documento guia para realizar la asesoria … · ley conjunto de normas jurídicas de ......

DOCUMENTO GUIA PARA

REALIZAR LA ASESORIA EXTERNA

CONAMED

Ley

Conjunto de normas jurídicas de observancia general

y obligatorias, que tienen por objeto regular las

conductas entre particulares y entre estos y el Estado,

para garantizar el orden social

ASESORÍA EXTERNA

Nombre del Asesor:______________________________________________________________ Especialidad:____________________ Cuestionario:___________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Fecha en que se solicita la asesoría:_____________________________ Plazo que se fijó para la entrega de su informe: ___________________ Fecha de entrega a CECAMED: ______________________________ Consideraciones: ________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Conclusiones: __________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

BIBLIOGRAFÍA

AUTOR TÍTULO EDITORIAL EDICIÓN Y AÑO

PÁGINA

Análisis:______________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

EVALUACIÓN DE ATENCIÓN MÉDICO-QUIRÚRGICA

A.- Razonamiento clínico: 1.- Estudio clínico: completo__________ incompleto____________

2.- Deficiencias: Interrogatorio_____ Exploración física_____ Otros_____ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 3.- Pruebas de diagnóstico necesarias:

Completas_____ Especificar______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Sustentación:_____________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Incompletas:_____ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Sustentación:_____________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Riesgo en procedimientos especiales: Riesgos en procedimientos de diagnósticos:________________________ Riesgo anestésico:____________________ Riesgo quirúrgico:____________________ Sustentación:_____________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Señalar obligaciones de resultados:___________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. Integración de hallazgos clínicos con los resultados de las pruebas: Integración correcta:________ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Integración incorrecta:________ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Sustentación:_____________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

5. Diagnóstico: ¿Hubo diagnóstico? Si_______ No_______ Diagnóstico:_____________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Correcto:___________ Incorrecto:__________ Sustentación:_____________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Hubo diagnóstico diferencial? Si_______ No_______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 6. Alternativas de tratamiento conforme a las circunstancias del caso: Especificar:

NUM. ALTERNATIVAS DISPONIBLES

7. Valoración de Alternativas:

NUM. RIESGOS BENEFICIOS OBSERVACIONES

8. Valoración del riesgo-beneficio:__________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 9. Elección:____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 10. Factores limitantes:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 11. Evaluación de la libertad prescriptiva: Criterio médico-quirúrgico:_________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 12. Limitaciones institucionales:___________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Disponibilidad de recursos:________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

13. Necesidad de modificación del tratamiento:________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 14. Condicionamiento y preferencias del paciente:_____________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ B.- Consentimiento bajo información: Inexistencia del consentimiento:__________________ Se suscribieron condiciones inaceptables y desventajosas:_____________ Se acredita solo consentimiento verbal:_______________ Se omitió consentimiento escrito, en casos obligatorios:_______________

Especificar:

NUM OMISIONES

La carta de consentimiento bajo información se suscribió con deficiencias:______ Se obtuvo consentimiento escrito con arreglo a derecho:______

C.- Tratamiento: Clasificación:

Tipo Indicador Tipo Indicador

1. De urgencia A. Preventivo 2. De elección B. Curativo 3. De competencia C. Rehabilitatorio

Idoneidad:

¿Se trataba de tratamiento de elección? Si________ No_________ ¿Se trataba de tratamiento de amplio espectro? Si________ No_________ ¿El tratamiento fue oportuno? Si________ No_________

Especificar:____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Se consideraron sinergias y antagonismos farmacológicos?_____________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 18. Señalar obligaciones de medios o de diligencias del personal de salud:

a) Personal médico.-

NOMBRE OBLIGACIONES OBSERVACIONES

b) Personal de enfermería.-


c) Personal paramédico.-


19. Señalar obligaciones de supervisión y personal responsable:___________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Especificar:____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 20. Evaluación de obligaciones de seguridad:_________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 21. ¿Eran exigibles algunos resultados? Si_______ No_______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 22. ¿Se modificó la conducta terapéutica conforme a la evolución y necesidades del paciente? Si_______ No________ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

D). Obligaciones del establecimiento:

NUM. ESPECIFICAR LAS OBLIGACIONES

Evaluación:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 1. Se dio información completa al paciente a lo largo de su tratamiento? Si______ No______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 2. Capacidad de respuesta institucional:______________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

3. ¿Existió y estuvo disponible la infraestructura necesaria? Si_______ No_______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. Era necesaria la referencia del paciente a un establecimiento de mayor complejidad? Si________ No________ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ E) Intervención de otros profesionales y problemas de tráfico: ¿El personal tratante debió abstenerse de continuar la atención y derivar al paciente a un

especialista? Si_______ No________ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Debió existir interconsulta a otros profesionales? Si_______ No______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Debió hacerse intervenir, además del personal tratante a otros especialistas en el

tratamiento? Si________ No_______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Se refirió adecuadamente al paciente? Si_______ No_______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

¿Se emitió alta voluntaria con arreglo a las disposiciones aplicables? Si_____ No_____ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Se emitió responsiva con arreglo a la ley? Si______ No______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Se incumplieron las obligaciones contraídas en la responsiva? Si______ No______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Se entregaron adecuadamente turnos críticos? Si_____ No______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Existen evidencias de carencia de personal? Si_____ No______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Existen omisiones imputables al personal hospitalario? Si______ No______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Señalar carencias, o limitaciones de auxiliares de diagnóstico y tratamiento:___________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

EVALUACIÓN DE RESPONSABILIDAD:

A) CONDUCTA MÉDICA:

1. El personal médico mostró capacidad de previsión: Si_____ No_____

Especificar:

NOMBRE CAUSA

2. El personal médico cumplió voluntariamente las disposiciones jurídicas:

Especificar:

NOMBRE CAUSA

3. El personal actuó contrariando de manera genérica normas jurídicas:

Especificar:

NOMBRE CAUSA

4. El personal médico actuó sin la previsión necesaria:

Especificar:

NOMBRE CAUSA

5. El personal dejó de lado reglamentos o deberes a su cargo cuando las condiciones eran previsibles:

Especificar:

NOMBRE CAUSA

6. El personal actuó con desconocimiento o falta de habilidad o destreza:

Especificar:

NOMBRE CAUSA

7. El personal omitió instrucciones precisas y/o supervisión adecuada:

Especificar:

NOMBRE CAUSA

B) NEXO CAUSAL:

1. Atendiendo a la historia natural de la enfermedad el padecimiento ocasionaba daños:

Si_______ No________ Especificar:__________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 2. ¿El evento adverso era de esperarse en ausencia de dolo, negligencia o impericia? Si______ No______

Especificar:__________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 3. ¿El evento adverso fue originado por yatrogenia o yatropatogenia? Yatrogenia_____________ Yatropatogenia ____________

Especificar:__________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

4. ¿El evento adverso se debió a una acción voluntaria o contribuyente del enfermo o de terceros? Si______ No_______

Especificar:__________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 5. ¿El evento adverso se debió a idiosincrasia u otras causas intrínsicas del paciente? Si_______ No________

Especificar:__________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 6. ¿El evento adverso se debió a un accidente en el que no intervino personal de salud ni alguno de los elementos anteriores? Si______ No_______

Especificar:__________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

C) FALLAS DE ORIGEN MEDICO: 1. Tratamientos no controlados:

Especificar:__________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

2. Medicamentos no tolerados:

Especificar:__________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Tratamientos inadecuados por razones técnicas (especialmente quirúrgicos):

Especificar:____________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Tratamientos inadecuados por razones económicas: Tratamientos baratos _________ Tratamientos ausentes _________ Tratamientos postergados _________

Especificar:__________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. Ausencia o inoperancia de la medicina rehabilitatoria:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

5. Medicamentos fuera de los límites de la necesidad terapéutica: Calidad_______ Cantidad________

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 6. Ausencia de registro de datos:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 7. Ignorancia de los antecedentes del paciente:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 8. Falta de consultas y tratamientos de especialistas:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

9. Falta de internamiento oportuno:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 10. Exámenes rápidos:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 11. Abuso de medicina invasiva:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 12. Negativa de atención injustificada:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

13. Aspectos adversos originados por alta prematura:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 14. Lesiones o perjuicios debidos a vigilancia inadecuada:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 15. Violación al secreto profesional:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 16. Ensañamiento terapéutico:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

D) FALLAS DE ORIGEN HOSPITALARIO:

1. Negativa de admisión sin justificar el impedimento:

Especificar:___________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 2. Perjuicios derivados del alta prematura:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 3. Lesiones o perjuicios durante el internamiento, producto de vigilancia inadecuada:

Especificar:___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 4. Accidentes durante el internamiento (caída de cama o camilla, quemaduras, etc.):

Propiamente accidentes ____________ Debidos a falta de vigilancia ____________

Especificar:___________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

5. Falta de mantenimiento de equipo o instrumental: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 6. Instalaciones inadecuadas: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 7. Error en la administración de medicamentos y soluciones por cambio de la medicación en la vía o en la dósis: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 8. Falta de insumos: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

9. Infecciones nosocomiales: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 10. Exigencias económicas injustificadas: Especificar.______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 11. Condicionamiento de atención por requisitos económicos: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 12. Retención indebida de paciente o cadáver: Especificar:_____________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

13. Manejo abusivo del paciente o ensañamiento terapéutico: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 14. Maltrato al paciente, discriminación y afectación de su dignidad: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 15. Insuficiencia de personal: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 16. Falta de capacitación al personal: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

17. Falta de supervisión al personal: Especificación:___________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 18. Deficiencias en el llenado del expediente clínico: Especificación:___________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 19. Deficiencias en servicios auxiliares de diagnóstico y tratamiento: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 20. Deficiencias en los servicios de urgencias, terapia intensiva y quirófano: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

Señalar desabasto de insumos para la salud:____________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Existió negativa de servicios?

TIPO DE SERVICIOS

NEGADOS SI NO

Preventivos

Curativos

Rehabilitatorios

Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Existió negativa de insumos? Si______ No______ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Existen problemas de traslado o en unidades móviles? Si______ No_____ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ¿Existió descortesía o maltrato del personal hospitalario? Si______ No_____ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Determinar incumplimiento en obligaciones de tráfico: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

21. Deficiencias en unidades móviles:_______________________________________________ Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 22. Deficiencias en la información al paciente y su representación legal. Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 23. Manejo indebido del alta voluntaria, egreso hospitalario y certificación de la defunción: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 24. Actos irregulares en investigación clínica o en necropsia hospitalaria: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

25. Actos irregulares en la disposición de órganos y tejidos: Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

E. CONCLUSIONES Y RECOMENDACIONES CONCLUSIONES Especificar:______________________________________________________________

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ___________________________________

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