2019 № 10 Medication and medical product procurement regulations in a multidisciplinary healthcare institution
Relevance. The process of organization of medication and medical product supply in conditions of the day hospital and inpatient care, that are part of the health insurance system, is assigned to the authority of the Ministry of Health of the constituent territory of the Russian Federation. However, the need to determine the quotas for medications and medical products from other sources of funding (federal budget, extrabudgetary activity) falls within the competence of a healthcare institution.
Aim. To propose tools and regulations that allow to plan volume and range of medications and medical products for health¬care institutions that provide medical services, both through compulsory medical insurance and on an extrabudgetary basis.
Materials and methods. The materials studied were the legislative and regulatory framework governing the medication supply of healthcare institutions of the Russian Federation and the Krasnoyarsk Territory; internal regulations of the FSFI FSRCC under the FMBA of Russia, a healthcare institution subordinate to the Federal Medical-Biological Agency. Mathe¬matical, analytical and descriptive methods were used in this work.
Results and discussion. Particular problems in determination of the volume and range of medications for the institutions providing medical services on an off-budget basis are associated with the impossibility of accurate planning concerning medication type and volume. The FSRCC uses a retrospective analysis of requests for each type and number of medical services using a technical medical service worksheet. Application of the designed and approved procurement regulations allows to plan future expenses the most optimal way for the uninterrupted high-quality routine medical care provision not only at the expense of compulsory medical insurance but also as a part of extrabudgetary activity.
Conclusions. The proposed algorithm for work with the regulations is recommended for the use in multidisciplinary health-care institutions in order to optimize procurement activity.
2020 № 1 Implementation of principles of lean production providing paid services in a medical organization
The aim of the study is to optimize the processes leading to increasing patient satisfaction level, providing accessibility to medical services, increasing efficiency and eliminating existing temporary financial and other losses using the implementation of lean manufacturing principles and tools. The experience of organizing medical services on a paid basis allowed us to establish a patient-oriented system in the provision of primary health care to the population.. Legislative and regulatory framework governing the provision of medical services on a paid basis, guidelines for the implementation of lean manufacturing principles in medical organizations. Mathematical, analytical and descriptive methods were used. Schemes for the implementation of medical services based on optimizing the flow of created values for the patient are proposed. Changes of some indicators of the medical organization activity are analyzed. Implementation of the principles and tools of lean production leads to the solution of the problems of the current healthcare system – the effective use of the personnel potential of a medical organization, the possibility of creation additional income source for medical workers within one healthcare facility.
2021 № 1 Process-oriented management and project management as tools for the public health organization efficiency improvement
Medical services implementation schemes, based on the optimization of the flow of patient created values, are
proposed. Changes appearing in certain performance indicators of the medical organization during the process of new
management model introduction are analyzed. Aim. Creation of a management model for a state medical organization
in the basis of which are the modern methods based on a process-oriented approach to the separation of management
functions. Relevance. The work of healthcare organizations in a highly competitive environment requires more flexibility
and mobility, thus the primary task is to create new management models of the organization, taking into account industry characteristics and consumer needs. Materials and Methods. The work uses the published results of the analysis of structural changes in organizational activity by other authors. The study was carried out on the basis of internal documents of the FSFI FSRCC FMBA of Russia on the creation of a new management structure focused on the development of an organization in the conditions of the market of medical services. Analytical and descriptive methods and sociological survey were used. Results and Discussion. Changes in the indicators for service provision for compulsory medical insurance and the volume of medical care provided as a result of the reforms carried out by the management of the healthcare organization of the FSRCC for four years have been analyzed. There was an increase in the number of patients seeking medical services at the FSRCC, who want to receive information/assistance quickly, in accordance with the adopted concept of a client-oriented marketing strategy, which required the development of “short” routes for patients, especially in conditions of increased service. By the joint efforts of marketers and specialist doctors, using design technologies, self-supporting Centres are being formed, which are virtual subdivisions that bring together highly qualified doctors to address the specific needs of patients. The “short” path scheme is based on the adoption of the definition of “medical service” as a unit of measurement of the complexity of the process of “medical care” provision. Conclusions. An increase in the number of visits at the outpatient-polyclinic stage of medical care provision (diagnostics, consultations) over five years doubles the achievement of the goals set for the medical organization, considered as an economic entity of a market economy.