SCOPE OF SERVICE WORKSHEET - kau
Scope of Service
Internal Medicine Department
|Department/Service: Internal Medicine |
|Form Completed by: |
|Dr.Abdulrahman Al shaikh (Director Of Internal Medicine Department) |
|1.Unit Description |
|1.1 Mission |
|To provide safe and effective preventive and therapeutic health care services covering all subspecialties of Internal Medicine including, |
|endocrinology, nephrology, pulmonology, heamatology, gastroenterology, rheumatology, medical oncology, dermatology. This service is provided for |
|adult and geriatric patients of both sexes attending Dr. Soliman Fakeeh Hospital through organized experienced teamwork. |
|1.2 Vision |
|To be the leading internal medicine department in the Middle East by providing the best medical care practices to our patients, continuously |
|improving quality of care techniques and continuous education of our staff with an outreach of care to our community. |
|1.3 Goals: |
|1.3.1 Achieve better quality of patient care as guided by quality indicators. |
|1.3.2 More emphasis on staff and patient education. |
|1.3.3 Introduction of new therapeutic and diagnostic techniques. |
|1.3.4 More respect to patient and family rights. |
|1.4 Days and Hours of Operation |
|The department of medicine is on duty 24 hours a day, seven days a week including national and religious holidays. |
|1.5 Staff availability |
|Consultants cover sixteen hours per day from 9 am - 1am and 8 hours on call 1am-9am.Specialists cover 24-hour service. |
|2. Patient Population |
|2.1 External customers |
|Internal Medicine services are available to all in-patient and outpatient adults and geriatrics patient of both sexes and all races regardless of |
|financial class on emergent, urgent and elective basis. Total number of patients attending outpatient clinics of Internal Medicine Department was |
|67847 patients during the previous 10 months. |
|2.2 Internal Customers |
|2.2.1 Service Type: |
|- In-patient |
|- Outpatient |
|- Emergency |
|2.2.2 Medical Services: |
|Endocrinology |
|Nephrology |
|Pulmonology |
|Respiratory care services |
|Gastro-enterology |
|Hematology |
|Medical Oncology |
|Rheumatology |
|Dermatology and Venereology |
|Staff health |
|Infectious diseases |
|2.2.3 Level Or Intensity Of Patient Care: |
|Acute |
|Chronic |
|Intensive |
|Check-up. |
|2.2.4 Patient Age: |
|Adolescent |
|Young adult |
|Middle age |
|Older adult including geriatrics |
|N.B.Some Specialties like Dermatology, Oncology, Hematology, Respiratory Care Services and Nephrology can check patients from younger age. |
|2.2.5 Patient Origin: |
|National |
|Non-national |
|2.2.6 Patient Physical Capacity |
|Movement impaired |
|Wheel chair bound |
|Bed bound |
|Vision impaired |
|Hearing impaired |
|Speech impaired |
|3. Assessment Process |
|3.1 Departmental procedures |
|3.1.1 Endocrine procedures: |
|Anterior pituitary function test, ITT (insulin tolerance test). |
|Glucose tolerance test. |
|Combine GlT and glucose tolerance tests. |
|Synactine test. |
|LHRH or GnRh test. |
|Colindine stress test. |
|Arginine stress test. |
|TRH stimulation test. |
|24 hrs. glucose monitoring (sensor). |
|Install s.c. insulin pump. |
|Thyroid FNA. |
|3.1.2 Nephrology Procedures: |
|Hemodialysis. |
|Peritoneal dialysis |
|Through cooperation with other departments: |
|Anesthesia: subclaviculian catheter, internal jugular catheter, permicatheter. |
|U/S: ultrasound guided renal biopsy. |
|3.1.3 Pulmonary procedures: |
|Pulmonary function testing. |
|Simple spirometry. |
|Spirometry before and after bronchodilators. |
|Diffusion lung capacity. |
|Procedures in cooperation with other departments e.g thoracic surgery and radiology |
|Bronchoscopic work-up. |
|Thoracocentesis. |
|CT Guided aspiration and biopsies. |
|Interpretation of sleep studies |
|Diagnostic and therapeutic CPAP and BIPAP |
|Respiratory Care Services other than the abovementioned: |
|Chest physiotherapy, Breathing exercises, incentive spirometry, oxygen therapy, care for ventilators and other respiratory care equipment, etc. |
|3.1.4 Hematology Procedures: |
|Bone marrow transplantation. |
|Bone marrow aspiration. |
|Bone marrow biopsy. |
|Transfusion of blood products |
|RBC exchange. |
|Plasma exchange. |
|3.1.5 Gastroenterology: |
|Upper gastrodeodenoscope. |
|Colonoscopy. |
|ERCP |
|Gastrostomy tube. |
|Through cooperation with other departments: |
|Ultrasound: ultrasound guided abdomenal paracentesis, ultrasound guided |
|liver biopsy |
|3.1.6 Rheumatology Procedures: |
|Joint aspiration for synovial fluid analysis. |
|Intra-articular injections |
|Ultrasound guided intra-articular injections of the hip joints. |
|Injection of musculoskeletal soft tissues. |
|C.T guided injection of the costo-vertebral joints. |
|3.1.7 Oncology Procedures: |
|Screening for cancer. |
|Chemotherapy treatment. |
|Radiation therapy service for: |
|External irradiation. |
|Brachytherapy for cancer cervix. |
|3.1.8 Dermatology unit Procedures: |
|Electrocautery. |
|Cryocautery. |
|Intralesional injection (Dermojet). |
|Phototherapy. |
|Photo chemotherapy. |
|Skin biopsy |
|Skin Bencard test. |
|Skin Desensitization Vaccination. |
|Botox injection. |
|Camedo and milia extraction. |
|Dermabrasion. |
|Chemical peeling |
|Facials |
|3.1.9 Staff Health Clinic Procedures: |
|Pre-employment assessment. |
|Immunization program implementation. |
|Primary care of employees. |
|Determination of limitations to work assignments. |
|Work restriction determination. |
| |
|4. Staffing Requirements |
|4.1 Position Tittles and licensure or specification requirements |
|The department of medicine is directed by MD (or its equivalent)-certified internist and is staffed by MD (or its equivalent), certified internits, |
|Master degree (or its equivalent) certified specialists in different, subspecialities and certified registered nurses/technicians/therapists in |
|specialty care units. |
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|4.2 Organizational Chart |
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|[pic] |
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|4.3 Continuing Education and Training policy and requirements |
|All department staff is required to attend the hospital orientation upon employment in the organization, in addition to departmental orientation by |
|director of medicine or his designee. |
|All internal medicine staff are required to attend weekly department meeting including various activities as mini lectures, journal clubs, case |
|presentations. |
|Attendance and participation of monthly CME program within the hospital |
|All medicine department staff should be BLS certified. |
|5. Modalities used |
|5.1 Diagnostic/detection Modalities needed: |
|5.1.1 Endocrinology: |
|Glucometer |
|Orchidometer |
|Tuning fork. |
|Ophthalmoscope |
|Proctoscope. |
|Rigid sigmoidoscope and biopsy forceps. |
|Needles for fine needle aspiration. |
|Continuous glucose monitor. |
|Subcutaneous insulin pump. |
|5.1.2 Nephrology: |
|Monitor- biopsy needle, glucometer |
| |
|5.1.3 Pulmonology: |
|spirometery and Diffusion Capacity Machine. |
|Peak flow meter, pulse oximeter, bronchoscopy set, CPAP, BIPAP. |
| |
|5.1.4 Hematology |
|Bone marrow biopsy needle. |
|5.1.5 Gastroenterology unit: |
|Upper endoscopies,sigmoidoscope,colonscope, ERCP,liver ,gastric and colonoscopic biopsy |
|5.1.6 Rheumatology unit |
|Equipment for synoval fluid aspiration |
|Goniometer |
|Nail fold capillaroscope |
|Magnifying lens |
|Meter |
|5.1.7 Oncology modalities: |
| |
|5.1.8Dermatology unit: |
|Punch biopsy |
|Bencard test |
|Needle aspiration |
|Skin scrapper |
|Probes and culture media |
|5.1.9 Staff health unit: |
|Glucometer |
|5.2 Therapeutic/corrective Modalities needed |
|5.2.1 Endocrinology therapeutic equipments: |
|Glucometer |
|Orchidometer |
|Tuning fork. |
|Ophthalmoscope |
|Proctoscope. |
|Rigid sigmoidoscope and biopsy forceps. |
|Needles for fine needle aspiration. |
|Continuous glucose monitor. |
|Subcutaneous insulin pump. |
|5.2.2 Nephrology: |
|HD machine |
|Defibrillator |
|PD set |
|Sublavian and internal jugular catheters. |
|5.2.3 Pulmonology: |
|Thoracentesis set |
|Bronchoscopy set |
|Nebulizer (jet and ultrasonic). |
|CPAP and BIPAP |
|Other respiratory care services modalities e.g. oxygen therapy equipment, incentive spirometers, suction systems, oxygen cylinders, etc. |
|5.2.4 Hematology |
|Cell separator, Hickman catheter. |
|WBCs filters |
|chemotherapy infusion pumps. |
|5.2.5 Gastroenterology unit: |
|ERCP, varicel injection and ligation,gastrostomy,polypectomy and paracentesis. |
|5.2.6 Rheumatology unit |
|Corticosteroid injections. |
|Lowerlock needles and injections. |
|Local anesthetic injections. |
|Local anesthetic spray. |
|5.2.7 Oncology modalities: |
|Urinary bladder catheterization for intravesical chemotherapy. |
|Chemotherapy infusion pump. |
|Simulator for planning Oncology patients. |
|Amersham brachytherapy applicator for caecium intracavitary. |
|5.2.8 Dermatology unit: |
|Phototherapy |
|Photochemotherapy |
|Electrocautery |
|Cryocautery |
|Intralesional injection (Dermojet) |
|Dermabrasion |
|Chemical peeling |
|Skin desensitization vaccination |
|Comedo and milia extraction |
|5.2.9 Staff health unit: |
|5.3 List the procedural Modalities needed |
|5.3.1 Endocrinology: |
|Consent for FNA thyroid. |
|Clinical protocols for dynamic endocrine testing. |
|5.3.2 Nephrology: |
|Consent for HD/PD/ renal biopsy/ subclavican/ permicatheter catheter |
|5.3.3 Pulmonology: |
|Consent form, checklists. |
|Respiratory Care services forms e.g. respiratory Care Services request form, respiratory therapy follow up form, ventilator flow chart, etc. |
| |
|5.3.4 Hematology |
|Consent form for blood transfusion. |
|Consent form for central line insertion. |
|Consent form for chemotherapy administration. |
|Consent form for stem cell donation. |
|Consent form for bone marrow transplantation. |
|Checklist for chemotherapy administration. |
|5.3.5Gastroenterology unit: |
|Consent form for endoscopy, biopsy and paracentesis. |
|5.3.6 Rheumatology unit |
|Consent forms for instituting cytotoxic and other immunosupprecive agents |
|5.3.7 Oncology modalities: |
|Consent form for chemotherapy and radiotherapy. |
|Checklists for chemotherapy preparation for every patient. |
|Checklists for chemotherapy administration for every patient. |
|Checklists for accuracy of radiation machines. |
|5.3.8 Dermatology unit: |
|Consent form before retinoid intake. |
|Consent and checklist before operation. |
|5.3.9 Staff health unit: |
|Software for specific services foe staff health, data analysis software, computer system |
|protocols for staff immunization. |
|OVR for sharp needle injury/on the job injury/communicable disease exposure. |
|Medical history questionnaire from |
|6. Support Service |
|6.1 Communication chart |
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|[pic] |
|6.2 Departmental Committees and Meetings |
|Weekly department meeting for medicine. |
|Pharmacy and therapeutic committee monthly. |
|Blood utilization committee every month. |
|General check-up task force committee every two month. |
|Renal dialysis committee every 2 month. |
|6.3 Communication methods with other Departments/Divisions/Services |
|Referrals |
|Meetings |
|Memos |
|Memorandums |
|Personal communication |
|6.4 Standard of Practice |
|Evidence based medical data. All policies are reviewd and approved by Director of Internal Medicine and subjected to chief medical officer approval |
|where applicable. |
| |
|Endocrinology: |
|American Diabetic Association ADA |
|American Endocrine Society. |
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|Nephrology |
|American society of nephrology. |
|EDTA |
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|Pulmonology: |
|American college of chest Physicians. |
|European Respiratory Society. |
|American Association of Respiratory Care (AARC) Clinical Guidelines. |
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|Hematology: |
|American Association of Hematology |
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|Gastroenetrology: |
|American society of Gastroenetrology |
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|Oncology |
|American society of clinical oncology. |
|European society of clinical oncology. |
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|Dermatology: |
|American Academy of Dermatology |
|European Society of Dermatology and Venereology |
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|Rheumatology: |
|American College of Rheumatology |
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|Staff Health |
|American college of Occupational and Environmental medicine. |
|MOH standards. |
|MRQP standards. |
|JCI standards. |
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|Hyperbaric oxygen therapy unit: |
|American society of aerospace medicine. |
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|7. Approval |
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|7.1 Prepared by: _____________________________ Date: 30/04/2006 |
|Internal Medicine Department Director |
|Dr. Samir Sally |
|7.3 Approved by: |
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|______________________________ Date: 30/04/2006 |
|Chief Medical Officer |
|Dr. Bravo Badee |
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|_____________________________ Date: 30/04/2006 |
|Owner & Director General |
|Hospital Executive Committee, Chairman |
|Dr. Soliman Fakeeh |
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Nursing Department
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The Internal Medicine Department Communication Chart
Department of Internal Medicine
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