Impact of Macro Factors on Effectiveness of Implementation of Medical Care Safety Management System

Abstract

The work analysed the impact of macro factors on effectiveness of medical care safety management system implementation in a medical organization. The authors show that existing macro factors in Russia hinder objective assess the amount of damage associated with the provision of medical care. In addition, they do not allow for setting up an effective system for adverse events risk management in medicine. Foremost, it is an imperfect economic model of the state health care system in Russia, the crisis of medical education system, government regulation of the industry, which does not take into account the main scope of medical workers activities. Formation of a general negative image of health care system in the media and the growing practice of criminal prosecution of doctors is important. It is shown that the solution of the described problems is impossible without effective interaction between the state, health care authorities, society and medical organizations. The economic model of state health care should be changed on a state level. The legislative and executive bodies should adopt a series of normative legal acts. Those acts should recognize the inevitability of adverse events, define their true causes, and classify health care as a high-risk service sector. They should also ensure rights and freedoms for health care providers, as well as formalize rights and obligations of patients. At the level of the health care authorities, national security programs should be developed, state regulation of the industry should be optimized and profound reform of the medical education system should be carried out. The latter implies the creation of university clusters, a change of the paradigm of value formation in health care and a change of models of competencies for graduate and specialist doctors. At the societal level, an open discussion regarding medical care safety should be organized and every effort should be made to create a unified team in safety management consisting of health care providers, patients, and their families.