Out Patient Department

An outpatient is a patient who is not hospitalized for 24 hours or more but who visits a hospital, clinic, or associated facility for diagnosis or treatment. Treatment provided in this fashion is called ambulatory care. Outpatient surgery eliminates inpatient hospital admission, reduces the amount of medication prescribed, and uses the physician's time more efficiently. More procedures are now being performed in a surgeon's office, termed office-based surgery, rather than in a hospital-based operating room. Outpatient surgery is suited best for healthy patients undergoing minor or intermediate procedures (limited urologic, ophthalmologic, or ear, nose, and throat procedures and procedures involving the extremities). Type of Patient in the Outpatient Department GENERAL OUT PATIENT All the patients other than emergencies who report directly to the OPD EMERGENCY OUT PATIENT A person given emergency medical care for condition which is real or perceived emergency. REFERRED OUT PATIENT A person referred to an OPD by his attending medical/dental practitioner for specific diagnostic/treatment procedure. 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. 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 physicians 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 physicians 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. Flow in the Outpatient Department the patient goes for registration and distribution at the Service Desk in a designated area of the hospital for the confirmation of the identity of the patient.

The patient goes to the designated Treatment Room waiting for diagnosis.

Outpatient Department completes all checks and performs treatment.

Patient goes to the pharmacy to get the medicines

The patient settles the account and is provided with certificate of diagnosis and a detailed statement of charges.

Importance of OPD
y y y y y y First point of contact It is the shop window of hospital Makes or mars the hospital image A good OPD service can reduce the load on in-patient services It is a place for implementing preventive & promotive health activities. Facilitates teaching About twice the in-patients attend OPD every day

Functions of OPD
y y y y y y y y y Early diagnosis, curative, preventive & rehabilitative care on ambulatory basis Effective treatment on ambulatory basis Screening for admission to hospital Follow up care & care after discharge Promotion of health by health education Rendering of preventive health care Promotion of health through health education Training of medical / nursing students Keeping up to date records for future treatment, medical education, epidemiological & social research Staffing depends upon objectives of department and volume of workload. Ancillary staff in OPD e.g X-Ray, EEG & ECG technicians. Clerical staff to carry out registration patient billing, cashiering etc. In teaching hospital interns and residents assisting physicians. Receptionist & other volunteer staff . Availability of Administrator for planning, organizing, supervising, evaluating, coordinating and improving out patient services.

Staffing

Planning Considerations
Location Separate entrance Easily accessible Should have approach from main road Adjacent to supportive facilities, x-ray & laboratory Amenable for Expansion General requirement y Sub-waiting area: Should be 1/3rd of total patients y visiting clinic /day y Consultation room: Space for doctors chair, patients stool, follower seat ,wash basin, examination couch,equipment for examination. Area 15-17 Sq.meter.& each clinic should handle 100 cases /day. y Special examination room :Required for certain departments.

Ancillary facility
Injection room : It should be with waiting area for 10- 20 patients with 0.6-0.8 sq.meter/patient. Area may vary from 12 to 40 sq.meter depend on work load. y Treatment & dressing room: About 12-16 sq.meter. y Pharmacy : It should accommodate 5% of total clinical visits to OPD in one session Auxiliary facilities y Laboratory Should be able to serve IP&OP Patients with 2 (male & female) washrooms & toilets 15 sq.meter. y Bleeding room 15-20 sq.meter with two or more examining tables. y Radiology Should serve both IP & OP PATIENTS. y Blood Bank y Health Education Facilities Min. area required is 15 sq.meter. y Medical Social Service Facilities should be located in y OPD with suitable cubicle for each social worker/Counselor. y Screening Clinic required in teaching or tertiary hospital & should be located near reception area having one or more cubicle with 12 sq.meter area for each cubicle y