Health Office

Step

Applicant/Client

Office/Activity

Duration of the Activity

1

Registers his name at the Logbook at the Front Desk.

Retrieve Individual Treatment Record and Family Number

Does initial interview. Fills up ITR-General Information Portion, vital signs and recording. Issues  Priority Number.

5 minutes

2

Proceeds to Consultation Room.

Reviews and confirms initial interviews.

15 minutes

Does Physical Examination.

Does Management to include writing orders.

3

Proceeds to waiting area.

Processes the Medico-Legal Certificate.

20 minutes

4

Receives Medico-Legal certificate.

Releases the certificate to client.

5 Minutes

Step

Patient / Client

Service Provided

Duration of

Activity

1

Get the number from the admitting table

Ask patient for their family number

10 minutes

Retrieves family folder

Interviews and get the medical history and vital signs, and records findings in the individual treatment record (ITR)

2.

Wait for the number to be called for consultation by the doctor

3

Proceeds to Consultation Room.

Reviews and confirms initial interviews, does history taking and physical examination of client.

13 minutes

Does Management to include writing orders, writing of prescription and or Laboratory requests.

3.a.1

Proceeds to Laboratory (if with laboratory request).

Collects Blood for CBC, Platelet, BSMP, Staining, reading and recording.

1 hour

Does Processing and microscopic examination of urine specimen and recording.

30 minutes

Does Stool examination.

15 minutes

Releases results (blood, urine, stool).

2 minutes

3.a.2

Comes back to Doctors Consultation Room (if with Lab. Result/s).

Interprets lab result, counseling. Writes orders and prescription.

8 minutes

3.a.3

Proceeds to Dispensing/Treatment Area.

Issue prescription. Dispenses medicines and supplies.

Instructs client as to the dosage.

7 minutes

3.b.1

Proceeds to Dispensing/Treatment Area (if with no Lab results).

Issues prescription. Dispenses medicines and supplies. Instructs client as to the dosage.

7 minutes

Step

Patient / Client

Service Provided

Duration of

Activity

1

Seeks consultation at Barangay Health Station due to cough two (2) weeks or more.

Assists and interviews client as to the purpose and for logbook registration.

5 minutes

Informs and issues checklist of requirements.

3 minutes

Does interview. Fills up of ITR.  General Information and clinical aspect.

12 minutes

Measures Vital signs and records.

5 minutes

Gives detail instructions for client to follow on how to collect sputum specimen.

5 minutes

Collects first spot specimen.

5 minutes

2

Submits on the 2^nd early morning sputum cup on the next day.

Receives 2^nd early morning sputum cup specimen.

3 minutes

Issues 3^rd sputum cup for on the spot specimen collection.

5 minutes

Ensures proper and correct labeling of the 3 specimens and proper packing.

10 minutes

Writes laboratory request.

3 minutes

3

Receives laboratory results.

Receives sputum and registers at TB Registry logbook.

Processes & examines sputum smear follow-up and spot.

20 minutes

Informs client of the laboratory result:

if sputum is positive, sets schedule for treatment at the Main Health Center with RHM.

5 minutes

if sputum is negative, issues chest X-ray request and treats for bacterial infection for 1 week.

8 minutes

4

Submits himself for further consultation and examination at the Main Health Center accompanied by the Barangay RHM.

Inspects submitted requirements as to the completeness and correctness as per instruction and for recording including logbook registration.

2 minutes

Issues priority number.

3 seconds

5

Proceeds to Doctor’s consultation room.

reviews and confirms initial interviews.

5 minutes

Does physical examination.

8 minutes

Does management to include writing orders and if sputum is negative, adds written orders for sputum re-exam. Repeats sputum exam and repeats chest x-ray.

5 minutes

Does TBDC referrals for patients with repeated negative sputum exam results.

15 minutes

6

Proceeds to TB-DOTS treatment room.

Complies with written orders and protocol of NTP TB-DOTS.

Registers client identified positive.

Opens NTP treatment card.

Dispenses medicines and supplies if available.

Instructs initial dose intakes by directly observed treatment (DOT) method.

Releases to RHM the remaining medicines for the whole month.

Provides continuous health education.

1 hour

7

Comes back to Barangay Health Station for Daily Directly Observed Treatment of Short Course Chemotherapy with the treatment partner.

Does weekly release of patients. Allocates medicines.

Does daily injections (if indicated).

Fills up patients treatment cards.

30 minutes a day for 6 – 12 months

2. Does Follow-up of sputum exam as scheduled.

Step

Patient / Client

Service Provided Activity

Duration of

Activity

Client

Stuff

1.

Pre-natal Care

Proceed to the main health Center or Brgy. Health Center

Retrieve the family folder if old. If new, make a new folder.

15 minutes

Get vital signs and record pertinent findings in the ITR

Proceed to the pre-natal room

Examine patient by abdominal palpation

Give iron and pre-natal vitamins

Give tetanus toxoid injection and schedule for the next injection.

Request for laboratory exams

2.

Delivery

Assist in normal deliveries preferably in the Health Center

10-18 hours

Referral to secondary or tertiary hospitals for management of complications and high risk pregnancies

Initiate and advise breastfeeding in newly delivered babies

3.

Post-Partum Care

Give iron supplementation if available

15 minutes

Give Vit. A supplementation

Conduct home visits 24 hours after delivery and a week after

4.

Newborn Care

Administer Hepatitis B vaccine right after birth

10 minutes

Referral for newborn screening

Issue growth monitoring card

Instruct mother when to come back for immunization

5.

Expanded program on Immunization

Proceed to Brgy. Health Center

Register the baby

10 minutes

Get family folder

Get personal data and record in the ITR and TCL

Get vital signs and record in the growth monitoring card

Perform immunization for:

    1. BCG – one

    2. Hepatitis B – 3 doses

    3. DPT & OPV – 3 doses

    4. Measles – one dose

Instruct mother when to come back for the next immunization

6.

Integrated Management of Childhood Illnesses

Proceed to Health Center

Get family folder

15 minutes

Get personal data and record in the ITR and TCL

Get vital signs

If manageable at the level of the nurse or midwife, give appropriate treatment

If not, refer to the MHO for further management

7.

Nutrition Program

Proceed to the Health Center

Get family folder

15 minutes

Get personal data and record in the ITR and TCL

Get vital signs and record findings

Give health information regarding Vit. A and iron supplementation and deworming. Provide information on when to avail said services

Instruct mother when to return for follow up

Return to health center for weighing every month for malnourished children

Step

Patient / Client

Service Provided Activity

Duration of

Activity

Client

Stuff

1.

Medical Certificate

Proceed to the main health

Fill up individual treatment record

20 minutes

Get vital signs and record in the ITR

Present ITR to the doctor for check-up

Issue medical certificate by the doctor

Refer to the treasurer’s office for payment of fees

Bring receipt back to the MHO

Release the medical certificate

2.

Death Certificate

Proceed to the main health center with death certificate

Retrieve the old individual record of the deceased

15 minutes

Informant will be interviewed by the MHO as to the cause of death of the deceased

MHO will sign and review the death certificate

Have the embalmer sign the death certificate

Bring back the death certificate duly signed by the MHO and the embalmer to the Local Civil Registrar & submits a file copy (photocopy) of the registered death certificate at the MHO.

3.

Certificate of Exhumation

Secure death certificate from the Local Civil registrar

Request Brgy. certificate to provide to prove that the tomb to be opened has already reached five (5) years

15 minutes

Pay the required fees at the Treasurer’s office

Fill up the form of exhumation

Released permit to open the tomb.

4.

Transfer of Cadaver

Secure complete documents

- official receipt

- death certificate

Release permit to transfer of cadaver

     10

  minutes

Step

Patient / Client

Service Provided Activity

Duration of

Activity

Client

Stuff

1.

Health Permit/ Sanitary Permit

Get personal data

15 minutes

Fill up health certificate form if all necessary documents are present

   - if requirements are complete:

Give requirements to client and advise to come back if all requirements are ready or complete

Give request for stool exam, sputum exam an\d refer to the laboratory

If result are negative, issue health certificate

If positive, refer to MHO for treatment and management

2.

Complaints with relation to environmental sanitation

Submit a letter complaint to the Rural Sanitary Inspector

Present letter to the MHO or Local Chief Executive

2 days

Conduct an ocular inspection

Make a solution/recommendation for the complaints

Make a report and furnish copy to the MHO, LCE and complainant

Step

Patient / Client

Service Provided Activity

Duration of

Activity

Client

Stuff

1.

Get number from the dental room

Retrieve ITR and fill it up

20 minutes

Wait for the number to be called for tooth extraction, filling up of cavities or prophylaxis

Get vital signs especially the blood pressure

Give prescription after tooth extraction

Instruct on how to take the prescription

Step

Patient / Client

Service Provided Activity

Duration of

Activity

Client

Stuff

1.

Present laboratory request to the person in charge

1 hour

Pay the required fees

Perform the laboratory examination

Instruct patient to come back after one (1) hour to get the result