Introduction

The K.L.E.S 1200 bedded hospital (750 beds to start with now) visualizes that at the end of second to third year of its operation it will have an occupancy of 70 to 80%, that means hospital will have at any one time approximately 500 to 600 patients admitted in the wards of hospital. Apart from this there will be approximately 1200 to 1800 new and old patients per day in the OPD. 'there would also be accident and emergency patients approximately 2 to 3% of OPD patients, which would mean about 36 patients per day. The private practitioners would also contribute'; to the admission of patients in die hospital . The patient care services will be executed through the diagnostic and therapeutic services spread over various technical functional are-is of the hospital i.e. OPD, Accident & Emergency department. In-patient Wards, diagnostic service:! like Hospital lab and Medical Imaging, specialized care areas like Operation 'theatre, Trauma Care Unit and I.C.U etc. While these are the 'CURE' aspect of the theme of our hospital. The 'CARE' of the patients will be served adequate nursing services, hospital dietary services, and other supportive services like laundry, CSSD and building; maintenance cell. 'this section of the document would therefore deal with broad policy formulation with respect to all these department and service areas individually.

Out Patient Department

OPD will provide health promotion diagnostic and therapeutic services to patients who need hospital services without; the need to be admitted would include references made from outside doctors, patients coming on their own, references from private clinics investigations recommendations and civil hospital references ' etc. The out patient department services will also attempt to reach the door step of it's beneficiaries through peripheral health centres in the hospital's catchments areas,

Out patients services in the hospital premises will be conducted through various specialized clinics in addition to one general clinic (filter clinic). The OPD consists of 18 specific discipline clinics which would be supplemented by further specialized clinics . Such special clinics run by specific disciplines would be on pre-determined, staggered days and timings using the infrastructural facilities as provided for the parent discipline clinic.

The peripheral health centres would be in the form of augmenting the three PHCs adopted .by J.N.M.C as well establishing dispensaries and medical staffed centres in selected catchment area towns. ,

The OPD will have a medical officer in charge for day to day administration of the department and co-ordination of the department and co-ordination among various clinics and administrative echelon of the hospital. Authority granted to officer in charge of OPD will be given in different section of the document

Grouping of OPD Clinics

Policy 1:- OPD will be classified in to six categories.

1) General OPD (filter clinic)
2) Speciality clinics
3) Higher speciality clinics
4) Special clinics
5) Pay clinics
6) Peripheral Health centres.

Policy 2 :- The basic disciplines would run on daily basis, super or higher specialities would also be attempted to be run on daily basis but depending on the availability of 'faculty, hospital authorities may have to run it on fixed periods on pre-decided days and time. Some other special clinics would be conducted once or twice a week depending upon the availability of faculty and flow of patients,

Central Registration

Policy 3 :- Initially every patient would enter at the central registration counters of the OPD in the main entrance lobby for his/her registration as a new case with central registration number. After registration the patients would be guided/sent to the particular clinic depending upon the nature of ailment judged by the patient or advised at the enquiry counter, The patient will get the clinical case No. at respective clinics. On the subsequent visits patients shall directly report to their respective clinics for follow-up management as advised by the concerned consultant/authorized doctor of the clinic.

Policy 4 :- The Entrance lobby will have a general enquiry/ guidance counter. This counter will assist patient in all respect for their registration and other needs in addition to general enquiry and assistance.

Policy 5 :- Registration of the new/ patients will be done in three categories.
I ) General OPD, maternity and Paediatrics.
2) Speciality clinics for conventional and broad specialities
3) Higher speciality clinics

Policy 6 :- These categories of registration will have specific counters in the main lobby. Attempt will be made to segregate male and female patients oil each category of the counter. The central registration for special clinics and pay clinics will also be done from same counters and under the parent discipline classification.

Policy 7 : - The registration fee for these categories of clinics, will be different. The General, maternity and Paediatric clinic registration fee will be the lowest, speciality clinic will be in the middle order and higher speciality and special clinics will be the highest. The purpose of this three tier registration has been to encourage general practice, make the OBG, and  Paediatric services accessible at the lowest affordable registration fee for the vulnerable group of population and also prevent unnecessary flocking of patient to speciality and higher speciality clinics, thus giving more lime to the clinic for each needy and genuine patients.

Policy 8 :- The pay clinic will be giving the registration card with a number, as an authorized documentary permit to the patient to reach his choice consultant for private consultation. The registration clerk will also collect the consulting fee of the concerned consultant as per the pre-fixed rate. The clerk will account for the collected fee for each consultant at the end of the clinic. Registration staff will handover the collected fee to the consultant alter deducting 25% of the same, which he will deposit to the hospital cashier simultaneously with detail account of collection against each consultant.

Policy 9 :- Registration at a given time will be for a specific ailment or set of ailments at the time of registration. Any subsequent or different ailment not related with the previous ailment will require a separate registration. However this may be modified for a contractual regular patients with the hospital .

Policy 10:-In case of professional cross references, no fresh card need to be made. Cross referral form will be initiated by the referral clinic .

Policy 11 :- OPD card once made will be valid for one month, after which repeat visit fee of 50% of original registration fee would be charged lo renew it. In case the patient discontinues his/her visit for consecutive one month the card will stand invalid, unless the long gap in follow up visit is on the doctors advise in writing on Us card.

Policy 12 :- The registration fie will be in the form of the cost of the central card printed/stamped on the card itself. The registration staff will make registration by collecting the prescribed registration lee directly while issuing the card to the patient and by entering the detailed bio-data and date in the register.

Policy 13 : - The registering staff will account for the registration card issued and deposit the collected cash at the cash counter at the expiry of his/her duty and return the unused registration cards to the authorized person.