TITLE: Ambulance ServiceCRH SIKKIMMANIPALUNIVERSITY DOCUMENT NO:

REVISION NO: 00CENTRAL REFERRAL HOSPITAL - SMIMSHi i > ^

REVISION DATE: (?0

DocumentedProcedure

61VERSION NO.ISSUE/EFFECTIVE DATE: ^o'V,

PAGE NO: OJ~±cll ■

DOCUMENT CONTROL STATUS: HAtTeg'- <^^7

Standard Operating

Procedure

Ambulance service

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TITLE: Ambulance ServiceDOCUMENT NO:

REVISION NO: & 6

REVISION DATE: (9 O

DocumentedProcedure

VERSION NO. 0 IISSUE/EFFECTIVE DATE: 3j?TV\ 7PAGE NO: D\ tD\\

DOCUMENT CONTROL STATUS: HACTC^CeTf

SL Contents Page No.No.

•T Abbreviations and Definitions 3

Abbreviations1.1. 3

Definition1.2. 3

Expected Outcome1.3. 3

Objective/Purpose1.4. 3

2 Scope 4

3 Process - Flow chart 5-6

4 Responsibility a. Ambulance for in patient.b. Ambulance for outpatient.

7-11

Records5 11

References6 11

Nefficai ^L^rintendont

CerVral R^errai Hospital T: •ono O:.

Appw?v5cl?filvi: DPPrepared By Reviewed ByAI1 information in this document is confidential and property of M/s Central Referral Hospital, Gangtok. Reproduction in any form either in pari or full to be done only with written permission.

TITLE: Ambulance Service(TO CRHvS

SIKKIMMANIPALUNIVERSITY DOCUMENT NO: &Op[ 14

REVISION NO:CENTRAL REFERRAL HOSPITAL - SMIMS o oREVISION DATE: & &

DocumentedProcedure

VERSION NO. O)

ISSUE/EFFECTIVE DATE:

PAGE NO: O \ \ IDOCUMENT CONTROL STATUS: HA^TeG»py

1. ABBREVIATIONS AND DEFINITIONS

1.1 Abbreviations

PCR Patient Care Report

Central Referral HospitalCRH

Personal Protective EquipmentPPE

Assistant Director of Nursing ServiceADNS

CPR Cardio Pulmonary Resuscitation

1.2 Definitions

Ambulance: An ambulance is a vehicle for transportation, from or between places of

treatment, and in some instances will also provide out of hospital medical care to the

patient.

1.3 Expected Outcome

> The ambulance should be ready within 15-20 minutes after receiving the call.> The ambulance service provides 24*7 hours.

1.4 Objective/Purpose

This document provides guidance to facilitate planningnfor and execution of patient transfer

at CRH, Gangtok and the ambulance facility. /

Reviewed By oQ P

All information in this document is confidential and property of M/s Central ReferStts^aTangto^!'Reproduction in any form, either in part or full to be done only with written permission.

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CfeCRH TITLE: Ambulance ServiceSIKKIMMANIPALUNIVERSITY l<14DOCUMENT NO:

REVISION NO:fJlR F. I) ' CENTRAL REFERRAL HOSPITAL - SMIMS OO

REVISION DATE: <90

DocumentedProcedure

D IVERSION NO.

ISSUE/EFFECTIVE DATE: ^Jb ^

o\ tT> \\PAGE NO:

DOCUMENT CONTROL STATUS: nAne^2 SCOPE

Information is presented in a chronological format and is provided at a level of detail that will

afford management authorities the flexibility to develop procedures that are suitable for proper

functioning and optimum utilization of ambulance services.

3 PROCESS

It is a two-way process flow-:

3.1 Receiving the patient from the outside of the hospital (out patient service).

3.2 Transferring the patient to their home or other places who were admitted in the hospital

(in patient service).

/

•c..ntr^ Referral Hp^P^________i&iriftp___

All information in this document is confidential and property of M/s Central Referral Hospital, Gangtok. Reproduction in any form, either in part orfull to be done only with written permission.____________________

ah Df. GSledi

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TITLE: Ambulance ServiceCg? CRH SIKKIMMANIPALUNIVERSITY Iccp\ &[ atDOCUMENT NO:

REVISION NO:CENTRAL REFERRAL HOSPITAL - SMIMS €>&

REVISION DATE: po

DocumentedProcedure

VERSION NO. O 1ISSUE/EFFECTIVE DATE: ^

PAGE NO: 0\ +V \\

DOCUMENT CONTROL STATUS:

Flow chart

Out patient

Caller / Public Call from other Hosoitals

If the patent is infected permission to be taken from higher authorityReceive call by Nursing supervisor

Nursing supervisor inform the billing section & inform/arrange the brother for ambulance

The billing department inform the driver/ambulance transport in charge

The brother & driver check the ambulance

Send the ambulance for receiving the patientNo further process to be

follow

Billing done for the ambulance

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Prepared By Reviewed By Approved ByAll information in this document is confidential and property of M/s Central Referral Hospital. Gangtok Reproduction in any form, either in part orfull to be done only with written permission.____________________________

m crhStvCENTRAL REFERRAL HOSPITAL - SMIMS

TITLE: Ambulance Service

&OP 1<X^ICDV[ 24DOCUMENT NO:REVISION NO: OVREVISION DATE: GO

DocumentedProcedure

VERSION NO. O |ISSUE/EFFECTIVE DATE: F^lc

01PAGE NO:DOCUMENT CONTROL STATUS:

In patient

W/IC inform ADNS (Nursing station)

W/IC passing the information to billing

The ADNS inform/arrange the brother & billing Dept.

The billing department inform the driver/ambulance transport in charge

Billing as per the requirement & category of vehicle

Check bill by brother and ambulance driver & process for transport

The brother & driver check the ambulance

Ambulance leave

Di fuev. iriptendent

r^ftnin DReviewed By 5'^prW^fYGxTgt 0 I_____________________________________________ vWi’i^ - 73 7^All information in this document is confidential and property of M/s Central Referral Hospital, Gangt^Krfull to be done only with written permission.

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Reproduction in any form, either in part or

TITLE: Ambulance Serviceif) CRH SIKKIM MANIPAL UNIVERSITY

CENTRAL REFERRAL HOSPITAL - SMIMS

DOCUMENT NO:REVISION NO:v.~< OoREVISION DATE:

DocumentedProcedure

VERSION NO. O \

ISSUE/EFFECTIVE DATE:PAGE NO: Ol ^

DOCUMENT CONTROL STATUS: MAije R.

A. AMBULANCE FOR IN PATIENT

4.a RESPONSIBILITIES

4.a.l Nursing staff:

4.a.1.1 Ward in charge:

1. When the patient party ask for ambulance, the ward in charge informs to the nursing

office/ADNS.

2. Ward in charge communicate to the ADNS whether the patient is ambulatory or non­

ambulatory.

3. Determine the need for nursing brother during transport to and fro from Central

Referral Hospital.

4.a.1.2 ADNS:

ADNS informs the billing section and call/arrange the brother as required by the

patient/patient party.

asps™,Centra! Referral Ho?

. U2 1Prepared By Reviewed ByAN information in this document is confidential and property of M/s Central Referral Hospital, Gangtok. Reproduction in any form either in part or full to be done only with written permission.__________

TITLE: Ambulance ServiceSIKKIMMANIPALUNIVERSITY#CRH

’ CENTRAL REFERRAL HOSPITAL - SM1MS

DOCUMENT NO:

REVISION NO:/7*ri> is'' ObREVISION DATE: OO

DocumentedProcedure

VERSION NO. o\ISSUE/EFFECTIVE DATE: VcJq

PAGE NO: 0\ ^V\\

DOCUMENT CONTROL STATUS:

4.a.2 Billing Section:

1) Inform all the charges of ambulance to the patient party.

2) Billing Dept, ask the patient party, if they required brother to accompany patient during

transfer or not.

3) Communicate the ambulance transport in charge and the driver.

4) Collection of ambulance charges.

4.a.3 Accompanying Paramedical (Nursing Brother):

1. Conduct brief patient assessment to determine patient's stability.

2. Verify patient management steps have been taken to facilitate event-free transport.

3. Provide CPR to the patient in emergency.

4. Ambulance personnel have use appropriate personal protective equipment (PPE) when

required.

5. After returning, the brother checks the ambulance (medicine, equipment, oxygen cylinder

etc.) for the next trip.

6. To communicate the billing Dept, about the ambulance charges after delivery of patent

in CRH.

. Qsutarn Deyerintende nt inpfifHosF ital

S^Ntile, Tacfong, Gangtok

WfevSii1? DP

A#01 Cen

Prepared By Reviewed ByAll information in this document is confidential and property of M/s Central Referral Hospital, Gangtok. Reproduction in any form, either in part or full to be done only with written permission._________________________________________________________________________________

TITLE: Ambulance ServiceSIKKIMMANIPALUNIVERSITYI® CRH

'X CENTRAL REFERRAL HOSPITAL - SMIMS

DOCUMENT NO:

REVISION NO: DO"Irfm ^

REVISION DATE: 0O

DocumentedProcedure

VERSION NO. 0\ISSUE/EFFECTIVE DATE: 10 "VV, f^'oK^CULLj OX'

PAGE NO: Ol ll

DOCUMENT CONTROL STATUS: CoH

4.a.4 Ambulance in charge:

The ambulance in charge should check the ambulance in every alternative day and

maintain the equipment, medicine check list.r

4.a.6 Security officer:

Security has to manages the traffic, when the ambulance reached the hospital.

4.a.7 Ambulance Driver:

1. The driver has to check the ambulance in daily basis and recheck it in every visit.

2. The diver maintains the log book of ambulance and daily cleaning check list of ambulance.

B. AMBULANCE SERVICE FOR OUT PATIENT

4.b. RESPONSIBILITIES:

4.b.l Nursing supervisor:

1. When the patient party called for ambulance, they called to the nursing supervisor (ph.

no.-6296815225). The nursing supervisor received the call and inquiry about the patent

& the patient requirement, then communicate to the billing department and arranged

the brother.

Dey

5l!Prepared By Reviewed ByAll information in this document is confidential and property of M/s Central Referral Hospital, Gangtok. Reproduction in any form, either in part or full to be done only with written permission.

TITLE: Ambulance Serviceil> CRH SIKKIMMANIPALUNIVERSITY DOCUMENT NO:

REVISION NO:CENTRAL REFERRAL HOSPITAL - SMIMS OOREVISION DATE: OO

DocumentedProcedure

VERSION NO. G \

p ?Jc Djb\T'ISSUE/EFFECTIVE DATE:

PAGE NO: Ol MDOCUMENT CONTROL STATUS:

2. In transferred case (any other hospital/clinic) to verify -

D The case details

D The place from transfer

3. If the patient is infected the decision taken by the higher authority, whether ambulance

is provided or not.

4.b.2 Emergency Department (Nursing in charge):

1) Ensure Emergency department is ready to receive patient.

2) Inform appropriate emergency management staffs and Doctor on duty on arrival of

patient.

4.b.3 Nursing Brother:

1. Conduct brief patient assessment to determine patient's stability.

2. Verify patient management steps have been taken to facilitate event-free transport.

3. Provide CPR to the patient in emergency.

4. Ambulance personnel have use appropriate personal protective equipment (PPE) when

required.

5. After returning, the brother checks the ambulance (medicine, equipment, oxygen cylinder

etc.) for the next trip.

ch e\AAHAprIvS ,̂ 6* •

DPReviewed ByPrepared ByAll information in this document is confidential and property of M/s Central Referral Hospital, Gangtok. Reproduction in any form, either in part or full to be done only with written permission._________________________________________________________________________________

#CRHCENTRAL REFERRAL HOSPITAL - SMIMS

TITLE: Ambulance ServiceSIKKIMMANIPALUNIVERSITY DOCUMENT NO: j>OP/

REVISION NO:

REVISION DATE: o0

DocumentedProcedure

VERSION NO. CMISSUE/EFFECTIVE DATE: 3*11TeJotojLJMOjPAGE NO: 0 I \ l

DOCUMENT CONTROL STATUS: copy

4.b.4 Billing Section:

1. Communicate the transport in charge of ambulance and the driver.

2. Collection of ambulance charges.

4.b.5 Ambulance in charge:

The ambulance in charge should be check the ambulance in every alternative day and

maintain the equipment, medicine check list.

4.b.6 Security officer:

Security has to manages the traffic, when the ambulance reached the hospital.

4.b.7 Ambulance Driver:

1. The driver has to check the ambulance in daily basis and recheck it in every visit.

2. The diver maintains the log book of ambulance and daily cleaning check list of ambulance.

5 RECORDS

a. Forms and formats billing

6 REFERENCES

MsWa.K&fiHWP*;

Q'-'/V-pn - / v*1__________________________________All information in this document is confidential and property of M/s Central Referral Hospital, Gangtok Reproduction in any form, either in part or full to be done only with written permission.

Dr.cita

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