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Identify “The Saints Private Clinic”, has been established in London’s Harley Street for 25 years. It also has another clinic in Manchester and consultancies in Southampton, Hove, Birmingham, Edinburgh, Nottingham, Bristol and York. Since the setting up of “The Saints Private Clinic” it has been able to save more than 100 lives in their emergency cases. In places like the Harley street, 25 years ago, there was no necessity for the government to set up a fully equipped hospital for the small population living there, but by observing the requirement for a medical asylum a few of the respected individuals decided to set up a small clinic which would contain enough medical supplies and help for minor difficulties and in cases of first aid and emergencies. But today, after 25 years even although the little town has prospered greatly and the population has increased by 3 folds, the clinic still stands proudly in its former position, covering a much larger area. The clinic which only contained 2 doctors and 5 nurses 25 years ago, now consist of a large medical team which includes surgeons, dermatologists, general practitioners, a number of nurses, physiotherapists, osteopaths and medical administrative staff who are standing by to be of assistance at all times. The reason why I have chosen this particular clinic for my I.T. coursework is that, although the clinic has now improved a lot from what it was 25 years ago, being just a clinic and not a professionally and highly equipped hospital, the data collections and processes seemed to have also grown increasingly high and difficult to handle along with the number of citizens with medical troubles. This is why I have mainly chosen the administration section of this clinic to study and improve its workings for the benefit of the clinic as well as its patients in the near future. How the department works. And what procedures are involved. The administration department is divided into mainly 2 sectors: the emergency section and the non- emergency section. The emergency section of course deals with the paper work related to all the emergency cases that come in. It mainly consists of 4 staff members: - the first one (receptionist) sits at the counter and attends to the urgent states of the patients. When a patient arrives, the employee asks whether he/she is a member and is carrying a health card. If the patient is not a member and does not carry a medical health card, issued by the clinic, then the employee quickly writes down the problem as well as the patient’s information on 2 cards, marked with the clinic’s stamp. The information written down is mainly the patients full name, gender, date of birth, nationality, address and telephone number (if the patient is aware of his/her blood group, then in that case that piece of information is also recorded) Each of the 2 cards is of a different color: - pink and yellow; one of which is given to the patient (pink) as a temporary health card to be used for the time being and the other card (yellow) is kept as a record and stored in short-term box file, incase the patient wishes to file in as a member later. This short-term box file contains all the yellow cards issued in the emergency section for the particular day. Patients who at the end of the day wish to have a permanent health card have their yellow cards removed and filed into another large box file that contains all the permanent members of the clinic. The other left over cards are cancelled out and trashed. If the patient is a member but is not carrying a health card, he/she is still permitted to meet the doctor due to the emergency case; however his/her details are noted down and checked very carefully for security reasons. Now after the card has been issued or made familiar with, the employee then notes down the patient’s difficulty and his/her name on a separate slip, which is then piled up with other slips and taken, by helpers, to the appropriate doctor, available. On the other hand if the patient is a member and is carrying a health card then employee#2, another of the staff members, who is made responsible for the storage and maintenance of all the yellow cards, checks in if the yellow card corresponding to the patient’s health card exists. Now for the reason that it would take a lot of effort for employee#2 to always go up and check the box file containing the yellow cards of the members every now and then, the employee instead keeps a log book besides him which consists of only the names and I.D. numbers of the members. So whenever a search is to be made, he just looks through the logbook and confirms the I.D. number and the name, and also writes the data down whenever a new member has joined. Now after he has confirmed that the health card is a legal one, the slip is made and sent to the doctor. But before the slips are taken away, another employee; employee#3 quickly runs a check through the list of doctors available in the doctors file, in order to get the most suitable doctor to attend the patient as quick as possible. This also means that he/she has to check if the doctor is free and is not occupied with another patient. The doctors’ files are of various types. There is one file for each day, which contains the required details of the doctors that are working that particular day; for example if the day is a Monday, there will be a special file for doctors that are present on Mondays; along with their names the file will also contain their specialties, and the specific times at when they are working. Being a health card holder, the clinic offers a 25% discount on normal check ups and medicines, and also provides free service during emergencies. In order to issue a new health card, an individual will have to pay a fixed amount after which the same offers mentioned above will be applicable for him. The process of issuing a new health card is not very long. The patient just has his yellow card removed from the short term box file and has more information added to it such as his/her blood group and a unique I.D. number. After the yellow card has been made permanent the patient is given an official health card containing the same information as the yellow card. The clinic enables the members to give their payments after every 3 months. Health card holders have a separate file called as the ‘Members’ Payment File’ where the details such as the name, I.D. number, address and the total payment due are recorded. Whenever a payment is made the name is simply cancelled out. Incases where the payment has not been made for nearly 3 months then a typed letter, issued by the clinic is sent on the member’s mail address along with a receipt, as a reminder. On the other hand for those who are temporary patients and do not hold health cards have to make their full payment to the administration counter on their way out of the clinic. Over here Employee #4 who is the accountant, comes into the picture, as he/she is the one responsible for the payments and all the other financial tasks that take place. Since the accountant is also responsible of maintaining bills for the patient’s who are not members, he usually keeps another file named as the ‘Nonmember’s payment file’ which consists of only temporary records of the patient which is later eradicated after the payment has been made. This file will usually include the “patient’s number”, “patient’s name”, “gender”, “age”, “ cost of medication”, “ name of the doctor he/she has checked with”, “total amount” and “other deductions (if any)”. It is also very important for him to keep a good account of the dates as in times of trouble it would be the dates that will be used to prove that a particular patient has paid his bill. Since this part of the job is a bit risky as it deals with money and the economy of the clinic, sometimes a fifth employee is also put to work in order to help the accountant. In the other, non-emergency section of the administration department, the situations are rather cool and calm as all the patients who come in here have their appointments already fixed with the doctor before hand. This part of the department consists of only 3 members. Similar to the emergency section, one of the employees sit at the counter to receive the patients who have come to consult with a particular doctor at a given time. If the patient is a health card holder the second employee, in charge of the records, makes a checking. Employee #2 along with confirming the validity of the card through his log book, also reconfirms the details of the appointment not only for the patient who comes in the clinic but also for them who wish to confirm through the phone (he/she is also liable for setting appointments for the patients who call by phone; or when told to do so by the doctor). This logbook is mainly known as the ‘Appointment file’ where the employee records the name of the patient, his/her I.D. number, the name of the doctor he is entitled to meet, the day and time of the appointment and the patient’s telephone number. Now after confirming the card, the first employee makes sure that the doctor is free and then admits the patient to the respected doctors’ office. The third worker of course handles the payment and financial tasks and his/her workings are exactly similar to Employee#4 in the emergency section. In situations where the patient is not a health card holder, no temporary health card is given to him/her but if the patient wishes to have one then the process of issuing a new health card is the same as in the emergency section. There are no slips passed around to the doctors in this section because there is no sign of a rush and so there is no need for any sort of written reminders for the doctors who already have a copy of the list of their appointments in their office made by the staff themselves. Along with the various important files, the administration department also maintains complete details about all its staffs. For the doctors, the department keeps a file containing all the detailed information of each and every doctor under employment at the clinic. This file usually consists of the following: - · Their full and complete names as well as their gender · Their qualifications and the subjects they have specialized in. · Their experience in the medical field. · Their address, nationality and telephone number. · And finally their basic salary per month. For the nurses and other staff a similar file, containing their full names, addresses, nationalities, telephone numbers, experiences as well as their basic salary is also created. And apart from all these, one of the most important files is the payroll file which contains the complete details of every staff’s “name”, “profession”, “contact number”, “wage”, “allowance”, “commission”, “gross salary”, “deductions”, “total”, “net salary”, etc. This file is however subdivided to 3 divisions, the first division belonging to all the doctors, the second division belonging to the nurses and the third belonging to the rest of the staff. An attendance file for every employee is also very essential. A separate ledger/file is kept for this. It shows the attendance for every month. This file consists of the “employee’s complete name”, which has to be checked again so that fewer mistakes are made. The file should also include the “employee’s post”, his “wages” and also the dates of the month and also an extra column for the ”Present/Absent” record. The records of the employees at different posts are organized so that the employees performing the same jobs are recorded together as a batch. The most important files in the administration department such as the ‘doctor’s information file’, the all ‘employees payroll file’, the ‘employees attendance file’ other such files regarding the employees of the clinic are all handled by the head of the department who is the manager. The clinic being a medical center also requires a certain number of stocks of important and essential medicines. Thus to handle such stocks and to make sure that all the necessary medicines are always available a medication file is maintained so that a record of all the medication is held. Throughout this entire system the manual reports/summaries included are: - 1. The temporary health card slips that contain brief information of the patient. 2. On emergency cases members have their summarized data such as their full names, I.D. number, etc. extracted from their personal files for their doctors 3. From the doctor’s working timetable reports such as his/her basic salary, bonuses etc are calculated. 4. From the same file a list of all the doctors available for a particular day is also produced. 5. The members’ personal details file and the member’s payment file are both involved in the production of the members payment report or bill which includes concise information of the member necessary for his identification and his billing conditions and results. 6. When members have not paid their bills in time, statements or letters are created in order to remind them. 7. Temporary statement bills are also created for non-member patients. 8. Regular reports based on the staff attendance are formed and sent to the manager, who makes sure the reports are used to update the attendance files. 9. And at the end of each day a report on the medicine stock is created which is then used to produce another report of all the necessary medicines to be reordered. Problems faced by the department As one should have noticed, the system that I have just described is entirely based on manual workings.
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