THE INTERNAL RULES OF PROCEDURE
OF UAB “FORMA PERFECTA”
No 2 of 12 March 2019
1. GENERAL PROVISIONS
1.1 The Internal Rules of Procedure (hereinafter referred to as the “Rules”) of UAB “Forma perfecta” (hereinafter referred to as the “Clinic”) define the general norms of behaviour of employees, patients, and visitors of the Clinic.
1.2 In its activities, the Clinic follows applicable laws of the Republic of Lithuania, resolutions of the Government of the Republic of Lithuania, and regulatory documents of the Ministry of Health and the National Health Insurance Fund, national and international standards of medical activities approved by the Articles of Association of the Clinic. The Clinic cooperates with other health care and medical training institutions.
1.3 These Rules must be followed by all employees, patients, and visitors of the Clinic.
1.4 The Rules may be supplemented, revised or amended if necessary.
1.5 Any violation of the applicable Rules, depending on the nature of the violation, may be subject to disciplinary or other measures in accordance with applicable laws of the Republic of Lithuania.
1.6 The premises and territory of the Clinic, marked with special marks, are monitored via video cameras.
1.7 The following behaviour is forbidden in the Clinic:
2. PROCEDURE FOR THE PATIENTS ADMISSION TO THE HEALTH INSTITUTION
2.1.1 The Clinic provides in-patient and out-patient health care services. An identity document is required upon arrival.
2.2 Patients are admitted to the Clinic:
2.2.1 With the referral of a family physician – in a planned manner, if required for the surgery reimbursement from funds of the Territorial National Health Insurance Fund (if the company has an agreement with the Territorial National Health Insurance Fund);
2.2.2 With the referral of other physicians, specialists – in urgent or planned manner;
2.2.3 Insured patients without any referral in urgent manner while providing emergency first aid;
2.2.4 When admitting the patients for the emergency medical aid, the description of the procedure and the scope of provisioning emergency medical aid provided for by the Law of the Ministry of Health of the Republic of Lithuania (Revision of 01/07/2018, No V-598) shall be followed;
2.2.5 Patients without any referral are admitted in accordance with the general procedure and shall pay the prices set by the Clinic;
2.2.6 Paid services are provided to the patients in accordance with the order and at the prices specified by the Director of the Clinic, which may vary according to the Clinic Marketing Policy. The prices are published on the official website www.ficlinica.lt;
2.2.7 Upon writing an application on a website or a Facebook profile;
2.2.8 Upon calling by telephone.
2.3 Application for consultation / procedures / surgeries:
2.3.1 The following ways of registration to medical consultation / procedures / surgeries are available:
Opening hours, contact details, and other data of the Clinic are published on the official website.
2.4 Patients who arrived for medical consultation / procedures / operations shall apply to the reception and fill in mandatory forms upon delivering their identity documents, unless they apply for emergency medical aid without any referral:
2.4.1 Must be acquainted with the Internal Rules of Procedure of the Clinic upon the acknowledgement of receipt and other documents set by the Clinic and fulfil the obligations specified therein;
2.4.2 Provide the specialists of the Clinic with maximum information on their health, diseases, surgeries, drugs that were used and are being used, allergy reactions, genetic inheritance, and other data known for the patients which is necessary for the adequate provision of health care services;
2.4.3 Upon the receipt of the information about the health care services prescribed to them, the patients must confirm their consent or refusal to accept such health care services in writing;
2.4.4 Follow prescriptions and recommendations of medical specialists or refuse health care services prescribed to them. The patients must notify the medical specialists about any deviations from the prescriptions or the regimen prescribed to them for which they have confirmed their consent;
2.4.5 Respectfully and properly treat all employees and other patients of the Clinic, fail to discriminate and defame the employees, other patients, or visitors of the Clinic with their actions, and respect their rights;
2.4.6 It is forbidden to admit a minor or an incapable person to the Clinic without the consent of their legal representatives (except for cases of emergency medical aid provided for by laws);
2.4.7 The administrators must report on patients who have suffered from violence, were poisoned or are suffering from infectious diseases to relevant authorities in accordance with legislation regulating thereof;
2.4.8 Medical aid to foreign citizens is provided in accordance with the procedure established by the Ministry of Health of the Republic of Lithuania;
2.4.9 Without referral may be hospitalized only patients whose health condition complies with the statutory indications for hospitalization in accordance with the relevant legislation.
3. RIGHTS AND OBLIGATIONS OF THE PATIENTS IN THE INSTITUTION
3.1 Right to information.
3.2 Right not to know.
3.3 Right to access their medical records.
3.4 Right to the immunity of private life.
3.5 Right to the indemnification of damage.
3.6 Right to complain.
3.7 Right to refuse surgery and treatment.
3.8 Right to obtain qualified medical aid within the scope of services provided by the Clinic.
3.9 Right to non-defaming conditions and respectful behaviour of healthcare specialists. The patients shall be given science-based pain relievers to remove suffering caused by their health disorder.
3.10 Right to obtain the information in accordance with legislation of the Republic of Lithuania regulating thereof.
3.11 Right to identify persons to whom confidential information about the presence of the patients in the health care institution, their treatment, health condition, diagnosis, prognosis and treatment, as well as any other personal information can (cannot) be provided.
3.12 The right to exercise other rights of the patients provided for in the legislation of the Republic of Lithuania regulating thereof.
3.13 Obligations of the patients:
3.13.1 The provision of health care services may be terminated for the patients who breach their obligations, thereby endangering their and other patients’ health and life, or hindering them from obtaining quality health care services, unless this endangers the patients’ life;
3.13.2 Carefully handle equipment and inventory of the Clinic. Not damage the inventory and other material assets of the Clinic;
3.13.3 Timely and completely pay for consultations and treatment according to the applicable prices.
3.13.4 Make advance payment for treatment-surgery:
220.127.116.11 EUR 500 when the surgery price is higher than EUR 1,000;
18.104.22.168 50% of the surgery price when the price is lower than EUR 1,000;
22.214.171.124 The advance payment for the surgery shall be made in cash, by card or by bank transfer no later than within two weeks after the date of scheduling the surgery. If the term of the service scheduled is shorter than two weeks, the advance payment shall be made within 3 days;
126.96.36.199 If the patients, who have made the advance payment, notify of their non-arrival more than 1 week before the date of the surgery, 50% of the advance payment shall be repaid;
188.8.131.52 If the patients notify of their non-arrival less than 1 week before the date of the surgery, the advance payment shall not repaid;
184.108.40.206 If the patients are unable to arrive for the surgery scheduled in case of force majeure circumstances, the question of advance payment is settled by mutual agreement of the parties. The patients shall fill the request to repay the advance payment stating the reason and provide the documents proving thereof.
3.13.5 Follow instructions of the treating physician and the nursing staff and stick to the prescribed individual patient care regimen.
3.13.6 Walk only in the territory of the Clinic.
3.13.7 The patients treated in the Clinic are prohibited:
220.127.116.11 bring large sums of money, jewellery, and other valuable items to the Clinic, because the staff of the Clinic is not responsible for their safety;
18.104.22.168 independently leave the territory of the Clinic;
22.214.171.124 independently visit other units of the Clinic;
126.96.36.199 smoke and play cards or other gambling games;
188.8.131.52 store and drink alcohol beverages and use drugs;
184.108.40.206 use radio sets, other music players or television sets, if other ward patients oppose it;
220.127.116.11 make noise;
18.104.22.168 the patients must indemnify the damage caused to the Clinic according to the procedure prescribed by law of the Republic of Lithuania; damage or loss of the hospital inventory caused by patients under 18 years of age shall be indemnified by their the legal representatives;
22.214.171.124 must take care of their health, exercise their rights fairly, not abuse them, cooperate with specialists and employees of the Clinic.
4. PROCEDURE FOR VISITING, DISCHARGING, AND TRANSFERRING TO OTHER HEALTH CARE INSTITUTIONS
4.1. Patients can be visited every day from 10 a.m. to 6 p.m.
4.2. The visitors must treat all employees and other patients of the Clinic with respect and dignity, fail to discriminate or defame the employees, other patients, or visitors of the Clinic with their actions, respect their rights, and not interfere the staff of the Clinic in work. Visitors who do not comply with these requirements may be expelled from the Clinic.
4.3.Patients are discharged from the Clinic:
4.3.1. after finishing their treatment and examination plan;
4.3.2. to continue out-patient treatment;
4.3.3. when they are referred to the rehabilitation unit;
4.3.4. when they are transferred to other medical institutions;
4.3.5. for gross violations of the Internal Rules of Procedure of the Clinic.
4.4. When the patients are discharged from the Clinic, all documents necessary in particular case (epicrisises, referrals, sickness certificates, etc.) are prepared and given to them.
4.5. Patients, whose medical condition requires additional treatment in the opinion of the physician, may be referred to other health care institutions after the discharging.
4.6. The Clinic is not responsible for the decisions and quality of treatment of other personal health care physicians.
4.7. Leave the outerwear in the cloakroom.
4.8. Not disturb the patients’ rest (take attention to the patients’ regimen and avoid visiting the Clinic with small children).
4.9. It is recommended that no more than two visitors would be present at the same time.
4.10. It is forbidden to bring food to the patients.
4.11. Visitors must leave the ward during the visitation of physicians and procedures of the patients.
5. PROCEDURE FOR THE SUBMISSION OF INFORMATION TO THE PATIENTS AND THEIR RELATIVES ABOUT THEIR HEALTH CONDITION
5.1. Information is submitted in accordance with legislation regulating thereof.
5.2. Information about the condition of the patients being treated can be submitted by treating physicians, physicians on duty and a director.
5.3. Representatives acting on behalf of the patients must submit a document certifying their representation and their identity documents.
5.4. Information about the patients is not submitted by telephone.
6. PROCEDURE FOR GIVING OUT OR MAKING COPIES OF DISEASE HISTORY, OUT-PATIENT CARDS, AND OTHER DOCUMENTS TO THE PATIENT, OTHER NATURAL PERSONS AND LEGAL ENTITIES
6.1. Information is submitted in accordance with legislation of the Republic of Lithuania regulating thereof.
6.2. Patients, who have submitted their identity documents to the physician of the Clinic, are entitled to obtain information about their health condition, medical diagnosis, clinical or other methods of treatment or examination known to the physician, possible risks, complications, side effects, treatment prognosis, and other circumstances that may have influence on the patients’ decision to accept or refuse the proposed treatment and the consequences of refusal of the proposed treatment.
6.3. The physician must submit this information to the patients, taking into account their age and health condition, in a form understandable to them, explaining the specific medical terms.
The physician may refrain from providing this information if this would harm the patients’ health or endanger their life or when the patients refuse to obtain such information, or when medical records contain a decision of the treating physician not to provide such information.
6.4. Any access to medical records of the patients must be given at the patients’ request and upon delivering the identity documents. The patients’ representatives, who act on behalf of the patients, are also entitled to have access to medical records of the patients and obtain copies thereof; they are required to submit their identity documents and documents certifying their representation. The access to medical records of minor patients under 16 years of age must be given to their representatives.
6.5. The access to medical records of the patients may be restricted, if the information contained therein would harm the patients’ health or endanger their life. The decision to withhold the patients from obtaining their medical records is taken by the treating physician upon making such entries in the patients’ medical records.
None confidential information about the patients’ treatment, health condition, and diagnosis as well as other personal information that will become known in the course of diagnostics, treatment and nursing, training, biomedical examination, and handling statistical and archival medical records shall be disclosed without written consent of the patients, except for specific cases stated by laws.
6.6. If during their clinical treatment the patients agree to provide the information on them referred to in Clause 6.1 to other persons, including family members, the consent for the provision of confidential information, filled in and signed by the patients and the treating physician, shall be included in the disease history or out-patient card (on the first page). The consent shall include specific individuals and institutions and specific information that the persons agree to provide on themselves.
6.7. In case where persons who apply or are delivered to the Clinic have puncture, cut, gunshot, or explosion wounds, or other type of body injuries that may be related to an offense, the physicians admitting such patients shall notify the police officers in accordance with the procedure set by the Clinic.
6.8. Patients’ entitlement to obtain information about their treatment, medical records or copies thereof is established by the Republic of Lithuania Law on the Rights of Patients and Compensation of the Damage to their Health, the Republic of Lithuania Law on Mental Health Care, the Republic of Lithuania Law on Legal Protection of Personal Data, other laws and orders of the director the Clinic.
6.9. Any confidential information may be provided only having obtained written consent of the patients and their identity documents, except for the law enforcement agencies, bodies supervising health care services, or other institutions subject to laws of the Republic of Lithuania.
6.10. Health care institutions wishing to obtain information about the patients must submit to the Clinic the letter signed by the head of such institution, specifying the nature of the information wished to receive and the purpose of its use. Other institutions or establishments wishing to obtain information about the patients must submit to the Clinic the letter signed by the head of the institution or establishment and the commission, decision, or other document to be submitted in such cases in accordance with legislation regulating the work of those institutions or establishments, or the letter, signed by the head of the institution or establishment, specifying the nature of the information wished to receive and the purpose of its use, and attach the written consent and the identity document of the patients or their legal representatives.
6.11. Patients must submit their written request and identity documents when applying for any official documentation. The representatives, acting on behalf of the patients, must submit their written request, identity documents, documents certifying their representation and written consent of the patients (in cases where the consent is required).
6.12. Written information submission services and information / documentation about the patients are provided when the patients or their representatives have submitted their request for the provision of written information submission services or for the obtaining of other information / documents (extracts from in-patient treatment history or other medical records, certificates, etc.) and upon payment of the specified amount for the provision of written information submission services or for the coping of the documents in accordance with the procedure prescribed by the Clinic.
6.13. Medical records (disease histories, out-patient cards, etc.) are the property of the institution – patients and their representatives are not allowed to take it from the institution independently.
7. WORKING HOURS OF THE ADMINISTRATION OF THE INSTITUTION, OTHER ASSISTANCE SERVICES
7.1. Working hours of the administration: from Monday to Friday, from 9 a.m. to 6 p.m.
7.2. In case of objective reasons, different working hours for individual employees of the administration and other assistant services may be approved by the order of the head of the institution.
8. PROVISIONS OF LAWS, OTHER LEGISLATION, AND REGULATORY DOCUMENTS IN REGARD TO OCCUPATIONAL SAFETY
8.1.Provisions of laws, other legislation, and regulatory documents in regard to occupational safety are enforced pursuant to:
8.1.1. Republic of Lithuania Law on Safety and Health at Work No IX-1672 of 1 July 2003 (Official Gazette, 2003, No 70-3170);
8.1.2. Order No A1-171/V-500 of the Minister of Social Security and Labour and of the Minister of Health of the Republic of Lithuania of 28 May 2008 “On the Order No A1-186/V-694 of the Minister of Social Security and Labour and of the Minister of Health of the Republic of Lithuania of 27 November 2003 “On the “amendment” of the approval of exemplary provisions for occupational safety and health institutions”(Official Gazette, 2008, No 62-2363);
8.1.3. Labour Code of the Republic of Lithuania (Official Gazette, 2017, No 64-2569);
8.1.4. Legislation and instructions of the Minister of Health of the Republic of Lithuania regulating occupational safety;
8.1.5. Other occupational safety and health legislation, regulatory legal acts, and rules of occupational safety and health of the institution;
8.1.6. Occupational safety and health provisions of the institution.
8.1.7. Upon notice any abnormal operation of indoor equipment (increase of noise, vibration, or temperature; specific odour, etc.) and other reasons endangering health or life, specialists of the health care unit shall be notified immediately.
8.1.8. Avoid actions that could endanger health or life of oneself or others.
Patients are not allowed to use any medical or household equipment except for which they have received the authorization of the administration of the unit in which they are being treated and have been made aware of the procedure for its use. It is not allowed to leave the equipment without supervision, except for that which has been or can be switched on continuously.
8.1.9. Patients are prohibited from using visually technically disordered electrical equipment: open parts with electrical voltage, damaged insulation of power cords, switch, or plug. It is not allowed to fix any equipment failures independently.
8.1.10. Patients are prohibited from touching the switched-on electro-technical device, cord, socket, or plugs with wet hands and clean them with damp cloth. They are prohibited from removing the plug out of socket by pulling it out of the cord, using the socket which is inappropriate for the plug of the device or which is technically disordered (cracked, sparking).
8.1.11. Patients are prohibited from touching grounded parts (central heating radiators, pipes, etc.) and electro-technical equipment with the body at the same time, and opening electrical panels and power cabinets. The patients are not allowed to change the position of the equipment and furniture in the ward, narrow the gap between the bed and walls and between beds and so on independently.
8.1.12. Patients must take all precautions when moving on surfaces that have been recently wet-cleaned or have spilled liquids or solid substances on them, as well as when having bath or shower. The patients must wear low heel and non-slip footwear.
8.1.13. When moving through the ward or corridor at night, the patients must watch out for the obstacles and use the night lighting system (where installed). If necessary, the health care specialists must be involved.
9. PROCEDURE FOR THE REGISTRATION AND STORAGE OF JEWELLERY, PRECIOUS METALS, EXPENSIVE DENTAL PROSTHESES, AND CASH OF THE PATIENTS
9.1.Patients are advised not to bring with them larger sums of cash, expensive personal items and pieces of precious metals (hereinafter referred to as the “Valuable Items”), because the hospital staff is not responsible for their safety.
9.2. If the patients’ condition suddenly deteriorates and becomes critical, and during surgeries, interventional treatment, and diagnostic procedures, or in the event of the patients’ death, the unit staff is entitled to take for storage cash and valuable items found with the patients. All such valuable items shall be stored in the safe having filled the receipt of taking the items and valuables from the patient, signed by the chief nurse and the treating physician (during on-call time – by the physician or the general practice nurse on duty).
9.3. Saved cash and valuable items shall be returned when the patients’ condition improves. If the patients die, they are returned to their representatives. The patients’ representatives must submit their identity documents. Persons who took the patients’ items for storage sign the receipt of taking the items and valuables.
10. PROCEDURE FOR SETTLEMENT OF DISPUTES AND CONFLICTS BETWEEN THE INSTITUTION AND THE PATIENTS
10.1. Considering that their rights have been violated in the course of provisioning health care services by the Clinic, the patients are entitled to submit a complaint. Complaints shall by submitted by email email@example.com or at the reception.
10.2. A complaint may be submitted by the patients or their representatives. Only complaints that are signed by the patients, have the name and the surname, actual place of residence, and contact details of the patients, and contain the essence of the complaint shall be considered.
10.3. If a complaint is submitted by patients’ representatives, the name and the surname and the place of residence of the representative, the document certifying their representation, and the patient on whose behalf they are applying shall be indicated.
10.4. Illegible complaints and those which do not comply with the requirements of legislation shall be returned to the patients stating the reason for the return.
10.5. When submitting their complaint, the patients must also submit their identity documents. When the complaint is sent by post or a courier, a copy of the complainant’s identity document certified by a notary or the patients’ lawyer must be attached thereto. The patients’ representatives applying for such information shall submit their identity documents and the document certifying their representation.
10.6. The patients are entitled to submit a complaint no later than one year after becoming aware of the violation of their rights, but it should be no later than within three years from the date of the violation.
10.7. Upon receipt of the patients’ complaint, the Clinic considers it and notifies the patients of the results in writing no later than within 20 working days.
10.8. The patients unsatisfied with the examination of the complaint (their representatives) may apply to the state institutions according to the procedure established by legislation.
11. FINAL PROVISIONS
11.1. The violations of the Rules shall be recorded in the medical records of the patients. The provision of health care services can be terminated for the patients who breach their obligations, thereby endangering their and other patients’ health and life, or hindering them from obtaining quality health care services, unless this endangers the patients’ life.
12. NOMENCLATURE AND ASSORTMENT OF OUT-PATIENT AND IN-PATIENT TREATMENT SERVICES
12.1 Out-patient treatment services:
12.1.2 accoucheuse and gynaecologist;
12.1.4 abdominal surgery physician;
12.1.5 plastic and reconstructive surgeon;
12.2 In-patient treatment services:
12.2.1 plastic and reconstructive surgeon;
12.2.2 reanimation and intensive care physician.