Implementing Rules and Regulations of R.A. 9420 (Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium)

October 21, 2008

DOH ADMINISTRATIVE ORDER NO. 2008-0032

 

I. Rationale:

The prevalence rate of leprosy in the country over the years has steadily declined, reaching the elimination target level set by the World Health Organization. This has been brought about by the effective implementation of the strategic thrusts of the Department of Health's National Leprosy Control Program in partnership with LGU's and Non-Government Organizations and the World Health Organization, mainly through improved case finding, case holding and the effective utilization of the Multi-Drug Therapy for all cases of leprosy. As a result of the decline in the number of leprosy cases, the Dr. Jose N. Rodriguez Memorial Hospital, along with the other seven sanitaria nationwide, had to redirect its role to respond to the ever increasing need for general health services as a result of the increase in the population of the catchment area needing general services that could be provided by the hospital.

In 1994, then Secretary of Health Juan Flavier started his campaign on the redirection of roles of the country's different sanitaria to be more responsive to the needs of the times considering that leprosy was no longer a major health problem. This continued up to the time of Secretary Manuel Dayrit with the lobbying in Congress for the conversion of Dr. Jose N. Rodriguez Memorial Hospital, and which eventually culminated in the passage of Republic Act No. 9420, otherwise known as "An Act Converting Two Hundred (200) Beds of the 2000-Beds of Dr. Jose N. Rodriguez Memorial Hospital and Sanitarium for Tertiary General Health Care, Appropriating Funds Therefore and for Other Purposes" authorizing the conversion of the two hundred (200) beds currently used as sanitaria of the facility into tertiary general health care.

II. Objective:

This Administrative Order sets the Implementing Rules and Regulations for the implementation of Converting Two Hundred (200) Beds of the 2000-Beds of Dr. Jose N. Rodriguez Jr. Memorial Hospital and Sanitarium for Tertiary General Health Care as provided for by R.A. 9420. STcADa

III. Definition of Terms:

1. Act — refers here as Republic Act 9420 converting the 200 beds to tertiary general health care.

2. Bed Capacity — refers to the number of beds offered by the hospital for tertiary patient care.

3. Custodial Care — refers to health service delivery to registered Persons Affected by Leprosy (PAL) who are patients who have deformities, the elderly, the abandoned and destitute, who need institutional care.

4. Conversion — refers to the 200 beds of the 2000 authorized bed capacity of the Sanitarium which is made available for tertiary general health care.

5. Departmentalization — refers to the re-organization of the present medical and nursing staffing into the different specialized and functional components or departments for tertiary care. aHIDAE

6. General Care — refers to health service delivery to all clientele, including Persons With Leprosy (PWL) who are patients currently receiving treatment for leprosy.

7. PAL — means Person Affected with Leprosy, a new and modified name for persons with leprosy characterized with deformities, who are abandoned, and destitute and/or elderly.

8. Sanitarium — refers to a residential establishment or institution for persons with and affected by leprosy.

9. Tertiary Level Health Care — refers to patient care that encompasses health promotion, prevention, specialized medical and surgical treatment and rehabilitative care, and in this context to include training and research. STaHIC

10. Facility — refers to Dr. Jose N. Rodriguez Memorial Hospital specifically as to a health care institution, generally.

IV. Policies and Guidelines:

A. General Policies:

The Dr. JOSE N. RODRIGUEZ MEMORIAL HOSPITAL (DJNRMH) shall provide tertiary general health care using 200 beds of the existing bed capacity, with fully departmentalized medical and surgical services, fully equipped with all the updated facilities and health human resource complement for a general tertiary health care facility.

It shall maintain the original mandate as a Sanitarium, including custodial services for persons affected with leprosy and further establish itself as Dermatology and Leprosy Research Center.

B. Implementing Guidelines

In support of the establishment of the 200-bed Tertiary Health Care component of the facility, the following guidelines shall be implemented: CDTSEI

1. Redirection of Role

By year 2010 a fully operational 200 bed facility for tertiary health care shall be implemented. Operationalization of the conversion shall be done by the following phases:

First Phase: one hundred (100) beds

Second Phase: one hundred fifty (150) beds

Third Phase: two hundred (200) beds

2. Structural reorganization

There shall be a creation/reorganization of the following service departments:

a. Department of Medicine

b. Department of General Surgery

c. Department of Anesthesia HCSDca

d. Department of Pediatrics

e. Department of OB-Gynecology

f. Department of Ophthalmology

g. Department of ENT

h. Department of Dermatology and Leprosy Services

i. Department of Pathology and Laboratory DHATcE

j. Department of Radiology

These departments shall be headed by a Department Head appointed by the Chief of Sanitarium. The Department Head shall also endeavor to apply for the required specialty accreditation.

3. Health Human Resource Complement

DJNRMH shall make an evaluation of the existing health human resources and upgrade positions and number of manpower complement to conform to the DOH Standard for a tertiary general care. cHECAS

Based on the DOH standard staffing pattern for a 200 bed tertiary health care, the hospital shall implement the approved rationalization plan, subject to DBM, CSC and DOH evaluation and approval.

4. Infrastructure and Facilities

The DJNRMH shall implement its Hospital Infrastructure Development Plan as follows:

a. Construction of new Out-Patient Department Complex

b. Construction of new Hospital Main Building including OR, DR complex, PhilHealth Ward, MICU, SICU, NICU, OB Ward, Pediatric Ward, Surgical Ward, Medical Ward, Rehabilitation Facility, Medical Records, Administrative, Medical, Nursing, Training Offices, Dietary, Laundry, & other Sections SHaIDE

c. Repair/Renovation of Laboratory & Morgue

d. Water and Waste Disposal System

e. Repair of perimeter fences

5. Equipment:

The DJNRMH shall make an inventory of the existing hospital equipment and undertake upgrading of equipment to conform to DOH standards for tertiary general facility.

Purchase and upgrading of equipment shall done by phases. Priorities and listing of equipment is provided in Annex A, p. 7.

C. Implementing Structure

1. Administrative Control

The Department of Health — Office of Special Concern, Center for Health Development — National Capital Region shall have jurisdiction over the hospital operations. It shall monitor the implementation of the 200-bed facility conversion as leprosy center and the daily operations of custodial care functions for PAL.

2. Organizational and Functional Structure

The existing organizational structure shall remain as is.

The Chief of Sanitarium shall create committees that will review and evaluate hospital policies and guidelines in conformity with the new mandate given by RA 9420. This includes areas on: caSEAH

a. job classifications and descriptions of professionals services, administrative services and nursing services;

b. expansion of department services, particularly nursing services

c. current SOPs on personnel recruitment and selection, hospital operations, accreditation and licensing requirements;

d. other needs that may emerge as the conversion is implemented.

Annex C, p. 9-10 provides for the prescribed structure of the three department services that would help in the day to day hospital operations. HTSIEa

3. Sourcing and Use of Funds

The budget for the conversion shall be made available from the national government and the DOH. The DJNRMH shall also tap other financing sources available like the proceeds from income retention mechanisms of the hospital to finance upgrading of the facility.

V. Repealing/Separability Clause:

Provisions from previous issuances that are inconsistent or contrary to the provisions of this Order are hereby rescinded and modified accordingly.

If any provision of this order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected thereby shall remain valid and effective.

All laws, decrees, orders, rules and regulations or parts thereof inconsistent with RA No. 9420 are hereby repealed or amended accordingly.

VI. Effectivity:

This Order shall take effect fifteen (15) days after publication in a newspaper of general circulation.

(SGD.) FRANCISCO T. DUQUE III, MD, MScSecretary of Health

Published in The Philippine Star on January 10, 2009.

ANNEXES

A. LIST OF EQUIPMENT

Purchase of equipment shall be prioritized as follows: aDIHCT

First Phase:

X-ray machines, Automatic x-ray processor

Ultrasound machine,

Dental chairs,

ECG machines,

Beds, bedside tables, stretchers & wheelchairs

Automated External Defibrillators

Laboratory Equipment

Stress tests machines

Fetal Monitors DTEAHI

Cardiac Monitors

Doppler Monitors

OR tables & lights & other OR equipment (autoclaves, wash sinks)

Anesthesia Machines

Operating Microscopes

Incubators, Radient warmers, Photo therapy units

Pulse Oximeters

Second Phase:

Centralized computer & communication system, Telephone (PABX) & TEAaDC

IT Hardware for EN-Gas,

Perfusion Pumps

Automated (Digital) IV regulator set

Third Phase:

Rehabilitation equipment

Body refrigerators

Autopsy sets & instruments cAECST

CT Scan/MRI

Orthopedic & Plastic Surgery sets

Endoscopic and other diagnostic equipment

B. INFRASTRUCTURE PRIORITY

Infrastructure Priority shall be the following:

First Phase:

+ Construction of new OPD (including Dental Clinic) Repair and renovation of Laboratory and Pathology

++ Construction of the Main Hosp Bldg., departments/wards such as the Medicare, Surgery, Pediatrics, OB-Gyne, Anaesthesia, Ophthalmology, ENT, Dermatology & Leprosy, Radiology OR/DR Complex, Wards (Medical, Surgical, Pediatrics & OB-Gyne) NICU, MICU, SICU, PHILHEALTH Ward SAEHaC

 Water and Waste Disposal System

Second Phase:

Continuation of + and ++

Property & Procurement Office

Administrative, Nursing & Medical Offices

Medical Records Office HacADE

Third Phase:

Continuation of + and ++

Dietary Unit

Rehabilitation Unit

Laundry/Housekeeping

Maintenance, Motorpool and other Ancillary Hospital Services

Construction of new Warehouse, IcCATD

Construction of Morgue

C. PRESCRIBED ORGANIZATIONAL STRUCTURE FOR THE DEPARTMENTAL SERVICES

Fig. 1.2

PROFESSIONAL SERVICES

Fig. 1.3

ADMINISTRATIVE SERVICES

Fig. 1.4

NURSING SERVICES