Manager Zdravoochranenia 2020 #6

Published: 2020-09-02



    Focus of problem
  • What checks are cancelled and which are retained for medical organizations of the country in terms of the situation with coronavirus infection

    The article contains a detailed analysis of the legal acts issued in April 2020 in connection with coronavirus infection and regulating the issues of state control (supervision) in relation to medical organizations until the end of 2020. In the publication, the authors present the main control and Supervisory measures that will be carried out in medical orga- nizations during 2020. A number of issues related to the legal regulation of control and Supervisory activities that require clarification are identified. In terms of the quality and safety of medical activities, the attention of medical organizations is drawn to the expediency of ensuring their own maximum readiness for various scenarios of carrying out certain control and Supervisory measures established before the end of 2020.

    Authors: Piven D. V. [58] Kitsul I. S. [58] Ivanov I. V. [29]

    Tags: coronavirus  infection11 license  control1 medical organizations23 on-site unscheduled  inspections1 quality and safety of medical activity12 remote  monitoring  tools1 scheduled  inspections1 unscheduled  inspections2

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  • Application of the method of analysis of “oriented trees with assessments” to identify regional features of forming the pathology of dairy teeth in children

    In order to identify regional features of the sequence of lesions of primary teeth in children, the data of the medical in- formation system of a children’s hospital using the method of “oriented trees with estimates” were used. The data of 3,405 children under the age of 6 years who contacted a dentist about diseases of deciduous teeth during 2015–2018 were analyzed. They had 17,462 appeals. It was found that in 516 children the first diseased milk tooth was 51, with an average age of 2.72 years. The second is either 61 (237 patients, with an average age of 2.91 years), or 52 (224 patients, with an average age of 2.58 years). In 113 patients, a sequence of newly diagnosed affected primary teeth 51–52–61 was observed. Only one tooth was observed in 59.9% of patients, in 13.1% of two and in 27% of three or more teeth. It is calculated that if premolar is the first diseased milk tooth, then with a probability of 0.619 the next will be the same as the premolar. Application of the method made it possible to es- tablish regional features of the sequence of lesions of primary teeth in children and to develop approaches to individual prevention.

    Authors: Choloyan S. B. [11] Pavlovskaya O. G. [8] Sheenkova M. V. [7] Ekimov A. K. [10] Baygazina E. N. [6] Tricomenas N. N. [3]

    Tags: baby  teeth1 medical care for children4 medical information system7 regional  features1 the  method  of  “oriented  trees  with  estimates”1

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  • Pregnant technologies in primary health care in rural doctor’s ambulatory

    The priority state project currently being implemented, “Creating a New Model of a Medical Organization Providing Primary Health Care,” is especially relevant for implementation in hard-to-reach areas. Since rural health care is character- ized by a shortage of personnel, a weak medical and diagnostic base, low material and technical equipment, a low level of development of information technologies, and a large territorial extent. Objective: to evaluate the effectiveness of the implementation of lean manufacturing technologies with the participation of nursing specialists in the work of a medical out- patient clinic. Materials and methods. To determine the directions for the implementation of lean manufacturing methods, a questionnaire was conducted among patients (n = 232). Mapping and visualization, as well as timing of the processes before and after the introduction of organizational measures in two areas of the medical ambulance clinic “Reception of healthy children” and “Reception of patients with acute disease and with exacerbation of chronic.” Results and discussions. In order to eliminate (minimize) the revealed losses, re-planning of the premises was carried out, the functions were redistributed and the working hours of the medical staff were structured, templates-forms of documentation were developed. Conclusion and conclusions. The introduction of organizational measures allowed us to significantly reduce the waiting time for admission of a healthy child on the day of the disease without additional financial costs, as well as to increase patient satisfaction.

    Authors: Pyreva E. V. [1] Noskova V.  A. [2] Pozdeeva T.  V. [4]

    Tags: a  medical outpatient clinic1 a  new  organizational  model1 elimination  of  losses1 general practitioner4 implementation effectiveness.1 lean  technologies1 medical care in hard-to-reach areas1 nursing  staff4 primary health care19

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  • Sociology of health care
  • 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.

    Authors: Moskvicheva  L.  I. [1]

    Tags: doctors8 health care system5 human resource management system1 oncology7 organizational  factors1 quality of medical care20 social consequences1 syndrome  of  professional  emotional  burnout1

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  • Subjective assessment of satisfaction of mothers of newborns with the attitude of para- medical personnel of obstetric care organizations

    Purpose.   To assess the satisfaction of mothers of newborns with the attitude of paramedical personnel in obstetric care organizations of the metropolis.
    Methods. An anonymous survey of 2949 mothers of newborns was conducted in 4 obstetric care organizations in St. Pe- tersburg. To assess the satisfaction of mothers, the methods recommended by FFOMS were used. Mathematical data pro- cessing was carried out using spreadsheets “MS Office Excel 2010” and the statistical software package PASW STATISTICS. Results. The obstetric care organizations of St. Petersburg have a “high level” of an integral indicator of satisfaction with the attitude of paramedical personnel in providing medical care to newborns (77.4%), which is higher in maternity hospitals than in perinatal centers (integral indicator (78.5% and 75.1%, respectively.) Regardless of the level of organization of obstetric care, mothers were more satisfied with the human qualities of the paramedical staff working with newborns (“high level” on the FFOMS scale). Motors were less satisfied with the amount of time and attention that nurses paid to children (“average level” according to the FFOMS scale). In contrast to maternity hospitals, when assessing the activities of nurses of perinatal centers, 16.7% more mothers were indicated in the rush and insufficient time, and 32 more were indifferent, 3%. Overall, 72.4% of mothers rated the work of secondary medicine the maternity staff of obstetric institutions with newborns was “excellent” and “good” (on av- erage 4.03 ± 0.07 points), but in maternity hospitals the respondents more often rated “good” and less often “satisfactory”. Conclusions. The study showed a high satisfaction of mothers with the attitude of paramedical personnel to newborns in obstetric organizations of a megalopolis, regardless of the level of medical care provided to them. The attitude of nurses in maternity hospitals was rated higher than in perinatal centers.
    Scope   of   the   results. Development of organizational measures aimed at improving the quality of medical services in obstetric care organizations.

    Authors: Moiseeva K.  E. [1] Yuryev V.  K. [1]

    Tags: level of satisfaction1 maternal satisfaction1 newborns1 nursing  staff4 organization of obstetric care1

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  • Information management
  •  On the issue of the feasibility of the im- munization informatization in penitentiary medicine

    The article highlights the use of information systems in immunization as one of the important problems of the pen- itentiary and civil healthcare sectors. It analyzes the existed software systems for automated immunization management and helpes to make conclusion that the implementation of such software products into the practice of penitentiary health care should be carried out taking into account all the specifics of the organization of medical activity in the penitentiary system.

    Authors: Ponomarev S. B. [2] Ponomarev D. S. [2] Polishchuk V. E. [2] Mihailova Yu. V. [1] Burt A.  A. [1]

    Tags: immunization1 informatization1 medical information system7 patient13 penitentiary medicine1

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  • Blood collection during the period of COVID-19 infection

    We searched Google Trends using terms in Russian and English: “coronavirus”, “blood transfusion”, “plasma transfusion”, “donate blood”. Object of study – requests submitted from February 15 to May 25, 2020 in the world, Russia and the USA. Anomalous increase in demand in the USA was revealed corresponding to the booming demand for plasma donors – convalescents of COVID-19: a) for “plasma transfusion” – March 30 – May 2, b) for “donate blood” March 17 – April 7. The studied Russian Google Trends indicators correspond to the reliable work of the blood service, which during the pandemic period solved the main task to provide hospitals with effective and safe components of donated blood. These data provide additional evidence of differences in the scientific validity of blood services in developed countries, and show that Google Trends can serve as a tool to track trends in blood donation.

    Authors: Zhiburt E. B. [15] Kuznetsov S. I. [6] Averyanov E. G. [6] Shestakov E. A. [6]

    Tags: blood8 blood collection5 blood service5 blood transfusion10 covid-1927 google trends1 pandemic8 safety4

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  • Foreign experience
  •  International experience in implementing programs of enrichment of vita- mins and minerals with diets for various social groups of the population

    The issues of the implementation of national programs for the enrichment of vitamins and minerals with diets of various social groups of the population and food products are considered, performance indicators of these technologies are reflected from the standpoint of public health.

    Authors: Mingazova E. N. [27] Vlasov Y.  V. [1] Gureev S.  A. [7]

    Tags: food fortification1 fortification1 micronutrients1 minerals1 public health8 social groups1 technologies1 vitamins1

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  • Law
  • Regulatory aspects of the organisation of medicine provision for welfare beneficiaries

    A legal basis has been established to regulate the issue of pharmacological support of special patient groups. It consists of several individual categories, diseases and drug lists. Nowadays pharmacological support is divided into federal and regional levels. However, some rules and regulations are duplicated in both of them. This fact can lead to organizational problems and also influence the negative budget issues. The analysis of the current legal basis will allow to determine the directions for further improve- ment of pharmacological support legislation

    Authors: Nagibin О. А. [3] Selyavina  O.  N. [1] Karausheva  L.  E. [1]

    Tags: clinical-economy  analysis2 edl2 essential  drug  list2 federal  law2 government  order  8902 healthcare  system2 high  cost  nosologies2 legal  acts2 life-threatening  committee2 onlp2 orphan  diseases2 pharmaceu- tical product1 pharmacological support1 regional  procurement2 russian  regions2 special  patient  groups2 state  guarantee  program4

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  • Manager of health care consults
  • Assessment of public policy in relation to certain issues of healthcare functioning during the spread of COVID-19 Coronavirus 

    Health care, as a predominantly public system, is objectively subject to serious regulation in special operating conditions, which include the spread of COVID-19 coronavirus infection. It is also important that the private healthcare system is also subject to direct or indirect regulation. At the same time, public authorities are sometimes forced to resort to "manual management", the consequences of which are not always clear for both public and private health care.

    Authors: Kadyrov F. N. [122] Obukhova O. V. [28] Bazarova I. N. [12] Starodubov V. I. [40] Endovitskaya  Yu.  V. [11]

    Tags: coronavirus3 covid-1927 crisis3 financing13 health care24 mandatory health insurance5 medical organizations23

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  • Questions and answers
  • Changes in the procedure for implementing incentive payments to medical workers for working with coronavirus

    Authors: Kadyrov F. N. [122]

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