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2nd Module: Introduction to PRSMS

AGENDA: Background Organizational Chart PRSMS Rules and Regulations PRSMS Programs Free Clinics Scientific Seminars Duties and Responsibilities _____________________________________________________________________________________ Background: December 12, 1952 7 years after the old hospital in Intramuros turned into ashes during the liberation, SJDH was transferred to its current location and consequently PRSMS was added as part of the hospital modernization program. Post polio, hemiplegia & other types of paralysis as well as joint and muscle pains were being treated. The section catered/treated war veterans for 2 years and was transferred to the newly built Veterans hospital. January 9, 1953 New Building was inaugurated which included the therapeutic gymnasium where different PT modalities is given - For 4 decades the Physical rehabilitation became stagnant 1993 The Physical Rehabilitation Department under Dr. Bee Giok Tans helm was modernized and Expanded. A graduate of UST who specialized in Physical rehabilitation & Sports Medicine at NYU, She added sports medicine and the department became Physical Rehabilitation and Sports Med Section. PRSMS became the first hospital who specialized in Sports medicine. 2001 Preparation for ISO certification 2002 we became the First Hospital with ISO certificate in Quality 2004 ISO in EMS was added PRSMS PROGRAMS 1. PT/MD Internship Program 2. Extended Home Rehabilitation Program 3. Virtual Rehabilitation Program (Interactive/Wii Sports and Balance/MOMO forcefeedback) 4. Continuing Professional Education Programs (Rehab staff is required to attend atleast 2 seminars/workshops in a year excluding the annual convention) a. Quarterly Case Presentation b. Bimonthly In house training c. Annual Scientific Seminar 5. PRSMS Programs for Quality a. Annual Internal Audit (Hospital Wide) b. Annual External Audit (Hospital Wide) c. Quarterly OTPs (Section) d. Yearly Time Motion Analysis 6. Social Responsibility Program a. Biennial Free Clinic with lay Forum (Foundation Day First Saturday of March, Disability Week 2nd Saturday of July) b. Annual Blood Donation Drive with free Bone Scan and Lay forum (Osteoporosis Week - 3 rd week of October) c. Feeding program and gift giving for the children in service ward (Coinciding with PRSMS Christmas party)

7. Spiritual Enhancement Program a. Annual retreat b. Monthly BEC Kamustahan (first Wednesday of the month) 8. Staff welfare Program (Hospital Program) a. Individual HIRAC b. Annual PE c. Hepa Vaccination d. Tetanus Vaccination e. Flu Vaccination 9. Social Programs a. Summer Group Dynamics b. Christmas Party with the patients c. Christmas party with MDs d. Quarterly celebration of Rehab Team Birthdays. ORGANIZATIONAL CHART RULES & REGULATIONS PT/OT affiliates must undergo 2 weeks of orientation, where the affiliates will learn the sections protocols, rules and regulations under the care of all the staff. PT/OT will also observe the rehab staff at work. After completing the 2 weeks of orientation, affiliates will have a written exam the scope of which includes sections protocols, rules/regulations and patients care. Upon passing the written exam, affiliates will undergo 3 months of volunteer work. All PT/OT affiliates shall observe all department rules and regulations. Ignorance is not an excuse. They shall observe proper decorum, courtesy, kindness and understanding to patients and to the public and shall not make any comments regarding physicians and their diagnosis and treatment protocols in the presence of patients and their relatives and friends. - Observe proper decorum in relationships with staff, patients and physiatrists. Avoid shouting, laughing boisterously during clinic hours. CONFIDENTIAL INFORMATION PT/OT affiliates are restricted to release information regarding the treatment, laboratory tests, untoward medical situations and other similar matter to patient or relatives w/o prior clearance from the AMD or Staff. ACCIDENTS AND UNUSUAL OCCURENCES No information shall be given out concerning accidents and unusual occurrences in the department without the permission of either the Section Chief, Medical Director and/or Ancillary Director - In case of untoward incident during treatment of patients, the PT/OT affiliates should immediately report this to the PT/OT Staff and likewise to the Physiatrist. In the absence of physiatrist, the incident should be reported to the Rehab Intern/MROD for any first aid treatment/interventions to be given. Furthermore, PT/OT affiliates must submit a written report duly signed by the PT/OT Staff-in-charge w/in the day. - Any untoward incidents concerning the patients i.e. burns, falls, and untoward medical problem encountered during treatment, to the staff in charge. Written report should be made within 24 hours from the time of incident. The attending physiatrist should be properly notified. - In case of emergency situation (refer to our section emergency protocol), patient will have to be transported to the ER for proper management. CLINICAL CHARTS AND RECORDS The charts and other records of the patients are official documents and their falsification, disfigurement, or mutilation/loss, may give rise to administrative disciplinary action and/or criminal prosecution. The PT/OT affiliates shall not remove them from the Section at all time. PT/OT affiliates are not allowed to use cell phones during patients treatment period, nor for games during office hours. Cell phones will have to be set on a silent mode during clinic hours. Lunch/Snacks are to be eaten at the cafeteria or at the pantry and not inside the clinic. Utilize the break time provided by the department.


PT/OT affiliates are strictly prohibited to receive tips or any monetary reward from the patient and/or patients relatives PT/OT affiliates are not allowed to entertain friends/visitors during clinic hours except for emergency situation (i.e. family) Channeling of patient is prohibited. UNIFORM:

1. All PT/OT affiliates are required to wear blue scrub suit/whit blazer at all times when on hospital duty
and should wear white blazer when treating in patients. 2. The complete uniform with Hospital ID includes: MALE -


Blue scrub suit or formal attire with white blazer White rubber shoes if with scrub suit and black leather shoes for formal wear No undershirt or undershirt with the same shade of blue as the scrubs Short/clean cut hair No moustache/beard/goatee No earrings/ no make-up/ no colored nail polish Blue scrub suit or formal attire with white blazer White rubber shoes if with scrub suit and black leather shoes for formal wear No undershirt or undershirt with the same shade of blue as the scrubs Long hair should be worn with ponytail or hair band Wearing of nail polish, inappropriate accessories/jewelries are prohibited No heavy make-up



1. All PT/OT affiliates are to adhere to the working hours, rules and regulations and attendance here at
San Juan de Dios Educational Foundation, Inc Physical Rehabilitation and Sports Medicine Section (SJDEFI-PRSMS) Duty hours are as follows: Monday-Friday 7:30 am - 6:00 pm Cut off treatment: 5:00 pm Saturday 8:00 am 4:00 pm Cut off treatment: 3:00 pm - PT/OT Affiliates are given 1 hour lunch break - PT/OT affiliates are allowed to have a 15 minute break in AM & PM - PT/OT affiliates are given 15 minute grace period (for late time-in) - The last hours of duty will be allotted for charting If a PT/OT affiliate is unable to report for duty, he/she should notify the Chief Therapist of the Section immediately (by phone) and must submit a Medical Certificate duly signed and noted by a Physician within two (2) working days after the actual date of absence. - For absences incurred due to reasons other than illness, an excuse letter duly signed by the PT/OT affiliate should be submitted within 1 working day from the actual date of absence. Likewise, if he/she should be late for duty, the Chief Therapist of the section should be notified early through telephone - For change off, PT/OT affiliates should inform the Chief therapist and the Section head for his/her intention to change their off 1 week ahead of time. CLINICAL PRACTICE 1. Prior to treatment:



OUT-PATIENT: PT/OT affiliates should check the patients receipt with the accompanying signature of the Secretary, on the OR number if it has been recorded. - For those patients whose bill is to be shouldered by a company/HMO such as HMI/Medicard/Maxicare, etc., the PT/OT affiliates should follow-up with Secretary if they already signed at the charge slip. 2. PT/OT affiliates should make sure that every treatment/procedure done with the patient is explained. RATIONALE! 3. Treatment time should be confined to an average of 1 hour for simple cases and 1 - 2 hours for CVA and any complicated diseases but without compromising quality care. 4. PT/OT affiliates should take all the necessary precautions in treating the patients particularly the new patients. During the first treatment session, the therapist may not give all the prescribed management (especially the strenuous one) if the condition warrants. 5. PT/OT affiliates may suggest physical therapy management for his/her patients but with approval first of the attending Physiatrist. 6. Home exercise program must be properly explained and outlined to the patients by the PT/OT affiliates. 7. CHARTING PT/OT affiliates must complete all the records of the patients assigned to them (Initial evaluation, re-evaluation, progress notes, endorsement notes, index card and discharged summary). - Use black ink in charting for PT/blue ink for OT - Daily PT notes - Notes should be countersigned by staff In any musculoskeletal case where there is joint restriction and motor weakness, a corresponding ROM and MMT chart should be accomplished and incorporated in the patients chart with proper labeling. 10. PT/OT Staff-in-charge and the PT/OT affiliates must take note of scheduled re-evaluation date and be responsible in informing the patients regarding the re-evaluation date. 11. Check up of patients with the attending physiatrist can be scheduled by PT/OT staff in charge ahead of the scheduled date for the following reasons; a. Slow progress of the patients condition or no progress at all b. Regression of the patients condition c. Any untoward incidents concerning the patients d. A new complaint is noted e. Remarkable improvement in patients condition which is a valid reason to change the present prescribed program 12. It is the responsibility of every PT/OT affiliates to make sure that any equipment he/she uses be returned to its proper place or order. AFTER CARE is a must. In case of any breakage/losses/damage caused by the intern on the equipment/properties/supplies of the section, that PT/OT affiliates will be held responsible due to negligence. 13. WARD ROUNDS: -Each PT/OT affiliates will also be rotated for ward rounds with the Physiatrist. He/she will go with the Physiatrist in evaluating both in and out patients. 13.1. The affiliates for the day should come early on the assigned week to do the ward rounds for the in-patients 13.1.1. He/she should review the patients rehab chart and should know the present functional status of the patient. 13.1.2. He/she should go the nurses station (assigned room of the patient) and note any medical concerns from the attending physician that negates treatment. 13.1.3. He/she should go and check the patients vital signs and condition. 13.2. He/she will inform the Physiatrist/PT/OT Staff-in-charge about the present status of the patient. 13.3. Do the history taking for both in and out patients (new ones) 13.4. Assists the doctors in taking down the pertinent findings 13.5. Be asked to do the special test, ROM measurement, manual muscle testing. DAILY CHORES

Morning chores: 7:00 am to 8:30 am To be done by Orderly/technician (observe PPE) and villaseran 1. 2. 3. 4. 5. 6. 7. Plug the hydro tank and paraffin bath Fold all dried towels Deposit the dirty linens and towels to hospital Laundromat Feed the fishes Transfer the w/c, tilt table, CPM in the pantry Sweep the floor (include mopping the comfort room [patients, staff and MD] Change linens in the cubicles

Afternoon chores: 5:00 to 6:00 pm To be done by orderly technician, PM staff/intern and villaseran 1. 2. 3. 4. Sweep the floor Collect the clean lines and towels in the hospital Laundromat Hang wet towels in our hydro room and put the not so wet towels atop our hydro collator tank Make sure that every cubicle has 10 hospital gowns, 5 bed sheets, 5 pillow cases, 1 scraper, 1 US gel, 1 timer and folded tissues 5. Make sure that all of our machines are unplug and clean 6. Transfer all our wheelchair inside the hospital Staff and Interns 1. Make sure that theres no patient charts in PT counter 2. Machine accessories are clean and complete 3. PT/OT modalities are within their proper place Additional Weekend Chores (Saturdays) 1. Clean the fish tank inside MDs clinic 2. Change/ clean the paraffin wax (every other Saturday) 3. Change water of the hydro collator tank Staff Make sure that we have enough mineral water for the coming week (Czarinas duty) Inspect all machines