Organizational Structure and Staffing Standars For Government Hospitals CY 2013

Revised
Organizational Structure
and Staffing Standards
for Government
Hospitals
CY 2013 Edition
TABLE OF CONTENTS
__________________________________________________
PART I – INTRODUCTION: CLASSIFICATION OF HOSPITALS
Classification of Hospitals . . . . . . . . . . . . . . . . . . . . . . 2
Categories of General Hospitals . . . . . . . . . . . . . . . . . . 3
PART II – MODEL ORGANIZATIONAL STRUCTURE

Organizational Configuration . . . . . . . . . . . . . . . . . . . . 8
Level 1 Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Level 2 Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Level 3 Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
PART III – STANDARD STAFFING PATTERN

Medical Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Nursing Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Other Hospital Professional Personnel . . . . . . . . . . . . 28
Supplemental Guidelines . . . . . . . . . . . . . . . . . . . . . . 29
Standard Staffing Pattern per Category
Level 1 Hospital
25 Beds . . . . . . . . . . . . . . . . . . . . . . . . . 31
50 Beds . . . . . . . . . . . . . . . . . . . . . . . . . 35
75 Beds . . . . . . . . . . . . . . . . . . . . . . . . . 39
Level 2 Hospital
100 Beds . . . . . . . . . . . . . . . . . . . . . . . . 44
150 Beds . . . . . . . . . . . . . . . . . . . . . . . . 53
200 Beds . . . . . . . . . . . . . . . . . . . . . . . . 62
Level 3: Teaching and Training Hospitals
200 Beds . . . . . . . . . . . . . . . . . . . . . . . . 71
300 Beds . . . . . . . . . . . . . . . . . . . . . . . . 82
400 Beds . . . . . . . . . . . . . . . . . . . . . . . . 93
500 Beds . . . . . . . . . . . . . . . . . . . . . . . .104
Annex: Tally of Positions by Level, by Bed Capacity . . . . . . 118
PART I
Introduction:
CLASSIFICATION OF
HOSPITALS
INTRODUCTION: CLASSIFICATION OF HOSPITALS
____________________________________________________
A. Classification of Hospitals
Hospitals are classified according to:

∙ Ownership
∙ Scope of Services
General Hospitals are further classified by functional capability.
1. Classification According to Ownership
a. Government – a hospital owned, established, established and created

by law; facility may be under the national government like the, the
Department of Health (DOH), Department of National Defense (DND),
Philippine National Police (PNP), Department of Justice (DOJ), State
Universities and Colleges (SUCs), Government Owned or
Controlled Corporations (GOCC) or Local Government Units (LGUs).
b. Private – a hospital owned, established and operated with funds through

donation, principal investment or other means by any individual, non-
government corporation, association or organization.
2. Classification According to Scope of Services
a. General – a hospital that provides services for all kinds of illnesses,

diseases, injuries or deformities. A general hospital shall provide medical
and surgical care to the sick and injured, as well as maternity, newborn
and child care. It shall be equipped with the service capabilities needed to
support board certified/eligible medical specialists and other licensed
physicians rendering services in, but not limited to, the following:
i. Clinical Services
1) Family Medicine
2) Pediatrics
3) Internal Medicine
4) Obstetrics and Gynecology
2
5) Surgery
ii. Emergency Services
iii. Outpatient Services
iv. Ancillary and Support Services, such as clinical laboratory,
imaging facility and pharmacy.
b. Specialty – a hospital that specializes in a particular disease or condition

or in one type of patient. A speciality hospital may be devoted to
treatment of any of the following:
i. Treatment of patients suffering from diseases of a particular organ or
groups of organs (e.g. Lung Center of the Philippines, Philippine
Heart Center, National Kidney and Transplant Institute); or a
hospital dedicated to treatment of eye disorders or cancers.
ii. Treatment of patients belonging to a particular group such as children,

women, elderly and others (e.g. Philippine Children’s Medical
Center).
B. Categories of General Hospitals According to Functional Capacity 1.
Level 1 Hospital
A Level 1 hospital shall have, as minimum, the following services and

capacity:
a. A staff of qualified medical, allied medical and administrative personnel

headed by a physician duly licensed by the Professional Regulation
Commission (PRC);
b. Bed space for its authorized bed capacity in accordance with DOH
Guidelines in the Planning and Design of Hospitals;
c. An operating room with standard equipment and provision for sterilization

of equipment and supplies in accordance with the:
i. DOH Reference Plan in the Planning and Design of an Operating

Room/Theater
3
ii. DOH Guidelines on Cleaning, Disinfection and Sterilization of Reusable
Medical Devices in Hospital Facilities in the Philippines
d. A post-operative recovery room;
e. Maternity facilities, consisting of ward(s), room(s), and a delivery room

exclusively for maternity patients and newborns;
f. Isolation facilities with proper procedures for the care and control of
infectious and communicable diseases as well as for the prevention of
cross infections;
g. A separate dental section/clinic;

h. A blood station;
i. A DOH-licensed secondary clinical laboratory with the services of consulting

pathologist;
j. A DOH-licensed Level 1 imaging facility with the services of a consulting

radiologist; and
k. A DOH-licensed pharmacy
2. Level 2
A Level 2 hospital shall have as minimum, all of Level 1 capacity, including, but
not limited to, the following:
a. An organized staff of qualified and competent personnel with Chief of

Hospital/Medical Director and appropriate board-certified Clinical
Department Heads;
b. Departmentalized and equipped with service capabilities needed to support

board-certified/eligible medical specialists and other licensed physicians
rendering services in the specialties of Medicine, Pediatrics, Obstetrics and
Gynecology, Surgery, their sub-specialties and ancillary services;
c. A general Intensive Care Unit (ICU) for critically ill patients; d.
A Neonatal Intensive Care Unit (NICU);
e. A High Risk Pregnancy Unit (HRPU);
4
f. Provision of respiratory therapy services;
g. A DOH-licensed tertiary clinical laboratory; and
h. A DOH-licensed Level 2 imaging facility with mobile x-ray inside the

institution and with capability for contrast examinations.
3. Level 3
A Level 3 hospital shall have as minimum, all of Level 2 capacity, including, but
not limited to, the following:
a. Teaching and/or training hospital with accredited residency training

program for physicians in the four (4) major specialties, namely: Medicine,
Pediatrics, Obstetrics and Gynecology, and Surgery;
b. A physical medicine and rehabilitation unit;
c. An ambulatory surgical clinic;
d. A dialysis unit;
e. A blood bank;
f. A DOH-licensed tertiary clinical laboratory with standard equipment

/reagents/ supplies necessary for the performance of histopathology
examinations; and
g. A DOH-licensed level 3 imaging facility with interventional radiology.
5
In summary, the services and facilities provided by each level of General Hospital is
shown below:
SERVICES LEVEL 1 LEVEL 2 LEVEL 3
Clinical Consulting All of Level 1 plus: All of Level 2 plus:

Services for Specialists in:
in-patients Medicine Departmentalize Teaching/training
Pediatrics d Clinical services with
OB-Gyne Services accredited
Surgery residency training
program in the 4
major clinical
services
Emergency and Respiratory Unit Physical Medicine
Out patient and Rehabilitation
Services Unit
Isolation Facilities General ICU
Surgical/ High Risk Ambulatory

Maternity Pregnancy Unit Surgical Clinic
Facilities
Dental Clinic NICU Dialysis Clinic
Ancilliary Secondary Tertiary Clinical Tertiary laboratory

Services Clinical Laboratory with histopathology
Laboratory
Blood Station Blood Station Blood Bank
1st Level X-ray 2nd Level X-ray 3rd Level X-ray

with mobile unit
Pharmacy Pharmacy Pharmacy
PART II
MODEL
ORGANIZATIONAL
STRUCTURE
7
MODEL ORGANIZATIONAL STRUCTURE

____________________________________________________ A.
ORGANIZATIONAL CONFIGURATION
1. The new standards on organizational structure and staffing pattern of government

hospitals took into consideration the following factors:
a. Minimum DOH Licensing Requirements and Philhealth Accreditation

Requirements
b. New hospital licensing category (Level 1, Level 2, Level 3 hospitals) based on

Department of Health Administrative Order No. 2012-0012.
c. Specialty Society Training Accreditation Requirements (particularly for Medical

Staff)
d. Distribution of Medical Staff to cover the Outpatient Department, Emergency

Room and Inpatient hospital areas; and
e. Health Human Resource Master Plan
Level 1 and Level 2 hospitals shall have four (4) basic organizational units: the
Office of the Chief of Hospital; Medical Service; Nursing Service; and Hospital
Operations and Patient Support Service (HOPSS). Internal management functions
are combined under one organizational unit, the HOPSS, which shall subsume
both administrative and finance services.
A Level 3 hospital shall be provided with an additional division-level entity, the

Finance Service, to handle accounting, budgeting, cashiering, billing and claims
and cash operations. Given the need to attain financial sustainability of said
hospitals, this unit shall be tasked to improve revenue generating capacity.
2. The general functions of the major organizational units are as follows: a.
Office of the Chief of Hospital/ Medical Center Chief
Shall be responsible for the overall management and administration of the

hospital; formulation of policies, plans, programs and strategies to ensure
implementation of health standards for the attainment of quality health
care and high standards of clinical training for medical and allied medical
personnel; and the day-to-day supervision and administration of the
functional units.
8
b. Medical Service
Shall be responsible for providing quality inpatient and outpatient care and
high standards of clinical training for medical and allied medical personnel;
provision of ancillary and allied health services to patients; promotion of
research activities; implementation of clinical resource management
system; and advising and assisting the chief of hospital in the formulation
and implementation of policies, plans and programs of the hospital.
c. Nursing Service
Shall be responsible for implementing nursing programs for total quality

health care; providing nursing care to medical cases; and developing,
coordinating and implementing relevant training programs for nursing
personnel.
d. Hospital Operations and Patient Support Service

(formerly Administrative Service)
Shall be responsible for the provision of administrative services relating to

personnel management, administrative records management, property and
supply management, general services, engineering, and security.
e. Finance Service
Shall be responsible for the provision of financial services relating to

budgeting, accounting, cash operations, billing and claims.
3. Below these offices/services, sub-units are allowed depending on service

capability, ancillary services, kind and level of care and segregation of patients,
and kind and variety of support functions. The hospital administration is given the
flexibility to structure/group its internal management support units in a manner
deemed more efficient and effective for the hospital’s organization and operation.
B. The model organizational structure for each category of hospital and

authorized bed capacity is shown in the succeeding pages.
9
Level 1 Hospital_ _____________
Model Organizational Structure for a Level 1 Hospital
(25 to 75 Bed Capacity)
Organizational Unit Number of Positions
Bed Capacity
25 50 75
A. Office of the Chief of Hospital 3 3 3
B. Medical Service 52 64 74 1. Outpatient 5 5 5 2. Emergency Room 5 9 12 3. Clinical Units 11 14

16 4. Clinical Laboratory 5 6 7
a. Blood Station 3 3 3 5. Radiology 4 5 6 6. Dental 2 2 2 7. Health Information

Management 3 3 3
a. Admitting/Information 4 4 4 8. Nutrition and Dietetics 4 5 6 9. Pharmacy 4 5 6 10.
Medical Social Work 2 3 4
C. Nursing Service 39 51 61 1. Office of the Nurse Supervisor 1 1 1 2. Clinical Nursing Units 13

24 34 3. Operating Room 6 6 6 4. Recovery Room 6 6 6 5. Isolation Room 4 4 4 6. Delivery Room 9
10 10
10
Bed Capacity
25 50 75
D. Hospital Operations and Patient Support Service 19 26 28 1. Office of the Administrative

Officer 2 2 2 2. Human Resource Management 2 2 2 3. Procurement, Property and Supply 2 2 2 4.
Engineering and Facilities Management 5 9 11 5. Housekeeping/Laundry 2 3 3 6. Accounting 2 3 3
a. Billing and Claims 2 2 2 7. Cash Operations 2 3 3 8. Security - to be contracted out
-
Total Number of Positions 113 144 166

11
Organizational Chart
Level 1 Hospital
25, 50, 75 Bed Capacity
Office of the Chief of Hospital
Medical Service Hospital Operations and Nursing
Service Patient Support Service
12
Bed Capacity
100 150 200
A. Office of the Medical Center Chief 4 4 5 1. Office of the Medical Center Chief 2 2 2 2.
Integrated Hospital Operations and Management Program 2 2 3
B. Medical Service 122 161 192 1. Office of the Chief of Medical Professional Staff 2 2 2 2.
Outpatient Department 9 11 12 3. Emergency Medicine Department 19 26 31 4. Clinical
Departments 26 35 48 5. Special Care Areas 4 6 6 6. Department of Pathology 2 2 2
a. Blood Bank 6 8 9 b. Anatomic and Clinical Laboratory 13 18 20 7. Department of
Radiology 8 11 11 8. Dental 3 3 4 9. Health Information Management 5 7 9 a.
Admitting/Information 5 6 7 10. Nutrition and Dietetics 9 13 15
11. Pharmacy 7 8 10 12. Medical Social Work 4 5 6
C. Nursing Service 122 180 227 1. Office of the Chief Nurse 4 4 4 2. Clinical Nursing Units
55 83 108 3. Operating Room 14 21 26 4. Delivery Room 11 17 21 5. Special Care Areas
13
Bed Capacity
100 150 200
a. Post Anesthesia Care Unit 7 10 11 b. Intensive Care Unit 6 9 10 c. Neonatal Intensive

Care Unit (NICU) 14 21 27 d. Pulmonary/Respiratory Unit 5 7 9 6. Central Supply and
Sterilization 6 8 11
D. Hospital Operations and Patient Support Department 44 59 69 1. Office of the

Administrative Officer 2 2 2 2. Human Resource Management 4 5 6 3. Procurement 4 5 5 4.
Materials Management 5 6 7 5. Engineering and Facilities Management 8 13 15
a. Housekeeping/Laundry 3 5 5 6. Budget 3 3 3 7. Accounting 5 6 7
a. Billing and Claims 5 7 9 8. Cash Operations 5 7 10 9. Security - to be contracted out -
Total Number of Positions 292 404 493
14
Level 2 Hospital
100, 150 and 200 Bed Capacity
Basic Structure
Office of the Medical Center Chief
Integrated Hospital Operations

and Management Program
(IHOMP Unit)
Hospital Operations and

Medical Service
Medical Service Areas1 Anatomic and Clinical

Laboratory
Nursing Service
Patient Support Service Blood Bank
Office of the Medical Center
Department of Radiology
Chief
Dental
Medical Service
Health Information Management

Outpatient Department
Admitting/InformationNutrition and Dietetics
Emergency Medicine Department
Clinical Departments Special Care Pharmacy

Department of Pathology
Medical Social Work
____________________
1
Special Care Areas:
Intensive Care Units (ICU), Surgical Intensive Care Unit (SICU), Post-Intensive Care Unit (PICU), Neonatal Intensive
Care Unit (NICU), etc.
15
Nursing Service
Nursing Service
Clinical Nursing Units Operating Room Delivery Room
Special Care Areas Central Supply &

Sterilization
Hospital Operations and Patient Support Service
Hospital Operations and Patient

Support Service
BudgetHuman Resource
Management
Cash Operations Billing

& Claims
Procurement
Accounting Materials
Management
Engineering & Housekeeping,
Facilities Management Linen & Laundry
16
Organizational Unit No. of Positions
Bed Capacity
200 300 400 500
A. Office of the Medical Center Chief 12 14 14 14 1. Office of the Medical Center Chief 4 4 4 4 2.
Professional Education and Training 5 5 5 5 3. Integrated Hospital Operations and Management
Program 3 5 5 5
B. Medical Service 306 455 592 727 1. Office of the Chief of Medical Professional Staff 2 2 2 2 2.
Outpatient Department 14 19 22 25 3. Emergency Medicine Department 34 49 64 76 4. Clinical
Departments 95 167 231 311 5. Special Care Areas 15 17 19 21 6. Department of Pathology
a. Blood Bank 12 17 21 24 b. Anatomic and Clinical Laboratory 34 51 63 70 7. Department of
Radiology 20 26 33 37 8. Dental 5 7 8 8 9. Health Information Management 16 18 22 25 a.
Admitting/Information 8 12 15 17 10. Nutrition and Dietetics 23 26 34 37 11. Pharmacy 20 32 42
54 12. Medical Social Work 8 12 16 20
C. Nursing Service 211 299 389 469 1. Office of the Chief Nurse 5 5 5 5 2. Clinical Nursing Units 84 125
165 205 3. Operating Room 32 44 57 69
17
Organizational Unit No. of Positions
Bed Capacity
200 300 400 500
4. Special Care Areas 31 44 57 69 5. Pulmonary/Respiratory Unit 11 14 19 21 6. Obstetric

Complex 5 7 9 9
a. Labor Room 5 8 10 12 b. Delivery Room 16 21 26 31 c. Obstetrical OR
i. Caesarean Section(CS) Operating Room (OR) 8 12 16 19 ii. Ligation Room 2 2 3 3 d. Recovery
Room/PACU 5 8 10 12 7. Central Supply and Sterilization 7 9 12 14
D. Hospital Operations and Patient Support Service 44 58 72 76 1. Office of the Administrative

Officer 3 3 3 3 2. Human Resource Management 8 9 11 11 3. Procurement 5 7 8 8 4. Materials
Management 5 7 8 8 5. Engineering and Facilities Management 18 25 32 35
a. Housekeeping/Laundry 5 7 10 11 6. Security - to be contracted out - E. Finance Service 36 44 55 63 1.
Office of the Finance Officer 2 2 2 2 2. Budget 3 4 4 4 3. Accounting 8 10 12 13 a. Billing and Claims 13
15 20 24 4. Cash Operations 10 13 17 20
Total Number of Positions 609 869 1,122 1,349
18
F. Specialty and Sub-specialty Services (Optional) 1.
Burn Unit
2. Rehabilitation Medicine
3. Respiratory Therapy Unit
4. Dialysis Unit
5. Heart Station
6. Electrophysiology Unit
7. Endoscopy Unit
8. Radiation Oncology
9. Nuclear Medicine
10. MRI Section
11. Interventional Radiology
12. Mammography
19
Level 3 Hospital
200, 300, 400 and 500 Bed Capacity
Basic Organizational Structure
Integrated Hospital Operations and Management Program (IHOMP Unit) Medical Nursing Non-Medical
Professional Education
And Training
Hospital Operations and

Medical Service
Nursing Service Medical Service
Patient Support Service Finance Service
Outpatient Department Laboratory
Blood Bank
Emergency Medicine Department
Medical Service Department of Radiology

Clinical Departments Special Care
Dental
Areas1
Office of the Medical Center
Chief
Department of Pathology Health Information Management
Anatomic and Clinical

Admitting/Information Nutrition and Dietetics Pharmacy Medical Social Work
_______________________
1
Special Care Areas:
Intensive Care Units (ICU), Surgical Intensive Care Unit (SICU), Post-Intensive Care Unit (PICU), Neonatal
Intensive Care Unit (NICU), etc.
20
Nursing Service
Office of the
Medical Center
Chief Special Care
Areas
Hospital Operations
and Patient Support Service
Hospital Operations and Patient
Support Service
21
Finance Service
Finance Service
Budget Cash Operations
Accounting
Billing
& Claims
22
PART III
STANDARD
STAFFING PATTERN
23
STANDARD STAFFING PATTERN

______________________________________________________
The staffing pattern of a hospital is determined based on the assigned classification, bed
capacity and organizational structure of the hospital.
A. Medical Staff
The medical staff is divided into general practitioners and specialists such as
surgeons, eye, ear, nose and throat specialists, internist, obstetricians,
roentgenologists, pathologists, radiologists, urologists, orthopedic surgeons,
dermatologists and psychiatrists.
The number of general practitioners needed for each hospital is based on the
ratio of one general practitioner for every 1,000 population.
The number and type of specialists required to staff a hospital are variable
depending on the services offered and the specialties and sub-specialties.
1. Medical Staff Positions
The Philippine hospitals’ standard for medical staffing is derived from the
study entitled “Developing Metrics for Hospital Medical Workforce
Allocation” (Shannon, et al, 2007) which is used internationally.
In addition, the DOH Administrative Order No. 2012-0012 dated July 18,
2012 entitled “Rules and Regulations Governing New Classification of
Hospitals and Health Facilities in the Philippines” is used as reference.
Based on the Shannon formula, DOH considered the last 3 years’ average
increase in inpatient discharges and outpatient visits for each level of
hospitals to determine the needed staff per level and bed capacity of the
hospitals. The formula applied follows:
a. Computation of the Required Number of Medical Specialist
(Average Inpatients x 0.489) (Average Outpatients x 0.252) 1,000 +
1,000
24
b. Computation of the Required Number of Medical Officers
(Average Inpatients x 0.737) (Average Outpatients x 0.181) 1,000 +
1,000
The total number of the required medical staff is based on the sum of the
computed number of Medical Specialists and Medical Officers. However, this
does not include the following:
a. Chief of the Medical Service

b. Head of the different Medical Departments
c. Medical Specialist and Medical Officers of the Pathology
Department
d. Medical Specialist and Medical Officers of the Radiology
Department
2. Computation of Additional Medical Staff for Teaching and Training

Hospital
The number of resident physicians and interns will be governed by the

type of hospital or level of care delivered by a teaching and training
hospital; and the accreditation requirement of Specialty Societies 1.
The considerations in number and types of medical specialists depend on

the level of care, number of inpatients and outpatients, authorized and
implementing bed capacity, specialty services, capability of the
hospital based on the physical structure, availability of equipment,
presence of accredited residency training program, wherein the ratio of
medical specialist to resident physician depends on the particular specialty.
In general, the standard ratio of one surgeon for every 50 beds is applied.
1
Philippine Society of Anesthesiologists, Philippine Academy of Family Physicians, Philippine College of Physicians,
Obstetrical and Gynecological Society of Pathologists, Philippine Pediatric Society, Philippine College of Radiology,
and Philippine College of Surgeons
25
The specialty requirements for training are the following:
SPECIALTY RATIO
∙ Pediatrics - 1 Consultant2 : 4 Resident3 Physicians
∙ Surgery - 1 Consultant : 1 Resident Physician

Minimum of 3 Fellows4 for 8 or
fewer residents.
A Fellow is added for every two
(2) additional residents.
∙ Neurology - 3 Training Neurologists : 3
Resident Physicians
1 faculty member responsible for each
of the following: Neurophysiology,
Neuroanatomy, Psychiatry and
Behavioral Sciences, Internal Medicine,
Pediatric Neurology, Neuropathology,
Neuroimaging
∙ Dermatology - 1 Consultant : 3 Resident Physicians
∙ Nuclear At least 3 Nuclear Medicine full time

physicians, diplomate status, for every
Medicine - gamma machine, and at least 3
training residents for every
accredited Nuclear Medicine
residency training facility
∙ Anesthesiology - 1 Consultant : 2 Resident Physicians
∙ Radiation 1 Consultant : 3 Resident Physicians
Oncology -
∙ Obstetrics and 1 Consultant : 2 Resident Physicians
Gynecology -
∙ Urology - 1 Consultant : 1 Resident Physician
∙ Otolaryncology 1 Consultant : 1 Resident Physician

-
(head and neck
surgery)
2
Consultants refer to those occupying Medical Specialist positions. Physicians accredited by their respective
specialty societies and are experts in their medical specialties act as training supervisors to residents.
3
Residents refer to Medical Officer positions that undergo specialty training program under the
supervision of the Consultants.
4
Fellows refer to physicians who enter a training program in a medical specialty after completing
residency; board-qualified specialist pursuing subspecialty training.
26
B. Nursing Staff
Staffing of nurses is the largest and the most crucial aspect of administration
because the quality of the personnel and their performance will determine the
degree of achieving the goals of the Nursing Service.
The goal of staffing is to provide the appropriate number and mix of nursing staff
(nursing care hours) to the actual or projected patient care needs that will lead to
the delivery of effective and efficient nursing care. This means determining the
level of care, average daily census and hours of care provided for 24 hours a day,
7 days a week.
1. Factors in Determining Nursing Staffing Needs
∙ Patients Acuity of Illness

i. Level of Care
a) Obstetrics – Gynecology
b) Pediatrics
c) Medical
d) Surgical
ii Degree of Dependence
iii. Communicability
iv. Rehabilitation Needs
∙ Special treatment and procedures
∙ Type of hospital
∙ Ratio of professional to non-professional nursing personnel ∙

Turn-over of patients and nursing personnel
∙ Hospital policy
i. Budget
ii. Available equipment/materials/supplies
iii. Population served.
∙ Patient Care Classification System
Patient care classification allows a more accurate computation of nursing

hours needed for different categories of care and patients.
The manner of computing the required number of nursing personnel using

the patient care classification system shall consider such factors as the
percentage of patients in each level of care, the number of nursing care
hours, ratio of professional nurses to non-professional nursing personnel
and distribution by shifts and number of relievers.
27
2. Required Staff to Patient/Bed Ratio
The nursing service staffing requirement shall adhere to the following staff-
patient/bed ratio:
UNIT Nurse to Staff Ratio
Ward 1 Supervising Nurse (Nurse III) : 50 Staff

Nurses 1 Head Nurse (Nurse II) : 15 Staff
Nurses 1 Staff Nurse ( Nurse I) : 12 beds per
shift 1 Nursing Attendant : 24 beds per shift
Critical Care 1 Supervising Nurse (Nurse III) : 30 Staff

Nurses 1 Head Nurse (Nurse II) : 15 Staff
Nurses 1 Staff Nurse (Nurse II) : 3 beds per
shift 1 Nursing Attendant : 15 beds per shift
C. Other Hospital Professional Personnel in Indirect Patient Care Services
In general, units or sections needing 24 hours services will require a minimum of

5 personnel to fill the 24 hours-seven days a week schedule following the 40-hour
labor law. Hence, the Emergency Room, Operating Room, Delivery Room, X-ray,
Laboratory and even the Pharmacy staff requirements will need to be computed
accordingly. With the operation of DOH Botikas, additional pharmacists are
needed. Also, with present demands for a commercial pharmacy (service for
outpatients as well), an extra pharmacist for such purpose will be needed. In
Dispensing Pharmacy, the ratio of pharmacist to administrative assistant
(pharmacy assistant) is: 1 pharmacist: 2
administrative assistants.
The requirement for other allied health personnel is determined based on the
time and motion study conducted by DOH's National Center for Health Facility
Development (NCHFD). As the result of the study, the ratios of staff to bed
capacity in the following units are indicated below:
1. Pharmacy 1:25
2. Nutritionist-Dietetics 1:60
3. Medical Social Work 1:25
4. Health Information Management 1:20
(formerly Medical Records)
28
In addition to the hospital administrator, there will be required assistants, clerks,
bookkeepers, cooks, engineers, attendants, nurse aide, orderlies, janitors,
maintenance crew and others so that the total hospital personnel will amount to
approximately two and one half (2.5) for each occupied bed.
D. Supplemental Guidelines
1. The number and level of positions prescribed for each hospital category shall
be the maximum that will be allowed for the various organizational units.
However, hospitals may adopt a lesser number and lower levels of
positions and/or merge different staff offices in the internal management
and support units, depending on their financial capability.
2. Hospitals that qualify for the next higher category shall adopt the
corresponding organizational structure and staffing pattern (OSSP) herein
prescribed. However, the hospital management has the option to adopt a
leaner OSSP by merging the prescribed organizational units
or using lower-level positions. If the authorized bed capacity of a hospital
falls between two of the specified bed capacities in the standard staffing
pattern, the higher set of standards shall be applied if the number of beds
is in excess of one half of their difference.
3. Hospitals that are not qualified for upward categorization may continue to
adopt their existing OSSP provided that existing positions higher than
those provided in the SP prescribed for their appropriate category shall be
abolished once vacated by their present incumbents. Hospitals may also be
allowed to adopt the new OSSP prescribed for the category that
corresponds to their existing category approved by the DOH.
4. In the case of downward categorization, the hospitals shall adopt the model
OSSP for the new category, provided that incumbents of positions higher
than those prescribed shall continue to retain their positions. Once
vacated, the same will be abolished and replaced by those appropriate
under the new category.
5. The security, dietary and utility services may be contracted out in accordance
with pertinent guidelines.
6. The Housekeeping, Linen and Laundry service may be contracted out but
subject to infection control mechanism.
7. As an option, additional staff per approved Specialty/Sub-specialty service may

be provided as part of the Medical Staff, contingent on the service
capability of the particular hospital and subject to the approval
29
of the Department of Health. The number of staff is not part of the regular
staffing standards for Level 3 Hospitals.
The standard staffing pattern for each category of hospital and authorized bed capacity
is shown in the succeeding pages.
30
Staffing Pattern for a
25 Bed Capacity Hospital
Level 1: 25 Beds
Org. Unit No. of Position Title Salary
Pos. Grade
A. Office of the Chief of Hospital
1 Chief of Hospital II 25
1 Administrative Assistant II 8
1 Computer Maintenance Technologist I 11
3
B. Medical Service
1. Outpatient Unit
1 Medical Officer IV 23
1 Health Education and Promotion Officer II 14
1 Psychologist I 11
1 Nurse I 11
1 Nursing Attendant I 4
5
2. Emergency Room
3 Nurse II 15
5
3. Clinical Units
5 Medical Specialist II 23
5 Medical Officer III 21
11
4. Clinical Laboratory
1 Medical Technologist II 15
2 Medical Technologist I 11
1 Laboratory Technician I 6
5
a. Blood Station
3
31
Level 1: 25 Beds
Pos. Grade
5. Radiology
1 Radiologic Technologist II 13
1 Radiologic Technologist I 11
1 Administrative Aide IV 4
4
6. Dental
1 Dentist II 17
1 Dental Aide 4
2
7. Health Information Management

1 Administrative Officer III 14
2 Data Controller I 6
3
a. Admitting/Information
4
8. Nutrition and Dietetics

1 Nutritionist-Dietitian II 15
2 Cook II 5
1 Administrative Aide III 3
4
9. Pharmacy
1 Pharmacist II 15
2 Pharmacist I 11
4
10. Medical Social Work

1 Social Welfare Officer II 15
1 Social Welfare Assistant 8
2
C. Nursing Service
1. Office of the Nurse Supervisor

1 Nurse V 20
1
32
Level 1: 25 Beds
Pos. Grade
2. Clinical Nursing Units

1 Nurse III 17
2 Nurse II 15
6 Nurse I 11
13
3. Operating Room
4 Nurse II 15
2 Nursing Attendant II 6
6
4. Recovery Room
4 Nurse II 15
6
5. Isolation Room
4 Nurse II 15
4
6. Delivery Room
4 Nurse II 15
4 Midwife I 9
9
D. Hospital Operations and Patient Support Service
1. Office of the Administrative Officer

1 Administrative Officer V 18
1 Administrative Assistant I 7
2
2. Human Resource Management

2
3. Procurement, Property and Supply

1 Administrative Aide VI 6
2
33
Level 1: 25 Beds
Pos. Grade
4. Engineering and Facilities Management

1 Engineer II 16
1 Medical Equipment Technician III 11
5
5. Housekeeping/Laundry
1 Laundry Worker II 3
1 Seamstress 2
2
6. Accounting
1 Accountant II 16
2
a. Billing and Claims

1 Administrative Officer II 11
2
7. Cash Operations
1 Administrative Officer I 10
2
8. Security ( to be contracted out)
Total 113
34
Staffing Pattern for a 50 Bed Capacity Hospital
Level 1: 50 Beds
Pos. Grade

3
B. Medical Service
1. Outpatient Unit
1 Psychologist I 11
1 Nurse I 11
5
2. Emergency Room
6 Nurse II 15
9
3. Clinical Units
14
6
a. Blood Station
3
35
Level 1: 50 Beds
Pos. Grade
5. Radiology
5
6. Dental
1 Dentist II 17
1 Dental Aide 4
2

3
4

2 Cook II 5
5
9. Pharmacy
1 Pharmacist II 15
3 Pharmacist I 11
5

1 Social Welfare Officer I 11
3
C. Nursing Service

1 Nurse V 20
1
36
Level 1: 50 Beds
Pos. Grade

2 Nurse III 17
3 Nurse II 15
12 Nurse I 11
24
3. Operating Room
4 Nurse II 15
6
4. Recovery Room
4 Nurse II 15
6
5. Isolation Room
4 Nurse II 15
4
6. Delivery Room
4 Nurse II 15
4 Midwife I 9
10

2

2
2
37
Level 1: 50 Beds
Pos. Grade

1 Engineer II 16
9
1 Seamstress 2
3
6. Accounting
1 Accountant II 16
3
2
7. Cash Operations
3
8. Security (to be contracted out)
Total 144
38
Level 1: 75 Beds
Pos. Grade
3
B. Medical Service
1. Outpatient Unit
1 Psychologist I 11
1 Nurse I 11
5
2. Emergency Room
8 Nurse II 15
12
3. Clinical Units
16
7
39
Level 1: 75 Beds
Pos. Grade
a. Blood Station
3
5. Radiology
6
6. Dental
1 Dentist II 17
1 Dental Aide 4
2

3
4

2 Cook II 5
6
9. Pharmacy
1 Pharmacist II 15
4 Pharmacist I 11
6
40
Level 1: 75 Beds
Pos. Grade

4
C. Nursing Service

1 Nurse V 20
1

2 Nurse III 17
4 Nurse II 15
18 Nurse I 11
34
3. Operating Room
4 Nurse II 15
6
4. Recovery Room
4 Nurse II 15
6
5. Isolation Room
4 Nurse II 15
4
6. Delivery Room
4 Nurse II 15
4 Midwife I 9
10
41
Level 1: 75 Beds
Pos. Grade

2

2
2
1 Engineer II 16
11
1 Seamstress 2
3
6. Accounting
1 Accountant II 16
3
2
42
Level 1: 75 Beds
Pos. Grade
7. Cash Operations
3
Total 166
43
______________Level 2 Hospital_____________
Level 2: 100 Beds

Pos. Grade
A. Office of the Medical Center Chief

1. Office of the Medical Center Chief
1 Medical Center Chief I 26
1 Administrative Assistant III 9
2
2. Integrated Hospital Operations and Management Program 1

Computer Maintenance Technologist II 15
2
B. Medical Service
1. Office of the Chief of Medical Professional Staff
1 Chief of Medical Professional Staff I 25
2
2. Outpatient Department
1 Medical Specialist III 24
1 Nurse III 17
1 Psychologist II 15
2 Nurse I 11
9
44
Level 2: 100 Beds
Pos. Grade
3. Emergency Medicine Department

1 Nurse III 17
7 Nurse II 15
19
4. Clinical Departments
26
5. Special Care Areas

4
6. Department of Pathology
2
a. Blood Bank
1 Medical Technologist III 18
45
Level 2: 100 Beds
Pos. Grade
2 Nurse II 15
6
b. Anatomic and Clinical Laboratory

1 Chemist II 15
2 Medical Laboratory Technician II 8
3 Laboratory Aide II 4
13
7. Department of Radiology
1 Radiologic Technologist III 15
8
8. Dental
1 Dentist IV 23
1 Dentist II 17
1 Dental Aide 4
3
46
Level 2: 100 Beds
Pos. Grade

1 Statistician II 15
1 Administrative Officer IV 15
1 Data Controller II 8
5
5

1 Nutritionist-Dietitian III 18
1 Nutritionist-Dietitian I 11
3 Cook II 5
9
11. Pharmacy
1 Pharmacist III 18
5 Pharmacist I 11
7

1 Social Welfare Officer III 18
47
Level 2: 100 Beds
Pos. Grade

4
C. Nursing Service
1. Office of the Chief Nurse
1 Nurse VI 22
1 Nurse V 20
1 Nurse IV 19
4

1 Nurse III 17
3 Nurse II 15
34 Nurse I 11
55
3. Operating Room
1 Nurse III 17
1 Nurse II 15
8 Nurse I 11
14
4. Delivery Room
1 Nurse III 17
4 Nurse II 15
3 Nurse I 11
48
Level 2: 100 Beds
Pos. Grade
3 Midwife I 9
11

a. Post Anesthesia Care Unit
1 Nurse III 17
4 Nurse II 15
7
b. Intensive Care Unit

1 Nurse III 17
4 Nurse II 15
6
c. Neonatal Intensive Care Unit (NICU)

1 Nurse III 17
9 Nurse II 15
14
d. Pulmonary/Respiratory Unit
1 Respiratory Therapist II 14
2 Respiratory Therapist I 10
5
49
Level 2: 100 Beds
Pos. Grade
6. Central Supply and Sterilization

1 Nurse II 15
6
D. Hospital Operations and Patient Support Department

1 Supervising Administrative Officer 22
2

4
3. Procurement
4
4. Materials Management
1 Warehouseman II 8
50
Level 2: 100 Beds
Pos. Grade
5

1 Engineer III 19
1 Engineer II 16
1 Medical Equipment Technician II 8
1 Medical Equipment Technician I 6
8
a. Housekeeping/Laundry
1 Hospital Housekeeper 8
1 Seamstress 2
3
6. Budget
3
7. Accounting
1 Accountant III 19
1 Accountant II 16
5
51
Level 2: 100 Beds
Pos. Grade

5
8. Cash Operations
5
Total 292
52
Level 2: 150 Beds

Pos. Grade

2

2
B. Medical Service
2
1 Nurse III 17
3 Nurse I 11
11
53
Level 2: 150 Beds
Pos. Grade

1 Nurse III 17
10 Nurse II 15
26
35

6
2
a. Blood Bank
54
Level 2: 150 Beds
Pos. Grade
3 Nurse II 15
8

1 Chemist II 15
18
11
8. Dental
1 Dentist IV 23
1 Dentist II 17
1 Dental Aide 4
3
55
Level 2: 150 Beds
Pos. Grade

7
6

4 Cook II 5
13
11. Pharmacy
1 Pharmacist III 18
6 Pharmacist I 11
8
56
Level 2: 150 Beds
Pos. Grade

5
C. Nursing Service

1 Nurse VI 22
1 Nurse V 20
1 Nurse IV 19
4

2 Nurse III 17
4 Nurse II 15
51 Nurse I 11
83
3. Operating Room
1 Nurse III 17
2 Nurse II 15
12 Nurse I 11
21
4. Delivery Room
1 Nurse III 17
6 Nurse II 15
57
Level 2: 150 Beds
Pos. Grade
5 Nurse I 11
5 Midwife I 9
17

1 Nurse III 17
6 Nurse II 15
10

1 Nurse III 17
6 Nurse II 15
9

1 Nurse III 17
14 Nurse II 15
21
7
58
Level 2: 150 Beds
Pos. Grade

1 Nurse II 15
8

2

5
3. Procurement
5
1 Warehouseman II 8
59
Level 2: 150 Beds
Pos. Grade
6

1 Engineer III 19
1 Engineer II 16
1 Engineering Assistant 8
13
1 Seamstress 2
5
6. Budget
3
7. Accounting
1 Accountant III 19
1 Accountant II 16
60
Level 2: 150 Beds
Pos. Grade
6

7
8. Cash Operations
7
Total 404
61
Level 2: 200 Beds

Pos. Grade

2

3
B. Medical Service
2
1 Nurse III 17
4 Nurse I 11
12
62
Level 2: 200 Beds
Pos. Grade

1 Nurse III 17
13 Nurse II 15
31
48

6
2
63
Level 2: 200 Beds
Pos. Grade
a. Blood Bank
3 Nurse II 15
9

1 Chemist II 15
20
11
8. Dental
1 Dentist IV 23
1 Dentist III 20
64
Level 2: 200 Beds
Pos. Grade
1 Dentist II 17
1 Dental Aide 4
4

9
7

5 Cook II 5
15
11. Pharmacy
1 Pharmacist III 18
8 Pharmacist I 11
10
65
Level 2: 200 Beds
Pos. Grade

6
C. Nursing Service

1 Nurse VI 22
1 Nurse V 20
1 Nurse IV 19
4

2 Nurse III 17
5 Nurse II 15
67 Nurse I 11
108
3. Operating Room
1 Nurse III 17
2 Nurse II 15
16 Nurse I 11
26
66
Level 2: 200 Beds
Pos. Grade
4. Delivery Room
1 Nurse III 17
8 Nurse II 15
6 Nurse I 11
6 Midwife I 9
21

1 Nurse III 17
7 Nurse II 15
11

1 Nurse III 17
7 Nurse II 15
10

1 Nurse III 17
18 Nurse II 15
27
67
Level 2: 200 Beds
Pos. Grade
9

1 Nurse II 15
11

2

6
3. Procurement
5
68
Level 2: 200 Beds
Pos. Grade
1 Warehouseman II 8
7

1 Engineer III 19
1 Engineer II 16
2 Engineering Assistant 8
15
1 Seamstress 2
5
6. Budget
3
69
Level 2: 200 Beds
Pos. Grade
7. Accounting
1 Accountant III 19
1 Accountant II 16
7

9
8. Cash Operations
10
Total 493
70
___Level 3 Hospital (Teaching and Training)___
Level 3: 200 Beds

Pos. Grade
1 Medical Center Chief II 27

1 Attorney IV 23
4
2. Professional, Education and Training

1 Medical Specialist IV 25
1 Nurse VI 22
1 Training Specialist IV 22
2 Training Assistant 8
5

Computer Maintenance Technologist III 17
2 Computer Maintenance Technologist II 15
3
B. Medical Service
1 Chief of Medical Professional Staff II 26

2
71
Level 3: 200 Beds
Pos. Grade
1 Health Education and Promotion Officer III 18
1 Nurse III 17
5 Nurse I 11
14

2 Nurse III 17
13 Nurse II 15
34
95
72
Level 3: 200 Beds
Pos. Grade

15
a. Blood Bank

4 Nurse II 15
12

1 Medical Technologist V 22
2 Medical Technologist IV 20
1 Chemist III 18
5 Medical Laboratory Technician III 10
34
73
Level 3: 200 Beds
Pos. Grade
(Diagnostic Radiology and Ultrasound, CT-Scan)
1 Health Physicist III 22
1 Radiologic Technologist IV 18
20
8. Dental
1 Dentist V 24
1 Dentist III 20
1 Dentist II 17
2 Dental Aide 4
5

1 Statistician III 18
74
Level 3: 200 Beds
Pos. Grade
16
8

1 Social Welfare Officer IV 22
8

1 Nutritionist-Dietitian V 22
1 Nutritionist-Dietitian IV 20
6 Cook II 5
23
12. Pharmacy
1 Pharmacist V 22
1 Pharmacist IV 20
75
Level 3: 200 Beds
Pos. Grade
6 Pharmacist II 15
20
C. Nursing Service
1 Nurse VII 24
1 Nurse VI 22
2 Nurse V 20
5
2 Nurse III 17
4 Nurse II 15
48 Nurse I 11
84
3. Operating Room
1 Nurse IV 19
13 Nurse III 17
13 Nurse II 15
32
76
Level 3: 200 Beds
Pos. Grade

4 Nurse III 17
23 Nurse II 15
31
5. Pulmonary/Respiratory Unit
1 Respiratory Therapist III 17
4 Physical Therapy Technician I 6
11
6. Obstetric Complex
1 Nurse IV 19
2 Nurse III 17
5
a. Labor Room
5 Midwife II 11
5
b. Delivery Room
4 Nurse II 15
4 Midwife II 11
8 Midwife I 9
16
77
Level 3: 200 Beds
Pos. Grade
c. Obstetrical OR
i. Caesarean Section OR
6 Nurse II 15
2 Midwife I 9
8
ii. Ligation Room

2 Midwife II 11
2
d. Recovery Room/PACU
5 Midwife II 11
5

1 Nurse II 15
7
1 Chief Administrative Officer 24

3
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Organizational Structure and Staffing Standars For Government Hospitals CY 2013

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PART I – INTRODUCTION: CLASSIFICATION OF HOSPITALS

PART II – MODEL ORGANIZATIONAL STRUCTURE

PART III – STANDARD STAFFING PATTERN

Annex: Tally of Positions by Level, by Bed Capacity . . . . . . 118

Hospitals are classified according to:

1. Classification According to Ownership

a. Government – a hospital owned, established, established and created

b. Private – a hospital owned, established and operated with funds through

2. Classification According to Scope of Services

a. General – a hospital that provides services for all kinds of illnesses,

b. Specialty – a hospital that specializes in a particular disease or condition

ii. Treatment of patients belonging to a particular group such as children,

B. Categories of General Hospitals According to Functional Capacity 1.

A Level 1 hospital shall have, as minimum, the following services and

a. A staff of qualified medical, allied medical and administrative personnel

c. An operating room with standard equipment and provision for sterilization

i. DOH Reference Plan in the Planning and Design of an Operating

d. A post-operative recovery room;

e. Maternity facilities, consisting of ward(s), room(s), and a delivery room

g. A separate dental section/clinic;

i. A DOH-licensed secondary clinical laboratory with the services of consulting

j. A DOH-licensed Level 1 imaging facility with the services of a consulting

a. An organized staff of qualified and competent personnel with Chief of

b. Departmentalized and equipped with service capabilities needed to support

c. A general Intensive Care Unit (ICU) for critically ill patients; d.

A Neonatal Intensive Care Unit (NICU);

e. A High Risk Pregnancy Unit (HRPU);

g. A DOH-licensed tertiary clinical laboratory; and

h. A DOH-licensed Level 2 imaging facility with mobile x-ray inside the

a. Teaching and/or training hospital with accredited residency training

b. A physical medicine and rehabilitation unit;

c. An ambulatory surgical clinic;

f. A DOH-licensed tertiary clinical laboratory with standard equipment

g. A DOH-licensed level 3 imaging facility with interventional radiology.

Clinical Consulting All of Level 1 plus: All of Level 2 plus:

Isolation Facilities General ICU

Surgical/ High Risk Ambulatory

Dental Clinic NICU Dialysis Clinic

Ancilliary Secondary Tertiary Clinical Tertiary laboratory

Blood Station Blood Station Blood Bank

1st Level X-ray 2nd Level X-ray 3rd Level X-ray

Pharmacy Pharmacy Pharmacy

MODEL ORGANIZATIONAL STRUCTURE

1. The new standards on organizational structure and staffing pattern of government

a. Minimum DOH Licensing Requirements and Philhealth Accreditation

b. New hospital licensing category (Level 1, Level 2, Level 3 hospitals) based on

c. Specialty Society Training Accreditation Requirements (particularly for Medical

d. Distribution of Medical Staff to cover the Outpatient Department, Emergency

e. Health Human Resource Master Plan

A Level 3 hospital shall be provided with an additional division-level entity, the

2. The general functions of the major organizational units are as follows: a.

Office of the Chief of Hospital/ Medical Center Chief

Shall be responsible for the overall management and administration of the

Shall be responsible for implementing nursing programs for total quality

d. Hospital Operations and Patient Support Service

Shall be responsible for the provision of administrative services relating to