INTERNAL REGULATIONS of the healthcare institution «4th city clinical hospital named after M. Saŭčanka» for patients
1. The internal regulations of the hospital organization for patients are the regulation (order) for implementing professional activities of hospital employees to ensure that the patients receive medical care af good quality, as well as the rights and obligations of patients when receiving medical care in the hospital.
2. The internal regulations of the hospital organization for patients are regulated by the Internal rules of the hospital for patients, approved by order of the head physician of the hospital in consultation with the trade union committee.
3. The internal regulations of the healthcare institution «4th city clinical hospital named after M. Saŭčanka» for patients (hereinafter – the Regulations) are mandatory for all patients undergoing examination and treatment in the hospital. Patients get acquainted with the Regulations upon admission to inpatient treatment with signature confirmation.
4. These Regulations are developed on the basis of the legislation of the Republic of Belarus and departmental (branch) regulatory documents.
5. The Law of the Republic of Belarus dated 18.06.1993 № 2435-XII «On Healthcare»;
6. Decree of the President of the Republic of Belarus dated 26.04.2010 № 200 «On administrative procedures carried out by state bodies and other organizations upon citizens' applications» (amended and augmented);
7. Decision of the Ministry of Health of the Republic of Belarus dated 05.07.2017 № 73 «On the approval of Sanitary norms and rules «Sanitary and epidemiological requirements for organizations providing medical care, including the organization and conduct of sanitary and anti-epidemic measures for the prevention of infectious diseases in these organizations», recognition as invalid of some decisions of the Ministry of Health of the Republic of Belarus»;
8. Decision of the Ministry of Health of the Republic of Belarus dated 02.11.2005 № 44 «On the procedure of informing the public about the provision of medical care in healthcare organizations and on the procedure of referring for receiving medical care»;
9. Order of the Ministry of Health of the Republic of Belarus dated 30.03.2006 № 236 «On approval of the Statute of the clinical organization of healthcare»;
10. Order of the Ministry of Health of the Republic of Belarus dated 01.07.2011 № 710 «On approval of the Instructions on the procedure for implementing effective control over the observance of the smoking ban in healthcare organizations and in the territories adjacent to them and the Approximate statute of the commission for the control of smoking ban in the healthcare organization»;
11. Order of the Ministry of Health of the Republic of Belarus dated 29.08.2005 № 477 «On strengthening measures for the prevention of epidemic typhus and fight against pediculosis»;
12. Order of the Ministry of Health of the Republic of Belarus dated October 21.10.2003 № 165 «On approving the rules of the external and internal content of healthcare organizations of the Republic of Belarus»;
13. «Recommended practices for the work of the admission departments of inpatient treatment and prevention institutions subordinate to the health committee of the Minsk city executive committee», approved by order of the health committee of the Minsk city executive committee № 613 dated 15.10.2004;
14. The Regulations are mandatory for all patients who apply (delivered) to the hospital for medical care.
15. Patients get acquainted with the Regulations with signature confirmation, studying them at the special exposition (stand, desktop folder). If necessary, the patient may be given a brief memo on the Internal regulations.
16. In case of refusal of the patient or his legal representatives (defined in the second part of Article 18 of the Law of the Republic of Belarus «On Healthcare») to familiarize themselves with the Internal regulations for patients, the specialist doctor makes an appropriate entry in the medical documents, which is certified by another medical worker of the same healthcare organization.
PROCEDURE FOR PATIENT APPLICATION TO THE HOSPITAL
17. For the purpose of disease prevention, timely diagnosis and treatment, citizens of Minsk are assigned to provide specialized medical care in accordance with the order of the healthcare committee of the Minsk city executive committee dated 01.02.2013 № 48 «On the procedure for hospitalization» and are hospitalized by the place of residence in the specialized departments of the hospital by the referral of assigned polyclinics and ambulance stations.
It is allowed to get guaranteed primary medical and sanitary care in the hospital at the place of temporary residence (by the referral of the polyclinic at the place of residence, certified by the administration of the polyclinic and the seal of the polyclinic institution).
18. Every citizen of the Republic of Belarus has the right to receive medical assistance in any healthcare organization and from any healthcare worker of private healthcare provider by his own choice at his own expense or funds of individuals or legal entities.
19. In conditions requiring urgent medical attention (accident, trauma, poisoning, other conditions and diseases that threaten the life or health of a citizen or those who are around him), it is necessary to contact the state emergency medical service by phone (103).
20. Referral to the hospitalization of patients requiring inpatient treatment is carried out by an outpatient polyclinic institution after a preliminary examination of patients to the particular hospital with an indication of a preliminary diagnosis.
21. In case of conflict situations, the patient has the right to contact the hospital administration according to the schedule of reception of citizens, approved by the head physician.
HOSPITALIZATION AND DISCHARGE ORDER FOR PATIENT
22. Reception of patients in the hospital is carried out around the clock, without days off, holidays and breaks.
23. Hospitalization of patients is carried out:
- by referrals of healthcare organizations (territorial assignation of the population for medical care in the hospital is carried out by the Health Committee of the Minsk City Executive Committee);
- by referrals of the healthcare institution «City ambulance station»;
- according to urgent (emergency) testimony of persons who applied to the hospital on their own;
- by the contract with the hospital on a paid basis in the prescribed manner.
24. The following categories of citizens have the right to extraordinary and priority medical care (except for cases when medical care is provided out of turn for medical reasons):
The next categories are accepted out of turn:
The right for benefit must be confirmed by an appropriate document.
25. The determination of medical indications for the hospitalization of persons who have addressed on their own or delivered by the ambulance team is carried out by the doctor of the admission department during the examination of the patient. In diagnostically complex or controversial cases, the need for hospitalization is decided on a commission basis with the participation of the head of the admission department or the responsible doctor on duty of the admission department.
26. In the case of a patient’s categorical refusal to hospitalize if there are indications for it, he must certify his refusal by signing in a special journal in the presence of a doctor and the head of the admission department (responsible doctor on duty) after receiving clarifications about the need for hospitalization and the consequences of refusal. In case of refusal of hospitalization, the doctor on duty provides the patient with the necessary medical care and makes a record of the reasons for refusing hospitalization, the taken measures in the journal of register of patients and refusals of hospitalization (form 001/У-07), and issues a certificate.
27. Upon admission to the hospital, the patient or his legal representative presents the following documents to the medical staff of the admission department:
28. Patients are admitted to the hospital in the admission department with timely examination. Here, a thorough examination of the patient necessary to clarify the diagnosis is carried out, a preliminary diagnosis is established and the question of in which specialized department he should be hospitalized is solved. An appropriate entry should be made in the medical record of the inpatient.
29. When a patient is admitted, the nurse of the admission department enters the passport data and the necessary information about the admission to the medical record and enters it to the patient and refusals of hospitalization registration record (form 001/У-07) or the outpatient registration journal (form 074/У)
30. Patients requiring emergency medical care may be admitted to a hospital without identity documents. In this case, the attending physician informs the patient (or his legal representative) of the need to provide identification documents within 3 days and monitors the implementation of this requirement. Without the provision of an identity document, a work incapacity certificate and other established certificates after inpatient treatment are not issued.
31. Persons accompanying adult patients await examination results in a specially designated lobby of the admission department. One of the parents accompanying sick children under the age of 18 may be present in the admission department when child is examined.
32. The presence of an accompanying person is permitted during an examination in the admission department of an adult patient, contact with whom is difficult due to his serious condition or existing impaired vision, hearing, psyche or movement.
33. The presence of accompanying persons, including parents are not allowed in bandaging, procedural, manipulation and other rooms with increased requirements of the sanitary-antiepidemic regime.
34. Accompanying persons are allowed to participate and assist the medical staff in transporting the patient for hospitalization to departments, with the exception of intensive care, operating and diagnostic departments.
35. When applying for hospitalization in the admission department, things, money, valuables, documents of the patient are returned to the accompanying relatives or accepted for storage in the prescribed manner until discharge. Food products are not accepted for storage. In the hospital departments the patient is allowed to be in home clothes, provided that it is weekly changed, and in house shoes, if this does not contradict the sanitary-epidemiological regimen. It is allowed to take personal hygiene items and utensils (a toothbrush, paste, soap, toilet paper, handkerchiefs, a towel, a razor, a cup, a spoon, etc.) into the ward.
36. The question of the need for sanitary treatment is decided by the doctor on duty. Sanitary treatment of the patient in the prescribed manner is carried out by the average medical or other staff of the inpatient department of the hospital and makes an appropriate mark on the medical record of the inpatient.
37. When a patient is hospitalized, the reception staff on duty must be sensitive and attentive to him, carry out transportation taking into account the severity of his health and accompany the patient to the appropriate department with a personal transfer to the duty nurse.
38. The hospital is not responsible for the safety of personal items and valuables that have not been deposited in the prescribed manner.
39. In the admission department, a patient must be examined for infectious diseases, if necessary, sanitary or disinsection treatment is performed (if common pediculosis is detected, hair can be removed).
40. When contacting (delivering) persons with injuries of a criminal (violent) nature or received as a result of a traffic accident, the admission department workers are obliged to inform the internal affairs bodies (102), and when delivering unconscious persons or children unaccompanied by relatives or without documents, information is transmitted to the Bureau of Accident Registration of the Central Internal Affairs Directorate of the Minsk City Executive Committee (8-017-390-01-99).
41. Patients undergoing treatment in a clinical hospital, in the process of providing them with medical care, with their consent, can be examined and (or) consulted by employees of university departments located at the hospital, with the participation of students, graduate students, and clinical residents in examinations.
42. During the process of providing medical care, a doctor and a patient have equal rights to respect for their human dignity and can protect it in accordance with applicable law. The relationship between the doctor and the patient should be based on mutual trust and mutual responsibility. The patient is an active participant of the treatment process.
43. If a patient fails to comply with medical prescriptions or the Internal regulations for patients, the attending physician, with the permission of the head physician of the hospital, may refuse to provide medical care to the patient if this does not threaten the patient's life or the health of those who are around him.
44. All medical interventions are performed only with the consent of the patient (or his legal representative), except of special cases when the severity of the physical or mental state does not allow the patient to make a conscious decision, or in other cases provided for by law. Consent to simple medical intervention is given orally by the patient or his legal representative. A prerequisite for a complex medical intervention is the prior written consent of the patient or his legal representative.
45. The patient is discharged from the hospital by the attending physician in consultation with the head of the department. Discharging at the end of the working day of the attending physician, on weekends and holidays is issued by the duty doctor of the department.
46. Before discharge from the hospital, a final examination of the patient is carried out and on the day of his discharge from the hospital he will be given an epicrisis indicating the terms of treatment and diagnosis and recommendations for further treatment and examination, and the temporary work incapacity certificate. The first copy of the epicrisis is pasted into the medical record of the inpatient patient, the second copy is sent to the territorial polyclinic at the place of residence, and the third copy is given to the patient according to medical reasons.
47. At the request of the patient (or his legal representative), the patient may be discharged ahead of schedule (before curing or until the condition is stabilized) only with the knowledge of the deputy head physician in charge of this unit, provided that the patient’s discharge does not pose a risk to his health. The application of the patient (or his legal representative) about his early discharge is filed on the medical record of the inpatient.
48. A medical record of a hospital patient after the patient leaves the hospital is drawn up and deposited in the medical archive of the hospital.
49. Temporary home leave for hospitalized patients is prohibited.
50. Free medical care in the hospital (including drug provision, diagnostics and rehabilitation) is provided in the amounts and manner established by the state minimum social standards in the field of healthcare and on the basis of current clinical protocols for the provision of medical care approved by the Ministry of Health of the Republic of Belarus.
51. Medical services in excess of the established guaranteed volume of free medical care are amount to additional services and are provided on a paid basis in the prescribed manner on the basis of written contracts (with the exception of paid medical services provided anonymously).
RIGHTS AND OBLIGATIONS OF THE PATIENT
52. The patient has the right for:
When providing medical care in stationary conditions, the patient has the right to admit a clergyman to him, as well as to provide conditions for the performance of religious rites, if this does not violate the internal regulations for patients, sanitary, hygiene and anti-epidemic requirements.
Granting to a patient the rights specified in this article cannot be carried out to the detriment of the health of other patients and violate their rights and freedoms.
53. The patient must:
PROCEDURE FOR VISITING PATIENTS IN HOSPITAL TREATMENT
54. The patient is admitted to the wards at the appointed time (see Appendix 1).
55. Time for visiting patients by pases in wards and without passes in the halls of departments:
on weekdays from 17.00 to 19.30,
on weekends and holidays from 10.00 to 14.00 and from 17.00 to 20.00.
56. To communicate with the attending physician or the head of the department and obtain a pass, the relatives of patients should contact the department. Relatives go to a conversation with doctors without a pass at the hours set for the appointment. The schedule (time) for meetings of relatives of patients and department heads is approved by the head physician and is posted on the information boards of the departments.
57. A pass can be issued at the request of the patient himself and transferred to the information desk for subsequent transfer to visitors.
58. During the quarantine declared by order of the head physician of the hospital, visits to patients are prohibited. Reception of deliveries and their conveyance is carried out by employees of the information desk on the ground floor of the therapeutic building.
59. Throughout the working day, admission to the department is allowed (except for patients and hospital health workers) only for:
patients undergoing examination on a paid basis – by right of a contract for the provision of paid services,
employees of internal affairs bodies on official need – by right of an official certificate,
other categories – with the permission of the administration or the doctor on duty at the hospital.
60. Visits of patients in the wards by passes are carried out in sanitary clothing (medical gown), removable shoes or shoe covers. For the convenience of visitors, a sale of disposable medical shoe covers is organized on the ground floor.
A medical gown for visiting (in case of the absence of one) can also be obtained in the wardrobe (with exchanging for outerwear).
One or two visitors at the same time are allowed to access the patient’s room for no more than 20 minutes. Intoxicated visitors and visitors with acute respiratory viral diseases are not allowed to have access to the patients.
61. During the visit it is prohibited to:
62. The wardrobe for hospital visitors is open in the autumn-winter-spring period (from September 1 to June 30). The wardrobe is open daily from 08.00 to 20.00.
63. Wardrobe workers bear material responsibility for the safety of clothes, with the exception of the contents of pockets (valuables, documents, etc.), hats are accepted by the wardrobe only in bags.
64. Visitors and patients should behave themselves correctly towards hospital workers. We draw your attention to the fact that an insult can be considered as a violation subject to punishment under the Code of Administrative Offenses of the Republic of Belarus (art. 2.3).
PROCEDURE FOR RESOLUTION OF CONFLICT SITUATIONS BY HOSPITAL EMPLOYEES AND PATIENT
65. In the event of a conflict, it is necessary to contact the head of the department or the hospital administration.
THE PROCEDURE OF PROVISION OF INFORMATION ON THE HEALTH OF THE PATIENT and PROCEDURE FOR DELIVERY OF MEDICAL CERTIFICATES, EXTRACTS FROM MEDICAL DOCUMENTATION TO A PATIENT OR OTHER PERSONS
66. Information about the state of health is provided to the patient in an accessible manner that meets the requirements of medical ethics and deontology by the attending physician, department head or other hospital officials. It should contain notifications about the results of the examination, the presence of the disease, the diagnosis and prognosis, the methods of examination and treatment, the associated risk, possible options for medical intervention and their consequences, as well as the results of the treatment and possible complications.
67. Information about the patient’s health status is transferred to his family members, unless the patient has forbidden to inform them about it or has not appointed a person to whom such information should be transmitted.
68. With regard to underages and persons recognized as legally incompetent, information about the patient’s health status is provided to their legal representative, and for patients who are unable to make a conscious decision for health reasons, it should be provided to the spouse, and in case of his (her) absence – to close relatives.
69. In case of the patient refuse to receive information about his state of health, an appropriate entry is made in the medical documentation.
70. The information contained in the medical documentation is a medical confidentiality and can be provided without a patient permission only on the grounds provided by legislative acts.
71. Certificates and extracts from the medical record are issued to the patient or other persons who have the right for this, established by the legislation of the Republic of Belarus.
72. Certificates and extracts from the medical record are issued to the patient or other persons by the nurse together with the doctor on the day the patient is discharged from 14.00 to 15.00.
73. On the day of discharge, if necessary, a work incapacity sheet (certificate) is issued to the patient, drawn up in the manner prescribed by law, as well as an epicrisis. If necessary, the patient is issued a certificate of inpatient treatment for submission to the housing maintenance service or other certificates of the established sample in the prescribed manner. Epicrisis is sent by e-mail to the outpatient healthcare institution at the place of patient registration within 3 working days after discharge.
74. In the event of the loss of the work incapacity sheet (certificate), a duplicate shall be issued by permission of the hospital’s medical advisory committee on the basis of the patient’s personal application and upon presentation of a passport (identity document).
75. The legal representative of a patient who is being treated in a hospital may be issued a power of attorney of the established form for a single receipt of the patient's monthly monetary allowance (pension).
76. Information about the patient’s health status to higher health authorities and law enforcement agencies is provided in cases stipulated by the legislation of the Republic of Belarus, on the basis of a written request.
77. Information about the state of health and the diagnosis of the patient is not provided by telephone to third parties by medical personnel.
TIME OF WORK OF THE HEALTHCARE ORGANIZATION AND ITS OFFICIALS
78. During the period of inpatient treatment, patients are recommended to:
behave correctly with respect to hospital workers. We draw your attention to the fact that the insult can be considered as a violation subject to punishment according to the Code of Administrative Offenses of the Republic of Belarus;
remember that the use of alcoholic beverages and drugs during inpatient treatment is strictly prohibited, in case of violation of this requirement, the patient is discharged ahead of schedule, with informing about the fact of violation of the hospital regime at the place of registration (in the epicrisis) and the employer (in the work incapacity certification).
79. Smoking in the hospital premises and stairwells is strictly prohibited. Smoking is allowed only in specially designated places on the hospital territory, if there are any.
80. It is allowed to leave the hospital only for the purpose of a short walk (within the hospital territory), with the permission of the medical staff on duty. The estimated time of absence of the patient should be specified. Absence of more than 2 hours in the department is not allowed and entails the discharge from the hospital with an indication of regime violation in work incapacity sheet (certificate) and in an epicrisis.
81. While being treated in a hospital, it is necessary to strictly adhere to the regimen and diet prescribed by the doctor, and follow the doctor's prescriptions.
82. The assortment of grocery transfers from home should be in accordance with the list approved by the doctor (in accordance with the prescribed therapeutic diet). It is allowed to store a small amount of products in refrigerators for the use of patients, and it is necessary to sign a package of products (full name of the patient, ward, date of receipt of the delivery) and monitor the expiration date of the products. In case of identifying products whose storage does not meet the above requirements, as well as products with signs of spoilage, these products are removed to food waste.
83. It is strictly forbidden to use boilers and other heating devices on one’s own, as well as to perform other actions that may result in a fire.
84. In the hospital it is not allowed to go to balconies that are designed for complying with fire safety measures and for emergency evacuation; it is not allowed to throw garbage through the windows and feed the birds with food waste.
85. In all rooms and on the territory of the hospital, it is necessary to observe tidiness, cleanliness, and be careful about the property of the hospital.
86. The use of sound-reproducing audio, video equipment is allowed only in the absence of objections to this by other patients of the ward, patients of neighboring wards and medical staff on duty.
87. In order to maintain a medical and protective regime during the afternoon rest (from 15.00 to 17.00) and when going to bed (after 22.00), it is necessary to turn off mobile phones.
88. The patient reimburses damage in case of loss of the property of the hospital or damage to it, and is also liable for other violations in accordance with the current legislation of the Republic of Belarus.
89. It is not recommended to store large amounts of cash and valuables with you in the hospital, as their safety cannot be guaranteed.
90. The administration of the hospital is not responsible for keeping things in the wards.
91. In the event of a gross or repeated violation of the Regulations, the patient may be discharged (by agreement with the head physician of the hospital) with a mark about violation of the regime in the work incapacity certificate.
92. In the event of an emergency in the hospital, the patient must comply with the instructions of the medical staff, including assisting medical personnel in the evacuation of seriously ill patients.
93. The schedule and mode of operation of the hospital is approved by the head physician of the hospital on the basis of local conditions, the completeness of staffing in coordination with local executive and administrative authorities.
94. The day regimen for inpatients:
6.00 – 7.00 rise, temperature measurement, execution of appointments
7.00 – 8.00 morning toilet
8.00 – 8.30 tests
8.30 – 9.00 taking medications
9.00 – 9.30 breakfast
9.30 – 10.30 doctor’s round
10.30 – 13.30 execution of appointments
13.30 – 14.30 dinner
14.30 – 15.00 receiving medicines, execution of appointments
15.00 – 17.00 afternoon rest
17.00 – 17.15 temperature measurement
17.15 – 19.00 visiting patients by relatives, free time
19.00 – 19.30 supper
19.30 – 20.00 receiving medications, measuring body temperature, execution of appointments, briefing to prepare for the examinations scheduled for the next day
20.00 – 21.30 free time
21.30 – 22.00 evening toilet
22.00 going to bed
At 20:00 the main entrances to the medical buildings of the hospital are closed.
95. Patients' places of residence are aired (in some cases, quartzized) and wet cleaned. To implement this, patients should leave the wards at the request of medical personnel.
96. Admission (of patients and their relatives) by the head doctor of the hospital or his deputies is carried out according to the established schedule.
97. The schedule for admission of citizens and legal entities at the Health Committee of the Minsk City Executive Committee is carried out according to the established schedule.
INFORMATION ON THE LIST OF PAID TYPES OF MEDICAL CARE AND SERVICES AND THE ORDER OF THEIR PROVISION
98. The list of paid types of medical care and services provided to the population in state healthcare organizations, as well as the procedure and conditions for their provision to the population (additional to the guaranteed volume of free medical care) by healthcare organizations, regardless of departmental affiliation, are determined by the Council of Ministers of the Republic of Belarus and are binding on all government healthare organizations.
99. Prices for paid types of medical care and services provided to the population in state healthcare organizations are formed in accordance with the established procedure.
100. Citizens of the Republic of Belarus may receive paid medical services of their own free will.
101. The list of paid medical services can be found on the website 4gkb.by or on the information stand of the administrative building of the hospital.
PROCEDURE OF MEDICAL CARE PROVISION IN CONSULTATIVE CABINETS
102. Medical assistance in the consultative cabinets of the hospital is provided to citizens of the Republic of Belarus according to the territorial principle (according to assigned polyclinics), approved by order of the Health Committee of the Minsk City Executive Committee.
103. The provision of medical assistance to foreign citizens, refugees, stateless persons is carried out in accordance with the legislation of the Republic of Belarus and international treaties.
104. For the convenience of patients, a pre-appointment with specialist doctors can be made. Appointments can be made by telephone, online, on the hospital’s official website, or directly in the advisory office.
105. Patient consultation at home is not performed.
106. At the initial or repeated application of registration, the patient is obliged to present a passport or other identification document, as well as a plastic medical care card.
107. Patient must come to the appointment with the doctor 10 minutes before the appointed time.
108. If the patient is late for more than 5 minutes, the ticket / record is canceled, and the patient can be accepted only if the doctor has free time between taking the recorded patients.
109. Contact numbers and information about the opening hours of consultative cabinets can be obtained in the help desk verbally and visually – on the information boards of the Hospital, as well as on the official website www.4gkb.by.
110. The volume of diagnostic and therapeutic measures for a patient is determined by the attending physician in accordance with the established standards and procedures for the provision of medical care approved by the Ministry of Health of the Republic of Belarus.
111. The right to extraordinary, priority and preferential provision of medical care is granted to categories of patients in accordance with the legislation of the Republic of Belarus, with the exception of cases when medical care is provided out of turn for medical reasons.