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“Es una oportunidad para afianzar la alianza estratégica con nuestros principales aliados”
-¿Cómo se gesta el bono por trato al usuario?
-Es producto del acuerdo firmado en octubre del 2011 y fue posible gracias a la tremenda fuerza de nuestra organización. Con ello logramos este bono, además del incentivo al retiro, recuperamos pasantías internacionales, acciones en la perspectiva de mejorar postas de salud rural y sapus y se consiguió el anhelado servicio de bienestar.
-¿Confusam lo pidió?
-En absoluto, lo que planteamos fue la necesidad de mejoras salariales. Y como desde hace tiempo se viene practicando la política del garrote y de la zanahoria, se establece esta nueva asignación contra resultado.
-¿Tuvieron participación en el proceso de elaborar el instrumento de evaluación?
-Esa fue una tremenda pelea, porque con el actual Minsal nos ha costado muchísimo mantener el trabajo de la Mesa técnica tripartita (Minsal, Asociación Chilena de Municipios y Confusam). Lo primero fue exigir que se nos dieran garantías respecto a la institución que formularía el instrumento y participamos de la decisión que fuera la Escuela de Salud Pública de la Universidad de Chile. La Escuela elaboró el instrumento en base a las propuestas de los tres actores y luego lo probó con expertos, reformulándolo varias veces, para finalmente aplicarlo en 9 regiones a una muestra de centros urbanos y rurales del norte, centro y sur del país, etc., con lo que desarrolló un riguroso proceso de validación.
-¿Se delimitó que no intervengan otros factores?
- El instrumento ha sido diseñado para aislar otras dimensiones de la evaluación de Satisfacción Usuaria y solo medir la percepción del Trato Usuario. Con ello busca aislar todos los elementos que no dependen del trabajador centrándose en la empatía, presentación personal, cortesía y confianza, disponibilidad, interés y confiabilidad en la relación con el usuario. Por ejemplo, es clave usar delantal y credencial que permitan que nuestros usuarios sepan quién y cómo se llama el funcionari@ que le atiende.
-Algunas características de la encuesta…
- Para ser sujeto de la encuesta, se requiere que el usuario haya sido atendido por personal administrativo, técnico y profesional y no que haya ido a buscar medicamentos ni a hacer trámites, como ir a buscar la interconsulta, por ejemplo.
En un artículo transitorio se señala que por este año se aplicará en el segundo semestre, pero desde el 2014 será aplicada en el primer semestre, antes de la campaña de invierno para que este factor no afecte los resultados.
-¿Cuáles son los requerimientos para percibir el bono?
-Todos los centros de salud primaria del país se van a rankear y el tercio mejor evaluado obtendrá una asignación de algo así como 270 mil pesos; el segundo tercio, 170 mil pesos y, el tercero, 90 mil pesos aproximadamente.
La ley establece que los centros deben obtener una calificación de a lo menos un 60 %, pero para este 2013 bastará con un 50%. Eso equivale a sacarte sobre una nota 3,5 y en la muestra nadie sacó menos de nota 5 y tanto.
El fondo es de 7.500 millones que se incrementará anualmente de acuerdo al crecimiento de la dotación y al reajuste del sector público.
Esta asignación la recibirá todo el equipo de salud sin distinción de categorías funcionarias. Los centros que no desarrollan labores asistenciales directas (como las direcciones de salud, laboratorios u otros), serán calificados con el promedio obtenido por los establecimientos de su comuna.
-¿Qué valor le otorgas a esta evaluación del trato a sus pacientes?
-Creo que no debe estresarnos, nadie va quedar en lista 3, ni tendrá anotación de demérito con esto. Tenemos que verlo como una oportunidad para poner atención en hacer los esfuerzos para romper con la rutina de la carga asistencial abrumadora y recuperar el sentido más profundo de nuestra labor que es la vocación de ayuda y de servicio público. Tenemos que humanizar nuestro trabajo; tenemos que mirarnos a los ojos, con nuestros usuarios y también con nuestros compañeros.
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