ДЕФЕКТЫ ЛЕЧЕБНО-ДИАГНОСТИЧЕСКОГО ПРОЦЕССА ПРИ ОКАЗАНИИ МЕДИЦИНСКОЙ ПОМОЩИ ПАЦИЕНТАМ ПО ПРОФИЛЮ «ПСИХИАТРИЯ» В СТАЦИОНАРНЫХ УСЛОВИЯХ

Abstract

Significance. Timely identification of defects in the treatment and diagnostic process during internal quality audit of care delivery stimulates evidence-based organizational and management decisions and improves quality of care delivery to mental patients. Material and methods. A retrospective analysis of 270 records of internal quality audit of care to mental patients treated at the Mental Hospital # 4 of the Moscow Healthcare Department has been conducted. A total of 156 inpatient records (57.8%) from 2015 to 2018 were compared with 114 inpatient records (42.2%) in 2019. Results and discussion. Heads of the structural units and deputy heads of the health care facility have evaluated quality of care delivery at the two levels of control. Primary medical documentation was assessed on 12 items (from 0 to 1 point). The arithmetic mean of the assessments for each of the items was calculated - the overall quality factor. At both levels of control, defects in the care delivery were described. The quality factor at the 1st level of control equalled to 0.95 (0.92; 0.96), and 0.86 (0.79; 0.91) at the 2nd level. The quality factor at the 2nd level of control in 2015 - 2018 (1.0 (0.90; 1.00)) was statistically significantly higher than in 2019 (0.86 (0.79; 0.91)) (p = 0.011). Data for the complete 2019, despite the order of the Ministry of Health of the Russian Federation as of June 7, 2019 No. 381n, were observed and obtained in accordance with the requirements of the Moscow Healthcare Department Order No. 932 as of October 30, 2019 “On procedure for implementing internal quality audit and safety performance of health organizations of the state healthcare system of the city of Moscow”. Conclusion. The ongoing monitoring of quality of inpatient health care delivery to mental patients to identify defects in the treatment and diagnostic process using internal quality audit records helps to improve quality of care delivery to patients.