İZMİR ŞEHİR HASTANESİ

The right to choose a physician can be defined as the ability of patients and their relatives to choose and change their healthcare provider—which is a fundamental patient right—and to play a participatory role in their diagnosis and treatment.

Our Ministry issued the "Directive on the Arrangement of Outpatient Clinic Services in Healthcare Delivery to Enable Patients to Choose and Change Their Physician" with the Official Approval No. 9379, dated October 17, 2007. Therefore, it is aimed to implement the provisions set forth in Article 5 of this directive.

Article 5- (1) In the provision of outpatient clinic services, it is essential to:

• Allow patients to choose a physician in healthcare institutions in order to ensure the exercise of the right to choose and change the physician who will provide their healthcare services, which is a fundamental patient right;

• Prevent overcrowding during certain hours and reduce patient waiting times by providing an outpatient clinic room for each physician, thereby increasing the number of examination rooms;

• Ensure that patients can choose the physician with whom they can best cooperate and communicate during healthcare delivery;

• Ensure that patients can be examined by the same physician every time they visit the healthcare institution, if they wish to do so;

• Ensure that the patient remains under the care of the same physician from their initial admission to the healthcare institution, in accordance with the patient's request;

• Provide the patient with the right to change their physician at any stage of their treatment in an inpatient treatment facility;

• Standardize the practices of choosing a physician in healthcare institutions and ensure uniformity in implementation during healthcare delivery;

• Provide the patient, upon request, with information about the identities, duties, and titles of the physicians who are providing or will provide healthcare services to them, within the scope of the right to choose and change a physician;

• Prioritize patient benefit in all arrangements, inform patients by providing necessary counseling services, and implement practices that facilitate staff-patient communication.

From the Ministry of Health:

REGULATION ON ENSURING PATIENT AND EMPLOYEE SAFETY

CHAPTER ONEPurpose, Scope, Basis, and Definitions

PurposeARTICLE 1 – (1) The purpose of this Regulation is to regulate the procedures and principles for ensuring a safe service delivery and a safe environment for patient and employee safety, improving the quality in service delivery, identifying potential risks for patients and employees in healthcare institutions, determining appropriate methods and techniques to eliminate these risks, and ensuring the sustainability of safe service delivery and a safe working environment through in-service training in all healthcare institutions within the scope of Article 2.

ScopeARTICLE 2 – (1) This Regulation covers public, university, and private sector secondary and tertiary healthcare institutions.

BasisARTICLE 3 – (1) This Regulation has been prepared on the basis of subparagraphs (e) and (f) of the first paragraph of Article 3 of the Basic Law on Health Services No. 3359 dated 7/5/1987, and Article 43 of the Decree Law on the Organization and Duties of the Ministry of Health No. 181 dated 13/12/1983.

DefinitionsARTICLE 4 – (1) In this Regulation, the following terms shall have the meanings assigned to them: a) Ministry: The Ministry of Health, b) Employee: All members of health professions who participate in the provision of health services in public or private health institutions, as well as persons who, even if they are not members of health professions, responsibly participate in and provide support to the delivery of health services, c) Department: The Department of Performance Management and Quality Improvement of the General Directorate of Curative Services, ç) Evaluator: The person assigned by the Department who evaluates the effectiveness of the Service Quality Standards in healthcare institutions, d) Evaluation: The activity of measuring the effectiveness of Service Quality Standards in healthcare institutions by the Department, e) Patient: Anyone who needs to benefit from health services, f) Patient and employee safety: Activities related to precautions and improvement practices to be taken regarding all kinds of procedures and processes that may cause harm to patients and employees during healthcare delivery, g) Service Quality Standards (SQS): The standards prepared by the Department for the service delivery of healthcare institutions, ğ) Healthcare institution: Public, university, and private sector secondary and tertiary healthcare institutions.

CHAPTER TWOBasic Principles, Patient and Employee Safety Practices

Basic principlesARTICLE 5 – (1) Healthcare institutions within the scope of this Regulation are obliged to make their own internal arrangements and take precautions in order to implement the provisions of this Regulation and to carry out necessary activities aimed at ensuring patient and employee safety. While taking precautions and making arrangements regarding patient and employee safety, healthcare institutions shall base them on the Service Quality Standards prepared by the Department and published on the official website of the Ministry.

Patient safety practicesARTICLE 6 – (1) Healthcare institutions within the scope of this Regulation shall take the necessary precautions and make arrangements regarding the following: a) Identification and verification of patient identity information, b) Obtaining the patient's consent for interventional procedures to be applied, c) Ensuring communication safety during healthcare delivery, ç) Ensuring medication safety, d) Ensuring the transfusion safety of blood and blood products, e) Ensuring surgical safety, f) Preventing patient falls, g) Ensuring radiation safety, ğ) Making arrangements for patients with disabilities.

Employee safety practicesARTICLE 7 – (1) Healthcare institutions within the scope of this Regulation shall take the necessary precautions and make arrangements regarding the following: a) Preparation of an employee safety program, b) Conducting health screenings for employees, c) Making arrangements for employees with disabilities, ç) Ensuring that employees take personal protective measures, d) Making arrangements to prevent physical assaults against employees.

Joint practices for patient and employee safetyARTICLE 8 – (1) Healthcare institutions within the scope of this Regulation shall take the necessary precautions and make arrangements regarding the following: a) Regarding the control and prevention of infections:

1. Preparing a program for the control and prevention of infections,

2. Conducting surveillance studies to monitor hospital infections,

3. Making arrangements to ensure hand hygiene,

4. Taking isolation precautions,

5. Implementing cleaning, disinfection, and sterilization practices, b) Regarding laboratory safety:

6. Taking necessary precautions according to the biosafety level,

7. Conducting quality control studies for tests performed in the laboratory,

8. Ensuring the notification of panic values, c) Regarding radiation safety; taking protective measures in areas where radioactive materials are used for diagnostic and therapeutic purposes, ç) Regarding color code applications:

9. Implementing the blue code application,

10. Implementing the pink code application,

11. Implementing the white code application, d) Regarding the safety reporting system:

12. Establishing a safety reporting system,

13. Ensuring that the events to be reported cover at least medication safety, transfusion safety, surgical safety, patient falls, sharps injuries, and contact with blood and body fluids,

14. Implementing corrective and preventive actions related to the reported events, e) Regarding training: providing training on patient and employee safety to all employees working in healthcare institutions, f) Regarding the establishment of committees:

15. Establishing a patient safety committee,

16. Establishing an employee safety committee.

CHAPTER THREEMiscellaneous and Final Provisions

ResponsibilityARTICLE 9 – (1) The highest-ranking official of the relevant healthcare institution is responsible for the uninterrupted and effective implementation of the procedures and principles contained in this Regulation, taking necessary measures to eliminate problems and malfunctions detected during implementation, and tracking and evaluating the practice.

EvaluationARTICLE 10 – (1) The Ministry evaluates healthcare institutions within the scope of this Regulation in terms of patient and employee safety. Service Quality Standards are used in the evaluation process of healthcare institutions. Evaluations are conducted by evaluators at least once a year over sections selected from the Service Quality Standards. Healthcare institutions must score at least 80 out of 100 on the patient and employee safety standards in the evaluated sections. The Ministry is authorized to increase this required score. (2) The Patient and Employee Safety Evaluation Score is calculated as follows: [Total Patient and Employee Safety Score Obtained from the Evaluated Sections in SQS / (Total Patient and Employee Safety Score in the Evaluated Sections in SQS – Total Score of the Patient and Employee Safety Standards Excluded from Evaluation in the Evaluated Sections in SQS)] x 100

Entry into ForceARTICLE 11 – (1) This Regulation enters into force on the date of its publication.

ExecutionARTICLE 12 – (1) The provisions of this Regulation are executed by the Minister of Health.

A human being steps into the world acquiring certain inherent rights simply by virtue of being human. The concept of rights is a universal one. Briefly, a right can be defined as the authority granted to individuals by legal rules. Human rights were first recognized in England in 1215. Officially, the American Bill of Rights and the 1789 French Declaration of the Rights of Man and of the Citizen were published in the late 18th century. With the establishment of the United Nations, human rights became universal. The Universal Declaration of Human Rights was published. Accordingly, it states that everyone is free, dignified, and equal in terms of their rights. Briefly, human rights can be described as all people being inherently equal and free in every aspect. This freedom is balanced by the obligation to respect the rights of others and the necessity of not violating these rights. There are various human rights. Patient rights are also among fundamental human rights.

1) Benefiting from services in general Benefiting from health services within the framework of the principles of justice and equity. Patients have the right to receive services without regard to race, language, religion and sect, gender, philosophical belief, or economic and social status.

2) Information and requesting information Patients have the right to learn what kinds of health services and facilities are available and to request all kinds of information regarding their health status verbally or in writing.

3) Choosing and changing the health institution and its personnel Patients have the right to choose and change the health institution and to benefit from the health services provided in the chosen health facility. They also have the right to learn the identities, duties, and titles of the physicians and other healthcare professionals who will provide or are providing health services, and to choose and change them.

4) Privacy Patients have the right to receive all kinds of health services in an environment that respects confidentiality.

5) Refusal, suspension, and consent Patients have the right to refuse treatment, to request its suspension, to have their consent obtained for medical interventions, and to benefit from services within the framework of this consent.

6) Security Patients have the right to receive health services in a safe environment.

7) Fulfilling religious obligations Patients have the right to fulfill their religious obligations to the extent of the health facility's capabilities and within the framework of the measures taken by the administration.

8) Respect for human values, experiencing dignity, and comfort Patients have the right to receive health services with respect, care, and attention, in a friendly, polite, and compassionate environment where all hygienic conditions are met and all noisy and disturbing factors are eliminated.

9) Having visitors and a companion Patients have the right to receive visitors within the framework of the procedures and principles determined by health facilities, and to have a companion to the extent of the legislation and the health facility's capabilities, provided the physician deems it appropriate.

10) Right to application, complaint, and lawsuit In case of a violation of their rights, patients have the right to exercise all kinds of application, complaint, and lawsuit rights within the framework of the legislation.

Patient Rights Regulation Official Gazette Date: 01.08.1998 Official Gazette No: 23420