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Outpatient Services Department in a Hospital

 

Reynaldo O. Joson, MD, MHA, MHPEd, MS Surg

February, 2005

 

Outpatient Services Department in a hospital refers to that section in the hospital, basically consisting of general medical clinics or offices, in which medical consultations are primarily done without the patients being confined (staying overnight) to a hospital bed. 

 

Inpatient Services Department in a hospital refers to that section in the hospital consisting of rooms or wards for overnight confinement of patients.

 

Outpatient Services Department can consist of two types depending on the arrangement provided by the hospital administration and depending on the presence or absence of a physician’s postgraduate training program that requires such a department by the accrediting specialty boards.  The first type consists of medical clinics manned by full-pledged physicians and specialists accredited by the hospital administration to hold office in these clinics.  The second type consists of medical clinics manned by physicians undergoing postgraduate training, such as residents and fellows, under the supervision of their physician-trainors.

 

At present, the commonly used terms for the first type, especially in private hospitals, are Medical Arts Building, Medical Arts Center, or simply, Doctors’ Clinics.  Outpatient Department is the most commonly used term for the second type both in private and government hospitals.  Government hospitals which provide medical clinics for private practice of its physician-trainors can have both types, the first type for the private practice of their physician-trainors, and the second type, for the training requirements of their residents and fellows.

 

As mentioned above, the types of outpatient services department will depend on the arrangement provided by the hospital administration and on the presence or absence of a physician’s postgraduate training program.  The final set-up could consist of just one type with one physical structure only or two types with two physical structures.  See table below for factors that would determine choice from the different set-ups.

 

Set-up

Indications

One set-up (one physical structure) only

 

Private outpatient clinics only

Private hospitals – usually have this set-up – part of business development program – to attract clients to the hospital; to entice physicians to utilize revenue units of the hospital, particularly the ancillary diagnostic tests and inpatient services department

Charity outpatient clinics only

Government hospitals

Charity non-government hospitals

Private outpatient clinics that incorporate training program of residents and fellows

If private hospitals want to save cost on building another outpatient department just for the purpose of training and as long as this set-up is acceptable to accrediting specialty boards;

Training program under this set-up  – apprenticeship – advantage of more supervision (there is minimal supervision by trainors in the usual outpatient department manned by residents and fellows).

Two types (two physical structures)

If hospital administration wants to have two separate physical structures because of reasons of governance;

If hospital administration cannot integrate the  objectives of the two types of outpatient services department into one physical structure

 

Private hospitals – need to have outpatient services department for residents and fellows because of the requirements of the accrediting training boards

 

Government hospitals – if they want to provide private outpatient clinics for their physician-trainors – primarily, to promote quality of training program, more physical presence - more supervision; secondarily, to promote their private inpatient services department if they have one.

 

 

Outpatient Services Department in a Private Hospital Setting

 

 

Goal: Effective and efficient use of private medical clinics

 

Set-up:

 

As much as possible one physical structure - private medical clinics which provide training program for the residents and fellows of the hospitals)

 

A structured training program should be formulated, implemented, monitored and regularly evaluated.

 

Full control of the private medical clinics – needed for accreditation by PhilHealth and ISO

 

                  Rules and regulations for use of clinics by the physicians

 

 

Business development aspects:

 

                  Goal: Promote financial sustainability of the hospital

 

Maximal use of private medical clinics in terms of space and time

 

                                    Rental by the hour

 

No business activities that will compete with hospital business development and financial sustainability program

 

No laboratory exams within clinics

 

Promote quality reputation of hospital

 

Quality patient care

                                                      Arriving on time

                                                      Competent physicians

                                                                        Patient care

                                                                        Bioethics

                                    Infection control                            

                                    Waste management

 

                                    *Refer to PhilHealth Benchbook for other standards

 

                 

                                                                       

Note: If there will be an outpatient services department in a private hospital setting for residency an fellowship training, this should be under the administration of the medical services division through the Committee on Medical Training or Education.

 

                  Policies and procedures should be installed.

                  This department’s objectives should be known to the public and staff.

 

 

 

Indications for admissions: