Support-Hospital Management

  • CEO

  • Superintendent

  • Head of Department

  • Intern curator

Nursing:

  • Deputy director

  • Nursing manager

  • Operational manager

support-facilities for healthcare professionals

1. Staff clinic

  •  located on ground floor just past polyclinic

  •  available to all health care workers

  •  Services: GP consultation, family planning and pap smear, immunizations (flu and hepatitis). All available between 8am and 11am on weekdays

  •  for needle stick injuries services extend to 4pm

2. Doctors rooms Are available in Obsterics and casualty

  •  usually left open so keep your valuables on you, car keys, money and phone/gadgets.

3. On call rooms – specific for each rotation

obstetrics and gynecology

  • Takes place over 4 months

  • Time is split among obstetrics and gynecology.

Routine dependent on rotation

  • obstetrics rotation includes (Ante natal ward, post natal ward,   theater and labor ward)

  •   gynae rotation (gynae ward, gynae clinic, theater, casualty cover)

  • interns are distributed across these roles and rotate throughout the rotation.

  • Public holidays and weekends: only interns on call work

  • Tuesdays  - intern presentation at 7:30am

  • Wednesdays - MO/ Consultant presentation at 7:30am

  • Thursdays  - Mortality and morbidity meeting at 7:30am

  • ESMOE training occurs according the departments stipulations

helpful hints

  • Have a measuring tape and obstetric wheel

  • Always have extra pens (black)

  • Fill in your log book and get it signed as you go along to avoid stress at the end of the rotation.

  • Stay well hydrated. Pack snacks or a lunchbox and get a power bank to keep your phone charged.

App to download

internal medecine -structure

  • General structure

  • All interns are split among 4 wards : ward 8 (male) ward 9 (female), each containing acute and chronic.

  • Monday Wednesday and Friday are  OPD days (where 3 interns cover the clinic with MO supervision)

  •  one intern covers casualty between 8-4pm daily with an MO

internal medicine - routine

•Post intake meetings every morning at 8am in ward 9

•Tuesday mornings are Academic presentations by interns and consultant

•Calls according to intern roster

•Intern on Weekend day call begin in the ward.

helpful hints

  • Phlebotomists start rounds daily from 10:30am. Ensure all patient details are in the  phlebotomy book before then (name surname ward, cubicle)

  • Remember TTO scripts (blue box)must be ready before 12pm. If its late you can call pharmacy to issue it.

  • Bone marrow must be booked 1 day in advance. Call the lab and they will issue with the equipment.

  • Ask for help when you need it!! Don’t suffer in silence!

  • Fill in your logbook and get it signed as you go along to avoid stress when the rotation ends

general surgery - structure

  • All patients are in ward 2 (male and female) and ward 5A for pediatric surgical patients.

  • Interns are split according to male or female side of the ward. Interns covering female ward also cover 5A.

  • Calls are allocated as per intern roster

  • Interns on weekend day call begin with the ward round

general surgery - routine

  • Rounds generally begin at 8am sharp with post intake presentation followed by ward round. Starts in ICU at 8am Sharp

  • Interns “cover the bench” – walk in patients who require blood for investigations, referrals, bookings, biopsy’s, admissions from SOPD)

  • One intern covers casualty daily between 8am and 4pm

  • One intern covers theatre the whole week.

  • Elective Theater day are Friday and  Mondays.

  • Make sure elective surgery and scope lists list is prepared and submitted to theatre, the ward and casualty the day before the procedure.

  • Make sure patients are prepared before surgery the day before with all the necessary investigations.

  • Minor theater is every Tuesday (in casualty).

  • Emergency theatre daily

  • Thursday is scope day in minor OT in casualty

  • Thursday morning interns present presentations

helpful hints

  • Delegation makes light work

  • The major hint for surgery…team work makes the dream work

  • Wards

  • Theater

  •   Make sure results, ecg, chest X-ray are all at the bedside before Anesthetic review

  • Drip theater patients with green Jelco’s

Clinic

  • The booking book for elective cases, minor cases and scopes can be found in SOPD

Calls

  • Prior to your call orientate yourself concerning where the resources you will need to perform procedures you need to perform

  • Make sure you eat and rest during calls

Presentations

  • Make sure your information is up to date and fully understand your content.

pediatrics- structure

  • This 4 month rotation is equally split between POPD, ward 5B and the neonatal unit.

  • The day generally starts at 8am.

  • 2 interns in each part of the rotation (POPD and wards)

  • Interns alternate covers weekly

  • NNU cover includes (casualty cover, theater, labor ward and postnatal ward)

  • NNU includes KMC, nursery, high care and isolation. Interns typically cover KMC, nursery and isolation and assist with procedures after the round.

  • Academic Teaching rounds occur weekly

pediatrics- routine

  • Tuesday Morbidity and mortality meeting – 8am in ward 6

  • Wednesday intern tutorial by consultant  - 8am in ward 6

  • Thursday academic presentation by interns, com serves and Consultants – 11:30 ward 6

  •  Calls are according to intern roster

  • On weekends if you are on day call you start with the ward round in 5A

calls

  • Peads calls take place in ward casualty and cover the ward too

  • On weekends one intern is on call for 24hrs.

  • patients for the unit over the weekend.

Neonates

  • This rotation takes place in Neonatal unit

helpful hints

  • Download the PedZ app for easy calculation of anthropometry.

  • Access a PDF of the EML guidelines

  • Download the EM guidance app

  • Start your Neonatal round as early as possible to avoid delay with procedures

  • Keep a bag of essential equipment (yellow and blue jelco’s, strapping, culture bottle, scissors and short lines)

  • Book all your imaging investigations personally and drop Xray forms yourself

  • Check all drips are functional before leaving the ward

  • Blood gases can be done in Neonatal ICU (for a small blood samples) and main ICU.

ORTHOPAEDICS-structure

  • Two month rotation

  • It is divided into two teams in one ward (blue and green) in ward 4 ( divided as male and female)

  • Clinic day is on Tuesday and each team sees their own patients

  • Interns rotating in orthopaedics do casualty calls

pedeatrics-routine

  • Weekdays start at 8am

  • Tuesday is grand round from 6:45am in ward 4

  • Tutorials by the consultant  - per announcement (at 7am)

Blue team theater day  - Wednesday

Green team theater day  - Thursday

  • One intern must cover casualty daily

  • Wards are covered by MO

  • Ensure theater list is prepared and submitted to theater and the ward the day before your teams theater day. Cases usually finalized after grand round

Helpful hints

  • Do not be late for the tutorials or the  grand round

  • Prepare theater lists early

  • Theater lists start at 7am sharp

  • Keep printed records of NHLS lab results

Anaesthetics - structure

  • 4 theatres with each intern rotating daily between each one

  • Interns will be allocated to an MO daily

  • Calls are done in casualty for this rotation

Anaesthetics - routine

  • day starts between 7:30 and 8am – this tie is allocated for your machine check

  • You will be allocated to a particular theater list on a daily basis

  • Check your patient in the waiting area .Look for- functional drip, consent, general condition

  • Pre-op assessments for the next days list must be done during the day and discussed with your senior

  • Days are generally long and end in the late afternoon

helpful hints

  • Pre read for the cases

  • Prepare your theater and drugs prior to cases

  • Take advantage to learn as much as possible in the anesthetic teaching offered in the first week of the block - ASK QUESTIONS!

  • INCUBATE and do spinals as often as you can - practice makes perfect.

  • Your 1st month with one senior should be used to gain confidence in your skill as an anesthetist

  • Owning a clip board and marker really helps

  • Early logbook submission is vital in this block

Psychiatry – structure

  • This rotation is a month long and takes place during the family medicine rotation

  • Maximum of 3 interns rotate through the department.

  • Interns rotate in acute psych in P2A (male) and P6 (female).

  • Psych OPD must be covered by at least 1 intern everyday.

Psychiatry – routine

  • Days begin at 8am sharp

  • MDT meetings every morning to present new admissions

  • The  Psychiatry OPD runs on everyday.

  • Every weekday an intern or registrar is assigned to cover the ward till 4pm.

  • From 4pm an intern and a MO will be on call.

  • Each intern gets a topic to present on a Friday.

helpful hints

  • The psychiatry rotation is enjoyable so use the time wisely.

  • Read up for all your cases before presenting at the MDT

Family medicine – structure

  • This rotation takes place over three months.

  • The rotation is divided as one month in casualty. One month in the clinics  and one in the wards and polyclinic.

  • All calls are done in the ED in this rotation

  • Days begin at 8 and end at 4pm

Family medicine – routine

  • Casualty

  • Starts at 8am to 4pm

  • Morning meetings for all family medicine interns daily at 8am in casualty

  • Wards and Polyclinic

  • Start with the ward round where short stay or level one patients are seen in ward 8 and 9

  • After the round you attend polyclinic till 4pm

Filling in forms

  • Paperwork forms a large portion of the work you will do

  • Filling In forms correctly saves time and improves efficiency of each task

  • Mandatory fields

  • 1.Patient details :first name and surname, hospital number, date of birth, sex and age

  • 2.Location: Hospital, Area (e.g. ward or clinic) and bed number (if inpatient)

  • 3.Drs’ details: initials, surname, IN number, contact (speed dial) and signature

Filling in forms

  • Before filling it in, make a photocopy of the form 10 A.

  • When filling in form 10A ensure that you use te full month as a duration e.g: 1/1/2018 – 31/4/2018 as opposed to 3/1/2018-29/4/2018.

  • DO NOT MAKE ANY CORRECTIONS TO THE FORM. That means don’t make your 9 and 8 or your I a T! they will reject your form.

  • Try to get your signatures at the end of each block to avoid stress later on. dont lose your logbook

pharmacy

  • OPD 1 pharmacy -  is used for in patients, casualty patients and poly. Clinic. This pharmacy is also responsible for dispensing to in patient TTO (blue box), and staff clinic

  • OPD 2 pharmacy – is used for specific out patient disciplines (SOPD, Peads OPD, MOPD,

  • You interact with them through the scripts you write

  • There are two types: bed charts and TTO (to take out medication)

Procedure :

  • Bed charts are for inpatients and kept in the ward file

  • Ensure that your name, degree and IN number are visible beneath your signature

  • A stamp is helpful

Procedure for TTO ‘ S:

  • Received from 8am to 12:pm everyday including weekends. On call requests are accepted to 2pm

  • No TTO will be issued without a discharge summary

  • Scheduled drugs require motivation (cosigned by MO)

radiology

Located next to casualty and provides the following services to inpatients and outpatients

 

  X-rays

  sonography

  CT scan

 

  • Bookings for all of the above are made here.

  • After hours services from 4pm – 8am on weekdays and weekends/ public holidays for all urgent services.

  •  There is no on sight radiologist. This means though imaging studies are done, no reports are issued with it (sent to private radiologists to access)

  •  Contrasted CT scans will not be done without a  normal UEC result that is less than 3  days old

  • If MRI is needed, telephonic bookings are made with the radiology department in Tshepong hospital

  •  Nuclear medicine scans at Chris Hani Baragwaneth Hospital (CHBAH)

  • Located next to new administration block

  • Provide services for chemistry, microbiology, histology, and cytology.

  • Histology sent to  Lancet laboratories via NHLS

  • Send specimen with fully completed form (patient details, hospital and ward, clinician details, tests being ordered)

  • Track specimen with barcodes (to be stuck on the specimen and in the file/patient notes)

  • Register with the NHLS to be able to track specimen and result

•Note:

  • Some tests will be rejected if an electronic gatekeeping code is not provided.

  • Some tests  take longer because they are done at a different lab ie VL/chromosomal studies/BMAT

Login : https://trakcarelabwebview.nhls.ac.za/trakcarelab/csp/logon.csp

-Username and password given once registered.

Blood bank(SANBS)

  • Located in the NHLS building.

  • Emergency blood in theatre for only extremely urgent cases

  • Make sure tube is not expired. THEY DO GET REJECTED.

  • Ensure that consent is done especially for patients who are unable to sign before relatives/guardians leaves

allied health

  • Includes Physiotherapists, Occupational therapists, Speech therapists  Dieticians and social workers.

  • Physiotherapy department: next to Thuthuzela, opposite new administration.

  • Occupational therapy: Ward 4

  • Speech/audiology: Ward 7

  • Dieticians : Ward 6B

  • Social Worker : OPD

  • Services available to inpatients and outpatients on request.

  • Can be accessed by filling out forms and dropping them off at respective sites.

transport

  • Transport department is located  at OPD.

  • Requests are

  • Unstable patients must be transported with Emergency medical services (EMS/ Ambulance)

  • Transfer forms and all other supporting documents must be prepared and placed in

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