Nội dung toàn văn Decision No. 1854/QD-BYT 2015 document about competence standards for general practitioners
THE MINISTRY OF HEALTH | SOCIALIST REPUBLIC OF VIETNAM |
No.: 1854/QD-BYT | Hanoi, May 18th, 2015 |
DECISION
ON APPROVAL FOR DOCUMENT ABOUT COMPETENCE STANDARDS FOR GENERAL PRACTITIONERS
THE MINISTER OF HEALTH
Pursuant to the Decree No. 63/2012/ND-CP dated August 31st 2012 by the Government defining the functions, tasks, entitlements and organizational structure of the Ministry of Health;
At the request of Director of Administration of Science Technology and Training,
DECIDES:
Article 1. Approval for the Document “Competence standards for general practitioners” enclosed with this Decision.
Article 2. Competence standards for General practitioners means the competences a general practitioner shall have when performing the medical examination and treatment in Vietnam.
Article 3. This Decision comes into effect from the day it is signed.
Article 4. The Chief of the Ministry Office, Director of Administration of Science Technology and Training, Directors of Departments, Directorate Generals of Directorates affiliated to the Ministry of Health; Directors of the Departments of Health of provinces; Directors of hospitals and institutes having hospital beds; Director of educational institutes, Principals of universities providing training for general practitioners and Heads of relevant units are responsible for implementing this Decision./.
| PP. THE MINISTER |
COMPETENCE STANDARDS FOR GENERAL PRACTITIONERS
Part one
GENERAL INTRODUCTION
1. Introduction
Medical doctors play an important role in medical staff members who directly examine and treat illnesses. For many years, Vietnamese medical system has faced a serious inadequacy of medical doctors. Since 2000, due to the development of training institutions in both quantity and scale, the number of medical doctors has obviously increased, at the same time, the quality of medical doctors is not satisfactory, causing bad effect to medical service quality, especially in grassroots-level medical facilities and medical facilities in disadvantaged areas. This reality requires that training institutions produce medical doctors reach the minimum competence standards.
By realization of the importance of this requirement, the Ministry of Health directs the formulation of Competence standards for General practitioners in Vietnam with the attendance of all the relevant parties, including experts in training/recruitment, managers, specialists and social organizations. During the formulation, Drafting Board has made reference to competence standards for medical doctors in other countries in ASEAN and around the world according to the reality in Vietnam.
Competence: is a range of attributes of a particular person satisfying the requirements of an activity to perform the activity well and efficiently.
Competence Standard: is the rank of levels or capacity to satisfy the real requirements of work that is certified through assessment and inspection according to professional competence standards.
Professional competence: is the conformity between psychological - physiological attributes of a person and requirements of his/her occupation. Each occupation has specific requirements; in general, professional competence includes 3 components: specialist knowledge, skills and professional attitudes.
Both competence and professional competence are not innate. They are formed and developed continuously through hard study and work and professional practice. During the professional practice, medical doctors will have to study continuously to develop new competence appropriate to their assignment.
2. Necessity for Competence standards for General practitioners
The formulation and issuance of the Competence standards for General practitioners are very importance due to the following basic reasons:
2.1. Regarding the society:
- Increase the supervision of residents, patients and the community of the fulfillment of the commitment between the training institutions and the society on trading quality.
- Reduce and eliminate the supply of unqualified medical service due to the incompetence.
2.2. Regarding training institutions:
- Form the basis for formulation of outcome standards, determination of suitable training programs, methods and contents for general practitioner training programs.
- Form the basis for students whose speciality is general practitioner to strive and make self-assessment of professional competence during the studying process and after graduation.
- Connect the training contents with the socio-economy reality of Vietnam.
2.3. Regarding management facilities of general practitioners:
- Determine the professional practice scope of general practitioners.
- Determine the responsibilities and obligations of a doctor and resolve the mistakes relating to general practitioners’ ethics or practice.
- Form the basis for managers to draw up plans and create opportunity for general practitioners to receive training to improve their professional skills.
2.4. Regarding international integration: Form the basis for comparison of basic competence of General practitioners in Vietnam with General practitioners in other countries, promote the integration and recognition of training level between countries in ASEAN and around the world.
2.5. Regarding the general practitioners: Form the basis for the general practitioners to complete and improve themselves to be granted practice certificates.
3. Basis for formulation of Competence standards for General practitioners
Resolution No. 46-NQ/TW dated February 23rd 2005 by the Politburo.
Resolution of the 8th Conference of XIth Central Executive Committee (Resolution No. 29-NQ/TW) on radical changes of education and training.
- The Law on People’s Health Protection dated June 30th 1989.
- The Law on Medical examination and treatment No. 40/QH12 dated November 23th 2009.
- Professional standards for Scales of General Practitioners according to the Decision No. 41/2005/QD-BNV dated April 22nd 2005 by Ministry of Home Affairs.
- The agreement of mutual recognition framework in medical practice between the ASEAN countries that Vietnam’s Government concluded with ASEAN members on December 8th 2006.
4. Process
4.1. Preparation
The Competence standards for General practitioners are formulated depending on the practical researches in Vietnam with reference to international documents. The preparation can be summarized as follows:
- A Compilation board of Competence standards for General practitioners is established including people who provide training, manage or formulate medical policies, Vietnam Medical Association and experts who are doctors.
- The Compilation board refers to the results of the ministerial project on “Establishment of outcome standards for general practitioners” made by Hanoi Medical University (2010-2013)
- The Compilation Board collects suggestions of training institutions and posts them on websites of the Ministry of Health and Administration of Science Technology and Training to collect more suggestions.
- Suggestions of general practitioner training institutions, hospitals, Departments of Health and relevant Departments are collected in writings or through seminars.
4.2. Procedures for approval by the Ministry of Health
- The Minister of Health establishes a Specialist Council to carry out appraisal of the Documents about Competence standards for general practitioners. The Council discusses and carries out appraisal and offer additional suggestions on contents and formula of documents. The Compilation Board acquires the suggestions of the Council and completes the documents.
- The Minister of Health signs the decision No. … dated ... issuing the Competence Standards for General Practitioners in Vietnam.
5. Summary of Competence standards for General practitioners
The set of Competence standards for General practitioners is structured according to the general format of sets of competence standards of the countries in Asia Pacific and the ASEAN to satisfy the requirements of the areas as well as to facilitate the comparison. The Competence standards for General practitioners is organized into 4 fields including 20 standards and 90 criteria.
Each field presents a basic function of a general practitioner, including: Competence in professional practice; Competence in application of medical knowledge; Competence in medical care and Competence in communication and cooperation.
Each standard is a component of a field, containing a task of the general practitioners.
Each criterion is a component of a standard. A criterion may apply to multiple standards/fields.
Part two
COMPETENCE STANDARDS FOR GENERAL PRACTITIONERS
FIELD 1: COMPETENCE IN PROFESSIONAL PRACTICE
General practitioners shall have a professional practicing manner according to moral and legal standards and shall respect the variety of culture.
Standard 1. Perform medical practice according to the social and cultural situation and actual conditions
1. Criterion 1. Respect the economic conditions, customs, beliefs, religions and cultures of each regions/individuals.
2. Criterion 2. Keep ready to work independently and cooperatively in interdisciplinary healthcare activities, commit to work according to the ethics and legal rules and take responsibilities for their own decisions in their specialities.
3. Criterion 3. Show their enthusiasm for their own choice of occupation by making commitment on compliance with the good practice standards and maintain the standards of profession, ethics and culture at the highest level.
4. Criterion 4. Approach patients and healthcare issues of the community in a scientific, thorough, honest, responsible, sympathetic, and altruistic way.
5. Criterion 5. Support the principle that people from all backgrounds have the right to access to good-quality health care service.
6. Criterion 6. Appreciate the cooperation of modern medicine and traditional medicine.
7. Criterion 7. Uphold the role and image of a doctor, value of a doctor to healthcare activities and to the society through the competence in completing professional tasks and performing social responsibilities with professional manners, wholesome lifestyle and good communicative skills and behaviors.
Standard 2. Perform medical practice according to professional ethical standards
8. Criterion 1. Take personal responsibilities for the decision and intervention in the healthcare service provided for patients or the community.
9. Criterion 2. Always give consider the safety and interests of patients as the center. Identify the threats to safety of patients in healthcare activities.
10. Criterion 3. Perform the medical practice within the certificated professional scope, conformable to occupational regulations and suitable with health conditions.
11. Criterion 4. Keep secret about the health conditions of patients and information the patients provided in medical records. Information of a patient shall be disclosed to other people only under the agreement of the patient or for improvement of quality of diagnosis, care services and treatment of practitioners who directly provide treatment for the patient or in cases allowed by law provisions.
12. Criterion 5. Strictly comply with the ethical principles in medical researches
Standard 3. Perform medical practice according to the regulations of laws
13. Criterion 1. Perform medical practice according to the legislation of Vietnam and relevant International Agreements to which Vietnam is a party.
14. Criterion 2. Comply with the regulations, principles and communication culture at workplace.
15. Criterion 3. Report the violations against the regulations in speciality and practice to competent agencies and take personal responsibilities for such report.
16. Criterion 4. Apply the approaching methods depending on the legality and ethics in the use of medical care sources.
Standard 4. Study continuously for personal development and for occupational capacity
17. Criterion 1. Make self-assessment and use the feedback about their work systematically, regularly and scientifically. Determine the actual requirements of work, their targets, expectation for occupational development and their own strong points and weak points.
18. Criterion 2. Draw up plans and participate in the study and development of their occupation using supportive sources that are suitable, effective and creative.
19. Criterion 3. Get ready to participate in training activities corresponding to their capacity on request. Assist their colleagues to improve of capacity and develop of occupational skills.
20. Criterion 4. Have ability to use English and/or other languages in study, research and occupational development.
21. Criterion 5. Have ability to collect, assess and use Vietnamese and foreign medical information that is valuable and reliable in the provision of health care service.
22. Criterion 6. Approach the archives and restore the clinical information in medical records (in printed paper or digital files), libraries and online sources of information in appropriate, sufficient and accurate way ensuring the privacy and legality.
FIELD 2: COMPETENCE IN APPLICATION OF MEDICAL KNOWLEDGE
General practitioners shall have ability to apply the knowledge about basic science and basic medicine, pathology and social and medical studies as the rationale for identifying, explaining and resolving the problems and transmit to individuals, groups of individuals and community about health conditions.
Standard 5. Apply the knowledge about basic science, basic medicine and pathology in medical practice
23. Criterion 1. Have the ability to give explanation about structure, functions and normal development in physical and spiritual conditions of human through development period in the interaction with natural and social environment.
24. Criterion 2. Have ability to give explanation about the interaction between structure and functions of human’s body, between the organs in normal conditions and about pathological signs and structure of symptoms and syndromes, the anticipating factors of abnormal signs and pathological at different ages.
25. Criterion 3. Have ability to give explanation about basic principles, indications, contraindications, procedures, weakness of procedures, techniques for physical examination and testing serving the diagnosis of common diseases.
26. Criterion 4. Have ability to present logical argument concerning the standards for diagnosis serving the determination/separation between the common diseases depending on scientific evidence.
27. Criterion 5. Have ability to give explanation about the principles and solutions for common health problems and some conditions requiring emergency treatment including treatment with drugs, surgeries, physical therapies, medical nutrition therapies, psychological therapies, traditional medicine and additional and replacement therapies…
28. Criterion 6. Have ability to assess the effectiveness of medical intervention.
Standard 6. Apply the public medical principles/methods in medical services
29. Criterion 1. Have ability to present the principles and models of organizational systems, functions of Vietnamese medical network and relationship between medical sector and relevant sectors.
30. Criterion 2. Have ability to present the basic principles on medicine management and main contents of national programs in the field of medicine.
31. Criterion 3. Have ability to analyze the concepts and basic principles of epidemiology, main medical indices, risks and relationship between the risks and the diseases/the epidemics.
32. Criterion 4. Have ability to give explanation about the principles and apply such principles to grade 1, 2, 3 providing plans; personal providing strategy, providing accessing depending on the community and providing accessing depending on the risk in disease prevention and health improvement.
33. Criterion 5. Have ability to give explanation about the risk of environment pollution and its affect to people’s health; principles for prevention and fighting against environment pollution.
34. Criterion 6. Have ability to give explanation about the risk of occupational diseases and prevention and fighting against occupational diseases.
FIELD 3: COMPETENCE IN MEDICAL CARE
General practitioners shall have ability to resolve a normal demand for medical care safely, promptly, economically and effectively depending on scientific evidence and conformable to the real conditions.
Standard 7. Give diagnoses and decisions on resolution depending on the evidence with attendance of the patients, their family and relevant medical officers according to the real conditions.
35. Criteria 1. Have ability to make diagnosis serving the determination/separation of common diseases and have ability to classify international diseases - ICD10.
36. Criteria 2. Have ability to solve the normal emergency cases and discover serious things that threaten human life to promptly intervene.
37. Criteria 3. Make suitable designation and analyze the results collected from the methods, procedures for clinical and subclinical physical examination and functional exploration.
38. Criterion 4. Provide information relating to health conditions and illness for patients, their family and their colleagues to make them peace of mind and agree to cooperate before and during the physical examination and treatment.
39. Criterion 5. Assess the role and select the treating methods like internal medicine, surgery, physical therapy, psychotherapy, medical nutrition therapies, radiotherapy, etc. depending on scientific evidences.
40. Criterion 6. Apply new knowledge, methods, techniques and technologies in diagnosis and treatment according to the reality.
41. Criterion 7. Give decision on care for patients, use the available evidences thoroughly, clearly with discussion and agreement with the patients and their family to avoid mistakes when making decision.
42. Criterion 8. Formulate medical records for patients on principles that patients are centered, must not discriminate.
43. Criterion 9. Formulate plans, provide total treatment for patients and diseases.
44. Criterion 10. Comply with the technical procedures and clinical skills according to the regulations of the Ministry of Health towards general practitioners conformable to the regulations, organization and resources at workplace.
45. Criterion 11. Supervise often to discover and handle promptly the accidents during the care and treatment.
46. Criterion 12. Discover the cases in which diseases exceed the professional capacity and transmit patients to the right place, right line and right time.
47. Criterion 13. Support patients in terms of psychology, constitution, social spirit; handle the symptoms until there is a definite diagnosis and provide specific treatment.
Standard 8. Apply the knowledge and methodology in terms of behaviors, psychology and society in medical care practice
48. Criterion 1. Have ability to analyze the psychological processes of patients both in normal conditions and when the disease occurs. Have ability to determine the impact of psychology, economy and society on patients when decide the treating methods.
49. Criterion 2. Have ability to apply the principles and psychological methods to create the agreement and cooperation of patients and their family with the diagnosis and treatment decision.
50. Criterion 3. Have ability to determine management method appropriate to patients having psychological problems.
Criterion 9. Treatment with drugs that are safe, economic and effective
51. Criterion 1. Make prescriptions according to the regulations, safe, reasonable, lawful, with reliable scientific evidences and after discussing with patients or their family and their colleagues.
52. Criterion 2. Comply with the basic principles in use of antibiotics on patients, avoiding the drug resistance.
53. Criterion 3. Discover and provide first aid for the signs of drug allergy.
Standard 10. Medical care for pregnant women
54. Criterion 1. Provide antenatal care and gestation management. Take care of pregnant women and discover the risks during the gestation, labor and postpartum.
55. Criterion 2. Have ability to determine the signs of labor predict the labor condition and carry out normal delivers.
56. Criterion 3. Provide first aid for obstetric and postnatal accidents.
Standard 11. Be enthusiastic in providing medical care in recovery, first aid and care
57. Criterion 1. Assess sufficiently, classify and make handling decision promptly, suitably and predictively for cases that threat human lives and/or not threat human lives but require an urgent treatment.
58. Criterion 2. Handle the basic emergency and the cardiac arrest according to professional treatment regimen.
59. Criterion 3. Provide patients and their family with guidance on predicting the conditions of diseases.
60. Criterion 4. Cooperate effectively with members of groups providing care in first aid and emergency aid.
Standard 12. Prolonged care and palliative care for patients with chronic or incurable diseases
61. Criterion 1. Improve the living quality of patients, decrease the physical and spiritual pains, helping patients to maintain an independent life. Always consider the personal characteristics and characteristics of the diseases that affect the ability and psychological - physiological attributes of the patients.
62. Criterion 2. Use appropriate drugs, auxiliary equipment and social services and transport vehicles.
63. Criterion 3. Mobilize and encourage the participant of the patients and their family, their friends and other members in prolonged care or palliative care.
Standard 13. Pain control
64. Criterion 1. Select and carry out the basic analgesic technique according to the treatment regimen in a suitable way.
65. Criterion 2. Have ability to perform the analgesic principles with drugs, physical therapies and psychology therapies.
66. Criterion 3. Have ability to determine the mission and have ability to cooperate or participate in pain management with other medical staff.
Standard 14. Traditional medicine and treating methods without use of drugs in treatment, prevention and recovery from a number of common diseases
67. Criterion 1. Provide treatment, prevention and recovery from a number of common diseases by combining traditional medicine and modern medicine in reasonable and scientific way.
68. Criterion 2. Guide patients to apply treating methods without use of drugs in treatment, prevention and health improvement.
Standard 15. Participate in infection control
69. Criterion 1. Comply with the procedures for prevention, isolation and control of bacterial contamination.
70. Criterion 2. Have ability to determine the main bacterial contamination and common biological pathogens that require medical care.
71. Criterion 3. Have ability to determine transmission routes starting from hospital to decide the suitable handling measures.
Standard 16. Provide propagation, education and mobilization for health improvement and preventive healthcare
72. Criterion 1. Determine the demands and contents of healthcare guidance/education to provide for individuals, family and groups of community.
73. Criterion 2. Provide consultancy and communications about healthcare education to increase knowledge and healthy lifestyle as a method for health improvement and maintenance and preventive healthcare.
74. Criterion 3. Use the forthcoming multimedia (telephone, email, Internet, book, newspaper, TV recording…) assisting the transmission of information through the skills in presentation, writing report/scientific articles effectively and suitably.
Standard 17. Death management
75. Criterion 1. Confirm the death.
76. Criterion 2. Notify the deaths of patients to their family.
FIELD 4: COMPETENCE IN COMMUNICATION AND COOPERATION
General practitioners shall have ability to communicate effectively with patients and their family, their colleagues and the community.
Standard 18. Have ability to create a friendly, cooperative and trustful relationship with patients, their family and the community
77. Criterion 1. Spend time listening, sharing, discussing and solving the anxieties and worries of patients and their family.
78. Criterion 2. Have knowledge about demands, psychological, physiological and sociocultural factors that affect the patients.
79. Criterion 3. Create a friendly and cooperative relationship with the community and organizations/individuals relating to healthcare environment.
80. Criterion 4. Guide, encourage and discuss with the patients, their family and other occupational organizations to participate in giving decision and solving healthcare issue through discussion.
Standard 19. Cooperate effectively with colleague and partners
81. Criterion 1. Be honest, polite, caring, discussion-based, respect the patients and avoid conflict.
82. Criterion 2. Have ability to determine the role and relationship of members in care provider groups; organize and manage the provision of care for patients, ensuring the healthcare is continuous, safe, economic and effective.
83. Criterion 3. Listen and share exactly and effectively the necessary information about patients through discussion via speech, writing, mail without infringement of privacy principle.
84. Criterion 4. Discuss often with colleagues to discover the cases exceeding capacity, ensuring the safety of patients.
85. Criterion 5. Comply with the medical consultation principle and carry out the decisions of medical consultation.
Standard 20. Effective communication
86. Criterion 1. Have a good voiced and unvoiced communication with patients, their family and their colleagues.
87. Criterion 2. Determine the unsuccessfulness of the communicating methods and try another one.
88. Criterion 3. Communicate effectively in cases patients have communicating obstacles such as the old, children, people having difficulties in listening, looking and speaking, ethnic minority people.
89. Criterion 4. Communicate effectively with people regardless of ages, genders, sociocultural characteristics in Vietnamese or the common language in the workplace.
90. Criterion 5. Have ability to communicate with patients who are irritable, vulnerable and patients who suffer violence, help patients and their family have psychological preparation before provide them with information about the deterioration of the diseases, honestly admit the lack of information and mistakes (if any).
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