E D I T O R I A L D E S K

EDITORIAL STAFF

LIAISON CONTRIBUTORS

Dr. Irmingarda P. GuecoOffice of the President

Dr. Bless E. ConcepcionProfessional Staff Development Office

Dr. Lito M. AcuinMedical Quality Improvement

Marilyn R. AtienzaProduct Development

Aura N. JavierSpecial Services

Alice C. QuimpoNursing Service

Rebecca C. TecsonAccount Management

Berdandina N. GalvezHuman Resource Department

The City Scan is a publication of The Medical City.

Everyone is enjoined to contribute by sending articles, news itemsand other materials to the Marketing Communications Department.

The sender’s name and department should be included in thematerials.

The editor reserves the right to publish only articles of choicedepending on their relevance, timeliness and space.

Dr. Marife C. YapEDITORIAL CONSULTANT

Augusto P. Sarmiento, MDCHAIRMAN

Alfredo R. A. Bengzon, MD, MBAPRESIDENT & CEO

Jane L. Natividad

I broke a leg one Saturday nightwhen I slipped on some steps in the rain,

I cried because I had NEVER feltSuch excruciating pain.

My husband drove me right awayTo nearby Medical City,I was wet, and shivering

from shock and cold,When we arrived at the Emergency.

Placed in a wet chair right awayan ice pack on my injury,

a nurse requested for personal infogently and patiently.

Building our community, creating our culture.

2006 VOLUME 2 NO. 2

“Building acommunity starts

with buildingrelationships.”

- Alfredo R.A. BengzonMD, MBA

• JCI - Joint Commission International• SHAMAN - Strategic Hospital and Medical

Automation Network• SMS - Short Messaging Service• PF - Professional Fee• GL - General Ledger• AR - Accounts Receivable• CMD - Cash Management Department• QuIPS - Quality Improvement & Patient Safety• QI - Quality Improvement• CABG - Coronary Artery By-Pass Graft• PACS - Picture Archiving Communication System• LIS - Laboratory Information System• SQD - Systems & Quality Department• OPCs - Operations and Procedures Circulars• QMS - Quality Management System• SPMS - Systems and Project Management Section• ICU - Intensive Care Unit• FAMSSCQI - Finance Administrative Management

Support Services Continuous Quality Improvement

• NSO - Nursing Service Office• ITD - Information Technology Department

The response was quickThe doctors caring

My suffering was lessenedAll because the personnel

Were VERY, VERY EFFICIENT.

I THANK the Emergency Staff Of the Medical City Hospital,

From the doctors who were there,X-ray technicians, nurses, even security

–YOU EACH DESERVE A MEDAL!!!

Gina RiveraBrought to Emergency June 3, 2006

Over the past year, Dr. Irma Gueco has encouragedand motivated members of the units that are underher supervision to chronicle, journal and write downtheir reflections as they travel their own journeys

in their personal and professional lives.  The reflectionspublished in this corner are the fruits of this continuing

effort and are being shared in order to put into perspectivethe rich lessons learned as well as to acknowledge that we can still continually improve our work and do thingsbetter.  This section celebrates the joys, challenges, pains and learning of our fellow co-workers.  May their insights teach, inspire and give us hope.

UICK GUIDE

>>This robust organization then serves as our platform in pursuing the objective of the Internal Business Process Perspective, the achievement ofexcellence in all aspects of our operation. Our goal is to provide safe, seamless, comprehensive, efficient and effective service across the entire patient

encounter- from access, to assessment, to case planning to care delivery, to disposition, to follow-up and back again.

I N T E R N A L B U S I N E S S P R O C E S S

Delivering service excellence through innovation and teamwork…

The Joint Commission on International Accreditation (JCIA) is an opportunity to test how far we have gone. It brings us closer to livingout our commitment of putting our patients on center stage and delivering to them service of greater worth. We are now ready for the

world to take a closer look at how we deliver service excellence through innovation and teamwork.

THE INTERNAL BUSINESS PROCESS TEAM

>>What we havecompleted..

Via SHAMAN System• New born Admission System• MD’s Profile System• On-line Inventory System (Warehouse

and Purchasing)• Pain Management Referral System• Average Cost of Confinement System• PF of Package Procedures (Doctor’s

General Code) System• Discharge Summary System• Home Medication System• Patient Procedures/ Medicines Summary

Report System• On-line Inventory Requisition System• Out to In System (Surgery/Delivery

Suite)• Satellite Clinic System

Actual/Expected Completion DateOctober 2005February 2006

May 2006

May 2006May 2006August 2006 (Parallel)Nov. 2006 (Full Implementation)September 2006October 2006

November 2006

December 2006

December 2006

4th Quarter 2006

Actual/Expected Completion Date

December 2005 onwards

February 2006

March 2006August 2006September 2006October 2006

November 2006

Systems Improvement

Other Systems

• HMO Inquiry System• Short Messaging Service (SMS)

System• On-line CME via TMC Website• Digital Document Imaging System• Disaster Recovery Plan System• CATV Technology• Digitized Patient Record System via

Web

Patient Care Improvement

• Development of Nursing Care Guidelines/Checklist for10 common diagnostic procedures

• Clinical Pharmacist Fielding at Nursing Unit 4A

• Continuous Quality Improvement through regular monitoring of quality indicators

• Satellite Clinic Expansion>Lipa City, Batangas>San Fernando City, Pampanga

• Regular review of pricing strategy

ER

1. Non-traumatic abdominal pain for adults

2. Adult Asthma3. Pediatric Asthma

OB-Gyn

4. Normal Deliveries

Medicine

5. Acute Gastroenteritis (AGE) in Adults

6. Cholecystitis7. Diabetes Mellitus8. Urinary Tract Infections in Adults9. Chest Pain

Surgery

10. Acute Appendicitis11. Cholelithiasis12. Colon Surgery13. Anorectal Surgery

Pediatrics

14. Community-acquired pneumonia15. Acute Gastroenteritis16. Asthma17. Acute Respiratory Infections18. Allergic Urticaria19. Presumptive Urinary Tract

Infection (UTI)

Orthopedics

20. Long Bone Fracture

Others

21. Cancer Pain22. CABG23. Kidney transplant recipient

SHAMAN Systems Enhancements

GROUP

Admission/DischargeChargingResults GenerationGL/AR/CMDOn-line Inventory

Identified

40477513561

Conceptualized

23354612748

% Completion

58%74%61%94%79%

Implemented

2128435348

% Completion

53%60%57%39%79%

P R O J E C T SClinical Pathways

• Documentation of Policies and Procedures> Disaster Manual> Standardizing all Operations and Procedures Manuals> Development of new policies

• Emergency Department assessment turnaroundtime

• Patient’s Rights and Responsibilities• Sedation and Restraint• Sentinel Event Reporting• Adverse Drug Reaction Reporting• Universal Protocol• Advance Directives and End of Life• Handling of Language Barrier• Ambulatory Surgery Suite

JCIA Initiative

• Creation of Teams/Committees>Quality Improvement and Patient Safety (QuIPS) Council

•Quality Improvement (QI) Team/Circles•Hazard Surveillance Team•5S Team•Spill Team

>Medication Team>Medical Records Team

• Medical Informatics Council-Medical Records Committee (RAT Patrol)

The Internal Business Process Plans For 2007

• Awareness Campaign• Self-Assessment Activities• Corrective Measure Activities• Various Capacity Enhancement and Refresher

Trainings• Mock Survey Activities• ACTUAL SURVEY: November 6 –10, 2006

• Team Leader/Nurse Surveyor:Ms. Connie Ma

• Administrator Surveyor:Mr. Robert Christmas

• Physician Surveyor: Dr. Arvind Patel

SHAMAN/Other Systems• Surgery/Delivery Suite System• Bar Coding/Digital Tablet• Electronic Patient Chart• Automation of all discounts• PACS/LIS interface

• More QI Projects• Continuous monitoring of all quality indicators• More Clinical Pathway development• Continuous SHAMAN System enhancements• Sustaining JCI standards

• MD Clinic System• Human Resource Information System• Fixed Asset System• On-line Room Reservation• Other Diagnostic Results (e.g.,Nuclear Medicine)

The Systems and Quality Department (SQD) is committed to improving the qualityof patient care and support services through the design, documentation and reviewof TMC’s operating policies, systems and procedures. Through its two sections, theSystems and Project Management Section (SPMS) and Quality Management Section(QMS), SQD performs the following functions:

1. Formulation of policies and procedures (i.e. Operations and Procedures Circularsor OPCs)

2. Evaluation and recommendation of human resource requirements3. Management of SHAMAN enhancements and new systems development4. Monitoring of newly-implemented policies and procedures and other quality

improvement initiatives

SHAMAN-related projects are facilitated by the SPMS through solidpartnerships with the Information Technology Department and the “PowerUsers” who represent the interests of various system stakeholders. Amongthe more significant SHAMAN projects are the following:

• Short Messaging Service (SMS)The system combines the power of instant messaging and the SMS capability of cellular phones. Simple messages of 160 characters can nowbe transmitted in real time to any GSM cellular phone locally or even internationally.

• WebsiteOur official website offers a variety of hospital information regarding our facilities, services, doctors, news updates, and even career opportunities.

• Doctor’s ProfileA profiling system of our doctor’s factual information

• On-line Inventory SystemThis is an on-line system of requisitioning, ordering, and receiving of ourwarehouse items. One feature is the re-order quantity wherein a certainstock level triggers the automatic requisition of an item.

• Women’s Health Care ResultsAlmost all of the unit’s results are improved and standardized

• Doctor’s General CodeThe system features the automatic assigning of specific general code

5. Oversees and coordinates TMC’s Joint Commission International accreditation

for a certain procedure not having encoded a doctor’s name during charging. With this code, reclassification can be processed easily.

The QMS diligently monitors the implementation and resulting impactof various quality improvement initiatives, including the enhancementof the Discharge Process and the initiative to ensure proper assignmentof Patient Identification Numbers. Regular monitoring of projects forthis Section include:

• Telephone ScriptThis is the hospital’s standard telephone service scripts when receiving a call and placing a business/official call internally/externally.

• Guidelines in Receiving Documents and/or ItemsThis is the hospital’s standard format in receiving of documents and/or items from persons or entities within and outside the organization. Each department shall have a list of specimen signaturesof all its staffs.

• Hazard Surveillance and Risk Assessment MonitoringThe process of assessing the environmental condition of the hospitalworkplace, observing current practices and evaluating staff knowledge to be able to determine/identify hazards in the workplaceand initiate/recommend corrective actions for improvement.

SQD Accomplishments to Date

Operations and Procedures Circulars (OPCs):

SHAMAN-related Projects

GroupsAdmitting/Discharge/Bed MngtChargingResults GenerationGL/AR/CMDOn-line InventoryNew SystemsTOTAL

Identified394073129558

344

Conceptualized222937120468

262

% Completion56%73%51%93%84%100%76%

Implemented19284147463

184

% Completion49%70%56%36%84%36%53%

Outstanding2012328295

160

% Completion51%30%44%64%16%62%47%

Identified

94

Released

16

% Completion

17%

Validation

19

% Completion

20%

Review

25

% Completion

27%

Drafting

34

% Completion

36%

AUTOMATED SYSTEM SYSTEM/PATIENT CARE IMPROVEMENT

Automated System

32please refer to back cover for acronym reference

By: Carla DiwaManager, Systems and Quality Department

>>Systems and Quality Department:Your Partner in Service and Work Excellence

A Festival of Excellence…A Celebration of Quality

By : Beth VargasQI Officer, Medical Quality Improvement Office

By: Florianne F. Valdes, M.D., FPPSHead, Center for Patient Education

Why go forJCIA?

1. Our patients will love us for it.2. We live our mission.3. We make our work place safe.4. We work more efficiently.5. We minimize work-related stress.6. We can go global.7. It makes good business sense.8. We stand a good chance of getting accredited.9. Being part of The Medical City, we can also be

distinguished as top-quality employees.10. We are continuously improving our quality of service

based on world-class standards.

4 54

Go JCIA in 2006! This is The Medical City’s battle crynowadays, and what better way to ignite and keep our JCIA fireburning than launch our accreditation effort with a bang – thefestive way!

Last July 7 and 14, 2006, the TMC community was treatedto a day-long “perya” of activities and treats. Game booths wereset up at the TMC foyer where our knowledge of JCIA was tested. Prizes included souvenirs, tokens, and more questions (!) on howwell we adhere to JCI standards. There were sandwich boardsworn by colorfully body-painted men who went around the foyerand nearby areas to remind us that indeed TMC has what it takesto get accredited. And what’s a “perya” without the circus? Wewere definitely entertained by the acrobats, the jugglers, themagicians, and the cyclist on the miniature bike!

To cap the day, we witnessed a meaningful and entertainment-laden program at the Augusto M. Barcelon Auditorium. Werecalled that eventful day in May 2005 when our JCI accreditationendeavor was announced and softly launched. We reviewed whatwe have done since then. We heard testimonials from our doctors,nurses, administrative staff and other partners on how workingthe JCI way positively affected not only their performance intheir jobs but their personal lives as well. And, of course, we werewowed by the dancing talents and creativity of the groups whojoined the “We Built this City!” Dance Contest.

As the entire TMC community was directed to look forwardto the 4th Quarter of 2006 when the JCIA team of auditors willbe conducting the final survey, we also acknowledged and thankedthe many people who were instrumental in bringing us to thisjuncture of our quest to seek accreditation. We were presentedwith the nominees and winners of “Galing Mo, TMC!”. Theseconsisted of members of the TMC community who are modelsof compliance to JCI standards. Finally, and most importantly,due acknowledgment was given to our JCIA Champs during theFestival. The Champs are those among us who relentlesslypersevered in reviewing our current policies and documentation,identified the gaps, and went about installing the necessaryprocedures and conducting training for the rest of the staff to be100% JCI-standardized.

The Festival of Excellence was also a celebration of thequality care we provide our patients. It demonstrates that ourinternal business and clinical processes are already at par withthe world’s best. It demonstrates how our work practices arepatient-centered, effective, consistent, efficient, error-free andsafe. With all these, what more can our patients ask for?

Excitement, anticipation, and even some anxiety have started to fill theair. The “ber” months are upon us and so the season of good cheer and gladtidings is soon to descend upon us. Adding to this excitement and anticipationin The Medical City community is a big and momentous event. All of us inour TMC family have been preparing for some months now for the upcomingsurvey to be conducted by a team of auditors from the international arm ofthe Joint Commission on Accreditation of Health Organizations (JCAHO),the JCIA or Joint Commission on International Accreditation (JCIA). GalingMo, TMC! Go JCIA for 2006! is the battle cry we proclaimed as we kickedoff our preparations.

As we move into our second year of operations in our new home, it is timefor us to proclaim to the country and to the world that indeed TMC is relentlessin pursuing its avowed mission of putting our patients and beneficiaries at theforefront of all that we do as we deliver the best and most appropriate healthcare services. Proud as we are of what we haveachieved in building our new hospital facility, weare even prouder of our human resources whocontinue to undergo learning and growth, of oursystems and processes that make our work moresystematic and efficient and of the partnershipswe have strengthened and built with our customers,partners and shareholders. No doubt, TMC is atpar with the best and most respected health facilitiesworld wide and the JCI accreditation that we seekto obtain is a stamp of recognition and approval.

The wheels to prepare for this have been setin motion since over a year ago. With the fullsupport of our leadership, the core group in chargeof our JCI bid, supported by our consultants andmanagers, has been working hard to lead us towardfull accreditation. All of the partners in TMC havebeen involved – Senior Management, UnitManagers, Supervisors, Administrative Staff,Housekeeping, Security, Medical Staff, NursingStaff and other allied health personnel. Indeed,everyone in TMC!

Why are we exerting all efforts toward a successful bid? What is in it forus? What do our patients, staff and stakeholders stand to gain from all these?

The indefatigable teams of Dr. Lito Acuin and Ms. Carla Diwa haveenumerated 10 reasons why we seek accreditation with JCI. In fact our lastTMC Bulletin explicitly stated all these. But for now, let us take a look at thetop 2 reasons:

We live our mission.

The JCI standards are perfectly aligned with our institutional goal ofproviding patient-centered services of greater worth, consistent with theinterests of our staff, employees and shareholders.

Our patients will love us for it.

The JCI standards provide guidance to help us improve the way wecommunicate with our patients, protect their rights and empower them toparticipate in their care. These are proven ways to ensure patient adherenceto treatments and to avoid conflicts with them. Our patients, your patients,will thank you for it.

How have we prepared for this? Are we prepared to live these standards?

Over the past year, we reviewed all existing documentation of our processesand operational procedures. Gaps were then identified in terms of thoseprocesses and procedures that were not documented, needed to be improvedand to be set up. So in order to continue to ensure safety and provide qualityservice to our customers and partners, we participated in workshops andtraining sessions so we could learn, unlearn, and re-learn. These activitieswere exhausting but also rewarding. It was definitely a great learningexperience.

We also committed to memory our TMC vision, mission and corporategoals. For many of the members of the medical and non-medical staff, thesepast months of bringing to high gear the preparations for the JCI have led toa more concrete and tangible appreciation of our corporate values in our dayto day activities.

Let me zero in on the roles of doctors in all these, focusing on our way ofrelating with our ultimate partners, the patients.

When the TMC Bill of Patients’ Rights and Responsibilities was firstdisseminated, some doctors reacted and asked: what are we doing? Are wepushing our patients to be this demanding? What do they know? Why do theyhave to know?

As time went on, many of our doctors started to begin to understand whyempowering our patients is very important. Ultimately, the end result we are

all aspiring for are patients who will truly partner with us in managing theirhealth, knowing full well they are part of the decision-making process regardingtheir health, giving them shared accountability. They would be satisfied thatthey are informed of their condition, of the options of treatment, of the possibleconsequences of compliance and non compliance, of the possible complications,and what they can do to prevent these complications. They will be free toweigh out the cost of all their decisions and choices. Meanwhile, we continueto pro-actively ensure that our patients are sufficiently capable of makingdecisions about their health, to sign the informed consents knowledgeably,understanding better what needs to be done. Patients are therefore engagedand become truly responsible as important information is disclosed to them,encouraging them to ask questions and clarifications. All these are envisagedto lead to higher patient satisfaction levels, less complaints (patients now feelthat they are part of the team!), and even less problems collecting paymentsfor services rendered.

We realize that still there are some practices and mindsets that we need toimbibe and practice until they become good habits. This will take some time.Yet in a few weeks time, all of us in TMC will put forward our best efforts and

do more to ensure that we obtain theaccreditation that we deserve. So, partners,allow us then to remind everyone of what weas health providers ought to think about, feeland behave, guided and enlightened by theJCI standards. Let us make an effort to remindourselves by being mindful of answering thesequestions:

1.Am I aware of and have I explained to thepatients, their rights and responsibilities?

2. Have I given them the information theyneed to be my partner in the management oftheir health? Have I explained to them andtheir families their disease condition, optionsfor treatment, its complications, consequences,and its financial costs?

3. As surgeons, have I sufficiently explainedto the patient and his family, how the surgicalprocedure will help them, how the surgery

will be performed, who will perform it, the costs, possible post op complications,etc? Do they possess the necessary data that will allow them to sign an informedconsent form?

4. Am I aware of my responsibilities as “captain of the ship” and attendingphysician? That I should confer with my colleagues who are involved in mypatients’ care (MDs, nurses, pharmacist, nutritionist)? That I should ensure aswift and comprehensive discharge process?

5. Can I assure my patients that I will render safe, seamless, and satisfyinghealth care services to my patients by practicing good and responsible medicine?Do I follow TMC practice guidelines? By making my orders understandable?Legible? By ensuring medication safety?

6. Am I aligned with TMC, my institution? Do I believe in carrying out itsvision, mission, and goals? Do I believe in and comply with the TMC Codeof Ethics for physicians?

7. Have I attended all the training sessions as per JCI bid requirements?

All of the above are just some of the questions we can ask ourselves. Thisdefinitely is not easy. But with all of our efforts, we are surely on our way tomaking this way of delivering our services, the TMC way.

This question was posed to us last July during our JCIA mocksurvey and this is a question that the real JCIA surveyors can ask youcome November. Are you ready to answer it? Or, do you have an answerto it?

The TMC Quality Improvement Program has been in place since2004. The importance of our QI program to enhance our internal businessprocesses is one of our fundamental quality policies. The QI programis totally aligned with our vision of providing our patients service ofgreater worth. Many of the output of our QI projects have resulted informulation of OPCs, putting up of SHAMAN enhancements, creationof new hospital policies and review of existing ones.

Here is a list of our QI projects. Is your department participating inany one of them? Have you been involved, either directly or indirectly,in any one of them? You may not realize it but, yes, you probably havedone something to improve quality of service in your unit. This is sobecause process improvement in TMC is everyone’s business – fromour MDs, nurses, and orderlies who provide direct care to patients; tothose of us buried in mountains of paper in our offices; to those of usguarding our entrances, mopping our floors, serving our food; up tothose occupying our Executive Offices – all of us are responsible forensuring continuous quality improvement.

Go through our list so that when you ask yourself “What have Idone lately to improve the quality of service in my unit?,” you will haveyour answer.

Service of greater worth = continuous quality& safety improvement in all aspects of patientcare and hospital services

Clinical Pathway Teams/ To develop, test and implementclinical pathways on selected conditions and procedures

All clinical departments •NSO

Name of QI Team/ Project Objective Team Composition Integration

Delayed Diagnostic Tests Team (DDT)/ To developnurses’ checklist and patient primers to sufficiently

prepare patients for diagnostic tests

Radiology • NSO • CVL •Laboratories • CPP

OPC on use of nurses’ checklists and patientprimers

IT Team/ To develop a Shaman User’s Manual NSO • ITD Manual has been uploaded in the hospital’sShaman System

ICU Pulmonary critical care team/ To reduce unplannedextubations among ICU patients

ICU • Pulmonology •Anesthesiology • Surgery

Hospital policies on sedation and restraintsformulated

Laboratories/ To reduce heel prick injuries amongnewborns

Laboratories • NICU •Pediatrics

Policies for collection of blood for blood typingand newborn screening were reviewed

PROUD Group / To develop themed menu choices forpatients

Medirest Continuous integration in nursing floors

FAMSSCQI / To improve the accuracy of data in patientinformation sheet

Finance • AMD • Admissions• Dietary

Patient information sheet appropriately revised

Surgery Team/ To design a patient data sheet for useat Ambulatory OR

Ambu- OR • NSO • SurgerySuites

Policies for ambulatory surgeries created; patientdata sheet designed and for roll out September

Sentinels / To monitor and reduce medication errors NSO including all nursingfloors • Pharmacy

Reporting of medication errors continuously donePolicy on medication safety created

Related sentinel event reporting policies released

Pediatrics / To improve communications betweenpatients and care providers

Pediatrics • NICU • NSO •CPP

Survey being conducted by CPP; responses from200+ patients already processed and analyzed;

CPP to increase number of respondents

Pediatrics / To improve the implementation of the baby-friendly hospital initiative in TMC

Pediatrics • OB-Gyn •DR/NICU • NSO • CPP

Results of initial survey presented during theTMC Breastfeeding Week celebrations

Radiology/ To increase the accuracy of radiologicreadings

Radiology Two batches of X-ray readings done and analyzed;CT scan readings to be done next

Swallow Team/ To develop a swallowing protocol foruse of acute stroke patients

ENT • PMR • Neurology •ACSU • ICU • Dietary • ER

Pilot testing of the protocol to be conducted as aresearch

Delayed Discharge Team / To reduce turn-around timeof discharge process

NSO • Finance • AMD • MTO• IT

OPC released; SHAMAN enhancementsincorporated

TrainingProblem identification

PlanningDevelopment of interventions

Integration throughhospital policies

Systems enhancement

MonitoringEvaluation

ContinuousImprovement

Implementation

6 7

Endorsing Patients withCare

As patients are transferred from one hospital unit toanother, the results of the assessments and treatmentsdone by the endorsing unit must be accuratelycommunicated to the receiving unit.

The information to be endorsed must include thefollowing:

1. History and PE findings2. Clinical impression and differential diagnoses3. STAT laboratory test results4. Interventions given at the endorsing unit5. The medical and nursing care plans

Proper coordination with the receiving staff is aimed at:

a. Ensuring continuity of medical and nursing interventions, including drugs

b. Preparing the needed equipment, devices and supplies

c. Preparing the staff for urgent medical and nursingneeds of patients, especially vulnerable ones

d. Alerting the staff to the required intensity of monitoring and re-assessment

Tips for SafeDischarging of

Patients

• PLAN the discharge ahead of time.

• ALERT nurses and doctors of possibledischarges.

• For every patient, BEGIN writing the discharge summary on admission.

• DOCUMENT the home medications,home instructions and follow-up schedules ahead of time.

The Medical CityEmergency Room

StandardsOur ER Physician leads our teamapproach to emergency care whichconsists of the following:

• Screening (immediate)

• Assessment (10-30min)

• Initial management

• Re-assessment (every 10-15min.)

• Modification of initial managementre-assessment

VULNERABLEPATIENTS?

Handle with specialcare!

Pay special attention in assessing, managingand relating to these patients:

• Anyone below 19• Anyone above 59• Anyone who has suffered physical or

mental trauma• Anyone with physical or mental

disability or dysfunction• Anyone who does not speak English

or Filipino

Write it down!Improving our chart

documentationpractice

• Legibly write the discharge diagnosis onthe Patient Data Sheet and sign it.

• Legibly write on the Order Sheet and sign it. Check if others can read it error-free.

• Make sure your patient’s discharge papers are prepared ahead of time.

Tips For SaferMedication Practice

• Write legibly on the patient’s chart.

• Write the generic name of the drug.Do not abbreviate.

• Verify the name of drug and the correctdosage.

• Match the patient, the drug and the dose.

• Check the patient’s weight.

• Double check the dose computation.

The Medical CityClinical PathwaysUse these pathways when caring forpatients admitted for:

• Abdominal pain• Acute asthmatic attack• Normal obstetric delivery• Acute gastroenteritis• Pneumonia in children• Pain management• Diarrhea in children• Coronary artery bypass graft

surgery

Elements Of EffectivePatient-Staff

Communication• Listening – give the patient ample

opportunity to fully explain reason forvisit

• Body language – watch and interpretnon-verbal cause, especially those that may indicate anxiety or distress

• Clarifying or “checking” – verify whatthe patient said and check the accuracyof your interpretation; confirm that thepatient has understood your explanationsand instructions.

• Handling emotions – always express empathy, compassion and support

The Medical CityDisaster

Preparedness Plan

• Dial Local 4 in case of emergency

• Familiarize yourself with exit routes andthe location of fire extinguishers

• Know the members of the LDRT in your department/unit

• “CODE RED” means “TOTAL EVACUATION”

• Stop work immediately and exit the building when “CODE RED” is called

• During evacuation, follow established exit routes and assemble at designatedareas outside the building (B1–EastGateand GF -WestGate

by: QuIPS Council