Part B Health Facility Briefing And Planning 560 -Books Pdf

Part B Health Facility Briefing and Planning 560
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Australasian Health Facility Guidelines,2015 Australasian Health Infrastructure Alliance. The Australasian Health Facility Guidelines AusHFG and the information in them are the copyright of the. Australasian Health Infrastructure Alliance AHIA The information in the AusHFG is made freely available. Australasian Health Facility Guidelines,Address PO Box 1060 North Sydney NSW 2059. Website http www healthfacilityguidelines com au,Email webmaster healthfacilityguidelines com au. The AusHFG are an initiative of the Australasian Health Infrastructure Alliance AHIA AHIA membership. is comprised of representatives from government health infrastructure planning and delivery entities in all. jurisdictions in Australia and New Zealand,Disclaimer. AHIA gives no warranty or guarantee that the information in the AusHFG is correct complete or otherwise. suitable for use AHIA shall not be liable for any loss howsoever caused whether due to negligence or. otherwise arising from the use of or reliance on this information. AHIA recommends that those seeking to rely on the information in the AusHFG obtain their own. independent expert advice, Part B Health Facility Briefing and Planning Page 2.
560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. INTRODUCTION 4,Preamble 4,Introduction 4,Policy Framework 4. Description of the Unit 4,PLANNING 6,Operational Models 6. Operational Policies 7,Planning Models 9,Functional Areas 10. Functional Relationships 12,Accessibility 13,Disaster Planning 13.
Infection Control 13,Environmental Considerations 13. Space Standards and Components 14,Safety and Security 15. Finishes 15,Fittings and Fixtures 16,Building Service Requirements 16. COMPONENTS OF THE UNIT 20,Standard Components 20,Non Standard Components 20. APPENDICES 25,Schedule of Accommodation 25,Functional Relationships 28.
Cleanroom Layouts 29,Checklists 30,Security Issues for Pharmacy Unit 31. Security Checklist for Pharmacy Unit 32,REFERENCES AND FURTHER READING 33. Further Reading 33,References 33, Part B Health Facility Briefing and Planning Page 3. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. INTRODUCTION, 560 001 000 This Health Planning Unit HPU has been developed by the Australasian Health.
502164 Infrastructure Alliance AHIA following extensive consultation during 2014 This HPU is. intended to assist in the planning and design process for the design team project. managers and end users,Introduction, 560 002 000 This HPU outlines the specific requirements for planning and designing a Pharmacy Unit. This document should be read in conjunction with the Australasian Health Facility. Guidelines AusHFG generic requirements and Standard Components described in. Part A Introduction and Instructions for Use, Part B Section 80 General Requirements and Section 90 Standard Components. Room Data Sheets and Room Layout Sheets, Part C Design for Access Mobility OHS and Security. Part D Infection Prevention and Control and,Part E Building Services and Environmental Design. Policy Framework, 560 003 000 Before undertaking a project planners and project staff should familiarise themselves with.
502166 individual jurisdictional plans policies and service specific guidelines Key policy and. related information is listed below, Guiding Principles to Achieve Continuity in Medication Management Australian. Pharmaceutical Advisory Council APAC 2005, Australian Commission on Safety and Quality in Healthcare Standards Australian. Commission on Safety and Quality in Health Care National Safety and Quality Health. Service Standards 2012, National Vaccine Storage Guidelines Strive for 5 Australian Government Department. of Health and Ageing 2013, Codes Guidelines and Policies Website Pharmacy Board of Australia 2015 and. SHPA Practice Standards Website The Society of Hospital Pharmacists of Australia. Other jurisdictional specific policy information is contained in the Further Reading section. of this HPU,Description of the Unit, 560 004 000 A Hospital Pharmacy Unit provides a facility for a range of services that may include.
inpatient and outpatient dispensing, maintenance and monitoring of inpatient drug distribution systems. patient advisory services including admission and discharge planning liaison with. community providers counselling and compliance monitoring. Part B Health Facility Briefing and Planning Page 4. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. controlled storage recording and distribution of narcotics and accountable. substances, manufacture preparation of non sterile compounds known as extemporaneous. compounds lotions ointments etc, sterile manufacturing and IV admixture services e g parenteral nutrition and. cytotoxic preparations, utilisation review and adverse drug reactions reporting.
drug monitoring information and advisory services, quality programs including antimicrobial stewardship. staff education and training and, management of drugs for specialised programs such as clinical trials and S100. medications, Part B Health Facility Briefing and Planning Page 5. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. Operational Models,560 005 000 MODEL OF SERVICE DELIVERY.
Pharmacists play an important role as part of the multidisciplinary healthcare team. Increasingly medication management is being enhanced through the use of technology. including e medication systems bar coding tele pharmacy robotics and automated. dispensing systems Many of these systems have been reported to. reduce the space required to store medicines Evaluation of an Automated. Dispensing System in a Hospital Pharmacy Dispensary The Pharmaceutical Journal. Vol 274 pp763 765 R Fitzpatrick P Cooke C Southall 2005. Improve service quality Evaluation of an Automated Dispensing System in a Hospital. Pharmacy Dispensary The Pharmaceutical Journal Vol 274 pp763 765 R Fitzpatrick. P Cooke C Southall 2005 Case study Novel Ways Automation Enhances. Medication Safety American Journal of Health System Pharmacy Vol 64 Issue 14. pp521 523 Witkowski Paul 2007, improve medication safety through reduced errors A Report Assessing the Impact of. an Automated Dispensing System at Kings College Hospital Brinklow N 2006. Witkowski 2007, reduce recurrent costs Impact of Pharmacy Automation on Patient Waiting Time An. Application of Computer Simulation Annals of the Academy of Medicine Vol 38 Issue. 6 pp501 507 Tan Woan Shin Et al 2009, allow pharmacists to be reallocated for clinical pharmacy A Report Assessing the. Impact of an Automated Dispensing System at Kings College Hospital Brinklow N. efficiency An Evaluation of Two Automated Dispensing Machines in UK Hospital. Pharmacy International Journal of Pharmacy Practice Vol 16 pp47 53 Franklin B et. As pharmacists move between the Pharmacy Unit and clinical units alternate work. practices such as the use of computer tablets are being implemented to promote the. interface with other electronic systems, Drug information services are now delivered electronically with minimal use of hand copy. reference books, The logistics management of medicines is also changing Many health care organisations.
are implementing vendor managed inventory systems where medicines are delivered from. the supplier direct to the point of use e g inpatient unit Pneumatic tube systems may. also be used to transport selected medicine to and from the Pharmacy Unit. As the role of pharmacists becomes more clinically focused pharmacy technicians are. increasingly being used, Pharmacy services are ideally organised as a single Pharmacy Unit This can maximise the. utility of expensive technology and staff This arrangement of service cannot always be. achieved as health services seek to bring services closer to the patient Examples include. an pharmacy collocated outpatient services and, chemotherapy pharmacy collocated with cancer services. Part B Health Facility Briefing and Planning Page 6. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. 560 005 005 Pharmacy services may be restricted to a single health care facility or services may be. 502169 extended to outlying facilities and the wider community the latter particularly in remote. rural areas This will create specific requirements for storage packing and dispatch of. goods In addition alternate delivery systems such as tele pharmacy may be needed. Operational Policies,560 006 000 GENERAL, Operational policies impact on the capital and recurrent costs of a facility The cost. implications of proposed policies should be fully evaluated to ensure the most cost. effective and efficient solutions are provided, Refer to Part B Section 80 General Requirements Australasian Health Facility Guidelines.
AHIA 2010 for further information,560 006 005 HOURS OF OPERATION. In general the Pharmacy Unit will operate during weekday business hours with a limited. service on Saturdays An after hours on call pharmacist service and or after hours drug. cupboard accessible to authorised staff is used for emergencies. 560 006 010 STORAGE OF PHARMACEUTICALS, Pharmaceuticals are generally received on the main loading dock and transferred to a. receiving area within the Pharmacy Unit or a bulk store The bulk store may be located in. an alternate location closer to the loading dock, The stock is then unpacked and decanted to the main store for imprest medications to. support dispensing for inpatient and outpatient services Storage will include open. shelving refrigerators and or cool rooms and freezers both general and specialised as. used for selected clinical trial preparations as there is an increasing number of. medications that need to be refrigerated Robotics storage systems are now available with. units providing storage for stock including refrigerated products. Schedule 8 medications will be stored separately in a large safe or strongroom The safe. will be large enough to store both stock on hand and medications awaiting delivery to. clinical areas Adjacent to lockable storage additional space will be needed for checking. registers and barcode equipment, Alternatively health services may utilise vendor managed inventory systems for imprest. stock which are delivered from the dock to the point of use e g inpatient unit. Pharmacy Units in larger hospitals will usually require additional space to accommodate a. range of activities including clinical trials highly specialised drugs programs Section 100. and medical access programs where access to new medicines is provided prior to the. implementation of funding arrangements Space impacts will include storage of medicines. including refrigerated storage and protocols and dispensing. A range of records will also need to be retained by the Pharmacy Unit. 560 006 015 STORAGE OF INTRAVENOUS AND DIALYSIS FLUIDS. A remote Bulk Store may be suitable for storing these fluids In some cases vendor. managed inventory systems will be used and fluids including dialysate will be delivered. from the dock to the point of use, The Pharmacy Unit will need to store limited supplies of intravenous fluids to reconstitute.
medicines and as a back up supply, Part B Health Facility Briefing and Planning Page 7. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. 560 006 020 ASEPTIC PRODUCTION SUITE, Selected health services usually tertiary referral hospitals will manufacture sterile. products including intravenous admixtures parental nutrition cytotoxic drugs antibiotics. and monoclonal antibodies These products are manufactured in an aseptic production. suite which is a specially constructed and enclosed area There are two types of aseptic. production suites used to manufacture pharmaceuticals and related treatments. conventional suites used to manufacture sterile products such as parental nutrition. containment suites used to manufacture cytotoxic drugs and other hazardous. substances These environments are capable of containing vapours and reduce. opportunities for contamination of operators and the working environment. Information related to relevant standards and design requirements are contained in the. Design section of this HPU,560 006 025 INTRAVENOUS ADMIXTURE. Local drug committees will determine who other than the pharmacist may prepare IV. fluids e g registered nursing staff and the impact this may have on space within the. Pharmacy Unit, Refer to jurisdictional policies to determine local approaches.
560 006 030 UNIT DOSE SYSTEMS, If a unit dose system is used there will need to be additional space and equipment for. supplies packaging labelling and storage as well as medication carts. 560 006 035 AUTOMATED DISPENSING CABINETS, Early consideration needs to be given to the use of these systems with regard to. the type of system being considered, IT integration of vendor and health service pharmacy management systems. arrangements for stock replenishment,impact on Pharmacy Unit storage. the impact on layout of clean utility medication rooms in clinical units. building service requirements such as power and data outlets and. security considerations,560 006 040 PHARMACEUTICAL BENEFITS SCHEME PBS.
Reforms to the Pharmaceutical Benefits Scheme PBS have been implemented in all states. except NSW and eligible patients can receive up to a month s supply of each medicine on. discharge or when attending a public hospital as an outpatient The Australian. Government also provides funding for certain specialised medications under the Highly. Specialised Drugs Program Highly Specialised Drugs are medicines for the treatment of. chronic conditions These restricted medicines are dispensed to outpatients and those. patients attending day services in a public hospital. This may have implications for storage both bulk and in dispensing areas. 560 006 045 PNEUMATIC TRANSPORT SYSTEMS, Should pneumatic transport systems be used to transport medications and scripts the. location of the station within the Pharmacy Unit location of stations in both the Pharmacy. itself and outlying units must be carefully reviewed to consider workflow and security. Part B Health Facility Briefing and Planning Page 8. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. Within the Pharmacy Unit bench space to prepare and sort items will be needed These. systems should not be used for the transport of bulk supplies accountable drugs glass. and cytotoxic drugs,560 006 050 ROBOTIC STORAGE AND DISPENSING. The use of robotic systems within Pharmacy Units may be considered to store medicines. and automate inventory systems Adoption of this technology is usually evaluated through. a business case These systems can also be used to, store a range of medicines including accountable drugs and items that require. refrigeration,pick medicines for imprest stock and.
medication dispensing including unit dosing, The workflow and design considerations will need to be considered during design In. addition IT integration of vendor and health service pharmacy management systems. needs to be considered early in the project,560 006 055 PATIENT SELF MEDICATION PROGRAMS. These programs are usually not suitable in acute healthcare environments but may be. considered for non acute care services, A locked drawer in the bedside locker can be used to store medications. 560 006 060 PATIENT COUNSELLING, Pharmacists will need access to an interview room for selected counselling activities A. dedicated room will usually be provided adjacent to the pharmacy counter Access to. bookable rooms in inpatient and outpatient environments may also be needed. Other information will be provided to patients at the collection counter This space will. need to provide some level of privacy,560 006 065 DISPENSING WORKFLOW.
The use of technicians in Pharmacy Units is common Dedicated dispensing stations will be. needed that can accommodate stock and some consumables a PC one or two screens a. bar coder printers and space to store medications waiting to be checked by the. pharmacist, This workflow will need to be redesigned if robotics systems are used. 560 006 070 WASTE MANAGEMENT, Planning teams need to establish disposal techniques and associated storage. requirements for all types of waste The disposal of drugs particularly accountable drugs. are subject to specific regulations, Other categories of waste will include sharps cytotoxic waste packing waste general. waste confidential waste glass and containers,Planning Models. 560 007 000 SINGLE UNIT, The Pharmacy Unit is usually a single self contained facility especially in small health.
Part B Health Facility Briefing and Planning Page 9. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. 560 007 005 DEDICATED OUTPATIENT PHARMACY, In large facilities it may be necessary to establish a separate Outpatient Pharmacy if it is. not possible to locate the main Pharmacy Unit in close proximity This approach also. collocates outpatient services in one easy to access location. 560 007 010 SATELLITE PHARMACY UNITS, A satellite Pharmacy Unit is a room or suite of rooms in a hospital that is located away. from the main Pharmacy Unit Typical examples include. a Cytotoxic Pharmacy collocated with cancer services and. satellites supporting clinical services e g a group of inpatient units Many health. services do not support this model as it duplicates stock and equipment and makes. the use of technical staff problematic,Functional Areas. 560 008 000 FUNCTIONAL ZONES,Functional zones within a Pharmacy Unit include.
entry reception waiting,after hours drug store, preparation areas including dispensing and sterile manufacture where provided. goods receipt bulk store drug store area and,staff areas. It is essential the arrangement of space within a Pharmacy Unit clearly demarcates public. and restricted areas and accommodates workflows so medication errors are eliminated. 560 008 005 ENTRY RECEPTION WAITING, At public outpatient counters staff should be able to see visitors as they approach. Counters should be located at some distance from the waiting areas so conversations. regarding medications being collected are not easily overheard Staff will be separated. from public waiting areas and the counter should be secured when not in use. An interview room will be located within this zone so pharmacists can provide counselling. regarding a patient s medicines This room will ideally have two entry points one from. within the Pharmacy Unit and one from the waiting area This room will need to be. secured when not in use so unauthorised entry to the Unit is not possible. In large and busy Units it is ideal if the process for droping off scripts is separated from. the collection of medicines to promote better work flows The location of a cashier needs. to be considered as many transactions require payments. 560 008 010 AFTER HOURS DRUG STORE, An after hours drug store may be part of the Pharmacy Unit accessible from the outside or. located in a 24 hour zone of the health service,560 008 015 MEDICATION PREPARATION AREAS.
Major areas include, imprest Storage and preparation space is required for items to be transferred to. clinical units Storage will be required for a range of medicines including bulky items. medication packets and refrigerated storage Bench space at standing height will be. Part B Health Facility Briefing and Planning Page 10. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. required to package items for distribution This area may also be used to prepare. specialised packs e g resuscitation trolley supplies Barcoding scanners will be. located at each workstation Trolleys will be located within this area to transport. items from the store to the bench An area is also required to store imprest stock. prior to delivery, dispensing Storage is required for a range of medicines such as medication packets. and refrigerated storage Medications are picked and taken to a dispensing station. Where this work is undertaken by technicians a dispensing station for a Pharmacist is. needed to check each medication Medications are then collected by a patient sent to. a clinical area or stored within the Unit awaiting collection. accountable drugs Pharmacists prepare imprest stock for clinical units adjacent to the. safe strongroom A workspace is needed for preparation administration and storage. of registers The medications may be collected by clinical staff so access needs to be. considered and, extemporaneous manufacture An area is usually provided to manufacture selected. non sterile preparation such as creams,560 008 020 GOODS RECEIPT BULK STORE DRUG STORE.
Newly delivered stock should be received in a good receipt area of the Unit so the newly. arrived stock can be processed checked and unpacked at a bench This area will also. require access to a workstation to support purchasing activities. The storage of expired and returned stock should be in a separate area so it is not. confused with current stock, The requirements for storage of old accountable drugs registers have recently increased. from two years to seven years and some pharmacies also store completed registers This. may be transferred to an off site location after a few months. 560 008 025 STAFF AREAS, This area will include a visitor reception office space a meeting room and staff amenities. In addition this area will provide space for drug information staff and auditing activities. 560 008 030 OPTIONAL AREAS, Depending on the service level the Pharmacy may also include. sterile manufacturing which may include sterile and cytotoxic manufacturing. cleanroom suites and, facilities for clinical trials including dispensing areas including refrigerated space. secure storage and office space,560 008 035 ASEPTIC PRODUCTION SUITE.
While air conditioning and other design requirements will vary between conventional and. containment aseptic production suites the overall layout and workflow is consistent. The aseptic production suite consists of four zones. an airlock designed as a change room, a preparation area that accommodates yet provides separation between a. decontamination and reconciliation finished goods area and. documentation bulk assembly and storage space, Part B Health Facility Briefing and Planning Page 11. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. Staff accessing the suite must change before they enter This involves removal of outer. garments and donning cleanroom attire A hand basin will be located outside of the. change room, The cleanroom will be accessed from the change room Staff working in the cleanroom will. receive decontaminated equipment and materials from the decontamination zone via a. pass through hatch When product is manufactured it is sent via another pass through. hatch to the reconciliation zone, It is possible for the decontamination and reconciliation zones to be located within one.
room to be referred to as a preparation room where the functions are separated and. each has a dedicated pass through hatch into the cleanroom External access to these. rooms will be needed as these spaces will not be directly accessed via the change room or. cleanroom excluding pass through hatch arrangements. Functional Relationships,560 009 000 EXTERNAL, Access to a loading dock and bulk storage if this is not part of main Pharmacy Unit Easy. access is required to all clinical areas within the health service Where patients pay for. medicines access to the main cashier may be required. 560 009 005 INTERNAL, Refer to the Functional Relationship Diagram in Clause 560 022 000. Part B Health Facility Briefing and Planning Page 12. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. Accessibility,560 010 000 EXTERNAL, The Pharmacy Unit will receive bulk supplies from the main loading dock Couriers will also. arrive from the loading dock and deliver supplies to the Pharmacy Unit or direct to clinical. areas i e Vendor Managed Inventory,560 010 005 INTERNAL.
Points of access are required by,pharmacy staff,other staff collecting scripts. outpatients delivering and collecting scripts and medications and. supplies delivery,Disaster Planning, 560 011 000 Consideration needs to be given to requirements for storage of large volumes of selected. 502195 medications such as antibiotics and Tamiflu. Disaster planning is discussed in more detail in Part B Section 80 General Requirements. Australasian Health Facility Guidelines AHIA 2010,Infection Control. 560 012 000 Hand hygiene facilities should be provided in each room space where medicines are. 502196 handled, Specific requirements relating to clean rooms are outlined in the Non Standard. Components of this HPU, Refer to jurisdictional infection control policies and Part D Infection Prevention and.
Control Australasian Health Facility Guidelines AHIA 2015. Environmental Considerations,560 013 000 GENERAL, Controlled temperature and humidity is required for drug storage and internal. temperatures should not rise above 25oC,560 013 005 ACOUSTICS. Ambient noise should be minimised to reduce staff distraction and the incidence of errors. The introduction of robotic systems may impact on ambient noise levels. 560 013 010 NATURAL LIGHT, The Pharmacy Unit should have access to natural light and external views where possible. Good lighting within a Pharmacy Unit is associated with a significantly lower rate of. dispensing errors This must be balanced with the potential for solar gain and security. Part B Health Facility Briefing and Planning Page 13. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines. considerations with windows located on the perimeter walls being reinforced to prevent. For further information refer to Illumination and Errors in Dispensing American Journal of. Hospital Pharmacy Vol 48 Issue 10 pp2137 2145 Buchanan T L et al 1991. 560 013 015 PRIVACY, Access to interview rooms in all patient locations is required This can be facilitated in.
bookable rooms or single bed rooms Pharmacy counters can also be designed to provide. some separation between drop off and collection In many cases this design will facilitate. confidential communication as shown in the picture below. Space Standards and Components,560 014 000 ERGONOMICS. Storage systems should be arranged so staff do not need to reach stock in high locations. A pallet jack may be located in bulk storage areas. Equipment such as spring loaded trolleys may assist staff move large parcels onto. preparation benches, Dispensing workstations should be arranged so workflows are accommodated and the. potential for error reduced These stations should be arranged so extended reaches are. avoided Task lighting may also be required, Anti fatigue matting may be needed in areas where staff stand for long periods. Refer to Part C Section 790 Safety and Security Precautions Australasian Health Facility. Guidelines AHIA 2015 for information, Part B Health Facility Briefing and Planning Page 14. 560 Pharmacy Unit Revision 5 0 11 November 2015,Australasian Health Facility Guidelines.
560 014 005 HUMAN ENGINEERING, Refer to Part C Section 730 Human Engineering Australasian Health Facility Guidelines. AHIA 2010 for information,560 014 010 ACCESS AND MOBILITY. Refer to Part C Section 730 Human Engineering Australasian Health Facility Guidelines. AHIA 2010 for information,560 014 015 DOORS WINDOWS AND CORRIDORS. Doorways should be wide enough to facilitate the delivery of large amounts of stock. including pallets Where shelving is used to store medications corridors should be a. minimum of 750mm wide to provide access to staff and trolleys. Reinforce windows on the perimeter walls to prevent entry. Refer to Part C Section 710 Space Standards and Dimensions Australasian Health Facility. Guidelines AHIA 2010 for information,Safety and Security. 560 015 000 Duress alarms should be located at the outpatient dispensing counter. Staff accessing the Pharmacy Unit should be restricted Staff entries will be separated from. public general staff entry points, The design should also allow areas of the Unit to be locked down when not in use such as.
evenings and weekends This will be facilitated by locked doors from public corridors and. locked shutters to publically accessible counters, 560 015 005 CCTVs will be used to monitor entry points and drug safe All external doors will be. 502207 operated with access control with only authorised staff permitted access Doors into the. Pharmacy Unit should be fitted with substantial locks and access control systems for. authorised staff Perimeter doors should be constructed if solid core with heavy gauge. metal sheeting Door hinges on external doors should be housed internally to avoid. tampering These doors should be fitted with a closing device so they cannot be left open. An intruder alarm system should be installed and centrally monitored when the Unit is. unoccupied External entry points should be well lit. Also refer to Part C Section 790 Safety and Security Precautions Australasian Health. Facility Guidelines AHIA 2015 for additional information. 560 016 000 WALL CONSTRUCTION AND PROTECTION,Walls should be. constructed of a solid material with as few windows as possible and. extended to the underside of the floor slab to prevent any intrusion over the wall or. from the ceiling cavity, Wall protection will be required to prevent damage from trolleys. Also refer to Part C Design for Access Mobility OHS and Security Space Standards and. Dimensions Australasian Health Facility Guidelines AHIA 2010. Part B Health Facility Briefing and Planning Page 15.


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