OPD Patient Journey

The Outpatient Department (JPL) serves as the primary entry point and general patient journey for all walk-in and appointment-based visits at KK Bandar Maharani. Every patient follows a structured pathway from triage screening through to discharge — with distinct CCMS statuses tracked at each stage and conditional branches to linked services when clinically indicated.

---

General Patient Journey

1

Triage & Redirection

Triaging

• Patient arrives at Triage Counter A.
• Based on presenting complaint and appointment type, redirect to the appropriate unit:

Presentation	Destination
Fever / URTI / respiratory symptoms	Fever Clinic
Maternal / child / postnatal / family planning	MCH Unit (KKIA)
Open wound / dressing	Wound Care Clinic (Room 9)
TB risk / high-risk group screening	TB Clinic
Existing NCD follow-up	NCD Unit
Acute non-fever / general consultation / new chronic case	OPD (Rooms 1–6)
Blood-taking TCA only	Procedure Room

2

Registration

Booked

• Registration staff key in patient profile and process payment (if required).
• Update patient contact & demographic details.
• Issue QMS number and direct patient to the registration waiting area.

Registration Counter, KKBM

Registration Process

Registration Process

3

Allocate to Unit

Arrived

• Registration staff auto-allocate patient to the correct unit in CCMS/SystmOne.
• The same QMS number is retained across all units; each unit sees the patient in their SystmOne rota list.
• Guide patient to the appropriate waiting area:
  • OPD / general cases → Waiting Area 17
  • NCD → NCD waiting area
  • Fever Clinic → Fever Unit waiting area

4

Vital Signs & Anthropometry

Waiting

• Health Assistant (PPK) records BP, PR, SpO₂, temperature, height, weight, BMI using the Assessment & Procedure Template.
• Conduct brief screening where indicated: BSSK, NHSI, PEKA B40, Mental Health (PHQ-9).
• Ensure accurate measurement and complete all 5 vital signs parameters.
• Escalate to MO immediately if vital signs are abnormal or system alerts appear.

5

Waiting for Doctor Consultation

Waiting

• Patient sits in the designated waiting area with checklist and QMS number.
• Doctor calls patient via QMS once status shows "Waiting".

6

Doctor Consultation & Assessment

In Progress

• Doctor calls patient and selects the appropriate CCMS Template for the encounter type.
• Perform clinical assessment, diagnosis formulation, and treatment planning.
• Conditional pathway according to scenarios:

A

Investigations & Procedures

• Blood test or procedure → allocate to Room 8
• X-ray → create imaging order, document indication and LMP → allocate Room 7
• ECG → create task order in SystmOne → Counter 17
• Update checklist

B

Referrals

• Internal referral → Register Special Services Template → print referral letter
• ED referral → print referral letter → allocate to Room 8
• Specialist clinic → Print & Refer Template → direct to HPSF Muar

C

Health Screening

• Offer age-appropriate screening when indicated
• Select appropriate screeenig plan: NHSI, PEKA B40, blood screening, Ca screening

D

Chronic Disease Care

• New / transfer-in NCD cases → refer to NCD Unit for registration
• Arrange complication screening when indicated
• Issue next TCA date accordingly

7

Back from Investigations / Procedures

• Patient returns to the referring doctor's room with investigation results or procedure completion note.
• Doctor finalises diagnosis using SNOMED-CT↴ coding.
• Complete treatment plan, update checklist & decide on disposition.

8

Appointment Setting (Counter 17A) — Conditional

• For chronic / follow-up cases: Counter 17A sets next appointment in SystmOne rota.
• Issue TCA card to patient with date, destination, and preparation instructions.
• Chronic cases only: printed medication slip auto-prints at Counter 17A.

9

Medication Prescription & Discharge

Finished

• Meds prescribed in SystmOne integrated with PHIS↴.
• Pharmacist cross-checks, verifies, and commences dispensing.
• Acute cases directed to Pharmacy immediately; chronic cases directed from Counter 17A.
• Patient discharged home after treatment and dispensing completed.

---

Doctor Decision Matrix

When the doctor identifies a need during consultation, use the following matrix to determine the correct action, destination, and return path:

If Doctor Identifies...	Action	Destination	Return To
Blood test & procedure needed	Create order; update checklist	Procedure Room 8	OPD Doctor
X-ray needed	Create imaging order; document LMP	Radiology Room 7	OPD Doctor
ECG needed	Create task order in SystmOne	Counter 17 area	OPD Doctor
Health screening indicated	Select screening plan; create order	Screening station / lab	OPD Doctor
Internal service referral	Register Special Services; print letter	Referred unit (NCD, Wound Care, Physio, etc.)	Referred unit doctor
ED referral required	Print referral; allocate Room 8 for preparation	Room 8 → HPSF ED	—
Specialist referral required	Use Print & Refer Template	HPSF Muar	—
New / transfer-in NCD case	Refer for NCD registration	NCD Unit	NCD workflow

Key rule:
Patients sent for investigations (blood, X-ray, ECG) always return to the referring OPD doctor for result review and finalisation.

---

Patient Flowchart Illustration

Outpatient Flow Movement Pg 1

Outpatient Flow Movement Pg 2

The flowchart illustrates the complete general patient journey from triage through to pharmacy discharge.