Quality of service to users in health entities. presentation

USER TREATMENT FOR HEALTH OFFICERS

Quality in User Service: Quality of service is user satisfaction, which is achieved when expectations, wishes and / or perceptions are exceeded.

In this case, a quality service is not conforming to specifications, as it is sometimes defined, but rather conforming to user specifications.

There is a big difference between the first and the second perspective, service organizations that make mistakes with users, regardless of how well they perform, are not providing quality service.

user-treatment-course-for-health-officials

Finally, quality of service is the great differentiator, it attracts and maintains customer service; if it is good, it wins customers and if it is poor, it loses them.

User Satisfaction

Generally, quality management teaches the user about the needs and what must be done to improve them, specifying the satisfaction and preservation of the users, the attraction of potential clients, the design of strategies that satisfy the changing needs of the users. new users and reduced costs by answering complaints and processing claims.

Within this context, Drucker (1990, p. 41), maintains that "the client evaluates the performance of the organization according to the level of satisfaction obtained by comparing it with their expectations."

To do this, it uses five dimensions:

• Reliability

• Security

• Responsiveness

• Empathy

• Intangibility Customer Expectations Regarding Service

Customer expectations "are attitudes that the customer assumes with respect to an organization." These are related to the product; with the service provided and with the professionalism of those who exercise contact with the user. When using an organization for the first time, expectations can be very high as they have no adverse precedent.

Within these there are factors that can be classified as positive and negative. Among the positive expectations are: Deference, service culture, personal interest and reliability. As for the refusals, there are: Rudeness in the treatment, delay before and during the response, incompetence and indifference.

ATTENTION TO THE PUBLIC

THE PUBLIC SERVICE

The customer is the center of the service offered

The current user is:

• More difficult to satisfy

• More demanding

• Less patient

• Less time

• More informed

The user requests that:

• Let's hear it.

• Let's meet him

• Let's understand it.

• Let us help you.

• Let's be responsible.

• We guide it.

• Let us not be indifferent to him

• We surprise you.

The moment of contact: the experience with the public

There are very few opportunities to create a very good experience. • Use the senses • Affects • Thought • Knowledge, • Interactions • All that the client perceives • Work all experiences with the user

Show a positive attitude

• Show enthusiasm

• We must reinforce our attitude all the time since…

• the public wants to keep the best of us, not the worst.

DEGREE OF USER SATISFACTION

USER CLASSES

THE MAD

They transmit two messages:

• one that has to do with the facts

• the other with your feelings.

It is up to us to transcend feelings to get the facts you need to solve the problem.

When dealing with these types of people, do not deny your anger, saying, "There is no reason to be angry" it will only make you more angry.

Some of the ways to reassure an angry person are:

- Stay in control.

- Don't get emotionally involved.

- Help the person to overcome their anger - Do not make promises that you can not keep.

- Pay more attention to what you can and not what cannot be answered.

- Ask the person how they would like their problem solved.

THE DISCUSSOR

- Speak softly

- Ask them for their opinion

- Focus on the points they agree on - "Count to ten"

These people take pleasure in discussions.

If you assure them that a sweater is white, they will say it is red. They are aggressive and probably will not agree or discuss everything you say.

When dealing with these individuals follow the following rules:

THE CONVERTER

When dealing with these individuals follow the following rules:

- Manage time according to demand.

- Show interest, but make it clear that you must serve other people.

These individuals can grab a lot of your time if you allow it.

Try to keep in mind that the reason these people talk so much is that they are alone.

THE USUAL COMPLAINANT

The usual complainer doesn't like anything.

When dealing with these individuals, follow these rules:

When the regular complainant calls, try to separate legitimate from false complaints.

Avoid becoming defensive, no matter what you say. -Let him talk.

If the complaint is valid, take the appropriate steps to resolve the problem

Do not allow this individual to discourage or depress you. Assume this is simply part of your personality.

THE RUDE OR OFFENSIVE

If you realize what these people really are like, it will be easier for you to deal with them.

- Don't try to "put them in their place", don't do it!

- A much more effective resource is to be kind, exceptionally kind, they will begin to give you the same respect that you offer them.

They present themselves as arrogant and with absolute personal security. However, underneath, they feel lonely and insecure.

When dealing with these individuals follow the following rules:

THE DEMANDING

-Treat them with the same respect as any other person, but do not agree to their demands.

You can do this by focusing on your needs and not on your ways.

These are individuals who interrupt you when you are in the middle of a conversation with another person.

They demand their immediate attention when feeling insecure.

When dealing with these individuals follow the following rules:

The curve of anger

The result of the moment of contact depends on:

HOW DOES THE USER PERCEIVE?

• By sight 40% (gestures, postures,

By what he feels 25% (aromas, flavors) expressions)

• By what he hears 35% (vocabulary, tone, language)

The main reason why the dissatisfaction of the

USER is reached:

NO SHOW INTEREST! THE ROLE OF ATTENTION STAFF

The role of the server as an advisor:

• Who?

• Identify the profile

• Know its context. That makes?

What ADVANTAGES does the company have to become the best option to solve your problems?

• Determine the standard needs. The role of the server as an advisor:

• What are the main characteristics?

• Relate each characteristic to a generic benefit

• What public problems does it solve? The role of the server as an advisor:

• How is it shaped?

• What relationship exists between strata?

• What benefits do they offer?

• What restrictions are there?

• Who makes it up?

Learn to measure what's important:

“Our fixation on quantitative measures leads us to underestimate or ignore less tangible qualitative measurements, such as quality of service, public satisfaction, flexibility in the face of new problems, the time necessary to resolve a problem demanded by the public, and the accumulation of training, aptitude and professional attitude made by the workers.

But it happens that these less tangible magnitudes are what really produce the success of an organization in the medium and long term. ”

TOM PETERS

Build credibility

Credibility exists only in the mind of the other, not in our reality. Therefore, we must work on techniques that help people to see us as credible in different areas.

• Taking an interest in their context

• Show Competences

• Affinity

• Interest and Intention

• Humanize the relationship: the public is not a number Principles of communication

No message is captured as the “sender” tries to say it. The message is subject to the understanding of the "receiver".

All communication has a verbal and a paraverbal component (the one we demonstrate with attitudes and gestures). Principles of communication

The “sender” is solely responsible for ensuring that the message is understood and must do everything possible to verify that it has been interpreted according to its intention.

EVERYTHING in human life is language.

GENERALITIES LAW Nº20.584

RIGHT AND DUTIES OF PERSONS IN RELATION TO ACTIONS LINKED TO THEIR HEALTH CARE

➢ User Satisfaction as a quality dimension, must be maintained as a prioritized Strategic Line in the attention of people.

➢ The information that is given to users, family members, is of high impact.

➢ They are protocols made from the clinical setting.

➢ Commissioning in October 2012 of Law No. 20,584 on the Rights and Duties of Persons, in relation to actions related to Health Information Fundamental Rights of Persons.

LAW 20,584

This law aims to regulate the rights and duties that people have in relation to actions related to their health care. -

Its provisions will apply to any type of health action provider, whether public or private. Likewise, and as appropriate, they will be applied to other professionals and workers who, for any reason, must attend the public or are linked to the provision of health care.

Users: Access health care

• Requesting care: patients, patients, users, clients

• Representatives (subrogation)

• Family and visitors INVOLVED IN THE LAW

Providers: Provide health care

• Institutional:

Organized and directed in healthcare establishments

• Individual:

Independent or dependent

• Health Team:

Group in charge of granting the benefit

There was a mouse that was always distressed because it was afraid of the cat.

A magician took pity on him and turned him… into a cat. But then, he began to be afraid of the dog. So the wizard turn him into a dog. Then he began to be afraid of the panther, and the magician turned him into a panther. Whereupon he began to fear the hunter.

At this point, the magician gave up and turned him into a mouse again, saying:

"Nothing I do for you is going to help you, because you will always have the heart of a

mouse."

The Eagle and the Roosters

Two roosters squabbled over the chickens' preference; and finally one hit the other.

Resignedly the defeated retired to a thicket, hiding there.

Instead, the proud winner climbed onto a high wall, singing with a great noise. But soon an eagle fell and kidnapped him. Since then, the rooster that had lost the fight

kept the entire chicken coop

To those who flaunt their own successes, it soon appears who takes them away.

1. Safety in Health Care

2. Dignified Treatment

3. Company and Spiritual Assistance

4. Information

5. Reservation of the Information Contained in the Clinical Record

6. Autonomy of People in their Health Care.

7. Autonomy of People to Participate in Scientific Research

8. Equal treatment and non-discrimination of people with intellectual mental disabilities

9. Participation of users

10. Medicines and supplies RIGHTS

HOMEWORK

1. Care of Facilities and Equipment

2. Respect for Officials:

- Disciplinary

discharge - Help of the public force

- Civil and criminal actions

3. Respect for the Internal Regulations

4. Inform / Dissemination

5. Truthful information about your health status

THE GOOD TREATMENT TO THE USER:

"Permanent challenge for health workers".

It is important to consider that the fulfillment of these rights are directly related to the good treatment of the user, so the main objective is to ensure that the service provided satisfies the user and makes him feel "well treated".

«What Elements of Health Care are, from the User Perspective, those that Contribute the Most to Feeling Satisfied“:

Users want a warm and human staff, especially in the relationship they establish with the doctor, since who perceive dehumanized health care.

Users want the information to be delivered in "NON-medical terms", that is, people want to understand what the professional tells them; have physical and psychological support and prompt attention.

Users perceive that on various occasions the staff is more concerned with the clinical, forgetting what the person feels.

CONCLUSIONS:

Good treatment is linked to many challenges that are currently faced and that become part of the daily work of every health official, regardless of their specific field of performance, since it is a transverse and transcendent feature.

Among these challenges are:

- Constantly improve being a friendly hospital

- Law enforcement of duties and rights in health (diagnosis)

Successfully assuming these challenges implies improving treatment, improving the quality of

what I offer.

DIAGNOSIS:

What is being done to comply with the rights of patients, from the treatment of the user beyond the law?

- Being a civil servant who gives good treatment requires a permanent self-evaluation - How am I doing it?

What will other officials and users of my way of dealing think?

THIS SELF-ASSESSMENT REQUIRES SELF-CRITICISM, TO ACCEPT ERRORS AND CORRECT THEM.

Achieve a balance between the time required by health functions, whether they are more sanitary or more administrative, over time to serve a user well and make him feel satisfied.

Why evaluate how we are doing it?

Because today we find a more empowered user who knows their rights and seeks to exercise them.

A more participatory user, who has been given more participation spaces and an evaluative and supervisory role in the work of the health official.

This change also requires a change in the profile of the official: friendlier, more welcoming, more prepared, who communicates assertively, able to resolve conflicts that arise, deliver a satisfactory response even though he / she cannot deliver what the user is looking for through various reasons, an “empathic” health official, who “treats well”.

SECOND LAW: A WORTHY DEAL

Right of people during their health care, to be called by name and to be treated in a friendly and cordial manner.

What do you understand?

➢Right to have the health team use an understandable language, based on their health status and socio-cultural conditions:

➢People who have a disability

➢People who do not speak Spanish

SECOND RIGHT:

ATTENTION WITH CULTURAL RELEVANCE

This is a right that is being implemented in a large part of the country, where the health officer must be receptive, empathetic and treat the user of indigenous peoples well.

• Intercultural Model • Intercultural

facilitators

• Signage in Spanish and indigenous

• Own religious assistance

THIRD RIGHT:

TO THE COMPANY AND SPIRITUAL ASSISTANCE

RIGHT TO THE COMPANY:

Right of hospitalized people who receive outpatient care to be visited by their relatives or significant people from their vital environment in the manner determined by the establishment.

• EXCEPTIONS:

The visit puts the treatment at risk

The normal development of clinical care actions

The safety of other inmates

The protection of institutional assets

FOURTH RIGHT OF PERSONS

RIGHT TO INFORMATION

1. DOCTOR OR PROFESSIONAL TREATING in accordance with the ability to

understand. Diagnosis, treatment, prognosis (Healthcare Ethics Committee)

2. INSTITUTIONAL PROVIDER: Internal regulation of establishment and Charter of Rights and Duties.

3. IDENTIFICATION OF THE HEALTH TEAM.

4. INFORMATION ON THE CLINICAL SHEET.

FIFTH RIGHT OF PERSONS

TO RESERVE THE INFORMATION CONTAINED IN THE CLINICAL CARD

Applicable to all.

Inspection: health superintendency

Clinical record:

It is compulsory to keep a

record of

each patient (partial files for services but integrated into the central unit  any support: paper, electronic, etc. sensibles Sensitive data

CLINICAL SHEET

• Content:

- complete identification of the patient

- No., institution or provider, creation date

- chronological record and dated care; antecedents

- with date

- patient decisions: informed decision, rejection - benefits, religious convictions, voluntary discharge etc.

• Storage:

• electronic: backup, backup systems, backup

• In every update

CLINICAL SHEET

• Paper

tokens: • -oriented central file for easy location

• Sequential ordering

• Replacement of damaged covers

• Entry and exit records, date and who • Administration: • -Centralized file • -Controlled

access and registry of those who access

• -Security measures

• Delivery in addition to:

• owner, legal representative, heirs

• 3rd authorized simple power of attorney

• courts

• public prosecutors

• authorized officials: statistical information,

• Incidence of illnesses, etc.

• Conservation: 15 years from last entry.

• Elimination: reliable method,

- record of what was done; public: ordering resolution

SIXTH RIGHT OF THE PERSONS OF THE AUTONOMY OF THE PEOPLE IN THEIR HEALTH CARE

_ What does it consist of?:

a) Right to freely express their will in relation to their health care, once the "right to information" has been fulfilled with respect to them.

b) For obtaining informed consent as well as for those decisions that can be taken when there is a terminal state of health, there will be a special regulation issued by MINSAL.

c) Right to request voluntary discharge when the recommended treatment or medications prescribed for this purpose are refused or interrupted (in these same cases, the Directorate of the establishment may determine forced discharge, after consulting the corresponding Ethics Committee)

INFORMED CONSENT

Right of people in their public and private health care, open and closed, who have received information about their status:

-Giving or denying consent to the treatment offered

-Free and voluntary without being pressured for it

INFORMED CONSENT

• Not applicable:

• - artificial acceleration or death search, or suicide

• - public health risk - spread or contagion

• - disabled patient and without legal representative

INFORMED CONSENT

• How to do it:

- Verbal

- Evidence in clinical record

- Evidence with affected signature in explanatory document

OF THE STATE OF TERMINAL HEALTH AND THE WILL PREVIOUSLY MANIFESTED

Terminal patients:

- I reject any treatment that artificially prolongs the clinically evident death process - as long as it does not accelerate or anticipate death - Rights:

- ordinary support

- palliative care-voluntary discharge

CALL PARTICIPATION IN THE LAW:

 Doubt of the trafficker about the capacity for personal autonomy in cases of risk of death or serious harm.

 Autonomous decision of the person or legal representative in cases of risk of death or serious damage "that would be prudently avoidable" following the indicated treatments.

 Rejection of the insistence of a treatment or the limitation of the therapeutic effort.

 Enforced discharge application for refusal or interruption of prescribed treatment.

 Mentally or intellectually disabled and application of invasive and irreversible treatments.

SEVENTH RIGHT OF PERSONS

RIGHT TO AUTONOMY TO PARTICIPATE IN SCIENTIFIC INVESTIGATIONS.

LAW 20,120. Scientific research on humans, their genome and prohibits human cloning

 Prohibits eugenic practices and human cloning.  Culture and storage of tissues and organs  Authorization of the Director of the Establishment.

Favorable Favorable report from the Scientific-Ethical Research Committee.

 Express, free, informed and written consent.

 National Bioethics Commission.

 Ministerial Commission for Research Ethics.

 Inspection of the Ministry of Health and SEREMI

RIGHTS AND DUTIES. LAW 20,584

SCIENTIFIC INVESTIGATION. LAW 20.120

MODIFICATION OF SUPREME DECREE Nº114 / 10 MIN.SAL.

• SCIENTIFIC ETHICS COMMITTEE: Accredited by SEREMI.

-Research protocol.

- Multicenter investigations.

- Adverse events.

• AUTHORIZATION- AGREEMENT: Director of the establishment.

• CRO. Intermediation with the Sponsor.

• ISP AUTHORIZATION: Medications without registration • FREE AND INFORMED CONSENT:

- Minors

- People with mental or intellectual disabilities

EIGHTH RIGHT OF PERSONS

RIGHT OF PERSONS WITH PSYCHIC OR INTELLECTUAL DISABILITIES

• Equal treatment and non-discrimination.

• Psychic or intellectual disability.

• Special regulation DSNº570 / MS

1. Hospitalization and non-voluntary treatments.

2. Invasive or irreversible treatments.

3. Containment of disruptive behavior.

4. Informed consent.

5. National Protection Commission.

6. Regional Commissions

NINTH RIGHT OF PERSONS RIGHT TO THE PARTICIPATION OF USERS

_ What is it ?:

Right to make the consultations and claims that they deem pertinent regarding their health care and to express, in writing, their suggestions and opinions about it.

_ How is this right exercised ?:

The form and means available to make this right effective will be contemplated in the internal regulations of each establishment.

TENTH RIGHT OF PERSONS, MEDICINES AND SUPPLIES

PAYMENT MECHANISMS AND MODALITIES

UPDATED ACCOUNTS

CHARGE FOR UNIT DOSE OF DRUGS

PRICES OF SERVICES, SUPPLIES AND MEDICINES

User Satisfaction: dimensions

User Satisfaction And Participation

Ethical dimension or the reason for user satisfaction:

Models of care and management focus on the needs and expectations of the user population within a framework of humanization of care and respect for the rights of people in health

User Satisfaction And Participation

Instrumental dimension:

Set of technical and methodological instruments that allow measurements, analyzes and dissemination of results. This constitutes the knowledge base about the evaluations made by the user population in relation to the provision of services and the operation of the healthcare network.

User Satisfaction And Participation

Relational dimension:

Interaction space between health teams and users of the sector. It is the space where users' goals, interests and expectations meet those of the officials. User satisfaction would be influenced by the quality of this relationship.

Determinants of User Satisfaction

- From the health services themselves

• Type of establishment

• Geographical location

• Access

• Pattern of interaction with the user community

• Care

model • Management model

Determinants of User Satisfaction

. From users:

• Effective use of services

• Patterns of use of services and information management by users and users