Decision 3869/QD-BYT 2019 promulgating forms and guidance for patient and health worker satisfaction surveys

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Decision No. 3869/QD-BYT dated August 28, 2019 of the Ministry of Health promulgating forms and guidance for patient and health worker satisfaction surveys
Issuing body: Ministry of HealthEffective date:
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Official number:3869/QD-BYTSigner:Nguyen Viet Tien
Type:DecisionExpiry date:Updating
Issuing date:28/08/2019Effect status:
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Fields:Medical - Health
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LuatVietnam.vn is the SOLE distributor of English translations of Official Gazette published by the Vietnam News Agency
Effect status: Known

MINISTRY OF HEALTH
____________________

No. 3869/QD-BYT

THE SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
____________________________

Hanoi, August 28, 2019

DECISION

Promulgating forms and guidance for
patient and
health worker satisfaction surveys

_________________________

THE MINISTER OF HEALTH

 

Pursuant to the Government’s Decree No. 75/2017/ND-CP dated June 20, 2017, defining the functions, tasks, powers and organizational structure of the Ministry of Health;

Pursuant to the Ministry of Health’s Circular No. 19/2013/TT-BYT dated July 12, 2013, on guiding the quality management of medical examination and treatment services at hospitals;

At the request of the Director of the Department of Medical Services Administration, the Ministry of Health,

 

DECIDES:

 

Article 1. Survey forms, guidance of methods and software for satisfactory survey are promulgated together with this Decision as follows:

a) Form No. 1: Survey form for inpatients’ opinions;

b) Form No. 2: Survey form for outpatients’ opinions;

c) Form No. 3: Survey form for health workers’ opinions;

d) Form No. 4: Survey form for mothers giving birth at hospitals;

dd) Form No. 5: Survey form on breastfeeding practices;

e) Guidance on methods for satisfaction survey of patients, mothers and health workers;

g) General information forms of hospitals registering to participate in surveys.

h) The online software to enter data of patient and health worker satisfaction surveys at http://chatluongbenhvien.vn/.

Article 2. Satisfaction survey forms and guidance of survey methods shall be commonly applied to both state and private hospitals.

Article 3. Assigning to implement:

1. The Department of Medical Services Administration shall

- Act as a focal point to guide relevant units in conducting satisfaction surveys of patients, mothers and health workers;

- Inspect and supervise units; synthesize, analyze data and report to the Ministry of Health's leadership on the results of the annual patient and health worker satisfaction indicator.

2. Departments of Health and health ministries and branches shall

- Urge and inspect hospitals under its management to conduct patient and health worker satisfaction surveys in accordance with guidance attached to this Decision;

- Synthesize and analyze the results of the general satisfaction indicator of units.

3. Public and private hospitals shall

- Conduct actively, regularly and scientifically patient and health worker satisfaction surveys;

- Enter and summarize data and results; record, review and analyze unsatisfactory comments;

- Resolve and fix promptly recommendations from patients and health workers and plan, implement quality improvement activities within the scope of authority and in accordance with the hospital's resources.

Article 4. This Decision takes effect from the date of signing and issuance.

Article 5. Chief of the Ministry’s Office; Director of the Department of Medical Services Administration; Directors of Departments, heads of relevant units and the men and women named in Article 1 shall be responsible for implementing this Circular./.

 


 

FOR THE MINISTER
THE DEPUTY MINISTER



Nguyen Viet Tien

 

 

MINISTRY OF HEALTH

FORM NO. 1

(COMPACT)

 

 

 

 

 

 

 

 

 

 

 

SURVEY FORM FOR INPATIENTS’ OPINIONS

Aiming to improve the quality of medical examination and treatment and meet patient satisfaction, the Ministry of Health and hospitals shall organize surveys to learn about patients' opinions. These valuable opinions shall help the health sector overcome difficulties and gradually improve quality to better serve the people. The Ministry of Health must ensure that information is kept confidential and must not affect treatment. Thank you very much!

1. Name of the hospital:  ……………………………………….. 2. Date of filling out form …………………………

3. Respondent      a. Patient     b. Family member

4. Name of the department for treatment before discharge from the hospital …………..….. 5. The department code (recorded by the hospital) ………………

PATIENT’S INFORMATION

A1. Gender: 1. Male 2. Female

A2. Age………

A3. Mobile number (required):

A4. Total number of days in hospital...days

A5. Do you use your health insurance card for this treatment?    1. Yes 2. No

EVALUATION OF THE USE OF MEDICAL SERVICES

Please mark with a cross on a number from 1 to 5, corresponding to the level of satisfaction or comment from very poor to very good for each question below:

  is:

  is:

 is:

 is:

 is:

Very dissatisfied

Not satisfied

Normal

Satisfied

Very satisfied

or: Very poor

or: Poor

or: Medium

or: Good

or: Very good

 

A. Accessibility

A1.

Diagrams and signs giving directions to departments and rooms in the hospital are clear, easy to understand and find.

A2.

Time to visit patients is clearly announced.

A3.

Building blocks, stairs, and patient rooms are clearly numbered and easy to find.

A4.

The hospital walkways and corridors are flat and easy to walk.

A5.

Patients can ask questions and call health workers when necessary.

B. Transparency of information and procedures of medical examination and treatment

B1.

Processes and procedures of hospital admission are clear, public and convenient.

B2.

While in the hospital, the patient/patient’s family member is informed clearly and completely about the rules and necessary information.

B3.

The patient/patient’s family member is explained clearly and completely the disease condition, method of treatment and expected treatment time.

B4.

The patient/patient’s family member is explained and advised clearly and completely before requesting tests, explorations, and high-tech tests.

B5.

Information on medication use and treatment costs is made public and updated

C. Facilities and means to serve patients

C1.

The treatment room is commodious, clean, and has adequate temperature control equipment such as fans, heaters, or air conditioners.

C2.

Each person has a bed including hospital bed, sheets and pillows which are safe, sturdy, and in good condition.

C3.

Toilets and bathrooms are advantageous, clean, and well used.

C4.

The patient/patient’s family member is guaranteed safety, security, order, theft prevention, peace of mind while in hospital.

C5.

The patient is provided with adequate, clean clothing.

C6.

The patient/patient’s family member is provided fully with hot and cold drinking water.

C7.

While in the hospital, privacy is guaranteed such as changing clothing, medical examination, going to the toilet in bed, etc. with curtains, partitions or lying separately.

C8.

The hospital canteen serves food and essential living needs with complete and high quality.

C9.

The environment within the hospital campus is green, clean, and beautiful.

D. Behavioral attitudes and professional capacity of health workers

D1.

Doctors and nurses have proper speech, attitude, and communication.

D2.

Service workers (nurses, security guards, accountants...) have proper speech, attitude, and communication.

D3.

The patient/patient’s family member is respected, treated fairly, cared for, and helped by health workers.

D4.

Doctors and nurses combine well and handle fluently and promptly work.

D5.

The patient is examined and encouraged by doctors in the treatment room.

D6.

The patient is got advice on diet, exercise, monitoring and preventing complications.

D7.

Health workers do not have signs of suggesting fostering.

E. Results of supplying service

E1.

Dispensing drugs and guidelines for use of medicines are conducted fully and with quality.

E2.

Medical equipment and supplies are complete, modern, and meeting expectations.

E3.

Treatment results met expectations.

E4.

Evaluation of your level of confidence in the quality of medical services.

E5.

Evaluation of your satisfaction with the price of medical services.

G1

Overall evaluation, how many percentages of your expectations do the hospital meet before you are hospitalized?

(filling out the number from 0% to 100% or filling out over 100% if the hospital provides good treatment, exceeding your expectations)

………..%

G2

If you need examination or treatment for similar diseases, will you come back or recommend it to others?

1. Definitely never come back

2. Will not want to go back but have few other options

3. Want to transfer to another hospital

4. Maybe will come back

5. Will definitely come back or recommend to others

6. Others (specify) …………………………………

H

Do you have any other opinions, please specify?

 

     

THANK YOU VERY MUCH!

 

MINISTRY OF HEALTH

FORM NO. 2

 

 

 

 

 

 

 

 

 

 

 

SURVEY FORM FOR OUTPATIENTS’ OPINIONS

Aiming to improve the quality of medical examination and treatment and meet patient satisfaction, the Ministry of Health and hospitals shall organize surveys to learn about patients' opinions. These valuable opinions shall help the health sector overcome difficulties and gradually improve quality to better serve the people. The Ministry of Health must ensure that information is kept confidential and must not affect treatment. Thank you very much!

1. Name of the hospital:  ………………………………………………. 2. Date of filling out form …………………………

PATIENT’S INFORMATION

A1.

Gender: 1. Male 2. Female

A2

Age: …………………

A3.

Mobile number (required):

A4.

Estimating the distance from residence to the hospital:  …….km

A5.

Do you use your health insurance card for this medical examination?    1. Yes 2. No

EVALUATION OF THE USE OF MEDICAL SERVICES

Please mark with a cross on a number from 1 to 5, corresponding to the level of satisfaction or comment from very poor to very good for each question below:

 is:

  is:

 is:

 is:

 is:

Very dissatisfied

Not satisfied

Normal

Satisfied

Very satisfied

or: Very poor

or: Poor

or: Medium

or: Good

or: Very good

 

A. Accessibility

A1.

Signs and directions to the hospital are clear, easy to see and find.

A2.

Diagrams and signs giving directions to departments and rooms in the hospital are clear, easy to understand and find.

A3.

Building blocks, stairs are clearly numbered and easy to find.

A4.

The hospital walkways and corridors are flat and easy to walk.

A5.

Patients can find out information and register conveniently for examination via phone or the hospital's website.

B. Transparency of information and procedures of medical examination and treatment

B1.

The medical examination process is clearly posted, public, and easy to understand.

B2.

Processes and procedures of medical examination are reformed to be simple and convenient.

B3.

Service prices are clearly and publicly listed.

B4.

Health workers welcome and guide patients warmly and enthusiastically through procedures.

B5.

Patients are lined up in order after completing registration procedures, payment, medical examination, testing, and screening.

B6.

Patients evaluate the waiting time for medical registration procedures.

B7.

Patients evaluate the waiting time for for a doctor's visit.

B8.

Patients evaluate the time taking to be examined and consulted doctors.

B9.

Patients evaluate the waiting time for tests and scans.

B10.

Patients evaluate the waiting time to receive test and imaging results.

C. Facilities and means to serve patients

C1.

There is clean, airy examination waiting rooms/lounges in the summer; airtight and warm waiting rooms/lounges in winter.

C2.

Waiting rooms have enough chairs for patients and are good to use.

C3.

Waiting rooms have fans (air conditioners) fully and operate regularly.

C4.

Waiting rooms have facilities to help patients feel comfortable such as television, pictures, leaflets, drinking water, etc.

C5.

Privacy is guaranteed during medical examinations, scans, and procedures.

C6.

Toilets are commodious, well-used, and clean.

C7.

The environment within the hospital campus is green, clean, and beautiful.

C8.

The medical examination area ensures security, order and prevents theft for people.

D. Behavioral attitudes and professional capacity of health workers

D1.

Health workers (doctors and nurses) have proper speech, attitude, and communication.

D2.

Service workers (nurses, security guards, accountants, etc.) have proper speech, attitude, and communication.

D3.

The patient is respected, treated fairly, cared for, and helped by health workers.

D4.

The professional capacity of doctors and nurses meets expectations.

E. Results of supplying service

E1.

Medical examination results have met Mr./Mrs.'s wishes.

E2.

Invoices, receipts, prescriptions and medical examination results are provided fully, clearly, transparently. Getting an explanation if there are any questions.

E3.

Evaluation of your level of confidence in the quality of medical services.

E4.

Evaluation of your satisfaction with the price of medical services.

F

Overall evaluation, how many percentages of your expectations do the hospital meet before coming for medical examination?

(filling out the number from 0% to 100% or filling out over 100% if the hospital provides good treatment, exceeding your expectations)

………..%

G

If you need medical examination, will you come back or recommend it to others?  

1. Definitely never come back

2. Will not want to go back but have few other options

3. Want to transfer to another hospital

4. Maybe will come back

5. Will definitely come back or recommend to others

6. Others (specify) …………………………………

    

THANK YOU VERY MUCH!

 

MINISTRY OF HEALTH

FORM NO. 3

 

 

 

 

 

 

 

 

 

 

 

SURVEY FORM FOR HEALTH WORKERS’ OPINIONS

Aiming to improve the quality of medical examination and treatment and improve the working environment of health workers, the Ministry of Health and hospitals organize the survey to find out opinions and aspirations of health workers. The Ministry of Health guarantees to keep information confidential. We hope that our colleagues will answer fully, objectively and accurately. Thank you very much!

1. Name of the hospital:  ……………………….. 2. Date of filling out form …………………………

RESPONDENT’S INFORMATION

A1.

Gender: 1. Male 2. Female

A2.

Age: ………..

A3.

Major:

1. Doctor

2. Pharmacist

3. Nurse, midwife

4. Technician

5. Other (specify) ...

A4.

Your highest degree:

1. Professional secondary school

2. College

3. University

4. Master's degree, specialist level I

5. Doctorate, specialist level II

6. Other (specify) ...

A5.

Number of years working in the medical industry: …………….

A6.

Number of years working at the current hospital: ……………

A7.

Current work position:

1. Hospital leader

2. Head of department/room/center

3. Deputy Head of department/room

4. Permanent/long-term contract worker

5. Short-term contract worker.

6. Other (specify) ...

A8.

Scope of professional operations:

1. Hospital administration blocks

2. Subclinical

3. Internal medicine

4. Surgery

5. Antenatal

6. Pediatrics

7. Infection

8. Odd specialties (ophthalmology, otolaryngology, odonto-stomatology, etc.)

9. Departments do not directly conduct medical examination and treatment

10. Pharmacy

11. Prevention

12. Other (specify), etc.

A9.

Are you assigned to concurrent multiple jobs?

1. Not concurrent multiple jobs

2. Concurrent 2 jobs

3. Concurrent 3 jobs or more

A10.

On average, how many times are you on duty in a month?................ times

        

EVALUATION OF HOSPITAL SATISFACTION

Please mark with a cross on a number from 1 to 5, corresponding to the level of satisfaction or comment from very poor to very good for each question below:

 is:

  is:

 is:

 is:

 is:

Very dissatisfied

Not satisfied

Normal

Satisfied

Very satisfied

or: Very poor

or: Poor

or: Medium

or: Good

or: Very good

 

A. Satisfaction with the working environment

A1.

The office is commodious, clean, and airy.

A2.

Office equipment, desks and chairs, etc. are full; old and outdated equipment is replaced promptly.

A3.

There is an on-call room for health workers.

A4.

Duty time and working hours outside of office hours are divided reasonably.

A5.

Protective equipment for health workers (clothing, masks, gloves, etc.) is complete, not old, wrinkled, and not restricted in use.

A6.

The learning environment creates conditions for health workers to update knowledge and improve qualifications: library, reading room, information lookup, internet access, etc.

A7.

The working environment ensures safety for health workers.

A8.

The hospital ensures security and order for health workers to work.

A9.

Patients and family members have the attitude of respect and cooperation with health workers during the treatment process.

B. Satisfaction with the direct leader and co-workers

B1.

The leader has the ability to handle, manage, and resolve work effectively.

B2.

The leader assigns tasks in conformity with the training expertise of workers.

B3.

The leader cares, respects and treats health workers equally.

B4.

The leader listens to and receives comments and suggestions from health workers.

B5.

The leader motivates and encourages workers when completing tasks well and making progress at work.

B6.

Co-workers have a sense of cooperation to complete common tasks.

B7.

The working environment is friendly and united.

B8.

Co-workers share experience and support each other at work.

B9.

Co-workers care and support each other in life.

C. Satisfaction with internal regulations, wages, welfares

C1.

Internal working regulations of the hospital are intelligible, practical and public.

C2.

The working environment at the department/room and hospital is democratic.

C3.

Internal spending regulations are fair, reasonable and public.

C4.

The distribution of welfare funds is fair and public.

C5.

Salaries commensurate with ability and dedication.

C6.

Employment and hazardous allowances are worthy of dedication.

C7.

Bonuses and increased income are worthy of ABC compared to dedication.

 

C8.

The division of increasing income is fairness and encourages employees to work actively.

C9.

Payment of social insurance, health insurance, periodic health checks and other support forms of sickness and maternity are fully guaranteed.

C10.

The sightseeing and relaxation is organized fully.

C11.

There are active movements of sports and arts.

C12.

The hospital union is active.

D. Satisfaction with job, learning and advancement opportunities

D1.

The amount of assigned work is appropriate.

D2.

The professional work meets personal aspirations.

D3.

The hospital creates conditions for health workers to improve their professional qualifications.

D4.

The hospital creates conditions for health workers to continue studying at higher levels.

D5.

Standards for leadership positions are made public

D6.

Leadership positions are appointed democratically and fairly.

D7.

There are opportunities for advancement when working hard.

E. General satisfaction with the hospital

E1.

Health workers feel proud to work at the hospital.

E2.

Health workers achieve personal success while working at the hospital.

E3.

Health workers believe in the future development of the hospital.

E4.

Health workers will work at the current department or room for a long time.

E5.

Health workers will work at the hospital for a long time.

E6.

General satisfaction with the hospital leaders.

E7.

Self-evaluation of the level of job completion at the hospital.

G. Do you have any other opinions or suggestions for the Ministry of Health and hospital leaders?

………………………………………………………………………………………………………

………………………………………………………………………………………………………

………………………………………………………………………………………………………

………………………………………………………………………………………………………

………………………………………………………………………………………………………

………………………………………………………………………………………………………

The hospital sincerely thanks our co-workers for their enthusiasm in providing information!

 

MINISTRY OF HEALTH

FORM NO. 4

 

 

 

 

 

 

 

 

 

 

 

SURVEY FORM FOR MOTHERS GIVING BIRTH AT THE HOSPITAL

With the goal of improving the quality of medical examination and treatment and meeting the satisfaction of mothers giving birth at the hospital, the Ministry of Health and the hospital organized a survey to learn about mothers' experiences during childbirth. These valuable opinions will help the health industry improving quality better. The Ministry of Health ensures the confidentiality of personal information. Sincerely thank you!

1. Name of the hospital:  …………………………………. 2. Date of filling out form …………………………

3. Names of departments treated: ………………..….. (Filling out all departments if applicable)

………………………………………………………………………………………………………

4. The department code (recorded by the hospital) ………………

5. The mother's code ................................... (If the hospital knows the code, the mother can fill it out by herself or the health worker can fill it out in later).

PATIENT’S INFORMATION

A1.

Age

A2. Mobile number:

A3.

Total number of days in hospital...days

A4. How many times have you been to this hospital?

A5.

Do you use your health insurance card for this treatment?

1. Yes 2. No

A6.

How to give birth?  1. Normal birth              2. Emergency cesarean section

 

                              3. Preparing cesarean section 4. Other methods (specify)

A7

During this pregnancy, do you go to the hospital for prenatal check-ups? If yes, how many times have you been examined?

1. Number of prenatal check-ups …….

2. Only for birth, no examination

3. Do not remember

     

EVALUATION OF THE USE OF MEDICAL SERVICES

Please mark with a cross on a number from 1 to 5, corresponding to the level of satisfaction or comment from very poor to very good for each question below:

 is:

  is:

 is:

 is:

 is:

Very dissatisfied

Not satisfied

Normal

Satisfied

Very satisfied

or: Very poor

or: Poor

or: Medium

or: Good

or: Very good

 

A. Accessibility

A1.

Diagrams and signs giving directions to departments and rooms are clear, easy to understand and find.

A2.

Calling and asking health workers when necessary (even outside of office hours).

B. The process of examination and hospitalization

B1.

The process of examination, testing and hospitalization is easy and convenient.

B2.

Waiting time for procedures and services is allowable.

C. Providing information, communication and advices

C1.

Be provided with requested information about prenatal testing, supersonic, etc.

C2.

Be received information and advices about the childbirth process and possible risks of complications.

C3.

Be received communication and advices on detecting dangerous signs, newborn care, nutrition and breastfeeding.

D. Facilities and means to serve patients

D1.

Mattress beds for mother and child are safe and do not lie together.

D2.

Full, clean blankets, sheets, pillows, dresses, and diapers are provided for mother and child.

D3.

Toilets and bathrooms are clean and have enough paper, soap, and water.

D4.

The patient room is airy, clean, and has a fan, heater or air conditioner.

D5.

When changing clothing, examining, and cleaning at the bed, privacy is guaranteed with curtains, mobile partitions, or a private room.

 

There are other convenient services for mothers and babies such as on-site shampooing, bathing and massage, of good quality.

E. Attitude of health workers

E1.

Doctors have appropriate speech, attitude, and communication.

E2.

Nurses and midwives have appropriate speech, attitude, and communication.

E3.

Service workers (nurses, security guards, accountants, etc.) have appropriate words, attitude, and communication.

E4.

Health workers do not suggest training (if there is a suggestion, fill out 1, if not, fill out 5).

G. The professional capacity of health workers

G1

Doctor have professional qualifications and good examination skills.

G2

Nurses and midwives have good professional qualifications and provide attentive care.

G3

Doctors, nurses, and midwives coordinate well and handle work competently and promptly.

H. The result of hospitalization

H1

Safe birth, good treatment and care.

H2

Dispensing fully medicine and complete instructions on medicine use.

H3

The price of medical services is reasonable, commensurate with the amount of money spent.

K1

Overall evaluation, how many percentages of your expectations do the hospital meet before you are hospitalized?

(filling out the number from 0% to 100% or filling out over 100% if the hospital provides good treatment, exceeding your expectations)

………..%

K2

If you have next labor (if any), will you come back or recommend it to others?  

1. Definitely never come back

2. Will not want to go back but have few other options

3. Maybe will come back

4. Will definitely come back or recommend to others

5. Others (specify) …………………………………

K3

Do you have any other opinions about giving birth at the hospital?

 

(Please clearly state any compliments or criticisms, comments or suggestions for the hospital and the Ministry of Health)

 

    

THANK YOU RESPECTFULLY AND WISH YOU HEALTHY AND GOOD BABY!

 

MINISTRY OF HEALTH

FORM NO. 5

 

 

 

 

 

 

 

 

 

 

 

SURVEY FORM ON BREASTFEEDING PRATICES

 

Aiming to improve nutrition and breastfeeding practices, the Ministry of Health surveys breastfeeding practices at the hospital and after leaving the hospital. Opinions will help the health industry to gradually improve quality, contribute to improving the quality of the population. The Ministry of Health and hospitals ensure the confidentiality of personal information. Thank you very much!

1. Name of the hospital: …………………………………….. 2. Date of filling out form …………………………

3. Name of department stayed ………………..….. 4. The department code (recorded by the hospital) ………………

5. Patient’s code (assigned by hospital) ……………………………..

PATIENT’S INFORMATION

A1. Age

A2. Mobile number:

A3. How many times have you been to this hospital?

A4. You have been in the hospital for .... days

A5. This is the ….. birth

A6. You gave normal birth or cesarean section......

A7. Your baby’s date of birth

 

BREASTFEEDING PRATICES

B1.

Have you seen the “Regulations on Breastfeeding” at the hospital? If having regulations, where are them?

(You can tick as many numbers as appropriate)

1. Examination department

2. Birth waiting room

3. Postpartum room/department

4. Consulting room

5. Other places, clearly state...................................

6. Not visible

B2.

Have you seen pictures or leaflets promoting breastfeeding at the hospital? If having pictures or leaflets, where are them?

(You can tick as many numbers as appropriate)

1. Examination department

2. Birth waiting room

3. Postpartum room/department

4. Patient’s room

5. Consulting room

6. Other places, clearly state...................................

7. Not visible

B3.

Have you received breastfeeding advices from the hospital? If having advices, where are them?

(You can tick as many numbers as appropriate)

1. The hospital does not provide advices

2. Giving advices during pregnancy check-ups at the hospital

3. Prenatal advices

4. Postpartum advices

5.Other times, clearly state............

B4.

Why do you not get advices by the hospital?

1. Because there is no prenatal check-up at the hospital

2. Due to emergency cesarean section

3. Because health workers do not give advices

4. Other reasons, clearly state................................................... .......

5. Getting advices of the hospital

B5

If you have been advised, do you understand advices of breastfeeding by the hospital? What is the level of understanding?

1. The hospital does not provide consultation

2. I gets advices but do not understand

3. I understand but do not remember what to do

4. I understand and remember what to do

5. I understands and is very interested in the meaning of breastfeeding

6. Other, please specify........................

B6.

When giving birth, it is estimated that after how many minutes will the mother and child "cut the umbilical cord"?

1. Cutting the umbilical cord immediately after birth

2. Cutting the umbilical cord slowly: estimated number of minutes............

3. Do not remember, do not know the number of minutes

4. Other, specify clearly........................

B7.

After giving birth, are you and your baby allowed by health workers to conduct "skin-to-skin contact"? If so, for how long?

1a. Is skin-to-skin conduct possible?

1b. Estimating how many minutes "skin to skin" lasts....

2a. Do not conduct “skin-to-skin”

2b. Reasons for not im conducting.............

B8.

How many minutes after birth do your baby breastfeed for the first time (estimating the number of minutes if you remember)

Specifying the number of minutes if you remember: …… minutes

1. Breastfeeding immediately after birth

2. For about 30 minutes

3. Within about 1 hour

4. Within about 2 hours

5. From 2 hours to 24 hours

6. After 1 day

7. The mother has no milk so the baby has to drink formula

8. Other reasons, clearly state...................

B9.

Do you receive support to practice breastfeeding? If so, who is it?

(You can tick as many numbers as appropriate)

1. Midwives, nurses

2. Doctors

3. Family members

4. Other (specify)………………….

5. None

B10.

If yes, in what form do you receive support for breastfeeding practice?

(You can tick as many numbers as appropriate)

1. Directly guiding mothers to breastfeed their babies properly

2. Breast massage

3. Practice milking (by hand or machine)

4. Uncloging milk ducts

5. Other, specify

B11.

While in the hospital, do you feed your child any other food? If yes, what is it (such as honey, lemon, salt, powder, medicine, etc.)?

1. Only breastfeeding exclusively (100%)

2. Giving more water to drink

3. Asking/buying milk from other mothers

4. Giving more formula milk

5. Feeding other foods

6. Giving supplements and functional foods

7. Giving medicine to treat the disease

B12.

Do health workers suggest buying powdered milk for your child?

1. Yes

2. No

B13.

In your opinion, what are the benefits of breastfeeding?

Clearly state the benefits:

……………………………………………………………

……………………………………………………………

B14.

In your opinion, children should be exclusively breastfed for at least several months and for how long?

1. At least ……… months

2. Lasts for …… .. months

B15.

What recommendations do you have for the hospital and health workers to make breastfeeding better?

Clearly write recommendations …………………………… ..

…………………………………………………......

………………………………………………………

THANK YOU AND WISH YOU HEALTHY AND GOOD BABY! END OF INTERVIEW.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

 

PART C. QUESTIONS FOR FOLLOWING BREASTFEEDING AFTER LEAVING FROM THE HOSPITAL

(the hospital and the mother are not required to conduct the survey).

 

Surveying the breastfeeding situation after leaving from the hospital will provide valuable information, helping hospitals and the Ministry of Health to improve the quality of breastfeeding activities, improve population quality and children's health.

Implementation method: The hospital shall assign workers in charge of the survey to call the mother regularly once a week and fill out information on the online software from the time the child leaves from the hospital until the child is 6 months old.

C1.

Mother's mobile number:

C2. The dated of calling for the interview:

C3.

Calling in the…week after birth

The…week (ordinal number)

C4.

During the past week, besides breast milk, did you breastfeed or eat any other food? If yes, what is it (such as honey, lemon, salt, powder, medicine, etc.)?

1. Only breastfeeding exclusively (100%)

2. Giving more water to drink

3. Only feeding milk asked/bought from other mothers

4. Giving more formula milk

5. Feeding other foods

6. Feeding exclusively in addition to breast milk

7. Giving medicine to treat the disease

8. Giving supplements and functional foods

9. Other, specify

C5.

What is the reason for feeding and drinking foods other than breast milk?

1. Due to insufficient breast milk

2. Due to the child's needs

3. Because the child is sick

4. Other reasons, clearly state

C6.

How does your child's height and weight compare to the child growth chart?

1. Stage 1 stunting

2. Stage 2 stunting

3. Meet standards

4. Exceeds standards of level 1

5. Exceeds standards from level 2 or higher

 

GUIDANCE ON THE CONDUCT AND METHOD OF SATISFACTION SURVEY OF PATIENTS, MOTHERS AND HEALTH WORKERS IN FORM NO. 1, 2, 3, 4, 5

(Applicable to state and private hospitals that conduct satisfaction surveys by their own and inspection and evalation teams of the quality of hospitals at the end of the year or unexpectedly)

(Appendix issued together with the Minister of Health’s Decision No. 3869/QD-BYT dated August 28, 2019)

 

1. SATISFACTION SURVEY SUBJECTS AND APPLICATION FORM

Hospitals and medical facilities with inpatient beds (not applicable to district medical centers with a preventive function, medical stations, and regional general clinics) conduct survey forms for the following subjects:

- Patients receiving inpatient treatment: form No. 1;

- The mother giving birth at the hospital: form No. 4, form No. 5;

- People going for medical examination at the hospital, outpatients: form No. 2;

- Health workers, management positions, leaders of departments/rooms, members of a Board of Directors for a Hospital: form No. 3.

2. GUIDANCE ON INFORMATION IN FORMS

The blank boxes at the top are: used to fill out the form code, filled out by the survey worker according to regulations of the Ministry of Health and conventions of hospitals. Filling out the correct form code shall help for statistics, storage, inspection, and monitor of satisfaction surveys by management agencies.

Recording form codes must comply with the following regulations:

The first to fifth boxes are the hospital codes issued by the Ministry of Health, in which the first two numbers are the province code, the third box is the hospital code/type and the fourth and fifth boxes are the order of the hospital. The next five boxes are recorded codes determined by the hospital to suit the characteristics of each hospital (for example, the sixth box is used to record the survey code in the quarter or year; the seventh box is written the surveyor's code or the patient's code; eighth, ninth, and tenth boxes is written numerical order of forms surveyed in each turn). Hospitals need to have written regulations on how to code from the sixth to tenth boxes to ensure the coding of form codes is applied uniformly, ensuring convenience in managing and looking up information when necessary. The coding is done simultaneously on paper forms and electronic forms on online software.

Persons conducting surveys, patients, and medical staff shall fill information in the following methods:

- Filling out the required blanks;

- Circling numbers 1 to 5 of the question conducting satisfaction;

- Circling number of ordinal number of answers to questions having multiple choice;

- Other opinion questions: patients, mothers and health workers answer information with unlimited length.

3. PATIENT SATISFACTION SURVEYS CONDUCTED BY HOSPITALS

3.1. General objective

Identifying issues with which patients are not satisfied when they are examined and treated at hospitals to improve quality, gradually serve patients better, and response to patient’s satisfaction and expectations.

3.2. Requirements

1. Ensuring scientificity, objectivity, and honesty when conducting surveys.

2. Identifying issues that patients are not satisfied with.

3. Comparing the level of satisfaction between different patient objects treated at different departments.

4. Using survey results to improve hospital quality.

5. Continuously monitoring patient satisfaction to continuously improve quality.

3.3. The survey method is conducted themselves by hospitals

3.3.1. Survey design: Cross-sectional survey.

3.3.2. Survey cycle:  at least once every 3 months.

3.3.3. Survey time:  Depending on the size of the hospital, the survey team shall choose the survey time as follows:

- During 1 or 2 days a week (except Saturday and Sunday).

- In 1 week, 2 weeks or in 1 month (until full survey sample size upon request).

- During 1 week, 2 weeks or 1 month (until the survey has the required sample size).

3.3.4. Sample size

3.3.4.1. For inpatients/mothers surveys:

1. For hospitals with more than 3,000 inpatients/mothers/day, apply the formula for calculating cross-sectional sample size, with a minimum of 300 people per survey.

2. For hospitals with inpatients/mothers from 1,000 to 2,999 visits/day, apply the formula for calculating cross-sectional sample size, with a minimum of 200 people per survey.

3. For hospitals with less than 1,000 inpatients/mothers/day, each survey should include at least 100 people.

4. For hospitals with less than 100 inpatients/mothers/month, all inpatients/mothers shall be surveyed within 1 month.

5. The sample size and sampling method of the survey of mothers giving birth at obstetric hospitals (or the obstetrics department of the general hospital) are similar to the survey of inpatients.

6. The mother giving birth at the hospital can be interviewed in both forms 4 and 5 or one form, depending on the mother's health condition and willingness to cooperate.

The mother giving birth at the hospital shall be interviewed for both forms No. 4 and 5 or one form, depending on the mother's health condition and willing cooperation.

3.3.4.2. For surveys of people going for medical examination and outpatients (hereinafter referred to as outpatients)

The selection of the sample of outpatients is based on the average number of outpatients visited per day.

1. For hospitals with more than 5,000 visits per day: surveying at least 300 outpatients for 1 survey period.

2. For hospitals with from 500 to 4999 visits per day: surveying at least 200 outpatients for 1 survey period.

3. For hospitals with from 100 to 499 visits per day: surveying at least 100 outpatients for 1 survey period.

4. For hospitals with less than 100 visits per day: surveying all outpatients on 2 days of the week (except Saturday and Sunday).

3.3.5. Sampling methods

3.3.5.1. For inpatient surveys:

To ensure randomness and representation, and at the same time to help the hospital to identify the dissatisfaction of patients, sampling methods are conducted as follows:

1. For hospitals with over 1,000 inpatients/day:

Each survey shall select at least 3 clinical departments, including 1 department with high bed-occupancy,1 department with medium bed-occupancy and 1 department with low bed-occupancy. Subsequent surveys will select other departments in turn. If the hospital has a service or treatment department on request, it will also be selected for survey like other treatment departments.

In each department, selecting patients according to the following method:

Getting a list of patients being treated (by software or by number). Each survey selects respectively 1 or more letters from A, B, C, etc. to X, Y.

Selecting the patient's name according to the first letter of the first name. In one day, the hospital can choose 1, 2, 3, etc. letters depending on the number of patients being treated, but the hospital needs to ensure that all patients having the same first letter of the first name are on the list. For example, the assurance of all patients named Ha, Hanh, Han, Hoan, Huong, Huy, Hoan, Hoa, Hung, Hoang, etc are included in the list for 1 day when conducting the survey and selecting the letter H

From the established list, patients who are to be discharged from the hospital patients for interviews are selectd; excluding patients who cannot answer or those who are hospitalized and do not have enough information to answer.

Conducting a survey to satisfy the required number of patients (300 or 200).

2. For hospitals with less than 1,000 inpatients/day, select a similar sample for enough 100 patients.

3. For hospitals with less than 100 inpatients/month, select a sample to survey all inpatients within 1 month or until there will be enough 100 forms, whichever comes first.

Requirements:

The hospital shall need to have a book or software to monitor the satisfaction survey. Such a book or software includes information such as planning, time to conduct the survey, name of the department selected to survey and names of letters selected in each round, assigning people to conduct, etc. Letter names are selected for survey respectively from A, B, C, etc. to X, Y.

After completing each survey, the hospital shall need to record information related to the survey, such as selected letters, the actual number of surveyors, and any arsing difficulties and problems, etc.

Selecting a sample based on the first letter of the patient's first name is a very important task. Hospitals shall need to comply with conducting uniformly nationwide with the sampling method to ensure randomness and science.

3.3.5.2. For outpatient survey:

According to the ability, resources, facilities, arranging medical examination departments and the actual situation of patients coming for examination, the hospital shall build its plan of the sampling method to be most appropriate and optimal within the hospital's capabilities and conditions (For example, the number of round surveys can be divided into several days of the week and several weeks of the year). However, all sampling plans shall need to ensure two important principles:

1. Ensuring random samples.

2. Ensuring collected information is objective and honest.

To select a random sample, the hospital shall randomly select patients according to numbers of medical registration forms according to the average number of examinations per day to select the appropriate k coefficient.

For example, the hospital shall examine 1,000 times/day, the number of forms for survey in one day is 100, so the coefficient k = 10. The survey team shall select a sample of 10 people apart, taking all patients with the number ending in 1, for example 11, 21, 31, 41, etc.

In the case of a hospital with 1,000 examinations/day but limited survey workers, only 20 outpatient forms shall be surveyed each day, the coefficient k is 50. In this case, for every 50 people, choosing one person, the selected examination numbers are 0050, 0100, 0150, 350, 500, etc.

The choice of the k coefficient shall be decided by the hospital, but it is necessary to ensure that the number of outpatients is representative of those who registered for examination at the beginning of the day and those who registered for examination at the end of the day. There shall be a difference between the satisfaction level of those who register early compared to those who register late.

Hospitals shall develop their sampling plans, but shall need to ensure randomness and representation when selecting surveyors. Hospitals can need to have written regulations if they have a separate sampling plan that differs from this Guideline.

If the person going for medical examination fills out the form themselves, the hospital shall issue the form to the patient at the same time as the medical examination number is issued. Before leaving the hospital, the patient shall return the form to the investigator or put it in the form box for comments.

If the hospital conducts a direct interview with the patient, the interview shall be done after the patient receives medicine at the pharmacy. In case the patient does not buy medicine, the interview shall be conducted after the patient completes the entire medical examination process and before leaving.

3.3.6. Investigators, surveyors

Human resources conducting the satisfaction survey include the following subjects:

1. Workers of the quality management department and members of the Quality Management network (note: those shall avoid wearing medical attire or name badges during the interview);

2. Workers of the customer care and social work department;

3. Professional investigators and surveyors are contracted with the hospital;

4. Students of medical and pharmaceutical universities and colleges;

5. Volunteers;

6. Patients shall fill out the form by themselves (after receiving detailed instructions).

4. PATIENT SATISFACTION SURVEY CONDUCTED BY A TEAM OF MANAGEMENT AGENCY

4.1. Survey design:  Cross-sectional study.

4.2. Survey cycle at least once a year during the year-end hospital inspection and evaluation (and mid-year if conducted by the management agency).

4.3. Survey time:  According to the size of the hospital, the actual situation and the consideration and decision of the head of the inspection and evaluation team; the patient satisfaction survey team shall select the survey time as follows:

1. Differ from the time when the inspection and evaluation team arrives at the hospital (for example, surveying before 1, 2, 3 days or 1 or 2 weeks, or appointing an independent surveyor of the team inspecting and evaluating hospital quality and providing results to the team).

2. At the same time when the inspection and evaluation team arrives at the hospital.

Notes: Teams shall prioritize choosing method 1 to conduct the survey.

4.4. Sample size:

4.4.1. For inpatient survey:

1. For hospitals with more than 30 inpatients/day, the survey shall be conducted at least 30 inpatients.

2. For hospitals with less than 30 inpatients/day, the survey shall be conducted for all inpatients who have been treated for 3 days or more.

4.4.2. For outpatient survey:

Surveying at least 30 outpatients.

Notes: In case the evaluation team has difficulties, limitations in time, human resources, and interviewing skills lead to the inability to collect 30 patients; teams shall reduce the number of inpatients and outpatients who need to be surveyed. The head and secretary of team shall be responsible for deciding on the number of patients but not less than 10 inpatients and 10 outpatients and must clearly state the reason for not collecting 30 forms in minutes and reports.

4.5. Sampling methods

4.5.1. For inpatient survey:

With the goal of ensuring randomness and representation, and at the same time helping the hospital to identify patients’ dissatisfaction, the sampling method is conducted as follows:

1. For hospitals with over 1,000 inpatients/day:

Selecting at least 3 clinical departments, including 1 department with high bed-occupancy,1 department with medium bed-occupancy and 1 department with low bed-occupancy.

In each department, selecting the patients according to the following method:

- To get a list of patients (by a software or book).

- To select the patient's name according to the first letter of the first name. In one day, the hospital can choose 1, 2, 3, etc. letters depending on the number of patients being treated, but the hospital needs to ensure that all patients having the same first letter of the first name are on the list. For example, the assurance of all patients named Ha, Hanh, Han, Hoan, Huy, Huong, Hoa, Hung, Hoang, etc. are included in the list for 1 day when conducting the survey and selecting the letter H

- In the established list, patients who are to be discharged from the hospital patients are selected for interview; excluding patients who cannot answer or those who are hospitalized and do not have enough information to answer.

- To conduct a survey for enough 30 patients, each department shall survey 10 inpatients. If the number of patients in three selected departments is not enough 30 people, other departments shall be selected continuously to satisfy the minimum sample size of 30 people.

2. For hospitals with less than 1,000 inpatients/day, select similar samples in different departments to have 30 patients.

3. For hospitals with less than 30 inpatients/day, select a sample of all inpatients preparing to be discharged.

4.5.2. For outpatient survey:

Depending on the actual situation and the team's human resources, the survey team shall select outpatients according to the plan of the number of medical registration forms or letter names as the sampling method conducted itself by the hospital. Sampling shall need to ensure the principle of selecting numbers or names of people going for medical examination (based on medical registration number) before meeting the person to be surveyed. The team shall need to select 30 people and reserve at least 10 more people. Investigators shall need to avoid going straight to the examination area and seeing which patients "seem" to be cooperating well or "seem" to have a lot of "frustration" to interview. This will affect the results and make judgments inconsistent with reality.

5. ANALYSIS OF DATA OF SATISFACTION SURVEYS

5.1. Calculating satisfaction scores (generally applicable to survey subjects)

- The patient's response options from 1 to 5 in satisfaction survey questions are scored from 1 to 5, respectively.

- The overall average satisfaction score is equal to the average score of all survey forms (compared to the maximum score of 5).

- Formula to calculate the overall average satisfaction score:

Numerator = [(Total score of all satisfaction survey questions of the first person) / (Total number of questions)] + [(Total score of all satisfaction survey questions of the second person) / (Total number of questions)] + [(Total score of all satisfaction survey questions of the nth person) / (Total number of questions)].

Denominator = Total number of people surveyed.

- The average score of each aspect is the average score of questions belonging to each aspect of all survey forms (compared to the maximum score of 5).

5.2. Calculating satisfaction rate (generally applicable to survey subjects)

- Calculating overall satisfaction rate (maximum 100%):

+ Numerator = {[(Total number of questions having answeres at level 4 + Total number of questions having answeres at level 5 of the first person) / (Total number of questions)] + [(Total number of questions having answeres at level 4 + Total number of questions having answeres at level 5 of the second person) / (Total number of questions)] + [(Total number of questions having answeres at level 4 + Total number of questions having answeres at level 5 of the nth person) / ( Total number of questions)]} x 100.

Denominator = Total number of people surveyed.

- Satisfaction rate for each aspect: applying the same calculation method.

5.3. Overall satisfaction indicator

Calculating the comprehensive satisfaction indicator:

+ Numerator = {(The first person has all satisfactory answers at level 4 or 5) + (The second person has all satisfactory answers at level 4 or 5) + (The nth person has all satisfactory answers at 4 or 5)} x 100

(The numerator excludes those who answered any of questions in levels 1, 2, 3);

+ Denominator = Total number of people surveyed.

5.4. Response rate compared to expectations

Response rate compared to expectations is calculated by the overall average rate of all surveyed subjects. Hospitals shall calculate other indicators developed and regulated by the hospital.

6. ENTERING DATA, WRITING REPORTS AND PUBLISHING RESULTS

6.1. Entering data

Hospitals and evaluation teams shall select from the following methods:

1. Interviewing and filling out information on paper forms, then entering data into the computer by using the office software (such as excel, data), then analyzing data.

2. Interviewing and filling out information in the online software by using phones, tablets, or desktop computers. The software shall automatically analyze and extract results for hospitals and evaluation teams as required.

6.2. Hospitals writing reports

The hospital shall extract results on online software, extract data and analyze other aspects in more depth (if someone analyzes the data). The hospital shall compare satisfaction rates and patient feedback between clinical departments, then write reports. The report shall have the identification of main issues making patients unsatisfied, and the appendix with detailed comments and suggestions from patients. According to the findings from the survey, the hospital shall create the list of prioritized issues that need to improve quality.

6.3. Inspection and evaluation teams writing reports

After conducting the survey, the worker who shall be assigned to conduct the survey shall enter data and extract results on the online software.

The result of the survey team's patient satisfaction survey shall need to be compared with the result of the hospital's survey.

The result of the survey team's patient satisfaction survey shall be published along with the evaluation result according to the set of criteria for hospital quality.

If the result of the satisfaction rate survey is very high and inconsistent with the quality evaluation results: the evaluation team shall not publish the result of the satisfaction indicator, only need to publish the patients' opinions and notable findings in the survey. The team shall need to learn from experience and review whether the survey method and process were conducted objectively, honestly, scientifically, etc. according to guidance. For example, if the team only surveys satisfaction on the day when the team comes to inspect and evaluate the hospital quality, the satisfaction rate shall be inaccurate due to the influence of many causes and impacts.

Note: the comprehensive satisfaction indicator shall be the indicator that has been included in satisfaction survey activities of the Ministry of Health since 2019 according to this Decision to monitor quality improvement. Hospitals and survey teams of management agencies shall be not required to publish the results of the comprehensive satisfaction indicator.

7. HEALTH WORKER SATISFACTION SURVEYS

7.1. The hospital conducting its health worker satisfaction survey

The hospital shall conduct the health worker satisfaction survey based on scientific, objective, honest principles, not writing the name of the respondent, ensuring confidentiality of information.

The hospital shall conduct itself the survey in the form of sampling all leaders, managers, and workers of the hospital or conduct the survey with each department respectively.

Surveying and filling out forms are conducted by entering data directly on the online software or filling out itself forms on papers. The unit assigned to conduct the survey used the form box for health workers to fill out and put in the form box.

The collection of survey forms shall be conducted at least once a year, each survey shall extend from 1 to 3 days to 2 weeks.

The methods of analyzing and writing reports on health worker satisfaction shall be conducted similarly to guidance for patient satisfaction surveys.

The department being in charge of the survey shall extract results on the online software or add other data analysis methods.

Notes:

The department assigned to conduct the health worker satisfaction survey shall be responsible for ensuring that 100% of the interviewee's information shall be kept confidential, even in cases where the Board of directors requests relevant information to find the interviewee.

If a hospital conducts a "health worker satisfaction survey" in the situation that health workers and leaders of departments fear of revealing confidentiality of information and possibly being reprimanded for responding to unsatisfactory opinions, the department assigned to conduct the health worker satisfaction survey shall not need to conduct the survey, but the reason must be clearly stated: "the survey can not be done because the hospital lost internal democracy".

7.2. The evaluation team conducting the health worker satisfaction survey

The evaluation team of the management agency shall inspect the conduct of the “health worker satisfaction survey” conducted by the hospital during the year on the online software and examine books, minutes, reports, etc about the worker satisfaction survey conducted by the hospital.

The team’s survey shall be conducted as follows:

- Randomly selecting health workers representing departments/rooms:

+ Selecting departments with many sources of revenue, departments with few sources of revenue, departments with many patients and departments with few patients, departments with patients being treated and departments/rooms with indirect or no patients;

+ Selecting health workers with representatives of doctors, pharmacists, nurses, technicians, and management positions;

- Selecting a survey sample size of at least 30 people.

The team shall conduct the survey according to the following 3 methods: (members of the team shall select the appropriate method):

1. Guiding health workers to fill out the online software by themselves (pre-login with the authority’s survey account);

2. Distributing paper forms for health workers to fill out, setting a time, and collecting forms;

3. Interviewing health workers directly in a separate space and location without other health workers attending the interview, then entering data on the online software.

Notes:

The management agency's evaluation team conducting the health worker satisfaction survey shall be responsible for ensuring that 100% of the interviewee's information shall be kept confidential, even in cases where the Board of directors requests relevant information to find the interviewee.

If the evaluation team does not have enough skills and expertise to conduct objectively, democratically, and scientifically the health worker satisfaction survey and have a risk of not being able to keep the confidentiality of information of health workers, the team shall not conduct surveys and clearly record them in minutes of inspection and evaluation of hospital quality.

8. THE SATISFACTION SURVEY ACCOUNT

8.1. Department of Health and Health ministries, branches

All Departments of Health shall be provided with login names and passwords for the satisfaction survey conducted by the management agency.

The account of the Department of Health shall view surveys of all affiliated hospitals but can not change the information.

8.2. Hospitals

Each hospital shall be provided with a hospital code to enter the form, and also provided with a login name and password.

For newly established hospitals, the Department of Health shall fill out the hospital's information according to the registration form and send it to the Department of Medical Services Administration in writing or by email at: [email protected].

The hospital shall automatically enter information according to the registration form to request a satisfaction survey account on the online software.

If hospitals change information, for example changing the hospital name, scale, and focal point, hospitals themselves update their information on the online software.

Notes:

During the conduct of the patient and health worker satisfaction survey, if the hospital or the quality inspection and evaluation team of the hospital encounters difficulties or problems, such hospital or team shall contact the Department of Medical Services Administration, Department of Quality Management and Line Direction for answers.

9. APPLICATION FORM FOR SATISFACTION SURVEY ACCOUNT

9.1. Details of the Department of Health

1. Name of Department of Health:

2. Full name of person filling out the Department’s information:

3. Position:

4. Phone number:

5. Email address to send the account:

9.2. Details of the hospital

1. Name of the hospital (clearly and fully stating hospital, institute or medical center):

2. Hospital code issued by the Ministry of Health/Department of Health to conduct medical examination and treatment under health insurance:

3. Level:

4. Rank:

5. Type of hospital* (selecting from 1 to 9 according to guidance below)

6. Number of beds according to the assigned or approved plan:

7. Actual number of beds (according to the hospital's statistical data before the application date):

8. Total number of health workers in the hospital (according to the hospital's statistical data before the application date):

9. Total number of doctors in the entire hospital (including regular, specialized and postgraduate doctors):

10. Total number of nurses and midwives in the entire hospital (including post-secondary school, college and university):

11. Average number of medical examinations per day (averaged in 1 month before registration):

12. Average number of inpatients per day (averaged in 1 month before registration):

13. Full name of person filling out the hospital’s information:

14. Position:

15. Phone number:

16. Hospital’s email address (shared or personal email assigned):

* Type of hospital, filling out numbers from 1 to 9 according to the following content:

1. Public hospitals covering their current expenditures and investment expenditures;

2. Public hospitals covering their current expenditures;

3. Public hospitals covering part of their current expenditures;

4. Public hospitals’ current expenditures covered by the State;

5. Private hospitals having domestic owners;

6. Private hospitals having foreign owners;

7. Private, joint-venture, and affiliated hospitals in domestic and foreign;

8. Other types, clearly stating;

9. Public hospitals assigned full autonomy.

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