Administrative Order No. 5-A series 1996

  

17 February 1996

ADMINISTRATIVE ORDER

No. 5–A series 1996

REVISED POLICIES, PROCEDURES AND GUIDELINES GOVERNING AFFILIATION AND TRAINING OF STUDENTS IN THE DEPARTMENT OF HEALTH (DOH) HOSPITALS AND OTHER GOVERNMENT FACILITIES

Section 1

Title

These Policies, Procedures and Guidelines shall be known as “Revised Policies, Procedures and Guidelines Governing Affiliation and Training of Students in the Department of Health (DOH) hospitals and other government health facilities.”

Section 2

Rationale

The production and development of Health Human Resource is necessary for the promotion, maintenance and delivery of health services. The Department of Health is making available its hospitals and accredited government community health resources for the learning and training of students from health professional schools. To maintain the quality of this relationship, guidelines were originally promulgated under Administrative Order 26–C series 1982 and Administrative Order 13 series 1986 governing affiliation and training of students.

Due to the changing needs of the society, advances in science and technology, changes in the Department of Health policies and procedures, and the current implementation of the Local Government Code (LGC), regulations governing affiliation and training of students in the Department of Health as embodied in Administrative Order No. 70–A series 1989 and Administrative Order No. 21–A series 1993 are hereby revised.

These revised guidelines shall be applicable to accredited DOH hospitals and government health facilities.

Section 3

National Committee on Affiliation and Training of Students (NCATS)

1. The National Committee on Affiliation and Training of Students (NCATS) shall be created at the national level which shall be chaired by the Director of Health Manpower Development and Training Service (HMDTS) and composed of professional representatives from other services concerned in affiliation and training and other government agencies.

2. Functions:

The National Committee shall:

a. Be responsible for the administration and supervision of all affiliation and training activities.

b. Formulate policies, standards, rules and regulations on affiliation and training of students.

c. Plan, implement, monitor and evaluate programs and activities of affiliation and training of students.

d. Supervise regional and hospital committee (NCATS/RCATS/HCATS) on the implementation of policies and standards on affiliation and training.

e. Accredit government health facilities such as hospitals, laboratories, health centers that are capable of providing the necessary resources for the student learnings. The list of accredited health facilities shall be sent to all universities, colleges and schools through the President of the Association of Deans and other concerned government agencies such as the Commission on Higher Education (CHED) and Professional Regulation Commission (PRC).

f.  Recommend for approval to the Secretary of Health the Contracts of Affiliation from special/specialty Hospitals and other agencies/institutions directly under the office of the Secretary of Health.

g. Maintain a list of schools that are qualified to affiliate with DOH facilities.

h. Keep records and reports.

i.  Maintain linkages and coordination and conduct regular dialogue with other services/offices/units concerned within and outside the Department of Health.

Section 4

Regional Committee on Affiliation and Training of Students (RCATS)

1. A Regional Committee on Affiliation and Training of Students (RCATS) shall be created to be chaired by HMDTD Chief with the Regional Training Nurse (RTN) as the executive secretary and members coming from the technical and training staff of the regional field office, the retained hospitals, laboratories, provincial health offices and financial services to be appointed by the Regional Health Director. The composition are as follows:

Chairman                    :           Chief, HMDTD

Vice–Chairman           :           Medical Training Officer

                                                Medical Center/Regional Hospital

Secretary                     :           Regional Training Nurse, HMDTD

Members                    :           Chief, Technical Division

                                                Chief, Finance or Accounting or Budget

                                                Representative from PHO

                                                LHB Representative

                                                Chief Nurse

                                                Chief, Regional Laboratory

2. Functions

The Regional Committee (RCATS) shall:

a. Supervise activities of affiliation and training of students at the regional level.

b. Formulate guidelines/policies on affiliation and training of paramedical and medical students appropriate to their area of jurisdiction consistent with the guidelines developed by NCATS.

c. Monitor all affiliation programs and activities in compliance to the guidelines and policies on training and affiliation.

d. Recommend for approval to the Regional Health Director Contracts of Affiliation from accredited DOH hospitals and field health units.

e. Accredit health facilities that are capable of providing the necessary resources for students learning. The list of accredited health facilities shall be sent to all universities, colleges and schools who are/shall be affiliating with DOH facilities.

f. Maintain a list of schools that are qualified to affiliate with DOH health facilities.

g. Keep records and reports.

h. Submit quarterly reports to the National Committee on the following:

(1)   Name of college, number and category of students

(2)   Name of hospital, area/department utilized for training

i.  Maintain linkage with other sectors concerned in affiliation and training like CHED, universities, colleges, schools and professional organizations.

Section 5

Hospital Committee on Affiliation and Training of Students (HCATS)

1. A Hospital Committee on Affiliation and Training of students (HCATS) shall be created. This shall be chaired by the Chief of Hospital and to be composed of designated training officers (or persons–in–charge of training) from each service/department where student – affiliates rotate and representatives from each position group existing in the institutions.

2. Functions:

a. Screen and approve affiliation applicant (school/universities/colleges) as per A.O. issued.

b. Supervise activities of students’ affiliation and training activities at the hospital at all levels in accordance with the set standards by NCATS/RCATS.

c. Formulate guidelines appropriate to their situation based on the set affiliation policies and procedures.

d. Monitor and evaluate all affiliation program and activities at the hospital.

e. Determine proration of affiliation fees both for the groups directly and indirectly involved in affiliation and training.

f.  Facilitate purchase of equipment, supplies, materials, journals and other needed paraphernalia for affiliation and training to prevent interruption of affiliation activities.

g. Update and maintain a list of schools/universities/colleges affiliating in the hospital.

h. Submit quarterly report to NCATS/RCATS of all affiliation activities taking place in the hospital and statistics reflecting the number of students admitted per school and per course, school remittances and affiliation disbursements.

i.  Conduct regular dialogue with the school/colleges/universities affiliating to facilitate discussion of problems, issues and other concerns organic to affiliation and training.

Section 6

If affiliation is at the RHU level, a Committee shall be organized to be composed of at least 5 RHU staff that are directly involved in affiliation and training. This Committee shall have the same functions as the Hospital Committee on Affiliation and Training of Students.

Section 7

The Regional Health Director is authorized to approve Contracts of Affiliation within the region except those of Special/Specialty Hospitals which fall under the jurisdiction of NCATS.

Section 8

Procedures in applying for affiliation with the Department of Health hospitals and other health facilities

1. Hospitals shall make available copies of affiliation contracts to schools, colleges and universities.

2. All contracts of affiliation shall be duly accomplished and signed by both parties (Chief of hospital and President of the College/University)

3. For newly established schools, colleges and universities with Medical, Nursing and Midwifery courses, their course curriculum should pass through the Partnership on Alternative Health Science Education (PAHSE) prior to recommendation for approval by NCATS/RCATS to the Secretary of Health or his duly representative.

4. All duly accomplished affiliation contracts for hospitals under the Department of Health shall be forwarded to the National Committee for evaluation, prior to recommendation for approval to the Secretary of Health or his duly representative.

5. For hospitals in the region, all duly accomplished contracts shall be submitted to the Regional Committee (RCATS) for evaluation, prior to the recommendation by the Chairman for approval by the Regional Health Director or his duly representative.

6. Application for affiliation shall be filed two (2) months before the start of the actual affiliation.

7. Affiliation Contracts shall be renewed yearly for the first two (2) years and every two (2) years subsequently.

8. For inter–regional affiliation, affiliating institution should submit a Certificate of Approval for Cross Regional Affiliation from the RCATS of the home region to the RCATS where they intend to affiliate

Section 9

Standard rates of Affiliation Fees

1. The following shall be the standard rate of fees to be collected by all agencies of the Department of Health from affiliating students from various disciplines

Medical Technology               P100.00/students/month

2. These fees shall be treated as trust receipts in the books of collecting agencies, deposited in an authorized government depository bank.

Section 10

Distribution of Affiliation Fees

1. General Principles

a. All staff members in the hospital shall have a share of honoraria form the total collection of fees per batch provided that all leaves and absences shall proportionately deducted from the amount due him;

b. Honoraria form resource person shall be taken from the Training Service/Department concerned and shall be based on the number of hour he/she has lectured consistent with the Civil Service Commission Issuance and Department Memorandum No. 25 s. 1995; and

c. In the event of conflicts regarding affiliation and training of students, the Chief of Hospital has the authority to resolve the issues within his level in accordance with the Administrative Order.

2. The collected affiliation fees shall be divided on the following manner:

a. Five percent (5%) of the total collection shall be remitted by Metro Manila hospitals and agencies to the National Committee on Affiliation and Training of Students (NCATS) and by Regional Hospitals, Medical Centers and other government health facilities to the Regional Committee on Affiliation and Training of Students (RCATS), respectively, and shall be used in the following manner:

1% – meetings, conferences and other activities

2% – equipment, supplies, materials, journals and literatures

2% – honorarium/incentive for Committee members

b. Forty percent (40%) shall be used to fund attendance of affiliation trainers to Human Resource Development activities and to procure supplies and equipment based on training need as well as for research related to training, as determined by the Committee. The Accounting Office shall furnish a copy of the updated report of affiliation fees collection and disbursement to the Director and Chief Training Officer copy furnished NCATS/RCATS.

c. Fifty five percent (55%) shall be intended for honoraria or incentive for personnel:

(1)   Sixty percent (60%) for the Training Service/Department concerned (pro– rated); Forty percent (40%) for the other hospital staff (pro–rated)

(2)   Guidelines for Pro–rata allocation

(a)   For Service / Department providing training

A HCATS shall be formed in the agency which is composed of one representative from each position group to formulate percentage distribution for each category or staff based on the degree of their participation in the training of students.

(b)   For Hospital Staff Members who are not involved:

For the other hospital staff members who are not directly involved in affiliation, HCATS shall work on the distribution of fees.

Section 11

Guidelines for each discipline

The guidelines for affiliation of students for each discipline are attached in the following annexes:

A.     Dentistry

B.     Health Aide

C.     Hospital Dietetics

D.     Medical Social Work

E.     Medical Technology

Section 12

Special Provision

Other government–owned or controlled schools or colleges shall be required to pay the affiliation fees to the Department of Health hospitals and rural health units/health centers except the University of the Philippines. However, the University of the Philippines shall be required to accomplish the necessary contract of affiliation.

Section 13

Repealing Clause

Administrative Order No. 21–A s. 1993 as amended.

Administrative Order No. 70–A s. 1989 & Administrative Order No. 13 s. 1986 and Administrative Order No. 26–C s. 1982 and other orders inconsistent with the provisions of this Administrative Order are hereby repealed.

Section 14

Effectivity

This Administrative Order shall take effect immediately

CARMENCITY N. REODICA, M.D., M.P.H., CESO II

Secretary of Health

GUIDELINES GOVERNING AFFILIATON AND TRAINING OF STUDENTS IN

MEDICAL TECHNOLOGY

I.     General Requirements

A.     Training Program

There should be an organized training program of affiliation prepared by the training hospital in coordination/consultation with the university/college/school consistent with the provisions under the Contract of Affiliation. It should contain the following:

1. Orientation on the DOH and hospital items:

a. DOH vision, mission, structure, programs/projects and current thrusts

b. Hospital organizational set–up, policies, rules and regulations shall also be emphasized especially the compliance to universal precaution against transmission of blood pathogens, the current regulation of instruments utilization as related to breakage/damages (i.e. endorsement, policy, placing of redeemable fees for damage/losses/breakage or incidence report system)

c. Medical Technology/Laboratory Services

d. A role clarification that covers discussion of role conception/expectation from the students and hospital staff and shall also be included to avoid assumption of roles by the students that are highly critical but not essential to their training.

2. Training Program for Affiliation

a. General objectives

b. Specific learning objectives

c. Course content/method/procedures and its principles to be taught and other essential content such as:

(1)   Right work attitude and ethical values

(2)   Precision

(3)   Issuances pertinent to Medical Technology practice

(4)   Methodology

(5)   Training schedule

(6)   Monitoring and evaluation

(a)   Performance Evaluation Instrument

(b)   Grading Scheme

(c)    Prelims/Midterm/Final evaluation instrument

(7)   Training Rules and regulations/merit and demerit guidelines/repeat internship

(8)   Affiliation contract

II.    General qualification standard of laboratories for affiliation and training

A. The laboratory should be duly licensed by the Bureau of Research and Laboratories (BRL) as specified by R.A. 4688 and should be included in the accredited list of NCATS/RCATS.

B. The number of student – affiliates to be accepted shall be based on the following:

1. Volume and number of laboratory procedures being undertaken;

2. Working space that would accommodate both the laboratory staff and the Medical Technology interns;

3. Number of Medical Technologist staff of the hospital to train;

4. Availability of supplies, equipment and other facilities for training;

C. Each of the following section should be staffed with a Medical Technologist and shall accommodate at least two (2) and not to exceed (5) interns at any one time. The minimum number of examination of samples of each section to accommodate one (1) intern are as follows:

1.     Clinical chemistry – 3,000 exams/annum

2.     Clinical Microscopy

a.     Urinalysis – 3,000 samples/annum

b.     Parasitology – 3,000 samples/annum

3.     Microbiology

a. Gram–staining, acid fast staining – 1,000 samples/annum

b. Isolation and identification of organism – 1,000 samples/annum

4.     Hematology

a. Peripheral blood study to include hemoglobin, white cell count, Schilling hematocrit and red cell morphology or CBC – 3,000 samples/annum

b. Sedimentation rate, platelet count, bleeding and clotting time, malarial smears  and other tests – 1,200 samples/annum

c. Blood Banking and Serology

(1)   Typing – 1,200 tests/annum

(2)   Complete cross – matching – 600 tests/annum

(3)   Serology

VDRL – 300 tests/annum

Others – 600 tests/annum

d. Histopathology – 600 specimens/annum

Cytology – 600 specimens/annum

e. Other related laboratory procedure

D. Minimal exposures in the following services shall also be required:

1.     Nuclear Medicine

2.     Pulmonary Services

3.     ECG

4.     EEG

5.     Other related laboratory procedure

E. The Director of the hospital is responsible for the admission of the number of interns approved by the HCATS. The hospital should not enter into any Contract of Affiliation with any school/college/university for Medical Technology if any of the conditions set forth in the Administrative Order are not complied with.

F. Priority should be given to interns residing within the area or regions where the hospital is located.

III.  Joint responsibilities of affiliating universities/colleges/schools of Medical Technology and Laboratories

A. Any change of the training schedule shall be by mutual agreement in writing of the authorized representative of the school and the training laboratory to be submitted to the HCATS.

B. A quarterly conference to be attended by the Pathologist, Laboratory Instructor and staff should be held to evaluate the implementation of the program and thresh out problems that might arise during the implementation and institution of changes that maybe necessary.

C. Maintenance of cooperation and harmonious working relation at all time among students and the staff of the hospital.

IV.   All schools/college/universities of Medical Technology must have met the following requirements before applying for affiliation to any clinical laboratory of the Department of Health:

A. Approval from the Commission on Higher Education

B. Compliance with the provision of P.D. 498 and Presidential Decree No. 534

These universities, colleges and schools shall:

A. Provide laboratory instructor experienced in actual laboratory work to monitor individual attendance, behavior and performance of the students and to act as liaison officer between the school and the hospital in case of technical problems.

B. See to it that all medical technology interns before beginning the internship in any section must have completed the theoretical aspect of the particular section.

C. See to it that before actual affiliation starts, all students endorsed to the hospital has undergone Hepatitis screening examination, photocopied certification of which should be submitted together with the Contract of Affiliation.

D. Pay to the hospital one hundred pesos (P100.00) for each intern each month. Payment is done within the first fifteen days of the month or period stipulated.

E. See to it that the laboratory instructor and students observe and abide with the policies, rules and regulations of the hospital and that discipline is maintained at all times.

F. See to it that the students and instructor are in their proper uniforms and provided with a laboratory gown, as stressed under the Universal Precaution, and should be worn with proper school identification.

G. See to it that no more than 20% of the Medical Technology interns shall be allowed to undergo night–shift training depending on the discretion of the Department’s Training Officer, workload and working area. Such interns should be under the responsibility of a staff – Medical Technologist of the hospital during night shift