2017 № 1 The organizational model is improving the examination of temporary disability in the city hospital
The article presents a model of organizational improvement examination of temporary disability, realized in the city hospital number 10 in Samara. The model is based on the organizational and methodological aspects and methodological approaches to quality control examination of temporary disability, which allows to take timely and instructive-methodological documents, raise the level of training, develop information support expertise of temporary disability, to ensure its quality control. As part of the organizational model to improve the organization of the examination of temporary disability from 2010 to 2013 increased quality of expertise of temporary disability. This reduces the number of defects, reduced the proportion of wrongly granted sick leave, increases the integral evaluation of the quality of care in terms of the model of end results of activity of temporary disability examination services in the city hospital from 0.75 in 2010 to 0.85 in 2013.
2017 № 4 Operational parameters and characteristics of MRI workflow in outpatient clinics of Moscow
We present continuous data of outpatient MRI units in Moscow, 2016. Unit uniformity, identical working conditions, compensation schemes, study justification, process monitoring and result analysis as well as first-time adoption of newest information technologies in Moscow allowed for process characterization and advanced result analysis of 28 outpatient MRI units. Presented data encompasses operational parameters of 64326 MRI examinations with results being evaluated on-line. Yearly median number of examinations for one MRI unit was 2076, with first and third quartile being 1830 and 2836. Reasons of low workload were analyzed. For instance, average number of work shifts in a month varied from 24 (95% CI 18-30) to 49 (95% CI 43-52). Workload during the day also varied. In first four hours of work shift up to 40% of all examinations were performed (95%; CI 40.5-41.2). In last four hours of work shift only 20% of all examinations were performed (95% CI 19.7-20.2). Additionally, the interval between sequential studies was 38 minutes, with first quartile being 29 minutes, and third quartile being 55 minutes. The delay was observed in 50.7 cases (95% CI 50.3-51.4). Every fifth delay was longer than 60 minutes, and in 7.4% of cases - longer than 90 minutes (95% CI 7.2-7.6). In best outpatient clinics, the prevalence of these intervals was only 4.8%. Average waiting interval in outpatient clinics was 7.8 days (95% CI 7.7-7.9). In 44.9% of cases, it was shorter than 6 days (95% CI 39.6-47.5) and in 8.2% of cases examination was performed on the day of study reservation. In several clinics waiting interval did not exceed one day without any detrimental effect on overall workload. The results highlight the need to improve operational processes and overall quality of diagnostic services.