Internal Rules and Regulations of Regional Hospital Limbe 

​I. Introduction:

The Regional Hospital Limbe (RHL) is a government owned tertiary care health institution with a capacity of 200 beds. 

 Its mission is as follows:  
1. To offer the best quality of care to patients at an affordable cost 
2. To offer pedagogic support to training institutions of health personnel in the country 
3. To carry out operational research within the context of improving patient welfare 
4. To co-operate and collaborate with other health institutions 

II. Vision

The vision of the entire staff working at the Regional Hospital Limbe is focused on assisting the populations of the South West Region and beyond to attain the highest possible level of quality health care at a cost that is affordable irrespective of ethnic, political and religious inclinations working as devoted teams, inspired by love and respect for patients especially.

III. Aim

The aim of having these internal rules and regulations written out for everyone working in the RHL is to sensitize and familiarize all the categories of the staff with those moral and ethical values within the context of government policies necessary as precursors to creating the conducive environment and atmosphere required to achieve its goals and objectives.

All newly posted or recruited workers to the RHL will be handed a copy of these internal rules and regulations during an induction session with the director and the rest of the administrative staff. The staff shall read and sign that s/he has read and understood the rules and regulations and make a commitment to abide by them.

Preamble

The year of our lord 2015 in the month of November during an enlarged meeting of the personnel of the hospital: 
  • Considering Decree No. 68-DF-491 of 14th October 1968 on the structural and organic functioning of hospitals and health facilities in Cameroon 
  • Mindful of Circular Letter No. D1/LC/MSP/SG/DMH/SDHHHS of 3rd July 1981 on prescriptions relative to the reception and follow up of patients by doctors in specialized hospitals and hospitals of 1st, 2nd and 3rd categories 
  • Mindful of Decree no. 83-166 of 12th April 1983, No. 83-167 of 12th April 1983 and No. 89-354 of 4th March 1989 respectively on the code of ethics of medical doctors, dental surgeons, and the nursing professions, midwives and medico-sanitary technicians 
  • Mindful of Decree No. 87-529 of 21 April 1987 fixing the nomenclature of professional acts of medical doctors, dental surgeons, pharmacist, medical biologists and medico-sanitary professions 
  • Mindful of Arrête No. 104-A-MSP-DSP-SDEF instituting the compulsory wearing of uniforms in public and private health establishments and in health personnel training schools 
  • Mindful of Arrête No. 0100/A/MSP/CAB of 16th April 1999 on the internal rules and regulations of the central services of the Ministry of Public Health 
  • Considering Decree No. 94-199 of 7th October 1994 on the General Rules and regulations of the Public Service modified and completed by Decree No. 2000/278 of 12th October 2000 
  • Considering Arrête no. 0003/A/MSP/CAB of 6th August 2001 on the creation of an anti-corruption cell in the Ministry of public Health 
  • Considering the necessity to provide quality healthcare to the populations at an affordable cost. 
  • Considering the need to create an atmosphere that is conducive for the provision of quality health care by the personnel of the RHL. 
  • We the entire staff of the RHL meeting in ordinary session unanimously accept to unconditionally abide by the following internal rules and regulations. 

CHAPTER ONE

GENERAL CLAUSES

Article 1
The Limbe Regional Hospital is a public referral hospital of the South West Region, category 3 on the health pyramid in Cameroon.

Article 2
The internal rules and regulations stipulate the rules binding the personnel interaction i.e.(between personnel and patients, personnel and administration) in order to optimize the delivery of care to patients.

Article 3
This document spells out the obligations/responsibilities as well as rights and privileges of the personnel.

Article 4
These rules and regulations are subordinate to all and various texts from hierarchy: Ministry of Public Health, Ministry of Public Service, Laws, Decrees, notes of service, circular letters etc of the Republic of Cameroon

CHAPTER TWO

WORKING HOURS AND UNIFORM AT WORK 

Article 3: WORKING HOURS 
Paragraph I
Being a health facility, the Regional Hospital Limbe provides 24hrs service 7 days a week. 
The service hours are defined by the Cameroonian legislature as follows: from 7.30am 3.30pm with a break from 12.30pm-1.00pm. This will apply for staff on permanent morning but a different arrangement will hold for staff running shifts. 
 
Paragraph II
​Taking into consideration the peculiarity of the service, the need to provide a 24hrs service  and the inadequate human resources a two shift system of 8:00AM - 5:00PM and 5:00 PM - 8:00AM has been adopted to cover the Hospital. This shall be adjusted according to the availability of staff. 
 
Article 4: HANDING OVER NOTES AND CALL REPORTS 
All patients in the hospital must be clerked and all follow-up information documented. 
Handing over must be comprehensive, documented and signed by both parties (incoming and outgoing teams). This applies to all categories of personnel. 

Call reports 

Call duty reports by doctors and teams on shift duty must be written and transmitted to the hierarchy and / or administration on a daily bases. 
The doctor in charge and the ward charge and general supervisor must read and sign the call /night duty reports on a daily basis. 
 
Article 5: Assiduity and Punctuality 
Paragraph I: Punctuality is arriving at work at 7:30am for those who are on morning shift and 8:00AM or  5:00PM for those on the 8:00 AM or 5:00 PM shifts. In the absence of tangible justifications late coming and absenting shall be sanctioned. 
 
Paragraph III:  
In order to track assiduity and punctuality, a means shall be put in place to enable staff sign in and sign out. 
 
Article 6: VISITING HOURS 
Paragraph I Visiting hours have to be respected as set out by the hospital administration. These hours are as follows; 
​Working days/public holidays​Sundays
​06.00am-7.00am​7.00am-8.00am
​12.00pm-2.00pm​12.30pm-7.00pm
​05.00pm-7.00pm

Paragraph II
Visiting hours remain the same for all services. However, patient guardians may go in and out of the hospital if need be with a pass provided by the hospital security.

Article 7:
Paragraph I Every staff must be at their various work post, unnecessary loitering and occupation of the
corridors is forbidden and shall attract sanctions.

Article 8: MEETINGS

  1. All meetings (routine and emergency) convened by the administration are obligatory.
  2. Unjustified late coming or absences from meetings shall attract sanctions
  3. All justifications should be written and in case of emergency the administration should be informed verbally, but later regularized in writing.
  4. All meetings without the prior authorization of the administration are illegal.
  5. Resolutions of meetings at which the administration was not represented must be on the directors table maximum 24hours after the meeting.
  6. Resolutions must receive the approval of the administration before they are implemented.
  7. Illegal meetings will attract disciplinary measures.
  8. Absence from one (01) official meeting without justification shall attract disciplinary sanctions.

Article 9: STAFF UNIFORM/ Dressing code 

Paragraph I

Staff must be in their complete uniform as prescribed by their dressing code whenever on duty. 
 
 Article 10: RESPECT FOR PATIENTS, COLLEAGUES AND HIERARCHY 

Paragraph I
Mutual respect between the staff and hierarchy is the backbone of a harmonious working relationship in the hospital. 
 
Paragraph II
The members of staff must exercise mutual respect among themselves 
 
Paragraph III
The staff must show due respect to patients and users who are in need of hospital services. 
 
Paragraph IV
1. It is forbidden to reproach or correct personnel in front of patients. 
2. It is forbidden to cancel or modify prescriptions of colleagues without their knowledge; colleagues must discuss with each other and agree on a concerted management plan.

Article 11: CORRUPTION 

Paragraph I

The anti-corruption committee must do its work to the satisfaction of the patients, staff and the institution according to the prescriptions of the texts in force. 

Acts of corruption shall attract: 
A-Conservatory sanctions: 
  • Appearing before the anticorruption committee 
  • Reduction of points
  • Loss of all or part of incentives 
B-Administrative sanctions from the competent authorities 
  • Warning 
  • Suspension from work 
  • Retarded advancement  
  • Dismissal

CHAPTER THREE

ANNUAL LEAVE AND AUTHORIZED ABSENCES

Article 12: SHORT BREAKS 
Paragraph I

Every staff is entitled to a 30minutes break for lunch. The time and rotation of personnel to this effect is determined by the hierarchy in the various services rendered in the hospital. 
 
Article 13: LEAVE 
Paragraph I

Annual leave is granted by the hospital administration only on the strength of a leave decision signed by the competent authority as stipulated by the public service rules and regulations. Leave notification is done in accordance with a calendar establish in a rotation system in order to avoid any interruption to the smooth functioning of services rendered in the hospital. 
 
Paragraph II
Leave should be scheduled at the beginning of every budgetary exercise and at the level of each department. 
 
Paragraph III
The resulting table should be promptly sent to the office in charge of the management of staff’s leave. 
 
Paragraph IV
The consent and approval of the service head is required for the staff’s departure on leave. 
The head of service does not only write seen and forwarded to the next level but more importantly says whether or not arrangements have been made for the service to be covered. 
 
Paragraph V
Without prejudice to the other provisions departure on leave may be deferred because of service need if the staff situation does not permit.

Article 11: PERMISSION 
Paragraph I All requests for permission of absence are done in writing clearly stating the reason and start and end date of the absence and the place of sojourn. The request must be tendered three days  prior to the intended date of departure. This delay is not respected in the case of emergencies but hierarchy must be informed within twenty four hours. 
 
Paragraph II
Within a budgetary year, a maximum of six days and ten days permission are allowed for contract staff and civil servant respectively. Any excesses shall be deducted from the annual leave. 
 
Paragraph III
All leave and permission are registered in the annual leave registry (sick leave, permission) for the attention of the director. 
 
Paragraph IV
Contract workers and state agents are entitled to 18 working days annual leave. 
 
Article 12: ABSENCE FROM DUTY 
Paragraph I  

Any person, who fails to show up at his/her place of work or arrives late due to some impediment beyond his/her control, must notify his/her superior by phone or any other means of the estimated duration of his or her delay or absence. 
 
Paragraph II
A personnel chart shall be kept  at the office of the Medical Adviser and General Supervisor 
 
Article 13: AUTHORIZATION FOR SPECIAL ABSENCES 
Paragraph I

A special authorization for absences can be obtained in the following two cases; 
  • For the accomplishment of a mission of public interest 
  • For family events within the following deadlines;

​Events ​Days 
​Marriage of the employee ​5 working days not including traveling days
​Death of spouse​5 working days not including traveling days 
​Wife given birth​3 working days not including traveling days
​Death of mother or father​3 working days not including traveling days
​Death of child​3 working days not including traveling days 

Paragraph II
These special authorizations for absence are not deductible from the annual leave of the
concerned.

Article 14: ABSENCES FOR ILLNESS OR ACCIDENTS
Paragraph I
All person impeded by illness or accident should inform his/her superior within 24 hours.

Paragraph II
All absences for health reasons lasting more than seventy-two hours (72) must be justified by an authentic medical document issued by a doctor registered with the national order of doctors.

Paragraph III
If at the deadline fixed by the document, the concerned is unable to resume work, a new medical document fixing the duration of the prolongation is required.

Paragraph IV
Beyond six months, the law governing extended leave becomes applicable.

Article 15: FURTHER STUDIES/TEMPORARY ABSENCES
Paragraph I
All persons wishing to undertake studies or research must obtain permission beforehand from the ministry of public service in order to carry out the training course and to be absent temporarily depending on the situation.

CHAPTER FOUR

RESPONSIBILITIES 
 
Article 16: HOSPITAL RESPONSIBILITIES 
The Regional Hospital Limbe answers only acts perpetrated by members of staff who are regular in service and within the framework of the mission assigned to the concerned. 

Article 17: RESPONSIBILITY OF THE TECHNICAL STAFF 
Paragraph I  The authority to prescribe is given to the medical doctor. However, within the context of laid 
down protocols, a senior nurse may prescribe in the absence of the doctor. 
 
Paragraph II
The specialists are responsible for any acts in his/her area of specialty. S/he is to fully direct all general practitioners deployed to his area of jurisdiction. 
 
Paragraph III
A general practitioner deployed to a specialized field of work is under the direct supervision of the specialist. S/he is must fully participate in the activities of the service. The specialist must give them maximum exposure and support. 
 
Paragraph IV
The nurse is a part of the team and in this respect; s/he applies nursing care and gives feedbacks to the doctor. 
 
Paragraph V
The specialized nurse or the medico-sanitary technician is responsible for all that is done within the framework of their specialty. 
 
Paragraph VI
The assistant nurse, asst. laboratory technician and the junior nurse all work under the direct supervision of the senior nurse. They are to effectively and fully participate in the nursing care activities of their branch. 
 
Article18: RESPONSIBILITIES OF ADMINISTRATIVE PERSONNEL
The administrative personnel are part and parcel of the hospital system as such must function to facilitate the work of all the personnel in all the departments. The staff must also work to facilitate the work of the administrative staff.

CHAPTER FIVE

WORKING RELATIONSHIP WITHIN THE HOSPITAL

Article19: STAFF RELATIONSHIP
A healthy relationship between the staff is a priority within the hospital. 

Paragraph I
Ward rounds, meetings have to be organized in every service regularly. 

Paragraph II
Each service must organize itself in order to avoid any situation having to breed conflicts and suspicion. 

Paragraph III
In order to promote mutual assistance between the staff of each service, the administration must encourage mutual assistance in moments of happiness, sadness among the staff. 

Paragraph IV
Gathering, leisure walks in the passage ways and corridors of the hospital are forbidden. 
 
Article 20: RELATIONSHIP BETWEEN THE STAFF AND USERS 
 Paragraph I

The hospital staff must be welcoming, serviceable and available towards users. 

Paragraph II
Users of the Limbe Regional Hospital must be sensitized on the rules and regulations of the hospital  

Paragraph III
In case of destitute the social service must manage it and in the case of emergency normal emergency procedures should be followed. 
 
Paragraph IV
The hospital is not a market, consequently any commercial transactions in the corridors or offices are strictly forbidden. Staff caught promoting these acts shall be sanctioned. 
 
Paragraph V
All manifestation of anti-team spirit collectively or individually is totally forbidden and will be severely sanctioned, e.g. gossiping, lying, quarrelling etc. 

Assault of a staff member by another is a criminal offense and shall attract a sanction from the administration without prejudice to the legal procedures that the victim will engage to seek justice. 

Paragraph VI: THE CONDUCT OF THE TRAINEE AT THE LIMBE REGIONAL HOSPITAL
The trainee at the Limbe Regional Hospital has obligations with regard to the training institution, the hospital administration, the users and the trainee’s own conduct. Every trainee must conduct him/herself according to the code of conduct and discipline of the hospital. 
 
1. IN RELATION TO THE INSTITUTION (PREMISES)
Cleanliness The trainee must assist the hospital administration to keep its premises clean by refraining 
from littering and educating others in the same line.  
  • Ensure the neatness of office furniture. 
  • Present his/her badge or school identity card in order to have access to the hospital. 

2. IN RELATION TO THE TRAINING TEAM
The trainee must be; · Submissive 
  • · Obedient and  
  • · Honest 
In fact the trainee is responsible for equipment entrusted them. It is forbidden for a trainee to; 
  • o Walk aimlessly within departments 
  • o Loiter in the hospital corridor. 
  • o Use equipment without prior permission from a superior. 
  • o Carryout any other activity at the hospital (apart from training) to which they have not been assigned. 
 
3. IN RELATION TO THE HOSPITAL ADMINISTRATION
The trainee is required as a collaborator and member of the health care team to observe the service notices of those in charge of the premises. 
 
4. IN RELATION TO USERS
The trainee has to;
  • Orientate patients and their families to the required service.
  • Be welcoming
  • Avoid administering treatment to patients without the consent of the staff in charge of the health care team.
  • If the trainee is guilty of keeping an article that belongs to the hospital, or some other person or the hospital staff in the hospital, the item must be returned and other sanctions applied as appropriate.
  • Keep professional secrets. 

5. IN RELATION TO THE TRAINEE
The trainee must develop qualities that will facilitate the learning process. 

Moral qualities ü Honesty 
  • Probity 
  • Devotion 

Dressing Code 
  • The trainee must put on a white uniform carrying a badge on which is written; names and surnames, school, training cycle and year of study. 
  • Putting on of jewelry is strictly forbidden during training hours. 
  • Nails must be clean and trimmed. 
  • A cap for ladies (females) is equally required for trainees in nursing. 
  • Putting on dressing that exposes breasts, upper thighs, abdomen and other intimate body parts must be avoided 

CHAPTER SIX

SPECIAL INSURANCE OF THE HOSPITAL

Article 21: INSURANCE MODALITIES 
Paragraph I In case of ill health, staff and members of their nuclear family benefit from exoneration on the charges for laboratory tests and other exams. The percentage shall be determined by the administration of the hospital.  Doctors, senior staff and their nuclear families are hospitalized in the private ward and the others in any other ward. While encouraging all working in the hospital to strive  to  to be covered by some form of insurance or risk sharing mechanism.  
 
Paragraph II
In case of an accident occurring when a member of staff is at work or on the way to or back from work, such is declared as a professional accident and the normal procedure for compensation by the National Social Insurance Fund is activated. Staff on permission that has been duly accorded are considered to be on duty. The hospital administration shall decide on how to assist staff employed by the management board hence cannot benefit from national social insurance fund. 
 
Paragraph IV
In case of death of staff, the accommodation of the corpse at the mortuary is free for a duration of 30 days. After this deadline 25% of the total charges will be paid by the family. For the staff’s nuclear family member, the accommodation of the mortal remains is free for a period of 15days. Fifty percent of the total charge shall be paid if this deadline is exceeded. For an extended family member the staff shall pay (50%) fifty percent of the charges. These percentages are subject to modification as proposed by the administration in place and accepted by the general assembly. 

CHAPTER SEVEN

GRATIFICATION AND SANCTIONS

Article 22: GRATIFICATION 
Paragraph I

A member of staff who distinguishes him/herself in the manner of working will have the right to a special letter of congratulation delivered by the administration of the Limbe Regional Hospital. 
 
Paragraph II
Upon retirement of a staff, the hospital shall organize a send off party. An envelope of one hundred thousand (100.000) FCFA “happy separation package”, deducted from the individual quota part of all the staff, shall also be handed over to the staff. (see RHOSA bylaws). The amount of the envelope is also subject to modification as proposed by the administration and voted by the general assembly. 
 
Paragraph III
At the end of each year, an end of year ceremony shall be organized during which the best performing staff/service of the year shall be identified and rewarded an amount agreed upon by the staff. It shall be deducted from the annual motivation of each worker and saved for this purpose. This ceremony shall be budgeted for in the revenue set aside budget and supplemented by funds raised through appeal letters. 
 
Article 23: SANCTIONS 
Paragraph I After a thorough investigation of the charges made, sanctions shall be meted out on any staff that acts contrary to the ethics and present internal rules. These sanctions shall range from conservatory measures (suspension of quota parts) to administrative measures as stipulated by the rules and regulations of the public service. o There verbal warnings 
  • Query letter 
  • Official warning with an entry in to the file 
  • Suspension from work 
  • Delay of promotion (advancement) 

Paragraph II
Any staff guilty of misconduct as serious as failure to administer treatment, illegal sale of medication, absences at shift and duty hours, extortion of money from patient’s or and their care taker, late coming, irregular absences, absenting from meetings; the administration of the regional hospital can be called upon to administer disciplinary measures ranging from suspension from quota part from one to more months against the staff in question, who shall lose the right of any benefits during these periods after facing the anticorruption and/or the disciplinary committee. 
 
Paragraph III
If it is established that a piece of equipment was defective because it was poorly handled, the staff shall have to pay for a new one or bear the cost of repairs. If the staff cannot be identified, the service shall be punished. 
 
Paragraph IV
To this effect, the sanction procedure which is to take effect within a maximum of three weeks shall be done as follows; 
  • An explanatory request addressed to the concerned 
  • An analysis of the file and an investigation by the disciplinary committee. 
  • Handing over of the accused to the medical committee and para-medical for doctors, dental surgeons, pharmacist, biologist and medico-sanitary staff and handing over to the administration i.e. copies of the report will be sent to these quarters.

CHAPTER EIGHT

SURVEILLANCES, DUTY CONSTRAINTS AND SUPERVISION

In order to ensure 24hrs functioning of the Regional Hospital Limbe, keeping watch over patients, duty calls and supervisions are organized within the hospital. 

Article 25: DOCTORS ON CALL 
Paragraph I All general practitioners working at the Limbe Regional Hospital are included in the shift   schedule 
 
Paragraph II
The medical adviser following the needs and work force available and proposals from the chiefs of services establishes the call duty roster for doctors. The medical adviser releases and distributes the shift schedule to those concerned. 

Paragraph III
The shift last 12hrs from 5.00pm to 8:00am on working days. On weekends and public holidays it shall be from 8.00am to 8.00am the next day. If there are many doctors, the doctor on call may be exempted from consulting during the morning shift before coming for the call in the afternoon but may be required to do the ward rounds etc whichever arrangement is deemed most appropriate. 
 
Paragraph IV
The Limbe Regional Hospital provides food and accommodation for doctors on call, and they receive incentive in cash every month of which the rates are determined according to the hospital revenue.

Paragraph V
The doctor on call is the head of the call team. S/he coordinates the medical and para-medical activities and calls on specialist in case of need. 

The backup specialist is not there to cover the doctor on call when s/he is absent, but to provide technical support when called to do so. 

If the doctor on call is to be absent s/he must make adequate arrangements for his/her shift to be covered. The staff accepting to cover the shift must manifest the acceptance by signing on the notification of absence submitted to the medical adviser. The same goes for all categories of staff. 

Paragraph VI
The technical supervisor of the doctor’s shift is the medical adviser and / or director when the director is a medical doctor. The administrative supervisor may be any other category of staff who has been trained to do so. 
 
Paragraph VII
The doctor on call writes and signs the reports of the shift. This report on the shift follows the format; date signature and stamp of the doctor, number of patients consulted, hospitalized by the service, deaths, potential epidemic illness (suspicion of meningitis, cholera etc.), problems encountered during the shift in the register provided for such cases. 
 
Article 26: ACTIVITIES OF SPECIALIST 
Paragraph I All specialists working at the Limbe Regional Hospital are included in the planning of call duties. 
 
Paragraph II
The medical adviser with the proposal of the chief of service establishes the call duty roster for doctors. 
The call duty roster is put in the department concerned and in the duty room of general practitioners and copied to the administration of the region. 

Paragraph III
Supervision covers a period of one week going from Monday-Sunday, the specialist on call can be called upon in case of need whether in the day or in the night. 
 
Paragraph IV 
The specialist may delegate their functions to a GP with whom s/he has worked and can attest that s/he is competent, but the specialist must maintain contact as backup. 

Paragraph V
The Limbe Regional Hospital compensates the specialist on supervisory duty with a bonus. 
(Monthly incentives to be determined by the administration) 

Article 27: SUPERVISION OF SHIFT 
Paragraph I

In order to solve administrative and/or technical problems, a supervisory system for shifts is put in place at the Limbe Regional Hospital. 

Paragraph II 
The pool of supervisors shall comprise of:
  • The medical adviser  
  • The service manager
  • The general supervisor(s)
  • Any other co-opted person(s) based on their competences 

The director shall be the overall supervisor 

Paragraph III 
The supervision by the medical adviser, general supervisor(s) shall be both technical and administrative but for the service manager it shall be technical only if s/he is a health professional. 
 
Paragraph IV
The shift supervisors (medical adviser/co-opted doctors for doctors and general supervisors/co-opted nurses for nurses) represent the director during the period of supervision within the limits of his/her prerogatives. The shift supervisors are charged with; 
 
Administrative aspects of supervision: 
  • Ensuring the effective presence of staff at their post 
  •  Ensuring the financial coverage of the expenses of the patients admitted within the framework of “bon de prise en charge” 
  • Solving any administrative problems that arise within the limits of their competence. 
  • Facilitating the coverage of expenses of emergency/urgent cases and/or the destitute 
  • Ensuring proper handling of equipment/ reporting any damage or misuse or malfunction. 

Technical aspects of supervision  
(for supervisors who are health professionals) 
  • Ensuring the appropriateness of medical attention given to patients. 
  • Proper reception of patients 
  • Proper recording of information in different management tools etc. 
The director should be notified about lateness, absence of the staff and also problems arising during the shift. 

Paragraph III
There are two kinds of supervisors;
  1. Technical supervisor comprising of health personnel (medical adviser, general supervisor(s), other co-opted health personnel) 
  2. Non-technical (administrative) supervisors 

Paragraph VI
The supervisors are required to be physically present for the supervisory exercise. 

Paragraph V
An allowance benefit included in the shares is allowance to supervisors (modalities reserved to the discretion of the administration) 

Paragraph VI
The supervisor informs the medical adviser in case of his/her absence, the medical adviser with the director then take the necessary measures for the continuity of service. 

CHAPTER NINE

REVENUE, QUOTA PARTS AND COST RECOVERY

Article 28: THE REVENUE 
Paragraph I The RHL does not yet enjoy financial autonomy. The revenue of the Limbe Regional Hospital 
is collected daily by the revenue collector on working days, weekends and public holidays and managed according to the existing texts. 
 
Paragraph II
No intermediary agent is allowed to keep funds. 
 
Paragraph III
In the absence of the revenue collector or service manager, the director will take measures to ensure that funds are collected normally and well secured. 
 
Paragraph IV
The areas of revenue collection have to be well secured. 
 
Paragraph V
Control should be regular and intensified by the administration to ameliorate the quality of revenue collection in order to reduce fraud. 

Anyone caught deviating hospital revenue shall be handed over to the legal department 
 
Article 29: QUOTA PARTS 
Paragraph I  

The Limbe Regional Hospital pays its medical and Para-medical staff quota parts deducted 
from the hospital revenue on monthly basis and distributed in accordance with ministerial 
texts. 
 
Paragraph II
The payment of quota part is monthly between the 1st and the 5th of every month. The periodicity can be modified by tacit agreement between the administration of the hospital and the staff.

Article 30: COST RECOVERY 
Paragraph I

By a resolution of the hospital management committee, it is instituted in the Limbe Regional Hospital an additional fee on some medical services offered known as cost recovery. 
 
Paragraph II
The collection is practiced in the mortuary, x-ray, echography, and lab, and all the staff of the hospital benefit from it according to ministerial text. Used for the purchase of reagents and some medical consumables. 
 
Paragraph III
By resolution of the management committee, it is instituted in the Limbe Regional Hospital an additional fee on some medical services offered known as kit. 

The collection is practiced in all the services and all the staff of the hospital benefit from it according to ministerial text. 
 
Article 31:  THE COMMISSION IN CHARGE OF REVENUE AND DISTRIBUTION OF QUOTA PARTS
Paragraph I
A commission in charge of revenue and the distribution of quota parts is created within the Regional Hospital. 
 
Paragraph II
Their duties are as follows;
  • To follow up revenue collection in all services of the hospital 
  • To work hand in hand with the commission for the fight against corruption. 
  • To make sure that staff receive their dues regularly 
  • To propose efficient and impartial methods for revenue collection and quota part calculation. 

Paragraph III
According to the text of the quota parts, the member of the committee of the Limbe Regional Hospital nominates the members, with the sole criteria being probity and sense of responsibility. It is composed of the following; 
  • The director 
  • Paramedical staff representative  
  • Doctors representative 
  • Dental representative 
  • Pharmacist representative 
  • Syndicate representative 
Paragraph IV
It is the committee that works in close collaboration with the administration for better follow up and supervises the distribution of the quota parts. This committee shall not by any means transform itself into an audit committee. 
 
Article 32 : NURSING CARE
Paragraph I  
Given the service rendered, vital signs, bathing, dressing etc, a sum determined depending on the prevailing financial circumstances will be paid by patients to cover for nursing care. 
 
Paragraph II
According to the prevailing financial situation an agreed weekly amount shall be charged for all inpatients to cover for nursing kits. This amount is paid once and must be receipted for in every ward. This amountwill cover for plaster, spirit, gauze, syringes, gloves, cannula, drip set, and cotton. This will help to keep patients from going up and down for different items and ease the work of the practitioners. 
 
Paragraph III
Each ward shall be charged with the management of the nursing kit. 
 
Paragraph IV
​The administration shall ensure the control of the nursing kit. 

CHAPTER TEN

SCALE OF APPRECIATION FOR ANNUAL MOTIVATION

I. Selection criteria;
The Limbe Regional Hospital at the end of each year organizes a ceremony on the occasion of the award of the best staff (paramedical, medical and auxiliaries). In order to minimize the risk of subjectivity in the appreciation of the staff, the criteria for selection are as follows; 
  • The use of criteria outlined in the books of record of the public service i.e. public service rules and regulation. 
  • Selection by professional categorization 
  • Designation of a jury and a sub-jury per department (service).  
  • Determination of the best staff by secret balloting or universal suffrage. 

I.1 Paramedical staff
Selection is by grading each staff attributes scores to the others according to the unit. Those who are pre –selected undergo the same test at the level of work. The final selection is done at the level of paramedical and medical committee. 
 
I.2 Doctors And Those Of The Same Category:
Pre-selection is at the level of the service, final selection at the medical committee. 
 
I.3 Non Medical Staff 1.
​The final selection at the level of the board of directors. 2. Pre-selection at the level of service. 

II. CRITERIA RETAINED

​QUALITIES MAXIMUM POINTS 
​Aptitude ​ /10 
​Serviceability ​ /10 
​Professionalism ​ /10 
​Morality ​ /10 
​Assiduity ​ /10 
​Respect of hierarchy​ /10 
​Human relationship ​ /10 
​Punctuality ​ /10 
​Putting on working uniform​ /10 
​Public relation​ /10 
TOTAL/100 
The appreciation of each criterion is easier on a scale comprising of three values: 
  • Excellent : 9-10 
  • Good  : 7.5-8.9 
  • Average : 5-7.4 
  • Poor  : 2-4.9 
  • Very poor : 0-1.9 
Marks below 5/10 and 10/10 must be accompanied by an explanatory note. 

CHAPTER ELEVEN

NHIMS

Statistics
i. Statistics must be compiled and forwarded to the administration on monthly bases by the ward charges and service heads. 
ii. The Statistician is responsible for distributing the statistics forms and follow up that statistics are collected and transmitted to the administration 
iii. The ward charges and service heads should inform the administration by writing in case statistics have not been collected by the 5th of every month. 

Service reports
By the 5th of every month every ward charge and service head should forward a comprehensive report in terms of activity, the state of equipment, personnel and staff strength. 
 
Research activities
No research or release of any hospital information is allowed without a written authorization from the administration and ethics committee. 
 
Paragraph IV
In the event of increase in work load due to medical emergencies, personnel shall be mobilized even during their rest/ leave period to reinforce the team already in place without any extra financial implications. 

Paragraph V Some Meetings

​Meeting ​Days ​Frequency ​Time 
​Monday coordination meeting​Monday ​Every Monday ​8AM 
​Therapeutic committee meeting​Wednesday ​Every Wednesday 8AM 
​Continues Medical Education (CME)​Thursday​Every Thursday ​8AM 
​Administrators meetings​Thursday ​Every Thursday ​10AM 
​General “grand” ward rounds​To be determined ​One service every week​8AM
​Management committee meeting (quarterly) ​To be determined ​Quarterly​To be determined
​Monthly coordination meeting to present comparative statistics of activitie​Tuesday​1st Tuesday of the month To be determined 
​General staff meeting ​Friday ​Twice a  year ​To be determined 
​Quota part committee meetingTo be determined 
​Monthly ​To be determined
​Anti-corruption committee meetingTo be determined  
​Every two months ​To be determined 
​Hygiene and sanitation committee meetingsTo be determined  
​Quarterly ​To be determined 

CHAPTER TWELVE

FINAL DISPOSITIONS

Article 33: 
Paragraph I

The present rules and regulation were adopted at the GENERAL ASSEMBLY meeting of the Regional Hospital Staff on the _________________. 
 
Paragraph II
These internal rules and regulations will be published in all departments of the hospital for adequate circulation. 
 
Paragraph III 
These internal rules and regulations shall be amended upon request from all of the members of the general assembly or when three quarters of the members deem it necessary. 

INTERNAL SANCTION SCALE OF ALL  STAFF 
The following rules are applied after thorough investigation of the accusations and within 3 weeks of notification of the offence: 

The sanctions are not classified in order of importance. 

These sanctions are applicable to all. 

All cases of indiscipline are sanctioned by a drastic reduction of bonuses and quota part according to the given percentage. 

The disciplinary file goes beyond local conservatory measures to the delegation of public health for further action.  

The table below shows the offence and malpractice and their sanctions. 

​Nº ​Offence ​Sanctions 
1​Perpetual late coming​25% of QP/Motivation 
2Absenteeism (unjustified)​100% of QP/Motivation
3​Not duty conscious​25% of QP/ Motivation
4​Deviation of patient​100% of QP/Motivation 
5​Parallel selling of drugs​100% of QP/ Motivation
6​Bribery and corruption​100% of QP/Motivation 
7​Not assiduous​100% of QP/Motivation 
8​Others​100% of QP /Motivation

ORGANOGRAM OF REGIONAL HOSPITAL LIMBE

​NB: From down to up this organogram is also represents  the complaints procedure. 

ACKNOWLEDGEMENT

This document is as a result of hard work of the following distinguished individuals:

1. Dr. BIJINGNI Kuwoh Pius
2. Dr EyongEta Divine medical Adviser
3. Kolle Alphons Service manager
4. Epingo Emilia General supervisor
5. Namondo Sally Asst Gen Supervisor
6. Dr Balimba Mpoke Marie
7. Dr Zouna Frank
8. Dr Simo Wambo
9. Dr Tseuko Dorine
10. Bumah Mercy
11. Dr Nlend Batam Noe Sylvain
12. Dr Tagne Cathy
13. Dr Ndifon Micheal
14. Mondoa abel
15. Zinkeng Goretti
16. Akumawah Delphine
17. Mbame Mary
18. Kamga Jean
19. Ebende Marie
20. Ndive Oscar
21. Teghen Samuel
22. Divine Ashu
23. Ewanoge Alice
24. Suireng Anicetus
25. Munge Beatrice
​26. Tatoh Adeline 

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