The PhilCAT Certification Self-assessment and Survey

Tool

PhilCAT CERTIFICATION STANDARDS

Survey Criterion Evidence of Progress and Achievements DOTS Surveyors' Comments Survey
Item Center
(Completed by TB DOTS Center) Team
Rating* Rating*
Goal The TB DOTS Center provides a safe and effective physical environment to its staff and patients.  
1. The TB DOTS center is Signages and signs are placed for easy access
easily located and to the center. EA
patients have convenient
and safe access to the
center.
This standard will be achieved when: 
1.1. There is appropriate Signages are placed to provide directions for
signage bearing the name easy access to the center. EA
of the TB DOTS center to
assist patients accessing
the center.
1.2. Physical access is The road to the center is spacious for easy
appropriate for the access EA
needs of patients.
1.3. Entrances and exits are
clearly marked and free  No parking sign is placed.
of  obstruction and other EA
hazardous conditions.
1.4. There are resources to
Daily and hourly schedules as well as the
inform patients of the
duration of the treatment are posted to ensure
daily and hourly
schedule of TB DOTS the quality of the service.
EA
services, ensure the
quality of
 patient waiting.

*Rating scale: 1
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM
(To be completed by sur vey team only. T he sur vey team must make comments on it ems where the survey team disagrees or parti all y disagrees with inf ormation pr ovided by the TB DOT

Goal: The TB DOTS Center provides a safe and effective physical environment to its staff and patients. Standard 1: The TB DOTS center is easily located and patients have conve

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 2
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*

GoalThe TB DOTS Center provides a safe and effective physical environment to its staff and patients
2.The TB DOTS CenterStructural and physical layout of the facility
provides facilities for the ensured the client‘s privacy and c omfort.  EA
comfort and privacy of  its patients and staff. 

This standard will be achieved when: 

2.1. The TB DOTS center
maintains a clean and
wholesome environment
within and immediately
outside its premises.
Housekeeping schedule is practiced to
maintain cleanliness.
EA

2.2
There are resources and Pamphlet and magazines are provided for
 processes to ensure the waiting patients. EA
quality of patient waiting.
2.3
The lighting in each area
The room is well ventilated and well lit for
of the center is
the patients comfort. EA
appropriate for the
assigned purpose of the
area.
2.4
The privacy of the staff-
Curtains are placed to provide privacy.
 patient encounter is
assured. EA

*Rating scale: 3
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM
(To be completed by sur vey team only. T he sur vey team must make comments on it ems where the survey team disagrees or part ial ly di sagrees wi th  inf ormation pr ovided by the TB DO

Goal: The TB DOTS Center provides a safe and effective physical environment to its staff and patients. Standard 2: The TB DOTS center provides for the privacy and comfort of

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 4
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*

Goal The TB DOTS Center provides a safe and effective physical environment to its staff and patients.
3. The TB DOTS center Proper procedures are strictly followed such EA
provides for the safety of  as hand washing, proper segregations of
its patients and staff.garbage and proper storage of drugs.
This standard will be achieved when: 
3.1 There is adequate clean water
Hand washing area is available inside the EA
for personal hygiene and center.
sanitation purposes.
3.2 The TB DOTS center  Hand washing and after care of the EA
maintains appropriate equipments are strictly followed to ensure
levels of cleanliness and quality service.
antisepsis of all physical
areas, equipment and
instruments.
3.3 General waste, sharps, Garbage cans are provided. They are EA
 pathological and  properly labelled for proper segregations.
infectious waste,
 pharmaceutical and
chemical wastes are
appropriately segregated,
safely handled and
disposed of according to
accepted safe disposal
 practices.
3.4 TB drugs are securely stored TB drugs are properly stored in the cabinets. EA
under appropriate
storage conditions.

*Rating scale: 5
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTS Surveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*
EA
3.5 Sputum and other body Sputum collection area is provided for the
fluids are collected in a safe and patient.
hygienic way. There are documented, disseminated and implemented procedures to identify and address the
risks of contamination of  staff and patients from
3.6 sources of infectious diseases. Flyers, pamphlets and posters are available EA
for further information about TB.

OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM

(To be completed by sur vey team only. T he sur vey team must make comments on it ems where the survey team disagrees or parti all y disagrees with inf ormation pr ovided by the TB DOT

Goal: The TB DOTS Center provides a safe and effective physical environment to its staff and patients. Standard 3: The TB DOTS center provides for the safety of its patients an

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 6
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool

PhilCAT CERTIFICATION STANDARDS

SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center Rating* Team Rating*

Goal Patients receive adequate and effective diagnostic and therapeutic ser vices at every phase of their management from screening for TB to
rehabilitation.
4. All patients undergo a Proper assessment is done by the physician EA
comprehensive assessment toand health education
facilitate is provided
the planning to the of treatment.
and delivery
 patient.

This standard will be achieved when: 

4.1 Appropriate professionals Staffs documented the relevant information EA
obtain and document the relevantregarding
history forpatient’s
each health.
 patient.

4.2 A physician completes The patient will undergo assessment by the EA

 physician.
and documents the relevant physical examination for each
 patient.

*Rating scale: 7
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM
(To be completed by sur vey team only. T he sur vey team must make comments on it ems where the survey team disagrees or parti all y disagrees with inf ormation pr ovided by the TB DOT

Goal: Patients receive adequate and effective diagnostic and therapeutic services at every phase of their management from screening for TB to rehabilitation.

Standard 4: Patients receive adequate and effective diagnostic and therapeutic services at every phase of their management from screening for TB to rehabilitation.

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 8
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool

PhilCAT CERTIFICATION STANDARDS

SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*

Goal: Patients receive adequate and effective diagnostic and therapeutic ser vices at every phase of their management from screening for TB to
rehabilitation.
5.All patients haveLaboratory with qualified and trainedEA
continuous access tomicroscopists are available for diagnostic
accurate and reliable TB  purposes.
diagnostic tests.
This standard will be achieved when: 
5.1 All patients undergo Qualified and trained microscopists are EA
sputum microscopy by a qualified and trained
available microscopist.
to examine the sputum collected.

5.1.1 The TB DOTS Procedures are being followed to ensure EA

reliable
center plans and implements policies andresults.
 procedures for assuring
the quality of sputum microscopy results.

5.1.2 If sputum Laboratory is available for the examination EA

of the sputum.
microscopy facilities are not available in the TB DOTS center, policies and procedures for referring patients to accessible centers are implemented and monitored for effectiveness.

*Rating scale: 9
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTS Surveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*
EA
5.1.3 External providers Laboratory results are being sent to the
of sputum microscopy are contracted based on
 policies and procedures
that include accreditation status and the presence of  quality control systems.

5.2 Policies and procedures Patients for X-ray examination are being EA
referred
for referring patients to accredited to accredited
and accessible X-ray
X-ray facilities
facilities such as
are implemented and monitored for effectiveness.
 NOPH.
Policies and procedures for referring Correct
patients procedures
to an and policies
appropriately are and accessible TB Diagnostic Committee are implemented and monitored for effectiveness.
constituted
 being followed.

5.3 Proper procedure in referring patients to EA

accessible TB Diagnostic Committee is being observed.

*Rating scale: 10
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM
(To be completed by sur vey team only. T he sur vey team must make comments on it ems where the sur vey team disagrees or parti all y disagrees wi th  inf ormation pr ovided by the TB D

Goal: Patients receive adequate and effective diagnostic and therapeutic services at every phase of their management from screening for TB to rehabilitation.
Standard 5: All patients have continuous access to accurate and reliable TB diagnostic tests.

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 11
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*

GoalPatients receive adequate and effective diagnostic and therapeutic services at every phase of their management from screening for TB to
rehabilitation.
6.A care plan is developed Treatment that is being implemented isEA
and followed for allaccording to the National TB program and
patients.these are documented properly.

This standard will be achieved when: 

6.1 All treatment is consistent  National Tuberculosis Program’s treatment is EA
with the National Tuberculosis Program guidelines.
strictly followed.
Flow charts of patient

Flow chart is being posted in order for the EA

6.2 management from entry to  patient to be aware of the treatment.
separation are used to facilitate quality care and are accessible to patients and staff.

6.3 DOTS partners are There is an assigned DOTS partner in each EA

selected and assigned TB patient. These DOTS partner ensures that the patient will follow the treatment regimen.
 based on predetermined criteria and procedures
and these are accessible to
 patients and staff.

*Rating scale: 12
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTS Surveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*
EA
6.4 Education is provided to Health teachings are provided by the staff to
all patients to help them understand theirhelp
further medical condition
the patient and prognosis
enhance and to encourage
his/her knowledge their
regarding the adherence to the
nature of the treatment
disease regimen
and how it canand health
be cured.
 promotion / illness
 prevention activities.
An appropriately comprehensive evaluation of the patient's clinical
 progress is made and documented at each visit.
Policies and procedures for detecting treatment defaulters and getting them back into treatment are implemented and monitored for effectiveness.

6.5 Follow up visits and check ups are being EA

done to evaluate the patient’s progress.
Proper documentation is observed.

6.6 Based on the records (TB registry), no EA

defaulters have been documented.

*Rating scale: 13
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM
(To be completed by sur vey team only. T he sur vey team must make comments on it ems where the survey team disagrees or parti all y disagrees with inf ormation pr ovided by the TB DOT

Goal: Patients receive adequate and effective diagnostic and therapeutic services at every phase of their management from screening for TB to rehabilitation.
Standard 6: A care plan is developed and followed for all patients.

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 14
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*

GoalPatients receive adequate and effective diagnostic and therapeutic services at every phase of their management from screening for TB to
rehabilitation.
7Patients have continuous TB drugs are being monitored and storedEA
access to safe and properly for safety administration.
effective anti-TB medications throughout the duration of their treatment.

This standard will be achieved when: 

7.1 The TB DOTS Center has Inventory report of the TB drugs is EA
developed and implemented policiesdocumented
and to assure that there is a continuous supply.
 procedures for assuring a
continuous supply of TB drugs to all its patients for the entire six months duration of therapy.
The TB DOTS center maintains an appropriate
 buffer stock of anti-TB
medications.
The TB DOTS Center has developed and implemented policies and
 procedures for assuring the Buffer stock of anti-TB drugs is always EA
quality and safety of its TB drugs.monitored to ensure there is always an available stock.

7.2
7.3 Drugs are properly stored and are being EA
checked for their expiration date.

*Rating scale: 15
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM
(To be completed by sur vey team only. T he survey team must mak e comments on i tems where the sur vey team disagrees or parti all y disagrees with  inf ormation pr ovided by the T

Goal: Patients receive adequate and effective diagnostic and therapeutic services at every phase of their management from screening for TB to rehabilitation.
Standard 7: Patients have continuous access to safe and effective anti-TB medications throughout the duration of their treatment.

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 16
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*

GoalThe management and staff adhere to clear and collaboratively developed policies and procedures for the efficient operation of the TB
DOTS center.
8. Policies and proceduresVision, mission, policies and procedures are EA
for providing care to being developed and are followed so that the
patients are developed,staffs will be guided.
disseminated, implemented and monitored for effectiveness.

This standard will be achieved when: 

8.1 The TB DOTS center's Staffs are aware of the vision and mission. EA
Thesewith
 policies and procedures are consistent are implemented and being
the organization's goals,followed.
statutory requirements, accepted standards, and the TB DOTS center's community responsibilities.
Policies and procedures for patient referral to other services are implemented and monitored for effectiveness.

Proper referral is being implemented. List of  EA

referral centers, addresses and contact
 persons is available.

8.2

*Rating scale: 17
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool

PhilCAT CERTIFICATION STANDARDS

SurveySurvey Item Survey Item Survey Survey Item Survey
Item Item Item
8.3 EA
Patient default rates are  No defaulters are being reported yet. But in case there is, it will be documented.
monitored and policies and
 procedures are developed and implemented to
improve default rates. The
 policies and procedures are monitored for  effectiveness.

8.4 Policies and procedures Policies and procedures are observed so t hat EA
for identifying and working witheach external
external group
groups are awareDOTS
in providing of theirservices
roles and
areresponsibilities.
developed, implemented and monitored for effectiveness.

*Rating scale: 18
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM
(To be completed by sur vey team only. T he sur vey team must make comments on it ems wher e the sur vey team disagrees or parti all y disagrees wit h  inf ormation pr ovided by the TB D

Goal: The management and staff adhere to clear and collaboratively developed policies and procedures for the efficient operation of the TB DOTS center.
Standard 8: Policies and procedures for providing care to patients are developed, disseminated, im plemented and monitored for effectiveness.

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 19
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*

GoalThe management and staff adhere to clear and collaboratively developed policies and procedures for the efficient operation of the TB
DOTS center.
9. Policies and proceduresRecords and reports were handled properly EA
for managing patientand securely to ensure consistency of t he
information areinformation.
developed, disseminated, implemented and monitored for effectiveness.

This standard will be achieved when: 

9.1 Each patient is uniquely Each patient has a case number which is EA
 beingthe
identified from entry and throughout recorded in the
course of  TB registry logbook. The case number is consistent with NTP treatment card and all related documents.
management.

9.2 The TB DOTS center  NTP forms are recorded properly, filled up EA
maintains a database of  correctly and is being updated with consistency.
 patient records and related registries and enables the
staff to easily access these databases.

9.3 Policies and procedures Records and reports are handled with EA
confidentiality
for ensuring the security and confidentiality of  and only authorized personnel are allowed to access.
 patient information are
developed, implemented and monitored for  effectiveness.

*Rating scale: 20
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTS Surveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*
EA
9.4 The TB DOTS center All the reports are submitted on time. The
staffs are
submits complete and accurate reports aware
to all of the
relevant deadlines.
agencies in a timely manner.
The TB DOTS center regularly reviews its records to assess and improve performance.

9.5 Staffs conduct meeting to improve and EA

review center performance.

*Rating scale: 21
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool

OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM

(To be completed by sur vey team only. T he sur vey team must make comments on it ems where th e sur vey team disagrees or par tial ly di sagrees wit h inf ormation pr ovided by the TB DO

Goal: The management and staff adhere to clear and collaboratively developed policies and procedures for the efficient operation of the TB DOTS center.
Standard 9: Policies and procedures for m anaging patient information are developed, disseminated, implemented and monitored f or effectiveness.

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 22
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool

PhilCAT CERTIFICATION STANDARDS

SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center Rating* Team Rating*

Goal The TB DOTS center staff provide efficient and competent DOTS services.
10. Staffs undergo trainings and seminars to EA
The TB DOTS Center
 provide personnel
has an adequate number of qualified quality careskilled
to TB patients.
in providing DOTS services.

This standard will be achieved when: 

10.1 An adequate number of The center is equipped of well trained staff EA
qualified and appropriately (physicians, nurse, midwives and
trained personnel provide microscopist).
and are accountable for the
following functions:
10.1.1 Leadership, City Health Officer is available for EA
management and overall leadership management of the center.
responsibility for the
operations, resources and
 performance of the TB
DOTS center
10.1.2 Clinical patient care  Nurses are capable of providing care to the EA
services  patient.
10.1.3 Diagnostic services, Trained medical technologist is capable of EA
including sputum  performing diagnostic services.
microscopy
10.1.4 Drug management Staffs instruct patients in drug administration EA
*Rating scale: 23
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
PhilCAT CERTIFICATION STANDARDS
SurveyCriterion Evidence of Progress and Achievements DOTSSurveyors' Comments Survey
Item (Completed by TB DOTS Center) Center  Rating* Team Rating*

and DOTS partner as well as in monitoring

 patient’s compliance.
10.1.5 Information Staffs observe confidentiality of patient’s EA
management record.

10.1.6 Financial Staffs do have monthly salary for their EA

management services.
A written
Personnel follow clear job descriptions, job description
responsibilities is accountabilities.
and being signed by each staffs.
10.2 EA
All personnel are responsible for safety in the workplace and the quality of the service they deliver.
Personnel receive up to date training based on training needs assessment.

10.3 Staffs are aware and follow procedure in EA

infection control.

10.4 Certificates are available as proof of the EA

training and seminars joined by the staff.

*Rating scale: 24
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.
 The PhilCAT Certification Self-assessment and Survey
Tool
OVERALL RATING AND COMMENTS, COMMENDATIONS AND RECOMMENDATIONS BY SURVEY TEAM
(To be completed by sur vey team only. T he sur vey team must make comments on it ems where the survey team disagrees or parti all y disagrees with inf ormation pr ovided by the TB DOT

Goal: The TB DOTS center staff provide efficient and competent DOTS services.
Standard 10: The TB DOTS Center has an adequate number of qualified personnel skilled i n providing DOTS services.

Rating (please tick appropriate overall rating for this standard)

Non- Achievement Low Achievement Moderate Achievement Extensive Achievement

*Rating scale: 25
1.  Non Achievement - The requirements of standard / criterion are not met.
2.  Low Achievement  - The requirements of standard / criterion are scarcely met
3.  Moderate Achievement - The requirements of the standard / criterion are generally met in most circumstances.
4.  Extensive Achievement - The requirements of the standard / criterion are fully met in the majority of circumstances and have been for some time.