Saratov JOURNAL of Medical and Scientific Research

quality indicators

Novel approach to evaluation of medical care quality delivered to patients with ST-segment elevation acute coronary syndrome: course to clinical result

Year: 2014, volume 10 Issue: №3 Pages: 408-413
Heading: Internal Diseases Article type: Author's opinion
Authors: Posnenkova О.М., Kiselev A.R., Popova Yu.V., Gridnev V.I., Dovgalevsky P.Ya., Danilov A.N.
Organization: Saratov Institute of Cardiology, Russia
Summary:

The purpose was to implement system analysis of clinical cases for development of healthcare quality indicators for STe-ACS patients, aimed at achievement of clinical result — decrease of in-hospital mortality. Mathehal and Methods. National recommendations on diagnostic and treatment of patients with myocardial infarction with ST-segment elevation on ECG (2007) were used to determine clinical result of treatment and key measures of medical care. To reveal major causes of clinical result non-achievement fishbone diagram was used. Results. Early reperfusion and optimal medical therapy were determined as the key measures of medical care delivered to patients with STe-ACS. The following indicators were developed to control these measures: «Primary reperfusion», «Thrombolysis in 30 minutes», «Primary percutaneous coronary intervention in 90 minutes», «Dual antiplatelet therapy in hospital», «Beta-blockers administration», «ACE-is/ARBs administration». The major causes of in-hospital mortality were separated. Indicators for assessment the major causes of clinical result non-achievement were proposed. Principal stages of performance measures creation were posed. Conclusion. Recommendation-based and clear definition of clinical result of treatment and key measures of the result achievement combined with methods of systems analysis allows development of evidence-based measures for assessment the quality of care delivered to patients with STe-ACS.

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Problems and solutions on issues of medical care quality in community-acquired pneumonia in hospitals of Saratov region

Year: 2011, volume 7 Issue: №2 Pages: 368-372
Heading: Health Service Organization Article type: Original article
Authors: Erugina M.V., Grozdova T.Yu., Savinov V.A. Sazanova G.Yu.,Dolgova E.M., Lotsmanov Yu.F., Ushakov Yu.V.
Organization: Saratov State Medical University
Summary:

Qualitative assessment of diagnostics and treatment of patients with community-acquired pneumonia (CAP) was carried out in ten therapeutic departments of urban and district hospitals of Saratov region, using quality indicators (Qls). Each case of CAP was assessed in expert health care quality (HCQ) card according to the diagnostic and treatment quality federal standards and the basic Ql. The application of Ql in CAP patients allowed revealing the following: low CAP agent isolation rate; late hospitalization of CAP patients; low frequency of sputum bacteriological and bacterioscopic investigations prior to antibiotic therapy; insufficient frequency of step-by-step introduction of antibiotics. Recommendations on CAP patients dispenserization were not properly prescribed; recommendations on vaccination were absent. The basic measures of HCQ improvement are as follows: organizing for each CAP patient therapeutic and diagnostic quality control according to Ql; quick administrative decisions; using of HCQ expertise during the first 2-3 days of treatment to correct diagnosis and treatment; optimizing hospital diagnostic resources (laboratory and instrumental) and rational pharmacotherapy

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