医疗机构员工对在俄罗斯医疗系统中实施基于风险的方法的态度

S. Russkikh, E. Tarasenko, T. Vasilieva, L. Moskvicheva, N. Y. Gabunia, E. V. Makarova, T. A. Dvornikova, E. A. Putilina
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引用次数: 0

摘要

研究的目的是在分析医生、组织者和医疗系统专家意见的基础上,提出改进医疗系统风险管理程序和统一风险管理内容的建议,以维护公众健康。材料和方法。作为 2022 年 9 月至 12 月进行的定量在线调查的一部分,对 104 名在俄罗斯联邦医疗系统工作的受访者进行了访谈。此外,作为定性社会学研究的一部分,还对医疗保健部门的组织者和专家进行了 6 次深入访谈。案头研究包括对科学文献的分析,以及与引入基于风险的医疗保健方法有关的监管框架。结果与讨论。文章从医疗机构、医疗系统和公共卫生(宏观层面)的角度,分析了医生、组织者和专家对医疗风险的认识,并对主要风险群体进行了识别和分类,在此基础上制定了风险管理措施。研究结果证明,在医疗机构的管理系统中引入风险管理的程度不够。半数受访者指出,风险管理原则在其所在机构(50%)和俄罗斯医疗机构(58.6%)中的应用程度较低或极低。同时,三分之一到一半的参与者认为,由于缺乏统一的方法、这套措施的标准和质量控制系统不完善、缺乏能够管理风险的专家、缺乏教育活动等原因,很难回答在其组织中实施风险管理的问题。为了采用系统的方法统一风险管理流程,有必要制定和批准最佳实践方法,并注意对专家的培训。结论。为了实施统一风险管理流程的系统方法,有必要制定和批准最佳实践方法,并注意对专家进行培训。医院管理者和员工必须重视改善患者安全管理的组织文化,将其作为维护公众健康使命的基础。有必要继续在这一方向上开展进一步研究,以便制定一项战略,在作为社会医疗和社会资源的公共卫生层面应对风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Attitude towards the risk-based approach implementation into the russian healthcare system among employees of medical organizations
Aim of the study was to develop recommendations for improving procedures and unifying the content of risk management of the healthcare system to preserve public health based on an analysis of the opinions of doctors, organizers and experts of the healthcare system. Material and methods. As part of a quantitative online survey conducted from September to December, 2022, 104 respondents working in the healthcare system of the Russian Federation were interviewed. Additionally, 6 in-depth interviews were conducted with the organizers and experts of the healthcare sector as part of a qualitative sociological study. Desk research included analysis of scientific literature, and the regulatory framework related to the introduction of a risk-based approach to healthcare. Results and discussion. The article presents an analysis the perception of risks in healthcare by doctors, organizers and experts at the level of a medical organization, of the healthcare system and of public health (macro level), with the identification and classification of the main risk groups, on the basis of which risk-management’ measures can be built. The results of the study testify to the insufficiently deep introduction of risk management into the management system of medical organizations. The half of the respondents noted the low and extremely low level of risk management principles’ usage in their own organizations (50 % of respondents) and in Russian medical organizations in general (58.6 % of respondents). At the same time, from a third to a half of the participants found that it was difficult to answer about risk management implementation in their organizations, due to the lack of a unified methodology, imperfection of standards and quality control system of this set of measures, lack of specialists who could manage risks, lack of educational activities. To introduce a systematic approach to the unification of risk management processes, it is necessary to develop and approve the methodology of best practices, as well as take care of the training of specialists. Conclusions. In order to implement a systematic approach to the unification of risk management processes, it is necessary to develop and approve a methodology of best practices, as well as to take care of the training of specialists. It is imperative that hospital managers and staff focus on improving the organizational culture of patient safety management as the basis for their mission to preserve public health. It is necessary to continue further research in this direction in order to develop a strategy for countering risks at the level of public health as a medical and social resource of society.
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