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PEJABAT PENGARAII HOSPITAL
HOSPITAL PULAU PINANG
JA.LANRESIDENSI
10990 PUIAU PINANG
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Tel :
RujukanTuan
:
Kami
:
Rujukan
Tarikh
S eperti
@s'"s"iurrtr
HoSPITALPUI-AU PlNAl{G
012225333 Fax : 04-2281737 l7eb : htp://hpp.moh.gou.my
:
(J1) dlm. HPP/O9OI
JOJulai,2010
Senarai E daran.
Melalui:
Negeri
.
Pongarah Kesihatan
Jabatan Kesihatan Negeri Pulau Pinang
Tingkat 35-37, KOMTAR,
10990 Pulau Pinang
Tuan/Puan;
INTER HOSPITAL TRANSFER oF PATIEI,ITS
Dengan segala hormatnya perkara di atas adalah dirujuk.
"'
2. Dimaklumkan bahawa pihak Jabatan Kecemasan Dan Trauma, Hospital pulau pinang
telah mengemukakan bebgrana garispanduan bagi menerima kemasukan kes-kes rujukan
pesakit yang tidak kritikal ke hospital ini untuk mengelakkan kesesakan dan
beban trgu,
yang tinggr di jabatan tgrsebut. Garispanduan yarg dib"rikan adalah
berdasarkan kepaAa
PekeliJin8 Ketua Pengarah Kesihatan Bil.zlz\\9-Girispanduan Rujukan dan perpindahan
Pesakit Diantara Hospital-hospital Kementerian Kesiiatan Malaysia
3.
Sehubungan dengan
itu pihak
Tuan/Puan adalah diminta agar dapat mematuhi
ar.u:"t te hospital ini
dapat dihantar terus ke wad-wad yang berkenaan tanpa melalui Jabatan Kecemasan
Dan
Trauma; tertakluk kepada persetujuan serta perancangan awal oleh pihak Tuan/puan
dengan
jabatan yang terlibat.
kesemua_ garispanduan yang_dinyatakan supaya pesakit-pesakit yang
.,
4.
Bersama-sama ini disertakan sesalinan gmrp*a*n yang dimaksudkan bertajuk
'Inter Hqspital Transfer Of Patients 'untuk rujukan dan panduan fuanlpuan.
Kerjasama dari
semua adalatr amat diharapkan bagi memastikan gmispanduan ini dapat diguriapakai
dan
dilaksanakan dengan sebaik mungkin.
d
Sekian, terima kasih.
..BERKIIIDMAT TINTUK IIEGARA"
*SATIJ MALAYSIA,
RAKYAT DIDAIIULUKAN, PENCAPAIAN DIUTAMAKA}I
Saya yang menurut perintah,
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(DR.RAJ4ib*ga"il""BrNRArAARrrFrN)
No. pendaftaratr MpM:
il'*i?r,'#iifl?1",*
24656
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INTER I{OSPITAL TRANSFER OF PATIENTS
BACKGROTIND
Hospital Pulau Pinang (HPP) is a tertiary hospital and receives
patients for step-up care from the
other hospitals in the state as well'as-hospiitals in ur"
No.tt"rn Region. The Current practice
requires the referring doctor to consult the dbctor in
the receiving hospTtal *;;r;; the patient is
accepted, such patients are sent to Emer8ency Departmen(EDj
in FIpp to u" ,"Ln by the ED
doctors first before they are reviewed by the ..l"iri,iti.*
of admitted to the respective wards.
However, not all patients need to be seen at ED prior
to admission and the current practice leads
to unnecessary delay in the handover process,
to .ong"rtion-i;E il l;..ru."a workload
for the ED staff' The ED doctor is meiely. functioning
"ddr ,r
u?-ua,,ioing officer in cases where the
"' "*'
patients
are stable and only require admisiion and
aoel;ilil;;;rl"ri"*]-'
Pekeliling Ketu4
Pengarah Kesihatan Btl }l2oog-.Garispanduan
Rujukan Dan perpindahan
Pesakit Di Antara Hospital-Hospital Kementerian
Kesihatan was sent to all hospitals in May 2009
to address issues in inter-hospital transfer of patients (cou"-*"nt
Hospitals). Among the issues
addressed was the process of patient handover in
s.gr.'-'
"tuur"
5.3.2 Patient
lfandover
Excerpts from this clause
o
Patients that primarily require admission should
be directly brought to the receiving
ward' The receiving team is responsible for providing
advanced notice to that ward and
the Admission Room, aboui the patient's .*pEJ"a time
o
of
to
arrival. The
team
accompanying the patient should be piovided with
clear instructions
us to
Lv irrei.
rr
specific
'v^rs eo
ward destination.
Patients that require a review by the specialty
team should be directed to the ED. The
receiving team is responsible for providing prior
noii". to the ED about the initial
management plan.
'
Any patient whose clinical status.deteriorated during
transfer and become unstable or
require active clinical intervention must be airecte?
immediately to the ED by the
accompanying team.
'
Any transfer to an intensive care bed must-be managed
in stict accordance to instructions
by the receiving team. The patient should ideally"L"'t.ugtt
to the ICU, minimizing
patient movements.and delay in transfer..
uTr";;s",y delays which may occur if the
patient is kansfe*ed via the ED or Admission
noo* i, io be jrevented ; t as possible.
The accompanying team shalt not leave the patienruntiithe
receiving team has formally
taken over care of the patient.
en Hpp, ir, ;;;;;; who are sin ar ED ?rst, th,
accompanying team witt stay with the-patieilyi
z io*, fo, the primary managing team
to make a decision, after which time tie *"oiprryirg"tJrm
o
OTIR PROPOSAL
r
"*
l"orr.
DIRECT ADI\fiSSION FOR CASES ALREADY
DISCUSSED WITII RECETYING
TEAM
-
GICU/PICU admissions
DWA/DpTA/HIDA scans
Paed.iatric patients for
Stable surgical cases
Stable medical cases
Elective admissions
r
Stable fractures
Pregnancy-relatedproblems
Oncology patients for radiotherapy
PATIENTS WHO REQIJIRE REVIEW
BY A SPECIALTY TEAM
AT
EMERGENCY DEPARTMENT BEFORE AD}VtrSSION
-
Head injury and other Neurosurgical cases
Polytrauma
Acute Myocardial Infarct
Haemodynamically unstable cases when first seen at refering hospital
Patients whose general condition deteriorated during transfer
PROCEDTIRE FOR DIRECT Apl\dIqSrON OF STABLE PATIENTS TO WARp
-
The referring team must have discussed the case with the receiving team and
agreement reached for transfer.
On arrival, the referring team will send the patient to flre designated ward.
The ward doctor willwrite an admission form.
The referring team will bring the admission form to Admission Room to admit
the patient.
The referring team
will bring the admission forms back to the ward.
CONCLUSION
The ED hopes that all hospitals referring patients to FIPP will follow the above guidelines for
inter-hospital transfer in order to minimize delay in the transfer process of patients from the
refening hospital and to avoid congestion in the space-constrained ED and unnecessary
workload for the ED staff. ED resources will then be spent on patients truly requiring
emergency care.
yz(tln
DR rEo_4+( H9IP
MBBS., M.ircd. (Emp,fgcncy M.diclnal
f"trra
laUatad/ feccmasan
Pakar Klinikal penlUatan Kccernasan
Hospital Pulau Pinang