乌克兰家庭医生工作的质量控制是成功实践的关键

I. Vysochina, N. Bashkirova, A.N. Anoshko
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引用次数: 0

摘要

总结。在乌克兰医疗行业改革的背景下,确保医疗服务提供的有效质量控制及其在保健机构和主要初级保健提供者(PCP)中的适当组织的问题已成为热门话题。今天在乌克兰,对全科医生——家庭医生的工作进行监督(审计)是一个持续的过程,其目的是提高医疗服务的质量。审计的特点是采用系统方法,从而能够发现问题,评估已达到的质量水平,计划和实施旨在提高医疗质量的改革。对医生工作的审计分为专业审计和行政审计,以及内部审计和外部审计。一般来说,对全科医生——家庭医生——工作的审计是所有这些类型的结合。内部质量控制由PCP提供者的总医务主任和机构的医务委员会执行,分为对结构、过程和结果的审计。此外,家庭医生工作的内部审计形式有:自我控制和质量自我评价、同事间相互评价、PCP提供者负责人评价。PCP供应商的外部审核以非部门控制、公共控制和部门控制为代表。管制的对象是医疗机构以外的授权机构。提供医疗服务的外部质量控制由国家当局、乌克兰卫生部临床专家委员会和公共组织进行。财务审计由乌克兰国家卫生局和乌克兰卫生部审计和分析司进行。行政审计由乌克兰卫生部审计和分析司进行。结论。一般来说,对全科医生-家庭医生的活动的控制是一个持续的过程,并涉及一个系统的方法。内部审计由同一行业的成员进行,这提供了一个独特的机会来识别不符合标准的情况,并在其导致不利后果之前改变策略。外部审计由国家机关进行。这两种审计形式的平衡应用可以实现医生的高质量工作。全科医生-家庭医生应努力提高质量,定期进行内部审计,作为实施家庭医学优质护理的主要纠正因素。
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QUALITY CONTROL OF THE WORK OF A FAMILY PHYSICIAN IN UKRAINE AS A KEY TO SUCCESSFUL PRACTICE
Summary. In the context of the reform of the medical industry in Ukraine, the issue of ensuring effective quality control of the provision of medical care and its proper organization in healthcare institutions, and primarily primary care providers (PCP), has become topical. Today in Ukraine, the control of the work of general practitioners-family doctors (audit) is a continuous process, the purpose of which is to improve the quality of medical care. The audit is characterized by a systematic approach, which makes it possible to identify problems, assess the achieved level of quality, plan, and implement changes aimed at improving the quality of medical care. The audit of the work of doctors is divided into professional and administrative, as well as internal and external. The audit of the work of general practitioners - family doctors, as a rule, is a combination of all these types. Internal quality control is carried out by the general/medical director of the PCP provider and the medical boards of the institution, and is divided into audit of the structure, process and result. In addition, there are forms of internal audit of the work of family doctors: self-control and self-assessment of quality, mutual assessment between colleagues, and assessment of the head of the PCP provider. The external audit of the PCP supplier is represented by non-departmental, public and departmental control. The subjects of control are the authorized bodies outside the medical institution. External quality control of the provision of medical care is carried out by state authorities, clinical expert commissions of the Ministry of Health of Ukraine, public organizations. The financial audit is carried out by the National Health Service of Ukraine and the Department of Audit and Analytics of the Ministry of Health of Ukraine. Administrative audit is carried out by the Department of Audit and Analytics of the Ministry of Health of Ukraine. Conclusions. In general, control over the activities of general practitioners - family doctors is an ongoing process and involves a systematic approach. Internal audits are conducted by members of the same profession, providing a unique opportunity to identify non-compliance with standards and change tactics before it leads to adverse consequences. External audit is carried out by state institutions. The balanced application of these two forms of audit allows to achieve a high quality of work of doctors. General practitioners - family doctors should strive for quality and regular internal audit as the main corrective factor in the implementation of quality care in family medicine.
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