OPD Appointment & TCA Management
This page consolidates appointment and TCA management for the general patient journey and all linked services at KK Bandar Maharani. It covers booking mechanics, slot limits, follow-up intervals, unit-specific scheduling rules, defaulter tracing, and patient communication standards.
Appointment Channels
Standard TCA Workflow
Clinician Defines Follow-Up Need
- Decide follow-up type: acute review, chronic follow-up, blood taking before review, wound reassessment, NCD review, TB milestone, or specialist referral.
- Document follow-up reason, interval & destination unit in SystmOne.
- Guide patient to Counter 17-A for appointment process.
Counter 17A Books the Appointment
- Check SystmOne rota for available slots and daily limit.
- Book the correct clinic/service slot with accurate unit assignment.
- Confirm patient contact details and preferred communication channel.
Issue TCA Card and Patient Instruction
- Write appointment date, time, destination unit and preparation requirement.
- Explain registration location on the appt day: OPD, Procedure Room, NCD, Wound Care, MCH, TB etc.
- Inform patient that rescheduling is by phone call or clinic visit only.
Link Supporting Appointments
- For chronic cases, arrange blood-taking 2 weeks before the doctor review when required.
- For imaging or specialist referrals, confirm referral letter validity and external appointment instructions.
- For linked service follow-up, document the destination clearly to prevent misallocation at registration.
Follow-Up Intervals by Patient Type
2 – 6 weeks, depending on clinical condition and MO plan.
2 – 6 months for stable hypertension, diabetes, and dyslipidemia.
Scheduled ~2 weeks before the planned follow-up consultation date.
Transfer-out accordingly to related KK next TCA
- NHSI, PEKA B40 (eligibility-based): 2 weeks
- Ca screening (protocol-based): immediate
2 – 6 weeks
3 – 6 months
1 – 3 months on Friday AM (dedicated new-case session)
Transfer-out within 1 – 2 months or next TCA
- HbA1c: every 6 months
- CVD screening (RP/LFT/FSL/UA): every 6 months
- Fundus camera: yearly · Foot care: every visit
Wednesday TCA for MOIC oversight review.
EOD, twice weekly, or weekly — adjusted by MA/FMS based on wound progress.
Per T.I.M.E. framework and healing trend at each visit.
Month 1 (CXR + sputum) → Month 2 (CXR + sputum) → Month 4 (MO/FMS review) → Month 6 (cure evaluation)
TCA at 3, 6, and 9 months post-treatment for relapse monitoring.
Daily supervised dose during standard office hours.
Per trimester protocol and risk stratification — nurses and doctors have separate rota slots.
Based on national immunisation schedule and developmental milestones.
Per method: Jadelle review, contraceptive follow-up — per case basis.
Typically within 6 weeks of delivery, then per need.
- Appointment only when clinically indicated
- Most acute fever cases are walk-in routed from triage.
- Set only if MO determines need
- Dengue case: daily or according to condition
- Post-antibiotic review: case-by-case basis
Daily Slot Limits
| Unit / Service | Slot Limit | Notes |
|---|---|---|
| OPD Walk-in Acute | 70-80/day | General consultation, non-appointment cases |
| OPD / NCD Hypertension | 40/day | Shared or split between OPD and NCD rota depending on allocation |
| OPD / NCD Diabetes | 40/day | Shared or split between OPD and NCD rota depending on allocation |
| Procedure Room — Blood Taking | 110-130/day | Room 8; includes appointment and walk-in blood sampling |
| Procedure Room — Wound Dressing | 15–20/day | Room 8 dressing procedures |
| Wound Care Clinic (Room 9) | 10/day | Dedicated wound care appointments |
| MCH — Nurses Antenatal | 30/day | KKIA nurse-led antenatal follow-up |
| MCH — Doctor Antenatal | 15/day per doctor | MO-led antenatal consultation |
| MCH — Doctor Procedure | 5/day | Friday only |
Capacity enforcement: These limits prevent overcrowding, minimise clinical errors, and ensure manageable workload. If demand exceeds capacity, the TCA date may be rescheduled to the next available slot.
Unit-Specific Scheduling Rules
NCD Unit
- Friday AM is reserved for new NCD cases only. Follow-up cases are not booked on Friday mornings.
- New cases are given extended slots to allow the NCD team to complete full complication screening (fundus camera, foot care, baseline labs) before further doctor consultation.
- Blood taking should be scheduled ~2 weeks before the NCD doctor review so results are available at consultation.
Wound Care Clinic
- All new wound cases receive a Wednesday TCA for MOIC oversight review (subject to future rota changes).
- Follow-up frequency is adjusted by wound severity: EOD for complex/infected wounds, twice weekly for moderate wounds, weekly for stable healing wounds.
TB Clinic
- Treatment reviews are fixed to 1, 2, 4, and 6 months — these are clinical milestones, not flexible intervals.
- Post-treatment surveillance appointments at 3, 6, and 9 months are mandatory for cure confirmation and relapse detection.
MCH
- MyVAS/MySejahtera sync is NOT used for MCH appointments. All MCH appointments are managed internally via SystmOne rota.
- If a TCA card is unavailable, a colored chip is clipped to the patient's physical book cover as an alternative appointment indicator.
- Rescheduling must be done by phone to avoid walk-in congestion.
Procedure Room
- Pre-planned procedures are handled on a demand basis without strict daily limits beyond blood-taking and wound dressing caps.
- If the number of procedures exceeds safe capacity for a single day, the appointment may be rescheduled to the next available slot.
Before Leaving Appt Counter: Patient Communication Standards
- Appointment date, time, location, and visit purpose.
- Whether the patient needs blood taking, fasting, imaging, documents, TCA card, referral letter, or previous book/card.
- Where to register on the appointment day.
- Whether the patient should go through OPD, Procedure Room, NCD, Wound Care, MCH, TB, Radiology, or another service.
- How to request rescheduling (phone call or clinic visit; MCH rescheduling is phone only).
- SystmOne appointment slot, unit assignment, and reason for follow-up.
- Any preparation instruction given (fasting, documents, previous book).
- Any special communication or accessibility need.
Contributors
Dr Fuad Jaafar
Facilitator, CCMS • KK Bandar Maharani
Dr Tn Mohd Azlan
MOIC • KK Bandar Maharani