Internal rules

APPROVED

By the Order No V1-171 of 31 May 2019

Of the Director of the Public Institution Vilnius City Clinical Hospital

INTERNAL RULES OF PROCEDURE

Of the Public Institution

Vilnius City Clinical Hospital

1. General part

• Public institution Vilnius City Clinical Hospital (hereinafter referred to as “the Hospital”, “the Institution”), institution code 302692454, address Antakalnio 57 and Antakalnio g. 124, Vilnius.
• The Hospital shall conduct its activities in accordance with the Constitution of the Republic of Lithuania, the Civil Code of the Republic of Lithuania, the Law on Health System of the Republic of Lithuania, the Law on Health Care Institutions of the Republic of Lithuania, the Law on Health Insurance of the Republic of Lithuania, the Law on Public Institutions of the Republic of Lithuania, the Law on the Rights of the Patients and Remuneration of Damage to Health of the Republic of Lithuania, the Government Resolutions of the Republic of Lithuania, the orders of the Minister of Health of the Republic of Lithuania, and any other legislative acts and regulatory documents regulating the activity of healthcare institutions, the Articles of Association of the Institution, the Rules of Procedure and any other documents internal to the hospital.
• The Hospital carries out the activities set out in the Articles of Association of the Hospital and in the personal health care licence of the Hospital.

The Rules of Internal Procedure of the Hospital (hereinafter referred to as the Rules) have been prepared in accordance with the laws and sub-legislative acts of the Republic of Lithuania and regulate the procedure of application of the patients to the Hospital, the rights and obligations of patients in the Hospital, the procedure of attendance of the patients, discharge and transfer to other personal health care institutions, the procedure of resolving disputes and conflicts between the Hospital and patients, the procedure of providing information to the patient and his/her relatives about his/her health condition, the procedure for making copies of medical documents (in-patient medical records/ pregnancy and childbirth records/ neonatal development records/ out-patient personal health records) and other documents, the procedure for issuing copies to the patient and to other natural and legal persons, the procedure for the opening hours of the administration of the institution and other departments, the provisions of laws, other legal acts and regulatory documents regulating the health and safety of employees, the procedure for the receipt and storage of precious objects (precious metal articles, prostheses) and money of the patient. These Rules shall apply to the departments of Vilnius City Clinical Hospital located at Antakalnio str. 57 and Antakalnio str. 124, Vilnius (except for the Polyclinic of the Hospital).

• These rules must be observed by all Hospital employees, patients, their representatives, visitors to the Hospital, and other persons within the territory and premises of the Hospital.
• The Internal Rules are published on the website www.vmkl.lt of the Hospital and on the information boards of the Hospital. Copies of these rules are available in each department and are accessible to the patients of the Hospital.
• The hospital has a quality management system in place that meets the requirements of LST EN ISO 9001 standard.
• The personal health care services provided by the Hospital are specified in the Personal Health Care Licence No 3421 (hereinafter - the Licence) issued by the State Accreditation Service for Health Care Activities under the Ministry of Health (hereinafter the VASPVT) on 6 January 2012. The current version of the Licence is available on the website of the VASPVT at: https://www.vaspvt.gov.lt/vaspvt/m/m_files/Lic/L3421.pdf .

2. Procedures for patient referral and admission

2.1 The Hospital shall provide inpatient and outpatient, essential and planned, financed from the budget of the Compulsory Health Insurance Fund (hereinafter referred to as “the Compulsory Health Insurance Fund” (hereinafter referred to as the CHIF), other sources of financing, and paid personal health care services.

2.2 To obtain information about the personal health care services provided by the Hospital, their prices and availability, legal entities and natural persons may apply in writing or orally to the Hospital administration, public relations specialists, heads of departments and attending physicians.

2.3 On arrival, the patient shall first go to the Admission-Emergency Department 1 / Admission-Emergency Department 2 / Obstetrics and Gynaecology Admission-Emergency Department, Pregnancy Pathology and Consultation Department, Paediatric Admission-Emergency Department, Intensive Care Unit and Consultation Department of the Hospital:

2.3.1. for day surgery services provided in Day Surgery Department 1 (Antakalnio str. 57), patients who arrive on a scheduled basis should contact the reception of this department;

2.3.2. for day surgery services provided at the Day Surgery Unit 2 (Antakalnio g. 124), patients who arrive on a scheduled basis should go to the Admissions-Emergency Department 2;

2.3.3. patients arriving for gynaecological day surgery services at the Department of Gynaecology on an elective basis should contact the reception desk of the Admission-Emergency Department of Obstetrics and Gynaecology, Pregnancy Pathology and Consultation.

2.4 Upon arrival at the Admission-emergency departments and/or reception desks, the patient must present his/her passport or other identity document (birth certificate for children), and upon arrival with a referral - a Medical Document Extract/Referral (the referral may be submitted electronically), form No 027/a (hereinafter referred to as the referral).

Persons insured with state health insurance in other countries of the European Union, the European Economic Area and the Swiss Confederation (hereinafter referred to as the EU countries) present a European Health Insurance Card (hereinafter referred to as the EHIC), a certificate replacing the EHIC or a structured electronic document (hereinafter referred to as the SED) S045, which entitles them to receive essential health care services and the necessary reimbursable medicines and medical aid devices (hereinafter referred to as MADs) to prove their insurance status. For citizens of other foreign countries and stateless persons, the Hospital provides only paid personal health care services, including emergency care.

                      2.5 Uninsured persons or persons without a referral, who have sought non-emergency care, shall pay for the personal health care services rendered the fee set out in the price list of paid services approved by the Director of the Hospital.

                      2.6 Patients attending on a scheduled basis must provide proof of identity and a referral letter issued by a personal healthcare institution (referral letter may be sent electronically). Patients must be referred for inpatient treatment by outpatient healthcare facilities after a complete examination when all possibilities for examination and treatment on an outpatient basis have been exhausted, or by inpatient healthcare facilities after appropriate treatment if it is necessary to continue it in another healthcare facility.

                      2.7 Patients shall be consulted and admitted to inpatient departments in accordance with the procedure laid down by the orders of the Hospital Director.

                      2.8 If the patient requires emergency care, it shall be provided in accordance with the legal acts approved by the Minister of Health of the Republic of Lithuania and the internal documents of the Hospital regulating the provision of emergency care. Emergency medical assistance shall be provided to the patient even in the absence of an identity document or a referral issued by a personal health care institution. The indications for emergency care shall be determined by the doctor examining the patient. The staff of the Emergency Department 1 / Emergency Department 2 / Admission-Emergency Department for Obstetrics and Gynaecology, Pregnancy Pathology and Consultation, Paediatric Admission-Emergency Department, Intensive Care and Consultation Department shall ensure the 24-hour provision of emergency medical care.

• The doctor who examines the patient in the admission-emergency department decides whether the patient should be hospitalised or referred to another medical facility for care (if the hospital does not provide it),
• whether the patient should be monitored in the admission-emergency department, or whether the patient can be discharged home for further outpatient treatment after tests and/or treatment. The doctor shall inform the patient (his/her representative) of the decision.
• It is forbidden to admit a person to an inpatient facility without their consent.
• It is forbidden to admit a minor or a disabled person to an inpatient institution without the consent of his or her legal representatives.

 

2.12. No consent is required from the patient or their legal representatives:

2.12.1. where the person’s life is at risk and he or she is therefore unable to give such consent;

2.12.2. where the life of a minor or disabled person is at risk and his/her legal representatives cannot be found quickly;

2.12.3. in other cases, provided by law.

2.13. The procedure for emergency admission shall be determined by the Minister of Health.

3. Nomenclature and range of free services, procedure for the provision of paid services

3.1 Provision of personal health care services and reimbursement of costs for the services provided shall be regulated by the Laws on Health System of the Republic of Lithuania, Health Insurance of the Republic of Lithuania, Health Care Institutions of the Republic of Lithuania, Government Resolutions of the Republic of Lithuania, Orders of the Minister of Health of the Republic of Lithuania, other legal acts and agreements with the State and Territorial Health Insurance Funds.

3.2 Patients with compulsory health insurance who are admitted to the hospital on a scheduled basis and who are hospitalised shall be provided free of charge with services related to the diagnosis, treatment and care of their illness.

3.3 Emergency medical care shall be provided free of charge to all patients in accordance with the requirements of legislation and internal documents.

3.4 A patient needs to pay for healthcare services if:

3.4.1. he/she is not covered by compulsory health insurance;

3.4.2. applies to a medical institution which has not concluded agreements with territorial sickness funds;

3.4.3. wants to consult a specialist rather than a family doctor, but does not have a referral (a referral is not required for urgent medical treatment, long-term follow-up or applying to a dermatovenereologist);

3.4.4. select additional services or procedures on their own initiative;

3.4.5. they want to receive the scheduled healthcare services sooner than they are scheduled;

3.4.6. the patient is provided with paid services included in the list of paid services approved by the Minister of Health (cosmetic surgery and cosmetology procedures, dental prosthetics (except for certain categories of persons), acupuncture and manual therapy, medical examinations when travelling abroad, for the purchase of weapons, for obtaining driver’s and aviator’s licences, in certain other cases regulated by the legislation).

3.5 Patients must have an ID with photo and a personal identification number when visiting their GP. When applying to consultants, hospitals or sanatoriums, the patient must also have a doctor’s referral, and the health care institution will provide emergency medical care even if these documents are not provided.

4. Rights of the patient

4.1 Every patient must receive quality healthcare services.

4.2 The patient has the right to be treated with respect for his or her dignity and honour and to be treated with dignity and respect by health professionals. The patient shall be provided with science-based painkillers so that he/she does not suffer from his/her own health problems. The patient has the right to be cared for and to die with dignity.

4.3 A of the patient rights shall not be restricted on the basis of his or her sex, age, race, nationality, language, origin, social status, religion, beliefs or opinions.

4.4 The patient must be informed of the name, title and professional qualifications of the attending doctor and nursing staff.

4.5 The patient has the right to choose the healthcare professional who will provide the services to him/her, provided that he/she is available to see the patient at the time and that this does not violate other of the patients’ rights or the procedures of the hospital and the rights of the employee.

4.6 Patients have the right to receive information about the services available in healthcare institutions, their prices and access to them.

4.7 The patient shall be informed in writing of the internal rules and procedures of the Hospital in relation to his/her stay in the institution.

4.8 The patient shall have the right to receive information on his/her state of health, the diagnosis of his/her illness, other treatments or investigations available in the healthcare institution or known to the doctor, possible risks, complications, side effects, prognosis of treatment and other circumstances that may influence the decision of the patient to accept or refuse the proposed treatment, as well as the consequences of refusing the proposed treatment, by presenting identity documents. The doctor must provide this information to the patient in a form that the patient understands, taking into account his age and state of health, and explaining special medical terms.

4.9 The information referred to in point 4.8 may be withheld from the patient only in cases where it would be detrimental to health of the patient or endanger his/her life or where the patient refuses the information in accordance with the procedure laid down in this Law. The decision not to provide the patient with information which may harm health of the patient or endanger his/her life shall be taken by the attending physician, unless the law provides for a different procedure for taking such a decision. The decision not to provide information and the reasons for it shall be noted in the medical records of the patient. In cases where the communication would be likely to result in damage to health of the patient, all the information provided for in this Article shall be communicated to the representative of the patient and shall be equivalent to the submission of information to the patient. The information shall be provided to the patient when the risk of harm to health has ceased. The specifics of the right of a patient with mental and behavioural disorders to receive information shall be determined by the Law on Mental Health Care of the Republic of Lithuania.

4.10. If the continued stay of the patient in a healthcare facility is not medically justified, the justification for such a decision and the continuity of care shall be fully explained to the patient or, in the cases provided for in this document and in any other laws or regulations, to the of the patient’s representative, prior to the patient being discharged from the facility to his/her own home or being sent to another healthcare facility. Upon receipt of such information, the patient or, in the cases provided for in this document and other laws and regulations, the representative of the patient, shall certify this by signing. When a patient who, at the time of his hospitalisation, cannot be considered to be capable of exercising a reasonable judgement as to his own interests, is discharged from a health care institution or sent to another health care institution, the information referred to in this paragraph shall be provided to the of the representative of the patient, provided that the latter is named in the medical records of the patient or that the representative of the patient has submitted to the health care institution a document confirming his representation in compliance with the requirements laid down herein and in the other laws, regulations and legislation.

4.11 Information about the state of health of a patient who cannot be considered to have the capacity to make a reasonable judgement about his/her own interests shall be provided to the spouse of the patient, cohabitant (partner), parents (adoptive parents) and adult children of the patient at their request. If the persons indicated are not available or cannot be contacted as soon as necessary, information on the state of health of a patient who cannot be considered to have the capacity to make a reasonable assessment of his/her own best interests shall be provided to one of the of the patient’s adult brothers (sisters) or one of the patient’s adult grandchildren, or one of the patient’s elderly grandparents, upon request. Without prejudice to the rights conferred on other persons, these persons shall also have the right to visit the patient, subject to the consent of the doctor(s) responsible for the patient.

4.12 Information must not be given to the patient against his or her will. The patient shall expressly refuse to receive information about his/her health and shall sign it.

4.13. Healthcare services shall be provided to a patient aged 16 years or over only with his or her consent, except in the case of emergency healthcare services where the patient is unable to express his or her own will.

4.14. A minor patient under the age of 16 years shall receive healthcare only with the consent of his/her representatives, except in the case of emergency medical services. In all cases, healthcare professionals shall select the diagnostic and therapeutic methods that are in the best interests of the minor, taking into account, in particular, the wishes of the minor and those of his/her representatives. In the event of disagreement between a patient under the age of 16 and his/her representatives, the choice of diagnostic and therapeutic methods shall be made by a consilium of doctors, taking into account the interests of the minor.

4.15. A minor patient under the age of 16 years who, in the physician’s reasonable opinion expressed in medical records, is capable of judging his/her own state of health correctly, has the right to seek and decide independently on the provision of the health care services he/she needs, except in cases provided for by law.

4.16. A patient shall not be treated or receive any other health care or care against his/her will, unless otherwise provided by the laws of the Republic of Lithuania.

4.17. Where healthcare is to be provided to a patient aged 16 years or over who cannot be considered to be capable of making a reasonable assessment of his or her own interests, and the persons referred to in Article 22(3) of the Law on the Rights of the Patients and Compensation for Damage to Health of the Republic of Lithuania are not available, or have refused to act as a representative, or are not available to be contacted as soon as is necessary or to obtain their information or obtain their reasonable consent in a timely manner, the decision as to the type of care to be provided to the patient and the extent of such care, the choice of an alternative, shall be made by the doctor who provides the healthcare and, if appropriate, by the consilium of doctors solely on the basis of the interests of the patient. The decision to form a consilium shall be justified by the doctor in the medical records of the patient.

4.18. In the case of a minor patient under the age of 16 years, whose parents refuse to act as legal representative and who is not under temporary guardianship or custody, where the parents (adoptive parents) of the minor patient disagree on the extent of the care to be provided, decisions on the extent of the care to be provided and the choice of an alternative shall be taken by the attending physician or, if necessary, by a medical consortium, based solely on the best interests of the patient.

4.19. Patients aged at least 16 years who are suffering from a list of diseases established by the Government or an authority authorised by the Government shall have the right to access healthcare services without disclosing their identity. The patient shall pay for healthcare services without disclosing the identity of the person himself/herself, except for the exceptions provided for by the legislation.

4.20. The peculiarities of the treatment of a patient, a mental patient who is unable to correctly assess his/her state of health, are determined by the Law on Mental Health Care of the Republic of Lithuania.

4.21. Doctors and nursing staff must respect personal privacy of the patients: a patient has the right to confidentiality of information about his/her health condition (except in cases provided for by the legislation of the Republic of Lithuania).

4.22. The private life of the patient is inviolable. Information about the facts of a life of the patient may be collected only with the consent of the patient and if it is necessary for the diagnosis, treatment or care of the patient.

4.23. The patient has the right to apply to the Hospital administration on any disputable issues.

4.24. A patient has the right to compensation for damage caused by a violation of his or her rights in the provision of healthcare.

4.25. The patient shall have other rights provided for in the legislation of the Republic of Lithuania.

4.26. All necessary information shall be provided/available to the patient during the stay or visit of the patient at the hospital. The information shall be announced on the information boards of the Hospital, on the website of the Hospital, and shall be available at reception desks and admission-emergency departments.

5. Responsibilities of the patient

5.1 The Patient shall be obliged to know the internal rules of procedure of the Hospital, other documents established by the Hospital to sign them and to fulfil the obligations specified therein.

5.2 A patient who has registered for a scheduled personal healthcare service but is unable to attend at the scheduled time must inform the provider at least twenty-four hours before the scheduled time of the service. The patient must inform the receptionist by telephone or other means of communication of his/her inability to attend.

5.3 Patients are required to provide proof of identity in order to receive healthcare services, except in the case of emergency care.

5.4 The patient must provide healthcare professionals with information about his/her health, illnesses, operations, medications taken and being taken, allergic reactions, genetic inheritance and any other information known to the patient that is necessary for the proper provision of healthcare services.

5.5 The patient, having received information about the healthcare services to be provided to him/her, shall, in the cases provided for by this Law, confirm in writing his/her consent or refusal to the provision of such healthcare services.

5.6 The patient must comply with the admissions and recommendations of health care professionals or refuse the prescribed health care services in accordance with the procedure established by this Law. The patient must inform the healthcare professionals of any deviations from the prescriptions or regimen for which he/she has given consent.

5.7 The patient must treat all healthcare facility staff and other patients with respect and dignity.

5.8 A patient who breaches his/her duties, thereby endangering health and life of his/her own or the other patients, or interferes with their access to quality health care, may have his/her health care terminated, unless the life of the patient would be endangered.

5.9 The patient must keep to the specified and agreed appointment time.

5.10 The patient must cooperate with the health care professional prescribing or providing the health care service, comply with his/her prescriptions and recommendations, or refuse in writing the prescribed health care service.

5.11. The patient is obliged to pay on time for the paid services (examinations, consultations, treatment, etc.) in accordance with the rates in force at the time, in accordance with the procedure established by the orders of the Minister of Health of the Republic of Lithuania and the Director of the Hospital.

5.12. The patient must follow the daily routine of the hospital department and follow the instructions of the doctor, nursing staff and other staff within their competence.

5.13. The patient must inform the nursing staff before using the bath/shower and before leaving the Department. Patients may walk only in the part of the Hospital area designated for walking.

5.14. The patient must be able to manage his/her own bed and cupboard, if his/her health permits.

5.15. Patients may only store non-perishable food, water and soft drinks in the cupboard. Perishable foods must be stored in the refrigerator in accordance with established procedures.

5.16. The patient is obliged to treat the equipment and inventory of the Hospital properly and to respect the property of the Hospital.

5.17. Patient must observe fire and electrical safety rules and be careful with themselves and others (e.g. do not sit on the window sill, lean out of the window, etc.).

5.18. Patients undergoing treatment at the Hospital are not allowed on the premises or territory of the Hospital:

5.18.1. to visit other departments of the Hospital arbitrarily;

5.18.2. to play cards and other gambling games;

5.18.3. to possess and use tobacco products, alcoholic beverages; possess and use narcotic drugs, psychotropic drugs and other psychoactive substances, unless prescribed by a doctor;

5.18.4. to store food in areas other than those designated for that purpose (e.g. on cupboards, windowsills, etc.);

5.18.5. to use radios, other recorders and televisions unless other patients on the ward object;

5.18.6. to lie in beds wearing outer clothing, footwear and a head covering;

5.19. The following is prohibited in the hospital (territory and premises):

5.19.1. to film, photograph premises and staff, patients or otherwise violate their privacy in the premises and territory of the hospital without the permission obtained in accordance with the established procedure;

5.19.2. enter with (bring in) pets;

5.19.3. disturb public peace and order.

6. Procedures for visiting, discharging and transferring patients to other personal health care institutions

6.1 Patients shall be seen in the departments on weekdays from 17.00 to 19.00, on non-working days and public holidays from 11.00 to 13.00 and from 17.00 to 19.00. Patients in serious condition may be visited at any time of the day or night, the time and duration of the visit being agreed with the attending physician or the Head of Department, and with the on-call physician during duty hours.

6.2 The Obstetrics and Gynaecology Clinic patients may be visited every day from 8.00 to 10.00 and from 16.00 to 19.00.

6.3 No more than one person may visit a patient in the intensive care profile department at one time, and no more than 2 persons in other departments.

It is not allowed to visit patients on the ward during procedures.

6.4 Visitors are prohibited from:

6.4.1. to go to the hospital department wearing outer clothing (jackets, coats) and footwear. Disposable footwear must be worn upon entering the department with outdoor footwear;

6.4.2. to smoke in the hospital premises and on the hospital territory;

6.4.3. to throw litter and make noise;

6.4.4. to take patients out of the hospital department without the consent of the attending physician (or on-call physician during duty hours) or the head of the department;

6.4.5. to visit patients during quarantine;

6.4.6. to carry or bring a firearm or a cold weapon to the patient;

6.4.7. to carry intoxicants, cigarettes, narcotic, psychotropic and other psychoactive substances to patients;

6.4.8. due to the risk of infections, it is not recommended that pre-school children visit newborn babies and patients in intensive care and surgical departments;

6.5 Visitors who violate the requirements of the internal rules may be removed from the department by the medical or security staff of the hospital.

6.6 Food products handed over to patients during quarantine must be neatly packaged and fit for consumption, with the name of the patient, department and ward written on the packaging.

6.7 The patient must be given notice of discharge 24 hours in advance to home or transfer to another healthcare facility (except in the case of an urgent transfer to another healthcare facility).

                     6.8 The documentation of the patient (Medical Records Extract/Referral - Form 027/a and other documents) must be processed as early as possible on the day of discharge, but no later than to 16:00. If the patient is transferred to another medical facility, these documents must be in order before the transfer.

                     6.9 Parents or guardians must be informed when discharging a minor patient.

                     6.10 Newborn babies are discharged on a scheduled basis before 16:00 every day.

6.11 Patients are discharged from hospital:

6.11.1. when the investigation and treatment plan has been completed;

6.11.2. to continue treatment as an outpatient;

6.11.3. to continue health recovery or rehabilitation treatment;

6.11.4. when transferring to another medical institution for treatment;

6.11.5. for gross violations of the internal rules of procedure of the Hospital, upon arbitrary departure from the Hospital, in accordance with the requirements of the legislation;

6.11.6. at the of the patient request, even though examinations and treatment have not been completed.

The request of the patient is recorded in the medical record and signed by the patient, and it is the responsibility of the attending/waking physician to provide the patient with the medical record to enter the request;

6.11.7. in other cases indicated in law.

6.12. Patients are transported (transferred) to other medical institutions:

6.12.1. when there is no possibility of providing qualified medical assistance locally;

6.12.2. when the necessary health care exceeds the competence of the institution, taking into account its complexity and scope;

6.12.3. when, after emergency treatment, they cannot be treated in a hospital according to the required profile, they may be transported to another medical institution only by special transport;

6.12.4. when other specialist consultations and tests are needed that cannot be provided (performed) in hospital;

6.12.5. when, after active treatment, it is necessary to continue supportive treatment in a facility providing supportive care and nursing services.

6.13. The heads of departments and attending physicians, and on-call chief doctors, shall decide whether patients should be transferred to other medical institutions, and shall sign the medical record to confirm their decision:

6.13.1. the physician providing care to the patient is responsible for assessing the condition and transportability of the patient;

6.13.2. the attending physician or on-call physician shall note the transfer of the patient to another medical facility in the medical records of the patient;

6.13.3. if necessary, a nursing assistant, nurse or doctor is assigned to accompany the patient.

6.14. Patients may be transferred to their home after hospitalisation if serious medical condition of the patient requires it. The conditions for transporting the patient shall be assessed by the attending physician or the physician on duty or the head of the department.

6.15. Patients who do not require special transport after in-patient hospital treatment can be transported to their home or another place (e.g. a nursing home) at the request of the patient or their relatives (the service is then chargeable).

6.16. Pursuant to the provisions of the Order No. V-1131 of the Minister of Health of the Republic of Lithuania of 27 December 2010 “On the Approval of the Description of the Procedure for the Provision of the EMS Services and the Procedure for Payment of Their Costs”, the following Emergency Medical Services (hereinafter the EMS) are provided, which are paid for by the funds of the Compulsory Health Insurance Budget:

6.16.1. in a personal health care institution, if the of the patient health care needed exceeds the competence of that institution;

6.16.2. patients in a stable condition are transferred from one inpatient personal health care facility to another inpatient medical facility if, after the on-call team of the EMS has brought the patient to the emergency department, it becomes apparent that this facility is not able to provide the necessary personal health care services within its competence;

6.16.3. patients who can only be transported by the EMS vehicle shall be transported from the admission-emergency department of an inpatient medical facility to their home, after the patient has been provided with the necessary personal health care services by the Ambulance on-call brigade;

6.16.4. patients receiving artificial lung ventilation at home are transported home after inpatient treatment.

6.17. In accordance with the provisions of the Order No. V-1131 of the Minister of Health of the Republic of Lithuania of 27 December 2010 “On the Approval of the Description of the Procedure for the Provision of Ambulance services and Payment of their Costs”, services of the EMS not covered by the funds of the Compulsory Health Insurance budget may be provided:

6.17.1. transport of patients from one inpatient treatment facility to another inpatient treatment facility for further treatment (the cost of the of the patient transport shall be borne by the sending medical facility in accordance with the contract with the EMS facility);

6.17.2. transport of patients from one medical institution to another medical institution for diagnostic, therapeutic procedures or examinations, if the transport is necessary due to the medical condition of the patient (indications to be agreed between the sending and the receiving institutions) (the cost of the transport of the patient shall be borne by the sending medical institution in accordance with the contract with the EMS institution);  

6.17.3. transport of patients from an inpatient treatment facility to their home after inpatient treatment, if this is necessary due to the serious medical condition of the patient (indications to be determined by the sending medical institution) (the cost of the of the patient transport shall be borne by the sending medical institution in accordance with the contract with the EMS institution);

6.17.4. transporting patients at their request or at the request of their relatives, if this is not necessary due to the medical condition of the patient (at the own expense of the patient).

6.18. Patients treated at the hospital are transported to other inpatient medical facilities for further treatment, scheduled consultations and examinations, on weekdays by hospital transport;

6.19. The hospital does not provide transport services for patients who have received outpatient services in the emergency department of the hospital and do not require special transport (the patient may be called a taxi or the relatives may be informed).

7. Procedures for resolving disputes and conflicts between the hospital and patients

7.1 A patient who believes that his/her rights have been violated shall have the right to lodge a complaint in accordance with the requirements of the content and form of the procedure for handling patient complaints as laid down in the Law on Rights of the patients and Compensation for Damage to Health of the Republic of Lithuania.

7.2 A complaint may be lodged by the patient or his/her representative. A complaint shall be considered if it is written in the official (Lithuanian) language, signed by the patient, containing his/her name and surname, actual place of residence and contact details, and stating the substance of the complaint. If the complaint is lodged by a representative of the patient, the name and surname of the representative, his/her place of residence, the document certifying the representation and the patient on whose behalf he/she is making the complaint shall be indicated. Complaints that are illegible and do not meet the requirements specified shall be returned to the patient, with the reason for the return.

7.3 The patient must provide proof of identity. Where such a complaint is sent by post or courier, it must be accompanied by a copy of the identity document of the applicant certified by a notary public or a lawyer representing the patient. The representative of the patient shall provide proof of identity and representation when requesting such information.

7.4 A complaint submitted by a patient (his/her representative) electronically and signed with an electronic signature shall be treated as a complaint submitted in writing. A patient (his/her representative) may submit a complaint electronically to the e-mail address (info@vmkl.lt) of the hospital.

An electronic complaint must be made in such a way that the hospital, upon receiving the complaint, may:

                     7.4.1. recognise the format of an electronic document;

                     7.4.2. open and process it using the electronic document management system or other information technology tools used by the hospital;

                     7.4.3. recognise the content of the request;

                     7.4.4. identify the electronic signature and the person making the request.

                     7.5 A complaint submitted electronically, where the format of the electronic document cannot be recognised, it cannot be opened and processed by the electronic document management system or other information technology tools used by the institution, or the content of the request cannot be recognised, shall be returned electronically (to the e-mail address) to the person who submitted the complaint, indicating the reason for the return, not later than the next working day. A complaint submitted electronically where the electronic signature and the person making the request cannot be identified shall not be examined, unless the Director of the hospital decides otherwise.

                      7.6 The Director of the Hospital shall appoint a responsible person to investigate the complaint, sets up a committee or order to an audit team to carry out an unscheduled internal medical audit.

                     7.7 Upon receipt of a complaint duly made by a patient (his/her representative), the Hospital shall investigate the complaint and inform the patient (his/her representative) in writing of the outcome of the investigation within 20 working days at the latest.

                     7.8 The Hospital shall only address complaints from patients (their representatives) which fall within the competence of the Hospital. If the information contained in the complaint is not within the competence of the hospital, the complaint shall be returned to the complainant within 3 working days of its receipt at the latest, stating the reason for not examining the complaint.

                     7.9 A complaint with which the same person repeatedly contacts the hospital on the same issue (for the same reason) shall not be considered unless new circumstances are stated which form the basis of the complaint or additional arguments are presented which cast doubt on the validity of the previous reply to the applicant. Where a repeated complaint is not investigated, the hospital shall inform the applicant within 5 working days of receipt of the complaint why his/her complaint is not being investigated.

                     7.10. If the patient (his/her representative) is not satisfied with the handling of the complaint by the hospital, he/she shall have the right to apply to the public authorities addressing the patients’ complaints, i.e. the complaint of the patient (his/her representative's) shall be addressed by the hospital in the first instance, and then the patient (his/her representative) shall have the right to apply to the other authorities for the handling of his/her complaint.

                     7.11 The patient has the right to lodge a complaint within one year of becoming aware that his/her rights have been violated, but not later than three years from the date of the violation of rights.

                     8. Procedures for providing information to the patient (his/her representative) about the condition of the patient

8.1 The patient (his/her representative) shall have the right to choose a healthcare institution in accordance with the procedure established by legislation. A patient who voluntarily comes to a hospital for inpatient or outpatient care shall be deemed to have been informed and to have consented to be examined by the hospital staff, to have his/her state of health assessed, to be prescribed and to undergo the necessary examinations, and to undergo the necessary medical procedures. The hospital must ensure that all necessary information is provided to the patient (his/her representative) during his/her stay or visit, and that hospital staff answer any questions the patient (his/her representative) may have regarding this information. If the healthcare professional is unable to answer the of the patient/representative’s questions, he/she must identify a responsible person in the hospital who can answer the questions of the patient/representative.

• Before the provision of personal healthcare services to a patient admitted to hospital, the nurse/midwife/medical registrar and the doctor, within the scope of their competences, shall inform the patient (his/her representative) on the following:
  • His/her rights and responsibilities;
  • the internal rules of procedure of the hospital;
  • the prices and availability of paid and partly paid services at the hospital, and the free services and availability of these services;
  • referral procedures, availability to choose the health care professional (including the professional qualifications of the health professionals providing the care);
  • the duty of the patient (of the patient’s representative) to cooperate with the healthcare professional prescribing and/or providing the healthcare service, to comply with his/her prescriptions and instructions, and to report any deviations from the prescriptions.
• The patient (or his/her representative) is also informed that the hospital has agreements with higher education institutions (universities, colleges) that train health professionals for the training of students and resident-doctors and that he/she (the patient (or his/her representative) may be involved in the training process if he/she agrees.
• The patient (his/her representative) confirms the fact that the above information has been provided and that he/she has understood it, as well as express his/her consent/non-consent by signing the internal form " Declaration of Will of the Patient for the Provision of Health Care Services at Vilnius City Clinical Hospital", which is a part of the medical documents to be filled in at the units. If the patient (his/her representative) does not agree to participate in the training process or to the use of information about him/her for scientific and educational purposes, he/she shall confirm his/her refusal by signing. In this case, the patient may not be included in the teaching process and the information contained in the of the patient medical records may not be used for scientific and educational purposes.
• The patient (or his/her representative) has the right to be informed about his/her state of health, the diagnosis of the disease, other treatments or investigations available in the hospital or known to the doctor, possible risks, complications, side effects, prognosis of the treatment, and any other circumstances that may influence the decision of the patient to accept or refuse the proposed treatment, and the consequences of refusing the proposed treatment. This information must be provided to the patient by the attending physician (on-call physician on his duty time) in a manner appropriate to the age and state of health of the patient, in a form that is understandable to the patient, and in a manner that explains special medical terms. The information referred to in this clause may be withheld from the patient only if it would be detrimental to health of the patient or endanger life of the patient, or if the patient (or the representative of the patient) refuses the information. The decision not to provide a patient with information that may harm his/her health or endanger his/her life shall be taken by the attending physician or specialist physician providing healthcare to the patient (on-call physician), unless the law provides for a different procedure for taking such a decision. The decision not to provide information and the reasons for it shall be recorded by the doctor in the medical records of the patient. In cases where the notice would be likely to result in damage to health of the patient, all information shall be provided to the representative of the patient, which shall be equivalent to providing information to the patient. The information shall be provided to the patient when the risk of such harm has ceased.
• Before a radiological examination, interventional and/or invasive procedure, or surgery planned, the physician shall inform the patient (or his/her representative) about the nature, purpose, course and possible complications of the procedure/operation. After having read the information provided, the patient (his/her representative) shall confirm his/her agreement or disagreement with the procedure/surgery by signing the internal use forms of the hospital, which are part of the medical records.
• Information about the of the state of health of the patient, the diagnosis of the disease, other treatments or investigations available in the hospital or known to the doctor, possible risks, complications, side effects, prognosis of treatment, shall not be provided to the patient (his/her representative) against his/her will. The patient/representative must expressly refuse the information and sign it in the medical records. The restrictions on the provision of information to the patient (his/her representative) referred to in this clause shall not apply where the refusal of the patient (his/her representative) to receive the information could lead to harmful consequences for the patient or other persons.
• The attending physician (on-call physician) or the specialist who examined the patient must explain to the patient (his/her representative) the meaning of the entries in his/her medical records, within the scope of his/her competence. If the request of the patient (his/her representative) is justified, inaccurate, incomplete, ambiguous data, or data not related to diagnosis, treatment or care, must be corrected, supplemented, completed, cancelled and/or replaced by the physician within 15 working days (indicating that the information in the hospital record has been changed at the of the patient request). A dispute between a doctor and a patient (his/her representative) concerning the correction, addition, completion, cancellation and/or amendment of entries in his/her medical records shall be settled by the hospital director.
• Patient information may only be disclosed to other persons with the written consent of the patient, which shall specify the basis for disclosure and the purposes for which it is to be used, unless the patient has indicated in the medical records in a signed statement which specific person is entitled to receive the information and the scope and timing of the disclosure of such information. The patient shall have the right to specify the persons to whom confidential information may not be provided.
• Hospital staff shall provide information to the patient (his/her representative) verbally, within the limits of their competence. Written information shall be displayed on the department notice boards and in files at each post.

9. Procedure for making copies of medical documents (inpatient medical records / Pregnancy and childbirth records / Neonatal developmental records / Outpatient personal health records) and other documents, for issuing copies to patients (representatives), state institutions and other bodies or other natural and legal persons, and for submitting information about the patient to state institutions and other bodies
   • Upon presentation of an identity document and completion of a request form, if the patient (his/her representative) so requests, in accordance with the procedure laid down by the legislation, the staff of the Statistical Department of the Hospital must make and issue copies of the medical records of the patient at his/her own expense, no later than within one working day from the date of the request of the patient (his/her representative) to the Hospital.
   • If the patient (or his/her representative) wishes, he/she can apply to the hospital and request to be provided with a description of the diagnosis and treatment. The service of providing written information is chargeable when it is not related to the provision of personal health care and pharmaceutical services. The patient (or his/her representative) must provide proof of identity when requesting written information from the hospital. Where such a request is sent by post or courier, it must be accompanied by a copy of the applicant’s identity document certified by a notary public or a lawyer representing the patient. The representative of the patient shall provide proof of his/her identity and representation when requesting written information. The request shall specify the nature of the information requested and the purpose of its use. The hospital shall provide the requested diagnosis and treatment descriptions to the patient (his/her representative) no later than within 10 working days from the date of the request. In the case of a written request for written information from a person with the indication ‘urgent’, the diagnosis and treatment descriptions must be issued no later than within 3 working days from the date of the request of the patient (his/her representative).
   • If the Hospital does not have the requested written information (no medical records about the patient and the services provided to him/her), it shall inform the applicant in writing within 5 working days of receipt of the request for information at the latest, and shall refund the payment for the service.
   • The Head of the Statistics Department is responsible for ensuring that the requested information is provided within the deadline.
   • Discharged inpatient and outpatient patients shall be issued, at their request, with a “Medical Record Extract/Referral”, form 027/a (the form 027/a of the VMKL is detailed and called “Epicrisis”); pregnant women shall be issued with a “Pregnancy Card” (form 025-113/a). For working patients, an electronic sick leave certificate is completed. For persons who have been treated in hospital or who have been nursing a child in hospital, a “Medical Certificate for Absence from Work, Employment Service Under the Ministry of Social Security and Labour of the Republic of Lithuania” (form No 094/a) is filled in the Electronic Health Services and Cooperation Infrastructure Information System (hereinafter referred to as “ESPBI IS”). If the patient was unable to attend the pre-trial investigation institution, prosecutor’s office, court or institution of the national defence system administering military liability, a medical certificate No 094-1/a (Medical certificate for absence from the pre-trial investigation institution, prosecutor’s office, court or institution of the national defence system administering military liability) shall be filled in ESPBI IS system.
   • Repeated extracts from medical records or other medical documents are available from the Statistics Department of the hospital upon payment of a fee.

9.7 All information about the patient is confidential and may only be provided with the written consent of the patient (his/her representative), except as provided by law.

9.8.Institutions wishing to obtain information about a patient shall submit to the Hospital a written request, order, decision or other document required to be submitted in such cases in accordance with the legislation regulating the work of the relevant institutions, signed by the head of the institution or his/her authorised person (hereinafter referred to as the “Request”), or shall enter into a contract with the Hospital for the provision of information about the patient (hereinafter referred to as the “Agreement”). The Request and the Agreement shall specify the legal basis for obtaining information about the patient, the condition for lawful processing, the purpose of the use, the scope of the patient information requested and the manner in which the patient information is to be provided.

9.9. Except for the cases stipulated by the legislation, the Request must be accompanied by the of the patient written consent to provide information about him/her to the institution requesting information about the patient (the original of the consent of the patient or a copy of it certified by a notary public or another person in accordance with the procedure established by the legislation of the Republic of Lithuania), which complies with the following requirements:

9.9.1. expressed in written form (either as a separate paper document printed (written) and signed by the patient, or as an electronic document created by the patient and signed with a qualified electronic signature);

9.9.2. the name and surname of the patient, personal identification number (if the patient does not have a personal identification number, the date of birth of the patient);

9.9.3. specify for what purpose and what specific information about the patient would be provided to the authority requesting the patient information with the consent of the patient;

9.9.4. the period of validity of the of the patient consent and the right of the patient to withdraw consent at any time.

9.10 Patient information may be provided without the consent of the patient:

9.10.1. for healthcare facilities where the patient is being or has been treated, cared for, undergoes a health assessment or registers for healthcare services;

9.10.2. for the authorities controlling the provision of healthcare services;

9.10.3. for the Incapacity Review Commissions to carry out their functions;

9.10.4. for the court, the prosecutor’s office, pre-trial investigation bodies, the State Child Rights Protection and Adoption Service under the Ministry of Social Security and Labour, and other institutions which are entitled to act so in accordance with the laws of the Republic of Lithuania.

• The hospital shall provide the information it holds on the patient no later than within 10 calendar days from the date of receipt of the Request or within the timeframe set out in the Agreement. The Hospital shall provide information on the of the patient presence to the pre-trial investigation bodies when they are searching for missing persons without delay, but not later than on the next working day of the Hospital from the date of receipt of the Request. The Head of the Statistics Department shall be responsible for the provision of the information within the time limit.
• The Hospital shall provide patient information on its own initiative (in the absence of a Request or Agreement) and without the consent of the patient in the following cases:
  • For law enforcement authorities about injured patients who may have been harmed by a criminal act;

9.12.2. if the State Child Rights Protection and Adoption Service under the Ministry of Social Security and Labour has information about a possible violation of the rights of the child, as referred to in thein Framework Law on the Protection of the Rights of the Child of the Republic of Lithuania (psychological, physical, sexual violence against a child, neglect of a child, minor children left without parental care, the need to protect the rights and legitimate interests of minors (due to the parents’ illness, death, departure or disappearance, parents’ refusal to withdraw their children from medical institutions, or similar reasons);

9.12.3. in other cases, established by the laws of the Republic of Lithuania.

• Patient information can be provided in the following ways:

9.13.1. by handing it to a person authorised by the institution, who comes directly to the Hospital and presents an identity document;

9.13.2. by registered post;

9.13.3. by sending via the National Information System for Electronic Delivery using the postal network;

9.13.4. where available, by sending via the integrated information systems of the Hospital (to the area designated for authenticated users);

9.13.5. by email - only if the Hospital and the institution receiving the patient information use two-way encryption keys to encode the email communication (asymmetric encryption);

9.13.6. by any other means ensuring the requirements for the protection of personal data set out in Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46/EC (General Data Protection Regulation, (OL 2016 L 119, p. 1).

9.14. Patient information is not provided by telephone.

                     9.15. At night, on weekends and holidays, the on-call doctor shall issue a Medical Document Extract/Referral, Form 027/a, to the representatives of the court and pre-trial institutions regarding the health condition of the patient (the victim) and the severity of the injury.

10. Provisions of documents governing safety at work

10.1 The safety and health of workers in the hospital shall be the responsibility of the person representing the employer, the hospital director, who shall ensure that the working conditions of the workers are safe and healthful in all aspects of their work.

10.2. The Occupational Safety and Health Department is established in the Hospital, and in carrying out its functions it is guided by the Law on Occupational Safety and Health, of the Republic of Lithuania, other legal acts regulating occupational safety and health, normative documents on occupational safety and health of the Hospital, and the Regulations of the Occupational Safety and Health Department of the PI Vilnius City Clinical Hospital.

10.3 The heads of departments who implement occupational safety and health requirements shall be appointed by order of the Director as the employer's authorised persons for occupational safety and health in the structural units of the hospital.

10.4 The Hospital shall provide briefings on occupational safety and health issues in accordance with the established procedures.

10.5 The hospital shall organise compulsory medical examinations for staff members and shall provide conditions for staff members to undergo medical examinations during working hours. Refusal to do so shall result in suspension from work and non-payment of wages for the period of time until the health check is carried out. On the basis of the findings of the health check, workers may be reassigned to another job with their consent. Pregnant women, women who have recently given birth or women who are breastfeeding are provided with a safe working environment.

10.6. Mild accidents at work shall be investigated by a bilateral commission, approved by order of the Director of the hospital, consisting of a representative of the employer - a specialist of the Occupational Safety and Health Department and a representative of the workers for safety and health. The injured worker may be present during the investigation of a workplace accident or an accident on the way to/from work. Any accident at work, on the way to or from work, or incident occurring at work, must be reported immediately to the head of the department by the injured worker or by a person who witnessed the accident or its consequences, and to the Occupational Health and Safety Department by the head of the unit.

10.7 The hospital shall organise an occupational risk assessment to determine the occupational safety and health status of its units and individual workplaces. If the situation is found not to be in accordance with the requirements laid down in regulatory legislation, the implementation of the necessary measures to eliminate and/or reduce the risks shall be organised.

10.8 All hospital staff shall be provided with safe working equipment. The mandatory safety requirements and conformity assessment procedures for work equipment shall be laid down in the relevant technical regulations (medical standards for medical devices). Particular attention shall be paid to the protection of workers from exposure to hazardous chemicals and preparations and biological agents.

10.9. In accordance with the procedure for the determination of drunkenness or intoxication of employees approved by the Director of the Hospital, if an employee is found to be drunk or intoxicated at work, he/she shall be immediately suspended from work, shall not be allowed to continue working, and shall not be paid any wages for the day on which he/she was found to be drunk or under the influence of narcotic drugs or other substances.

10.10. Smoking (use tobacco products and electronic cigarettes) is prohibited on the premises of the Hospital and its territory.

10.11. It is forbidden to drive mechanical and electrical scooters on the hospital premises.

10.12. Any employee who violates the mandatory requirements of occupational safety and health legislation of which he/she has been informed shall be liable to the liability indicated in law.

11. Procedures for registering and storing precious metal articles, precious prostheses and money held by the patient

11.1 Personal documents of the patients, precious metal articles, precious prostheses and money handed over/received by the hospital for safekeeping shall be recorded on the “Description of Personal Documents, Precious Metal Articles, Precious Prostheses and Money of the Patient” (VNB No 275/b) and placed in an envelope.

11.2 Documents, precious metal articles, precious prostheses and money that are not handed over to the hospital staff for safekeeping and are kept on the ward are the responsibility of the patient (his/her representative).

11.3 Each department shall provide patients (their representatives) with information on the procedure for the receipt, recording and storage of personal documents, precious metal articles, precious prostheses and money. Such information shall be provided verbally (by the attending physician, on-call physician; ward nurse/midwife) and may also be displayed on the ward notice board.

11.4 A patient who comes to the outpatient clinic for examination or treatment procedures may hand over his/her personal documents, precious metal articles, expensive prostheses and money for a temporary safekeeping by a member of the clinic staff.

11.5. The personal documents, precious metal articles, expensive prostheses and money of the patient shall be kept in the department safe.

11.6 Staff actions when hospitalising a patient who is unable to express his or her own will:

11.6.1. in the case of hospitalizing a patient who is unable to express his/her own will (the patient is unconscious, drowsy, diminished consciousness, inadequate judgement of situation, etc.):

11.6.1.1. the personal documents, precious metal articles, expensive prostheses and money of the patient shall be noted in the “Description of Personal Documents, Precious Metal Articles, Expensive Prostheses and Money of the Patients” (VNB No. 275/b) and placed in an envelope. The first (top) part of the Description shall be placed in the envelope and the second part shall be fixed on the last page of the Inpatient Medical Record (Form No 003/a) or the Outpatient Personal Health Record (Form No 025/a). The name and contact details of the patient shall be written on the envelope. The envelope shall be sealed, stamped at the place of sealing by the admitting staff member and handed over to the staff member (nurse/attendant) of the department to which the patient is admitted.

11.7 Personal documents, precious metal articles, precious prostheses and money of the patient may be accepted for temporary storage in the Admission-Emergency Departments 1 or 2.

11.8 Staff actions during the hospitalisation of a patient who is able to express his or her own will:

11.8.1. a patient who is admitted to hospital and who is able to express his/her own will shall be informed that he/she may hand over his/her personal documents, precious metal articles, expensive prostheses and money to the staff of the department in which he/she is being treated for safe keeping;

11.8.2. if the patient wishes his/her personal documents and/or precious metal articles, precious prostheses and money to be kept in the department where he/she is being treated, he/she shall hand over his/her personal documents, precious metal articles, precious prostheses and money to the Senior Nursing Administrator (Senior Midwife) of the department; in his/her absence, to the General Nurse/Midwife of the department;

11.8.3. The fact of handing over and accepting documents and other valuables shall be noted by completing the “Description of Personal Documents, Precious Metal Articles, Expensive Prostheses and Money of the Patients” (VNB No 275/b).

11.9 The security of patient documents and material valuables handed over for safekeeping shall be the responsibility of the department staff.

11.10. If the patient does not hand over personal documents and other valuables in his/her possession to the hospital staff for safekeeping, he/she is responsible for their security.

11.11. The patient (his/her representative) may collect the stored personal documents and/or precious metal articles, precious prostheses and money on the day of discharge from the hospital, on transfer to another medical institution or during the stay in hospital.

11.12. The patient (his/her representative) confirms the fact of taking back the documents and/or material valuables and the fact that he/she has no complaints to the hospital staff regarding the return of the stored items by signing the “Description of Personal Documents, Precious Metal Articles, Expensive Prostheses and Money of the Patients” (VNB No.275/b) by signing it.

11.13. When a patient dies or is transferred to another hospital, the personal documents and material valuables of the patient shall be collected by the representative of the patient upon presentation of a document confirming the identity of the patient (and, if necessary, a document confirming the legality of the representation of the patient). The representative of the patient shall certify by signing “Description of Personal Documents, Precious Metal Articles, Expensive Prostheses and Money of the Patients” (VNB No 275/b) the fact of collection (return) of the documents, precious metal articles, precious prostheses and money, and the fact that he/she does not have any complaints against the hospital staff regarding the return of the stored items of the patient.

11.14. Procedures for storage of patient clothing:

11.14.1. During the hospitalization of a patient, the nurse assistant or other staff member of the Admission-Emergency Department, the Admission-Emergency Department for Obstetrics and Gynaecology, Pathology of Pregnancy and Consultation, or other staff member, shall register the clothes taken from the patient (if the patient is unconscious and cannot express his/her own will) or registers clothes handed over by the patient for storage in the internal use form VNB No.16/b , “Record of Items”, completing two copies of this form: one copy to be left in the medical records of the patient and the other to be handed over with the clothing of the patient to the Patient Clothing Storage on its working hours.

11.14.2 Before leaving home, the patient (his/her representative) or the staff of the department where he/she has been treated shall collect the clothes from the Patient Clothing Store by submitting the “Record of Items” (VNB No.16/b). If the patient leaves during the closed hours of the Patient Clothing Storage of the patients, the clothes shall be collected in advance, i.e. during the opening hours of the Patient Clothing Storage of the patients.

12. Opening hours of the hospital, hospital administration and other departments

12.1 The hospital provides services to patients 24 hours a day, without rest days.

• The administration of the Hospital and other departments are open from 8.00 am to 4.30 pm. (lunch break from 12.30 to 1.00 pm).
• On the days before the holiday, the hospital administration and other departments are open from 8.00 am to 3.30 pm. (lunch break from 12.30 to 1.00 pm).

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