INTEGRATED APPROACH TO REFORMING FEDERAL MULTIDISCIPLINARY HOSPITAL IN THE CURRENT CONDITIONS
The Concept of long-term social economic development of the Russian Federation for the period ending in 2020 has presented for the public health a problem of preservation and improvement of health of the population. A professional medical staff, development of infrastructure, resources provision, and improved organization are indispensable for the effective functioning of the system of public health. This study was conducted at the municipal hospital No.83, Moscow, Russia where a reform of the clinic - with the purpose of upgrading the quality of specialized medical care and making it more accessible - was under way in recent years. Our experience elucidated some problems to be solved on this way which can be common to many others medical establishments as well: 1. Structural reorganization with involvement of novel branches of medicine and introduction of brand-new medical technologies. Utilized capacity of medical and surgical departments was compared to real population-based needs and insurance companies' evaluated ones for various kinds of medical care. As a result, bed capacity of the hospital was reconsidered and rearranged. Intra-hospital standards of diagnostics and treatment inclusive of medical forms for various nosologies were introduced. New departments were created, as well as a special center for medical advice and diagnosis. 2. Active staffing policies. In selection of the staff only those physicians were preferred that did fit with adopted here some specific technologies of diagnosis and therapies, had the command of the skills in related specialties, presented sound motivation, and expressed ideas on further vocational training. 3. Implementation of modern marketing and advertising techniques. The efforts were applied to wide coverage among the population basis of perfect capabilities of the clinic, for more complete and opportune awareness of insurance companies or their agents about all aspects of the clinic activities, for verifying the image a skillful and benevolent medical personnel in patients with access to medical care here. 4. Arrangement of intra-hospital common information space. Medical information system was designed for better accounting and control of medical activities in this hospital; the tool to this end was to equip every workplace with a capacity to conduct electronically the medical records, to draft research projects, to obtain upon enquiry the required diagnostic data, etc. These combined 4-focuses management brought about significant improvement in the main qualitative and quantitative indicators of this clinic's activities. Growth in number of treated patients for the last three years was of 39.8%, number of surgical procedures performed grew by 35.6%, mean hospital stay reduced by 3.3 days. Thus consistent multi-focal management strategy enlarged the volumes of specialized highly qualified medical care for the population.