Standard 51: Mobile Clinic and Outreach (Version 11)

Why it matters. A mobile clinic that arrives at an unsafe site can harm patients and staff before the first patient is seen. Assessing each site before use, for safety, access and shelter, is the check that stops it.

Sample. Review the site assessment records for every site used in the last 12 months, and observe one site on arrival.

1. Each site is assessed before the first session.

Method. Check each site for an assessment dated before its first session.

Evidence to show. Site assessment record (MOB-FRM-001).

Pass when. Every site has an assessment dated before first use.

2. The assessment covers safety, access, privacy, infection control and facilities.

Method. Check each assessment for the five areas.

Evidence to show. Site assessment record.

Pass when. Every assessment covers all five areas.

3. A site with a failed safety item is not used until the fault is fixed.

Method. Check each failed item for the fix and the date of first use.

Evidence to show. Site assessment record.

Pass when. No site was used with an unfixed safety failure.

Immediate fail (any one means the criterion is not met)

• A site is used with a safety failure that is not fixed.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. A mobile unit away from a hospital has no second chance. The equipment, medicines and emergency drugs it needs must be on board, checked before each deployment.

Sample. Review 10 deployment checks in the last 6 months, and the equipment and medicines list for each service offered.

1. Each deployment has a defined list for the services offered.

Method. Check each service against its list.

Evidence to show. Deployment equipment and medicines list (MOB-POL-002).

Pass when. Every service offered has a defined list.

2. The vehicle is checked against the list before departure.

Method. Check each deployment for the completed check.

Evidence to show. Deployment equipment and medicines check (MOB-FRM-002).

Pass when. Every deployment has the check completed before departure.

3. Medicines are carried and stored as the rules require.

Method. Check the medicines check register for each deployment.

Evidence to show. Vehicle maintenance, equipment and medicines check register (PTR-REG-002).

Pass when. Every deployment shows the medicines check recorded.

Immediate fail (any one means the criterion is not met)

• A deployment leaves without its emergency items.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. When a patient in a remote site becomes unwell, the route to a hospital decides whether they survive. The route must be defined before each deployment, not worked out on the day.

Sample. Review the transfer plan for 10 deployments in the last 12 months, and the record of any transfer made.

1. Each deployment has a route to a hospital with the transport and the travel time.

Method. Check each deployment plan for the route, transport and time.

Evidence to show. Deployment plan record (MOB-FRM-003).

Pass when. Every plan has the route, transport and time.

2. A communication method and a back-up are named.

Method. Check each plan for both.

Evidence to show. Deployment plan record.

Pass when. Every plan names both.

3. The team is briefed before the first session.

Method. Check the briefing record for each deployment.

Evidence to show. Deployment plan record.

Pass when. Every deployment has the briefing recorded.

Immediate fail (any one means the criterion is not met)

• A deployment starts with no route to a hospital.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. Records made in the field must reach the clinic and stay safe. A record lost on the road, or left open in a village, is a patient who cannot be followed up.

Sample. Review the records return register for the last 6 months, with the count taken and returned for each deployment.

1. Each patient seen is recorded.

Method. Check the register for each session against the patient count.

Evidence to show. Records return register (MOB-REG-001).

Pass when. Every patient seen has a record.

2. Records are returned to the main service.

Method. Check the count taken against the count returned for each deployment.

Evidence to show. Records return register.

Pass when. The count returned matches the count taken for every deployment.

3. Records are kept securely under the retention rule.

Method. Check storage at the main service against the records retention policy.

Evidence to show. Records management and retention (REC-POL-001).

Pass when. Records are stored and retained under the rule.

Immediate fail (any one means the criterion is not met)

• A patient record is lost on the road with no report.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. Working in a community or a remote site is different from working in a clinic. Staff need training for the setting, including safety, isolation and making decisions with limited support.

Sample. Review the training records for all staff who work in the community or remote sites, and the training matrix.

1. Staff are trained for community or remote work.

Method. Check each person on the community team for the training.

Evidence to show. Training matrix register (WRK-REG-001).

Pass when. Every person working in the community has the training recorded.

2. Training covers the staff member’s own safety.

Method. Check the training content and the record for each person.

Evidence to show. Training matrix register.

Pass when. Every person has training on their own safety recorded.

3. Training is recorded and refreshed.

Method. Check the refresher dates.

Evidence to show. Staff credential record (STF-FRM-001).

Pass when. No refresher is overdue.

Immediate fail (any one means the criterion is not met)

• A member of staff works in a remote site with no training for the setting.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. Patients in the community are often seen in their homes or in the open. Consent and privacy must be protected at every visit, not only in a clinic room.

Sample. Review the consent records and the privacy notes for 20 community consultations in the last 6 months.

1. Consent is obtained before each treatment.

Method. Check each consultation for consent before treatment.

Evidence to show. Consent record (CON-FRM-001).

Pass when. Every treatment has consent recorded before it.

2. Privacy is protected as far as conditions allow.

Method. Check each consultation for the privacy measure or the reason none was possible.

Evidence to show. Community consent and privacy procedure (MOB-SOP-001).

Pass when. Every consultation has a privacy measure or a recorded reason.

3. Information is shared only with the patient’s agreement.

Method. Check the records for any sharing and its agreement.

Evidence to show. Consent record.

Pass when. Every sharing of information has agreement recorded.

Immediate fail (any one means the criterion is not met)

• A treatment is given with no consent recorded.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. A patient seen by a mobile clinic may need care the clinic cannot give. A defined route to continue care, given to the patient, keeps them from being lost after the visit.

Sample. Review the referral and follow-up records for 20 patients who needed further care after a session in the last 6 months.

1. Each patient who needs follow-up has a route to continue care.

Method. Check each patient for the follow-up or referral booked.

Evidence to show. Referral criteria (PHC-SOP-003).

Pass when. Every patient needing follow-up has a route recorded.

2. Referrals are tracked to completion.

Method. Check each referral for its tracking to a result.

Evidence to show. Referral tracking register (PHC-REG-002).

Pass when. At least 90% of referrals are tracked to a result.

3. Continuity of care is recorded.

Method. Check each record for the handover to the next provider.

Evidence to show. Referral tracking register.

Pass when. Every record shows the next provider.

Immediate fail (any one means the criterion is not met)

• A patient who needs care the unit cannot give is not referred.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. A mobile clinic can miss the people who most need it, if it does not look at who it reaches. Reviewing coverage finds the groups who are left out and sends the clinic to them.

Sample. Review the coverage reviews for the last 12 months, and the schedule changes made after each review.

1. Coverage is reviewed each quarter.

Method. Check the register for a review each quarter.

Evidence to show. Coverage review register (MOB-REG-002).

Pass when. Every quarter has a review recorded.

2. Groups not reached are named.

Method. Check each review for the groups named.

Evidence to show. Coverage review and schedule change procedure (MOB-SOP-003).

Pass when. Every review names the groups not reached.

3. The schedule is changed to reach them.

Method. Check each named group for the schedule change that followed.

Evidence to show. Coverage review register.

Pass when. Each named group has a schedule change recorded.

Immediate fail (any one means the criterion is not met)

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. A vehicle that breaks down on the road strands the team and the patients. The vehicle must be roadworthy, insured for its use, and equipped before it leaves.

Sample. Review the daily checks, maintenance records and insurance for the vehicle over the last 12 months.

1. The vehicle is roadworthy and checked daily.

Method. Check the daily check record for each day the vehicle was used.

Evidence to show. Vehicle daily check record (PTR-FRM-006).

Pass when. At least 95% of days of use have a daily check.

2. The vehicle is maintained on a recorded schedule.

Method. Check the maintenance register against the schedule.

Evidence to show. Vehicle maintenance register (PTR-REG-002).

Pass when. Every scheduled service is recorded.

3. The vehicle is insured for its use.

Method. Check the insurance for the vehicle and its use.

Evidence to show. Transfer insurance and data sharing rules (PTR-POL-002).

Pass when. Insurance covers the vehicle’s use at each check.

Immediate fail (any one means the criterion is not met)

• A vehicle with a fault affecting safety leaves on deployment.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course

Why it matters. A staff member who works alone in the field can be hurt or fall ill with no one to notice. A check-in at set times, and a clear response when a check-in is missed, makes sure help comes.

Sample. Review the check-in log for the last 3 months, including every missed check-in and its response.

1. A lone worker or out-of-contact team checks in at the set time.

Method. Check each scheduled check-in in the log.

Evidence to show. Lone working check-in log (MOB-FRM-004).

Pass when. At least 98% of check-ins are made on time.

2. A missed check-in starts the response at once.

Method. Check each missed check-in for the response and its time.

Evidence to show. Lone working check-in and response procedure (MOB-SOP-002).

Pass when. Every missed check-in starts the response at once.

3. Each response is recorded with its outcome.

Method. Check each response for the outcome.

Evidence to show. Lone working check-in log.

Pass when. Every response has an outcome recorded.

Immediate fail (any one means the criterion is not met)

• A check-in is missed and no response starts.

Staff, training and documents

Read across each row to see who does each step. Click a document name for its full text.

Staff responsible

Which level applies to you: it depends on your setting. Humanitarian settings have the fewest essential courses; standard settings have the most. Check the colour for your setting in each criterion.

Documents: who does each step

E-learning: who must take each course