Implementing Rules and Regulations of R.A. No. 8561 (Upgrading Bataan Provincial Hospital into a Tertiary Level II Hospital)

May 21, 2015

DOH ADMINISTRATIVE ORDER NO. 2015-0023

 

I. Rationale/Background

The Bataan General Hospital (BGH) was established on November 30, 1941 with 20-bed capacity and 17 personnel. On December 10, 1942 it was used as a war hospital. It became a 50-bed Medicare hospital in 1970s. It was integrated to the Provincial Health Office in 1983 and increased its bed capacity to 200 under the Ministry of Health. By virtue of Local Government Code of 1991, BGH was devolved to the province of Bataan. On February 26, 1998, BGH was renationalized and was upgraded from 200 to 350 beds through Republic Act No. 8561.

BGH, as the only tertiary government hospital in the locality, serves as the referral hospital of all district hospitals, rural health units and other LGUs of the Province of Bataan and the neighboring municipalities of the provinces of Zambales and Pampanga. It also serves as a referral hospital of other private hospitals. For the past four years (2011-2014), BGH has had an average bed occupancy rate (BOR) of 118% which is beyond the ideal limit of 85%.

This situation has compromised the quality of services that the hospital provides due to the lack of health human resources, facilities, equipment and funding. But as mandated, health services have to be delivered at its best despite meager resources. Thus, systems and processes are being continually improved as evidenced by its being ISO certified since March 2014 which was realized through its committed and dedicated management and health workers. It is however, imperative to implement RA No. 8561 through a supporting implementing rules and regulations that will address the current resource deficiencies and the continuously increasing demand of the people for a quality health care they so deserve.

II. Objective

This Administrative Order sets the Implementing Rules and Regulations for the Implementation of Republic Act No. 8561, "An Act Upgrading the Bataan Provincial Hospital in the Province of Bataan, into a Tertiary Level II Hospital, Increasing its Bed Capacity to Three Hundred Fifty (350) Beds, under the Direct Control, Supervision and Management of the Department of Health, and Appropriating Funds Therefor, and for Other Purposes".

III. Scope

The Rules and Regulations discussed in this Administrative Order shall pertain only to the provisions of Republic Act No. 8561. CAIHTE

IV. Definition of Terms/Acronyms

1. Act — Republic Act No. 8561, "An Act Upgrading the Bataan Provincial Hospital in the Province of Bataan, into a Tertiary Level II Hospital, Increasing its Bed Capacity to Three Hundred Fifty (350) Beds, under the Direct Control, Supervision and Management of the Department of Health, and Appropriating Funds Therefor, and for Other Purposes."

2. AO 2012-0012 — refers to the Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines dated 18 July 2012.

3. BGH — Bataan General Hospital.

4. Bed Capacity — refers to the number of beds made available for in-patient care.

5. Bed Occupancy Rate (BOR) — is the ratio of actual in patient service days for a given period to the declared bed capacity of the hospital for the same period.

6. DBM-DOH Joint Circular No. 2013-01 — refers to the "Revised Standards and Organizational Structure and Staffing Pattern of Government Hospitals," CY 2013 Edition dated 23 September 2013 by the Department of Budget and Management and the Department of Health.

7. DOH-CO — Department of Health-Central Office.

8. ISO — International Organization for Standards.

9. Level II Hospital — refers to the DOH hospital classification as prescribed in AO 2012-0012.

10. LGU — Local Government Unit.

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

V. Policies and Guidelines

A. General Policies

The BGH shall provide tertiary level of promotive, curative, preventive, rehabilitative health care services and research. It shall be fully equipped with state-of-the-art equipment and facilities, complemented by adequately trained and competent health human resources appropriate for a licensed and accredited Level II hospital.

Furthermore, the BGH shall strengthen its existing services and aim for the improvement of its service capability and capacity while continually serving as a referral hospital complementing the services of local government health care facilities in the province and the region. The increase in bed capacity shall be consistent with the Development Plan of BGH. DETACa

B. Implementing Guidelines

In support of the implementation of R.A. 8561, the following guidelines shall be implemented:

1. Expansion of Services

The BGH is now operating as a Level II general hospital and aims to upgrade as a 350-bed capacity, Level III teaching and training hospital with highly specialized services on mother and child health care with high-end diagnostic services and continuously upgraded through time. Structural reorganization with additional services shall be established based on the Hospital Development Plan.

The BGH shall also aim to have at least the following services: Respiratory Unit, Physical Medicine and Rehabilitation Unit, Ambulatory Surgical Clinic, Dialysis Clinic, Tertiary Laboratory with Histopathology, Blood bank, MRI, 3rd level X-ray and Mammography.

2. Health Human Resource

The BGH shall continue to honor the positions, security of tenure and other rights of its human resource complement. The hospital shall evaluate the existing health human resources, re-classify and/or upgrade positions, promote professional development and shall hire additional staff to comply and conform to the DOH standards and intent of RA No. 8561.

The BGH shall increase its health personnel based on recommended staffing pattern for a 350-bed capacity hospital following the DBM-DOH Joint Circular No. 2013-01, "Revised Standards and Organizational Structure and Staffing Pattern of Government Hospitals," CY 2013 Edition dated 23 September 2013.

3. Assets and Liabilities

All records of assets, movable and immovable of BGH as well as its liabilities and obligations shall be properly updated and shall be accounted for in accordance with existing policies and guidelines.

4. Equipment

The BGH shall make an inventory of the existing hospital equipment and undertake upgrading to conform with DOH minimum standards of a Level 3 hospital as provided for under DOH AO No. 2012-0012. Additional equipment and facilities that will complement the expansion of services shall be procured with the support of DOH.

5. Infrastructure

The BGH shall implement and seek the support of DOH for the construction/repair/renovation of physical infrastructure to conform with all existing laws and licensing standards and current international standards for hospital buildings in line with Hospital Safe from Disasters Program, among others.

6. Systems Development

The BGH shall develop and sustain the standards of hospital operations to provide quality patient care and safety for patients, health workers and clientele of the hospital. It shall implement an electronic information system conforming with the basic requirements of the Integrated Hospital Operations and Management Program (IHOMP).

7. Quality Management

The BGH shall sustain quality management system in conformance with ISO 9001:2008 standards. The BGH shall enhance and implement Continuing Quality Improvement Program, Patient Safety, 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.

VI. Implementing Structure

A. Administrative Control

The highest ranking designated DOH official or the head of the Health Operations shall continue to have oversight jurisdiction over the hospital operations of Bataan General Hospital. DOH Regional Office No. III shall monitor the implementation of Republic Act No. 8561 and may recommend further the necessary upgrading guided by this Administrative Order.

The Medical Center Chief of Bataan General Hospital 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 through the DOH Regional Office No. III.

B. Source of Funds

The amount necessary to carry out the provisions of Republic Act No. 8561 shall be sourced out accordingly:

1. Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), Health Facilities Enhancement Program (HFEP), hospital income which includes PhilHealth payments, public-private partnership and other modes of financing scheme subject to prevailing government rules and regulations.

2. The additional maintenance and other operating expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital income, PhilHealth payments, public-private partnership and/or other modes of financing scheme.

3. Personnel Services (PS) to carry out the full implementation of the staffing pattern of 350 beds shall be implemented in compliance with DOH-DBM Joint Circular 2013-01 dated September 23, 2013 and other related issuances.

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

VIII. n  Repealing/Separability Clause

Provisions of 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.

IX. Effectivity

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

(SGD.) JANETTE LORETO-GARIN, MD, MBA-HActing SecretaryDepartment of Health

n Note from the Publisher: Copied verbatim from the official copy.