Quality of Service Evaluation and Supplier Performance Control
The basics of the system for assessing the quality of a service and monitoring its delivery are usually laid at the planning and design stage of the service model. Due to this at the stage of the practical operation of the model, regular monitoring of the efficiency of the service is provided and, if necessary, revision of the components of the model. Tracking of the control results allows to identify the most effective forms, means and methods of rendering services, to detect possible drawbacks of models and make necessary adjustments.
Let's consider separate models of rehabilitation of invalids. In the UK, for example, the model of rehabilitation of disabled adults with visual impairments is used. This model is based on the social concept of disability and the above principles of comprehensive rehabilitation. Particular attention in the framework of this model is paid to the assessment of individual needs and the formation on its basis of a clear integrated (interdisciplinary) rehabilitation program.
Loss of vision is one of the most common causes of disability. Today this form of disability affects more than 2 million people in the UK. With the problem of disturbing the functions of vision in one or another segment of one's life, one in seven Britons will face to some extent.
For most people, a partial or total loss of vision is tantamount to the end of the world, and the notion of new life realities becomes a difficult test. However, the distinctive feature of this form of disability lies in the fact that people with visual impairment most often do not need long-term inpatient treatment or care in institutions of permanent residence. The British experience shows that, provided that they receive consultations, support and training provided by local outpatient services, these people successfully adapt to the restrictions and continue to lead a full life in the conditions of their own family and the local community.
It should be noted that the methodology for the rehabilitation of adults with visual impairments is fundamentally different from the methodology for the rehabilitation of blind and visually impaired children. In the second case, the strategy of early rehabilitation intervention assumes a key role in the planning of rehabilitation services.
Disability determination procedure
The process of registration of a disability for a person suffering from a particular form of visual disturbances begins with a visit to a local therapist who conducts primary diagnosis and decides whether to send the patient to the ophthalmologist - to a hospital or a specialized clinic. The degree of visual impairment is established by an ophthalmologist-consultant who, after carrying out the diagnosis, issues an opinion on the presence of visual pathology. This conclusion confirms the fact of an official statement on the national registration records. At the request of the client, a copy of the report can be sent to the local department of social services, after which a specialist of the department for sensory violations contacts the client and finds out if the client needs to provide services. The registration is carried out voluntarily; This procedure allows the client to access a wider range of services and is an important source of statistics for local authorities and central government.
A client who is not on the national registration record also reserves the right to receive services from local social services.
In this case, the client needs to receive a referral from the doctor or independently contact the social services with a request for services.
Interesting, in our opinion, are the technologies of using ergotherapy (occupational therapy) in Japan.
Ergotherapy - is a kind of therapeutic effect in which labor is seen as the main factor contributing to the health and well-being of a person. "Labor cures and restores strength", - this is the main concept of ergotherapy. The interpretation of the concept of "labor" applied to this therapeutic method will be given below.The main goal of ergotherapy is to make a person as independent as possible in everyday life, active in social life and as dependent as possible on the help of others. "Encouragement of any manifestations of activity", -the second "whale", on which stands ergotherapy.
To achieve positive results, the ergotherapist motivates the patient to perform various functions that somehow contribute to the socialization of the person, help him to change his life for the better on his own. Socialization - the third of the most important aspects of ergotherapy.
Ergot therapists have repeatedly investigated the true needs of their clients. In modern ergotherapy, it is customary to consider the concept of "Labor as a Means of Self-Realization" as a combination of three aspects. The first aspect is the development and consolidation of the client's self-service skills. In other words, the task of the ergotherapist is to make the client fully or partially independent in everyday life and independent of the help of others. The second aspect is socialization. This term means self-realization of the client through active interaction with others: gaming, studying, housekeeping, professional activity, volunteer work. The third aspect is the organization of leisure, namely: active and passive types of recreation, communication and interaction with the outside world. Leisure is seen as the most important factor contributing to the most complete self-realization of a person.
Consider the functions of ergotherapy depending on the stage of the disease.
Acute illness. In this case, the task of the ergotherapist is to engage the patient with an active activity that contributes to the improvement of his physical and mental state. The ergotherapist helps the patient to independently control his condition, be hardy and resistant to stress, actively interact with the outside world.
The stage of recovery. This is a stage directly related to the intensive rehabilitation process. At this stage, the patient is assisted by a team of specialists of various profiles, depending on the needs and requirements of each individual person. In this case, the leading role is played by a social worker with a medical education: he helps a person who recently returned from a hospital to adapt to domestic conditions. In the field of rehabilitation, physiotherapists, speech rehabilitation specialists and ergotherapists are engaged. The team of specialists periodically meets at a consultation to discuss the dynamics of the state of health of a particular inpatient. When a person is discharged from the hospital, the doctor contacts the clinic where the patient is now going to be observed and transmits the following documents (with the patient's permission): the results of treatment and rehabilitation, a list of recommended preventive measures, a forecast of possible problems and difficulties.
The recovery phase. At this stage, the activation of the patient's physical and intellectual activity as a way of constructive interaction with the outside world plays a key role.
As our country is faced with the problem of the "aging population", advocacy and support of active lifestyles in old age is the main direction of state social policy.
In 2008, the Japan Association of Occupational Therapists developed a plan called 5 + 5 & quot ;. The goal of this plan is to make sure that the number of members of the association working in medical institutions and the number of members of the association working in social institutions is equal to 50% of doctors and 50% of specialists in the social sphere within five years. The planned timeframe for the plan is already close, but the "preponderance" is still evident. towards doctors: at the moment 72.3% of the members of the association work in medical institutions. Nevertheless, more than 13 500 professionals who do not have a direct relationship to medicine, work in the health and social care of children and adults with disabilities.
Diseases with which ergotherapy works. The task of the ergotherapist is not to cure a specific disease, but to eliminate the negative impact of this disease on the patient's physical and mental health, although among non-professionals it is traditionally common to identify the concepts "disease" and "psychosomatic consequences of the disease." Thus, ergotherapy works with three groups of disorders: physiological, mental and physical and intellectual development disorders. As for physiological disorders, most ergotherapists work with disorders in the central nervous system. First of all, these are diseases such as stroke and Parkinson's disease. Among the mental disorders the central place is occupied by schizophrenia and Alzheimer's disease. Physical and mental disabilities - are usually cerebral palsy or Down's disease.
Regional system of medical partnership. This system was developed by the Japanese Council for the rehabilitation of citizens who suffered a stroke. Since 1985, stroke ranks third in Japan in the list of the most dangerous diseases: this disease accounts for about 10% of all deaths. The first place in this list is cancer, the second - cardiovascular pathology. The federal and regional government pays much attention to the prevention of stroke and the rehabilitation of sick people. Thus, the regional system of medical partnership is of national importance.
When the patient is discharged from the hospital, doctors, nurses and other specialists involved in rehabilitation activities in one way or another make up a plan for recommended medical care and a schedule of preventive examinations, and then send these documents to the clinic where the particular patient will be observed after discharge. Such a system guarantees the process of continuous intensive rehabilitation, as well as the high quality of social and medical services offered to the patient. Taking into account the importance of this approach, the Government of Japan tries to provide medical institutions with qualified specialists of various profiles, and also partially pays for the costs of treatment for stroke.
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