Dr. Anil Bhadoria
TRAINING PROGRAM FOR MP, ESI SERVICES
2013

30 AUGUST

EFFECTIVE
GRIEVANCES
HANDLING &
ATTITUDINAL CHANGES
TO ENSURE SMOOT...
GRIEVANCES HANDLING


-
WHY WE NEED TO DISCUSS……
We are Health Industry, day begins with
complaints.
 Complaints not attended properly, Patient w...
WHY WE NEED TO DISCUSS……


ESI Scheme has –












150 Hospitals & 42 Annexie Wards
22325 beds
1402 Dispens...
WHY WE NEED TO DISCUSS……
1 Million Patients is a huge number.
 There is sufficient scope of inadvertent &
willful harassm...
WHY WE NEED TO DISCUSS……
Citizen Charter was introduced in 1997
 To improve Public service delivery system.
 A service e...
WHY WE NEED TO DISCUSS……

1.
2.

What is Vision Panchdeep:
Better coordination & awareness of scheme.
Improvement in –

...
GRIEVANCE


How do we Define:

Any lack in service that disappoints the
beneficiary of ESI Scheme and is
presented to ser...
GRIEVANCE HANDLING


1.
2.
3.
4.
5.
6.
7.
8.

90% of grievances are minor at ESI Scheme which
include:

Improper attentio...
GRIEVANCE HANDLING

1.
2.
3.
4.
5.
6.
7.
8.

CAUSES Emergency health situations.
Work Environment.
Poor Infrastructure of...
GRIEVANCE HANDLING
INVESTIGATE THE GRIEVANCE:
1. What is the matter?
2. Who is involved?
3. Why did the situation occur?
4...
GRIEVANCE HANDLING
Grievance Redressing:
1. Develop a list of available alternative
solutions.
2. Gathering information fr...
GRIEVANCE HANDLING

1.
2.
3.

4.
5.

5 stages to resolve the problem:
Level - 1 redressing in first 48 hours.
Level - 2 r...
GRIEVANCE HANDLING ATTITUDE
G.R. PROCEDURE:
1. First & foremost……….Don’t Panic.
2. Hold your temper.
3. Take a lead.
4. Co...
FEAR FACTOR






GRIEVANCES CAN BE FILED –
 To State Medical Council which reaches the MCI ultimately.
 Under IPC 30...
FEAR FACTOR








Suspension of license is a criminal punishment versus
compensation which is a civil punishment.
...
GRIEVANCE HANDLING

1.

2.
3.
4.
5.
6.
7.
8.

ATTITUDINAL CHANGES:
Be punctual.
Be a good Listener.
Identify potential ca...
GRIEVANCE HANDLING
……….continued
9. Any grievance, not attended or answered within
48 hours or specified time limit shall ...
GRIEVANCE HANDLING


1.
2.
3.
4.
5.
6.

7.

Benefits of EARLY settlement of Grievance
RedressalQuick Resolution
Superior ...
GRIEVANCE MEETING










Discuss rationally - Law of natural justice.
Review the Grievance with grievant & the
...
GRIVANCE REPORTING :
LOCAL LEVEL
IMO/IMP at Dispensary/Panel clinic level.
Manager at Branch Office level.
MS/DMS at Hospi...
GRIEVANCE HANDLING

1.
2.
3.
4.
5.

6.

Prevention at local level:
Direct observation.
Suggestion box.
Personal counselor...
GRIEVANCE HANDLING
Key features of good grievance handling
procedure:
1. Fairness
2. Procedural steps
3. Promptness
4. Def...
TAKE HOME MESSAGE
Every Grievance has a Life Span.
 Early resolution is better.
 No grievance is bigger so long as we ar...
WAKE UP


Goalkeeper & attending Grievance cell are
same. You can make a 100 brilliant saves but
the only shot that peopl...
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SOCIAL SECURITY SCHEME FOR LABOR COMMUNITY E.S.I.SERVICES, INDIA

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ORGANIZED SECTOR LABOR COMMUNITY IN INDIA IS COVERED UNDER E.S.I. SCHEME (LABOR & EMPLOYMENT MINISTRY) FOR SOCIAL & HEALTH SECURITY.

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SOCIAL SECURITY SCHEME FOR LABOR COMMUNITY E.S.I.SERVICES, INDIA

  1. 1. Dr. Anil Bhadoria
  2. 2. TRAINING PROGRAM FOR MP, ESI SERVICES 2013 30 AUGUST EFFECTIVE GRIEVANCES HANDLING & ATTITUDINAL CHANGES TO ENSURE SMOOTH & SMART DELIVERY OF
  3. 3. GRIEVANCES HANDLING  -
  4. 4. WHY WE NEED TO DISCUSS…… We are Health Industry, day begins with complaints.  Complaints not attended properly, Patient will be dissatisfied and generating GRIEVANCE. 
  5. 5. WHY WE NEED TO DISCUSS……  ESI Scheme has –          150 Hospitals & 42 Annexie Wards 22325 beds 1402 Dispensaries 7983 IMO & IMPs 1.67 Crores IP and their family units 28.60 Insured Females > 7 Crores Beneficiaries 1 Million ESI Beneficiary attend our service outlets daily nation wide. In MP, daily average of 5686 patients have attended ESI Set-up in 2012-13.
  6. 6. WHY WE NEED TO DISCUSS…… 1 Million Patients is a huge number.  There is sufficient scope of inadvertent & willful harassment of IPs and Family Members because  Expectations are high.  Limited resources.  IP is our VIP as well.  IP is a consumer as ours are contributory services.
  7. 7. WHY WE NEED TO DISCUSS…… Citizen Charter was introduced in 1997  To improve Public service delivery system.  A service excellence model SEVOTTAM was initiated in 2005 to thrust implementation of citizen charter.  Citizen Charter & Grievance Redressal Bill 2011 is right of citizens for time bound delivery of goods & services & Redressal of their grievances bill or Citizen Charter bill 2011  ESIS is also covered under RTI Act 2005 
  8. 8. WHY WE NEED TO DISCUSS……  1. 2. What is Vision Panchdeep: Better coordination & awareness of scheme. Improvement in –     3. 4. 5. Delivery system, Work environment, Grievance Handling & Fulfillment of Men & Material resources. Scheme in new areas. Skill Development. Simplify Rules & Regulations for hassle free services.
  9. 9. GRIEVANCE  How do we Define: Any lack in service that disappoints the beneficiary of ESI Scheme and is presented to service-provider verbally or in written is a Grievance. All beneficiary have equal right to present his complaints to service provider at lower or higher levels to obtain their redressing.
  10. 10. GRIEVANCE HANDLING  1. 2. 3. 4. 5. 6. 7. 8. 90% of grievances are minor at ESI Scheme which include: Improper attention to patient. Delayed services like supply of drugs, impending surgery. Generic & substitute Drug Products. Unavailability of basic services like path investigations. Reimbursement- Rejection or Delayed or at CGHS rate. Misbehavior by health care provider. Mob Management as every one is in hurry. Not meeting with the expectations like cashless
  11. 11. GRIEVANCE HANDLING  1. 2. 3. 4. 5. 6. 7. 8. CAUSES Emergency health situations. Work Environment. Poor Infrastructure of health industry. Poor quality of material. Misbehavior (From either side). Services not meeting with expectation. Excessive Patient Input. Punctuality
  12. 12. GRIEVANCE HANDLING INVESTIGATE THE GRIEVANCE: 1. What is the matter? 2. Who is involved? 3. Why did the situation occur? 4. Where did the grievance occur? 5. What are the circumstances? 6. What remedy the Grievant is seeking? 
  13. 13. GRIEVANCE HANDLING Grievance Redressing: 1. Develop a list of available alternative solutions. 2. Gathering information from past experiences. 3. Final decision in clear & unbiased terms. 4. Follow up. 
  14. 14. GRIEVANCE HANDLING  1. 2. 3. 4. 5. 5 stages to resolve the problem: Level - 1 redressing in first 48 hours. Level - 2 redressing in 3 days. Grievance committee level making GR in 7 days & decisions implemented within days of receipt of recommendations from committee. Appeal for revision in 1 week. Arbitrator level GR whose decision shall be binding on both the party.
  15. 15. GRIEVANCE HANDLING ATTITUDE G.R. PROCEDURE: 1. First & foremost……….Don’t Panic. 2. Hold your temper. 3. Take a lead. 4. Consider the possibility of early settlement which is possible in maximum cases. 
  16. 16. FEAR FACTOR    GRIEVANCES CAN BE FILED –  To State Medical Council which reaches the MCI ultimately.  Under IPC 304A to the Police and  To the State or National Consumer Forum By filing a case in State Medical Council, the complainant has a fair chance of getting more compensation if the State Medical Council gives a decision against the doctor which includes 1. Warning, 2. suspension of license on finding any deficiency of service in the hospital treatment. There is a fundamental principle in law that one is supposed to LOOK ONLY INTO THE ALLEGATIONS specified by the complainant and not pursue or do the post mortem of the whole case.
  17. 17. FEAR FACTOR       Suspension of license is a criminal punishment versus compensation which is a civil punishment. Medical councils do take actions against medical doctors. Action against doctors is much higher in the medical councils than in the Consumer Forums. Doctors are covered for a financial disputes under a contract, for civil negligence under the law, for criminal negligence under IPC 304A and for a professional misconduct under MCI Ethics regulations. MCI Law 7.5 says that once you are convicted in a criminal case, the same amounts to professional misconduct. If there is a warning or a suspension of license, the same can be taken adversely by the Criminal Courts or the Consumer Courts which may award punishment or heavy compensation to the patient even without going further into the inquiries.
  18. 18. GRIEVANCE HANDLING  1. 2. 3. 4. 5. 6. 7. 8. ATTITUDINAL CHANGES: Be punctual. Be a good Listener. Identify potential cause. Correct the problem promptly. Encourage corrective suggestions. Be objective & consistent. Be fully informed about policy matters. Be communicative & give advance notice to changes. Continued……
  19. 19. GRIEVANCE HANDLING ……….continued 9. Any grievance, not attended or answered within 48 hours or specified time limit shall be submitted to next step, be it Regional Dy. Director or Medical Supdt. 10. Grievance not appealed to next step in writing within time limit will be considered withdrawn.
  20. 20. GRIEVANCE HANDLING  1. 2. 3. 4. 5. 6. 7. Benefits of EARLY settlement of Grievance RedressalQuick Resolution Superior Credibility Services Entrusted Respect Regained Prolonged conflict avoided Local mob control is maintained Further Grievance avoided
  21. 21. GRIEVANCE MEETING         Discuss rationally - Law of natural justice. Review the Grievance with grievant & the representative. Don’t bargain with the grievant. Be certain that you have all the information you need before responding. Don’t respond to a demand for an instant answer. Adhere to time line for your response. Provide an answer which is concise & complete. Obtain acknowledgement of receipt or your answer from grievant with time & date mentioned.
  22. 22. GRIVANCE REPORTING : LOCAL LEVEL IMO/IMP at Dispensary/Panel clinic level. Manager at Branch Office level. MS/DMS at Hospital level. STATE LEVEL GRO or Regional Deputy Director or Director,ESIS SMC or Sr SMC CORPORATE LEVEL/ HQ DG / MC / IC or Director (Public Grievance) Toll free : 1800-11-2526 Email: jd-pg@esic.nic.in For Suggestions & Grievances
  23. 23. GRIEVANCE HANDLING  1. 2. 3. 4. 5. 6. Prevention at local level: Direct observation. Suggestion box. Personal counselor. Exit Interview. Misc Channels. ( Receiving inputs from field workers about supply chain, Inventory & follow up of grievances placed at higher levels). Grievance Register at all levels.
  24. 24. GRIEVANCE HANDLING Key features of good grievance handling procedure: 1. Fairness 2. Procedural steps 3. Promptness 4. Definite time limits (TL) 5. Facilities for representation at each step. 
  25. 25. TAKE HOME MESSAGE Every Grievance has a Life Span.  Early resolution is better.  No grievance is bigger so long as we are  Punctual  Communicating  Patient Friendly  Sympathetic as well as Empathetic  Informing properly the channels above & below
  26. 26. WAKE UP  Goalkeeper & attending Grievance cell are same. You can make a 100 brilliant saves but the only shot that people remember is the one that gets past you.  You don’t need a reason to help people.  An error gracefully acknowledged is a victory won. THANK YOU !

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