137
Operation Policy In Obstetrics and Gynaecology Services
2. All new appointments will be seen within one month
3. All other follow up cases will be seen according to the severity of cases
4. The payment for the patients would be RM 13 for foreigners, RM 5 for
government staffs and RM 30 for referral from general practitioners. Fees Act
5. All the patients in the clinic will be seen within 1 hour from the appointment
time. 6.
All patients would be counselled regarding their problems and the plan of management clearly documented in the folder.
7. The relatives of the patients would also be counselled
Measurable elements of 20.2.1
1. Consultation by subspecialist
2. New appointments within 1 month
3. Fees paid
4. Presence of relatives
5. Consultation given to patients
6. Waiting time in clinic
Compliance with practice protocols std: 100
OPERATIONAL POLICIES
138
Operation Policy In Obstetrics and Gynaecology Services
20.2.2 Urodynamic Studies Standard
All patients will be seen by a subspecialist
Intent of 20.2.2
1. Waiting time will be less than 45 minutes
2. All cases will be seen by sub specialist
3. Fees paid RM 13. Fees Act
4. The decision for the study is made by specialist and limited for patients who
have not responded to routine management. 5.
The patients would be consulted and the condition, prognosis and plan of management clearly explained to the patients and documented in the folders.
6. Relatives of the patient would also be counselled.
Measurable elements of 20.2.2
1. Indications for urodynamic studies
2. Consultation by sub specialist
3. Waiting time in clinics
4. Presence of relatives
5. Explanation to patients
OPERATIONAL POLICIES
139
Operation Policy In Obstetrics and Gynaecology Services
6. Relatives counselled
Compliance to practice standards std: 100 20.2.3 Urogynaecology Operation Theatre
Standard
All urogynaecological patients planned for operation will be seen by subspecialist
Intent of 20.2.3
1. All decisions for urogynaecological operative procedures must be made by
subspecialist 2.
Time from decision to operation would be less than 6 months 3.
All patients would be counselled regarding the indication, the operative procedure and associated complications.
4. Consultation would be made by the urogynaecological team
5. The relatives would also be explained regarding the planned procedure and
associated risk
Measurable elements of 20.2.3
1. Review by subspecialist
2. Waiting time from decision of surgery till operation
3. Counselling of patients
OPERATIONAL POLICIES
140
Operation Policy In Obstetrics and Gynaecology Services
4. Consent from patients
5. Presence of relatives
20.3 ADMINISTRATIVE RESPONSIBILITY Standard
The urogynaecologist is the head of the urogynaecological unitteam.
Intent of 20.3
1. Heshe is responsible of smooth running of this unit, which comprises a
consultant, specialist, medical officers, continence nurses physiotherapist and support group aided by voluntary staff from NGOs.
2. The urogynaecologist will be responsible as the head of urogynaecological
services, for running the daily activities of the unit, financial management, staffing, equipment purchase and others.
3. Ensure the smooth running of urogynaecoloical clinic, ward, daycare centre
operating theatre. 4.
The urogynaecologist from time to time will attend meetings which are relevant to the provision of the urogynaecological subspecialty at various
levels hospitals, state, and national.
Measurable elements of 20.3
1. The unit is headed by a urogynaecologist
2. Urogynaecology activities supervised and administered by urogynaecologist.
OPERATIONAL POLICIES
141
Operation Policy In Obstetrics and Gynaecology Services
OPERATIONAL POLICIES
3. Equipment, staffing, financial balance are accredited by Head of OG
Department.
Compliance with practice protocols std: 100 20.4 EDUCATION RESEARCH RESPONSIBILITY
Standard
Teaching and training of staff
Intent of 20.4
1. The urogynaecologist is responsible in providing the necessary teaching and
education to all the members of the unit. This includes the consultants, specialist, trainees, medical officers, house officers, continence nurses
physiotherapist and the support groups. 2.
The urogynaecologist is responsible to provide theoretical and practical knowledge to the subspecialist trainees.
3. The urogynaecologist and the team is responsible to organize regular courses
for all categories of staff. The suggested courses are perineal episiotomy workshop, 3rd 4th degree tear repair workshops and others.
4. The urogynaecological unit will also from time to time provide teaching
training for doctors from the private sector. 5.
The urogynaecology unit should keep a database of all the cases that are seen. This would be incorporated into the annual report of the department.
142
Operation Policy In Obstetrics and Gynaecology Services
6. The urogynaecologist and the team should initiate and oversee research
projects on a regular basis. There should be an aim to present at least one study at the national or international level. The publication of articles in
urogynaecology should be made regularly.
Measurable elements of 20.4
1. Courses and seminars organized by the urogynaecology unit
2. Adequate training of staffs
3. Departmental report and database
4. Number of presentations and publications
Evidence of continuous monitoring of above standards and remediable actions taken Std: 100
20.5 PUBLIC AWARENESS SUPPORT GROUP Standard
The urogynaecologist is responsible to create public awareness relating to incontinence and pelvic organ prolapsed
Intent of 20.5
1. With increasing life expectancy, urogynaecological problems have now
become the most common chronic medical condition in women. This problem is much more common than hypertension, diabetes and psychoses.
2. The creation of awareness can be done through public forums, advertisements,
public campaign and others.
OPERATIONAL POLICIES
143
Operation Policy In Obstetrics and Gynaecology Services
3. Support groups comprising patients, public, NGO’s and continence advisors
should be encouraged. Formation of local support group should be encouraged to improve the quality of life of our aging population.
Measurable elements of 20.5
1. Public forums and awareness campaigns
2. Support groups
3. Patients awareness and understanding
Evidence of continuous monitoring of above standards and remediable actions taken Std: 100
20.6 RELATIONSHIP WITH THE DEPARTMENT OF OG. Standard
The urogynaecological unit will function within the ambit of the Department of OG.
Intent of 20.6
1. The urogynaecologist will share calls in the Department of OG until such
a time when there are sufficient Advanced OG subspecialists to handle obstetric calls.
2. Similarly all support staff such as medical officers and nurses will form part of
the Department and will be multifunctional when required in the general interests to do so.
OPERATIONAL POLICIES
