DOH Administrative Order No. 2014-0018 implements the rules and regulations for Republic Act No. 10613, which increases the minimum bed capacity of the Zamboanga City Medical Center (ZCMC) from 250 to 500 beds. This expansion addresses the hospital's growing patient census, which has exceeded its original capacity, and aims to enhance healthcare services in the Zamboanga Peninsula. The order outlines policies for service expansion, human resources, infrastructure development, and quality management to ensure ZCMC operates effectively as a Level 3 General Hospital. It also details funding sources for the necessary capital investment and operational expenses related to this expansion. The order will take effect 15 days after publication in the official gazette.
May 29, 2014
DOH ADMINISTRATIVE ORDER NO. 2014-0018
| SUBJECT | : | Implementing Rules and Regulations of Republic Act No. 10613 "An Act Increasing the Minimum Bed Capacity of the Zamboanga City Medical Center from Two Hundred Fifty (250) to Five Hundred (500), Amending for the Purpose Section 2 of Republic Act No. 7272" |
I. Rationale/Background
The Zamboanga City Medical Center (ZCMC) has its origin as a simple dispensary known as Zamboanga General Hospital in 1918. Then in 1958, with the reorganization of the Department of Health (DOH) the hospital came to be known as Zamboanga Regional and Training Hospital and shortly thereafter, renamed as Zamboanga Regional Hospital.
On March 24, 1992 then President Corazon C. Aquino signed into law Republic Act No. 7272 converting the Zamboanga Regional Hospital into Zamboanga City Medical Center, which shall serve as the principal hospital facility of Region IX with a minimum bed capacity of two hundred fifty (250) under the jurisdiction of the DOH.
In January 2013, the ZCMC was licensed by the DOH and accredited by the Philippine Health Insurance Corporation (Philhealth) as a 300-bed capacity hospital. However, daily census of patients over the years has been increasing with bed occupancy rate ranging from 110-130% (330-390 inpatients per day), stretching the limits of available resources for ideal health care and compromising its efficiency.
On August 28, 2013, Republic Act 10613 was approved increasing the minimum bed capacity of ZCMC from two hundred fifty (250) to five hundred (500).
The ZCMC is the only Level 3 General Service Training and Teaching Hospital in Zamboanga Peninsula Region. It is the end referral hospital of 26 infirmaries, 31 level 1 hospitals, and 8 level 2 hospitals in the Region and the ARMM provinces of Basilan, Sulu and Tawi-Tawi. However, patients needing specialized care that are not available in ZCMC are referred to medical centers located in Davao, Cebu or Metro Manila.
With Department Order 2011-0188 "Kalusugan Pangkahalatan" Execution Plan and Implementation Arrangements", the ZCMC is mandated to provide universal health care through its hospital services by increasing the number of its health human resources, improving its infrastructures, and upgrading its capabilities in terms of expertise, instruments and equipment.
At present, mechanisms for service provision and training of health professionals are in place, however future development of ZCMC is strained by the limitations of physical facilities and human resources. Thus, pursuant to R.A. 10613, these Implementing Rules and Regulations (IRR) are set forth.
II. Objectives
This Administrative Order sets the Implementing Rules and Regulations for Republic Act No. 10613, "An Act Increasing the Minimum Bed Capacity of the Zamboanga City Medical Center from Two Hundred Fifty (250) to Five Hundred (500), Amending for the Purpose Section 2 of Republic Act No. 7272."
III. Definition of Terms/Acronyms
1. Act — refers here to Republic Act No. 10613 entitled "An Act Increasing the Minimum Bed Capacity of the Zamboanga City Medical Center from Two Hundred Fifty (250) to Five Hundred (500), Amending for the Purpose Section 2 of Republic Act No. 7272."
2. AO 2012-0012 — refers to the Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines dated 18 July 2012. STcHDC
3. Bed Capacity — refers to the number of beds made available for inpatient care.
4. Bed Occupancy Rate (BOR) — is the ratio of actual inpatient service days for a given period to the declared bed capacity of the hospital for the same period.
5. DBM — Department of Budget and Management.
6. Level 3 Hospital — refers to the DOH Classification of ZCMC as defined by AO 2012-0012.
7. Referral Hospital — refers to a health care institution capable of accepting referrals from lower level hospitals and render general and specialized health care services.
8. Medical Center — refers to a hospital staffed and equipped to care for many patients and a large number of kinds of diseases and dysfunctions using modern technology.
9. ZCMC — Refers to Zamboanga City Medical Center.
IV. Policies and Guidelines
A. General Policies
The ZCMC as a general, teaching and training hospital shall provide general health care services with a five hundred (500) bed capacity shall provide a tertiary level of curative, promotive, preventive and rehabilitative care fully equipped with all the necessary updated facilities, equipment and health human resource complement for a Level 3 General Hospital.
B. Implementing Guidelines
In support of RA 10613, the following guidelines shall be implemented:
1. Expansion of Services
The ZCMC shall operate as a Level 3 General Hospital with five hundred (500) bed-capacity medical center by the end of 2016 with additional sub-specialty services in Heart Surgery, Endoscopy, Nuclear Medicine, Magnetic Resonance Imaging, Interventional Radiology and Mammography.
2. Health Human Resource
The ZCMC shall continue to honor the positions, security of tenure and other rights of its human resources. It shall also make an evaluation of the existing health human resources and upgrade the positions and hire additional staff to comply and conform with DOH standards as per DBM-DOH Joint Circular No. 2013-1, "Revised Standards on Organizational Structure and Staffing Pattern of Government Hospitals, CY 2013 Edition" dated September 23, 2013.
3. Equipment
The ZCMC shall make an inventory of its existing hospital equipment and undertake upgrading to conform with the DOH minimum standards of a general hospital as provided for under DOH AO 2012-0012. Additional equipment and facilities that will complement the expansion of services shall be implemented.
4. Infrastructure
The ZCMC shall implement construction, repair and renovation of physical infrastructure to conform to all existing laws and licensing standards, and current international standards for hospital buildings in line with Hospitals Safe from Disasters Program, among others.
5. Systems Development
The ZCMC shall develop and sustain standards of hospital operations to provide quality patient care and safety of patients, clientele and personnel of the hospital. It shall implement an electronic information system conforming to the basic requirements of Integrated Hospital Operations and Management Program (IHOMP).
6. Quality Management
The ZCMC shall implement the quality management system in conformance with ISO 9001:2008 standards. The ZCMC shall enhance and improve Continuing Quality Improvement Program, Patient Safety, policies and standards provided by the DOH, the Philippine Health Insurance Corporation (PhilHealth) and other health standards provided by international health organizations which are supportive of existing local and national standards.
V. Implementing Structure
A. Administrative Control
The highest DOH designated official for Region IX and the ZCMC's Executive Committee shall have oversight jurisdiction over the hospital operations and management. The DOH Regional Office IX shall monitor the implementation of the Act guided by this Administrative Order.
The Medical Center Chief of ZCMC shall be accountable and responsible for the implementation of quality standard hospital operations and management and shall submit developmental and financial report to the DOH Central Office. TacADE
B. Source of Funds
The amount necessary to carry out the provisions of the Act shall be sourced out accordingly, as follows:
1. Capital investment for infrastructure and equipment shall be sourced from the DOH General Appropriations Act (GAA), hospital revenues, Philhealth reimbursements and other mode of financing scheme subject to prevailing government rules and regulations.
2. The additional Maintenance, Operating and Other Expenses (MOOE) resulting from the hospital expansion shall be sourced from the GAA, hospital revenues, Philhealth reimbursements and other sources.
3. Personal Services to carry out the full implementation of the approved hospital staffing pattern of a 500-bed capacity hospital shall be sourced from the GAA 2014 onwards as provided in DOH-DBM Joint Circular 2013-01 dated September 23, 2013.
4. Release of funds shall be approved by the designated appropriate authority.
VI. Repealing/Separability Clause
Provisions from previous issuances that are inconsistent or contrary to the provisions of this Order are hereby rescinded and modified accordingly.
If any provision of this Order is declared unauthorized or rendered invalid by any court of law or competent authority, those provisions not affected thereby shall remain valid and effective.
VII. Effectivity
This order shall take effect fifteen (15) days after publication in the Official Gazette or in at least two (2) newspapers of general circulation.
(SGD.) ENRIQUE T. ONA, MDSecretaryDepartment of Health
Published in The Philippine Star on July 15 and 16, 2014.