This legal framework offers an opportunity for those working within the IESS in terms of the major challenges that it involves, especially for the medical units responsible for providing individual and family health care to Ecuadorian citizens.

The good practice followed to strengthen compliance with institutional rules, especially with regard to the organizational structure, as set out in Resolution CI 056, issuing the General Regulations respecting IESS medical units, is providing a basis for the consolidation of work teams in each of the areas, units and centers of the Manuel Ygnacio Monteros Hospital, with a view to increasing the production of services and improving their quality.

The good practice followed has greater need of the added value offered by human resources in giving effect to the rules, than of financial resources. The still partial results demonstrate the organizational change in accordance with the needs of users, with the participatory approach promoting learning and the development of internal actors, thereby strengthening key processes which are placing the organization on the road to excellence. Its application will be extended to other regulations and instructions which have still not been applied over one year after their adoption.