Propuesta de mejora en la prestación de servicios, para el sistema de referencia y contrarreferencia en una IPS, basado en la NTC-ISO 9001: 2015

Abstract

The lack of articulation, addressing and structuring of a quality management system for the reference and counter-referral process can generate a negative impact on the cycle of user care and financial sustainability, the reference and counter-reference systems present difficulties such as Timely communication between collaborators of the same institution, between the IPS (Health Provider Institution) and the EPS (Health Promoting Company), failures with who issues the information and who receives, since there are no established parameters or criteria, reason why It becomes a risk for the health care of the entire population that presents a need. The opportunity is one of the aspects that influences the cycle of user care, this can be presented as a positive and negative factor, it all depends on the response times issued by the IPS where the patient is commented for possible acceptance, being the negative factor that can generate complications for health and that can become a mortality.

According to zurita (2014), it is necessary to optimize the Reference - Counter-reference system to contribute to the improvement of the users' health care. The main barrier that is presented for the previous compliance is the ignorance of the reference and counter-referral system the IPS-S of first and second level of health care, in which patients comment and send without justification or relevance for the level or service required .

The institutions that provide health services must have a structured reference and counter-referral system, which must respond to internal and external needs in accordance with current regulations that allow access, opportunity, relevance and comprehensiveness throughout the care cycle. of the user and his family, achieving a global satisfaction of the service delivery process. According to Ramírez and Guzmán (2012), the satisfaction of users and EPS-S is relatively low, since there is no mechanism that guarantees continuity in the reference and counter-reference processes, which can contribute to the effectiveness of the health service delivery network, which can provide timely, diligent and relevant response to the user's needs. Eliminate in these ways the most frequent barriers in the reference and counter-reference processes. The purpose of this research is to generate a proposal for a reference and counter-reference system within the framework of the requirements set forth in NTC ISO 9001: 2015. It begins with an analysis of each of the numerals of the standard if applicable to the process of reference and counter-reference. In the numbers that apply, the supports are described or the process for compliance with it, it must be based or justified if it applies or does not apply and finally a time in hours is assigned in each of the numbers that apply.