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Internal regulations for patients of the health care institution "Minsk Clinical Center of Phthisiopulmonology"

General Provisions

These Internal Regulations for Patients of the Healthcare Institution "Minsk Clinical Center for Phthisiopulmonology" (hereinafter - Rules) developed on the basis of part one of article 43 Law of the Republic of Belarus of 18.06.1993 No. 2435-XII
"On Health Care" in accordance with the Model Household Rules for Patients, approved by the resolution of the Ministry of Health of the Republic of Belarus from 30.10.2015 No. 104 "On Approval of the Model Internal Regulations for Patients". For the purposes of these Rules, the terms and their definitions are used in the meanings, established by the Law of the Republic of Belarus "On Health Care":

treatment – complex of medical services, aimed at eliminating the disease in the patient;
medical activity – activities for the organization and provision of medical care, ensuring the sanitary and epidemiological well-being of the population, medical examination, carried out by legal entities and individual entrepreneurs in the manner, established by the legislation of the Republic of Belarus;
health care – complex of medical services, aimed at preserving, strengthening and restoring the patient's health, including medical prevention, diagnostics, treatment, medical rehabilitation and prosthetics, by medical professionals;
medical prevention – complex of medical services based on the patient's personal interest, aimed at reducing the likelihood of disease, identifying causes and conditions, contributing to their emergence and spread;
medical rehabilitation – complex of medical services, aimed at restoring the normal functioning of the patient's body and compensating for its functional capabilities, disturbed as a result of the disease;
medical service – medical intervention or a complex of medical interventions, as well as other actions, performed in the provision of medical care;
medical ethics and deontology – body of principles, norms and rules of conduct for medical, pharmaceutical workers in the performance of their official duties;
medical devices – medical products, Medical equipment;
medical checkup – medical service, aimed at assessing the patient's health, detection of diseases, risk factors for their occurrence;
medical worker – individual, with higher or secondary specialized medical education, confirmed by a certificate of education, and in the order established by the legislation of the Republic of Belarus engaged in activities, related to the organization and provision of medical care, provision of sanitary- epidemiological well-being of the population, medical examinations;
a patient – individual, seeking medical attention, under medical supervision or receiving medical care.

When providing medical care, methods are used, approved by the Ministry of Health of the Republic of Belarus.
In exceptional cases, established by the Ministry of Health of the Republic of Belarus, in the interests of the patient, the use of scientifically based, but not yet approved for use in the procedure established by the legislation of the Republic of Belarus methods of providing medical care. The decision on their use is made with the written consent of the patient., and with regard to the following persons:

minors – with the written consent of one of the parents, adoptive parents, guardians, trustees (Further – legal representatives);
persons, recognized as legally incompetent, – with the written consent of their guardians;
persons, not capable for health reasons to make an informed decision, – with the written consent of the spouse (spouses) or one of your close relatives (parents, adult children, siblings (sisters), grandchildren, grandfather (dibs)).

In the absence of the above persons, or impossibility in a reasonably short time (based on the patient's health) locate them, decision on the use of scientifically based, but not yet approved for use in the procedure established by the legislation of the Republic of Belarus methods of providing medical care.
The procedure and conditions for the application of methods for the provision of medical care are determined by the Ministry of Health of the Republic of Belarus..
Household rules for patients include:

the procedure for referring a patient to the outpatient departments of the center; patient rights and obligations;
the procedure for providing information about the patient's health; procedure for issuing certificates, extracts from medical records to a patient or other persons;
working hours of the outpatient departments of the center and its officials;
information on the procedure for providing paid medical services to citizens of the Republic of Belarus in outpatient departments of the center, stateless persons, permanently residing in the Republic of Belarus and foreign citizens;

Internal regulations for patients are posted in the lobby of the outpatient departments of the center in an accessible place and on the official website of the center.
With the internal regulations of the outpatient departments of the center, the patient (legal representatives) get acquainted orally.

The procedure for treatment and stay in an outpatient setting and in the day care unit of the health care institution "Minsk Clinical Center for Phthisiopulmonology"

Health care institution "Minsk Clinical Center of Phthisiopulmonology" (further - Center) ensures the provision of medical care to patients in accordance with their therapeutic and diagnostic capabilities, and also, if necessary, directs them to receive medical care in other health care institutions in the manner, determined by the Ministry of Health of the Republic of Belarus. The center carries out dispensary observation of patients in accordance with the profile. The Center provides medical assistance to citizens of the Republic of Belarus, registered and / or actually living in Leninsky, Frunzensky, Partisan, Factory, Central October, Soviet and Pervomaisky districts. Minsk, assigned to state healthcare institutions at their place of residence (place of stay), and in the presence of departmental healthcare organizations – also at the place of work (study, service). Also, medical care is provided to citizens outside their place of residence. (place of stay) in the manner determined by the Ministry of Health of the Republic of Belarus. Patients in the institution are provided with planned and emergency (urgent) assistance depending on medical and diagnostic capabilities. Emergency medical care is provided when a patient suddenly develops a disease, states and (or) exacerbation of chronic diseases, diseases, conditions without obvious signs of a threat to the patient's life, requiring urgent medical attention. Routine medical care is provided in the presence or suspicion of a patient's illness, not requiring emergency or urgent medical intervention. requiring urgent medical attention. Planned medical care is provided if the patient has or is suspected of having diseases, healthcare organizations, who applied independently, as well as in the direction of other organizations, authorized to issue referrals for medical examinations (examination for certain types of diseases).

Outpatient medical care

In order to prevent diseases, timely diagnosis and treatment, citizens of the Republic of Belarus are assigned to healthcare organizations at their place of residence (place of stay), and also have the right to receive medical care in public health institutions outside their place of residence (place of stay) on an application for temporary assignment to an institution for a certain period with the permission of the head (his deputy).

When a patient contacts the Center for medical assistance, the patient enjoys rights and responsibilities, provided for in Articles 41 and 42 Law of the Republic of Belarus dated 18.06.1993 No. 2435-XII "On health care", other acts of legislation and these rules of the internal routine for patients.
If it is necessary to receive medical care, the patient applies to the registration center of the Center., where medical documentation is issued for the patient in accordance with the requirements, established by the Ministry of Health of the Republic of Belarus. When a citizen is temporarily fixed outside his place of residence (place of stay), the procedure for organizing the provision of medical care in state health care institutions to citizens of the Republic of Belarus outside their place of residence (place of stay) defined by instruction, approved by the decree of the Ministry of Health of the Republic of Belarus from 22.12.2008 № 229 "On approval of the Instruction on the procedure for providing medical care to citizens of the Republic of Belarus outside their place of residence (place of stay)». When contacting the Center for medical care, the patient or his legal representative, or an authorized person is required to present a document, proving the identity and allowing to determine the citizenship and place of registration (passport or other document, proof of identity, residence permit in the Republic of Belarus, refugee certificate – for foreign citizens and stateless persons, who are allowed permanent residence in the Republic of Belarus). To streamline the admission of patients and record their visits to the Center, in the registration office of the Center, an appointment is made and coupons for an appointment with doctors are issued.

Pre-registration of patients for an appointment with a specialist doctor without time limit is carried out when they directly contact the Center's registry or by phone, indicated on the website and stands of the institution, as well as by filling out an online form on the center’s website. When making an appointment with a doctor, the patient must indicate his last name, name, patronymic, home address and telephone. Coupons for appointments with doctors are issued on the day of contact with the indication of the surname, name, patronymic of the doctor, queue and reception room numbers, as well as the time of the patient's arrival at the doctor's appointment. At the time specified in the coupon, the patient must go to the doctor's appointment to receive medical services. If the patient does not appear for an appointment with a doctor at the time specified in the coupon, in order to organize the separation of patient flows within the framework of infection control, the patient needs to re-apply to the registry to make a new appointment with the doctor. Information about the time of appointment with specialist doctors, indicating the room number, about the time and place of reception of visitors by the head physician and his deputies, about the opening hours of the Center (including weekends and holidays), the patient can receive from the reception orally, clearly on information stands, as well as on the website of the Center. The duties of the receptionists do not include informing by phone, pre-registered patients for an appointment with specialist doctors in the event of a change in the work schedule, doctor's illness. Referral of patients, in need of inpatient medical care, done ok, established by the Ministry of Health of the Republic of Belarus. At the registration desk of the outpatient departments of the Center, during the initial visit, the patient presents a passport and a medical card of the outpatient is entered into it. (Further – medical card). Further document, proof of identity, presented at each visit to the institution. The medical record is the property of the Center and is stored in the institution in accordance with the regulated terms.
Medical care is provided to minors accompanied by one of the parents. (legal representative) or faces, actually caring for the child.

Medical care in a day care unit

The referral of patients for treatment to the day care unit is carried out by the TB doctors of the Center or other doctors of the center together with the heads of the departments. Patients are referred for treatment, registered in r. Minsk and / or attached to service in the city's polyclinics. Minsk (according to the decree of the Ministry of Health of the Republic of Belarus from 22.12.2008 № 229), as well as foreign and stateless persons – in accordance with the legislation of the Republic of Belarus.

Indications for referrals to ODP UZ "MKTSFP"
to provide specialized medical care:

active tuberculosis of the respiratory or extrapulmonary localization to start a course of treatment on an outpatient basis in order to control the possible development of adverse events on specific therapy and to stop side effects;
active tuberculosis of the respiratory or extrapulmonary localization with the presence of concomitant pathology ( HIV infection, diabetes, cardiac pathology, viral hepatitis, Ph.D. liver disease, GIT, Ph.D. noncommunicable diseases associated with TB, requiring daily monitoring by the doctor of the patient's condition) for the relief of adverse events or the progression of comorbidities.
active respiratory or extrapulmonary tuberculosis with poor tolerance to specific therapy, the development of adverse reactions to anti-tuberculosis drugs, not requiring transfer to a round-the-clock hospital for their relief;
suspicion of respiratory tuberculosis in patients of certain categories (who have had tuberculosis in the past, with the presence of concomitant pathology and poor tolerance of antibacterial agents), requiring daily examination by the attending physician;
respiratory diseases, for infusion bronchodilator, nonspecific anti-inflammatory therapy, not requiring 24/7 monitoring, requiring daily dynamic medical supervision;
mycobacteriosis of the lungs to start a course of treatment, control over drug tolerance and correction of adverse events of the therapy.

Indications for referral to the day care unit are the need for medical supervision over a certain period of time for the patient when using therapeutic agents in connection with possible adverse reactions., monitoring and correction of side effects for specific therapy, use of parenteral, in particular, intravenous, methods of drug administration, as well as the use of physiotherapy in the complex treatment, laser irradiation, etc..

Common contraindications for referral to day care are:
-general serious condition of the patient, severe concomitant disease, complication or progression of the underlying disease, necessitating round-the-clock medical supervision and medical care;
-the need for the patient to comply with strict bed rest; severely limited possibilities of independent movement of the patient;
-acute inflammatory processes, febrile diseases;
-common forms of tuberculous process with abundant bacterial excretion (by bacterioscopy);
-some infectious and skin contagious diseases, requiring patient isolation.

Upon admission to the day care unit, the patient presents a document, proof of identity, X-ray documentation, referral for hospitalization of the established form with the results of the necessary examinations, treatment card, as well as other documents, characterizing the state of health. Upon admission to the day care unit, the nurse of the day care unit registers the patient in the “Patient admission and hospitalization refusal log” (f. № 001 / u), enters his passport data into the "Medical record of the patient of the day care unit", introduces him to the daily work schedule and the rules of patient behavior (according to application). In case of refusal of hospitalization – the doctor or the head of the department makes an entry in the "Register of patients admission and refusals of hospitalization" and informs the phthisiatrician, referring the patient to the day care unit. Before prescribing anti-tuberculosis treatment, the patient signs an informed consent for treatment and prevention. The length of stay of the patient in the day care unit is determined by the attending physician, taking into account the medical and diagnostic measures carried out and depending on the patient's state of health, but not more 4 hours a day. If necessary, the length of stay of the patient can be increased by the attending physician; The doctor of the day care department examines patients daily, recording the examination data and appointments in the medical record at least 3 once a week (if necessary – more often), controls, adjusts the prescribed treatment. When the patient's condition worsens and the need for round-the-clock medical supervision, as well as the identification of abundant bacterial excretion (by bacterioscopy), the patient is immediately transferred to a 24-hour hospital.

The provision of medical and diagnostic assistance to patients of the day care unit is ensured with the involvement of the relevant structural divisions of the Center.: X-ray departments, clinic- diagnostic laboratory, physiotherapy room, functional diagnostics room, etc.. The patients, those being treated in the day care unit must comply with the rules of conduct in the institution.

The patient is discharged from the day care unit by the attending physician, carried out at:
– loss of indications for treatment in the day care unit;
– the need to transfer to another healthcare facility;
– with systematic violations of the treatment regimen, failure to appear for treatment.

The patient is examined before discharge from the day care unit, after that, an extract from the inpatient card is issued, transferred to the phthisiatrician at the place of dispensary observation.
After the patient is discharged, his "Medical card of an inpatient" is drawn up and submitted to the archive, where is stored in accordance with the established terms (10 years).

2.3. Home health care

Medical assistance outside the healthcare organization is provided in case of exit (departure) a medical worker of a healthcare organization at the place of residence or place of stay of the patient. Home assistance is provided by the Center in the form of an inpatient facility at home.. Hospitalization in a hospital at home is carried out by the decision of the medical consulting commission of the institution. Indications for hospitalization are set individually, the basis is the impossibility of regular visits to the institution to receive anti-tuberculosis therapy for objective reasons.

Working hours of the health care institution "Minsk Clinical Center of Phthisiopulmonology"

The working hours of the institution are established by the decision of the Minsk City Executive Committee. The head of the institution establishes the operating mode of individual structural divisions, taking into account production needs.

Working hours of the Center:
Working day:
Monday Friday 8.00-20.00
doctor on duty. 19.00-20.00
administration 8.00-16.30

Sunday, Republican holidays in accordance with the calendar are days off.

Working hours of individual structural divisions:

Working day:
Registry 07.30-20.00
Reception of specialist doctors 08.00-20.00
Performing medical procedures 08.00-20.00

Performing laboratory 07.30-11.00
diagnostic procedures

Saturday days: 15.00-17.30
Registry: 09.00-15.00
Consultation with a specialist doctor: (doctor on duty)
adult population 09.00-15.00
child population (first Saturday of the month) 09.00-15.00

Performing medical procedures. 09.00-15.00

Reception schedule for the administration of the institution

Tumashik Svetlana Mikhailovna - chief physician
tel. 362-71-29 (reception)
Reception of citizens:
1, 2, 3, 4, 5-th Thursday 8.00 – 13.00
3-I'm Saturday 9.00 – 12.00

Bulavina Elena Nikolaevna - Deputy Chief Physician for Medical Affairs
tel.258-71-19

Reception of citizens:
Tuesday 16.00 – 20.00
Wednesday 8.00 – 12.00

Visloukh Natalya Ivanovna - Deputy Chief Physician
for organizational and methodological work, chief freelance phthisiatrician of the Health Committee of the Minsk City Executive Committee

cabinet: 206
telephone: 301 20 17

Reception of citizens: Monday 8.00 – 12.00

Patient rights and obligations

In accordance with Article 41, 42 Law of the Republic of Belarus of 18.06.1993 No. 2435-XII "On Health Care" (as amended by 11.12.2020 №94-З) the patient has the right to:

getting medical care;
choice of the attending physician and healthcare organization;
participation in the choice of methods of medical care;
stay in a healthcare organization in conditions, meeting sanitary and epidemiological requirements and allowing to exercise the right to safety and protection of personal dignity;
respectful and humane treatment by health workers;
obtaining information in an accessible form about the state of one's own health, applied methods of medical care, as well as the qualifications of the attending physician, other healthcare professionals, directly involved in providing him with medical care;
refusal to enter information, constituting a medical secret, to the centralized health information system, excluding information, provided by healthcare organizations to law enforcement agencies in accordance with paragraph two of part eleven of article 46 of this Law;
familiarization with medical documents, available in the healthcare organization and reflecting information about the state of his health, the facts of seeking medical help;
choice of faces, who can be provided with information about his state of health;
refusal to provide medical care, including medical intervention, except in cases, provided by this Law;
pain relief, associated with the disease and (or) medical intervention, by all methods of providing medical care, taking into account the therapeutic and diagnostic capabilities of the healthcare organization;
implementation of other rights in accordance with this Law and other legislative acts.

The granting of the rights specified in this article to the patient cannot be carried out to the detriment of the health of other patients and violate their rights and freedoms..

The patient is obliged:
– take care of your own health, take timely measures to preserve it, strengthening and rebuilding;
– treat healthcare workers and other patients with respect;
– follow the recommendations of medical professionals, necessary for the implementation of the chosen treatment tactics, cooperate with healthcare professionals in the provision of medical care;
– inform health care providers about the presence of a disease, hazardous to public health, human immunodeficiency virus, and also observe precautions when contacting other persons;
– inform medical workers about previously identified medical contraindications to the use of medicines, hereditary and past diseases, about seeking medical help, as well as changes in health status;
– follow the house rules for patients, take good care of the property of a healthcare organization;
– perform other duties, provided for by this Law and other acts of legislation.

Information about the established prohibitions in the institution

The institution is prohibited:

smoking, with the exception of "specially designated places, drinking alcoholic, low alcohol drinks, guilt, drug use, psychotropic substances, their analogues, toxic or other intoxicating substances.
have a cold weapon or firearm with you, show it to staff or others;
try to move any property outside the Center, Consumables, medicines, which belong to the institution;
behave noisy, create problems for other visitors to the institution;
engage in any kind of trade or exchange;
bring or bring animals to the institution, birds;
use mobile communications while at the Center, including during the provision of medical care;
enter the institution in dirty clothes with a strong specific odor.
be at the reception in a state of alcoholic and (or) drug intoxication.

Photo and video filming in the institution can only be carried out taking into account
Art. 140 Civil Code of the Republic of Belarus from 07.12.1998 №218-З, Art. 18 Law of the Republic of Belarus dated 10.11.2008 No. 455-З "About information, informatization and information protection ", item 7 of Art. 32 Law of the Republic of Belarus dated 17.05.2011 No. 262-З "On copyright and related rights", item 9, Art. 10 Law of the Republic of Belarus dated 10.05.2007 №225-З "About advertising", as well as guided by clause 4 of Art.. 34, Art. 40, Law of the Republic of Belarus dated 17.08.2020 No. 427-З "On the Mass Media".

In exceptional cases, established by the Ministry of Health of the Republic of Belarus, in the interests of the patient, the use of scientifically based, but not yet approved for use in the procedure established by the legislation of the Republic of Belarus methods of providing medical care. The decision on their use is made with the written consent of the patient., and for minors – with the written consent of one of the legal representatives; persons, recognized as legally incompetent, - with the written consent of their guardians; persons, not capable for health reasons to make an informed decision, - with the written consent of the spouse (spouses) or one of your close relatives.

Information on the procedure for providing paid medical services to citizens of the Republic of Belarus, foreign citizens and stateless persons, temporarily and permanently residing

(located) in the Republic of Belarus

The procedure for the provision of paid medical services to citizens of the Republic of Belarus. Medical services in excess of the guaranteed volume of free medical care established by the state are additional and are provided by state healthcare institutions on a paid basis in accordance with the procedure, established by the Council of Ministers of the Republic of Belarus.

Paid medical services in the state and other health care institutions are provided to citizens of the Republic of Belarus on the basis of written agreements (excluding paid medical services, provided anonymously),
List of paid medical services, provided to the citizens of the Republic of Belarus by the institution, established by the Council of Ministers of the Republic of Belarus. Based on this list, a list of services and a price list for services are developed, approved by the head. The price list is in the registries and at the heads of structural divisions.

The procedure for the provision of medical services * to foreign citizens and stateless persons.

Foreign citizens and stateless persons, permanently residing in the Republic of Belarus, have the right to affordable medical care on an equal basis with citizens of the Republic of Belarus, including to receive free medical care on the basis of state minimum social standards in the field of health care in public health care institutions, unless otherwise provided by legislative acts and international treaties of the Republic of Belarus.

Foreign citizens and stateless persons, temporarily staying or temporarily residing in the Republic of Belarus, have the right to affordable health care at their own expense, funds of legal entities and other sources, not prohibited by law, unless otherwise provided by legislative acts and international treaties of the Republic of Belarus.

The procedure for providing information about the patient's state of health

In accordance with Article 46 Law of the Republic of Belarus dated 18.06.1993
No. 2435-XII "On health care" (as amended by 11.12.2020 №94-З) information about the patient's health status is provided by the attending physician to the patient or persons, specified in part two of article 18 of this Law:

minors - with the written consent of one of the legal representatives;
– persons, recognized as legally incompetent,
– with the written consent of their guardians;
– persons, not capable for health reasons to make an informed decision,
- with the written consent of the spouse (spouses) or one of your close relatives.
– an adult patient has the right to identify persons, who should be provided with information about his state of health, or prohibit its message to certain persons. Information about the patient's state of health is presented by the attending physician in the form, complying with the requirements of medical ethics and deontology and an understandable person, with no special knowledge of health care.
– an adult patient has the right to identify persons.
– an adult patient has the right to identify persons, persons authorized by him or persons, specified in part two of article 18 Law of the Republic of Belarus dated 18.06.1993 No. 2435-XII "On health care", the institution issues extracts from medical documents and other documents (conclusions of the medical consulting commission, etc.), containing information about the patient's health, in order, established by the legislation of the Republic of Belarus. The use of information about the patient's health status in the educational process and scientific literature is allowed only with the consent of the patient or persons, specified in part two of article 18 Law of the Republic of Belarus dated 18.06.1993 No. 2435-XII "On health care". Information about the fact of the patient's appeal for medical help and the state of his health, information about the presence of the disease, diagnosis, possible methods of medical care, risks, medical intervention, as well as possible alternatives to the proposed medical intervention, other information, including personal, received during the provision of medical care to the patient, and in case of death, information about the results of the pathological examination constitutes a medical secret.. A responsibility, confidentiality, determined by Art. 178 Of the Criminal Code of the Republic of Belarus. Provision of information, constituting a medical secret, without the consent of the patient or persons, specified in part two of article 18 in the Law of the Republic of Belarus dated 18.06.1993 No. 2435-XII "On health care", produced according to Art. 46 Law of the Republic of Belarus dated 18.06.1993 No. 2435-XII "On health care" (as amended by 11.12.2020 №94-З).

Healthcare organizations ensure the storage of medical records in accordance with the requirements for maintaining medical secrecy.

The order of implementation of administrative procedures

Procedure for issuing certificates, extracts from medical documents to the patient or his legal representative in the outpatient department of the Center are carried out in accordance with the Decree of the President of the Republic of Belarus dated 26.04.2010 № 200 "On administrative procedures, carried out by state bodies and other organizations at the request of citizens ".

The list of administrative procedures performed is posted on the information stand and on the institution's website, indicating the deadlines, list of documents to be submitted, responsible persons.

The procedure for resolving controversial, conflict situations

All controversial and conflict situations, arising between staff and patients, resolved by negotiation. If it is impossible to resolve the dispute through negotiations, the parties have the right to contact higher organizations, court, other organizations of the Republic of Belarus authorized to consider applications in the prescribed manner. When a controversial (conflict) the situation in the structural unit of the institution, the patient has the right to contact the head of the department, deputy chief physicians, to the head physician during the hours of their appointment. The patient has the right to make an entry in the "Book of comments and suggestions", which is located at the registry and issued on demand. All applications received are considered in accordance with the law.