Механизм управления структурой медицинского учреждения как организационной системой массового обслуживания в условиях нестационарного потока

Abstract

The task of organizing the process of repurposing medical and preventive institutions by managing the bed resource on the basis of coordination of the interests of agents in the non-stationary dynamics of diseases, in particular coronavirus infection, is considered. The relevance of the task is due to the need to make effective management decisions when limiting the temporary resource and the impossibi¬lity of using previously used approaches, in particular statistical data on incidence peaks. The solution is possible through the proposed control mechanism. Aim. The purpose of the work is to develop a mechanism for managing the composition and structure of the organizational system, which allows ensuring the rational behavior of channels with a demanded ratio of performance indicators and quality of service. These measures help to reduce patient queues, reduce the number of unmet patients by providing the necessary and sufficient bed capacity in a timely manner. Materials and methods. It is proposed to use principles of open management of systems with active elements, method of simulation modeling to describe processes of loading of departments of institution with known period of discrete accumulation of applications and process of their processing, as well as mechanism of complex evaluation and generalized median mechanisms of coordination of opinions of agents. This choice is due to the unsteady flow of applications for hospitalization and the need to make management decisions in the organizational system when limiting the temporary resource and bed capacity. These methods will allow agents to quickly make decisions and exclude factors of subjectivism. Results. A subject-oriented model was built in a separate unit using a software product represented by complex evaluation mechanisms. The importance of a comprehensive assessment reflects the significant influence of factors in the search for a rational mode of operation of the department and makes it possible to predict its timely change. The modified median scheme allows you to quickly agree on the true opinions of agents, and the graphoanalytical method in this matter makes the procedure for finding a coordinated solution visual and convenient. Conclusion. The mechanism proposed in the work allows effective management of the composition and structure of the organizational system, thereby improving the work of the medical institution in case of non-stationary processes of receipt of applications for hospitalization.