Implementing Rules and Regulations of R.A. No. 10345

June 9, 2014

DOH ADMINISTRATIVE ORDER NO. 2014-0021

 

I. Rationale/Background

The Quirino Memorial Medical Center (QMMC), formerly known as Quirino Labor Hospital, was formally opened to the public as the first government hospital in Quezon City with a 75 bed capacity on August 15, 1953.

On June 22, 1955 it was designated as teaching and training hospital per Department Order No. 3 and became the tertiary regional general hospital by virtue of Batas Pambansa Bilang 442. By August 15, 1964, the hospital was renamed to Quirino Memorial General Hospital (QMGH) by virtue of RA 3965. In 1986, by virtue of Executive Order 119, the hospital was renamed, "Quirino Memorial Medical Center" (QMMC) with 250 beds.

Due to the increase in bed occupancy rate of 150% by 1997, the hospital's bed capacity could no longer accommodate the increasing health needs of its primary catchment area, Quezon City. It had also accommodated patients from the neighboring cities and provinces. Thus, on March 17, 1997, Republic Act No. 8313, "An Act Upgrading the Quirino Memorial Medical Center, Appropriating Funds Therefor, and for Other Purposes" which upgraded the bed capacity to 350 beds, was approved.

The average occupancy rate of QMMC had increased to 268% during the period 2007-2012. At the same time QMMC had evolved as a Level 4 (AO No. 2007-0021) medical center catering to various catastrophic cases requiring highly specialized hospital services. This justified the enactment of Republic Act No. 10345, "An Act Increasing the Bed Capacity of Quirino Memorial Medical Center from Three Hundred Fifty (350) to Five Hundred (500) Beds, Amending for the Purpose Republic Act No. 8313, Appropriating Funds Therefor, and for Other Purposes" on December 12, 2012.

With Department Order 2011-0188 "Kalusugang Pangkahalatan Execution Plan and Implementation Arrangements", the QMMC is mandated to provide universal health care through its hospital services. Thus implementation of Republic Act 10345 responds to the provision of Section 15, Article II of the Philippine Constitution, which is "to protect and promote the right to health of the people and instill health consciousness among them."

II. Objective

This Administrative Order sets the Implementing Rules and Regulations for the implementation ofRA 10345, "An Act Increasing the Bed Capacity of Quirino Memorial Medical Center from Three Hundred Fifty (350) to Five Hundred (500) Beds, Amending for the Purpose Republic Act No. 8313, Appropriating Funds Therefor, and for Other Purposes."

III. Definition of Terms/Acronyms

1. Act — refers to Republic Act 10345, "An Act Increasing the Bed Capacity of Quirino Memorial Medical Center from Three Hundred Fifty (350) to Five Hundred (500) Beds, Amending for the Purpose Republic Act No. 8313, Appropriating Funds Therefor, and for Other Purposes."

2. AO No. 2012-0012 — refers to "Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines", dated July 18, 2012.

3. Bed capacity — refers to the number of beds offered by the hospital for inpatient care.

4. Bed occupancy rate (BOR) — refers to the ratio of actual inpatient service days for a given period to the declared bed capacity of the hospital for the same period; the ideal or recommended BOR is from 65% to 85%.

5. HOMIS — refers to Hospital Operations and Management Information System.

6. IHOMP — refers to Integrated Hospital Operations and Management Program. cEaACD

7. IRR — refers to the Implementing Rules and Regulations of Republic Act No. 10345.

8. Level 3 — refers to the DOH Classification of QMMC as defined by AO 2012-0012.

9. QMMC — refers to Quirino Memorial Medical Center.

10. Referral Hospital — refers to a health care institution capable of accepting referrals from lower level hospitals and render general and specialized health care services.

IV. Policies and Guidelines

A. General Policies

The QMMC as a general, teaching and training hospital with a five hundred (500) bed capacity shall provide a tertiary level of curative, promotive, preventive, rehabilitative care and research, fully equipped with state of the art equipment and adequate and competent human resource complement. The increase in bed capacity shall be consistent with the Development Plan of the QMMC.

B. Implementing Mechanisms

In support of the Republic Act 10345, "An Act Increasing the Bed Capacity of Quirino Memorial Medical Center from Three Hundred Fifty (350) to Five Hundred (500) Beds, Amending for the Purpose Republic Act No. 8313, Appropriating Funds Therefor, and for Other Purposes" the following guidelines shall be implemented:

1. Expansion of Services

By the end of 2015, QMMC shall fully operate as a 500 bed level III tertiary teaching & training medical center with additional services on neuroscience, nuclear medicine, family medicine, pulmonary unit and emergency department. Structural reorganization with additional services shall be established based on the approved hospital development plan of QMMC.

2. Health Human Resource

The Quirino Memorial Medical Center shall continue to honor the positions, security of tenure, rights of its human resource, upgrade their positions and hire additional staff to comply and conform with the DOH standards as per DBM-DOH Joint Circular No. 2013-1, "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals CY 2013 Edition" dated September 23, 2013.

3. Equipment

The QMMC shall make an inventory of all existing hospital equipment and undertake upgrading to conform to DOH standards fitted for a tertiary level III medical center. Listings for this are found in the Hospital Development Plan which is attached and form part of this Order.

4. Infrastructure

The QMMC shall implement construction, repair and renovation of physical infrastructure to conform to all existing laws and DOH standards especially for licensing purposes as per AO No. 2012-0012.

5. Systems Development

The QMMC shall develop and implement standards of hospital operations to provide quality patient care and safety for patients, personnel and clientele of the hospital. It shall sustain the implementation of the Integrated Hospital Operations and Management Program (IHOMP).

6. Quality Management

The QMMC shall maintain and sustain the ISO 9001:2008 standards, Continuing Quality Improvement Program, Patient Safety Program, policies and standards provided by the DOH, the Philippine Health Insurance Corporation (PhilHealth) and other health standards provided by international health organizations which are supportive of existing local and national standards.

V. Implementing Structure

A. Administrative Control

The highest DOH designated official for Metro Manila DOH Hospitals shall have an oversight jurisdiction over the hospital operations and shall monitor the implementation of R.A. 10345 guided by this Administrative Order.

The Medical Center Chief of QMMC shall be accountable and responsible for the implementation of quality standard hospital operations and management and shall submit developmental plans, financial and statistical reports to the DOH central office. AIDcTE

B. Source of Funds

The amount necessary to carry out the provisions of Republic Act No. 10345 shall be sourced out accordingly.

1. Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), hospital revenues, Philhealth reimbursements and other mode of financing scheme subject to prevailing government rules and regulations.

2. The additional Maintenance, Operating and Other Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital revenue, Philhealth reimbursements and other sources.

3. Personal Services to carry out the full implementation of the approved hospital staffing pattern of a 500-bed capacity hospital shall be sourced from the GAA 2014 onwards as provided in DOH-DBM Joint Circular 2013-01 dated September 23, 2013.

4. Release of funds shall be approved by the designated appropriate authority.

VI. 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.

VII. Effectivity

This order shall take effect fifteen (15) days after publication in the Official Gazette or in at least two (2) newspapers of general circulation.

(SGD.) ENRIQUE T. ONA, MDSecretary of Health

Published in The Philippine Star on July 11, 2014.