Service Points


Follow us on Facebook: HMISSwaziland

Business Hours
Days Hours
 Monday - Friday  08:00 - 16:45
 Lunch Time  13:00 - 14:00
* We shall observe all holidays as stipulated by the Government of Swaziland

Contacts
Physical Address: Cooper Centre Office 106, Mbabane, Swaziland

Postal Address: P.O Box 5 Mbabane, Swaziland

Phone: 2404 7712

Fax: none

HMIS - Service Points

The Health Management Information System (HMIS) unit under Strategic Information Department (SID) of Ministry of Health (MoH), Swaziland's Ministry of Health (MoH) has a variety of Service Points. A Service Point is a site/point from which our organization and other stakeholders make their services available to its customers.
Service Point List:
1. Registry: The registry service prepares the patient or client before he can walk into the consultation room. The patient gets  ...more details...  registered, pays (if required) and obtains a Patient Card with a blank Prescription Sheet attached. Patient education normally happens once a week (at intervals) and early TB screening is also an activity within the Registry Office.

Remarks:
  • The process is fairly simple and has few instruments to be filled

Work-Flow Diagrams:
2. Out-Patient Department (Nursing): The outpatient department offers many services to patients who do not need be admitted in a healthcare facility.  ...more details...  The department acts as a first stop where patients are medically screened and given care when their condition is not critical. In a situation where the patient is found critical at the said screening then he/she is referred to a specialist.

Remarks:
  • All patients from registry still have to re-enter their demographic data in the OPD register.
  • All forms were identified to contain the patient's demographic data to some extent.

Work-Flow Diagrams:
3. Dispensary: The patient brings the prescription sheet from the OPD or any other service prescribing medication.  ...more details...  The pharmacist checks the validity of the prescription and stock availability of the prescribed medication then dispenses the medication if stock is available otherwise (or else) orders the medication from the main pharmacy of the facility. The pharmacist here also performs the duty of instructing patients on the administering of medication.

Remarks:
  • There is only one form to work with, the prescription sheet.

Work-Flow Diagrams:
4. Casualty: The casualty department is a medical treatment facility specializing in acute care of patients who present themselves  ...more details...  without any prior appointment. The casualty (emergency) department is usually found in a hospital or other primary care facilities. Due to the unplanned nature of patient attendance the department must provide initial treatment for a broad range of illnesses and injuries, some of which may be life-threatening and require immediate attention.

Remarks:
  • It's a fairly basic process with an OPD register and other services interfacing forms like the admissions form for those patients that proceed to the In Patient or passing through the pharmacy.

Work-Flow Diagrams:
5. Admissions and Accounts: The admissions and accounts department is the gateway to the In-Patient Department of the facility. The accounts  ...more details...  section is auxiliary and comes in when patients must pay for their stay in hospital.

Remarks:
  • The process has too many instruments within the admission and discharge tasks

Work-Flow Diagrams:
6. Paediatric Ward: The Paediatric ward specializes in the medical care of infants, children and adolescents. For the  ...more details...  fact that infants and children cannot communicate with the care giver, the process was designed to have as few instruments as possible. The process commences with the admission of the patient, proceeds to the checking of the vital signs and continues through the other clinical procedures till the patient is discharged.

Remarks:
  • The process is fairly straight forward with few instruments to fill and most tools in the workflow are filled with results from various tests.

Work-Flow Diagrams:
7. Private and Gynaecology Ward: Patient arrives and on producing the admission and/or discharge form s/he is posted to bed and oriented,  ...more details...  history is taken and then patient is examined.

Remarks:
  • It's a fairly straight forward process with very few instruments.

Work-Flow Diagrams:
8. Maternity: The Maternity department provides care for women during pregnancy and child birth as well as for newly  ...more details...  born infants.

Remarks:
  • It's a very busy workflow with too many instruments to fill

Work-Flow Diagrams:
9. Medical Ward: The medical ward is an in-patient department where no surgery is required on the admitted patients. The patients  ...more details...  here are treated by medication. The workflow commences with a history and vital signs check, then nurse care supporting doctor's checks on the patient. Finally, exit point which includes patients being referred to other specialty services, pharmacy, being discharged and the morgue.

Remarks:
  • The workflow has too many instruments to fill.
  • There are too many activities running concurrently.
  • Workflow interfaces with many other services including pharmacy, mortuary, diagnostics (x-ray), etc.

Work-Flow Diagrams:
10. The surgical ward: The surgical ward prepares patients proceeding to surgery or theatre, it takes patients from the casualty  ...more details...  (emergency) ward. Patient vitals are taken followed by a doctor's examination who then decides whether the client must proceed to theatre or otherwise. When referred to theatre the client is educated as to what follows and consent is obtained.

Remarks:
  • There are far too many forms to be filled, at least 18 in number.

Work-Flow Diagrams:
11. Surgery (Theatre): It's a simple process but surgically executed and includes only anaesthesia, surgery (operation) and monitoring.  ...more details...  Patients here are referred from the surgical ward.

Remarks:
  • A simple process with too many tools used though
  • Has mortality risk inherent and probably faces too many legal suits

Work-Flow Diagrams:
12. Laboratory: The Laboratory workflow is auxiliary and very basic; it is invoked by a request from service points where diagnostics  ...more details...  are required. The requested tests are then performed and the results sent back to the requester. Laboratories vary in size and also perform different tests. All requests are logged into the register. After the tests are performed results are printed on some instrument and transferred to a standard form that is sent back to the requester.

Remarks:
  • The process has very little forms to be filled.
  • The forms go back the same place they come from, i.e. to the requester.

Work-Flow Diagrams:
13. Radiology: The Radiology workflow is an auxiliary one and very basic. Radiology offers x-ray and ultra sound; process is invoked by  ...more details...  a request for service on a request form. All requests are logged in the register (x-ray register). Patients come with their treatment card. The x-ray service produces the image and results are recorded on the request form. The ultra-sound section has a further register and bookings form. The results are recorded in the ultra-sound report.

Remarks:
  • There are two registers in the entire workflow process.
  • There is no doubt that demographic data is duplicated in these registers

Work-Flow Diagrams:
14. Pharmacy: The Pharmacy workflow is a bit more complicated. It involves the following:  ...more details... 
Payment:
  • Dispensary to patients and wards
  • Monitor ward stock
  • Stock management

Remarks:
  • The process is directly linked to CMS and accounts processes

Work-Flow Diagrams:
15. Art clinic: Patients go through the registry and are directed for counselling, Pre-ART and ART services. The Pre-ART  ...more details...  and ART services are mutually exclusive, the entry point is the Pre-ART process before the patient proceeds for the ART process when the CD4 count equals or is less than 350 or is WHO Stage III or IV.

Remarks:
  • There is a lot of information duplication especially in the various registration books.
  • There is a register at every service point all containing patients' demographic data.

Work-Flow Diagrams:
16. Gynaecology and Cervical Cancer: It's a fairly simple process. It commences with a history check, then examination by a Gynaecologist for gynae  ...more details...  and cervical cancer related ailments. If complications are identified then the patient is referred to a specialist as required otherwise sent for medication.

Remarks:
  • The process is fairly basic but has a lot of instruments

Work-Flow Diagrams:
17. Dental: The Dental process has three main components namely patient examination and diagnosis, treatment and exit.  ...more details...  The patient comes in with a patient card and prescription sheets from OPD. The dentist fills in the dental register, examines the patient to identify the actual problem, then the patient is treated and this includes tooth cleaning, filling, extraction, accident repair, and recording any follow-ups. Patient exits through the pharmacy (prescription filled), dental health education or referral (referral form filled) to a specialist.

Remarks:
  • The process is fairly simple with few instruments to fill for the dentist
  • The dental register duplicates the patient demographic data

Work-Flow Diagrams:
18. Eye Clinic: The eye clinic is one of the simple workflows, OPD being the entry point. Process has three segments, namely  ...more details...  history at the "gate", treatment and the "exit" which would include referral to the specialists (namely ophthalmologist and optometrist) and/or the pharmacy.

Remarks:
  • The process is very simple and records data on very few instruments.

Work-Flow Diagrams:
19. Mortuary: The Mortuary workflow depicts what transpires after a patient is deceased and explicitly shows the ensuing  ...more details...  processes on how the corpse is handled until it leaves the mortuary for the incinerator or graveyard. The workflow is invoked with a death anywhere in the facility, normally from in-patient or even outside the facility. The corpse is brought into the mortuary with a corpse-tag, demographic data is then entered into the corpse register, process includes the services of a Medical Officer in case there is need to extract a foetus from the corpse, Otherwise corpse goes to the pathologist's services for post-mortem and finally payment before the corpse is released for either burial or incineration. On release the collection register is filled with the collectors' (normally next of kin) information as well.

Remarks:
  • The workflow has two registers documenting information about the corpse (mostly) and the next of kin. There is duplication in these registers on the corpse demographic information
  • The municipality intervenes on cases where corpses are not claimed by family members. It (the municipality) takes these corpses and have them buried.

Work-Flow Diagrams:
20. Clinics workflow: The diagram outlines data flow process and an overview of the services offered in a generic clinic. Clinics  ...more details...  covered in this assessment were stratified by type: having maternity and those without maternity. The process commences from the consultation room where patients are screened, offered treatment and sent to dispensary to collect medication. If the patient condition needs some further diagnosis and treatment, the patient is referred.

Remarks:
  • Clinics with maternity i.e. Gebeni Clinic have a maternity ward with beds, but maternal cases are being referred to hospitals due to limited working hours of their staff.

Work-Flow Diagrams:
21. Ante –Natal Care : This process deals with cases of women who have been already confirmed to be pregnant, the process starts with  ...more details...  general check-up which is done by the nurse to the patient followed by tests for HIV, Haemoglobin and rapid plasma reagin. Patients undergoing HIV testing are recorded in the HTC register and those testing positive are referred for CD4 count in other health centers. The ANC and CTX sheet exercise book are the instruments used to record results obtained.

Remarks:
  • Too many data collection tools to be filled, some with the same data elements.

Work-Flow Diagrams:
22. Family Planning: Most cases seen at family planning points in clinics are those of women trying to avoid falling pregnant or  ...more details...  rather with unverified pregnancy status. Patients coming for family planning services in clinics are offered pregnancy test and also general tests by the nurse and the results are recorded in the FP register, FP follow up Card and FP client record card. When pregnancy test is done, the results are further sent to the LAB for verification. Should the patient require medication (contraceptive), they are sent to the dispensary with a prescription form.
Work-Flow Diagrams:
23. Post Natal Care: The Postnatal Care service provides health care to both mother and child following childbirth. Services offered are just  ...more details...  general check-up, family planning counselling and HIV testing. Any diagnostics results are recorded in the PNC register, Tally sheet, maternal health card, patient card and HTC register.

Remarks:
  • With most clinics, all these services are offered within one room/point.

Work-Flow Diagrams:
24. Pre-ART: All patients diagnosed to be HIV positive and with CD4 count above 350 need to be enrolled into Pre-ART for  ...more details...  monitoring to ensure that they stay healthier, patient information is recorded in the pre-art register and ART follow up card.

Remarks:
  • Too many data collection tools to be filled, some with the same data elements.

Work-Flow Diagrams:
25. ART: Patients seen at this service point are normally those referral from Pre-Art or other services. The clients on ART  ...more details...  benchmark for initiating is measured by CD4 count of less than 350 or a WHO stage III or IV. Data collection tools used for this process include an appointment register used to schedule the next follow days, ART register tracking patients initiated on ART, ART follow up card used for initiation and follow up dates, lab request form for further lab tests investigation and prescription form for collecting prescribed drugs.

Remarks:
  • Service requires the filling of many data collection tools, most with duplicated data elements.

Work-Flow Diagrams:
26. TB: TB screening services are offered to patients presenting at this service point. Patients are assessed using  ...more details...  TB screening tool for any vital signs leading to TB related illness and for cases where screening results are positive, sputum is forwarded to lab for further examination. Sputum sent to the lab goes along with a Lab request sputum form which records outcomes from the examined sputum.

The initiation of patients on treatment relies on the turnaround time for smear microscopy results. Tools used to record clinical data and follow up dates are treatment support card, TB card, TB registers and prescription form.
Work-Flow Diagrams:
27. Dental: Dental care services offered in clinics include: Preventative, Curative (Surgical) and referrals, patients undergo  ...more details...  an assessment and from the assessment a decision is take on any of the three processes to be undertaken and if it is either a Preventative or Curative case medication is prescribed else patient is referred.
Work-Flow Diagrams:
28. Non-Communicable diseases: Mostly patients seeking Non-Communicable disease services are referred to major facilities. A process  ...more details...  of screening is carried out to verify the type of NCD and treatment is given if there are no further investigations desired.
Work-Flow Diagrams:
29. Child Health services: Child Health services offered in clinics include nutrition, growth monitoring, early infant HIV diagnosis,  ...more details...  immunization and treatment of minor ailments. Mothers with new born have their babies weighed and screened for vital signs. Those that are exposed to HIV undergo HIV testing and counselling to the mother, further tests are also sent to the lab for further examinations on dried blood spots and Polymerase Chain Reaction (PCR).

Instruments used in this process flow include, Immunization card for routine immunization, Mothers to Mothers register for counselling and adherence to exposed mothers, immunization tally sheet for calculating the immunizations given, dry bloodspot log book for lab tests and referral form for referral of major cases.
Work-Flow Diagrams: