BOLERADA UAB – InnMed KLINIKA
INTERNAL RULES OF PROCEDURE
I. GENERAL PROVISIONS
1. The present internal rules of procedure (hereinafter – the Rules) shall establish the principles of relationship of the staff, patients and visitors, and standards of conduct of Bolerada – InnMed klinika, legal entity code 304402572, head office address Statybininkų g. 1A-102, Vilnius (hereinafter – the Clinic).
2. The Clinic operates in accordance with the laws of the Republic of Lithuania, the Government resolutions, the orders of the Minister of Health, the medical standards (medical and hygiene norms), the Clinic’s Articles of Association, procedures, the present Rules and other internal documents.
3. The present Rules must be complied with by all employees, patients and visitors of the Clinic.
II. PATIENT APPLICATION PROCEDURE
4. The patients shall contact the Clinic on their own initiative or by referral issued by a health care institution.
5. The patients who contact the Clinic’s physicians and specialists shall be registered at the Customer Reception Desk at Statybininkų g. 1A-102, Vilnius, or by calling: +37070050050 or sending an e-mail to firstname.lastname@example.org
6. When registering by phone in advance for an appointment with a doctor, the patients shall specify to the receptionist with their full name, date of birth, address and phone number.
7. Upon arrival at the Clinic in person, the patients are received at the reception desk and must produce a passport or other identification document. Persons under the age of 16 must be accompanied by parents (adoptive parents), guardians or caregivers.
8. At the Clinic, the patients can receive only paid consultations and other health care services according to the rates applied at the Clinic.
9. The patients shall be admitted to the Clinic for outpatient health care services during the working hours of the Clinic’s medical specialists.
10. The patients shall be registered with the Clinic’s physicians based on the availability of places with the respective physicians.
11. The patients shall be seen by the doctor at the time scheduled during advance registration. If the patient is late for the appointment at the set time, the Clinic shall not be obliged to ensure his/her admission.
12. If the doctor is unable to receive patients who have registered to see him/her due to an illness or other circumstances, the Clinic shall inform them by calling the indicated phone number or e-mail.
13. A contract shall be concluded with each patient for the services provided at the Clinic.
III. CLASSIFICATION AND RANGE OF SERVICES. PROCEDURE OF PROVISION THEREOF
14. It shall be considered that the patient who comes to the Clinic voluntarily has been informed and agrees that the Clinic specialist will examine him/her, assess his/her health condition, prescribe and perform the necessary examinations and treatment procedures. The Clinic shall ensure that all necessary information shall be provided to the patient during his/her visit to the Clinic.
15. The Clinic does not provide any state-guaranteed (free) personal health care services, except for emergency medical services.
16. Necessary (first and emergency) medical care shall be provided at the Clinic to all patients. Everyone who visits the Clinic shall receive emergency medical care immediately, regardless of their place of residence or social guarantees. The procedure, scope and indications for the provision of necessary medical care are specified in the Procedure and Scope of Provision of Emergency Medical Care approved by Order No V-208 of the Minister of Health of 8 April 2004. If it is not possible to provide the necessary emergency medical care quickly at the Clinic, the Clinic administration or doctor must call the emergency medical services and inform the patient about the reasons and time it will take for the patient to receive emergency medical care.
17. The Clinic carries out the necessary public health care measures and provides the necessary medical care in accordance with Order No V-450 of the Minister of Health of 11 July 2003 “On the competence of healthcare professionals and pharmacists in the provision of first aid, first aid boxes and first aid kits”.
18. The classification of medical services shall be determined according to the scope of the Clinic’s licensed medical services specified in the Clinic’s health care licence.
IV. RIGHTS AND OBLIGATIONS OF THE PATIENTS
19. The right to quality health care services:
19.1. The patient shall have the right to quality health care services;
19.2. the patients’ rights may not be restricted on grounds of sex, age, race, nationality, nationality, language, origin, social status, religion, belief, opinion, sexual orientation, genetic characteristics, disability or any other grounds, except in cases required by law, without prejudice to common human rights principles;
19.3. the patient shall have the right to conditions that do not degrade his/her honour and dignity, and to the respectful treatment of the Client’s specialists;
19.4. the services shall be provided to patients older than 16 years only with his/her consent, except in cases of emergency medical services, when the patient is unable to express his/her will;
19.5. health care to minor patients younger than 16 years shall be provided only with the consent of his/her representatives, except in cases of provision of emergency medical care. The specialists of the Clinic must in all cases choose such diagnostic and treatment methods that would best suit the interests of the minor, taking into account first of all the will of the minor, as well as his/her representatives.
19.6. the patient shall have the right to choose a doctor working at the Clinic according to their availability at the Clinic.
20. Right to information:
20.1. the patient shall have the right to receive information about the services provided at the Clinic, their prices and opportunities to use them. At the Clinic, the patient must be provided with information about the Clinic specialist (name, surname, position) who provides services to the patient and his/her professional qualification;
20.2. the patient shall have the right to receive information about his/her state of health, disease diagnosis, other treatments or examinations used or known to the doctor, possible risks, complications, side effects, treatment prognosis and other circumstances that may affect the patient’s decision to accept or refuse the proposed treatment, and as well as the consequences of refusing the proposed treatment. This information shall be provided to the patient by the doctor taking into account his/her age and health conditions in a form that he/she understands, with clarifications of specific medical terms;
20.3. at the request of the patient, he/she shall receive his/her medical documents (file, examination report, medical history or other documents);
20.4. the health care professional must, within his/her competence, explain to the patient the meaning of the entries in his/her documents. At the reasonable request of the patient, inaccurate, incomplete and ambiguous data, or data not related to the diagnosis, treatment and nursing must be corrected, supplemented, completed, deleted and/or changed within 15 business days. The dispute between the specialist and the patient regarding the correction, supplementation, completion, deletion and/or change of the entries in his/her documents shall be resolved by the Director General of the Clinic;
20.5. the patient shall have the right to request that copies of his medical records be made at his/her expense.
21. Right to privacy:
21.1. private lives of patients shall be inviolable. Information about the life of patients may be collected with the consent of patients and only if it is necessary to diagnose the disease, treatment or care;
21.2. ensuring the patient’s right to privacy shall be based on the premise that the patient’s interests and well-being take precedence over the public interest;
21.3. the information on the patient’s visits to the Clinic, his/her state of health, diagnostic and treatment measures applied shall be entered in the patient medical documents of the form and type established by the Ministry of Health. The protection of the patient’s privacy must be ensured in the procedure of use of these documents;
21.4. all information about the patient’s visits to the Clinic, state of health, diagnosis, prognosis and treatment, as well as all other personal information about the patient must be kept confidential even after the patient’s death. The right to receive information after the patient’s death belongs to the heirs according to the will and according to the law, the spouse (partner), parents and children;
21.5. the confidential information may be disclosed to other persons only with the written consent of the patient, stating the grounds for the provision of such information and the purposes for which it is used, unless the patient has indicated in the medical documents under signature who is entitled to receive such information, as well as the scope and terms of provision of such information. The patients shall have the right to identify persons who may not receive their confidential information;
21.6. the persons directly involved in the treatment or care of a patient, or performing a patient’s health examination, may receive the confidential information without the patient’s consent in cases and in the scope necessary to protect the patient’s interests. When a patient is considered unable to make a reasonable assessment of his/her interests and provide consent, the confidential information may be provided to the patient’s representative, spouse (partner), parents (adoptive parents) or adult children in the scope necessary to protect the patient’s interests;
21.7. the representatives of a minor patient shall have the right to access the medical documents of the minor patient, if it is not in conflict with the interests of the minor patient;
21.8. The Clinic must immediately notify the law enforcement authorities about injured patients who may have been injured in an act of crime.
22. The right to choose diagnostic and treatment methods:
22.1. the patient must be informed about the methods of diagnosis and treatment used in the Clinic and their characteristics, and may make a choice, or refuse treatment. The choice of patients, including minor patients aged 16 to 18 years, shall be documented in writing. The representatives of minors under 16 years of age, as well as other patients who, due to their condition, are unable to objectively assess diagnostic and treatment methods, shall make the choice and sign for them.
22.2. prior to performing an invasive and/or interventional procedure on a patient, an informed patient consent must be obtained for performance of a specific invasive and/or interventional procedure. This consent must be expressed in writing by signing a form approved by the Minister of Health;
22.3. when obtaining informed consent for an invasive and/or interventional procedure, the information shall be considered appropriate when the patient, depending on his/her age and health condition, has been familiarised with the essence of the surgical or invasive and/or interventional procedure in a form he/she understands, with clarification of specialised medical terms, its alternatives, nature, objectives, known and possible complications (adverse reactions), and other circumstances that may influence the patient’s decision to accept or refuse the intended surgery or invasive and/or interventional procedure, as well as possible consequences of refusing the intended surgical or invasive and/or interventional procedure;
22.4. the patient may refuse health care services in writing, and revoke his/her consent to treatment;
22.5. if the patient’s medical condition does not allow him/her to unable to express his/her will for consent to treatment and for the choice of diagnosis and treatment methods, as much as possible, without prejudice to the patient’s interests, his/her previously documented will shall be taken into account. In the absence of a duly expressed will of the patient (his/her representative), nursing, diagnosis and treatment may be applied only on the grounds and in accordance with the procedure established by law, when there is a real threat to the health or life of the patient or people around him/her;
22.6. where health care must be provided to patients older than 16 years who cannot be considered able to reasonably assess their interests, or to a minor patient under the age of 16, and whose representatives are not present or it is not possible to reach them as quickly as it is necessary, or receive their informed consent in time, the decision on the choice of the health care to be provided to the patient and its scope shall be made by the Clinic physician.
22.7. the decisions on the scope of health care to be provided to a minor patient under 16 years of age whose parents abandon the functions of a legal representative, and where temporary custody or care has not been established, or when the parents (adoptive parents) of the minor patient do not agree on the scope of health care, shall be made by the attending physician.
23. Right to complain. The patient who considers that his/her rights have been violated, may submit a complaint to the Clinic in accordance with the requirements established by normative legal acts and the procedure for resolving disputes and conflicts between the clinic and patients.
24. The patient shall be obliged:
24.1. to take care of his/her health, to use his/her rights fairly, not to abuse them, and cooperate with the specialists and employees of the Clinic;
24.2. to arrive at the Clinic at the appointed time. A patient who is unable to arrive on time must inform the Clinic at least 24 hours before the scheduled time of receipt of the service.
24.3. to have identity documents (passport/ID card);
24.4. to maintain order and cleanliness in all premises of the Clinic;
24.5. not to disturb the peace, not to interfere with work in the offices;
24.6. follow the instructions of the doctor and other medical specialists, and behave in a way that improper actions do not prolong the disease;
24.7. to handle the Clinic’s equipment and inventory with due care (the patient shall be materially liable for intentional or negligent damages to the Clinic’s equipment);
24.8. to provide timely payments for the services;
24.9. to treat all Clinic staff and other patients or visitors with respect and dignity;
24.10. to comply with personal hygiene requirements;
24.11. at the request of the specialist, the patient must provide to the best of his/her ability information on the diagnosis (if any), tests performed, treatment applied, state of health, diseases previously suffered, operations performed, medicines previously or currently used, allergic reactions, genetic heredity and other information required for the provision of health care services;
24.12. to inform the doctor about changes in the state of health during treatment;
24.13. to carry out the prescriptions and recommendations of the Clinic specialists or to refuse the assigned health care services.
24.14. The patient must inform healthcare professionals of deviations from the prescriptions or recommendations;
24.15. to get acquainted with the presented internal rules of procedure of the Clinic, to comply with their requirements, to get acquainted with other documents of the Clinic and to fulfil the obligations specified therein;
24.16. to confirm acquaintance with the documents of the Clinic in writing in the agreement concluded with the Clinic, in the informed patient consent form or in the service order form.
25. The patient and patient’s visitors shall be prohibited:
25.1. to smoke, keep and drink intoxicating beverages, use narcotic, psychotropic and other psychoactive substances in the premises of the Clinic and its surroundings;
25.2. to bring into the premises of the Clinic any items that may endanger patients or their visitors, the staff of the Clinic, other patients or visitors, including, but not limited to, weapons, explosives or toxic substances;
25.3. to act ruthlessly towards oneself and others;
25.4. to enter the premises of the Clinic, which the patients and visitors are not authorised to enter, without prior consent;
25.5. to remove medical documents from the Clinic;
25.6. to make arbitrary changes to medical records;
25.7. to film and/or photograph inside the premises of the Clinic both individually and by inviting a third party without a prior written permission of the administration of the Clinic.
26. The provision of health care services to patients who violate their duties, thereby endangering the health and lives of their own and other patients, or obstructing other patients’ access to quality health care, may be suspended, unless it could endanger the patients’ life.
27. The administration of the Clinic and the medical staff shall be responsible for organisation the implementation of the fulfilment of patients’ rights and obligations in the Clinic.
28. A copy of the internal rules of procedure shall be kept at the reception desk in a place visible to patients, ensuring that their easy access.
29. Having familiarised with the present Rules, the patient shall confirm this by signing a special form of declaration of will or a contract for the provision of health care services.
30. The employee of the Client receiving the patient shall be responsible for providing information to the patient about his/her rights and obligations.
31. If a patient fails to comply with the obligations set out in these Internal Rules of Procedure, the receptionist or the attending physician shall give the patient a warning. If the warning is ineffective, the Head of the Clinic shall be notified, who shall then decide on the following actions.
V. PROCEDURE FOR SETTLEMENT OF DISPUTES AND CONFLICTS BETWEEN THE CLINIC AND PATIENTS
32. A patient or his/her representative who is dissatisfied with the health care services or considers that the patient’s rights have been violated, shall have the right to submit a written complaint to the Clinic that meets the requirements applicable to the form and content.
33. The complaints that have been signed by the patient, indicating his/her name, current place of residence and contact details, the essence of the complaint and a copy of the patient’s identity document certified by a notary or a lawyer representing the patient, shall be examined. Anonymous complaints shall not be considered.
34. In the event of a dispute or conflict between the patient and the Clinic staff member, the relevant employee of the Clinic must immediately notify the Head of the Clinic or his/her authorised person about the conflict situation.
35. Upon receipt of a patient’s complaint, the Clinic must examine it and inform the patient in writing of the results of the examination as soon as possible, however, no later than within 20 business days. Following examination of the complaint, the answer shall be provided to the patient in writing.
36. If the patient or his/her representative is dissatisfied with the examination of the complaint in the Clinic in accordance with the above procedure, the patient or his/her representative shall have the right to contact the state institutions examining patient complaints.
37. The material and non-material damage caused through violation of the established rights of patients shall be indemnified in accordance with the procedure established by the Civil Code and other legal acts.
38. The patient or the person representing the patient must compensate the material and non-material damage suffered by the Clinic as a result of a manifestly unfounded or false complaint of the patient or his/her representative.
VI. PROCEDURE FOR PROVISION OF INFORMATION TO THE PATIENT, PATIENT’S RELATIVES AND OTHER PERSONS ABOUT THE PATIENT’S STATE OF HEALTH
39. Information on the patient’s state of health, diagnosis of the disease, medical examination data, treatment methods and treatment prognosis shall be provided in accordance with the rules specified in Section IV Rights and Obligations of the Patients hereof.
40. Information on the patient’s state of health shall be provided by the patient’s treating physician or other competent person. Other staff of the Clinic shall not be entitled to provide the above type of information. The official document with the patient’s health information provided to the applicant (extracts or copies of medical records) shall be signed by the attending physician. The cover letter shall be signed by the Head of the Clinic or his/her authorised representative. The Clinic shall send the prepared document (information shall not be provided verbally) to the Applicant no later than within 10 business days from the date of receipt of the request.
41. Information on the patient’s health may be provided to the third parties only with the patient’s written consent or in cases provided for by the laws of the Republic of Lithuania.
42. Information about the patient’s state of health must be provided to the patient or his/her representative in a form that he/she understands, with a clarification of specific medical terms. When informing about treatment, the doctor shall explain to the patient or his/her representative the course of treatment, possible treatment outcomes, available alternative treatment methods and other circumstances that may influence the patient’s decision to accept or refuse the proposed treatment, as well as the consequences of refusing the proposed treatment.
43. The fact of provision of information to the patient, his/her decision to accept treatment, refusal of the proposed treatment and information on possible consequences shall be recorded in the medical history or in another document signed by the treating physician and the patient or his/her representative.
VII. OPENING HOURS OF THE CLINIC AND DUTIES OF THE STAFF
44. The administration of the Clinic is open on working days from Monday to Friday: from 8 a.m. to 8 p.m.
45. The reception desk of the Clinic is open on working days from Monday to Friday: from 8 a.m. to 8 p.m.
46. The Clinic doctors and other medical staff work on working days from Monday to Friday according to an individual schedule: from 8 a.m. to 8 p.m.
47. The Clinic staff must base their relationship with patients and visitors on the principles of kindness, mutual understanding, medical ethics and tolerance, and to maintain business relations with each other;
48. The staff of the Clinic must respect each other and their Clinic, and represent it in Lithuania and abroad.
49. Duties of the Clinic staff:
49.1. to observe work discipline, to come to work at a set time, and to allocate all time at work for the proper performance of their duties;
49.2. to work honestly and competently, to fulfil the requirements of their job descriptions, qualification categories, and lawful instructions of the Clinic management;
49.3. to conserve and protect property (instruments, equipment, inventory, etc.), to prevent its damage, looting and use for selfish purposes;
49.4. to use of work materials, medicines and energy resources sparingly;
49.5. to maintain order and cleanliness in their workplaces, to comply with the requirements of sanitation, hygiene and occupational safety;
49.6. to improve their professional knowledge and bring it up to date;
49.7. must immediately notify the management of the Clinic about the injuries received in relation to work, acute health disorders, accidents on the way to and from work, and indicate the circumstances and consequences of the event.
50. The clinic administration shall be obliged:
50.1. to ensure the continuity of services provided at the Clinic;
50.2. to ensure that the Clinic provides only those health care services that are specified in the licence;
50.3. to organise the work of employees according to their specialities and qualifications, to ensure normal working conditions, to provide the materials, instruments, equipment and mechanisms necessary for work, work clothes and personal protective equipment;
50.4. to be liable for violations in accordance with the laws and normative acts of the Republic of Lithuania.
VIII. PROCEDURE FOR REGISTRATION AND STORAGE OF PATIENT’S PRECIOUS METALS, EXPENSIVE PROSTHESES AND CASH
51. The clinic does not accept and register the patient’s articles of precious metals, expensive prostheses, cash, mobile phones and/or other valuable items of the patient.
52. The Clinic shall not be responsible for and shall not guarantee the protection of material values of the patients or other persons visiting the Clinic while on the Clinic’s premises.
53. The Clinic shall not provide compensation to patients or other persons visiting the Clinic for loss, theft of other disappearance of the valuable items belonging to the said persons during their visit at the Clinic.
IX. PROCEDURE FOR DISCHARGE AND TRANSFER OF PATIENTS TO OTHER PERSONAL HEALTH CARE INSTITUTIONS
54. The patient shall be discharged from the Clinic:
54.1. upon full recovery;
54.2. for further outpatient treatment;
54.3. upon transfer for treatment to another personal health care institution;
54.4. upon transfer for rehabilitation treatment;
54.5. when further stay in the Clinic is not medically justified;
54.6. due to violations of the present Rules;
54.7. at the request of the patient (his/her representative);
54.8. upon completion of the provision of necessary medical assistance and failure of the patient (his/her representative) to produce documents proving his/her health insurance.
55. The patients must be informed about discharge from the Clinic in advance. The medical documentation and recommendations (discharge summary and/or an extract from medical records, a referral can be issued after if deemed necessary, and a certificate of incapacity for work, etc.) shall be provided upon discharge in accordance with the established procedure.
56. The minor patients shall not be discharged from the Clinic without the knowledge of their parents or other legal representatives.
57. A patient shall be transferred to another personal health care institution, if, in the opinion of a medical specialist, his/her state of health requires additional medical attention, which the Clinic cannot provide within its competences.
58. A patient is referred to another personal health care institution shall be issued a referral (Form No 027/a).
X. PATIENTS’ RIGHTS PERTAINING TO PERSONAL DATA
59. The patients’ rights pertaining to personal data shall be implemented as follows:
59.1. To sign up with the Clinic’s family doctor and/or prior to receiving health care services, the patient shall sign an agreement with the Clinic informing about the processing of his/her personal data.
59.2. A patient who submits a written request and a personal identification document or a copy thereof to the Clinic in person, by post or by electronic means, shall have the right to familiarise with his/her personal data processed at the Clinic and to receive information from which sources and what personal data processed by the Clinic are collected, grounds for processing, and to which data recipients they are provided and have been provided during a period of at least 3 years. The information requested by the patient shall be provided no later than within 30 calendar days from the date of receipt of the request referred to in this subparagraph.
59.3. If a patient, having acquainted him-/herself with his/her personal data processed in the Clinic, discovers that his/her personal data processed by the Clinic is incorrect or inaccurate, he/she shall have the right to submit a written request and ID documents, or copies thereof, to the Clinic in person, by post or electronic means and demand to correct the incorrect or inaccurate personal data processed by the Clinic. Upon receipt of the request referred to in this subparagraph, the Clinic shall immediately, however, no later than within 5 business days from the date of receipt of the request, verify the processed personal data of the requesting patient, and upon confirmation of validity of the request, to correct the incorrect or inaccurate personal data and/or suspend the processing of such personal data.
59.4. Proper implementation of patient rights shall be ensured by the Head of the Clinic.
XI. ENTRY INTO FORCE AND PUBLICATION OF INTERNAL RULES OF PROCEDURE
60. The present internal rules of procedure of Bolerada UAB shall come into force on 4 February 2021 upon their approval by the order of the Director of the Clinic.
61. The Rules shall be published in a visible place on the premises of the Clinic making is possible for patients and other persons visiting the Clinic to familiarise therewith.
62. The Clinic staff shall be familiarised with the Rules under signature.
63. Any amendments to the Rules shall take effect upon their publication on the premises of the Clinic.