Republic of the Philippines

Province of Negros Oriental

Bindoy, Negros Oriental
MUNICIPAL HEALTH OFFICE

STANDARD OPERATING PROCEDURES &

POLICIES

BINDOY RURAL HEALTH UNIT

BINDOY, NEGROS ORIENTAL

9.1 POLICY ON SERVICE HOURS

  For all medical and laboratory services we are open
Monday to Friday at 8:00 AM to 5:00 PM

 For our Lying-in Clinic we render services to our pregnant women who are
about to give birth
Monday – Sunday 24 hours open and during Holidays

 For our delivery of basic health services like immunization, prenatal and family
planning etc. each barangay has its respective schedule.

9.2 POLICY AND PROCEDURES FOR REFERRAL OF PATIENTS TO

HIGHER LEVEL OF CARE

In referring, patients to a higher level of care, it’s important to follow a set of policies and
procedures to ensure a smooth transition and the continued well-being of the patient. Here are
some guidelines, policies, and procedures applied in the facility:

Guidelines

1. Utilize Central Visayas Electronic Health Referral System (CVeHRS) for referral.
2. Electronic Health Referral System (EHRS) shall take into consideration the general
welfare of the patient and the capabilities of facilities within the system.
3. Patient that needs and/or requires specialized medical services in the health facilities shall
be referred to the next appropriate facility, within the Health Care Provider Network
following the CVeHRS.
4. Patient’s data shall be inputted completely and accurately to the system prior or during
the transport of the patient to the referral facility.
5. Call requests are encouraged to facilitate and ensure successful referral. Referring
physician shall ensure that referral has been accepted or redirected by referral facility
prior to transporting the patient.
6. Thorough assessment by the personnel on duty and initial life-saving interventions shall
be done before referring the patient to the facility. The physician on-duty shall ensure that
the patient’s vital signs shall have been stabilized medically prior to transport or while in
transit to the referral hospital. In no way, shall the patient be transported unstable.
7. A referred patient shall be attended to immediately upon arrival, giving preference to
urgent and/or emergent cases.
8. A turnaround time of 15 minutes or less, but not later than 30 minutes upon arrival shall
be strictly followed for an emergency case.
9. Encoder Edgar Seit is designated to access and monitor the CVeHRS and alert the MHO
to receive, direct or in certain justifiable circumstances and further refer or re-direct the
referred patients.
 10. While on transit, continuous medical care must be afforded by the accompanying nurse or
midwife which shall be in communication with the referral facility for medical direction.
11. Transporting nurse or midwife must obtain proper training on basic life support and in
managing emergency patients to attain well-coordinated interventions in saving the life of
the patient.
12. Referral facility shall notify the referring facility once patient has arrived.

Policy

A. As a Referral Facility

1. Accepts electronically the referring hospital’s request for referral of patient;

2. Facilitates in receiving the referred patient within the given turnaround time of 15
minutes or less;
3. Receives the patient and immediately provides appropriate interventions;
4. Informs the referring facility as to the current status of the patient through the
electronic health referral system; and
5. In the event the referral facility is incapable of handling the patient, the Referral
Hospital shall call the 711 Healthline to redirect and facilitate admission of the patient
to the appropriate health facility.

B. As Referring Facility

1. Attends to the incoming patient’s medical needs;

2. Assesses the physical condition of the patient. If the hospital facility is incapable to
handle the patient’s ailment by reason of manpower, facilities and capabilities in the
performance of the needed procedures/interventions, the patient shall be referred to the
next appropriate hospital facility through the electronic referral system;
3. Fills-in the details of the patients found in the web-based application prior to transfer or
while in transit to the referral facility;
4. Provides the ambulance or necessary vehicle in transporting the patient from the referring
facility to the referral facility with a qualified accompanying nurse or midwife trained
with Basic Life Support; and
5. Ensures that all processes and details are taken cared of to guarantee smooth admission of
patient in the referral hospital.

Procedure in Referring the Patient through HCPN

Below is the e-Referral system flowchart within the Health Care Provider Network using the
CVeHRS as deemed appropriate of the patient’s care need.

GRAPHIC PRESENTATION OF THE E-REFERRAL FLOWCHART

BARANGAY HEALTH STATION

RURAL HEALTH UNIT (RHU)

INFIRMARY HOSPITAL

LEVEL I LEVEL I

LEVEL II

LEVEL III / APEX / SPECIALTY HOSPITAL

The flow of the e-referral is dependent on the capability of the health facility. In some instances,
it may not follow specific orders as shown in the diagram depending on the condition of the
patient. However, only external referral is considered in this guideline with the following sub-
types:

a) Horizontal referral – happens between facilities with the same functional capacity (e.g.,
referral between two level 1 hospitals. It is done in consideration of catchment area,
availability of services (e.g., the hospital’s ICU is full, so the patient is transferred to
another hospital with available ICU bed), economic factors (e.g., from a private to a
public hospital with the same functional capacity), and others.

b) Vertical referral – is executed between health facilities with different functional

capacity (e.g., a health center and a level 1 hospital). It can either be an upward referral,
which is done from a lower- to a higher-level facility when a patient needs more
 advanced care, or the opposite – downward referral which referral is done when a
patient has to be referred back to the originating primary care facility, or when a service
can be more efficiently provided in a lower-level facility.

9.3 POLICY ON REFERRAL OF PATIENTS TO OTHER SERVICES

It is the policy of Bindoy Rural Health Unit to ensure a collaborative approach to care through
the coordination of care, treatment and community-based services based on the patient’s needs.
This includes but is not limited to specialty care, ancillary services, dental, mental health and
substance abuse, self-management support, health education, and health promotion.

Policy

 When the needs of the patient are outside the scope of services provided by Bindoy RHU,
the provider refers the patient to an appropriate healthcare facility provider
 The provider discusses the referral with the patient and
completes the referral, which includes pertinent information about the patient’s medical
condition, reason for referral, the provider’s assessment and the request for treatment
services.
 The patient is given a copy of the referral form, which contains the contact information of
the referral provider, facility or community resource
 If the Laboratory and Diagnostic services under PhilHealth Konsulta Package, the patient
is referred to the identified Service Delivery partner which is Bindoy District Hospital.
 The receiving facility must send a complete feedback form to the referring facility after
services is done.

9.4 POLICY ON TRANSFER OF REGISTRANTS IN CASE OF WITHDRAWAL/

SUSPENSION OF ACCREDITATION OR CLOSURE OF THE HEALTH FACILITY

 In the case of withdrawal of suspension of accreditation of Bindoy Rural Health Unit,

the registrants continue to receive the health services needed for the registrants for
his/ her health needs and treatment.
 If in case that Rural Health Unit will be close all registrants will be referred to Bindoy
District Hospital which is a higher referral facility of Bindoy Rural Health Unit.
9.5 POLICY AND PROCEDURES ON SUPPLY CHAIN MANAGEMENT,
INVENTORY, AND STOCK-OUT

source:
 DOH Supply Chain Management Service Warehouse Operations Manual, 2nd edition 2022.

Procedures

 Receive shipping documents from the suppliers/ DOH, IPHO, and other agencies
 Check for completeness and validity of shipping documents
 Supervise the offloading of the commodities
 Counter check, inspect
 Stock following manufacturer’s direction or supplier’s direction
 For items requiring cold chain management, endorse to trained personnel responsible for
proper supervision on handling and storing items requiring cold storage.
 Transfer commodities to its assigned storage space after counter checking
 Prepare and update Bin Card and stock cards
 Encode Inbound summary report and Monthly Inventory Report in LMIS
 Monitor the storage area; segregate commodities considering First-Expiry-First-Out
(FEFO) and First-In-First-Out (FIFO) Principles
 Product Monitoring; Ventilation and Temperature and humidity monitoring
 When transferring the supplies to Barangay Health Stations,
o Prepare based on approved allocation list
o Place designated area for packing
o Assign per facility
o Update stock cards
 Inventory of supplies done monthly
 Maintain buffer stock to prevent stock-outs

Prepared by:

MICHAEL ETHAN E. BAOL, MD.

MHO