2022 № 10 Approaches to developing an information resource for managing patient flows in a medical organization during a global biological challenge (on the example of COVID-19)
Patient flow management in medical organizations and rational use of human, material, medical and technical resources during the period of global biological challenge are the key to the effective functioning of the health care system.
The formation of a set of indicators and criteria that allow the organization, planning and management of hospitalizations should be carried out with using of modern information aggregators integrated with medical information systems both at the level of a single hospital and in general across a network of medical organizations in the region that provide specialized medical care in hospitals.
Purpose of the study is to develop an information system architecture that allows assessing the level of use of the resources of a medical organization during a global biological challenge (on the example of COVID-19) and distributing patient flows depending on its current capabilities.
Materials and methods. Based on the data on the results of hospitalization of 7576 patients with COVID-19 in the Noginsk Central District Hospital, 6 consecutive stages of developing an information system were formed, including user stratification and determining roles and levels of access to information for them, classifying the resources of a medical organization, developing digital models of databases data, standardization and mapping of work processes in the structural divisions of the hospital, compiling a list of input (accounting) and output (reporting) indicators correlated with each other through the use of directories and registers, as well as on the basis of logical links.
Results. Digital layouts of 4 registration cards were developed (data of medical workers; data of patients, medical services provided to them and the time for their implementation; use of medical equipment and time spent on research; registration of hospitalizations in hospital departments), 10 reporting forms (on the activities of medical workers and medical services rendered by them; on the structure of hospitalized and diagnostic tests carried out by them; on the use of medical equipment; on hospitalizations and the use of hospital beds) and templates of analytical reports for making management decisions based on the data of reporting forms for 6 categories of users (for medical workers of the relevant structural units of the hospital heads of structural subdivisions, deputy heads of a medical organization and head of a medical organization, a specialist of a public authority of a constituent entity of the Russian Federation in the field of health protection).
Conclusion: The information resource proposed for development makes it possible to carry out a current assessment of the workload of medical workers and medical equipment, the employment of the bed fund, compliance with time parameters when performing standard operating procedures in the structural divisions of the hospital and ensure operational management of patient flows.
2022 № 9 The evaluation of the provision of specialized medical care to patients with COVID‑19 in the conditions of the central district hospital
Planning and managing the activities of a medical organization in the context of a biological challenge associated with the spread of a new coronavirus infection (COVID‑19) is an urgent task for the healthcare system, determining the possibilities of its functioning in the conditions of transformation and re-profiling of the bed fund, mobilization of human, material and technical resources. Based on the results of assessing the parameters of the activities of a medical organization, it is possible to systematize and streamline the work of its structural divisions.
P u r p o s e of the study is to determine the optimal burden on medical workers, to establish factors that affect the duration of hospitalization and determining the outcomes of the disease among patients with COVID‑19.
M a t e r i a l s a n d m e t h o d s . The retrospective continuous study of hospitalizations of 7576 patients was planned and conducted with an analysis of the duration of hospitalization, the dependence of the results of hospitalization on gender and age, as well as the impact on this indicator of the severity of the disease (using Pearson’s linear correlation coefficient (r-Pearson)) and analysis of survival by evaluating Kaplan-Meier.
R e s u l t s . The results of the analysis showed that the average number of patients per doctor per month was 28,23 ± 13,27 patients [IQR: 16,93; 41,25]. The dependence of the duration of hospitalization on sex and age showed the absence of statistical significance between these indicators (r-Pearson = 0,079; p < 0,001). The dependence of the duration of hospitalization on the severity of the course of the disease showed no statistical significance between these indicators (r-Pearson = 0,04; p < 0,001). The risk of death was increased with the length of hospitalization.
C o n c l u s i o n . The results of study are relevant for public health specialists who plan the resources of medical organizations and assess the possibilities of using the bed fund.