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Main arrow Archive of previous Issues arrow 2 2013 (30) arrow Challenges in improving management of emergency units in modern context
Challenges in improving management of emergency units in modern context Print
Thursday, 18 April 2013

Summary. Emergency departments and units in Russia differ from similar heath care facilities abroad in that they handle house calls which results in high utilization of the service.

The major difference between emergency departments and units and other health care facilities is that they move around the catchment area handling emergency calls while other health care facilities provide services indoors. Catchment areas of emergency departments and units differ in their utilization rates, quality and mileage of roads, distance to the referral facility for hospitalization, availability of communication tools, and other factors. Therefore, performance indicators applicable to health care facilities cannot be applied to emergency units or departments; while differences between catchment areas make it impossible to conduct comparative performance evaluation of different emergency units.

Currently each emergency unit has its own indicators to evaluate performance of its subunits, teams and staff. Some units use as much as 130 performance indicators. However, current indicators fail to estimate the correct number of teams needed, to assess quality of teams management and ensure differential remuneration of medical staff.

The article presents methods for estimating average daily work-load of a unit, subunit, emergency team and medical staff to ensure determination of the optimal number of teams to timely hands all emergency calls, territorial distribution of teams, quality management of teams and differential remuneration based on amount of services provided.

Keywords: emergency unit; performance evaluation; optimal number of emergency teams; differential remuneration.

References

  1. Berg AI, Chrnyak YuI. Information and Management. Moscow: Nauka; 1966. 43 p. (in Russia).
  2. Boev VS. The Methods for Calculating the Cost of Emergency Team Visit. Sovetskoe zdravookhranenie 1986;(8):16-19 (in Russian).
  3. Vyalkov AI. On the Need to Implement New Economic Models in Healthcare. Ekonomika zdravookhraneniya 2001;51(1):5-11 (in Russia).
  4. On approving the Order for Delivering Emergency Medical Care, the Regulation of the Ministry of Health and Social Development of the Russian Federation 179 of 01 November, 2004. [Internet]. 2004 [cited 2013 Feb 20]. Available from: http://www.zdrav.ru/library/regulations/detail.php?ID=26237 (in Russia).
  5. On the Equipping Medical Ambulance Vehicles, the Regulation of the Ministry of Health and Social Development of the Russian Federation 752 of December 01, 2005. [Internet]. 2005 [cited 2013 Feb 20]. Available from: http://www.law7.ru/legal2/se13/pravo13546/index.htm (in Russia).
  6. Starodubov VI, Solodkiy VA, Shilyaev DR. Some Results of Implementation of New Methods for Healthcare Management and Their Financing at a Regional Level. Zdravookhranenie 2000;(5):10-15 (in Russia).
  7. Tatarovskiy AP, Kucherenko VZ, Matveeva AP. Methods for Calculating the Indicators of Emergency Medical Care at a Pre-Hospital and Hospital Stages. Dnepropetrovsk. 1988. 21 p. (in Russian).
  8. Shestakov GS. New Information Technologies of Emergency Station Management. Moscow: Trovant; 2008. 142 p. (in Russian).

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