Improving the technology of work of heads of therapeutic departments of Central district hospitals

Abstract

The article presents the results of studying the organization of work of heads of departments of central district hospitals (CRH) and the quality of therapeutic care for the rural population. The study was conducted in 2017–2019. on the basis of 26 Central District Hospital of the Republic of Dagestan. The quality of therapeutic care was studied through an expert assessment of 1,085 inpatient and 748 outpatient patient records. The timing of the working time spent by the heads of the departments of the Central District Hospital for 845 hours. It was found that under the current conditions the heads of departments devote up to 50.7% of their working time to the fulfillment of the main duties. Waste of time is 15.1%. In the therapeutic departments of the Central District Hospital, an untimely and complete examination of a significant part of the patients took place; treatment is not always complete and complete, there is no continuity in the examination and treatment of the patient between the clinic and the hospital. On the basis of the research materials, a set of recommendations was developed to improve the technology of work of heads of departments of the Central District Hospital and improve the quality of medical care. Experimental verification of the recommendations confirmed their effectiveness: the time spent on the main work increased from 51.2% to 72.4%, the share of time spent on organizing and managing the treatment and diagnostic process increased by 15.5%. Improving the organization of work of heads of departments during the experiment had a positive effect on the quality of medical care: the proportion of patients examined at the prehospital stage increased by 25.4%; the number of those fully surveyed increased from 58.4% to 90.3%; the number of patients who received full treatment increased by 14.7%.