In just a few years, consumers have drastically changed their levels of demand: they analyze how they spend money and highly value the service. In highly competitive markets, the customer dominates the scene. Meeting it is no longer a strategic advantage, but a necessary condition for survival.
Managing consortiums is providing a service. Unlike companies that manufacture products, where quality has a high level of tangibility, in services, quality is defined almost exclusively by customer perception. The truth is that for both products and services, low quality damages the image of the company and loses customers. Of course, no one wants to lose customers, especially when it costs a lot to incorporate new customers (five times more than keeping current ones).
The company or organization that we will focus on in this Customer Service study is the Centro de Rehabilitación Teletón (CRIT), which serves children with neuromusculoskeletal disabilities in the region surrounding the State of Mexico.
customer-service-on-the-critThere are currently three centers of this type in Mexico: one in the State of Mexico, one in Jalisco and the other under construction in the State of Oaxaca.
It should be noted that this service that is provided is free, but it is not ruled out providing the service to different segments of the segment to which it is focused, that is, if it has economic resources, a study will determine the "significant" amount that he is going to charge it. We put significant in quotes because really this institution is not for profit.
If the estimates of the total number of children in the population are taken and the traditional fraction of 10% is applied to estimate the proportion with disabilities, the amount will be 16 million in the central region of Mexico.
This figure, however, is not reliable. It depends on the definitions used and the way the data was collected. In the United States, for example, a household survey found that 19.4% of the population had a disability, half of which had a severe disability, or close to the traditional percentage. However, it found that only 5% of children had a disability and of these only 1 in 5 (1%) had a severe disability. The data on children were not as complete as that of adults and reflected the interest of the host of the study, the ministry of health and social welfare. And the results clearly depend on the definition used.
We think that their mystique that they handle summarizes everything that their Customer Service implies:
All of us who work at the Teletón Rehabilitation Center (CRIT), on our first day of work, make a solemn promise to follow the Mystique by the Teletón foundation:
Deliver our best effort, adhering to the strictest professional ethics.
Print a deep human sense to the care of children, filling the environment with love for them and for ourselves.
Feel pride and fight for the prestige of the CRIT, before your own.
Establish ties of affection and respect with all those who work here.
Do not seek greater reward than gratitude.
Spread the knowledge that defends the health and lives of children.
Don't sacrifice convictions to personal interest.
Strengthen adherence to these principles throughout life.
Conclusion:
We can conclude that in terms of service (consortium administration is a service company) it is not enough to be efficient in tangible areas, it is also necessary to be efficient in intangible areas, which are those that are most closely linked to the human factor, since The service is revealed in the direct contact between the provider and the client.
Personal quality will immediately increase the quality of service. For a company, the perception that the beneficiary has of the "intangible" quality of the service is vital.
Introduction about disabilities
Statistics
We have 9 million people with disabilities. 2.7 million disabled people are minors, according to the statistics of the O rganization M orld of S avalanche.
Disability affects the poor and the rich equally regardless of age or sex. In 1990 there were 500 million disabled people in the world and by the year 2000 it will increase to 100 million more.
Each year the Health Sector provides care to 140 thousand people.
The Education Sector has 6,791 minors with disabilities incorporated and there are 312 Special Education schools. In 1995 Probecat provided 726 scholarships, in 1999 it provided 2,923 scholarships.
Official figures establish that one person in 10 suffers from a disability and 4 out of 10 are linked to it.
How many children with disabilities are there, where are they and how are they measured?
If the estimates of the total number of children in the population are taken and the traditional fraction of 10% is applied to estimate the proportion with disabilities, the amount will be 16 million in the central region of Mexico.
This figure, however, is not reliable. It depends on the definitions used and the way the data was collected. In the United States, for example, a household survey found that 19.4% of the population had a disability, half of which had a severe disability, or close to the traditional percentage. However, it found that only 5% of children had a disability and of these only 1 in 5 (1%) had a severe disability. The data on children were not as complete as that of adults and reflected the interest of the host of the study, the ministry of health and social welfare. And the results clearly depend on the definition used.
The current international standard for definitions of disability is the World Health Organization's International Classification of Handicaps, Disability and Handicap. This classification is in a review process as it was considered to be limited in terms of disability due to its medical focus and the individual rather than the individual and their environment. In the current classification, a distinction is made between a deficiency (physical or mental condition that limits an individual) and a disability. If a person succeeds in overcoming the impairment (such as a visually impaired person wearing glasses, it does not lead to disability). In a similar way, a distinction is made between a disability and a handicap. For example,a person with limited mobility who requires the use of a wheelchair is handicapped only if the physical environment does not allow access to classrooms at school. The original definitions implied that the responsibility for removing barriers lay with the individual rather than with society, and this was one of the reasons for revising them. The new categories are deficiencies, activities, participation, and environmental factors.
There is an emerging consensus on how to apply these definitions to collect information. The United Nations Statistics Division Manual for the Preparation of Statistical Information for Policies and Programs Relating to Persons with Disabilities contains suggestions on standards to apply. It underlines that the existence of reliable information on the number of people with disabilities, the types of disability, their age and their location are key to the development of fair and effective policies.
Some countries in Latin America have made efforts to estimate the number of people with disabilities and the nature of their disabilities. For example, according to WHO estimates for Chile, it is estimated that between 7.5% and 10% of the population has some degree of disability; that's about one million four hundred thousand people.
Meanwhile, the National Socioeconomic Characterization Survey (CASEN), carried out by Mideplan in 1999, reflected the following situation, in a universe of 616,434 people: hearing disability, 27.3%; vocal disability, 5.6%; visual impairment, 26.9%; mental disability, 13.1%; physical disability, 21.2%, and psychiatric disability, 5.9%.
As another example, also in 1999, in Mexico, a record of disabled minors was made in the State of Mexico, one of the states of the country, resulting in the following table:
REGISTRY OF MINORS WITH DISABILITIES 1999
GLOBAL REPORT STATE OF MEXICO, MEXICO
| CONCEPT | QUANTITY |
| Total Minors with Disabilities | 43,238 |
| Minors with Disabilities of the Female Sex | 14,896 |
| Minors with Disabilities of the Male Sex | 15,600 |
| Minors with Disabilities of Unspecified Sex | 12,742 |
| Minors with Disabilities with Age Less than 5 Years | 4,962 |
| Minors with Disabilities between 6 and 12 Years Old | 27,237 |
| Minors with Disabilities between the ages of 13 and 20 | 10,637 |
| Minors with Disabilities of Unspecified Age | 402 |
| Minors with Blindness | 459 |
| Minors with Visual Weakness | 12,921 |
| Minors with Deafness | 917 |
| Minors with Hearing Debility | 4,948 |
| Minors with Mudez | 346 |
| Minors with Language Difficulties | 6,848 |
| Minors with Neuromotor Difficulty | 458 |
| Minors with Amputations | 187 |
| Minors with Congenital Malformations | 1,090 |
| Minors with Cerebral Palsy | 315 |
| Minors with Mental Impairment | 2,100 |
| Minors with Epilepsy | 594 |
| Minors with Down Syndrome | 328 |
| Minors with Autism | 1,013 |
| Minors with Other Disabilities | 17,016 |
SOURCE: INEGI, DIF State of Mexico, Ministry of Education and Culture
Sociodemographic aspects of the State of Mexico
Total population by age groups and their percentage distribution according to disability status, 2000
| Age group | Total population | Disability condition | ||
| No disability | With disability | Not specified | ||
Entity |
13,058,570 | 97.2 | 1.8 | 1.0 |
| 0 - 14 years | 4,355,521 | 97.8 | 0.8 | 1.4 |
| 15 - 29 years | 3,863,685 | 98.2 | 1.0 | 0.8 |
| 30 - 59 years | 4,051,975 | 97.4 | 2.0 | 0.7 |
| 60 and over | 754,999 | 87.6 | 11.6 | 0.9 |
| Not specified | 32,390 | 91.2 | 3.8 | 5.0 |
|
Market segment
The market segment to which the Telethon Children's Rehabilitation Center (CRIT) is directed are children and young people from 0 to 18 years of age with neuromusculoskeletal disability, this term includes deficiencies that occur as a result of congenital or acquired diseases of the nervous and musculoskeletal systems.
A geographical segmentation was carried out, due to the fact that we are going to focus on the CRIT Estado de México. Our segment is very well defined, it is aimed at children and young people from 0 to 18 years old with a low to medium-low socioeconomic level, mainly for free.
Of course, children and young people of other economic levels would be served, but with a socioeconomic study to charge them a "symbolic" fee.
To determine this segmentation, it was carried out with:
Geographical segmentation: since this CRIT State of Mexico is going to attend to children who are in the states bordering the State of Mexico.
Demographic segmentation, where our target market is going to be the one with a low and medium low socio-economic level, and who have children or relatives with any of the aforementioned physical or mental disabilities.
What is the Telethon?
It is a project of national unity where we Mexicans have the opportunity to come together around our values and work for the same cause: the rehabilitation and integration of our children and young people with disabilities.
Telethon represents the opportunity to renew confidence in people and institutions, to reflect on our values and incorporate them into daily life. Teletón not only seeks to raise financial resources, but also to promote a culture of integration and participation. Telethon is a global communication phenomenon that is transformed into a social phenomenon of correspondence towards Mexico.
The objectives of the Telethon:
- Promote national unity around a common cause.
The Telethon gives each of us Mexicans the opportunity to unite fraternally as we have done over the years in various events. In this case, love leads us to participate in the struggle to improve the living conditions of thousands of Mexicans who live with some type of disability.
- Promote a culture of integration in favor of people with disabilities.
In order to achieve full integration of people with disabilities into the various areas of life, it is necessary to have a culture that leads us to respect human dignity first and foremost.
- Build and operate rehabilitation centers for minors with disabilities.
For the Telethon, the rehabilitation of minors with neuromusculoskeletal disabilities is of great importance, so the largest percentage of resources is allocated to the construction, equipping and operation of child rehabilitation centers, the goal being to satisfy the greatest possible demand throughout the Republic.
- Support institutions that serve people with disabilities in the Mexican Republic through the Telethon Fund for Institutional Support.
With a percentage of the money raised, the Teletón Institutional Support Fund is established, through which the Teletón Foundation supports with donations to institutions that provide care for people with disabilities throughout the country. "All Mexico collaborates with Teletón, now Teletón wants to collaborate with the entire country."
What is the CRIT?
The Telethon Children's Rehabilitation Centers are spaces that have been designed with the most advanced medical equipment in our country, to care for and help children who have a disability so that it improves and they can develop socially in the best way.
Telethon Mission
"We are a non-profit foundation that is dedicated to the care and attention of children with a psychomotor disability, who due to their scarce resources, do not have access to health services, with the technology and quality that they require"
CRIT mission
Respecting and safeguarding the dignity of the person, we seek to serve minors with neuromusculoskeletal disabilities through comprehensive rehabilitation, promoting their full development and integration into society.
View
To be the leading institution in pediatric care in the region surrounding the State of Mexico, promoting, rehabilitating and preserving the health of the disabled infant. Through national unity around a common cause, with a culture of integration in favor of children with disabilities. Building and operating rehabilitation centers for minors with disabilities to meet the highest possible demand in the region.
Mystic CRIT
All of us who work at the Teletón Rehabilitation Center (CRIT), on our first day of work, make a solemn promise to follow the Mystique by the Teletón foundation:
Deliver our best effort, adhering to the strictest professional ethics.
Print a deep human sense to the care of children, filling the environment with love for them and for ourselves.
Feel pride and fight for the prestige of the CRIT, before your own.
Establish ties of affection and respect with all those who work here.
Do not seek greater reward than gratitude.
Spread the knowledge that defends the health and lives of children.
Don't sacrifice convictions to personal interest.
Strengthen adherence to these principles throughout life.
CRITS in Mexico
There are three CRITS in Mexico: one in the State of Mexico, one in the State of Jalisco, and one in the State of Oaxaca (under construction).
Location:
Via Gustavo Baz No. 219
Colonia San Pedro Barrientos
Tlalnepantla, State of Mexico
CP 54010, Mexico
Tel: (5) 321-2223
Why was it the first?
The State of Mexico has the highest concentration of people with disabilities in the entire Mexican Republic. The National Registry of Minors with Disabilities published by INEGI detected 691,839 cases of people with disabilities in the state.
How many children do you serve?
The CRIT of the State of Mexico has a service capacity of 10,000 people a year and so far:
From them, 42% belong to the Cerebral Palsy Clinic.
9% to the Spina Bifida and Spinal Injury Clinic.
5% to the Myopathies Clinic, Neuromuscular and Neuromotor Plaque.
14% to the Clinic for Amputees and Osteoarticular Deficiencies.
12% to the Congenital and Genetic Anomalies Clinic.
18% to the Early Multiple Stimulation Clinic.
At CRIT Estado de México, the following have been attended to:
1654 children from the State of Mexico
768 children from the Federal District
299 children from other states of the Mexican Republic.
Model of attention
The Teletón Children's Rehabilitation Centers serve children and adolescents from 0 to 18 years of age with neuromusculoskeletal disabilities. Its comprehensive rehabilitation model focuses on the person and their abilities and addresses the physical, psychological, social and spiritual.
Rehabilitation in CRITs has an integral human sense that considers the physical challenges of each child, their interests, desires and family and social circumstances.
The comprehensive care model developed in the CRIT Estado de México, applicable to all CRITs of the System, contemplates as main lines of action:
Emphasize prevention
Offer an interdisciplinary healthcare approach in the field of rehabilitation through clinics
Provide specialized services of physical, occupational, speech therapy, early multiple stimulation, neurotherapy, psychology, social integration and parenting school
Offer a comprehensive rehabilitation model to children and young people with disabilities, with the aim of achieving the integration of children into the family, school and society.
Provide a family-centered model of care
An important part of the rehabilitation of our children and young people with disabilities is the love and trust of the family. For this reason, the CRIT has created the School for Parents, where families are supported to overcome the challenge of integration, and thus be able to work together for the benefit of the little ones.
To achieve comprehensive care for children, the CRITs have a team of interconsultant doctors in various specialties other than rehabilitation medicine, thus avoiding that minors and their families have to resort to various institutions seeking this service and thus reduce the times and costs they would incur.
The CRIT diagnostic studies area has the most advanced equipment to provide physicians with the best tools to support their diagnoses and recommend their treatments.
The CRITs have a comprehensive computer system for managing children's medical records and agendas, which ensures orderly, timely and complete care, which also allows communication between areas and the collection of statistical and research data.
Finally, it is worth mentioning that the Centro de Rehabilitación Infantil Teletón Estado de México has a modern laboratory where the orthotics and prostheses that minors require for their rehabilitation are designed and manufactured.
Process followed in CRIT
Services
| Clinics | |
| Infant Cerebral Palsy and Brain Injury Clinic | Mild and moderate cerebral palsy |
| Mild and moderate brain injury | |
| Dependent infantile cerebral palsy | |
| Dependent brain injury | |
| Spinal Injury Clinic | Spina bifida |
| Meningocele | |
| Myelomeningocele | |
| Arnold Chiari malformation | |
| Spinal cord injury | |
| Neuromuscular Disease Clinic | Myopathies |
| Neuromuscular plate alterations | |
| Clinic for Amputees and Osteoarticular Diseases | Congenital amputation |
| Transverse aplasias | |
| Longitudinal aplasias | |
| Generalized bone disease | |
| Inflammatory bone and joint diseases | |
| Musculoskeletal injury | |
| Burn | |
| Congenital and Genetic Diseases Clinic | Bad position |
| Congenital torticollis | |
| Developmental dysplasia of the hip | |
| Coxa vara | |
| Coxa valga | |
| Clubfoot congenital adduct | |
| Scoliosis | |
| Other congenital malformations | |
| Hereditary diseases | |
| Dysmorphic syndromes | |
| Imperfect osteogenesis | |
| Congenital arthrogyphosis | |
| Hoarding syndromes | |
| Metabolic disturbances | |
| Early Stimulation and Neurotherapy Clinic | Children with risk factors |
| Children with deviation in their neuromotor development | |
| Children with neuromusculoskeletal disabilities in structuring or structured pathways | |
| Children with neuromuscular disorders associated with sensory disabilities |
| Interconsultants |
| Pediatrics
Neuropediatrics Pediatric orthopedics Urology Ophthalmology Human Communication Pediatric dentistry Nutrition Anesthesiology |
| Diagnostic studies | |
| With equipment for: | Electroneurodiagnosis
Imaging Audiometry and Tympanometry Uroproctodynamics |
Value for the customer
CRIT Benefits
Tangible benefits:
The colorful and cheerful atmosphere of the CRIT is specially designed to make the visit of children to the hospital as pleasant as possible
Research and publications
Parents always have the option of accompanying their children to the session.
A whole treatment from start to finish in one place, without the need to move from one place to another.
Intangible benefits:
Professional and committed support that helps you on your path to rehabilitation, without uprooting you.
Comprehensive care for the child and his family.
Special care for little patients to make them feel at home.
Course to prepare volunteers.
Dissemination of a culture of prevention of accidents that cause irreversible damage to the brain or spinal cord, disabling them, giving first aid courses.
Elimination of social and physical barriers.
Implementation of teaching and research programs, prevention and epidemiology in rehabilitation, in accordance with the established medical plan.
Integration into society
Labor integration
Price: It is generally free, but through a socioeconomic study it is defined whether or not it is charged.
Value map
| SATISFACTION ATTRIBUTES | Attribute weighting | CRIT Telethon | San Luis Gonzaga Hospital | Amanecer educational center | Cuenca Nexapa Children's Support Foundation |
| Attributes related to benefits | 0.80 | ||||
| Tangible | |||||
| Nice facilities | 0.13 | 10.00 | 8.00 | 10.00 | 9.00 |
| Research and publications | 0.03 | 9.00 | 10.00 | 8.00 | 8.00 |
| Presence of parents in treatment | 0.10 | 9.00 | 8.00 | 9.00 | 9.00 |
| All treatment in one place | 0.20 | 10.00 | 7.00 | 6.00 | 7.00 |
| Intangibles | |||||
| Professional support in rehabilitation | 0.15 | 9.00 | 10.00 | 8.00 | 8.00 |
| Comprehensive child and family care | 0.10 | 10.00 | 7.00 | 8.00 | 9.00 |
| Special care for children | 0.09 | 10.00 | 10.00 | 10.00 | 10.00 |
| Volunteer preparation | 0.03 | 9.00 | 7.00 | 8.00 | 9.00 |
| Dissemination of accident prevention culture | 0.09 | 10.00 | 10.00 | 10.00 | 10.00 |
| Elimination of social and physical barriers | 0.08 | 10.00 | 7.00 | 10.00 | 10.00 |
| TOTAL BENEFITS | 1.00 | 9.69 | 8.31 | 8.48 | 8.68 |
| Price-related attributes | 0.20 | ||||
| Price of the service (how free is it) | 1.00 | 9.00 | 5.00 | 8.00 | 9.00 |
| TOTAL PRICE | 1.00 | 9.00 | 5.00 | 8.00 | 9.00 |
| VALUE FOR THE CUSTOMER | 9.55 | 7.65 | 8.38 | 8.74 |
Requirements of the client
The requirements that the client frequently demands of the Institution can be summarized in 3:
Quality.
Comfort.
Security.
Which in turn can be divided into two areas:
Regarding the facilities.
They ask the Center to have both facilities and quality equipment, since due to the type of institution we are talking about, it is very important that both the facilities and the instrument are in good condition, and that this is noticeable at sight from the patients.
Comfort, it is requested that there be an adequate distribution of the facilities, and with adequate dimensions, since as it is a Children's Rehabilitation Center, most of the patients use a wheelchair, stretchers, or any other type of support to displacement, so that the corridors are wide, that there is parking for quick access to it. The distribution of the different areas that the center has, that patients of all kinds are not in the same place, that according to the characteristics of their disease and their treatments are managed in a comfortable and adequate.
With regard to security, if there are quality facilities and equipment, and comfort is managed, this will lead us to obtain a feeling of security from the client towards our institution, since they know that if any A special device, or some type of property to be attended to, you are sure that it will work and that you will be able to offer an adequate service.
Regarding the service.
A quality service is requested, understanding this a Timely, Adequate and Low Cost service. In order to offer a quality service, the Institution requires having prepared people, who have a presentation and education (both family and business), which will result in good customer service from the staff. The Quality service must be offered by all the Institute's personnel, from the lowest level to the top management.
With regard to Comfort, with their comfortable service they mean that they are not hindered of all kinds, and that more time is wasted in solving these types of problems than the time that is invested in the patient's therapy.
Security, we return to the same, by having people prepared, and who know how to properly use the Institution's furniture and equipment, as well as the place where it is located, we can offer customers a quality service and comfort, that brings with it the feeling of security on the part of the patient, not all people feel good in a place or with a certain person, but if we want our clients to feel safe with us, it is very difficult for them to change us for the competition, and especially in this type of delicate services such as the one offered by a Hospital.
Requirements towards the supplier
With regard to the Institution's requirements towards the supplier, our main suppliers are those who supply us with:
Healing materials and medicines.
Equipment such as:
Electroneurodiagnostics
Electromyography
Electroencephalography
Evoked potentials
Imaging.
X-rays
Computerized Axial Themograph
Orthopantomography
Audiometry and Tompanometry
Uroproctodynamics.
Waxes.
There are also suppliers of stationery and other minor items, but those directly related to the operation of the Institution are those previously mentioned.
What is mainly sought in both suppliers and the products they offer is:
Quality. That there is both a quality service and a quality product, considering at this point what is appropriate, appropriate, and that it is low cost. But it is also very important to consider the delivery time, since many times they are products with a low period of life, such as some medicines, so it is necessary to have a short and above all reliable delivery time.
In addition to the above, they have an excellent maintenance service, both preventive and corrective, since this type of device is very delicate and not just anywhere has the ability to repair it. Within this range, preventive maintenance should occupy 80%, since it is very important that they never stop working. And as for the corrective, it is also very important, since if the devices ever stop working, because they are specialized, the spare parts are not always available, or who can repair them.
Another point is technological advance, since you must always be looking for point technology, both in devices and in waxes and medicines.
These three points could make a difference when selecting our suppliers, and they must always be considered as a priority, since if any of them were to fail, it could endanger any of the requirements that our clients demand of us as an Institution.
Database
The CRITs have a comprehensive computer system for managing children's medical records and agendas, which ensures orderly, timely and complete care, which also allows communication between areas and the collection of statistical and research data.
By having the Institution with this type of system, and keeping a detailed control of appointments and / or treatments, they can be perfectly aware when a patient desertes, and when this occurs with one of the patients, the cause is thoroughly investigated, as that the service offered in this Institution is free, and / or through scholarships. The investigation of these reasons is done through the social worker through personal visits.
This same system is used as a database, since all patients who enter the Institution are registered in it, even when it has only been one visit.
The data included here are such as:
Name.
Date of birth.
Parents name.
Parents' generals such as address, telephone number, occupation, etc.
Diagnosis of the child.
Treatment to follow.
Consultation dates.
Attending physician, etc.
Quality philosophy
The philosophy of quality of the Teletón Children's Rehabilitation Centers is summarized in a single sentence, which, although short, has enormous wealth in its content:
"Love and science at the service of life and man"
Guarantee policy in CRIT
Still many hospitals do not care about the satisfaction of their clients, and do not develop guarantee policies for clients. Regarding the Telethon Infant Rehabilitation Centers (CRIT), one might think that the “clients” are loyal by definition, since there are not many CRITs in Mexico… However, several factors can influence loyalty to a hospital, and particularly in loyalty to a CRIT: geographic location, competence of doctors, cleanliness and modernity of the facilities, medical equipment (technology), satisfaction obtained in the past, etc.
The Teletón Children's Rehabilitation Centers, even though it is a non-profit entity providing free help, understands the needs of its patients and therefore is committed to offering treatment alternatives to its patients.
The loyalty of its patients is centered on the quality of its treatments and the human warmth generated by the institution. The general public feels great support and trust, which gives them an assurance that when they need help they will get it, they will be cared for and they will be given the best possible treatment, just as if it were in a hospital or private clinic.
Patients who managed to recover and adapt to daily life are very grateful and remain active and participants with the different activities carried out by this institution.
"At CRIT we guarantee to offer the best rehabilitation service available in Mexico for children and young people from 1 to 18 years of age, with neuromusculoskeletal disabilities of congenital origin or acquired in the nervous systems, all in a comfortable, friendly, safe and hygienic environment., with the latest technological advances and with a team of specialized Doctors and Therapists with great experience in the different areas of rehabilitation ”.
Basically, the CRIT guarantee policy can be summarized in the following points:
The quality philosophy of the Teletón Children's Rehabilitation Centers is summed up in a single sentence, which, although short, has an enormous wealth of content: "LOVE AND SCIENCE AT THE SERVICE OF LIFE AND MAN". The Telethon also has a slogan that appears in several parts, for example on the website: "Compliance is what counts!"
The CRIT model of care is a comprehensive rehabilitation model that focuses on the person and their abilities and addresses the physical, psychological, social and spiritual. Rehabilitation in CRITs has an integral human sense that considers the physical challenges of each child, their interests, desires and family and social circumstances. We saw in the first part that this model has 5 well-defined lines of action. Thus, parents are assured that their children will receive full attention.
The care provided to children is individual or group. When it is a group, they are groups of four children. Training is also provided for teachers and parents, as working with parents and families is very important to the success of the programs. In addition, the necessary support is provided for a better acceptance of the limitation. Once the skills and abilities of children with disabilities have been discovered and developed, school integration is carried out, which entails an extensive training program for parents and teachers. In addition, Teletón provides transportation, shelter and partial collaboration in technical aid to people with limited economic resources.
The competence of physicians: To achieve comprehensive care for children, the CRITs have a team of interconsultant physicians in various specialties other than rehabilitation medicine, thus avoiding that minors and their families have to resort to various institutions seeking this service and in this way reduce the time and costs they would incur.
Quality facilities and equipment: The CRIT diagnostic studies area has the most advanced equipment to provide physicians with the best tools to support their diagnoses and recommend their treatments. The CRITs have a comprehensive computer system for managing children's medical records and agendas, which ensures orderly, timely and complete care, which also allows communication between areas and the collection of statistical and research data. Finally, it is worth mentioning that the Teletón Estado de México Children's Rehabilitation Center has a modern laboratory where the prostheses that minors require for their rehabilitation are designed and manufactured.
Reliability: The treatments and therapies offered at the Center have proven to be effective and satisfactory for patients and physicians. The CRIT in the state of Mexico has the capacity to serve 10,000 people a year and is exceeded by almost 100%.
There is a real interest in helping their patients, so the same level of commitment from doctors and therapists is always offered to everyone who attends the Center. Each patient is given their history, evaluations and treatments to follow so that everyone has the same right and opportunity to rehabilitation.
The facilities, amenities of its centers, easy access and commitment of its staff, make the families who take their children feel that they are in the best hands, that everything that can be done will be done and that they will obtain an expected result.
Honesty: The evaluations and treatments of patients who request help from CRIT are free for patients with low monetary resources, however, we proceed to attend patients of other socioeconomic levels who need the technology and the help of the Center's staff. In these cases, a fair charge is usually made for the services received so that it is reinvested in the center in its different work areas.
Patients who have been cared for and charged for treatment or rehabilitation still find rates much lower than those of private hospitals and clinics. They also feel and know that they have been treated with the same service and care with which other patients are treated.
All these points are essential to meet the quality, comfort and safety requirements of customers.
There are also other activities to promote customer loyalty.
In order to meet customer expectations regarding service, and if possible to exceed them, the CRIT has a Department of Teaching and Research, where the following activities are available:
Continuing Education: Its objective is to keep the collaborators of the Medical Directorate permanently updated in knowledge that impacts their daily work. It is carried out through thematic, bibliographic, clinical and general sessions. In addition, the collaborators participate as teachers or assistants in academic events such as congresses, workshops, symposiums and work meetings, intra and extramural.
Training of Rehabilitation Professionals. Its objective is to prepare professionals, creating the undergraduate or postgraduate courses necessary for the operation of the Telethon Children's Rehabilitation Centers.
Quality of care in rehabilitation: Includes all those actions that allow us to continuously improve the diagnosis, treatment and psychosocial integration of minors through this program.
Investigation. It aims to generate new knowledge in rehabilitation for the solution of the problems faced by children with disabilities. These activities are increased in accordance with the development of the CRITs, opening up the ever more in-depth study of this problem.
Continuous innovation. Government and public support through their contributions allow them to have sufficient funds and the support of specialists in the purchase of high-tech medical and rehabilitation equipment to be able to offer treatments and rehabilitations that help improve and sanitation of their patients.
Year after year they continue to renew and replace equipment with new ones that are more effective and give our patients the assurance that there is a continuous concern to have the latest technology for their benefit.
Additionally, support groups are being worked on with families to be able to extend treatments to children through new techniques, therapies that speed up the rehabilitation process at home and also so that they can understand a little more the problems their children face.. New discoveries, therapies and related issues are communicated through newsletters and brochures which are continually renewed and keep all members of the family updated.
Through a staff that is the best trained possible, we can offer a better service to our clients, but in addition to an academic education, a culture of service is very important, since no matter how much knowledge one has, if it is not of interest to serve the customer, our level of service will never improve.
Telethon
This name during the last 10 years has become a symbol of hope for many families who do not have sufficient financial resources to be able to provide treatment and therapy for neuromusculoskeletal disabilities.
Its donors, doctors and volunteers, feel full confidence that the resources and time that are donated to this center, is invested in the best way in the purchase of equipment and in payment of trained personnel with the commitment to serve and help. The continuous innovations, openings of centers, purchases and results of the treatments, give full satisfaction and assurance that everything that Teletón endorses is synonymous with security and hope.
For all these characteristics and attributes, CRITs are strongly supported, preferred and respected by the entire population in general and will continue to be the main rehabilitation centers in the country.
Service cycle
Moments of truth, key success factors
- Request for consultation with a doctor:
- Friendly receptionists who serve parents of new patients Immediate response to CRIT questions and inquiries Availability of immediate or same-day appointments Comfortable waiting areas with facilities and distractions for children
- Opening of a new patient file:
- Friendly nurses with availability to fill out the application Brief and concise request for general patient information Professionalism when asking questions File areas organized for easy access by doctors
- Consultation and examination of the patient:
- Experience and knowledge of the doctor in neuromusculoskeletal diseases of congenital or acquired origin Kind and professional treatment at all times during and after the consultation General and complete review of the symptoms or problems presented by the patient Office adequately equipped with the assistance of a nurse or therapist.
- Diagnosis and treatment / therapy to follow:
- Comprehensive explanation with justifications about the results of the examination Accurate diagnosis concerning the type of disease or physical problem Explanation of the alternatives to follow for rehabilitation or therapy A statement of risks and treatment efforts.
- Appointment and order of treatment:
- Availability of dates to start as soon as possible Assignment of specialist personnel in rehabilitation or therapy Flexible schedules that allow parents to take their children Written order of the different treatments to follow.
- Rehabilitation sessions, therapy and treatments:
- Availability of rooms and necessary equipment for the session Comfort and hygiene of the room where the treatments are carried out Continuous attention throughout the process Attention to service and delivery to work by assistants and therapists.
- Evaluation of the rehabilitation process, progress and improvements:
- Analysis of the doctor on the progress of the treatment with results and progress of the patient Discussions and evaluations of the patient with the therapists and nurses who assisted him in his sessions Measurement of improvements by examining the patient and asking him to show his progress Talks with the patient to ask about his progress and how you feel you have progressed or improved.
- Decision to continue treatment or discharge the patient:
- Correct diagnosis that allows to make the most accurate decision about the patient's condition Support through a report of improvements and results their decision to continue or to discharge them Exchange of opinions with other doctors to review details of the treatment Communicate the patient now your parents of your final decision.
Blueprinting diagram
Complexity and divergence
Expectations and customer perception
Within the procedure considered to quantify the level of customer satisfaction, it involves the application of questionnaires in each of the key success factors, to facilitate the coding and interpretation of the information obtained, the questions will be answered based on a scale that goes from one to five, with one being very dissatisfied and five being very satisfied. The results of the questionnaires applied to the CRIT committee will be presented monthly to define the actions to be taken.
For each of the key success factors, a questionnaire has been developed as shown below:
Request for consultation with the doctor
For each question, answer your degree of satisfaction with what the question indicates. Number one indicates that you are very dissatisfied and number five indicates that you are very satisfied.
1.- Was your appointment scheduled in less than two days?
1 2 3 4 5
2.- Was the doctor's secretary kind in assigning your consultation?
1 2 3 4 5
3.- Shall I present alternatives for the consultation hours?
1 2 3 4 5
4.- Did they call you to remember your appointment in advance?
1 2 3 4 5
5.- Did the secretariat answer all your questions regarding the appointment request?
1 2 3 4 5
Opening of new patients file.
For each question, answer your degree of satisfaction with what the question indicates. Number one indicates that you are very dissatisfied and number five indicates that you are very satisfied.
1.- Was the nurse and / or social worker friendly?
1 2 3 4 5
2.- Did the nurse and / or social worker clearly explain the information requested for the file?
1 2 3 4 5
3.- Was the nurse and / or social worker aware of your doubts?
1 2 3 4 5
4.- Was sufficient time given to answer the filling out of the file?
1 2 3 4 5
5.- Were you notified in a timely manner about the information necessary to open the file?
1 2 3 4 5
Consultation and examination of the patient.
For each question, answer your degree of satisfaction with what the question indicates. Number one indicates that you are very dissatisfied and number five indicates that you are very satisfied.
1.- Was the doctor kind in his treatment?
1 2 3 4 5
2.- Did the doctor use terms that you understand?
1 2 3 4 5
3.- Did the doctor show interest in the patient's case?
1 2 3 4 5
4.- Did the doctor demonstrate knowledge regarding the patient's illness?
1 2 3 4 5
5.- Did the doctor have the necessary tools to evaluate the patient?
1 2 3 4 5
Appointment and order of treatment
For each question, answer your degree of satisfaction with what the question indicates. Number one indicates that you are very dissatisfied and number five indicates that you are very satisfied.
1.- Was your appointment for the treatment scheduled in less than two days?
1 2 3 4 5
2.- Was the specialist's secretary kind in assigning your consultation?
1 2 3 4 5
3.- Shall I present alternatives for the consultation hours?
1 2 3 4 5
4.- Did they call you to remember your appointment in advance?
1 2 3 4 5
5.- Did the secretary answer all your questions regarding the request for the treatment appointment?
1 2 3 4 5
Rehabilitation, therapy and treatment session
For each question, answer your degree of satisfaction with what the question indicates. Number one indicates that you are very dissatisfied and number five indicates that you are very satisfied.
1.- Is there the necessary equipment for the patient's rehabilitation?
1 2 3 4 5
2.- Were the functions of each equipment used in the treatment explained to you?
1 2 3 4 5
3.- Was the necessary level of hygiene shown within the facilities?
1 2 3 4 5
4.- Did the support staff show kindness in their treatment of the patient?
1 2 3 4 5
5.- Did the staff demonstrate capacity and experience in the rehabilitation stages?
1 2 3 4 5
6.- Did the equipment used maintain good operation throughout the patient's treatment stage?
1 2 3 4 5
7.- In the event of an emergency, was there an adequate and timely response?
1 2 3 4 5
8.- Was the doctor aware of during the rehabilitation sessions?
1 2 3 4 5
Evaluation of the rehabilitation process, advances and treatments and Decision to continue or discharge.
For each question, answer your degree of satisfaction with what the question indicates. Number one indicates that you are very dissatisfied and number five indicates that you are very satisfied.
1.- Did you identify an improvement in the patient's response with the applied treatment?
1 2 3 4 5
2.- Do you consider that the rehabilitation treatment was adequate?
1 2 3 4 5
3.- Do the results meet your expectations of improvement in the patient?
1 2 3 4 5
4.- Was the scope of the treatment congruent with the explanation made by the doctor at the beginning of the treatment?
1 2 3 4 5
5.- Did you receive training from the staff to monitor the treatment at home?
1 2 3 4 5
6.- Would you recommend the services of this Institution to people who have a relative with the same problem?
1 2 3 4 5
7.- How do you consider the training of the employees of this Institution?
1 2 3 4 5
8.- Your overall appreciation of the services you received from this Institution were:
1 2 3 4 5
CRIT's internal and external monitoring systems
In the CRITs, the monitoring system about the perception of customers towards our service will be carried out through two dimensions:
External Monitoring.
This will be carried out through a personal interview through the application of a questionnaire, in which the questions will be directed to knowing the client's satisfaction in all our "Key Success Factors".
To facilitate the response of the clients, and at the same time the codification and interpretation of the information obtained, the questions will be answered based on a satisfaction scale that goes from number 1 to number 7, with one being totally in agreement or satisfied and 7 a totally disagree or dissatisfied.
As our main clients are children and young people from 0 to 18 years of age with neuromusculoskeletal disability, but the parents of these children being the main decision-makers in the choice and evaluation of services, this questionnaire will be applied to the latter.
The application of the questionnaires, and therefore the periodicity of the monitoring, will be periodically every six months, this being a considerable time for the modification of the Factors in which some improvement or a complete redefinition is needed.
In the CRIT, a service is offered that takes care of the physical, psychological, social and spiritual aspects, dividing its activities in different areas, the most convenient thing would be to apply the questionnaire in the area of Tambor, which corresponds to the psychosocial aspect, where seeks to provide the necessary tools for the total integration of both children and families. In this part, these questionnaires could be applied, since in addition to therapies, a coexistence is sought, which is why the service is in its terminal phase.
Internal Monitoring.
An internal monitoring will be carried out since, as our collaborators feel satisfied with their work, external clients will find greater satisfaction in our services.
This monitoring will be carried out in a slightly more informal way through talks and information sessions, in which employees can present their points of view and at the same time propose solutions to improve the service, both for the points presented by them and for the Factors in which external clients showed disagreements, establishing a Commitment Plan
The periodicity of these monitoring will be more frequent, being a period of no more than three months, in order to also monitor the implementation of the agreed Action Plan.
Parametric and non-parametric monitoring
A parametric monitoring refers to the monitoring that is applied when “hard” or parametric variables are involved: for example, the speed of the service (minutes, seconds), number of account statements that bring an error, etc. As you will see, these variables are called parametric because their measurement is performed at a "target" level - the minutes, the number of errors, and so on. they are comparable in different times and spaces. One minute has the same dimension and meaning here as it does in China; the proportion (%) of erroneous Account Statements is "universally" interpretable.
On the other hand, "non-parametric" monitoring refers to soft variables - such as courtesy, professionalism, perceived speed of service, willingness to clarify doubts, etc. These variables are quantified through "soft" variables such as, for example, measurement scales of, for example, 5 points (Very Good… Very Bad). Although they are subjective or non-parametric (the "4" can have a different meaning for 10 different clients) they are extremely useful scales in practice as they reasonably robustly capture client concerns, preferences and satisfactions.
Parametric Monitoring
Income Report (Patients)
Expenditure report by section
Report of patients who conclude their cycle of care.
Non-Parametric Monitoring
Direct interview by section
Home interview
Service standards for each key success factor
Request for consultation with a doctor:
85% of patients will have an appointment to see the doctor that same day or at the latest in the next two days.
Opening of new patients file.
90% of patients will be satisfied with the quality of the service provided by the nurse and / or social worker who opens the file, as well as the length of time.
Consultation and examination of the patient.
90% of patients will be satisfied with the treatment and explanation that the doctor gives in regards to the patient's diagnosis.
Appointment and order of treatment.
85% of patients will have an appointment for treatment the next day or within two consecutive days and within an accessible time for treatment.
Rehabilitation, therapy and treatment sessions.
90% of patients will be satisfied with the therapy, treatment and hygiene of the facilities in the therapy area.
Evaluation of the rehabilitation process, progress and treatment.
85% of patients, as family members, will perceive a satisfactory progress in the rehabilitation process.
Decision to continue treatment or discharge the patient.
95% of the patients will be satisfied with the results obtained once the treatment is finished and the patient is discharged.
Patient satisfaction will be measured through the scale mentioned in the application of the questionnaires, accepting as permissible parameters those that are not greater than 2 points.
Complaints attention
The CRIT complaint response policy is part of the objectives to increase customer loyalty (probability of CRIT reuse)
This policy must favor the development of activities aimed at improving the handling of complaints presented by users of the services offered by CRITs.
We will make available to clients a "Comments, Suggestions and Complaints" document to facilitate the communication of eventual problems on the part of the clients, and to simplify the complaint to the client.
We will develop a staff training policy to train them to receive and deal with customer complaints: in the CRIT, the policy for handling complaints will be developed so that each employee can report a complaint.
The CRITs undertake to answer a complaint within a time limit of one week, whether by written or oral means. Apart from this process of satisfactory response (solution of the problem itself), a letter or a call to the client will be made to advise the client of the good reception of their complaint (fast response) In addition, two weeks after receiving a complaint, A quick satisfaction survey will be carried out, by phone, in order to see if the CRIT has effectively responded to the customer's complaint.
Quarterly reports will be carried out where the treatment of complaints and concerns from clients can be followed, in how much average time complaints were answered, the results of the satisfaction survey by telephone, and especially the reasons for the complaints and the Actions to implement to improve the items that customers complained about. This will reduce the risk of the same error occurring.
Basic letter
June 28, 2001
Ref: 00030/2001
Mr. Justino Morales Pérez
Pino Street 40-6
Tlanepantla, Edo. from Mexico
Dear Mr. Morales:
I refer to your attentive letter dated June 14 of this year, addressed to Lic. Fernando Landeros Verdugo, our General Director of the Teletón Foundation, which was sent to this Management for his attention.
In this regard, I would like to inform you that I have carefully analyzed the content of your writing and I deeply regret this incident, since there was probably an involuntary error in not indicating that due to the care provided in our centers, it is difficult for us to immediately follow up your doubts and comments that arise during the treatment.
Due to the above, I understand your discomfort, since at that time I wanted to be informed of what was the progress of your son Jimmy in the treatment he is following.
Regarding your valuable comments, related to the attitude of service on the part of our staff, I can assure you that this foundation is fighting precisely so that the quality of the services we provide improve day by day and consequently, that our little ones patients and their parents feel satisfied by it.
I am infinitely grateful for the time and trouble you took to let us know about these types of irregularities, and I also take advantage of this to invite you to continue with us and enjoy the benefits that the CRIT grants not only for you and your family but mainly for your child..
I ask you to accept our sincere apologies for the disruption that we have caused you, hoping that you will once again give us the opportunity to serve you with the efficiency and courtesy that you deserve.
Sincerely, Lic. Luis Gustavo García Vega
Customer Service Manager
FH / lggv *
Bibliography
- http://www.fba-consulting.com/hosp_ps01.htmhttp://www.teleton.org.mx Innovations in Hospital Marketing William J. Winston. The Haworth Press, 1984. Marketing Fundamentals. Michael J. Etzel, Bruce J. Walker, William J. Stanton. Boston: McGraw-Hill / Irwin, c2001. 12th ed. Beyond Customer Service: How to Keep Customer Loyalty Forever. Gerson, Richard F. México: Iberoamérica, 1993. ISBN: 9706250352.How to provide comprehensive customer service: the best of Kaizen strategies, creation of a powerful and functional customer service program. Wellington, Patricia. Bogota Colombia.: McGraw-Hill, 1997. Marketing in Service Businesses: Compete for Quality. Leonard L. Berry, A. Parasuraman. Bogota Colombia.: Editorial Norma, 1993. ISBN: 9789580424956 Orientation, information and complaints system.Presidency of the Republic. General Coordination of Administrative Studies. Mexico, 1978 Marketing Services. Christopher H. Lovelock. Third edition. México, DF: Editorial Pearson, 1997
