahospital,offeringspecialized
servicesasdeterminedbyDOH,whichiscontractedasastand-alonefacilityby
PhilHealth.
SpecialtyCenter-aunitordepartmentinahospitalthatoffershighlyspecialized
careaddressingparticularconditionsand/orprovidingspecificproceduresand
managementofcasesrequiringspecializedtrainingand/orequipment.
HealthCareProviderNetworks(HCPN)
—agroupofprimarytotertiarycare
providers,whetherpublic,privateormixed,offeringpeople-centeredand
comprehensivecareinanintegratedandcoordinatedmannerwiththeprimarycare
provideractingasthenavigatorandcoordinatorofhealthcarewithinthenetwork.
PublicHealthUnit(PHU)-aunitinthehospitalfacilitatingtheprovisionof
population-basedservices,implementationofnationalpublichealthprograms,
coordinationwithprimarycareprovidernetworks,andprovisionofaone-stopshop
patientnavigationsystemwithinthehospital.
PrimaryCareProviderNetwork(PCPN)—referstoacoordinatedgroup
ofpublic,
privateormixedprimarycareproviders,asthefoundationoftheHCPN.
PrimaryCareFacility
—isaprivateorapublicinstitutionthatprimarilydelivers
primarycareserviceswhichshallbelicensedorregisteredbytheDOHwiththe
prescribedservicecapability(AnnexA).
HealthStation—isaprivateorapublichealthfacilitythatfunctionstoaugmentthe
deliveryofpublichealthservicesofaPrimaryCareFacility(AnnexA).
Referral—theprocess
inwhichahealthfacilityofficiallyandappropriately
transfersthemanagementofa
patienttoabetterordifferentlyresourcedfacility,
andrefersthepatientbacktotheassignedprimarycareprovider.
GENERALGUIDELINES
A.Public,private,ormixedHCPNsshallbeestablishedtoprovideallpopulation
groupswithcontinuoushealthcarefromprimarytotertiary,whichshallbe
deliveredinasafe,efficient,andcoordinatedmechanism.
\
he

3. VI.
B.AllHCPNsshallhavefunctionalcarecoordinationwiththePCPNservingasthe
patient’sinitial-contactandnavigator.
C.HCPNsshallestablishapatientnavigationandcoordinationsystem,patient
recordsmanagementsystem,harmonizedinformationandcommunication
technology,medicaltransportsystem,standardizednetworkmechanismsfor
operations,andfinancialandperformancemanagement.
D.PublicHCPNsmaycompletetheirservicecapabilitythroughcontractual
arrangementswiththeprivatesectororviceversa.
E.AllHCPNsshallhaveprimaryto
tertiarycareproviderswithlinkagestoanapex
hospitalandotherfacilitiesprovidingspecializedservicesneeded
by
its
catchment
population.
F.AllDOHhospitalsshallendeavortobecomeapexhospitals;Providedthat,inthe
interim,DOHHospitalsthatcurrentlydonotqualifyasapexhospitalsmay
be
contractedbyPhilHealthasstand-alonefacilities.
G.TheDOHshalldetermineeligibleapexorend-referralhospitals.Theseapexor
end-referralhospitalsshalibecontractedasstand-alonefacilitiesbasedonthe
guidelinesissuedbyPhilHealth.
H.AllhospitalsshallhaveaPublicHealthUnittofacilitatetheimplementationof
population-basedhealthservicesandseamlesspatientnavigationwithintheHCPN.
SPECIFICGUIDELINES
A.ComponentsoftheHCPN
TheHCPNshallbecomposedofPCPNprovidingprimarycareservice,and
hospitalsdeliveringsecondary
andtertiarygeneralhealthcare.
1.ThePCPNshallbecomposedofthefollowinghealthfacilitiesthatprovide
populationand/orindividual-basedprimarycareservices:
a.PrimaryCareFacilities,suchasRuralHealthUnits,HealthCenters,and
MedicalOutpatientClinics,whichshallensureproper
coordinationand
servicedeliveryacrossthePCPN;and,
b.Otherhealthfacilitiesnecessaryforthedeliveryofprimarycare,suchas
butnotlimitedto,
healthstations,stand-alonebirthinghomes,stand-alone
laboratories,pharmaceuticaloutlets,anddentalclinics.
2.Thefollowinghealthfacilities,whetherpublicorprivate,shallprovidegeneral
in-patientcareservicesfortheHCPN:
a.Infirmaries,ifpresentintheexistinggeographicorpoliticalboundary;
and,
wecS

4. b.Hospitals,asclassifiedbytheDOH,whichshallinclude:
1.AtleastoneLevel
1
providingsecondarycare;and,
2.AtleastoneLevel2or
3hospitalprovidingtertiarycare.
B.Network-wideRequirements
AllHCPNsshall
havethefollowing:
1.Licensedandaccreditedhealthfacilities.Allpublicandprivatehealthfacilities
thatarepartofthenetworkshallbelicensedbyDOH andaccreditedby
PhilHealth.
Servicecapabilityprofiling.AllHCPNsshalldetermineandcontinuously
monitortheservices,humanresources,equipment,andinfrastructureofallits
healthfacilities.
AllparticipatinghealthfacilitiesshallannuallycomplywiththeHealth
FacilityProfilingofDOHandPhilHealth.
Adirectoryandmap
ofallthehealthfacilitiesintheHCPNwithallthe
servicesprovided,address,clinichours,andcontactnumbersshallbe
postedineachhealthfacility.
AllHCPNsandtheirapexhospitalsshallendeavortomeetaccessstandards
forhealthfacilitiesinalignmentwiththePhilippineHealthFacility
DevelopmentPlan,whereinpeopleshallhaveaccesstoaprimarycare
facilitywithinthirty(30)minutestraveltimeandtoahospitalwithinone
(1)hour.
Primarycare-basedcoordination.TheHCPNshallestablishafunctional
referralsystemrootedineffectiveprimarycarenavigationacrossthenetwork.
a.HCPNsshalldeveloplocalizedreferralprotocolsbasedonclinicalpractice
guidelinesinconsiderationofthelocalcontextsuchasavailableroad
networks,modesoftransportation,availabilityofhealthhumanresources
includingclearandstandardizedcriteriafortransferofpatients.An
algorithmforemergencyandnon-emergencyreferralsandpatientflowin
thenetworkshowninAnnexB
HCPNsshallhaveapatientrecordmanagementsystemwithan
interoperableelectronicmedicalrecordinallmemberhealthfacilities
capable
ofreal-timeinformation-sharing.Thesystemshallincludepatient
records,diagnostics,treatmenthistory,andotherpertinentmedical
informationthatenablesmedicalcare,subjecttoguidelinestobedeveloped
byDOHandPhilHealth,andincompliancewiththeDataPrivacyActor
RA10173.
HCPNsshallensuretheavailabilityofambulancesandpatienttransport
vehiclesasnecessary
foritscatchmentpopulation.

5. d.HCPNsshallstandardizetheprocessofcommunication:
i.Appropriatecommunicationfacilitiesavailableforcontactduring
operations(e.g.telephonenumber,cellularphone,two-wayradio).
ii.Standardizedcommunicationtoolsforendorsementssuchasthe
SituationBackgroundAssessmentRecommendation(SBAR)
communicationtool(AnnexC).
iii.
|
Uniformreferralformwithminimumdatacomponentsindicatedin
AnnexDandaback-referralformwithfollow-upandhome
instructions,whichmaybetransformedintoanelectronicreport.
iv.Localcallcenter/chathotlineforhealthideallywithageographic
informationsystem(GIS)thatshallcoordinatepatientemergency
referral,incompliancewithExecutiveOrder56,s.2018,entitled:
“TnstitutionalizingtheEmergency911HotlineastheNationwide
EmergencyAnsweringPoint,ReplacingPatrol117,andforOther
Purposes.”
4.Network-widehealthfacilityoperations.HCPNsshallstandardizehealth
facilityoperationsinitscatchmenttoincludethefollowing:
a.Integratedfinancialmanagementincludingpooledfundmanagement,
providerpaymentmechanism,unifiedpricestructuresofservices,and
accountingprocessesacrosscomponentfacilities,amongothers;
b.Maintenanceteamincharge
oflocalcapitalassetmanagementespecially
forequipmentandinfrastructuredepreciationandobsolescence;
ce.Unifiedsupplychaininventorymanagementsystemsforessential
medicines,supplies,andequipment;
d.Systematichealthcarewastemanagementforthenetworkincludingproper
wastehandlingasindicatedintheHealthCareWasteManagementManual
andasewagetreatmentplantforhazardoussolidwastethroughin-house
treatmentorthirdpartyhauler;
e.Unifiedclientsatisfactionsurveysandpatientengagementprogramsinline
withtheFrameworkonIntegratedPeople-CenteredHealthServices
analyzedattheHCPNlevel;
f.UnifiedPatientSafetyProgramwithdesignatedPatientSafetyOfficers
whoshailoverseeandpromoteacultureofsafetyineachhealthfacility;
and,
g.Capacitybuildingandmentoringactivitiesofallhealthfacilitieswithinthe
networktoimproveservicecapabilityandhealthhumanresource
competencies.
5.Network-wideperformancemanagement.TheHCPNshallensurequality,
efficient,andeffectiveservicesacrosshealthfacilitiesthroughManagement
Reviewsin
thefollowingcomponentsconductedat
leastquarterly:
en

6. a.Network-widehealthoutcomesincludingmorbidityandmortalityreviews,
compliancewithfinancialriskprotectionmeasures,andpatientcareand
responsiveness;
b.Utilizationofprimarycareprovidersbythecatchmentpopulationasthe
entrypointofcare;
ce.Evaluationofappropriatenessandtimelinessofreferralsmadewithinand
acrossthenetwork;
d.Patientsatisfactionratingusingthestandardizedclientresponsivenesstool;
e.Compliancetobasicaccommodationrequirements,nobalancebillingor
noco-paymentpolicies,whichmay
contributetoareductionofoutof
pocketexpenses;
f.Adherenceto
clinicalpracticeguidelinesandreferralprotocols;and,
g.Accessibilityandadequacyforhealthfacilitiesandhumanresourcesforthe
catchmentpopulation.
C.CompletingServiceCapabilitythroughPartnerships
1.HCPNsmaypartnerthroughcontractualagreementswithotherfacilitiesto
complementitsservicecapability.
2.PublicHCPNsshallfollowcurrentlegalframeworksandpoliciesfor
partnershipwiththeprivatesectorincluding,butnotlimitedto,thefollowing:
a.GovernmentProcurementReformActanditsIRRforinfrastructure,
equipmentandservices;
b.PublicPrivatePartnershipforHealththrough:
i.NEDAJointVentureGuidelines,providedthatthenecessary
ordinancesareinplace;and,
ii.BuildOperateandTransferLaws;and,
ce.GuidelinesforLocalGovernmentUnitssuchasPublic-PrivatePartnerships
forthePeople(LGUP4)asissuedbytheDILG.
D.LinkageofHCPNstoApexHospitals
1.ApexhospitalsshallbelinkedtoHCPNsandshalldeliverspecialtyhealthcare
servicesnotexpectedtobeprovidedinHCPNs.
a.TheDOHshalldetermineeligibleapexhospitalsbasedonthefollowing
servicecapability:
i.Asingle-specialtyhospitalthatisdesignatedbylaworlicensedbythe
DOH,
or
ii.Ageneralhospitalwiththefollowing:
nee
\
f
(it

7. 1.Accreditedteachingandtraininginatleastthefollowingfour
majordepartmentsnamely,Medicine,Pediatrics,Surgery,and
ObstetricsandGynecology;and,
2.AtleasttwoSpecialtyCentersaccordingtoDOHstandards.
b.Apexhospitalsshallhavetheabilityandcommitmenttoprovide
performancementoringandtechnicalassistancetotheHCPNsinthe
followingareas:
i,Quality,efficient,andpatient-centeredclinicalservices;
ii.Teachingandtrainingofhumanresources;
iii.Functionalityofthereferralsystem;and,
iv.Clinical,publichealth,andoperationsresearch.
ce.ApexhospitalsmaybeownedandmanagedbyDOH,otherNational
GovernmentAgencies,StateUniversitiesandColleges,orprivateentities.
d.Thedesignationofapexhospitalsbyspecialtyshallfollowthisprocess:
i.Survey,mappingandevaluationofservicecapabilityofallLevel3
governmenthospitalsandvolunteerprivatehospitals;
ii.Approvalofthelistofeligibleapexorend-referralhospitalsbythe
SecretaryofHealththroughtheDOHExecutiveCommittee;
iti.Matching/linkingofapexorend-referralhospitalstotheHCPNassisted
byCentersforHealthDevelopment;and,
iv.Submissionofthelistofapexorend-referralhospitalswithlinkageto
HCPNsto
PhilHealthforcontracting;
e.HCPNsshallenterintoamemorandumofagreement(MOA)with
atleast
oneapexhospital.
2.AllHCPNsshallhavelinkagewithDrugAbuseandTreatmentRehabilitation
Centers,BloodCenters,amongothers.
E.PublicHealthUnitsinHospitals
AllhospitalsshallhaveaPublicHealthUnit(PHU)to
facilitatetheprovisionof
population-basedhealthservicesandpatientnavigation.
1.ThePHUshallensurethathospitalpoliciesarealignedwithnationalpublic
healthprograms.
ThePHUshallassistthehospitalmanagementinensuringsurveillanceand
reportingofnotifiablediseasesthroughthediseasesurveillanceofficeror
diseasesurveillancecoordinator.
ThePHUshallensureproper
referralandnavigationofpatientswithinthe
hospitalandfromthehospitaltoprimarycarefacilitiesandothernecessary
facilitiesinthenetwork.

8. VIL.
4.ThePHUshallbeestablishedundertheOfficeoftheMedicalCenterChiefor
ChiefofHospitalwiththefollowingminimumdedicatedordesignatedstaff
(seeAnnexE):
a.Healtheducationandpromotionofficer;
b.Carenavigator/educator;and,
c.Administrativestaff.
ROLESANDRESPONSIBILITIES
A.HealthFacilityDevelopmentBureau(HFDB)
1.
2.
3.
Survey,mapping,andevaluationofservicecapabilityofallLevel3hospitals;
AnnuallysubmittoPhilHealththeeligiblelistofapexhospitals;and,
Issueguidelinesformonitoringfunctionalityandperformanceofprimarycare
facilitiesandhospitals,includingapexhospitals.
B.FieldImplementationandCoordinationTeam(FICT)
1.
4.
CoordinatewithconcernedCentralOfficeunitsfortheprovisionoftechnical
assistancetoCHDs,LocalHealthSystems,andHCPNs;
CoordinatewithrespectiveCentralOfficeunitsforasystematicperformance
monitoringofHCPNs;
OrganizewithrespectiveCentralOfficeunitsaharmonizedcapacitybuilding
ofCHDpersonnelformonitoringperformance;and,
OrganizewithrespectiveCentralOfficeunitscapacitybuildingofHCPNs.
C.KnowledgeManagementandInformationTechnologyService(AMITS)
1.Setinteroperabilityanddatastandardsforinformationandcommunication
technologysystemsinthenetworkincludingpatientrecordmanagement
system.
D.HealthFacilitiesandServicesRegulatoryBureau(HFSRB)
1.
2.
Setlicensingstandardsforprimarycarefacilitiesandotherhealthfacilitiesin
theHCPN;and,
EnsurecomplianceofalllicensedhealthfacilitiestoDOHstandards.
E.BureauofLocalHealthSystemsDevelopment(BLHSD)

9. Vii.
1.Formulateframeworks,policies,guidelines,andstandardsonLocalHealth
Systems.
F.CentersforHealthDevelopment(CHD)
1.AssessperformanceandmonitorthefunctionalityofHCPNsandapex
hospitals;
2.GuidethedevelopmentofHCPNsaccordingtotheirmaturitygrade,basedon
theCHD
capacityforassistance;and,
3.Provideand/orfacilitatetheprovisionoftechnicalassistancetoresolveissues,
concernsandproblemsonthedevelopment,utilization,andimplementationof
thecarecoordinationmechanismswithinthenetwork.
G.PhilHealth
1.DevelopcontractingguidelinesandmechanismsforHCPNsandapex
hospitals;
2.MonitorfinancingperformanceindicatorsofHCPNsandapexhospitals(e.g.
utilizationrates,outofpocketexpenses,nobalancebilling);
3.IncentivizehealthfacilitiestobecomepartoftheHCPNs;
4.IncentivizecontractedHCPNsandapexhospitalsbasedontheirperformance;
and,
5.ProvidepertinentdatatoDOHforselectionofapexhospitals,oversightof
networkperformanceandnational-levelmonitoringandplanning.
H.LocalGovernmentUnits(LGUs)
1.EnsurethattheHCPNdesign,requirementsandsupportmechanismsare
availablewithintheirjurisdiction;
2.Providetheneededresources,includingfunds,toensurethefunctionalityof
theHCPN;
3.Endeavortomeetthegapsof
healthfacilities,humanresources,equipmentand
infrastructurewithintheirjurisdiction;and,
4.Adoptappropriateordinancesforpublic-privatepartnershipforhealth.
SEPARABILITYCLAUSE
IfanypartorprovisionofthisOrderisrenderedinvalid,byanycourtoflawor
competentauthority,theremainingpartsorprovisionsnotaffectedshallremainvalid
andeffective.

10. x.
REPEALINGCLAUSE
AliOrders,rules,regulations,andotherrelatedissuancesinconsistentwithorcontrary
tothisOrderareherebyrepealed,amended,ormodifiedaccordingly.Allother
provisionsofexistingissuanceswhicharenotaffectedbythisOrdershallremainvalid
andin
effect.
EFFECTIVITY
Thisordershalltakeeffectimmediately.
FRANGASCO T/DUQUEIIL
MD,MSc
SecrétaryofHealth
10

11. AnnexA.PrimaryCareFacilityServices
(RefertoPrimaryCareFacilityManual)
Services PrimaryCareFacility*STMTere
Medicaloutpatient Yes No
Labservices In-houseoroutsourced No
Imagingservices In-houseoroutsourced No
Pharmaservices In-houseor
outsourced
Distributionofpublic
healthprograms
Birthingservices In-houseoroutsourced No
Minorsurgeries Yes No
PublicHealthservices Yes,ifgovernment Yes
PT/OT/ST Optional No
Transport Ambulance(canbeshared)
|
Patienttransportvehicle
Licensing Yes No
*PublicPrimaryCareFacilityshalldeliverpopulation-basedservices.*Can
beaone-stopshopserviceproviderornot
AnnexB.PatientFlowintheHCPNandReferralAlgorithm
+
Single APEXOREND-
Specialty! REFERRAL
Multl-Specialty HOSPITAL
Hospital
.
“stand-alone
(tt
L2and3Hospital
“"
nw HEALTHCARE
“EH
PROVIDER
NETWORK
LtHospitals&
{HCPN)
ck Otherhealthfacllities== —_
GlobalBudget
& *
wf
¥
I~
ate
I>
<<
PRIMARYCARE
MOSTCONCERNS
NN
PROVIDER
7
primaryCareFacility
+ NETWORK
i
{PCPN)
Servicesthatmay
HealthStation becontracted
AnnexC.ReferralAlgorithm
oe

12. (stant)
oN.
ae
DECIDEto
refer
4
SECUREinformed
consent
1
FILLOUTReferralForm
uNIsitan
>
(a>
A}
ed
1
RECORDReferralinthe
Registry
t
DECIDEto
discharge
patient
i
MESSAGE
“|
Receiving
Facilityfor
schedule
FILLOUTBackReferral
Form
4
INSTRUCTPatientabout
Followup
CALLReceiving1
4
TRANSFERPatient
:
PatientArrivesatthe
ReceivingFacilitywith
ReferralForm
Whiteboxes—byInitiatingFacility
Blueboxes—byReceivingFacility
"Stepsmayhappensimultaneously(i.e.Callismadeduringtransferofpatient)
t
SENDpatienthomewith
BackReferralForm
4
RECORDbackreferralin
theRegistry
ee,
Coo)

13. StandardCommunicationProtocols
ForEmergencyandNon-EmergencyCasesviaphone
SITUATION
Iam(name),(position)of(initiatingfacility)
Iamcallingaboutanemergencyreferral
Who
am
Italkingwith?[WaitforResponse1]
S Patientisa(age),(sex)withchief
complaint/problem:(statechiefcomplaint)Present
workingimpressionis:(WorkingImpression)
Reasonforreferralis:(statereason)
Currentvitalsignsare:(BP,HR,RR,O2Sats,Temp)
we -»|BACKGROUND.- Be
usgcd
B *..|-(Nameofpatient)nas
&-(Clinioal
History)
oo
:
os
Findings<age:(statfindings)
ASSESSMENT
A Ithinktheproblem/concernis:(describe)
(stateissuesforthereferral)
|‘RECOMMENDATION
aWewould
likétotransfer.
the‘patientimmediately.
.Ro
Response
1 Nameofreceiverandposition
2 Yes,pleasetransfertoourfacilityimmediately.
No,
our
facility'scapacityisfull.Pleasetransferto(specifyanother
facility)
Otherinstructions:(e.g.givemedicinesontheway)
So
tyr

14. HCPN
loGo
AnnexD.UniformReferralForm
NameofHEALTHCAREPROVIDERNETWORK
REFERRALFORM
Nameofinitiatingfacility
Address
ContactNumber
DateofReferral
Nameofreceivingfacility
Address
TimeCalled*
ReceivingPersonnel
Response
ReferralCategory
WorkingImpression
ReasonforReferral
1Emergency
OFOutpatient
OConsultation
©odiagnostics
O)treatment/Procedure
Oothers
NameofPatient
Age
Address
ChiefComplaint
ClinicalHistory
Findings
VitalSigns:8P.
(attachlaboratoryresults)
TreatmentGiven
(attachtreatmentcards}
HR RR. O2sats Temp Weight
identitynumber
Sex OMaleOFemale
PrintName&SignatureofHealthProfessional DateandTime
“foremergencycases
ActionPoint:Received
Referred
ReturnSlip

15. ANNEX E.PublicHealthUnitStaffingPattern
Personnel
Hospitals
Level1 Level2 Level3
Healtheducation
|
publicHealthAdvisor
Healtheducationand
andpromotion
Healtheducationand
Healtheducation promotion once promotionofficer
andpromotion officer/disease
: Diseasesurveillance
: surveillanceofficer
officer surveillance
Disease
officer
coordinator : Diseasesurveillance
surveillance :
. coordinator
coordinator
CareNavigator/
Care
Navigator
Care
Navigator
CareNavigator(Nurse
Educator
(NurseorSocial (Nurseor
Social
orSocialWorker)
Worker) Worker)
Administrative Adminstaff
Adminstaff
Adminstaff
|yr