1. Nazario Macalintal Jr., MD Department of Internal Medicine*
07/16/96
MHP Section October UPDATE Part of October Presentation to Execom IM Dept
Nazario Macalintal Jr., MD
MHP SECTION
Department of Internal Medicine
12/9/2018 *

2. MUST RECONCILE ITS DIRECTION COLLECTIVELY WITH*
07/16/96
MUST RECONCILE ITS DIRECTION COLLECTIVELY WITH
HOSPITAL and IM DEPARTMENT’s MISSION AND VISION
PCP EXPECTATIONS
RESIDENTS REQUIRED TRAINING EXPOSURE
12/9/2018 *

3. The Role of the MHP Section*
07/16/96
The Role of the MHP Section
12/9/2018 *

4. MHP Section MISSION Statement*
07/16/96
MHP Section MISSION Statement
To become an effective arm of the MMC in its commitment to provide adequate medical care to the indigent constituents of the community 2
12/9/2018 *

5. *
07/16/96
MHP Section Goal 1
To actively participate in the MMC MHP Service by providing adequate medical care within the prescribed working budgetary allocation provided by the institution, with the view in mind of achieving the vision-mission statements of the institution and the department.
12/9/2018 *

6. *
07/16/96
MHP Section Goal 2
To maintain the delivery of quality services and ensure the competent medical residency program via continuous cooperation from all Medical Consultants of all subspecialties
12/9/2018 *

7. *
MHP Section Goal 3
07/16/96
To utilize the MHP in helping Consultants comply with the General Requirements of Section 3.5 No. 10, to wit “assist in any Medical Staff-approved teaching activities for medical students, interns, residents, fellows, nurses, Medical Staff members, and others as required by the Department of which they are a member”.
12/9/2018 *

8. *
07/16/96
MHP Section Goal 4
To help MMC reduce the cost of healthcare delivery while maintaining an effective, practical management of medical cases
12/9/2018 *

9. CRITICAL AREA II. CONSULTANTS’ ROTATION*
07/16/96
CRITICAL AREA II. CONSULTANTS’ ROTATION
12/9/2018 *

10. MUST TIE UP PLANS OF ACTIONS COLLECTIVELY WITH*
07/16/96
MUST TIE UP PLANS OF ACTIONS COLLECTIVELY WITH
HOSPITAL EXPECTATIONS
IM DEPT REQUIREMENTS
PCP EXPECTATIONS
RESIDENTS REQUIRED TRAINING EXPOSURE
JCI AND ISO REQUIREMENTS - NOT AN ISSUE.
THEY CAN BE DECKED AS LONG AS THEY ARE MEMBERS OF THE MEDICAL STAFF ASSOCIATION / MILA UY SEPT
12/9/2018 *

11. Recall MHP SECTION Goals…*
07/16/96
Recall MHP SECTION Goals…
To utilize the MHP service in complying with the General Requirements of Section 3.5 No. 10, to wit “assist in any Medical Staff-approved teaching activities for medical students, interns, residents, fellows, nurses, Medical Staff members, and others as required by the Department of which they are a member”.
12/9/2018 *

12. Original assumption that is no longer valid*
07/16/96
Original assumption that is no longer valid
“PREVIOUS DECKING STRATEGY WORKED”
Px GETS REFFERED TO MD NEXT-ON-DECK AND SO ON.
NEXT ON LINE COMPLAINED.. And REFUSED, AND DID THE SAME….
12/9/2018 *

13. Option 1 - ROTATE ALL INTERNISTS in the MHP Decking*
Option 1 -
07/16/96
ROTATE ALL INTERNISTS in the MHP Decking
Problem 1:DO THEY HAVE OPTION TO REFUSE?
HOSPITAL DIRECTIVE ON ALL CONSULTANTS -
General Requirements of Section 3.5 No. 10, ...“assist in any Medical Staff-approved teaching activities for medical students, interns, residents, fellows, nurses,, Medical Staff members, and others as required by the Department of which they are a member”.
Implemented : October 1st, 2004 per ADL Memo Sept 28, 2004
12/9/2018 *

14. *
Option 1a
07/16/96
ROTATE ALL INTERNISTS in the MHP DECKING
Problem 2 on Option 2 PCP EXPECTATION? - “How much of teaching staff is PCP Fellow?
Solution: Create TANDEM NON-PCP/PCP for PCP Accreditation Committee viewing purposes only but allow non-FPCP to participate in the care of pxs
Example: DE LA CRUZ (n-PCP) / Litonjua PCP - means dela Cruz renders the care, “together” with ADL
Example: de la Cruz (n-PCP) / LITONJUA PCP - means LItonjua renders the care, “together” with dela Cruz
Benefit 1: BOTH PCP and non-PCP Consultants are able to participate in the MHP service, allowing them to comply with the hospital’s Section 3.5 directive;
Benefit 2: The IM Department is able to comply with the PCP requirements, without the non-PCP being left behind
12/9/2018 *

15. Option 2 - DECKING PROBLEM Solution : GET A BACK UP*
07/16/96
Option 2 -
DECKING PROBLEM Solution : GET A BACK UP
MAKE THE SECTION BOSS THE BACK UP -
The one on deck will think twice before calling his/her back up.
Should back up be called, the Section Boss just decides whom to refer and ORDERS the transfer of service or referral, not necessarily to the one next on deck.
THE ONE CALLED WILL BE HESISTANT TO REFUSE BEC IT’S HIS/HER SECTION BOSS WHO CALLED
12/9/2018 *

16. *
OTHER ISSUES
07/16/96
NEED TO DECK ALL SPECIALTY REFERRALS TO THOSE ON CALL FOR THE SAID SPECIALTY BY PRACTICE
CANNOT DECK ADMISSIONS BY SPEC OF CASES SINCE
~1/3 OF CASES IS CARDIO.
~ 1/3 IS PULMONARY
Cannot use On-Call for Private Patients - almost ALL CARDIOLOGISTS! (Why?)
BY PRACTICE, REFERRAL TO SPEC IS BY THE DATE THE NEED FOR REFERRAL IS REQUIRED , NOT ON THE DATE CASE WAS ADMITTED
12/9/2018 *

17. CRITICAL AREA 2: CONSULTANT DECKING - PLANS OF ACTION*
07/16/96
CRITICAL AREA 2: CONSULTANT DECKING - PLANS OF ACTION
Create Stop-Gap measure for the next quarter DONE
Secured Consultants’ Updated Directory - talked to Mila Uy
Announced the new Decking System before year end
But some not aware of their scheduled decking
12/9/2018 *

18. CRITICAL AREA 2: CONSULTANT DECKING - PLANS OF ACTION*
07/16/96
CRITICAL AREA 2: CONSULTANT DECKING - PLANS OF ACTION
Summary of Results - if things go as proposed
Total decking / consultant : only 3-5 / YEAR for each of the 180 consultants
MMC General Requirement for consultants to train residents /fellows is ADDRESSED
12/9/2018 *

19. Oct-Dec 2004 Schedule of Decking for MHP Admissions*
07/16/96
Oct-Dec Schedule of Decking for MHP Admissions
Memo released for this last quarter
INITIAL Observations:
Objections from Consultants was NIL
PROJECTION:Only a handful from the WHOLE IM STAFF will refuse being decked for MHP 3-5x a year…
12/9/2018 *

20. TOGETHER
EVERYONE
MORE
ACHIEVES
12/9/2018

21. ISSUE 4…:Consultants not receiving communication letter on decking*
07/16/96
ISSUE 4…:Consultants not receiving communication letter on decking
12/9/2018 *

22. ISSUE 5…: ER Consultants under the Dept of Medicine - for decking??*
07/16/96
ISSUE 5…: ER Consultants under the Dept of Medicine - for decking??
12/9/2018 *

23. HSP Issues as of per Ces Landicho NOV 2007
JCI does not allow tandem decking
Referral only to Active / Assoc Active
Total IM = 183
Active / Assoc Active = 133
Excluding MDs 60/?> ,(#34) no decking option
Only 101 willing to be decked
Therefore 365decking days/101MDs = IMs will be decked 3.6x a year ONLY
Non-PCP = 50
What role can they have ?
12/9/2018