Summary of Patient Satisfaction Survey Results at Public Service Units under Dak Lak Provincial Department of Health from 2016 to 2020

encourage this form to exist. Or it is from the lack of care and concern for patients that some things go too far, affecting the health, body parts or innocent lives of some people.

The medical profession is a special profession, it can be a profession to save people or it can be a lack of conscience that leads to harming people. However, these incidents happen very rarely, it can be a medical accident due to negligence but in short, no one will intentionally harm people. Therefore, cultivating skills, learning to improve professional capacity is an important and indispensable thing in the organization. Moreover, professional skills for medical staff are even more important than other professions when related to human health and life.

2.2.4. On attitudes and office culture

Attitude here is understood as professional attitude in terms of behavior towards colleagues, behavior towards patients and their families, attitude towards assigned work and awareness of work. Work attitude plays a very important role in the professional activities of each health worker.

Office culture is a system of values that are specific in nature and are stipulated in regulations and rules that must be followed. This is necessary for every civil servant working in public health service units. Office culture plays a very important role in the provision of public services, determining the development and quality of public health service units. The nature of office culture needs to be humane, adaptive, and suitable to the working environment. The Ministry of Health issued Circular No. 07/2014/TT-BYT dated February 25, 2014, regulating the code of conduct for civil servants, public employees, and workers working in health facilities.

Regarding the attitude of staff towards patients and their families: Patient satisfaction is the top concern of the agencies.

A medical facility cannot develop if patient satisfaction is not placed together with the capacity of medical staff. Patient satisfaction index is assessed based on: The relationship between medical staff and patients, quality of service, value of service compared to the cost, response to patient expectations. Patient satisfaction index is used as a measure to build short-term and long-term development plans, creating a working environment that helps change the thinking and attitude of medical staff in contacting people.

Table 2.9: Summary of patient satisfaction survey results at public service units under the Department of Health of Dak Lak province from 2016 to 2020

Patient satisfaction

2016

2017

2018

2019

2020

Patient satisfaction

outpatient

(%)

Patient satisfaction

boarding

(%)

Patient satisfaction

outpatient

(%)

Patient satisfaction

boarding

(%)

Patient satisfaction

outpatient

(%)

Patient satisfaction

boarding

(%)

Patient satisfaction

outpatient

(%)

Patient satisfaction

boarding

(%)

Patient satisfaction

outpatient (%)

Patient satisfaction

inpatient (%)

Medium

90.66

92.81

89.00

90.39

92.06

93.27

90.8

89.4

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Source: Report on the results of medical work implementation from 2016 to 2020 of Dak Lak Provincial Department of Health.

Through a survey over the past 5 years from 2016 to 2020 by the Dak Lak Provincial Department of Health, it was shown that medical service units in the area have had clear changes from the quality of medical examination and treatment to the capacity of staff, contributing to increasing patient satisfaction. The Dak Lak Provincial Department of Health always implements

The strategy of innovating service style and attitude towards patient satisfaction has brought about practical results, with positive changes in service style and attitude towards welcoming people. The working attitude of medical staff must always be polite, gentle, encouraging, comforting, and respectful of patients and their families. Seriously implement Uncle Ho's teaching "A good doctor must be like a mother"; Implement the slogan "When patients come, they are warmly welcomed, when patients stay, they are taken care of wholeheartedly, when patients leave, they are given careful instructions". The satisfaction rate of patients at hospitals is highly appreciated, mostly over 90%.

On health workers' satisfaction with their profession:

Table 2.10: Summary table of health care staff satisfaction survey results

STT

Unit	Employee satisfaction health with work (%)
1	Central Highlands General Hospital	84.6
2	Buon Ho General Hospital	96.8
3	Buon Ma Thuot City General Hospital	92.2
4	Regional Hospital 333	97
5	University Hospital	85.8
6	Thien Hanh General Hospital	92.6
7	Cao Nguyen General Hospital	90
8	Tuberculosis & Lung Hospital	86.6
9	Traditional Medicine Hospital	90.1
10	Eye Hospital	93.8
11	Tay Nguyen Eye Hospital	95.4
12	Mental Hospital	91
13	EaH'Leo District Medical Center	75.4
14	Krong Nang District Medical Center	91.4

STT

Unit	Employee satisfaction health with work (%)
15	Cu MGar District Medical Center	94.8
16	M'Drak District Medical Center	96.2
17	EaKar District Medical Center	89.8
18	Krong Pac District Medical Center	87.4
19	Krong Bong District Medical Center	85.2
20	Krong Ana District Medical Center	98.2
21	CuKuin District Medical Center	95.2
22	Lak District Medical Center	85.4
23	Buon Don District Medical Center	93.2
24	EaSup District Medical Center	93.4
	Medium	90.90

Source: Survey of Dak Lak Provincial Department of Health.

In reality, health workers work in a very stressful environment, from dealing with epidemics to unfair treatment in their relationships with patients. There are countless silent sacrifices for the country day and night, and sometimes just a small mistake is a stain that is always mentioned. Many patients believe that health workers must give without asking for anything in return. Many opposing streams of thought have invisibly caused the relationship between patients and doctors to fall into a state of imbalance, lacking respect for each other. From these things, the perception of the work of a part of health workers becomes negative, distorted, unenthusiastic and grumpy with patients.

There are units where there is discrimination, repression, and oppression of workers, leading to internal strife and mutual accusations. These things

affecting the image of the medical profession, affecting working spirit

of individuals in the group. Recently, private hospitals have sprung up, gradually attracting skilled doctors, nurses, etc. to work. This is partly due to the influence of the treatment regime, salaries that do not meet the living standards of medical staff, and partly due to negative effects on job awareness.

There are also some civil servants who are not fully aware, and their deviant behavior tarnishes the image of medical staff in the hearts of the people and colleagues. In many agencies, there are still situations of coming late and leaving early, leaving their positions in the middle of the day, going to work with an umbrella in the morning and returning with an umbrella in the afternoon, impolite attitudes, offensive clothing, arbitrary behavior, poor discipline, factionalism, and bullying that cause loss of sympathy and hurt others. There are regulations and codes of conduct, but they are still formalistic, not seriously implemented, and communication skills are limited. Propaganda, mobilization and inspection of the implementation of office culture are still sketchy, and there are no clear sanctions to handle violations.

Because the health sector is a service sector, more attention should be paid to improving the professional attitude of civil servants and improving the quality of the working environment. At the same time, it is necessary to develop and have measures to positively impact the awareness of civil servants, especially those who are directly responsible for patient care. In addition to focusing on developing professional capacity, it is also necessary to focus on implementing good professional attitudes to contribute to improving the capacity of civil servants.

2.2.5. About the level of work completion

The level of work completion of civil servants is assessed periodically every year, in December. The assessment is currently carried out in accordance with the provisions of Decree 90/2020/ND-CP dated August 13, 2020 of the Government on assessment and classification of the quality of cadres, civil servants and public employees.

There are 04 classification levels as follows:

- Complete the task excellently;

- Complete the task well;

- Complete the mission;

- Failed to complete the task.

Table 2.11: Classification and evaluation statistics of civil servants of public service units under the Department of Health of Dak Lak province in 2020

Rating Level

Number (people)	Rate (%)
Complete the mission excellently	436	7.73%
Complete the task well	4,953	87.76%
Complete the mission	217	3.84%
Level of violation	Number (people)	Rate (%)
Reprimand	13	0.21
Warning	9	0.14
Salary reduction	0	0
Demotion	0	0
Dismiss	0	0
Dismissal	0	0
Forced to quit	18	0.29
Total	40	0.64
Mission not completed	38	0.67%

Source: Report on quantity and quality of civil servants in 2020 of Dak Lak Provincial Department of Health.

In general, most of the officials were assessed as having completed their tasks well, only a small number were assessed as having not completed their tasks, accounting for 0.67%. The number of professional officials disciplined was 40 people (accounting for 0.64%).

is due to the use of illegal diplomas and certificates; violation of internal rules and regulations of the agency; failure to complete assigned tasks; failure to comply with professional procedures; lack of responsibility in professional work; lack of civility in handling work; violation of family planning policies. The assessment of the level of work completion is carried out in accordance with the correct process, through many assessment steps. However, the assessment of the level of work completion according to the general situation is still done in a formal way, following the trend of being the same every year, being considerate and lacking a spirit of criticism. Therefore, this assessment of the level of work completion is not really in-depth, does not accurately assess the current situation and is not effective.

The Party and the government have made many decisions related to the management, evaluation, inspection and supervision of civil servants, but in practice, the instructions do not always go as smoothly as ideal. Although the standards of ethics, conduct, capacity and qualifications of civil servants have been clearly defined in legal documents, the activities of evaluation, inspection and supervision are still formal. Violations by civil servants have occurred in many places, for many years, but have not been detected and handled. It is necessary to carry out the management, evaluation, inspection and supervision more seriously to serve as a basis for commendation, reward, planning and development of civil servant capacity appropriately.

2.2.6. Working conditions and environment

Currently, the common situation in public health care units is the overload of hospital beds, old facilities, medical staff are easily abused by patients' relatives, and are not treated and cared for properly... This is a type of work with a special nature, with distinct characteristics in terms of working conditions, so it needs to be cared for and treated properly.

Every day, medical staff have to work at night, have unstable working hours, are exposed to toxic environments, have many bacteria, are easily infected and have a high risk of occupational stress or depression. The hospital environment has many patients coming for examination and treatment, so the air source and facilities have many types of bacteria from different diseases such as: Tuberculosis, HIV - AIDS, influenza, ear - nose - throat infections, hepatitis, cancer. This is a very difficult and dangerous working environment.

The requirements for professional work are very high, requiring absolute precision, so at the same time, it is necessary to meet the factors of working environment conditions to motivate employees. Healthcare is a profession that has many categories listed as arduous, toxic, and dangerous. Although the existing legal system also has Circulars and Decrees on training for health sector employees, these regulations have not been fully implemented. As a result, many employees have not received benefits and training worthy of their contributions.

The current law does not have specific sanctions and is not deterrent to protect medical staff at hospitals and centers. Therefore, medical violence, insults to honor, dignity, and mental abuse occur a lot. A safe working environment is the ideal condition for each staff to develop their existing capacity, cultivate their potential to contribute to the country's medical career.

The relationship between colleagues and the relationship between leaders and subordinates is not really harmonious and gentle in many places. There are many disputes, coercion, pressure, accusations, suppression, mutual demotion and even fights. An ecosystem with troubled relationships makes many officials lose faith in the agency, become discouraged and leave the industry.

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