2020 № 4 Training in clinical recommendations and assessment of the level of knowledge of doctors involved in providing primary health care, using remote educational technologies
The implementation of clinical recommendations is an urgent task, and it is important to maintain continuity between primary health care and specialized medical care. Distance learning courses were developed for 25 modules, and a testing system was created, which was implemented during the training of 1928 doctors from 128 medical organizations in three regions. The purpose of the work was to analyze and evaluate the effectiveness of the developed and implemented set of measures for training and testing doctors in three regions of Russia who participate in primary health care, on the implemen- tation of clinical recommendations.
Data analysis was performed using the IBM SPSS Statistics 16 software package. The samples were checked for the normality of the distribution using the Kolmogorov-Smirnov method. A nonparametric Wilcoxon test for dependent samples was used to assess the statistical significance of differences in cases where the distribution in the samples differs from the normal one. The level of statistical significance was defined as p ≤ 0.05.
The program of work consisted of five stages and included the development and implementation of distance courses in the format of multimedia lectures for doctors providing primary health care, studying a number of clinical recommendations, as well as conducting primary and repeated testing with automated evaluation of results for groups of clinical recommendations at the level of the region, medical organization and specific doctor.
The original software made it possible to evaluate the initial and received level of knowledge, to get differentiated results online, and on this basis to give reasonable targeted recommendations for further training of a particular employee, as well as for planning training events in the region as a whole.
The developed methodology of distance learning cycles allows to provide training of a significant number of doctors in a rel- atively short time with operational control of the quality of knowledge of doctors of various specialties, which is why the tested system can be easily scaled and adapted to solve any problems to improve professional competence of doctors.
2018 № 3 To create a new model of medical organization providing primary health care: characteristics of medical staff of district health services
The results of the analysis of the provision of the population of the russian federation by district physicians, general practitioners, district pediatricians are presented. Significant differences in the indicators in the subjects of the Russian Federation were established. These differences necessitate a differential approach when planning actions to improve the organization of primary health care in the subjects of the Russian Federation
2019 № 2 Organizational and methodological basis of the preliminary analysis of the work of outpatient clinics at the stage of the beginning the project «Lean polyclinic
In order to start optimization and structural transformations, the external (questionnaires of patients, n = 200) and internal audit (time-related studies, n=186) of the outpatient clinic participating in the implementation of the priority project «Creating a new model of primary health care». For this purpose, 5 interrelated processes are identified in which the patient participates in the receipt of primary health care: 1 process – «Record for outpatient admission»; 2 process – «Registration»; 2 process – «Waiting for reception »; 4 process – «Medical care of the patient». 5 process – «Analysis of the nearest and remote end points». It is shown that there is a need in the outpatient clinic for information and technical improvement of the polyclinic’s Internet portal; need to improve sanitation in public places; optimizing the activity of outpatient doctors to reduce waiting times in the queue (optimizing the workplace, analyzing the workload of medical personnel, reducing the time spent on medical documentation, personalized approach to patients). Overall, 82,4% of patients were satisfied with the work of the polyclinic, assessing it as «good» (76,5%) or «excellent» (5,9%). In the future, it is planned to monitor morbidity, disability and mortality indicators as a criterion for the effectiveness of the project.
2018 № 7 Development of an integrated assessment tool health and social well-being of patients aged 60 years and over and their needs for different types of care
A tool for the comprehensive assessment of the condition of patients 60 years of age and over which allows to objectify patients’ demand for medical and social assistance, taking into account their individual characteristics has been developed and tested In the framework of this study. The suggested methodical tool is primarily focused on the use in the primary health care, makes it possible to form both a program of work with each patient at the age of 60 years and older, and an action plan to support the attached population of the given age category at the site or a specific medical organization level, and also assess the efficiency of the assistance provided
2018 № 1 The Department of Medical and Social Assistance to the Adult Population and the Department of Nursing: the concept and principles of organization
The concept of the organization of medical and social assistance to the most socially vulnerable population contingents (people in the residential and senile age, the disabled and citizens with a temporary restriction of the ability to move and self-care after the transferred diseases and injuries) is proposed. This includes the creation departments of medical and social assistance in medical organizations that provide assistance to the adult population on an outpatient basis
2016 № 3 Primary Health care. Medical Network organization features and staff provision
Annotation. Changes of Medical organizations network, providing ambulatory treatment, were studied, for past 10 years. In addition, trends of manning tables formation in outpatient clinic were analyzed, as well as population provision by district doctors (uchastkoviy doctor) and general doctors. The analysis of main indicators of doctors’ activities in medical organizations, providing ambulatory treatment, is provided.
2020 № 3 Improving the regulatory and legal framework for delivering primary health care to the population in the field of non-communicable diseases prevention and the implementation of a healthy lifestyle standardization
In order to prevent non-communicable diseases and carry out measures to model a healthy lifestyle, the article proposes changes to the regulatory and legal framework for delivering primary health care and primary specialized health care, including the introduction of a position of a physician for common hygiene in medical organizations. It is proposed to introduce additions to the nomenclature of medical services provided. There was developed a section of occupational standards program “Specialist in hygiene”, on the job functions of a physician for common hygiene. It is proposed to include in the job functions of a physician for common hygiene the diagnostic testing in health centers in order to assess the functional reserves and adaptive capabilities of a person affected by adverse environmental factors, and the prescribing appropriate curative and preventive measures. Implementation of the proposed activities in the health centers will improve the efficiency of medical and preventive work of medical organizations and reduce the level of uncertainty of preventive activities carried out, and of the expected results of preventive work carried out by a therapist and a general practitioner (family doctor). The proposed changes will help to identify causal relationships between the health status of the population and the impact of adverse environmental factors, to form risk groups among adult population in accordance with diagnostic criteria of risk factors and other pathological conditions and diseases associated with the impact of adverse environmental factors that increase the likelihood of developing of chronic non-communicable diseases in risk groups, if there are diagnostic criteria of risk factors to send the indigent to health organization for in-depth examination and carrying out the necessary medical and preventive measures, to prepare research and information materials and to participate in hygiene education, to promote healthy lifestyles and to improve health literacy of population.
2018 № 8 Modern approaches to organization of care to persons of elderly and senile age: a review of international experience
The research is devoted to the study of international experience in organizing care for people of older age groups. The analysis of literature data has shown that the organization of care for patients of elderly and senile age varies considerably in different countries, reflecting their specific economic, social, cultural conditions. At the same time, the use of structured questionnaires for assessing the health status and social well-being of older people becomes a common approach, making it possible to organize targeted assistance to such patients in the most rational way.