No medical errors: a quality management system for a healthcare provider

On the second day of the 11th Gaidar Forum, a panel discussion "Institute for the Reduction of Medical Errors: a Quality Management System for a Healthcare Provider" took place at the RANEPA. The session participants discussed what problems are associated with the implementation of quality assessment for medical services provided, why it is important to bring transparency into the investigation of medical errors, and how the implementation of protocols and standardization can protect doctors and patients.

Speaking about lean technologies, the First Deputy Minister of Health of the Russian Federation Tatyana Yakovleva emphasized that this is not about saving money, but about saving time and the correct routing of the patient. Since 2021, all children's polyclinics in the country will switch to lean technologies, and adults' polyclinics will follow them in 2024. "When we talk about standardization, we talk about basic mandatory things, for example, medical information technologies and proper organization of working hours, which, of course, leads to an increase in the quality of services." According to Tatyana Yakovleva, although each patient is unique, "the treatment is always based on the clinical protocol, which we have already adopted as a binding document."

The head of the Federal Service for Surveillance in Healthcare Mikhail Murashko noted that when assessing quality in healthcare, it is necessary to clearly understand what parameters are involved and that they must be measurable. "The whole world understands the necessity of continuous data collection now. We have internal control protocols. But we need to regulate the provision of medical care," said the head of Roszdravnadzor.

According to his statistics, four out of ten patients face the fact that they cannot get a clear and timely diagnosis. According to Murashko, the investigation of such cases should be open, but criminal cases should not be instituted for each case, "otherwise they will keep on hiding the medical errors." Any medical organization must have internal control and a quality management system, "Everyone should know what is where, where to go and who to call. Because the life of the patient depends on it," the speaker noted.

The topic of medical standards was continued by the moderator of the discussion, Dean of the Faculty of Management in Medicine and Healthcare at RANEPA Leonid Pechatnikov. According to him, when the healthcare reform was carried out in Moscow, many were outraged that the doctor was given only 12 minutes to see a patient. "When we were in South Korea, we were shown that each visit takes only five to six minutes. And South Korean medicine is one of the best world practices! Why do they manage to everything in time? This is because the visit itself is as standardized as possible," Pechatnikov explained. "Most of the work that a doctor does in this country is done by paramedical personnel everywhere else in the world."

According to the Head Physician of the Republican Clinical Hospital of the Ministry of Health of Tatarstan Rafael Shavaliev, everyone should follow the quality standard of healthcare services, but "patients are satisfied only when our actions exceed their expectations." "Our task is to create a system of risk prevention that would allow us not to dive in them every day," said Viktor Fisenko, Minister of Health of the Primorsky Krai. Leonid Pechatnikov drew attention to the fact that Russian medical education is "not at the highest level, especially after many extra-budgetary students have entered medical institutions." This thesis from current statistics directly correlates with the Message to the Federal Assembly of the President of Russia Vladimir Putin, where the priority tasks include bringing the targeted enrollment of medical students sponsored from the budget for a number of specialties up to 75–100 %. In medical residency in the most demanded specializations, it is proposed to establish almost one hundred percent targeted training, and doctors with practical experience in primary care, especially from rural areas, will have an advantage in admission.

 

The Gaidar Forum is held at the RANEPA under the auspices of the Government of the Russian Federation and in 11 years it has become one of the most respected expert venues, which traditionally sets the vector for public and scientific discussion at the beginning of each year. The organizers of the 11th Gaidar Forum are the Russian Presidential Academy of National Economy and Public Administration, the Gaidar Institute for Economic Policy, and the Association of Innovative Regions of Russia.

The title partners of the Gaidar Forum are Gazprom PJSC and Gazprombank JSC. The strategic partners are Coca-Cola, Mastercard, Russian Railways, Pharmstandard group of companies, Johnson & Johnson, Sanofi, Novartis group of companies, MSD, AKIG group of companies, EF Education First. Partners are Prosveshchenie group of companies, EY, Huawei, RVC JSC, Russian Agricultural Bank JSC.

The title information partners of the Gaidar Forum are the Russia-24 TV channel, TASS, RBC, Business FM. The strategic information partners are Kommersant Publishing House, Interfax, Rossiyskaya Gazeta, Invest Foresight magazine, Federal Press Agency. The main information partners are Anews.com, Gazeta.Ru, Lenta.Ru, News.ru, Profile. International partners are RT, ThomsonReuters, Sputnik, EFE, Cision, Pan Pacific Agency. Information partners are Snob media project, AEI PRIME, RNS, Expert magazine, Parlamentskaya Gazeta, Polit.ru, Ekho Moskvy radio station, PRO Business TV channel, FINAM.RU information and analytical agency, Davydov.Index holding, Strategiya magazine, Ekonomika i Zhizn newspaper, Econs portal, Gosudarstvennaya Sluzhba magazine, TV BRICS.