The organizational clinical system of development of medical care based on electronic personified data of medical services under angina pectoris and myocardium infarction

The article presents the analysis of quality of medical care of patients with coronary heart disease at the phases of the clinic, ambulance and hospital based on the data from electronic personalized records and registry accounts of the territorial mandatory health insurance foundation. The results of implemented analysis and application of principle of inter-agency information interaction, the clinical organizational system of managing quality of outputs of medical care provision to patients with ischemic heart disease has been developed. The developed medical care quality management system based on database of personalized electronic patient records was tested in practice and demonstrated positive results

Organizational and technological algorithm of primary specialized health care at cardiovascular diseases

Aim. To develop an algorithm for primary specialized cardiovascular care with a priority of endovascular strategy. Methods. The study was conducted in 2018–2019 based on the Central Clinical Hospital “Russian Railways-Medicine” and 14 polyclinics in the regions of the Russian Federation. The subject of the study is cardiovascular surgeons (n=2), possessing the skills of endovascular care. The object of the study was patients (n=1018) attended regional polyclinics of the Russian Federation. Patients were divided into two groups: group A consisting of 673 patients with clinically significant atherosclerosis of the coronary, brachiocephalic and peripheral arteries and abdominal aortic aneurysm; group B consisting of 345 patients with chronic lower limb ischemia that does not require surgical treatment. The average age of patients in group A was 69±6.1 years, in group B — 63±7.2 years. There were 467 men in group A (69.4%), and 339 in group B (98.3%). An organizational and technological algorithm was developed to improve the primary specialized cardiovascular care. The results were assessed by the presence of outcomes (heart attack, stroke, bleeding, death), the availability of endovascular care and patient survival follow up 12 and 24 months. A content analysis of scientific publications on the issue under study has been performed. Results. An organizational and technological algorithm of primary specialized cardiovascular care has been developed, including the activities of the cardiovascular surgeon, who has the skills of endovascular care and a nurse in an outpatient clinic. The implementation of the algorithm ensured continuity, 100% availability, safety and quality of cardiovascular care using endovascular technology. Outcomes are not registered in both groups. Both patient groups showed 100% one and two-year survival. Conclusion. The developed algorithm of primary specialized cardiovascular care has provided high quality healthcare. © 2020 Author

The development of prototype of "ideal" model of competences of executive manager in health care

The formation of a prototype of the organizational functional model of competences of the "ideal" health care manager and availability of objective assessment of its activities are of considerable practical interest. In any medical organization there is a need for trained, experienced and motivated administrators - managers capable effectively achieve their goals. This need can be met by developing and improving managerial competencies in managers at all levels. The competences of manager can be developed on the basis of organizational functional model and in accordance with personal responsibilities, work status, goals of medical organizations and professional standard. THE PURPOSE OF THE STUDY: was to develop a prototype of "ideal" organizational functional model of competencies of administrator - health care manager. MATERIALS AND METHODS: On the basis of data content analysis, evaluation of experimental results and logical and comparative technique a prototype of the "ideal" organizational functional model of health care manager was developed and tested. The development of model of administrators competences was based on comparative parameters of the professional standard "The specialist of health care and public health," personal managership of administrators of medical organizations, in accordance with the work status and objectives proposed in the course of the study organized in the Chelyabinsk Regional Children's Clinical Hospital (n = 26). THE RESULTS: The analysis of the factors affecting quality of management functions performed by managers, presented in t professional publications and based on the results of competence model testing, permitted to conclude that the requirements of the professional standard "The specialist of Health Organization and Public Health" are not sufficient to completely assess the activities of administrator - manager. To improve comprehensiveness of assessment of managers and the development of "ideal" model of executive manager competence the listing of requirements in the professional standard is to be supplemented with "The necessity of satisfaction with own work", "The necessity of conscious motivation to work at managerial position", "The necessity of abilities to perform management activities"