2020 № 6 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.
2019 № 6 Medical staff resources of the Moscow psychiatric service during its reform
Medical staff resources of the Moscow psychiatric service during its reform. Since 2010, a modernization of the psychiatric service has been carried out in Moscow. Reforms affect both outpatient and inpatient units. An analysis of the staff resources of the service reflects the effectiveness of the reforms. The aim of the study was to improve the quality of psychiatric care based on the analysis of staff resources of the Moscow psychiatric service. The article presents data on the staff resources of the psychiatric service in 2008-2017. During the modernization of the psychiatric service, the number of psychiatrists was at a high level, the provision of psychiatrists to the Moscow population of was higher than the average provision to the Russian Federation. Growth in the number and staffing of ambulatory rates in psychiatric institutions in Moscow in 2015-2017 partially compensated for the decrease in the number and staffing rates in psychiatric hospitals, however, there is currently a staff shortage in the psychiatric service of Moscow, as indicated by the excess of job-sharing coefficients in individual institutions. During the study period, there was a positive change in the number of visits per 1 psychiatrist.
2020 № 6 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.