PATIENTS RIGHTS CHARTER 2014 Promoting Quality Healthcare and Safeguarding the Public is our Prime Concern
TABLE OF CONTENTS 1.0 INTRODUCTION...1 2.0 OPERATIONAL DEFINITIONS...2 3.0 PATIENTS RIGHTS...3 3.1 Access to Health Care Services...3 3.2 Informed Consent...3 3.3 Appropriate Discharge and Referal...4 3.4 Human Dignity, Safety and Health Environment...4 3.5 Privacy and Confidentiality...5 3.6 Access to Entitiled Information...5 3.7 Participation in Decision Making Relating to Health Care Delivery...6 3.8 Right to Emergence Care...6 4.0 PATIENTS RESPONSIBILITIES...7 5.0 CONCLUSION...7
1.0 INTRODUCTION Zambia is undergoing a phase of transformation characterized by rapid population growth, overcrowding in cities and towns, emerging new diseases as well as chronic communicable diseases such as Tuberculosis, HIV/AIDS and non-communicable diseases such as Diabetes Mellitus, Hypertension, Cancers and many other such conditions that demand and consume most of the limited resources available. These challenges are compounded by inadequate number of health care providers. Amidst all these challenges the dispensation and professional observance of patients rights to some degree is considered a luxury. This situation among other reasons, has compelled the Health Professions Council of Zambia to develop the Code of Ethics as well as the National Health Care Standards (NHCS) to guide the health practitioners to be professional and respect the constitutional rights of patients as they are seeking and receiving health services. The Charter is an informant to all the citizens seeking health services as well as a reminder to patients regarding their responsibilities towards the health care personnel who are providing care to patients. The charter was developed in the interest of balance, that, whilst patients have rights when seeking health services they also have responsibilities towards their health care providers.. The Patients Rights Charter which was developed by the Health Professions Council of Zambia, is intended to raise awareness and promote quality of health care, thus, fostering a competent and professional delivery of health services in both public and private health facilities. In addition, it will motivate the community to participate in the management of their health by promoting disease prevention, timely referral of patients and access to individual health related information. It is the hope of the Health Professions Council of Zambia, that the availability and the existence of this Charter will promote responsible and balanced actions by the health care providers, the patients and their relatives. 1
2.0 OPERATIONAL DEFINITIONS Health Care Service - means a service provided by a health practitioner or health facility for the prevention, treatment and management of illness and the preservation of mental and physical well being.. Health facility any site, fixed or mobile providing services for the prevention, diagnosis and treatment of disease of illness and include a diagnostic centre, a hospice and a hospital. Health Practitioner: means a person registered under Section 8 of the Health Professions Act No. 2009 of the Laws of Zambia. Support Staff: means all other employees at the health facility who are not health practitioner. Patient - refers to any client seeking or receiving health care services at a health facility. Medical Emergency - a life threatening situation that poses an immediate danger to the continuity of life or severe irreversible disability, if medical intervention is not given urgently. Medical Information refers to information directly related to patient s care that includes : History notes taken by the attending health practitioner, including a typed patient discharge summary or summaries. Laboratory reports and other laboratory evidence such as histology sections, i. Cytology slides and printouts from automated analyzers, X-ray films and reports, ii. ECG or EEG traces and other acceptable (electronic records. Stored patient specimens Audiovisual records such as photographs, videos and tape-recordings. Clinical research forms and clinical trial data. Other forms completed during the health interaction such as insurance forms, disability assessments and documentation of injury on duty. Death certificates and autopsy reports as well as referral letters to and from other health care practitioners. 2
3.0 PATIENTS RIGHTS Each health facility shall protect and promote individual patient s rights. This includes the establishment and implementation of written procedures for respecting, recognition and enforcing patients rights. All patients seeking or receiving health services at any health facility within Zambia, shall have the right to: 3.1 ACCESS TO HEALTH CARE SERVICES 3.1.1 Receive reasonable, respectful and safe access to health services by competent personnel that the health facility is required to provide according to these standards; 3.1.2 Treatment and medical/care services without discrimination based on race, age, colour, religion, ethnicity, national or social origin, sex,, handicap, diagnosis, source of payment or other status; 3.1.3 Retain and exercise to the fullest extent possible all Zambian constitutional and legal rights to which the patient is entitled ; 3.1.4 Be informed of the names and functions of all health practitioners and/or other clinical practitioners who are providing direct care to the patient. These practititioners shall identify themselves by introduction and wearing a name tag. 3.1.5 Receive, as soon as possible, the services of a translator or interpreter to facilitate communication between the patient and the health facility personnel if the patient cannot understand the official local language. 3.2 INFORMED CONSENT 3 3.2.1 Informed written consent prior to the start of specified non-emergency procedures or treatments only after a health practitioner has explained specific details about the recommended procedure or treatment, the risks involved, the possible duration of incapacitation, and any reasonable medical alternatives for care and treatment in terms that the patient understands. 3.2.2 If the patient is incapable of giving informed, written consent, consent shall be sought from the patient s next of kin or guardian or through an advance directive, to the extent authorized by law. If the patient does not give written consent, a health practitioner or other clinical practitioner shall enter an explanation in the patient s medical record; 3.2.3 Refuse medication and treatment and to be informed of the consequences of refusing treatment/care, except in cases where such refusal will pose a risk to both the patient/service user or others;
3.2.4 Be informed if the facility has authorized other health care and educational institutions to participate in the patient s treatment. The patient also shall have the right to know the identity and function of these institutions, and may refuse to allow their participation in the treatment of the patient. 3.2.5 Consent to the production of photographic, audio, video or other similar identifiable recording that involves the patient. 3.3 APPROPRIATE DISCHARGE AND REFERAL 3.3.1 Be informed by the attending health practitioner about any continuing health care requirements after the patient s discharge from the health facility. The patient shall also have the right to receive assistance from the health practitioner and/or other appropriate health care facility staff in arranging for required follow-up care after discharge; 3.3.2 Receive sufficient time before discharge to have arrangements made for health care needs after hospitalization; 3.3.3 Be transferred to another practitioner or facility with the reasons recorded in the patient s medical record that: The transferring health facility is unable to provide the type or level of medical care appropriate for the patient s needs. The health facility shall make an immediate effort to notify the patient s next of kin and document that the notification was received; or The transfer is requested by the patient, or by the patient s next of kin or guardian when the patient is mentally incapacitated or incompetent; 3.3.4 Receive from the health facility or practitioner an explanation of the reasons for transfer or referral of the patient to another practitioner or facility, information about alternatives to the transfer and expected benefits; 3.4 HUMAN DIGNITY, SAFETY AND HEALTH ENVIRONMENT 3.4.1 Be treated with courtesy, consideration, and respect for the patient s dignity and individuality i.e. the right to care that respects the patient s personal values and beliefs; 3.4.2 Be free from physical and mental abuse, neglect, sexual harassment, sexual violence and exploitation; 3.4.3 Be free from physical or chemical hazards that are not medically necessary, unless they are authorized by a competent health practitioner for a limited period of time to protect the patient or others from injury; 4
3.5 PRIVACY AND CONFIDENTIALITY 3.5.1 Have personal and physical privacy during medical treatment and personal hygiene functions, such as bathing and using the toilet, unless the patient needs assistance for his or her own safety. The patient s privacy shall also be respected during other health care procedures and when health facility personnel are discussing the patient; 3.5.2 Confidential treatment. Information in the patient s records shall not be released to anyone outside the hospital except the following circumstances; If the patient has approved the request. If another health facility to which the patient was transferred requires the information. If the release of the information is required and permitted by law. If the patient s identity is anonymous, the hospital may release data about the patient for reporting or masked for studies containing aggregated statistics. 3.6 ACCESS TO ENTITILED INFORMATION 3.6.1 To receive from the patient s health practitioner(s) an explanation of his or her complete medical condition, recommended treatment, risk(s) of the treatment, expected results and reasonable medical alternatives in terms that the patient understands. If this information shall be detrimental to the patient s health, or if the patient is not capable of understanding the information, the explanation shall be provided to his or her next of kin and be documented in the patient s personal medical record; 3.6.2 To know the actual price of services and procedures; 3.6.3 Receive a copy of the health facility payment rates, regardless of source of payment. Upon request, the patient or responsible party shall be provided with an itemized bill and an explanation of the charges if there are further questions. 3.6.4 To have prompt access to the information contained in the patient s medical record, unless a health practitioner or other clinical practitioners prohibits such access as detrimental to the patient s health, and explains the reason in the medical record. In that instance, the patient s next of kin or guardian shall have a right to see the record. This right continues after the patient is discharged from the health facility for as long as a copy of the record is kept; 5
3.6.5 Obtain a copy of the patient s medical record and receive a medical certificate in English 3.6.6 Present his or her suggestion or grievances, without fear of retribution, to the health practitioner or health facility staff assigned by the health facility to respond to questions or grievances about patient rights and to receive an answer to those grievances within a reasonable period of time without discrimination. 3.6.7 Be given a summary of these patient rights, as approved by the HPCZ and any additional policies and procedures established by the health facility involving patient rights and responsibilities on matters such smoking,alcohol or drug abuse, use of cell phones, noise, visiting hours, including provision of food from home 3.6.8 The patient is informed of his or her rights during the admission process; 3.6.9 This summary include the name and phone number of the health facility or its support staff to whom patients can complain about possible patient rights violations; 3.7 PARTICIPATION IN DECISION MAKING RELATING TO HEALTH CARE DELIVERY 3.7.1 To be informed and participate in decisions relating to their care and participate in the development and implementation of a plan of care and any changes. 3.8 RIGHT TO EMERGENCE CARE 3.8.1 Patients have the right to emergence care wherever they are by the nearest health facility without the pre-requisite of finances. All health facilities and health providers will be obliged to provide emergence care, in the interest of humanity, to untimely victims of illness or accidents, and thereafter, process appropriate referrals. 3.8.2 A summary of patient rights should be posted conspicuously in the patient s room and in public places throughout the health facility or be made available at nurse stations and other patient care registration areas in the health facility. 6
4.0 PATIENTS RESPONSIBILITIES Every patient shall have the following responsibilities to the health facility and health facility staff, to ; 4.1 Provide, to the best of the patient s knowledge, accurate and complete information regarding past medical history and issues related to the patient s health, including unexpected changes to the patient, this information should be provided to the health professional responsible for the patient s care; 4.2 Follow the course of treatment and instructions proposed by the health practitioner or other clinical practitioners and accept the consequences if treatment instructions are not followed.; 4.3 Be considerate of the health facility premises, amenities, furniture and equipment and to use them without abuse 4.4 Patients and accompanying persons should not verbally or physically abuse health care providers 4.5 Not to litter the health care facility premises 4.6 Report any changes in his/her condition or anything that appears unsafe, strange or abnormal to the attending health practitioner. ; 4.7 Be considerate of the rights of other patients and to respect their privacy; 4.8 Patients and accompanying relatives should respect the health providers 4.9 Fulfil the financial obligations as promptly as possible; 4.10 Keep all appointments and notify the health facility or the appropriate person when unable to do so; 4.11 Observe the health facility policies and procedures, including those on smoking, alcohol or drug addiction, use of cellular phones, noise and visitors; 5.0 CONCLUSION All members of the health profession need to ascribe to the universal tenets and respect for patients as well as human rights at all levels of health care. All health practitioners have the obligation to uphold and support patients rights as well as educate patients regarding their responsibilities. 7
Published by: Health Professions Council of Zambia, P.O Box 32554, Dental Training School Premises, Wamulwa Road, Thornpark, Lusaka. Tel: (260-1) 236241, Fax: (260-1) 239317 Email: hpcz@iconnect.zm Website: www.hpcz.org