2020 № 8 Satisfaction of patients as an indicator of the effectiveness of organizational models of providing medical care in the outpatient sector
The object of the study is patient satisfaction with the medical care provided as a potential tool for evaluating the effectiveness of organizational changes in the outpatient unit. The patient-oriented approach is becoming more and more widespread in the world and domestic health care, so it is also necessary to take into account the opinion of the recipients of medical care in order to evaluate the ongoing changes. The purpose of the study was to test the developed online patient satisfaction assessment service TesMed in the implementation of systemic organizational changes in the outpatient section of the Tomsk region (united in one document – the Standard for organizing outpatient care in the Tomsk region). Patients were able to use the smartphone functionality to identify the medical organization and put a rating on a five-point scale. If the patient scored less than five points, the app asked them to select a reason for dissatisfaction from the list. The data of 2898 forms were analyzed. By the time of the beginning of noticeable
changes for visitors of polyclinics (changing the format of the reception area, staff jobs, registry, formation of corporate culture), the share of visitors who rated the work of a medical organization by five points was 57.78%. After a month of project implementation, this parameter increased to 85.79% and did not fall below 72% until the end of 2019. The analysis of factors affecting negative ratings showed that the structure of reasons for their decline has not changed significantly. The study showed that the use of assessment methods used in the provision of medical care organizational models based on the opinion of patients, along with standard performance indicators, contributes to improving the effectiveness of interaction between medical organizations and patients.
2020 № 1 The effectiveness of the reorganization of dermatovenerological care in the Samara region in terms of “lean production”
By implementing “lean manufacturing”, medical organizations can save on all costs, while improving acces¬sibility and improving the quality of care.
The roadmap “Changes in social sectors aimed at improving the efficiency of health care” set the task of increasing the share of outpatient care costs in the total costs of the “Program of state guarantees of free medical care” from 25.3% in 2013 to 31.7% in 2018. the Share of inpatient care costs should be reduced from 60.3% to 50.3%. In providing effective treatment of patients with dermatovenerological pathology of great importance is the use of the necessary amount of der¬matological care, as well as therapeutic methods of diagnosis and treatment, which determines the need for continuity in the work of PHC and PHC. In 2010. in the Samara region the restructuring of the bed Fund and partial reduction of der-matovenerological beds, improvement of selection of patients for inpatient treatment according to the developed criteria of hospitalization in hospitals of round-the-clock stay and day hospitals on the profile of dermatovenerology were carried out, clinical protocols were introduced at the outpatient stage – all of the above contributed to the efficiency of the use of the bed Fund in dermatovenerology. The reorganization of dermatovenerological care improved the quality of medical care for patients with dermatovenerological diseases and clinical and organizational indicators of dermatovenerological care.
2021 № 5 Organization of medical care for patients with cancer on the basis of lean production in the interests of developing organizational health-saving technologies during the pandemic
The article presents the results of the application of lean manufacturing (LM) technologies for the successful implementation of the state task of a clinical medical organization to provide high-tech medical care during the restrictions caused by the COVID19 pandemic. The highest degree of implementation of LM values and technologies was achieved in the section of respect for the person and corporate culture – 89%, compliance with specialized standards – 86%, satisfaction with quality and safety, as well as quick response to changes‑85% for each,
which allows implementing organizational health-saving technologies. The most accessible and widespread health-saving technology can be considered specialized information on the prevention of non-communicable diseases posted on the website of a medical organization in a special section and attracting the attention of patients in a voluntary informed consent. The organizational and methodological department can become the organizing structural unit of a medical organization for testing the introduction of lean production technologies and testing organizational health-saving technologies, whose specialists should be engaged in improving the level of professional training of doctors,
specialists in clinical profile and secondary medical personnel on health-saving issues, conducting communication campaigns aimed at increasing the responsibility of patients who come for examination and treatment for their health, their relatives and relatives, awareness of the value of human life and health, the formation of a culture of health in various age and social groups.