DAY CARE HYSTEROSCOPY .1 Standard DAY CARE TUBAL LIGATIONS .1 Standard

76 Operation Policy In Obstetrics and Gynaecology Services 6. After the procedure and if a specimen is sent for histopathology, the patient will be re-counselled regarding the findings any complications and discharged once well. The review clinic appointment is given within 2 weeks in urgent cases or 6weeks for normal cases. Measurable elements of 14.1.1 1. Time taken from consultation to time procedure being done. 2. All cases should be managed by specialist or privileged medical officer. 3. Waiting time at hysteroscopy clinic 4. Time taken for HPE report to be ready. Evidence of continuous monitoring of above standards and remediable actions taken Std: 100 14.2 DAY CARE TUBAL LIGATIONS 14.2.1 Standard Patients undergoing laparoscopic Tubal Ligations must fully satisfy all requirements and is decided by specialist. Intent of 14.2.1 1. All patients for tubal ligation are seen at the gynaecology clinic. 2. They are given an appointment during the first 2 weeks of their LMP. 3. On the morning of the procedure, a UPT and an Ultrasound scan is done for the patient. OPERATIONAL POLICIES 77 Operation Policy In Obstetrics and Gynaecology Services 4. Patient is explained regarding the procedure failure rates and risks before consent is taken. 5. After the procedure, patient is told to rest and discharged after 6 hours with adequate analgesics. 6. Patients are followed up 2 weeks post laparoscopic BTL. Measurable elements of 14.2.1 1. Time taken from appointment to procedure. 2. Only credentialed and privileged doctors should do the case. 3. Ensure consent with proper counselling done Evidence of continuous monitoring of above standards and remediable actions taken Std: 100 OPERATIONAL POLICIES 78 Operation Policy In Obstetrics and Gynaecology Services OPERATIONAL POLICIES

15.0 GYNAECOLOGY SATELLITE SERVICES

15.1 Standard

Satellite services provided by O G Deparments. Intent of 15.1 1. The OG specialists from the Fetomaternal, Reproductive Medicine, Gynaeoncology and Uro-gynaecology units are providing specialist care at other hospitals. 2. The days for these services are preplanned and known to the visiting hospitals. 3. The specialists will usually do procedures in the morning and see patients in the afternoon session. 4. They will also bring patients to other hospitals to be operated on. 5. Patient seen by visiting Reproductive Medicine Specialist would continue the care for patients who require ART at the Kuala Lumpur Hospital. Measurable elements of 15.1 1. Specialists in other hospitals trained by subspecialists. 2. Shorter waiting time for major surgery Evidence of continuous monitoring of above standards and remediable actions taken Std: 100 79 Operation Policy In Obstetrics and Gynaecology Services OPERATIONAL POLICIES

16.0 SPECIALIST CLINICS

Standards Obstetrics and gynaecology clinic a. Patients with appointment b. Walk in patients c. General clinic policies

16.1 Standard

Patients with appointment Intent of 16.1 1. A planned maximum number of patients will be seen per day for every clinic session. 2. All patients referred to the clinic are expected to present with a referral letter. 3. The appointment will be fixed according to the staggering system in the first come first serve basis. 4. Patient with more urgent clinical conditions will be given an earlier appointment. 5. All appointments will be given not later than 6 weeks. 6. The hospital has the authority to change the appointment to a different date and patient will be informed of the changes. 7. Patients are expected to be punctual according to the appointment time given.