2020 № 6 The syndrome of professional emotional burnout in doctors of cancer institutions in Moscow: the prevalence and severity of the syndrome, the factors affecting its development
The health protection system plays an important role in preserving and developing the country’s economic potential. Features of medical activity are a high degree of use of social contacts, its significant responsibility and stress. High requirements for doctors of professional, organizational and psychological nature contribute to the development of constant work stress, against which there is a decrease in the psychological adaptability of specialists, leading to the development of «professional burnout syndrome».
The purpose of this study is to assess the prevalence and severity of the syndrome in doctors who provide specialized high-tech medical care to patients with cancer, as well as to identify factors for the development of this syndrome.
This article presents the results of a survey of 58 doctors. High and extremely high levels of the syndrome were detected in 64% of respondents. Individual, organizational and social factors associated with the development of this condition are identified. As the main methods of prevention and control of this syndrome, preliminary and periodic assessment of the level of employee’s susceptibility to organizational stress, the degree of their satisfaction with organizational factors of work, as well as the social environment is proposed.
The results obtained can help to optimize the process of working with personnel in medical organizations, as well as in- crease the productivity of medical workers.
2016 № 5 Assessment of the quality and effectiveness of health care for medical rehabilitation
Abctract. The method of evaluating the quality and effectiveness of medical rehabilitation in the parameters is described. The method allows to determine the capabilities of the service, results and quality research. The basis for determining the level of quality of care in health organizations based on three main components: quality of structure; quality of process; quality of the results. This method allows to judge about the possibilities of rehabilitation services in determining logistical base, human resources, technical equipment and the condition of the equipment. Data on the quality and effectiveness of treatment can serve as a basis for performance assessment and volume of the study identified a number of indicators and their conformity to regulatory standards. The Toolkit is designed for health care providers, experts, economists working in health care organizations Federal, regional and municipal levels, as well as researchers and teachers in the field of health planning.
2015 № 3 Cluster principle of efficiency increase of scientific, educational and medical activity
A brief characteristic of goals of clusters and their role in the innovation development in a health care are presented. The integration process of scientific, educational, medical institutions and businesses in the regional cluster is shown. Illustrated by the example of Kemerovo city the efficiency of a consolidation is evaluated, which is characterized by the creation of scientific production with its subsequent commercialization of high-tech enterprises, continuing vocational education, medical care in cardiovascular diseases on the full-cycle basis.
2022 № 4 Patient support program as a part of value-based healthcare implementation
Patient support programs as a new institutional phenomenon take over part of the functions of the Institute of Healthcare in drug provision, diagnostics, clinicians and patients education, infrastructure support.
Purpose: to evaluate the role of patient support programs (PPMS) by describing the mechanisms of their implementation.
Materials and methods. On the basis of open sources of information and scientific literature data, the initiatives to launch PPP in Russia of medicines and medical devices were analyzed.
Results. The most common programs are that combine financial and information mechanisms. The key principle of the development of the PPP is orientation to the patient’s pathway. Typical tools for the implementation of PPP include the following: hotline, SMS-informing, patronage service, online monitoring, patient training, insurance. The effectiveness of the PPP is assessed by four groups of indicators: patient adherence, quality of life and patient experience, clinical outcome indicators, cost savings.
Conclusions. Health authorities and medical professionals should be aware of the possibilities of programs to achieve the goals of improving the quality and accessibility of medical care, and can also help to systematically assess the effectiveness of such programs from the perspective of public health.
2013 № 4 Ensuring the rights of the patient and the need to develop a medical organization necessary internal regulatory documents (Sankt-Peterburg, Irkutsk, Russia)
The questions related to patients' rights in health care. Detail the mechanisms to ensure patients' rights to information about their rights and responsibilities, their health status. The authors emphasize that the rights of the patient in health care is impossible without a clear regulation of this work relevant internal documents of the medical organization. Specific recommendations on the content of these documents.
2019 № 4 The improvement of specialized medical care for patients injured in road traffic accidents based on information technology
The information system was developed as a part of a Uniform State Health Information System (USHIS) in Mos- cow Region. It enables to perform a statistical and economic analysis, to simulate the work of trauma centers, resulting in an improved quality of medical care, as well as to decrease unreasonable economic loss and the road traffic mortality. It also helps to support patients after limbs amputation with prostheses without any delays.
2019 № 4 On the criteria for evaluating the activities of medical organizations in the new patient-oriented healthcare system
The patient-oriented approach will allow taking into account individual preferences and needs of patients in the process of providing medical care. The study is devoted to the system analysis of the main provisions and conditions for their implementation in the patient-oriented model. The paper presents the composition of evaluation criteria in the developed model. The introduction of a new patient-oriented model implies a broader application of modern methods and technologies for their personal information support at various stages of medical care.
2020 № 10 Analysis of practical experience in development and implementation of standard operating procedures in the activity of medical personnel
Innovative technologies use in the daily nurse practice makes their work more professional, comfortable, ensures safety and convenience of performing basic professional duties, reduces labor costs, and allows to quickly and efficiently ensure the implementation of new diagnostic and treatment process.
Aim: analysis of the experience in the development and implementation of SOPs for nurses for 2018–2019. in Central
City Clinical Hospital № 6, Yekaterinburg.
Methods. The work analyzed reporting documents (SOP implementation logs for each subdivision of Central City Clinical Hospital № 6, Yekaterinburg during 2018–2019 period), characterizing the number, type of developed SOPs, depending on their purpose, the timing of their implementation.
Results. During 2018–2019 period there have been all main nomenclatures SOPs developed and implemented into the
nursing practice. The main stages of the development of SOPs are analyzed, illustrative examples are given. Encountered by the staff of the medical institution SOPs development and implementation related difficulties are discussed. Main prospective activity directions in the field are determined.
Conclusion. On the basis of municipal Central City Clinical Hospital № 6, Yekaterinburg, SOPs development and implementation for various types of nursing activities have been successfully carried out.
2020 № 8 Improving rural health care through business process management
Meeting the needs of the rural population in all types of primary health care (pre-medical and general medical
care), as well as specialized medical care, improving the quality of medical care for the rural population is an important
public health problem that is difficult to solve and is of particular concern to government structures at all levels of government. The article presents an analysis of the literature on the use of business processes in modern healthcare, the main tasks of which are the creation and development of effective models for the provision of medical care that increase not only its accessibility and quality, but also the satisfaction of the population. As part of the activities of the modernization program for the implementation of information technology in healthcare, it is planned to create information resources and services that would allow, using this system tool, to move to a qualitatively new level of organization of industry management. It is noted that at present, at the level of management of the medical organization as a whole, and in the management of individual areas of its activity, the application of the process approach is becoming relevant, in which the medical organization can be considered as a separate business system, which is a related set of business processes, the ultimate goal which, undoubtedly, is the provision of quality medical services. It is shown that the development and modeling of business processes will increase the relevance of management information, will make it possible to focus on rationalizing cross-functional processes to significantly reduce time and / or costs, increase revenue, improve service quality and reduce risks, the information system allows you to simulate processes and carry them out further optimization.
The analyzed works examine the experience of process-oriented management in medical organizations and its role in ensuring the improvement of the quality of medical services provided. In addition, the introduction of a process approach will allow the application of certain managerial decisions necessary in each specific situation, including in the field of medical services for the rural population.
2015 № 10 About formation of new content of work of the head of the medical organization to ensure and control the quality and safety of medical activity
The article deals with the problems and issues that impede the implementation of legislative requirements on ensuring and monitoring the quality and safety of medical activities in medical organizations. The article presents and justifies a specific list of the main activities of the head of the medical organization to ensure and control the quality and safety of medical activity. Proposed and substantiated the areas of control that should be reflected in the internal control of quality and safety of medical activity. Reasonable changes in the activities of medical commissions. Emphasized the need for active and systematic participation of the health authorities and the territorial departments of Roszdravnadzor in the formation of a new content of the work of the head of the medical organization to ensure and control the quality and safety of medical activity.
2016 № 8 Family-oriented approach to child health care
In this review article you can consider the parent involvement in children medical care, because in paediatric practise precisely parents can influence good relationship with parents and whole healthcare system, what is more they can influence the compliance on attitude between patient (parents or legal representatives) and health provider. The last decade researches indicate the necessity of parent involvement in all stages of medical assistance to children, moreover the last surveys showed that family-centred approaches are highly-efficient. The competence of paediatricians in working with parents and the concept of family-oriented approach in foreign literature are being considered in this topic. Moreover, the advantages of using family-centred approach and barriers, including staff shortages, interrupting the process of using this model, are being under special control in this topic. There are many variants of changing and ways of implementation offering in this article. In conclusion, there is a statement that implementation family-centered medical care to children in whole medical care system requires comprehensive changes in all stages of medical care quality ensuring, including medical care organizers professional outlook, adjusting the regulatory framework and standards of training specialists.
2020 № 3 Standard operating procedures as the nursing acitivies quality and safety assurance system component
Nursing is a cornerstone component of the high-quality medical care organization assurance within a medical institution general activity. Standard operating procedures (SOP) when implemented into the nurse practice helps to standardize the performance of individual medical procedures. The SOP related activities results can be easily monitored and assessed. The most frequent activities to be assigned to SOPs are subcutaneous, intradermal, intravenous, intramuscular administration of drugs and solutions, taking blood from a finger, administering drugs with enemas, etc. The main advantages SOPs application include minimizing the risk of a contractor misunderstanding their duties, comparability and compliance with regulatory requirements assurance. International standards, Russian federal state standards (GOST), industry standards (procedures medical care, medical standards assurance), regional regulatory documents (orders, orders, regulations) are used as the basis to create a SOP. SOPs implementation in conjunction with the continuous nurses training, comprehensive material and technical equipment provision of medical institutions will contribute to improving the quality and safety of their activities.
2020 № 9 Improving the technology of work of heads of therapeutic departments of Central district hospitals
The article presents the results of studying the organization of work of heads of departments of central district hospitals (CRH) and the quality of therapeutic care for the rural population. The study was conducted in 2017–2019. on the basis of
26 Central District Hospital of the Republic of Dagestan. The quality of therapeutic care was studied through an expert assessment
of 1,085 inpatient and 748 outpatient patient records. The timing of the working time spent by the heads of the departments of
the Central District Hospital for 845 hours. It was found that under the current conditions the heads of departments devote up to
50.7% of their working time to the fulfillment of the main duties. Waste of time is 15.1%.
In the therapeutic departments of the Central District Hospital, an untimely and complete examination of a significant part of the
patients took place; treatment is not always complete and complete, there is no continuity in the examination and treatment of
the patient between the clinic and the hospital.
On the basis of the research materials, a set of recommendations was developed to improve the technology of work of heads of
departments of the Central District Hospital and improve the quality of medical care. Experimental verification of the recommendations confirmed their effectiveness: the time spent on the main work increased from 51.2% to 72.4%, the share of time spent on organizing and managing the treatment and diagnostic process increased by 15.5%. Improving the organization of work of heads of departments during the experiment had a positive effect on the quality of medical care: the proportion of patients examined at the prehospital stage increased by 25.4%; the number of those fully surveyed increased from 58.4% to 90.3%; the number of patients who received full treatment increased by 14.7%.
2017 № 6 Regulatory framework for providing high-technology ophthalmological medical care under outpatient treatment
The article analyzes the existing legal basis for providing high-technology ophthalmological medical care through a systematic review of regulatory enactments that directly regulate this type of activity (14 regulatory enactments, including 2 federal laws).
High-technology medical care is a separately licensed type of medical activity carried out by approved federal or regional medical organizations, financed by subsidy or directly from federal budget, provided for approved types of medical care in a hospital. The source of funding for healthcare determines essential conditions. The existing legal framework creates significant restrictions for providing high-technology ophthalmological medical care under outpatient treatment in the case of healthcare covered by Compulsory Health Insurance or an appropriate budget. The article outlines the ways of solving this problem proposed by the authors, including for a medical institution, without violating the current legislation. Healthcare covered by other sources of funding can be provided in any conditions, including outpatient
2017 № 2 New tasks and directions of work of the medical commision in the system of providing and controlling the quality and safety of medical activities
The article deals with the reasons of insufficiently work of medical commissions of medical organizations. It was noted that today the medical Commission, continuing to be the third level of quality control of medical care in medical organization, often is the third level of quality control and safety of medical activities. In the publication of the proposals to improve the efficiency of the medical Commission, including revealed the contents of its work in accordance with the objectives and functions set by law, which often remain outside the purview of heads of medical organizations.
2017 № 6 Metamorphosis standardization of medical care
The article discusses a bill regulating the development and use of clinical guidelines in public health practice. The authors believe that the bill makes clinical recommendations to the regulatory option binding standards of сare. This approach only superficially converts the ways of ensuring the quality of medical care. From the point of view of the authors of the health care system fell into the organizational trap of technological regulation of the actions of the physicians, while the traditional values of the medical profession is gradually devalued. The authors propose to reconfigure relationships in the industry, not only by importing foreign countries, but in accordance with the usual Russian professional medical community’s leadership in the field of cultural, spiritual and intellectual development
2016 № 10 Аnalysis of the application of standards of care
The article addresses the problem of application of standards in the provision of medical care, and also when exercising control and expert activities. Set out grounds for revision of the paradigm of quality assessment of medical aid in system of obligatory medical insurance based on the comparison of the standardized and the actual performance of medical-diagnostic process.