Functions, structure of the front desk. Organization of the work of the hospital admission department

The admission department (emergency room) is the “face” of any hospital. From how specialists will meet the patient, his psychological disposition for recovery, general well-being depends. Foster care will be an integral part of any hospital, clinic along with medical spaces, administrative and utility rooms. In the article we will analyze in detail the structure of the admission department, its functions, the organization of work of specialists.

What is it?

Reception ward - medical and diagnostic department of the clinic, where the patient’s service begins. It is intended for the following:

• Registration of the patient.
• Reception and initial examination of the patient.
• Anthropometry (weight, height of the patient), measurement of the most important vital signs - blood pressure, body temperature, etc.
• Sanitary, hygienic treatment of patients.
• The provision of medical emergency care.

The structure of the reception department is such that the actions of the staff here are characterized by coherence, clarity, speed, interconnectedness. Not only the success of further treatment in a hospital depends on all this, but sometimes a person’s life if he was admitted to a hospital in critical condition.

The structure of the reception department

As a rule, the emergency room is located in a separate building or in one of the medical buildings. Now about its own components. The structure of the reception department (the composition of the premises filling the building) is as follows:

• Waiting hall. Here patients who do not need bed rest, as well as the persons accompanying them, are waiting for admission. Be sure to have comfortable seats, a table to fill out the documentation. There are stands on the walls in the room with all the information necessary for patients and visitors — the institution’s work schedule, hours of talks with the attending doctor and meetings with patients, a list of products that can be brought to the patient as a hotel, and so on.
• Registry. We continue to consider the structure of the inpatient department. New patients are registered here. The staff is filling out relevant documents.
• Inspection room (depending on the scale of the clinic, there can be one or several). Here is a medical examination of patients. The specialist puts the newly arrived preliminary diagnosis. Next, the doctor determines the type of sanitary, hygienic treatment of the new patient, the necessary measures for anthropometry, thermometry, additional studies (for example, taking an electrocardiogram).
• Sanitary room (sanitary inspection room). There will be showers, bathrooms, a changing room.
• Diagnostic room. Here, patients with an undetermined diagnosis in the examination room are additionally examined.
• Insulator. The new entrants are sent to this room with suspicion of an infectious disease.
• Treatment room. A special room where first-aid is provided in critical condition.
• Operating room (or dressing room). Another room for first aid is already specialized (for those with bleeding, knife, gunshot wounds).
• X-ray room.
• Laboratory room.
• Doctor's duty room.
• The office where the head of the emergency room is located.
• The toilet rooms.
• Warehouse, storage of clothing, personal items received at the hospital.

This is the general plan for the structure of the hospital ward. Now let's move on to the details.

Structure specifics

The structure of the diagnostic department of a multidisciplinary hospital can be supplemented by a number of other elements. For example, resuscitation, trauma surgery, cardiology room (for those with myocardial infarction) and so on.

In general, the structure and organization of the admission department are directly dependent on the specifics of the medical institution, of which it is an integral part. What classrooms, rooms are characteristic of the reception room in general, we have examined.

Sequence of work

Each patient admitted to the emergency room must go through three stages. The strict sequence of the emergency room is as follows:

1. Registration of a new citizen.
2. Medical examination of a hospital patient.
3. Sanitary treatment measures for the patient.

As you noticed, the structure of the reception department (BSMP Novocherkassk will serve as an example here) corresponds to this strictly specified sequence.

Let us now reveal the activity of this element of the hospital.

The main functions of the reception

We continue to analyze the structure and functions of the front desk. The latter category includes the following:

• Reception and registration of newly admitted patients.
• Registration of hospitalized, people who have been provided with outpatient care, citizens who were denied hospitalization.
• Initial examination, examination, express laboratory diagnostics - in relation to all who applied to the hospital (regardless of the channel of admission).
• The distribution of admission to emergency and planned, by severity, profile, nature of injuries, pathology, disease.
• The provision of emergency qualified medical care, resuscitation.
• The provision of medical assistance to persons who turned to the emergency room, but do not need to stay in the hospital.
• Filling in the necessary documentation for hospital stay.
• Maintaining documents that are filled in when the patient refuses hospitalization.
• Transportation of the patient to the appropriate treatment department.
• Observation of patients in the waiting room awaiting diagnosis.
• Registration of protocols on the fact of medical examination of alcohol, drug intoxication received.
• Transfer of information to the police, the traffic police about citizens delivered with physical injuries of a violent nature, victims of traffic accidents, accidents, persons brought unconscious, without documents, corpses.
• Obtaining information about the movement of patients in the hospital, the relationship with other departments of the hospital, as well as with attached clinics.
• Sanitary treatment of the citizens.

Organization of activities

The organization of work of the in-patient department of the hospital, its structure, equipment, documentation are the objects for monitoring the deputy head physician in the medical field.

The department’s work is supervised by an emergency room doctor. Direct management can also be the prerogative of the doctor on duty. As a rule, this is a reception on weekends, holidays, night and evening.

For a clear organization of work with patients, especially those entering the department in critical condition, it must be provided with a full set of necessary documentation.

Mandatory instructions for organizing the activities of the department

This includes the following:

• A folder with emergency personnel instructions.
• Methodological instructions of higher authorities, the chief physician of the clinic.
• A folder with instructions for identifying especially dangerous infectious diseases.
• Instructional documentation in case of fire, terrorist attack and other emergencies.
• Instructions on the algorithm of actions of paramedical personnel before the arrival of a doctor to provide emergency medical care to a newcomer.
• Instructions for compliance with the sanitary-epidemiological regime.
• Standards for examination, examination of the patient.
• Duty Schedule.
• Provisions for a Responsible Physician.
• Table of poisons and related antidotes.

Tasks of a doctor

The main duties of a specialist department are:

• Reception, inspection and examination of newly arrived citizens.
• Diagnosis.
• The decision on the hospitalization of the applicant.
• Registration of both incoming and outgoing patients.
• Filling in the passport part of the medical history.
• Express laboratory tests.
• Sanitary treatment of patients.
• Consultation of applicants, reference and information activities.
• Monitoring of patients in the emergency room.

Initial examination of a planned patient

In respect of the planned admission, the following activities are carried out:

1. Inspection of a new patient.
2. Checking that he has all the documents necessary for hospitalization.
3. Record in the medical history, statement of the preliminary diagnosis.

Emergency admission

The measures that the doctor should take are, in this case, the following:

1. Immediate thorough inspection.
2. Carrying out the necessary laboratory and instrumental studies - analysis of urine and blood, ECG, ultrasound, x-rays of individual zones and so on.
3. The call of specialists of hospital departments regarding the admission, the diagnosis of which is difficult.
4. A preliminary diagnosis, referral of a patient to a specialized medical department.
5. Registration of a medical record of a hospital patient.
6. Organization of patient transportation.

If an infection is suspected, the doctor on call calls the infectious disease doctor, conducts the necessary amount of diagnostic tests, and then makes a decision on the need to place the newly admitted to the isolation ward.

Work with the documentation

We disassembled the structure of the front desk. Documentation here also plays a significant role. Its registration is carried out by the nurse on duty - after examining the patient with a doctor, making a preliminary diagnosis and deciding on the need for hospitalization.

The function of the nurse will also be anthropometry, thermometry, etc. Then she draws up the patient's documents:

• Entering contact information about a new patient - full name, date of birth, place of residence, registration.
• Where and by whom the new patient was delivered.
• The diagnosis made by the institution that sent the patient to the clinic.
• Preliminary diagnosis by a doctor
• Arrival time.
• The address of further hospitalization is the department of the medical building.
• Filling out the title page of the medical history is almost the same information. Additionally, contact information about relatives, relatives of the applicant is indicated.

Foster care is an important component of any hospital. Here, not only newly arrived patients are registered, but also emergency medical care is provided, a preliminary diagnosis is prescribed, and the patient is sanitized.