Out patient services in the past was provided by aninstitution called “Dispensary”.In many western countries,general care is given byprivate practitioners and all hospitals dont have OPD.In India apart from private practitioners OP services inhospitals are the primary means wherby people receivemedical care.The focus in medical care has to a considerable extentshifted from entirely IP oriented to the OP orientedservice.
OPD ORIGINS•Originated in mid 17th centuryby Sir George Clark.•In Hotel Dieu in Paris 6 physicianwere detailed for regular sessionon Wednesday or Saturdayadvising poor individually, in turnintroducing the idea of OPD.•Modern OPD services emergedin 1850 in USA from frameworkof dispensaries.
OPD-ALL ABOUT•Definition-Ambulatory medical care provided topatients who are not confined to bed can beprovided at a general practitioner’s clinic,a specialistclinic,a health centre or a hospital.•To provide care for patients who are not registeredas in patients while receiving health services.•Section of hospitals with allotted physical facilities.
IMPORTANCE•First point of contact.•It is the shop window of the hospital.•Makes or mars the image of the hospital.•A good OPD services can reduce the load on IPDservices.•It is the place for implementing preventive andprimitive health activities.•It is a stepping stone for health promotion anddisease prevention.
FUNCTIONS•Early diagnosis,curative,preventive & rehabilitativecare on ambulatory basis.•Screening for admission to hospital.•Follow up care and &care after discharge.•Promotion of health by health education program.
TYPES•Two types of OP services-1. Centralized outpatient services2. Decentralized outpatient services• Based on type of patients-1. General out patient2. Emergency out patient3. Referred out patient
PLANNING CONSIDERATIONLOCATION-•Separate entrance•Easily accessible•Should have approach from main road•Adjacent to supportive facilities:x-ray,laboratory•Amenable for expansion
CONT…ADMINISTRATIVEAREAS-1.Adm office2.Business office3.House keeping4.Storage facilityCIRCULATIONAREAS-1.Corridors,Stairs,Lifts2.Easy accessibility ofelevator3.Corridor-1.8m wide4.Security check post atstrategic point5.Availability of STD/ISDfacility
IN PATIENT DEPARTMENT•Inpatient" means that the procedure requires thepatient to be admitted to the hospital, primarily sothat he or she can be closely monitored during theprocedure and afterwards, during recovery.•An inpatient is "admitted" to the hospital and staysovernight or for an indeterminate time, usuallyseveral days or weeks (though some cases, like comapatients, have been in hospitals for years).
1.To provide the highest possible quality of medicaland nursing care for the patients.2.To provide necessary equipment,essential drugsand all other stores required for patient in anorganized manner.3.To furnish most desirable environment substitutingas temporary home for the patients.4.To provide facilities to meet the needs of thevisitors and attendants.5.To provide highest degree of job satisfaction for thenursing & medical staff including training & research.FUNCTIONS
PLANNING & ORGANISING IP UNITPOLICY OF HOSPITALS.General.Super specialty.Specific hospitalPHYSICAL FACILITIES.Location & area.Size-Type of patients-Requirement of staff-position of the HeadNurse & Ward Clerk
AREAWARD1.Area per bed within theward2.Obstetrics &Orthopedics3.ICU4.Single bed room5.Standard dimension ofhospital bedSIZE=70-90 sq.ft=100-120 sq.ft=120-150 sq.ft=125 sq.ft=6’6”x 3’3”
INFLUENCING FACTORS1. General2. Hospital staff3. Education and training4. Physical facilities and equipments5. Clinical and service facilities6. Effective use of beds7. Quantum of work8. Administration
CONCLUSION“NEVERTHELESS,THE TWO SHOULD BE INTEGRATEDPHYSICALLY,FUNCTIONALLY AND FROM THE CLINICALADMINISTRATIVE POINTS OF VIEW.”