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Manager Zdravoochranenia 2017 #2
Published: 2017-02-02
1765
CONTENT OF THE ISSUE
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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.
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The application of the process approach for operations management of the medical organization
The article noted the possibility of using as a tool the creation of an internal control of medical organizations quality and safety of medical activities of the quality management system in accordance with the principles and requirements of the national standard is identical to ISO 9001:2015 «Quality management systems – Requirements». Using the principle of process approach, the authors in the activities of medical organizations identified the main macro-processes that determine the outcome. Describes the organizational role and direction of the actions of the process owners. Formulated own definition of diagnostic, therapeutic, and expert processes from the standpoint of the analysis of their content. Marked by close integration relationship and mutual influence of these processes on each other. Outlined the prospects for improving the quality of medical activities of the organization and its results by introducing a process-centric technologies to enhance business processes.
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A three-tier model of management of large state dental Association
Presents a three-level model of the system of management of large state dental Association built on the basis of a combination of linear-functional and divisional guidelines. The structure and specific mechanisms of functioning of the units strategic, tactical and operational levels, with a vertical subordination and the cycle: planning – implementation – control – improvement. A distinctive feature of the levels of strategic and tactical management is the addition of block execution solutions – branch network of enterprises, continuously operating educational level, including the effective management of School resources and School quality the quality management System of enterprises. Ring operational management includes all structural units of enterprises, data, indicators and operation parameters which come in a comprehensive system of weekly monitoring, forming a set of actual data about medical operation clinics enterprises, financial and economic condition of the clinic, the medical support materials, tools and medicine, repair, construction and engineering works. Analysis of the obtained data allows managers to quickly in the field if necessary to develop corrective solutions.
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Analysis of resourse utilization for laboratory diagnostics by Russia’s hospitals
For evaluate the use of human and material resources for laboratory services was study the structure and expenses for laboratory diagnostics in 82 hospital institutions from eleven Russian regions. The data showed that the laboratories occupy 2.5% of hospital areas (median), they employed 4.2% of all employees, including 4.5% of hospital doctors. In the structure of total institutions costs \ laboratory costs account for 4.4% (1st quartile, 2.9%, the third – 6.4%). These costs are 93.7% for wages and the purchase of reagents and materials. The share of labor costs were twice as high as on the reagents and materials (62.9% and 28.7%, respectively). Median costs for community charges amounted to 1.9%, and equipment maintenance – 1.2%. As an additional task carried out a separate assessment of the resource costs of microbiological laboratories. In half of health facilities, these costs amounted to less than 1% of hospital expenditures, although ten of the thirty-nine – exceeded 1.8%. The median labor costs, reagents and materials amounted to 92.6%. For all laboratory expenditure in general, the predominant contribution here was added labor costs.
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Non-medical and other staff working in the medical organizations subordinated to the subject of the Russian Federation
The demand for increasing efficiency in the use of health resources, including human resources, require improved approaches to demand determination for non-medical personnel of health. Over the past three years, almost half (47.3%) increased the absolute number of «other staff» and medical organizations increased by 24.6%, its share in the total number of health workers. Analyzed data provided by the health authorities of the Russian Federation on the size, composition and the additional requirements of healthcare organizations-medical and other staff. The necessity of developing a unified nomenclature of positions in the non-medical part of the health workforce, clearly defined methodological approaches to the formation of the staffing structure and numbers of non-medical personnel depending on the type and capacity of the medical organization.
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The performance management system of the healthcare institutions: experience of using information technology to enhance research productivity
The original platform «Benchmarking research productivity» was developed in 2010 and integrated as a component of the research process management system in the NII KPSSZ. The designed platform addresses all the critical issues relevant for the management of the modern major health research institute. In the period from 2011 to 2015, the number of the articles published every year the research staff increased by 42.6%, the number of articles indexed in Web of Science and / or Scopus – increased 2.2 times; the number of citations for all publications increased 6 times; the average number of publications per 1 author increased by 27.1%. Information technology being one of central components allows to assess research productivity in the Research Institute management system and to monitor accurately the task performance by the local staff. The platform provides transparency of productive processes and gives opportunity to achieve main management objectives, i. e. motivation and coordination.
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Loss of control of healthcare and the gap between the patient and physician
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The ways to counter the "consumer (patient) extremism" in the provision of paid medical services
The medical organization in the provision of paid medical services are faced not only with a large number of inspectors, with unreasonable restrictions (which usually applies to state and municipal institutions), the discontent of the population by the fact of payment for medical care, etc., but with the incorrect behavior of patients seeking unreasonably to obtain the benefits that they are not guaranteed. We are talking about the phenomenon called «patient extremism». The position of the regulators is often in almost unconditional support for patients. The current mentality is based on the incorrect position of «the patient is always right». Meanwhile, the provision of paid medical services is a sphere of civil relations where there should rule the law. In recent years adopted laws (including amending the Civil code) allow healthcare organizations to more successfully assert their legal rights when lawful execution and performance of contracts for the provision of paid medical services to patient and resist extremism. The analysis of the legislation addressed in this article.
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Questions answered by PhD of Economic F.N. Kadyrov
