Institutional Work Research Articles

Institutional policing work in a constellation of labels and spaces of place: video game development management insights

Purpose This paper aims to explore (a) the dynamics of place and space in an institutional setting and (b) institutional work done in different spaces of the same place. Design/methodology/approach Traditional ethnographic methods (participant-observation, interviews and artefacts) were used over the course of 12 months of fieldwork in a multi-organizational video game development space. Findings The paper presents two main findings. First, the authors show how the place was a dynamic rainbow constellation and manifested as different spaces over time and for different actors. The authors describe the spaces based on existing literature (accelerator, experimental, incubator or coworking space) or inductively (atrium and hybrid). Second, the authors show how institutional work changed depending on the spatial conceptions of the institutional place. In particular, the authors show dynamic rainbow constellation of fluid spaces raises different forms of institutional policing work (self, backroom, spectacle, tangential and preventative) and the conditions under which institutional policing work is subtly fluid and takes form, but also changes. Originality/value Significant contributions are made to understanding how actors work at forming a rainbow constellation ring of fluid labels and spaces of a place. This paper explicates and amplifies the forms of institutional policing work, providing a novel case example of that social interaction.

Relations between reflexivity and institutional work: A case study in a public organisation

Reflexivity is often considered a prerequisite for institutional work. However, the relationship between reflexivity and institutional work has rarely been examined rigorously in empirical research, and there is a lack of consensus on when and how reflexivity motivates such efforts. This study aims to address this gap by reviewing existing operationalisations of reflexivity and exploring how different forms of reflexivity impacted employees’ engagement in institutional work in a public organisation undergoing institutional change. The empirical results revealed seven distinct patterns of reflexivity and institutional work, indicating that variations across three dimensions of reflexive evaluation – scope, openness and relationality – contributed to decisions about whether and how to engage in institutional work. The results also demonstrated that reflexivity is profoundly grounded in individuals’ concerns and shaped by their work and professional histories. These findings suggest that researchers and practitioners must develop a deeper understanding of the multidimensional nature of reflexivity in order to foster meaningful employee contributions to institutional processes.

Pendekatan Kepemimpinan Kependidikan Al-Ghazali dan Ibnu Khaldun: Relevansi dalam Manajemen Agile Modern

Leadership is an individual's personal ability that plays an important role in bringing the organisation to its goals. The complexity of the environment of modern society, along with the pressure of competition between educational institutions, the increasing expectations of parents and the need to introduce changes in the process of working in Islamic educational institutions led to a great deal of interest in agile management methods. Al Ghazali and Ibn Khaldun are great figures who pay great attention to the world of education, including the concept of educational leadership. The presence of leaders in facing these conditions is absolutely necessary so that Islamic educational institutions can still exist to contribute to the intellectual life of the nation. The purpose of this research is to examine the concept of educational leadership of Al-Ghazali and Ibn Khaldun and explain the relevance of these concepts in the context of agile management. This research uses the Library Research method. The author searches for literature sources in the form of books and journals. The analysis used is comparative analysis. The conclusion of this research is the relevance of the concept of educational leadership of Al-Ghazali and Ibn Khaldun in the context of agile management, namely working to achieve the pleasure of Allah swt, holding fast to the goals of Islamic education, having leadership skills, involving customers in educational projects, involving customers in educational projects, teamwork and collaboration, new work processes, regular reflection and continuous quality improvement.

Features of endodontic treatment of teeth with curved root canals according to a survey of dentists

Purpose: to identify difficulties of endodontic treatment of teeth with curved root canals according to a survey of dentists. Materials and methods: 90 dentists (26 men, 64 women) participated in the survey. 68 people had a therapeutic certificate, 19 people had an orthopedic certificate, 10 people had a surgical certificate, 6 people had a certificate in pediatric dentistry, and 43 people had a certificate in general dentistry (some respondents indicated that they had several certificates). The average age of respondents is 32 years (23–60). The interviewed dentists conduct practical work in public medical institutions, private dental clinics, and rented offices. The questionnaire included 20 questions (6 questions were aimed at collecting demographic data, 14 questions were aimed at obtaining information about the treatment of teeth with curved root canals). The questionnaire was submitted electronically to Google Forms. Statistical analysis of conjugacy tables using the Pearson chi-square test was performed using the program StatTech (Russia). Results: this survey reliably showed that dentists often experience difficulties in treating teeth with curved root canals. Dentists working in state institutions are significantly more likely to note that the rubberdam latex interferes (p= 0.049) and the clamp bow (p= 0.029) compared to doctors working in other institutions. Dentists working in a rented office are significantly more likely to report that a rubberdam latex interferes (p= 0.024) compared to doctors working in other institutions. Dentists who report difficult access when working with the mesial buccal canal of the lower molars are significantly more likely to note that a rubberdam latex interferes (p= 0.036). Dentists who use the approach «first negotiation to the working length – then coronal flaring» significantly more often experience difficulties when working with the mesial buccal first canal of the upper molars. Conclusions: the results of the survey demonstrated a number of differences in the performance of endodontic treatment of teeth with curved root canals. Based on the survey, statistically significant relationships were identified between some work features and difficulties encountered by doctors at the stages of treatment.

Mandating Women Board Members in Sport Organizations: Change via Coercive Institutional Pressure

Boosting board representation of women redresses structural unfairness and improves corporate governance and performance. The Change Our Game initiative, running over 3 years statewide in Victoria, Australia, mandated 40% representation of women on state sport boards. At the start, only 44% of state sport boards had 40% women representation; by the mandate deadline, this had increased to 93%. Using an institutional theory lens, the authors qualitatively analyzed four stakeholder groups: mandators, policy champions, operationalists, and mandate targets. Stakeholder sentiments were analyzed pre- and postmandate deadline over 3 years. Sentiments ranged from positive to equivocation to denigration. The mandate’s coercive pressure, supported by institutional legitimacy and work to accelerate changes, led to institutional change and achieved a significant increase in women board members. Change was grounded in strong ethical and cognitive support from mandate champions. Microsocial expressions of denigration and change resistance did not prevent successful change.

Artificial intelligence – NPHIs’ role in utilizing its opportunities and addressing the risks

Abstract Issue & Problem National Public Health Institutes (NPHIs) in many countries are at the forefront of action to mitigate the impact of current and future threats to health as well as improving population health and wellbeing. Through research, collaboration, and support, NPHIs can approach these new realities together. One of the many emerging realities that NPHIs will need to engage in is how NPHIs best can utilise the powers of artificial intelligence and deal with the ethical and legal issues that come with it. Methods In preparation of IANPHI’s (International Association of National Public Health Institutes) Europe Regional network meeting in April 2024 a survey was conducted among the 42 members. 16 countries replied to questions, around e.g., 1) current applications of (generative) artificial intelligence (AI) in the work of institutes, 2) which experiences were made and 3) which measures NPHIs take to best utilize the possibilities and overcome challenges of AI technologies. Within four weeks 16 replies were shared. Lessons & Conclusions Some institutes have not yet adopted AI, while others report multiple applications but the primary areas of application vary considerably among Europe. Applications include summarizing and reformatting text; translation; transcribing and documenting meetings; search information in documents or databases; coding; creating visuals; literature review; surveillance of infectious diseases; disease forecasting; analysis of transmission dynamics; vaccine efficacy assessment and development; image recognition; diagnosis and prediction of diseases from medical datasets; text mining; symptom extraction; social listening; prediction of nitrate concentration in groundwater; drug analysis and measuring psychological resilience in social crisis. Key messages • AI poses opportunities and risks for public health and work of national public health institutes and capacity building initiatives are essential. • IANPHI decided to develop a joint framework for the use of AI in its member organisations with a focus on research and responsible use.

Personnel reserve: training of medical personnel

In the article we consider the existing approaches to the training of nursing staff. The study is based on the analysis of scientific literature, regulatory legal acts regulating the activities of nursing staff and their own supervision of the work of an educational institution and the work of young staff.

Effect of government's environmental attention on corporate philanthropy based on the institutional theory: Evidence from China's heavily polluting companies.

The underlying motivation behind corporate philanthropy (CP) is subject to multiple interpretations. For emerging markets, traditional interpretations based on a perspective of interest exchange often fall short. The institutional environment in China is characterized by uncertainty, particularly in the field of environmental protection, where the government's attention, a scarce institutional resource, can influence the behaviors of heavily polluting companies. The government's environmental attention (GEA) may be subject to campaign-style investment, which provides an opportunity for research. This study attempts to use institutional theory to construct a difference-in-differences model using the Central Inspection of Environmental Protection as an exogenous shock. It examines the causal impact of GEA on CP, observing that GEA has a positive effect on CP, especially for large companies, companies in less competitive industries, companies located in high-pollution areas, and companies with high environmental expenditure. The results indicate that campaign-style institutional changes provide a non-transactional political motivation for CP. In addition, we discuss the mechanism, which is the expectation change. Campaign-style institutional changes work by altering corporations' expectations of the future institutional environment. We verify this mechanism from two perspectives, namely, the intensity of changes caused by uncertainty and corporate sensitivity to changes. Our results remain robust when subject to several tests based on different identification hypotheses and alternative measures. Unlike the existing literature on the political connections driving CP in China, this study, based on the institutional theory framework, reveals that campaign-style institutional changes constitute a non-transactional, unidirectional political motivation, which is a significant driving factor for CP in a Chinese context. This study evaluates the importance of GEA and reveals the non-transactional political motivations from the institutional theory perspective. This not only enriches existing discussions on the political motivations of CP but also broadens our understanding of the relationship between institutional uncertainty and CP in emerging markets.

СОСТОЯНИЕ ФИЗИЧЕСКОГО ВОСПИТАНИЯ В ВЫСШИХ УЧЕБНЫХ ЗАВЕДЕНИЯХ КРЫМА В СЕРЕДИНЕ 30-Х ГОДОВ ХХ ВЕКА

Based on the analysis of previously unexplored archival documents, the state of physical education and mass sports work in higher educational institutions of the Crimea in the mid 30s of the 20th century are considered. Research has established that the departments of physical and military training in Crimean higher educational institutions were opened in 1932. During the period from 1933 to 1935, there was an intensive development of physical culture and mass sports work in Crimean higher educational institutions in the form of full coverage of the contingent of students with compulsory academic physical education classes, the creation of physical education collectives at institutions, the improvement of their sports base, the opening of student sections on sports and the establishment of intra-university competitions. The most important aspect of the physical education work of higher educational institutions was the involvement of students and teachers in passing the standards for the badge «Ready for work and defense of the USSR». The Supreme Council of Physical Culture of Crimea took an active part in the activities of Crimean higher educational institutions to improve physical education, performing coordinating, organizational and supervisory functions.

Value-based banking as a factor of sustainable development

The banking sector is one of the drivers of economic development and is closely related to the functioning of society, the demands of which change according to its evolution. In the era of public demand for guidelines regarding the conscious conduct of business and life, the question of introducing values into banking is acute. Its transformation in the direction of introducing a personal approach and ethical principles while working with clients is being observed; awareness that the formation of close relationships is possible only on the basis of socially significant values and assessment of their impact on the environment, communities and space. That is why the implementation of a value-based approach to banking is an impor­tant and relevant topic. During the re­search, a hypothesis was put forward regarding the need to introduce value-based banking as one of the key drivers of sustainable economic develop­ment. A traditional set of methods for researching economic processes is used: ana­lysis, comparison, and logical genera­lization. The essence and basic norms of the functioning of value-based banking are revealed, the authorʼs vision is formulated. The work prin­ciples of value-based banks, defined by the Global Alliance for Banking on Values, the principles of the concept of sustainable develop­ment, the practical aspects of the implementation of value-based banking based on target, ethical characteristics in the work of individual banking institutions were studied, and on their basis, the own principles of value-based banking were formulated. The main interna­tional and domestic aspects of the functioning of banks that introduce elements of value-based banking are analyzed. It was determined that in fact all the leading banks in the world banking sphere prioritize streng­thening the principles of value banking in the near future. Banks of Ukraine are not lagging behind this process, and certain elements of value-based banking, such as corporate social responsibility, ESG prin­ciples, etc., are being introduced into their activities. The prospects of banking based on a client-oriented approach and the application of the principles of conscious business conduct are formulated.

Operations Regarding Safe Educational Institutions of Educational Institutions under the Jurisdiction of the Saraburi Primary Educational Service Area Office 2

Background and Aims: The purpose of this research is to study and compare the opinions of personnel regarding safe educational operations in educational institutions under the jurisdiction of Saraburi Primary Educational Service Area Office 2. Classified by position educational institution size and work experience in addition, the objective is to study guidelines for promoting and developing the operation of safe educational institutions in educational institutions under the same affiliation. Methodology: The sample group used in the research consisted of 317 personnel from educational institutions under the Saraburi Primary Educational Service Area Office, Area 2, obtained by stratified random sampling (Stratified Random Sampling). The research instrument was the questionnaire has a 5-level rating scale with an IOC between 0.80 - 1.00 and a confidence value (Cronbach's Alpha) equal to 0.79. Structured interviews were also used to collect additional information. Statistics used in data analysis include frequency, percentage, mean, and standard deviation, T-test (t-test) and analysis of variance (ANOVA or F-test). Results: The results of the research found that: (1) The operation of educational institutions is safe. of educational institutions under the jurisdiction of the Saraburi Primary Educational Service Area Office 2, overall and in each aspect It was found to be at a "very high" level in all aspects, which shows that the operation of safe educational institutions has been carried out efficiently in every dimension. (2) Results of comparative analysis operations in the area of ​​safe educational institutions. Classified by position It was found that there was a statistically significant difference at the 0.05 level while categorizing by school size and work experience found that there was no difference. (3) Operational guidelines Regarding safe educational institutions under the Saraburi Primary Educational Service Area Office 2, it was found that: 1) In terms of preventive measures should proceed with the preparation of a safety plan that covers all dimensions. 2) Instilling measures safety workshops should be organized for teachers. educational personnel and students 3) suppression measures guidelines for managing or suppressing incidents should be established. Including assistance when an incident occurs in an educational institution and create mutual awareness in all sectors. Conclusion: Operations regarding safe educational institutions of educational institutions. There should be a safety plan for educational institutions that covers all dimensions. Educational institutions provide an environment and atmosphere that is safe for students, teachers, and educational personnel. There are guidelines for managing or suppressing incidents. Assistance when an incident occurs in an educational institution and there are workshops on safety of educational institutions for teachers, educational personnel and students.

Forms of perpetuating the historical memory of the Heroes of the Soviet Union in urban toponymy (using the example of commissar Moskovsky Street in Tambov)

Importance. The activities of the Tambov city authorities, public organizations and institutions, their motives in the work on the preservation of military historical memory in the urban enviro nment during the second half of the 20th – beginning of the 21th century on the example of perpetuating the memory of the first Hero of the Soviet Union from Tambov region – A.N. Moskovsky, are considered. The importance of the research lies in the fact that the use of trends in modern historical science, namely, an interdisciplinary approach to research, political history and historical urbanism, allows us to obtain qualitatively new knowledge about the activities of the Russian cities authorities (based on Tambov materials) to preserve military historical memory in urban toponymy and objects of monumental art during the second half of the 20th century – the beginning of the 21th century.Materials and Methods. The methodological basis of the research is based on the principles of consistency, historicism, and objectivity. Comparative historical, problem and chronological methods are used. The research is based on such general scientific methods as analysis, synthesis, generalization, and systematization. The main sources of the research are archival materials stored in the State Archive of Tambov Region, the State Archive of Socio-political History of Tambov Region, published and posted on the Internet, as well as materials in the funds of the Museum and Exhibition Center of Tambov Region.Results and Discussion. The features of the ideological work of local authorities on the development of military historical memory are analyzed. The patterns and continuity of approaches in the military historical work of the city authorities at different chronological stages are revealed. The mechanisms of preserving the memory of a particular hero, senior political instructor, commissar A.N. Moskovsky, are investigated. The forms of historical and patriotic information about the objects of urban toponymy and monumental art created during the development of the urban environment, concerning the perpetuation of the memory of A.N. Moskovsky, are highlighted.Conclusion. As a result of studying the problem, conclusions are drawn about the multi-faceted approach in the work of city authorities, institutions and public organizations for the preservation of military historical memory in the region.

Technologies for ensuring the unity of physical and military-patriotic education of high school students

The article examines the content and technologies of the unity of physical and military-patriotic education of high school students. It is highlighted that the relevance of the research is determined by society's need for a self-sufficient, goal-oriented, decisive, self-confident individual who is able to realize his role in the life of the state, to take an active part in applied physical training, physical culture and health activities and social life, to be ready to protect the Motherland , devoted to her interests. The article mentions the study of modern psychological and pedagogical literature on the studied category. The results of the analysis of the practice of educational work of general secondary education institutions confirm that the levels of physical and military-patriotic education of high school students do not meet modern requirements in the conditions of martial law. It is highlighted that the content of applied physical training consists in the fact that high school students (future soldiers of the Armed Forces of Ukraine) during the lessons of physical culture and "Defense of Ukraine" acquire the necessary knowledge, skills and abilities about physical and tactical-technical training, physical, the need to overcome significant physical exertion and adverse factors of combat activity. In our opinion, using the unity of physical and military-patriotic education in the process of applied physical training helps high school students to gain the necessary knowledge and ideas, new interesting practical experience; try yourself in various physical and mass activities and military-patriotic roles; to acquire the necessary skills and abilities to work in a team. Also, the benefit of this research lies in the actualization of important functions of education, namely: increasing the levels of physical fitness, physical and military-patriotic upbringing of schoolchildren in conditions of armed and informational aggression; increasing the level of readiness of students to serve in the Armed Forces, other military formations and the defense of Ukraine; protection of high school students from hostile information and propaganda influence.

Strengthening the fight: is the adoption of IPSAS helping Latin America tackling corruption?

PurposeThis paper examines the relationship between the adoption of accrual-based IPSAS and the level of perceived corruption of Latin-American countries, considering the moderating effect of the country’s institutional quality.Design/methodology/approachThe study adopted a longitudinal analysis of 19 countries, between 2010 and 2020, following a quantitative approach by using multiple linear regression with panel data.FindingsMain findings indicate that the harmonization of public sector accounting through the adoption of IPSAS generates a positive effect on the corruption level in Latin-American countries, causing a reduction in their indexes of perception of corruption. The countries’ institutional context, as hypothesized, increases such effect, making it even more significant in the cases of partial adoption.Practical implicationsTo improve accountability and decision-making in public sector entities overall, contributing to reduce corruption, IPSAS adoption requires an institutional environment favorable to take the best of their benefits.Social implicationsThe adoption of IPSAS in an environment with a high institutional quality, allows a greater effect in reducing corruption in the jurisdiction.Originality/valueThis study contributes by providing a comprehensive view of IPSAS and its impact on perceived corruption levels, expanding the existing research to Latin America, where corruption is generally high and IPSAS may contribute to reduce it. It makes an important addition by defining and considering an index of the country’s institutional quality, providing evidence that when this is high, the context enhances the work of institutions, including IPSAS, to fight corruption.

Elements, Contexts, and Attributes of Teacher Leadership Identified by College Professors in southeastern Mexico

Teacher leadership has its beginnings in Western countries as a response to fast changes that have taken place in the social, political, and economic environments. Currently in the Latin American context it has become a focus of interest for educational researchers particularly because the incipient research on the topic in these contexts. This study focused on knowing the elements, contexts, and attributes identified by college teachers about teacher leadership southeastern Mexico. All full-time faculty from a college at a public university (50) participated in this study, 20% of whom have formal administrative functions in addition to their teaching. The main findings show that: the main elements that are related to the concept of teacher leadership are behaviors focused on interpersonal relationships and school innovation. Regarding the contexts, the development of teacher leadership is often based on institutional context and collaborative work. Regarding the attributes, special emphasis is placed on interpersonal relationships, change, and individual development and recognition. No significant differences were found in the perceptions of participants who have an administrative appointment and those who do not, regarding the contexts and attributes of teacher leadership, except for the elements of the concept of teacher leadership between men and women.

Selecting facility location of Gendarmerie Search and Rescue (GSR) Units; An analysis of efficiency in disaster response

Disasters, referred to as events that result in physical, economic, and social losses for individuals and disrupt the daily activities of human communities, necessitate ongoing preparedness due to their unpredictable nature. Swift response during and after a disaster is crucial for preserving human life. Hence, it is imperative to initiate planning immediately following a disaster to ensure readiness for various tasks. Given these factors, search and rescue units must carefully select a base location that enables them to promptly reach affected areas.Disasters exhibit unique characteristics across different regions of Türkiye. While some regions are prone to earthquakes, others face the risks of landslides, avalanches, or floods. Consequently, the required measures for disaster management vary from region to region. Nevertheless, when the term “disaster” is mentioned in Türkiye, earthquakes often come to mind due to their frequent occurrence and significant impact. The Gendarmerie Search and Rescue (GSR) units have been actively responding to these earthquakes, renowned for their exemplary institutional discipline and working methods. This study aims to examine the operations and deployment locations of GSR units, which play a crucial role in mitigating the impact of frequent earthquakes in Türkiye, utilizing a SWOT analysis. Additionally, a Multi-Criteria Decision Making-based mathematical model will be employed to optimize task activities and to select the most suitable facility locations for GSR units. The use of mathematical modeling in this context ensures that GSR units are strategically positioned to maximize their operational effectiveness and minimize response times. The results will be evaluated through sensitivity analysis.

Beyond teaching: the extended role of informal entrepreneurship education and training in challenging contexts

PurposeWe seek to understand how informal entrepreneurship education and training (EET) processes support marginalised women in challenging institutional contexts into gainful participation in entrepreneurial activities, facilitating empowerment and emancipation.Design/methodology/approachThe study employs an inductive qualitative approach drawing on in-depth individual interviews, a focus group and observation of how female informal EET educators facilitate hands-on EET to marginalised female entrepreneurs in Uganda.FindingsWe specify a range of novel complementary practices that informal EET educators undertake during the main instructional EET stage and present the wraparound purposive work, both pre-and-post the instructional stage, they enact to support female empowerment processes for their disadvantaged learners. We then propose a grounded model capturing practices enacted by EET practitioners that illuminates ways in which informal EET can contribute to processes of empowerment and emancipation.Originality/valueOur contributions are twofold. First, we conceptualise EET educators as institutional entrepreneurs undertaking institutional work beyond core teaching. Second, we specify a range of novel complementary practices they undertake before, during and after the conventional instructional part. This illuminates how EET can contribute to processes of empowerment and emancipation. Drawing on data from a unique institutional context, we illuminate novel practices enacted by informal EET educators thereby extending both the pedagogy and the realm of entrepreneurship education with implications for grander empowerment and emancipatory outcomes beyond the development of entrepreneurial competencies.

Governing the paradox of success in a hybrid supporter-owned professional football club

ABSTRACT Research question Using insights from success paradoxes and hybrid institutional logics, we analyse the institutional work undertaken to construct a novel governance structure in a supporter owned professional football club. Research methods A single exploratory case study design was adopted, focusing on the transition from existential crisis to supporter ownership. A mixed method strategy involved collecting participative observation, primary interview and secondary documentary data. Results and findings We observed a shared understanding of the overlapping priorities for the Club and (supporter) Foundation that formed the basis for collaboration. Ambiguity as to what constituted success, and awareness of latent paradoxes contributed to the institutional work necessary to develop a resilient governance structure. A distinctive aspect arose from harnessing the productive friction between the corporate and professional logics of the Club, and the community and family logics of the Foundation. Implications Institutional work undertaken in creating a new governance structure shows the potential within clubs for cooperation between different actors, demonstrating the mediating influence arising from mutual dependency between actors. When there is a high level of co-dependencies between the club and stakeholders, and contestation over what constitutes success, tensions between logics can be leveraged to benefit the hybrid organisation. While any governance solution needs to reflect a club’s specific context, the adopted governance structure should integrate resilience, mutual dependencies, business acumen, inclusion, emotion, engagement and accountability.

Experience of integrating lean technologies into the quality management system of a medical organization providing primary medical and sanitary care

Objective. To evaluate the effectiveness of implementation of lean production methods into the practical activity of primary health care on the example of the State Institution of Health Care «Saratov City Polycli nic № 2». Materials and methods. The study was divided into three stages: data collection through anonymous sociological surveys using phones or tablets, timing and improvement of the process, and a follow-up questioning of participants to assess their satisfaction. 296 residents of Saratov receiving primary health care at the polyclinic took part in the survey. The survey was conducted using a specially developed electronic questionnaire via Google Form. For mathematical processing, the results of the study were initially transferred into an electronic database; the results of the study were analyzed using the descriptive statistics method. Results. According to the survey, the majority of respondents are satisfied with the quality of outpatient medical care. This shows that organization of the medical care is focused on the patients` needs and desire to meet their demands. The organization of the front office and the premises of the polyclinic in accordance with the requirements for the new model of the organization providing primary medical care made it possible to achieve a high evaluation of the information stands and the waiting area. The study showed that ineffective organization of the registry office contributed significantly to the patients` low assessment. In our opinion, in order to solve the problem, it is necessary to optimize the work of the registry office by introducing modern technologies and equal distribution of duties among the employees. Conclusions. In order to improve the quality and accessibility of medical services, it is necessary to make certain changes in the organization of medical care. The level of patient satisfaction with the work of medical institutions may depend on various factors, such as waiting time for a doctor, the timing of medical services provision after the appointment, the availability of necessary diagnostic tests and specialists.

Organizational and economic factors of assessing the management of accessibility and quality of medical care in the Republic of Tatarstan

BACKGROUND: Today, when assessing the availability and quality of medical care, objective criteria and indicators prevail, and the factor of patient feedback as end consumers is practically not taken into account, which does not allow us to form a comprehensive view and get closer to solving this problem. AIM: To identify the factors that have the greatest impact on patients' assessment of the availability and quality of medical care, to study the influence degree of organizational and economic problems of medical organizations on this assessment and to develop quantitative indicators for managing this indicator. MATERIAL AND METHODS: The study was conducted using a questionnaire from October to December 2023 based on medical organizations of the Republic of Tatarstan. Two types of questionnaires were compiled. The first questionnaire was for consumers of medical care, covering 2,419 patients of hospitals and clinics from all cities and districts of the Republic of Tatarstan. The second questionnaire was for medical personnel. A total of 20,330 medical workers took part in the survey: 5,206 doctors, 10,841 nurses, 4,283 junior medical personnel from all types of medical organizations, including central republican hospitals, city and district hospitals and clinics of Tatarstan. The results of the questionnaires were processed by means of correlation and regression analysis using the least squares method. RESULTS: It was revealed that for patients of medical organizations the most significant factors in assessing the quality of medical care were: (1) queues and constant waiting (50.5% of respondents); (2) inability to see a specialist (48.9%); (3) unavailability of diagnostic procedures (biochemical blood test, computed tomography and magnetic resonance imaging, ultrasound; 40.7%); (4) inattention, indifference of medical workers (27.5%). Factors in the work of medical institutions and personnel that had the greatest impact on patients' assessments of the indicator of availability and quality of medical care were identified: stress at work, overload and high work pressure, dissatisfaction with salary. The regression coefficients of the identified factors allow them to be used as indicators of management decisions aimed at increasing the importance of availability and quality of medical care. CONCLUSION: Patient assessments obtained by medical organizations as a result of feedback allow not only to bring the level of availability and quality of medical care as close as possible to the expectations and needs of patients, but also to identify areas of management influence to improve it.