T.N. Baklanova, V.K. Popovich, I.B. Shikina
City hospital ¹ 17 Departments of public health services of a city of Moscow

Summary. Health care quality assurance is one of the most important and complicated problems of modern medicine. In the last decade the healthcare system of Russia has developed a medical practice quality control system which combines public, departmental, and internal control. In this context, the role and significance of the medical commission as the body established under each healthcare institution have been increasing. The adoption of the Law “On Health Protection of Citizens of the Russian Federation” has legally fixed the status of the medical commission in the medical organization, which is attributed by many healthcare experts to one of the amendments of medical law. The fundamental function of the medical commission in health care quality is the study of each case of death of patients in order to identify the causes of death. The objective of this work is to reveal the instruments of improvement of health care quality in a multi-field hospital on the basis of the analysis of fatal cases as a general criterion of health care quality.

The study shows the practice of continuous monitoring (2009 - early 2012) of deaths of patients, methods of quantitative and qualitative analysis of the study of such cases by the medical commission in a multi-field hospital in Moscow, as well as separate areas of organizational and methodological support of the work of the subcommission on the study of fatal cases.

The practical results of the work of the medical commission are considered as system indicators of health care quality assurance and efficiency of diagnostic and treatment measures in a multi-field hospital, as well as the basis for timely development by the administration of effective measures to eliminate and prevent violations in patient diagnostic and treatment processes.

Conclusions. Systematic compilation of the results of statistical analysis of deaths in the medical organization, results of the analysis of the quality of the diagnostic and treatment process, keeping of medical records, results of post mortem studies in combination with the practice of collective decision-making by members of the medical commission and collective discussion of decisions with the medical staff:

• facilitate the formation of professional self-consciousness in the medical organization;
• generate processes of self-regulation of professional activity within the medical communities based on individual and corporate responsibility for the results;
• serve as an efficient instrument for ensuring the quality of medical services.

Keywords. The medical commission, a subcommittee on research of lethal outcomes, an analysis algorithm of medical documentation, reviewing of stories of diseases.

References

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