Policy on Duration of Hospitalisation under ECHS – Ministry of Defence Clarification
Common Mistakes committed by ECHS Poly Clinics and Empanelled Hospitals filling up documents when Hospitalisation is extended
Central Organisation, ECHSAdjutant General’s BranchIntegrated HeadquartersMinistry of Defence (Army)Maude LinesDelhi Cantt-110010
B/49770/AG/ECHS24 Nov 14
POLICY ON DURATION OF HOSPITALISATION
1. Refer Central Org ECHS letter No B/49770/AG/ECHS dt 15 Mar 10.2. The empanelled Hospitals, ECHS authorities at various levels and SEMO have been found to be filling the Appx ‘A’, ‘B’ and ‘C’ incorrectly which can invite audit observations later on.3. An advisory in this regard is forwarded with this letter as Appx and flow chart for the info of all. All Regional Centres will intimate the same to the various Polyclinics under their AoR and to their empanelled Hospitals to follow the guidelines strictly.4. All service HQ‘s are requested to info the various SEMO‘s under their command and the OIC Stn Cell ECHS to adhere to the policy strictly.(Vijay Anand)ColDir (Med)for MD
Encls: As above.Appx ‘A’
FLOW CHART(To be filled up by empanelled Hosp for extension of Hospitalisation beyond 12 days upto 30 days)COMMON MISTAKES
(a) Date of visiting the patient and date of admission are same.
(b) No dates are mentioned under the signature block of auth rep/treating physician of the Hosp.
Appx ‘B’(For extension from 31 days to 60 days)COMMON MISTAKES
(a) Date of admission and date of visiting the patient are same.
(b) Appx ‘B’ is not countersigned by Dir RC, Jt Dir (Med) and rep of Stn HQ.
(c) SEMO signing instead of rep of SEMO.
(d) All Colums of Part II are not filled correctly.
(For extension from 61-120 days)COMMON MISTAKES
(a) Late submission of the appendices by the Hosp and ECHS authorities to Central Org
(b) Appendices in a bunch are fon/varded rather than single appx for one approval.
(c) Members of tech committee are not leaving any space for Dir (Med) and MD ECHS to sign.
|Duration of hopitalization||Salient features of policy||Common mistake||Remedial measures|
|Upto 30 days||(a) Appx ‘A’ is initiated by hospitals to accord sanction by OIC ECHS Polyclinic after 12 days of hospitalization.||(a) Date of Visiting the patient and date of admission are same||(a) OIC Polyclinic to check the anomaly before approving the Appx ‘A’.|
|(b) MO Polyclinic is required to visit the patient after receiving Appx ‘A’ and fill up the date of visiting the patient on para 13 of part-II of the appendix||(b) The hospital advises discharge of patient in the summary forwarded with Appx ‘A’ but the ECHS authorities grant extension.||(b) -do-|
|(c) Date of signing the Appx ‘A’ is to be mentioned by the hospital rep.||(c) No date is mentioned by the hospital rep under the signature block.||(c) All empanelled hospitals to be instructed by Dir RC to strictly follow the policy.|
|From 30 days upto 60 days||(a) Appx‘B’ is initiated by the hosp.||(a) Date of visiting the patient and date of admission are same.||(a) Jt Dir (Med) of the RC to check.|
|(b) A technical committee comprising of MO Polyclinic, rep of SEMO (tech member) and rep of Stn HQ visits the patient to ascertain that the finality of treatment has been reached or not.||(b) The hospital advises discharge of patient in the case summary on Appx ‘B’ but the ECHS authorities still grant further extension.||(b) Dir RC & Jt Dir (Med) to check the anomaly before approving the Appx ‘B’.|
|(c) The Appx ‘B’ – is not countersigned by the approving authorities i. e. Dir RC and Jt Dir(Med).||(c) Dir RC and Jt Dir (Med) to familiarize themselves with this policy.|
|(d) SEMO is signing on the form instead of his rep which is not possible as SEMO is generally either the Co of MH or a senior officer who can not be relieved to visit the patient. Hence, the technical aspect of the policy is neglected.||(d) SEMO should not sign on behalf of his rep which is incorrect. A letter in this regard to be forwarded by Jt Dir (Med) to the SEMO.|
|(e) Part II of the Appx ‘B’ columns are not filled up properly.||(e) MO Polyclinic to ensure it.|
|(f) No dates are mentioned either for the duration of extension required or under the signatures of the concerned officers.||(f) -do-|
|(g) The appendix is not signed by the rep of Stn HQ.||(g) OIC ECHS Stn HQ should keep himself abreast with all policies.|
|From 61 days 120 days upto||Cases requiring in patient treatment beyond 60 days will be reviewed by the station technical committee again between 45th and 60th day and in exceptional circumstances where hospitalization beyond 60 days is absolutely necessary their recommendations will be recorded on Appx ‘C’ and forwarded to Central Org for approval by fastest means.||(a) Appx ‘C’ are being forwarded much later than the period of hospitalization required for extension.||(a) OIC ECHS Polyclinic to monitor and if the delay is on part of the hospital then it should be warned.|
|(b) Appx ‘C’ in a bunch are being forwarded to Central Org ECHS rather than one appx for only one period.||(b) -do-|
|(c) Officers countersigning as Appx ‘C’ are taking up the space earmarked for Dir(Med) and MD ECHS which is not in order.||(c) Members of technical committee to ensure.|
|(d) Officers not authorized to sign on the Appx ‘C’ are also signing leaving no space for Dir(Med) and MD ECHS for counter signing.||(d) SEMO should nominate a concerned spl offr to visit the patient and give his recommendations.|
|(e) A stamp giving approval vide Central Org ECHS letter No B/49778/AG/ECHS/PA/Ruling dt 28 Dec 11 has been put under the signatory block of MD ECHS which is incorrect as the ibid letter pertains to prior approval for unlisted procedures/ tests/ implants.||(e) Being done by one SEMO which is not in order.|