Quality Of Medical Activities Research Articles

Использование высокотехнологичных методов лечения – путь повышения эффективности и качества оказания специализированной медицинской помощи пациентам с урологической патологией.

Diseases of the genitourinary system due to their high prevalence in the population and the frequent development of complications are an urgent medical and social problem and require timely, effective and high-quality medical care. In the Russian Federation, urolithiasis, prostate adenoma, obstructive (reflux) uropathies occupy the leading positions in the structure of hospitalized morbidity in urological departments of hospitals, which account for more than 3/4 of all hospitalizations. Improving the efficiency and quality of medical activities in providing specialized medical care to patients with diseases of the genitourinary system in hospital settings requires the use of high-tech diagnostic and treatment methods. The purpose of the study is to study the dynamics of morbidity of the adult population of the Orenburg region with diseases of the genitourinary system, and to assess the effectiveness and quality of specialized medical care for patients in the urological department of the Orenburg Regional Clinical Hospital. Materials and methods. The study analyzes information copied from information statistical collections of the Ministry of Health of the Orenburg Region and the Federal State Statistics Service. The indicators of general and primary morbidity of diseases of the genitourinary system among the adult population of the Orenburg region are analyzed. The dynamics of changes in morbidity rates was studied for the period from 2017 to 2021 by constructing dynamic series and calculating special indicators: absolute increase/decrease, growth/decrease rate, growth/decrease indicator, visibility indicator. To assess the effectiveness and quality of specialized medical care for patients with diseases of the genitourinary system, the urological department of the Orenburg Regional Clinical Hospital named after V. I. Voynov was selected as the base of the study. During the study, the bed performance indicators and special indicators of the effectiveness and quality of medical activities were analyzed. Study period: 2019–6 months of 2023. In addition, a comparative analysis of the department’s performance in 2007 and 2022 was carried out. The following research methods were used: statistical and analytical. Statistical processing of the materials included the calculation of absolute, relative and average values. Results. In the Orenburg region, from 2017 to 2021, the level of general morbidity of the adult population with diseases of the genitourinary system decreased by 14,4%. At the same time, in the studied region over the past period, the indicator of primary morbidity of the adult population with diseases of the genitourinary system had a more pronounced decrease, which amounted to 37,4% over five years. It has been established that over the past 5 years, when high-tech operations using endoscopic and laser technologies were widely performed in the urological department of the hospital, the overall performance of the department has improved. The exception was in 2020, when a tense epidemiological situation was recorded for the new coronavirus infection Covid‑19. In the last 3 years, there has been a decrease in the average length of patient stay in bed, which allowed an increase by 19,3% in the number of treated patients, as well as to perform more operations – in 2022, 1 019 surgical interventions were performed compared to 905 in 2019. The urology department of the hospital has a low mortality rate, which was minimal (0,3%) in 2019 and 2023. As a result of a comparative analysis of the performance of the urological department in 2022 and in 2007, it was found that in recent years, the average length of stay in a bed has decreased in 2,5 times. If in 2007 the number of operations amounted to 385, then in 2022 their number increased to 1019. At the same time, the turnover of the bed increased 2,6 times. There was also a 27,5% increase in surgical activity. Conclusions. Thus, in the Orenburg region over the past five years, there has been a decrease in the level of general morbidity of the adult population with diseases of the genitourinary system by 14,4%, and the level of primary morbidity of the adult population with diseases of the genitourinary system by 37,4%. The introduction of high-tech methods of surgical treatment, including endoscopic and laser technologies, in the urological department of the V. I. Voynov State Medical University has significantly improved the efficiency and quality of specialized medical care for patients with diseases of the genitourinary system.

KNOWLEDGE, SKILLS AND COMPETENCIES OF STUDENTS AND WORKING NURSES, MIDWIVES AND PUBLIC HEALTH INSPECTORS FOR THE SUPERVISION AND CONTROL OF NOSOCOMIAL INFECTIONS

To improve the safety and quality of medical activity, there is a Medical Standard for Prevention and Control of Nosocomial Infections. The introduction of the concept of preventive measures is aimed at reducing the risk of bumps, cuts, interventions using microinvasive and invasive methods, as well as assessing the activity or service and their risk to the patient. 
 Objective: To study and assess the knowledge of health professionals - nurses and midwives, as well as nursing students, midwives and public health inspectors, about the regulatory framework for the surveillance and control of infections associated with health care. 
 Materials: the general population covered 362 respondents. 
 Methods: theoretical analysis, statistical methods, graphic and sociological methods. A statistics software package - IBM SPSS for Windows v.20.0 - was used to process the data. 
 Results: The requirements of Decree No. 3 of the Ministry of Health of May 8, 2013 have been met. As of May 11, 2013, the following is valid (43.20% for working people and 50.70% for students, respectively), but working specialists demonstrate more knowledge about rules, the requirements for the study of carriage in hepatitis B are met, workers Specialists are more often examined for the presence of hepatitis and HIV infections compared to students (79.90% versus 59.50%).Conclusions. Medical practitioners have a significant difference in immunization against hepatitis B and are less immunized (49.80) than in the study (81.80). Working health care workers are more informed (81.30%) about the waste management system than those currently undergoing training (30.40%). Hepatitis C, Hepatitis C, HIV / AIDS after infection were in 40.70% of workers and 19.40% of students.

Quality control as a fundamental institute of medical activities (review of literary sources)

The aim of the study, analyze and evaluate the quality control and safety of medical activities carried out in medical organizations. Results: the essence of the concept of quality control in the field of medical care was determined, criteria for assessing the quality of medical activities were identified, the main aspects of developing a program for internal quality control and safety of medical activities were characterized, key risks existing in medical activities were identified, directions for improving the quality and safety of professional activities of medical workers. Conclusion: modern approaches to the organization of quality control and safety of medical activities make it possible to ensure a high level of medical care provided to the population and improve the quality of life of the population as a whole.

External audit of outpatient-polyclinic division of medical organizations for dealing with complaints from citizens as an effective way to improve the quality of medical activity

External audit of outpatient-polyclinic division of medical organizations for dealing with complaints from citizens as an effective way to improve the quality of medical activity

Agent-Based Architecture for the HealthCare of patients at The Emergency Department

Though multi-agent systems have been explored in a wide variety of medical settings, their role at the emergency department care level has been relatively little investigated. In this paper, we propose a tool to assist decision-making process for the care of patients at the emergency department. This tool aims to improve the quality of care within the emergency departments with rapid access to pertinent data, integration of care's protocols and assures knowledge of the quantity and the quality of medical activity. This multi-agent model was adopted to define the behavior of entities by distributing data and tasks in an attempt to explain and predict events in the emergency department. We have chosen to build intelligent agents that perform coordination tasks for the users, i.e. the medical staff. To solve some problems, the agents have to cooperate. To ensure this cooperation, the system uses an agent interaction protocol making it possible to accelerate the process of task allocation.

Assignment of Tasks to Multi Skills in Agent-Based Architecture at The Emergency Department

Abstract In this paper, we propose a tool to assist decision-making process for the care of patients at the emergency department. This tool aims to improve the quality of care within the emergency departments with rapid access to pertinent data, integration of care's protocols and assures knowledge of the quantity and the quality of medical activity. This multi-agent model was adopted to define the behavior of entities by distributing data and tasks in an attempt to explain and predict events in the emergency department. We propose an efficient activity scheduling process of care within emergency department which plays a crucial role in order to ensure the delivery of the right treatment at the right time and to improve quality of care.