2021 № 5 Methodology of creating Proposals (Practical recommendations) on the organization of internal quality control and safety of medical activity in medical organizations providing care in the profile of nephrology (renal replacement therapy)
Until 2020 in the Russian Federation there were no general approaches to the quality and safety management system in dialysis centers, which take into account the specifics of the organization of centers and allow to minimize the risks of adverse events associated with the conduct of replacement renal therapy.
An urgent problem of healthcare organization in the Russian Federation is the creation of a methodology for organizing internal control and approaches to building a quality and safety management system in dialysis units and dialysis centers.
Purpose is to design and prove the effectiveness of practical recommendations for quality and safety of medical practice in organizations providing care in the field of nephrology by methods of replacement kidney therapy.
M a t e r i a l s a n d m e t h o d s . Methodology of creation of a system of internal control of quality and safety of medical activity is based on practical recommendations for the organization of internal control of quality and safety of medical activity in a polyclinic and in a hospital.
R e s u l t s . On September 29, 2020, experts of FGBU “National Institute of Quality” of Roszdravnadzor assessed the system of organization and implementation of internal control of quality and safety of medical activity in separate subdivision № 1 of “B. Brown Avitum Russland Clinics” LLC in Saint Petersburg (Nevsky Nephrological Center).
According to evaluation results experts made a unanimous decision on correspondence of the system of internal control of quality and safety of medical activity of “B. Braun Avitum Russland Clinic” LLC to standards of the system of voluntary certification “Quality and Safety of Medical Activity”.
The cooperation of B. Braun Avitum Russland Clinic LLC and FGBU “National Institute of Quality” of Roszdravnadzor resulted in the development and successful practical application of propositions (Practical Recommendations) on the organization of internal control of quality and safety of medical activity in medical institutions providing nephrological care (Renal Assisted Therapy).
F i n d i n g s . The proposed methodology has proved its practical orientation and can be used in medical organizations irrespective of their geography, size and form of property.
2020 № 2 Оrganization of extracorporeal care in a multidisciplinary medical institution
Organization of round-the-clock extracorporeal (EC) treatment in required volumes and options is one of the
most important tasks of a modern surgical hospital. The annual volume of extracorporeal procedures at the B. V. Petrovsky
National Research Center for Surgery (NRCS) is 1.5–2.0 thousand. The most significant methods are transfusiological blood
saving, high-volume plasmapheresis, and renal replacement therapy. Doctors of various specialties are traditionally engaged
in conducting EC procedures: resuscitators, nephrologists, transfusiologists. In modern medicine, EC hemocorrection
methods are in wide demand. Their effectiveness can be determined by the start time of the procedure. Therefore, roundthe-
clock access to all the necessary manipulations is important. In the absence of specialized departments of extracorporeal
treatment with around-the-clock working schedule the implementation of the necessary extracorporeal procedures is
possible in close contact with resuscitators, nephrologists, transfusiologists, in collaboration with the doctor of the clinical
diagnostic laboratory. The quality of providing high-tech extracorporeal care depends on the adequacy of the treatment
process management in a particular medical institution. Collegial performance of EC procedures for one patient by specialists
of various profiles – resuscitators, nephrologists, transfusiologists – gives a high clinical result.