Chapter VIII
ON-CALL PRACTICE IN HEALTHCARE
Article 42. Healthcare entities that provide on-call practice
On-call practice, for the purpose of this Chapter, applies to health facilities with inpatient beds; healthcare facilities with beds for monitoring and treatment of patients ; out-of-hospital emergency care facilities (hereinafter referred to as healthcare facilities).
Article 43. Rules for on-call practice
1. On-call practice outside of office hours and on holidays, and days off must be organized by healthcare facilities to ensure continuous medical examination and treatment 24 hours a day.
2. On-call shifts must be strictly organized, with adequate human resources, means of transportation, medical devices, and drugs for emergency care.
3. On-call positions must be easily accessible and have sufficient contact information.
4. On-call staff must be present before the on-call time to receive the handover from the previous on-call shift, and then hand over to the next on-duty shift when the time ends, must not leave the duty position and must comply with the on-duty orders of the superior.
5. On-call schedule is made monthly and announced at least one week before the on-call time, approved by the hospital leader, and specified on the board for each on-call position. Officers, public employees, and employees who have been assigned in an on-call schedule can only change their own on-call schedule with those who are at their same level, together with the approval from the leader.
Article 44. Duties of on-call positions in the hospital
1. On-call leaders:
a) On-call leaders: Director, deputy director, dean of department, head of department who are designated by the director to participate in leadership on-call and this type of on-call practice must be authorized in writing.
b) Duties of on-call leaders:
- Check and supervise on-call shifts in the hospital.
- Direct the resolution of difficult problems and situations that are beyond the professional capabilities of on-call subordinate staff.
- Direct the handling of unusual security and order incidents occurring in the hospital.
- Report to the superior body of the hospital on special and unexpected cases that occur beyond their authority.
2. On-call clinical staff:
a) Organization of on-call clinical practice:
- The head of on-call shift is a practitioner holding the position of dean, deputy dean, or doctor with a postgraduate degree.
- On-call clinical doctor is a qualified practitioner who independently solves tasks and is responsible for their task solution.
- Nurses, midwives, and medical technicians who are practitioners assigned to on-call clinical practice by the hospital director.
b) Duties of the head of on-call clinical shift:
- Manage human resources during the on-call shift.
- Examine and order treatment for emergency cases, newly arrived patients and seriously ill patients undergoing treatment with unusual developments when the on-call clinical doctor of the department cannot resolve the issue.
- Report and seek advice from direct leadership in cases beyond their professional capacity to handle and special cases such as suicide, epidemics, catastrophes, and mass emergencies.
- Notify the on-call security guard and report to the on-call leaders in case of loss of security and order in the hospital.
- Check and urge on-call positions to fulfil their duties.
c) Duties of on-call doctors:
- Receive patients coming to the emergency room.
- Monitor and handle transferred patients.
- Guide and urge on-call staff to fully implement instructions.
- Assign responsibilities to each on-call member to closely monitor and promptly respond to any adverse changes in level-1 seriously-ill patients.
- Examine patients and document medical records after each visit.
d) Duties of on-call nurses, midwives, and medical technicians:
- On-call nurses are nurses of each department who can organize inter-department nursing duties as decided by the hospital director.
- Carry out doctor's orders and provide patient care and follow-up care.
- Urge patients to follow hospital regulations.
- Preserve records, medicine cabinets, and assets of the department.
- Detect a patient with unusual developments, at risk of death, report to the on-call doctor, and record all developments in the monitoring sheet.
3. On-call subclinical staff:
a) Organize separate on-call practice for each department, depending on the workload in each department to arrange the appropriate number of on-call staff;
b) Duties of on-call subclinical staff: perform tasks for diagnosis and treatment according to clinical instructions.
4. On-call logistics and administration staff:
a) On-call pharmacy and medical device staff shall ensure adequate supply of medicine and operation of medical devices to serve the on-call team;
b) The on-call finance and accounting staff shall ensure the collection of hospital fees from outpatients and inpatients outside of business hours;
c) The on-call IT staff shall ensure that the hospital management network system operates normally;
d) On-call electricity and water staff shall ensure operation of generators when there is an unexpected power outage; repair abnormal electricity and water damage;
dd) On-call administration staff must ensure communication by phones and other forms of information (according to regulations of the healthcare facility);
e) On-call security guards shall ensure security and order in the hospital;
g) On-call drivers shall ensure that ambulances are ready to perform duty when ordered.
5. Out-of-hospital on-call permanent staff:
a) In addition to the people assigned to be on call as mentioned above at the 4 permanent levels, depending on the actual circumstances of each hospital, hospital leaders can arrange on-call permanent staff outside the hospital to be ready to provide professional and administrative support when needed;
c) On-call permanent staff must keep in constant contact during their on-call time and be present at the hospital when mobilized.
Article 45. Required items in an on-call shift report
1. After an on-call shift, the on-call sub-teams shall document developments of all required report items in the on-call book; faculties and departments must hold briefings to hear the on-call shift reports from the following on-call sub-teams: clinical, subclinical, logistics, and administration sub-teams.
2. An on-call clinical report must document all developments of the following during the on-call shift:
a) Death: Clearly state the patient's progress, treatment, cause, time of death, and specific actions after the patient's death;
b) Emergency: Clearly state the name, age, address, diagnosis, and solution for each patient coming to the emergency room;
c) Serious developments of inpatients: Clearly state the developments of illness and treatment for each patient;
d) Medicines: release statistics and reports on the number of medicines used during the on-call shift.
3. On-call subclinical staff: Report emergency tests and paraclinical techniques performed during the on-call shift.
4. On-call logistics and administration staff: Report the items as prescribed in Clause 4, Article 44 of this Circular.
5. On-call leaders: Give general comments on the progress of on-call shift at the hospital-wide briefing.
Article 46. On-call practice at a healthcare facility that is not a hospital but has inpatient beds or beds for monitoring and treatment of patients
1. A healthcare facility that is not a hospital but has inpatient beds or beds for monitoring and treatment of patients (except for the case specified in Clause 2 of this Article) must arrange human resources for an on-call shift as follows: There is at least 1 practitioner with the title of doctor or physician assistant and 1 practitioner with one of the following titles: nurse, midwife, or medical technician.
2. A commune-level health station must arrange human resources for an on-call shift as follows: There is at least 1 practitioner with one of the following titles: doctor, physician assistant, nurse, midwife, medical technician.
Article 47. Out-of-hospital on-call emergency
1. Out-of-hospital emergency facilities (including patient transport facilities established under the Law on Medical Examination and Treatment No. 40/2009/QH12) shall organize 24-hour emergency operations (including holidays and days off) according to Decision No. 01/2008/QD-BYT dated January 21, 2008 of the Minister of Health on emergency and intensive care and anti-toxic care.
2. Healthcare faculties with out-of-hospital emergency operations must arrange:
a) 24-hour human resources on call;
b) the minimum number of people for one on-call shift as follows:
- 1 practitioner with the title of doctor or physician.
- 1 practitioner with one of the following titles: nurse, midwife, or medical technician.
- 1 ambulance driver.
c) Staff in the on-call emergency shift specified in Point b of this Clause must be distinct from personnel assigned to other concurrent on-call shifts and can be arranged in the form of permanent duty.
Tìm kiếm
Thông tư 32/2023/TT-BYT (Bản Word)
