The policy of refusing or not continuing treatment for the patient

Policy: the hospital is committed to ensuring the right of the patient, his family or his legal representative to refuse treatment or continue it, after making sure that he or his legal representative is informed of the results related to the refusal or non-continuation of treatment and the related responsibilities.

Purpose: to respect the patient's right to refuse treatment or not to continue treatment with the definition of the consequences of this and to hold the patient fully responsible in case he insists on refusal.

Action steps:

· The specialist doctor will inform the patient of his condition in a clear and appropriate way and introduce him to the types of treatment used for him, whether medication or surgery.

The refusal of the patient or those who have the legal right to do so for treatment or continuation of treatment is proved by the following:

* The nurse supervising the implementation of treatment for the patient registers the refusal in the patient's file.

* The nurse supervising the implementation of treatment for the patient informs the doctor of the patient's refusal or continuation of it.

* The doctor supervising the treatment explains the effect of refusing treatment or not continuing it and the health consequences resulting from this to the patient or to those who have the legal right to do so.

* The doctor will change the treatment or continue it, if possible.

* The doctor supervising the treatment clarifies that the patient or who has the legal right to do so bears full responsibility in case of insistence on refusal.

* The doctor supervising the treatment records the refusal of treatment or continuation of it in the patient's file in case the patient continues or whoever has the right to do so on the refusal with the recording of the summary of the patient's dialogue.

* The doctor registers the patient's refusal of treatment with documentation from him and the nursing staff.

· The doctor supervising the treatment makes sure to do the following steps:-

* Accommodate the patient or whoever has the right to it to describe the patient's general condition.

* The patient or whoever has the right to it understands the expected result of the refusal and the ensuing consequences.

* Understand the patient or those who have the right to it how dangerous it is to refuse treatment.

* Accommodating the patient or those who have the right to do so to bear full responsibility when refusing treatment.

* Write the statement of the patient's refusal of treatment despite the doctor's advice (the name of the attending physician) and the patient signs this refusal.

* The patient's signature on the refusal of treatment in the file and in case the patient refuses to sign, the attending physician and the responsible nurse sign this refusal as witnesses .

* The nurse responsible for carrying out the treatment records that the patient refused the treatment and left the place before the doctor came in case the patient was discharged without permission.

* The specialist doctor will prove the patient's desire to leave the hospital despite the advice of the treating team with the patient's file and prove that the risks of this procedure have been explained to the patient or who has the legal right to do so.

* The patient or the one who has the legal right to do so signs his wish to leave against the advice of the treating medical team and records the date and hour.

* The patient or the person who has the legal right to this undertakes to be shown to one of the specialized doctors outside the hospital as soon as possible.

* The employee of the Citizens Service office fills out the patient's opinion form about the medical service and clarifies any complaints to them.

* In case the patient leaves the hospital and refuses treatment despite the advice, the nurse reports the patient's escape from the hospital .

In charge:

§ The Attending Physician.

§ Nursing staff

§ Employee of the Citizens Service office.

Models:

§ Customized exit declaration form.

§ Sample patient opinion questionnaire.

References:

§ Egyptian accreditation standards.

Preparation	review	The trust

Patient complaints and suggestions policy

Policy: the hospital is committed to developing a system or procedures to ensure that patients know how to submit their complaints and suggestions to work on examining and removing the causes of complaints and studying the proposals submitted by patients and their families.

Purpose: to clarify how patients and their families submit a complaint or suggestion and to ensure that the complaint is examined, its causes are removed, and the submitted proposals are studied for the continuity of the performance improvement process at the hospital.

Means of submitting complaints and suggestions:-

- First: complaints received from outside the hospital.

- Second: complaints issued from within the hospital.

Actions:

First: complaints received from outside the hospital.

1.    The secretarial employee receives the complaints received by the hospital from abroad by phone and reports them to the Citizens Service office.

2.    The secretariat employee directs the complainant to the Citizens ' Service office.

3.    The chairman of the complaints committee shall review the complaint and identify the responsible department or persons to verify and respond to it.

4.    The person responsible (citizens ' service ) for verifying the complaint writes the appropriate response for presentation to the chairman of the Complaints Commission.

5.    The chairman of the complaints committee determines the necessary action to be taken on the complaint.

6.   The chairman of the complaints committee determines who sends the response to the concerned body of the complaint or calls the complainant by phone / Telegraph to schedule an appointment to meet with him and to inform him of what has been taken regarding the complaint.

Second: complaints issued from within the hospital.

1-complaints submitted through complaint boxes:

* The hospital administration sets up boxes to collect complaints from customers by distributing them in different areas in the hospital (administration building-reception)

* The Complaints Committee opens the complaint boxes, classifies them and hands them over to the chairman of the committee.

* The chairman of the complaints committee examines the complaint and writes a summary of it, if the name of the complainant is not mentioned, to be presented to the director to discuss what came of it, and if the name of the complainant is mentioned, the chairman of the committee assigns the person who answers what came of the complaint.

* The results of complaints are submitted to the manager weekly.

* The director of the hospital shall take the necessary measures according to the result received by him.

2-complaints submitted by phone call:

* The patient or his representative calls the internal number of the hospital.

* The director's Secretariat listens to the complaint and registers it in the special register, provided that at the end of the working day it informs the chairman of the complaints committee of all complaints in the register.

* Complaints are received by phone during the morning working hours (eight in the morning to two in the afternoon)

3-receiving patient complaints during personal interviews with them:

* First: the patient or his representative submits a complaint:-

The patient or his representative submits his complaint to The Citizen Service officer.

* Second: the passage of the employee of the Citizens Service office to the internal departments:-

i) the employee of the Citizens Service office visits the patients, hears their complaint, registers it in the special form and works to resolve it by contacting the official, and in case of inability to do so, he submits it to the chairman of the complaints committee.

ii) the employee of the Citizens Service Office presents the complaint form daily to the chairman of the complaints committee to discuss the problems and what has been done about them.

* Third: the passage of the coordinator of patients ' rights:-

1.    The Patients ' Rights Coordinator visits a random sample of patients to hear their complaints and suggestions, make sure that the Citizens Service office employee passes by them, and record those complaints, if any, in his traffic record.

2.    The Citizens ' Service officer examines the complaints he found .

3.    The Citizens Service officer fills out the patient satisfaction form in the relevant department of the complaint if the complaint or proposal needs to be followed up.

Actions taken with complaints

* The chairman of the complaints committee shall address the relevant sections of the complaint or proposal either orally or in writing.

· The department concerned with the problem or proposal is obliged to research it and respond to it within a specific time period determined by the chairman of the committee.

* When the specified period of time has elapsed, if no appropriate decision has been made in the relevant department, the subject is presented to the director for a decision on it with the hospital administration.

* The recommendations of the hospital manager are followed up by the Citizens Service officer and the complainant is informed of the result .

* The confidentiality of the person reporting the complaint is maintained without exposing him or trying to harm him.

In charge:

- Head of the director's Secretariat.

- Complaints committee.

- Citizen Service officer

Models:

- Sample passage of patient complaints

- Inpatient complaint form.

- Patient survey form.

Documentation:

- Register of complaints.

References:

Egyptian accreditation standards .

Preparation	review	The trust