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.
2018 № 5 Assessments of laboratory centralization projects in the Russian regions (pilot study)
In the past years, a great amount of centralization projects took place in laboratory medicine in Russia. Advisors’ opinion of 65 Russian regional healthcare departments on the goals, models and results was investigated in the research. It was identified, that goals for such projects are rarely specific, measurable and achievable. The majority of laboratories are small or middle sized. The effects for regional healthcare systems are estimated rarely. In the paper a few typical models are identified, that are used in the country, and a few definitions and methods of project estimation are offered