Professional Documents
Culture Documents
BY
RACHAEL KATHAMBI
ADMNO: GTI/HCA/RK/1104/2023
DECRALATION
I hereby declare this is my original work and has not been submitted to any other examination body. No part of
this report should be produced without my concert or that of GoCare Training Institute
Name……………………………………………….Sign………………………..Date………………………..
Supervisor…………………………………………..Sign………………………..Date………………………..
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ACKNOWLEDGEMENT
For the period I have been to Jumuia Hospital Huruma, I would like the following individuals and groups for
the respective help they have done to me. First I would like to thank the Jumuia Hospital Huruma general
administration for allowing us undergo the field attachment in their facility being led by medical superintendent,
also the administration for the recognition they have given to the students studying in the hospital. Finally I
would like to acknowledge the support from my family for her generous funding to make sure am comfortable
at the hospital at the time it was appropriate and her utmost concern to make sure that the entire attachment was
successful. Above all, I thank the Lord Almighty for the divine protection, guidance and the opportunity of a
memorable and fruitful period at Jumuia Hospital Huruma
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ABSTRACT
My report covers different activities in different sections and departments which I all attended and gained new
skills.
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ABBREVIATION USED
MOA- Mode of Admission
DOD-Date Of Discharge
DOA-Date Of Admission
OP-Outpatient
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FP-Family Planning
CTX- Cortrimoxazole
Table of Contents
DECRALATION.................................................................................................................................................2
ACKNOWLEDGEMENT...................................................................................................................................3
ABSTRACT.........................................................................................................................................................4
ABBREVIATION USED....................................................................................................................................5
CHAPTER ONE: INTRODUCTION......................................................................................................................7
1.1. Historical Background of Jumuia Hospital Huruma.............................................................................7
1.2. Main Functions or core activities of Jumuia Hospital...........................................................................7
1.3. Mission, Vision statement and core values of the institution................................................................7
1.4. Orgizational structure of Jumuia Hospital.............................................................................................8
1.5. Duties and responsibilities of the key personnel in the organization....................................................9
CHAPTER TWO: HOST ATTACHMENT DEPARTMENT..............................................................................10
2.1. Key functions / Activities of the department.......................................................................................10
2.2. Staff establishment of the department in terms of the number of employees and their duties and
responsibilities................................................................................................................................................14
Functions........................................................................................................................................................16
activities..........................................................................................................................................................16
Tools used.......................................................................................................................................................17
2.3. Student Main objectives for the attachment Exercise.........................................................................18
2.4. Attaché’s assigned routine duties and department’s participation forums..........................................18
CHAPTER THREE: EVALUATION OF THE ATTACHMENT PERIOD........................................................19
3.1. Success/Failure of the attachment exercise vis-à-vis Student main objectives...................................19
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3.2. Challenges encountered by the student during the attachment period................................................19
3.3. How Challenges were Overcomed/solved..........................................................................................19
3.4. Recommendations...............................................................................................................................19
3.5. Conclusion...........................................................................................................................................19
BIBLIOGRAPHY/ REFERENCES......................................................................................................................20
Jumuia provides unique value, attention and care to the patients. Our quest for better health and high-quality
care is our driving force. At Jumuia, we are focusing to provide high quality patient care and enhance quality of
life for all, through research and awareness, and we do it irrespective of race, creed or ethnic origin.
I – Integrity
C – Compassion
A – Accessibility
R – Respect
E – Excellence
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1.5. Duties and responsibilities of the key personnel in the organization.
Recording Medical History and symptoms.
Administering medications and treatments.
Collaborating with teams for patient care.
Performing diagnostics test.
Conducting vesical examinations.
Monitoring patient’s health.
Provide support and advice to patients.
Operate medical equipment’s.
Educating patients about how to manage illness.
Advocating for the health and well-being of patients.
Providing basic bedside care.
Maintain inventory
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CHAPTER TWO: HOST ATTACHMENT DEPARTMENT
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Do coding of diseases
Indexing of the coded files
Retrieve patient files when they are needed
Filing of the patient files
Compiling of monthly, quarterly and annually statistics
Provide data for research when they are needed.
Teaching students on attachment.
Creation of master index cards
Designing of medical forms
c. Causality/Emergency department
At this station, it acts as the reception for the people who are in emergency conditions. It also acts as the
reception for the inpatient clients. The registration and admissions of the patients is the main activities that take
place here. The admission is done using EMR for the new admissions and readmissions. Readmission is done
for those given patients have come for another admission and that means previously have been admitted in the
same facility. The software used in the EMR in admission is called Check Health Information System (CHIS).
When admitting a patient, the details of the patient are captured into the Inpatient Register (MOH 305). The
details include the patient number, full names, residents, the person who brought the patient and the ward
admitted.
The patient is generated by numerical way of listing patients as the way they get admitted, the patient being
admitted is given a unique identifying number to the next previous patient in the ascending order. The patient
there for is given the Inpatient Card, whereby in case of a readmission, the particular patient should show the
card the Health Records officer to avoid forgetting in case it happens.
Duties of health records officers at casualty include
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Teaching students on attachment
Filing patients notes
Issuing of files to patients
Registering patients
Retrieving and tracing of patient files
Birth notification
Filing back patient files
Doing file search for research
d. Outpatient Department
It acts as the reception for outpatient patients. The outpatient department deals with those patients who come
treatment for just a while and go back home. Here the patient is received and given the direction on how he is
going to receive the treatment
Outpatient management
Click on GOK, revenue code its records department to specify where you are billing from for accountability.
Enter the patient OP number on the receipt that has been registered with….. then get charges on either request
form that has been given by the doctor or prescription that has been written on the paper that the patient has just
come with, click on the search services and enter the request services.
At a time when the doctor sends the charges and it reflects immediately the patient no is entered… you click on
the respective services and you bill as you give the receipt out.
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Patient registration
There is creating new patient file- for the first visit and here the patient has to pay ksh.70 for the registration.
This is for the first time for the patient’s name to be entered into the system. The information about the patient
is entered into the system and the receipt printed out. The information about the payments reflects to the
doctor’s systems.
Revisit
For those who have ever come to the facility and their names are reflecting in the system. Here the patient only
pays ksh.50 for the visit. All his or her information is captured from the system and is displayed.
a) Outpatient (over 5) Register MOH 204B – this register is for registering all patient over 5 years who
visit the hospital through the section. Their number is generated separately.
b) Outpatient (under 5) Register MOH 204A- this register is for registering all patients who are less than 5
years of age. There outpatient numbers are generated separately.
The registers are not commonly used nowadays due to electronic registration using EMR. The system has all
information required from the patient captured and the patient given an outpatient appointment card which
carries the OP number of the patient, names and location. The card helps the patient in case of revisit to be
traced in the system easily.
1.2. Staff establishment of the department in terms of the number of employees and their duties and
responsibilities
A. Comprehensive care Centre (CCC)
CCC is a clinic on it’s on and is managed as any health facility. At this station. Clients are received from
different entries after having been diagnosed or tested positive. These entries include; PMTCT, IPAD, TB
clinic, OPD, VCT, IPDCh. There are several clients who are also transferred in from different facilities in the
count. The patients at this station they are enrolled onto either CTX or ARVs as per the level of CD4 counts in
the body. The type of filing system that is used in this section is straight numerical for the patients who started
ART with the facility, for the transferred in they are filed alphanumerically.
Health records that work in the CCC must operate under bound laws to make sure the information about any
patient cannot be exposed to any outsider. This law of conduct includes;
1) Confidentiality- it involves the privacy of the clients and the information they having.
2) Discipline- this is a code of conduct of behaving well before other staff, patients and to other students.
3) Communication- it refers to the transmission of information from one person to another. It can be within
the department or from the top management and it carries different information as per to the chain of
command.
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4) Security- the information about the patient should be handled under a high security, the information
should never be interfered with in any manner.
5) Disclosure- the patient of the patient is not supposed to be disclosed to any person since it can be used as
a weapon against that person. But due some circumstances the information is disclosed out;
By court order
Patient’s consent
Safeguard the interest of the hospital or for the doctor
Transfer of information between authorized health agencies
Disclosure for higher duties of outbreak of diseases or side effect.
6) Ownership- the records used belong to the hospital but they normally carried by patients during every
time of revisit.
It is in CCC that we learnt tools used to collect and how data is collected. The tools used to collect data are,
daily activity register MOH 366, MOH 731, MOH728, Pre-ART Register MOH 361A, ART register MOH
361B.
In patient files there is a blue card (MOH 257) which we extract information that we use for tallying in the DAR
Register. The totals from DAR are transferred to Monthly Tally Sheet MOH 728 and finally it is reported into
MOH 731.
MOH 361A is used to show all the patients that have enrolled into care including those transferred in. while
MOH 361B is used to update the conditions of the patients who enrolled to ART up to when these patients die,
transferred out and lost to follow.
Analysis and interpretation of data
I learnt about ways and presentation of data, these were; pie charts, line graph, tables and histograms.
Tools used in ccc
They include the following;
Pre-ART Register MOH 361A
ART Register MOH 361B
Daily Activity Register MOH 366
Monthly Activity Sheet MOH 728
Patent Appointment card MOH 258
CCC Patient Card MOH 257
Functions of health records and information officers
a) Booking clients for every next revisit
b) Retrieval of files
c) Tallying daily Register and combining daily report
d) Filing back
e) Giving direction to clients
f) Updating and initiation of ART Registers
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g) Making of daily calendars
h) Registration of clients into EMR
i) Enrollment of patients and generating unique numbers
Tracing back patients records
j) Sorting files
k) Checking for misfiling
l) Recording of viral loads and CD4 results
Activities done by health records and information managers
a) relating and handling of clients
b) to keep the records that belong to the patients
c) maintaining confidentiality of the patient’s information
d) booking appointments dates for patients
e) understanding the terms used in the CCC
f) understanding the tracing system used
g) understand the tools used in the CCC
h) understand the filing system used and the ethics used in records
i) making the daily reports
B. Central Records/Library.
Central records act as the central library for records for the patients. After discharge, patients’ files are collected
and brought here, through a series of activities are stored here. Files are collected from different wards. When
files are picked from any given ward after discharge, the files are captured in the MOH 361 to show that they
have been dispatched to the central records for storage.
At this station, I learnt about coding and indexing of diseases. Coding is the assigning alphanumeric value to a
disease or a condition. There are three ICD 10 books that are used for coding;
I. volume 1(tabular list) -this one is used for confirming codes
II. volume 2(instruction manual)-this book is used for providing guidelines
III. Volume 3(alphabetical index)- this is used for coding. And has three sections (section 1, section 2 and
section 3)
There are established steps for coding diseases. These are;
(a) Identify the type of condition to be coded and refer to the appropriate section to be coded i.e. section 1,
section 2 or section 3.
(b) Locate the lead term. Lead term is always a noun for pathological conditions.
(c) Read and be guided by any notes that appear under the lead term.
(d) Read any term enclosed in the parenthesis after the lead term.
(e) Follow carefully any cross-references found in the index (see this and this).
(f) Refer to the tabular list to verify the suitability of the code selected.
(g) Be guided by any inclusion r exclusion terms under the selected codes or under the chapter, block or
category heading.
(h) Finally, assign the code.
Functions
(a) Receiving files from wards
(b) Coding and indexing
(c) Sorting of files
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(d) Filing
(e) Retrieving of patients files when need arise
(f) Tracing of patients files
(g) Checking of misfiling
(h) Issuing of burial permit
activities
Sorting files as per the last two terminal digits
Filing back
Tracing the file incase its missing from the library
Retrieving the files for readmission of the patient
Coding
Tools used
Computer- the computer is used to capture the received the files, the name, conditions and the wards
from which the files are coming from.
ICD 10 Books; vol 1 and 3- these are used for coding
Tracer book- it is used to follow up a given file that was taken ou the central records section to other
places such as wards and by who took it.
Diagnostic disease index card- index cards are used to monitor the disease trends, that’s is there is
outbreak of a given condition, pandemics, epidemics and endemic conditions in the population
catchment of the locality served by the hospital.
C. Maternity
This section is only for women. Most of them come to deliver and others for pregnancy checkups. In maternity
there are units of file collection, these are; antenatal ward, postnatal ward and new born unit. During collection
of files, they are written in the dispatch book and received at the records department.
Functions
Tools used;
Computer-for checking patient name, IP numbers or OP numbers just in case the patient doesn’t
remember.
Patients’ cards- which has got patient information as per the clinic and the booking dates.
Tracer book- for locating files that has left out to other sections of the hospital.
Activities
Booking of clients for the next clinic
Retrieving of patient file to be taken to the doctors
Filing back
Tracing of patient files
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CHAPTER THREE: EVALUATION OF THE ATTACHMENT PERIOD
1.9. Conclusion
Despite the above challenges, we undertook our attachment and came out successful. We recommend
other students to come for attachment at KCGH, work hard and be disciplined
Summary of Attachment Report:
During my attachment period at the KCGH I had the opportunity to
gain valuable experiences and knowledge in strategic management. The attachment provided me
with insight into different fields of strategic management and allowed me to develop various
skills that are essential for a successful career in this area. One of the main experiences I gained
during my attachment was being exposed to the practical application of strategic management
concepts in a real-world setting. I was assigned various tasks and projects related to strategic
planning, risk management, and innovation. This allowed me to understand the importance of
aligning organizational goals with strategic initiatives and the need for effective risk assessment
and mitigation strategies in a dynamic business environment. Additionally, I had the chance to
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BIBLIOGRAPHY/ REFERENCES
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