Each day, I spend a lot of time directing patient at the Out Patient Department (OPD). I haven’t yet become tired of doing so but it looks like every patient seems to get confused at a point in time at the OPD. The problem is usually not about directions but ‘where to go from where.’
The OPD has several units operating under it. Talk of the medical records unit, triage, consulting room, pharmacy, laboratory and other ancillary units such as the physiotherapy and the diet therapy unit. This cluster of units sometimes make accessing healthcare at the OPD an uncomfortable activity. This week, I want to give you a ride at the OPD and tell you all you need to know when it comes to accessing healthcare at the OPD. I hope you will enjoy the ride…
RECEPTION / ENQUIRIES UNIT
A lot of hospitals especially the private facilities have a Reception or the Enquiries unit. This is where one can get all the information about specialist bookings and appointments, the hospital’s operation hours, the kind of services they provide and even information about the first point of contact when you want to seek for healthcare. If this unit is available, they are usually situated nearer to the entrance of the OPD or at a point where they can be easily identified from the entrance. As a new client in the hospital, if you see this unit, do not pass by it. Get all the information you need before you get stranded at the OPD.
MEDICAL RECORDS UNIT
At times, you may find yourself in a health facility without a reception. In this case, you have to look for the Medical Records unit (mostly referred to as ‘Records’). This is where you will be registered and assigned a hospital number. Your name, date of birth, sex, place of birth, place of residence, next of kin and other relevant information may be collected to complete the registration process. A folder will then be prepared for you – this is a booklet where all your medical information will be recorded.
You may be asked to pay some amount of money. For a new client, this money usually covers your Registrationin the hospital (which include the cost of the booklet) and Consultationwith the doctors and nurses. A client who has already registered with the hospital (anyone who has visited the hospital more than ones become an automatic registered member of the hospital) may pay an amount that covers only consultation.
A small card will then be issued to you bearing the name of the hospital, your name and registration/hospital number. You have to show this card to the Medical Records personnel anytime you visit the hospital. If not it will be assumed that you’ve not been to the hospital before and therefore will have to start the whole process again.
Also remember that the Registration/Hospital number is very important. It helps the Medical Records Unit to retrieve your medical records or folder on your next visit. Without it, your past medical records that the doctor may need to make a definite diagnosis for your current condition will not be available. It is therefore prudent to copy the number in a diary, on your phone or any easily accessible place.
CASH OFFICE / ACCOUNTS
The Registration cum Consultation fee (which is commonly referred to as Folder fee) is paid at the Cash Office/ Account. In some decentralized health facilities, each unit is mandated to collect and issue receipts for monies collected. Remember to collect official receipt for any payments in the hospital and seek for convincing explanation for payments that do not attract any official receipt. If not you can seek for clarification from the hospital administrator or write to the hospital later for clarification.
From the Cash Office, one may be required to send the receipts to the Records Units for clearance. Do not leave your receipts with them. Every receipt issued at the hospital is your personal receipt and you will be given a double receipt if the Records unit may need to keep one. Do not also forget to ask the personnel at the records unit to direct you to your next unit.
NURSES TABLE / TRIAGE UNIT
In most hospitals, from the Medical Records unit, one may be asked to go to the Nurse’s table where some medical information will be obtained from him/her. The nurse may record your body temperature, blood pressure, pulse (a measure of your heart beat) and breathing rate. Others such as your body weight and height, blood sugar level and blood oxygen saturation (SPO2) may also be taken depending on the signs and symptoms you are presenting. The nurse may also ask and record your complaints or health problems too.
At times, the nurse can give you some first aid interventions before seeing the doctor. For instance, they can give you a drug to bring down your body temperature if it is too high.
This unit is also called the Triage Unit. The nurse will use the information obtained from you to group you among other patients according to the level of severity of your illness. Those who are very sick may be asked to see the doctor first. This decision is solely based on the professional discretion of the nurse and not on the patient. This is one of the reasons why seeing the doctor in a hospital does not always follow the first-come first-served principle.
From the Triage unit, the nurse may ask you to join a queue that leads to a consulting room.
The Consulting Room is where you get to interacts with a medical practitioner or a doctor. The doctor will ask for your complaints or health problems and in addition to the one recorded in your folder by the triage nurse, ask you some series of questions. This helps him/her to get a better understanding of your condition.
He can also make a physical examination of the affected part of the body or on the whole body. For instance, he can examine your ear with an otoscope or listen to your heart beat with a stethoscope. Consulting room procedures are usually less painful or not painful at all.
At times, in order to make a definite diagnosis from the health problems you are presenting with, the doctor may request for laboratory investigations. This may require you go to a medical laboratory, ultrasound unit or radiology unit for the requested investigations to be done.
Treatment usually commences after the results for the laboratory investigations are ready. In some cases too, the doctor may start prior treatments whiles waiting for the laboratory results.
Treatments could be in the form of drugs, lifestyle modifications or changes in dietary habits. The doctor may also refer you to a specialist such as an eye specialist, dentist, gynaecologist or to another unit such as the physiotherapy and diet therapy unit.
In recent times, it is more likely to end up in a clinical laboratory after the consulting room for requested investigations to be done. At the laboratory, one may be ask to pay for the investigations requested. This can be done either in the lab (if mandated by the clinic) or at the Cash Office. Do not forget to collect a valid receipt for all payments.
Depending on the type of investigations requested by the doctor, one may be asked to produce a sample. The sample can be in the form of blood, urine, stool, sputum (phlegm), and swab from your wound or vagina. The laboratory technician will give you clear instructions on how to take the sample or will assist you to take the sample.
You can be asked to return the next morning for the sample to be taken or for the investigation to be done because that investigation may require some special preparation. For instance, you may be asked to return the next morning on an empty stomach for a Fasting Blood Sugar (FBC) to be checked.
Remember to observe all instructions given by the laboratory technician prior to the investigation and ask for clarification if you don’t understand anything. This will help them to get you an accurate result for proper assessment of your condition.
Laboratory investigations may take from few minutes to several days; possibly a week or more for the results to be ready. The laboratory technician will give you the exact time you are to come for your result.
PHARMACY / DISPENSARY
This is the place where drugs are given out. Most patients who visit the OPD end up in the pharmacy. You may be asked to pay for the drugs either at the pharmacy (that is if mandated to do so) or at the Cash office. Do not forget to take a receipt for any payment done.
You may be required to send a small sheet called prescription form to the pharmacy. The pharmacist will serve your drugs accordingly as prescribed by the doctor. Also, he/she will give you information on the drugs served. He will tell you the number of capsules or tablets or amounts you are to take at a time, the number of times you are to take the drug in a day and also the duration of the treatment.
He/she will also give you information on the side effect of the drugs and whether you are to take it before or after meals. Other relevant information pertaining to the drugs will be given too. You can ask questions if you do not understand anything. The pharmacist will refer you to the treatment room if the drugs include injectable preparations.
This is the place where minor outpatient procedures such as injections, wound dressing, suturing of wound and ear washing are done. It is sometimes referred to as the Injection Room. All procedures done there are also charged and paid at Cash office.
We’ve come to the end of our tour at the OPD. I hope you enjoyed it!
Written By Assandoh-Mensah Prince