Quality of services of emergency medical care in terms of health care reform

2016 ◽  
Vol 10 (4) ◽  
pp. 102-111
Author(s):  
Алексей Белобородов ◽  
Aleksey Beloborodov ◽  
Елена Данилина ◽  
Elena Danilina ◽  
Екатерина Яковлева ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Performance Indicators ◽  
Structural Model ◽  
Medical Services ◽  
Emergency Medical Care ◽  
Emergency Medical ◽  
And Performance ◽  
Definition Of

The article deals with the question of quality assurance of emergency medical care. It is of vital importance in terms of reforming the system of healthcare in the Russian Federation, as the quality and availability of various types of medical services are priority indicators of reform. Quality ensuring of emergency medical care is the most important socially significant task of health care, which lies in maintaining the health of people in extreme conditions and in meeting the challenges of mortality reduction. This is resulted in increased attention to research in this area. Quality ensuring of emergency medical services actualizes the task of improving of its assessment methodology. The methodological problems of services quality assessment in the system of emergency medical care limiting applied research are the subject of the study. The structure of emergency medical care is specified, the separation of concepts of "medical service" and "medical care" of services of emergency medical care is accomplished, and the concept of "medical care" is defined in the article. Based on the results of market research of patients’ satisfaction with quality of medical care in emergency hospital of Krasnoyarsk a structural model of services of emergency medical care has been created. This model reflects the patients’ understanding that the quality of service of emergency medical care is an integrated category, combining the quality of the result of medical services and quality of care. Content analysis of the definition of basic concepts in the field of quality of health care has allowed to formulate the concept of "service quality of emergency medical care”. Its difference is that the definition includes goal-setting of quality of emergency medical care as ensuring the effective medical care, as well as performance indicators of emergency medical care are formulated. The proposed concept and performance indicators of emergency medical care stimulate new directions for research in this area.

THE QUALITY OF MEDICAL CARE IN MEDICAL ORGANIZATIONS OF MOSCOW PUBLIC HEALTH CARE SYSTEM IN APPRAISALS OF PATIENTS AND PHYSICIANS

2017 ◽  
Vol 16 (2) ◽  
pp. 100-106 ◽  
Author(s):  
I. Ya Tadjiev ◽  
A. V Belostotsky ◽  
S. S Budarin
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Medical Personnel ◽  
Public Health Care ◽  
Fee For Service ◽  
Emergency Medical Care ◽  
Emergency Medical ◽  
Quality Of Medical Care ◽  
High Level

The article presents the analysis of results of complex medical sociological survey of effectiveness and efficiency of medical care as main criteria of its quality and accessibility. The survey comprised 1,737 patients of various social groups of population of Moscow and 203 physicians of polyclinics. At self-rating of health, 13.2% of respondents determined it as unsatisfactory, 45.1% as satisfactory and 31.3% as good. In all population groups, the most called-for proved to be polyclinic institutions. The high level of satisfaction of patients with quality of emergency medical care was established in all groups. The quality of medical care in polyclinics and hospitals was assessed significantly lower. The most negatively assessed criteria turned out transition to fee-for-service forms of medical support and time limits of waiting for all modes of medical care, except emergency medical care and district therapist. The evaluation by physicians of their own activity and present problems is characterized by their unanimity in need of increasing of salary (100%) and increasing of typical sectoral standards of time of reception of a patient (96.5%), decreasing of intensity of work of medical personal (92.3%) and reduction of some forms of record cards with the purpose of releasing of time and attention of physician for a patient (88.4%). The disrespectful attitude of patients to medical personnel was mentioned by 77.3% of physicians which is a new phenomenon testifying loss of confidence in patient-physician relationship. The quality of implemented work was assessed equally and rather high by both young and experienced physicians. The positive and negative aspects of reorganization of health care were analyzed. Two alternatives of problems were established to focus plans of development of system of Moscow health care to support accessible and qualitative medical care of population.

The emergency medical system

2015 ◽  
Author(s):  
Marc Sabbe ◽  
K Bronselaer ◽  
O Hoogmartens
Keyword(s):  
Medical Care ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Emergency Medical Care ◽  
Hospital Emergency ◽  
High Quality Research ◽  
Emergency Medical ◽  
System P ◽  
Quality Of Medical Care

The mission of the emergency medical services is to promote and support a system that provides timely, professional, and state-of-the art emergency medical care, including ambulance services, to anyone who is victim of a sudden injury or illness, at any time or location and at any phase of the emergency incident. These phases include lay people’s prevention and preparedness, occurrence of the problem, its detection, alarming of trained responders, help provided by bystanders and trained pre-hospital providers, transport to the appropriate hospital, and, if necessary, admission or transfer to a more appropriate hospital. In order to meet the goal outlined, emergency medical services must work closely with local and state officials—fire and rescue departments, other ambulance providers, hospitals, and other agencies—to foster a smooth functioning network. The term emergency medical services evolved to reflect a change from a simple system of ambulances, providing only transportation, to a system in which actual medical care is given at the scene and during transport. Medical supervision and/or participation of emergency medicine physicians in the emergency medical services systems contribute to the quality of medical care. This emergency medical services network must be capable of responding instantly and reliably around the clock, with well-trained, well-equipped personnel linked, as needed, through a strong communication system. Research plays an important role in conserving resources and improving the delivery of health care. This chapter gives an overview of the different aspects of emergency medical services and calls for high-quality research in pre-hospital emergency care in a true partnership between cardiologists and emergency physicians.

scholarly journals Making Emergency Care in Rural Areas Fit for Future: Protocol for multi-method and multi-perspective longitudinal analysis and control group study (Preprint)

2019 ◽  
Author(s):  
Camilla Metelmann ◽  
Bibiana Metelmann ◽  
Dorothea Kohnen ◽  
Clara Prasser ◽  
Rebekka Süss ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Care ◽  
Rural Areas ◽  
Statutory Health Insurance ◽  
First Aid ◽  
Medical Services ◽  
Emergency Medical Care ◽  
Free Interval ◽  
Emergency Medical

BACKGROUND The German Emergency Medical Services is a two-tiered system with paramedic staffed ambulances as primary response supported by pre-hospital emergency doctors for life-threatening conditions. As in all European health care systems, German medical practitioners are in short supply whilst the demand for timely emergency medical care is constantly growing. In rural areas, this has led to critical delays in the provision of emergency medical care. In particular, in cases of cardiac arrest, time is of essence [1], because with each minute passing, the chance of survival with good neurological outcome decreases. OBJECTIVE The project follows four main objectives: 1) Reducing the therapy-free interval through widespread reinforcement of resuscitation skills and motivating the public to provide help (called bystander-CPR), (2) fast, professional first aid in addition to rescue services through alarming trained first aiders via smartphone, (3) faster and higher availability of emergency physicians through introducing the tele-emergency physician (TEP) system, and (4) enhanced emergency care through improving the cooperation between statutory health insurance on-call medical services (German: Kassenärztlicher Bereitschaftsdienst) and emergency medical services. METHODS The implementation of the project is evaluated through a tripartite prospective and intervention study: (1) in medical evaluation, the influences of various project measures on quality of care are assessed using multiple methods. (2) The economic evaluation mainly focuses on the valuation of inputs and outcomes of the different measures while considering various relevant indicators. (3) As part of the scientific work and organizational evaluation important work- and occupational-related parameters but also network and regional indexes are assessed. RESULTS The project was started in 2017 and enrollment will be completed in 2020. The pre-analysis phase recently finished. CONCLUSIONS Overall, the implementation of the project entails the realignment of emergency medicine in rural areas and the enhancement of quality of medical emergency care in the long-term. It is expected to lead to a measurable increase in medical laypersons’ individual motivation to provide resuscitation, to strengthen resuscitation skills as well as much more frequently provided first aid through medical laypersons. Furthermore, the project is intended to decrease the therapy-free interval in cases of cardiac arrest by dispatching first aiders via smartphones. As demonstrated by previous projects in urban regions, the TEP system has already proven a higher availability and quality of emergency call-outs in regular health care. A closer interrelation of emergency practices of statutory health insurance physicians with the rescue service is expected to lead to a better coordination of rescue and on-call services. CLINICALTRIAL Ethikkomission (ethics comission) an der Universität Greifswald BB 111/17 http://www2.medizin.uni-greifswald.de/ethik/

scholarly journals Hospital Referral Patterns: How Emergency Medical Care Is Accessed in a Disaster

2010 ◽  
Vol 4 (3) ◽  
pp. 226-231 ◽  
Author(s):  
Michael J. Reilly ◽  
David Markenson
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Major Incident ◽  
Emergency Medical Care ◽  
Referral Patterns ◽  
Disaster Victims ◽  
Emergency Medical ◽  
The Impact

ABSTRACTBackground:A prevalent assumption in hospital emergency preparedness planning is that patient arrival from a disaster scene will occur through a coordinated system of patient distribution based on the number of victims, capabilities of the receiving hospitals, and the nature and severity of illness or injury. In spite of the strength of the emergency medical services system, case reports in the literature and major incident after-action reports have shown that most patients who present at a health care facility after a disaster or other major emergency do not necessarily arrive via ambulance. If these reports of arrival of patients outside an organized emergency medical services system are accurate, then hospitals should be planning differently for the impact of an unorganized influx of patients on the health care system. Hospitals need to consider alternative patterns of patient referral, including the mass convergence of self-referred patients, when performing major incident planning.Methods:We conducted a retrospective review of published studies from the past 25 years to identify reports of patient care during disasters or major emergency incidents that described the patients' method of arrival at the hospital. Using a structured mechanism, we aggregated and analyzed the data.Results:Detailed data on 8303 patients from more than 25 years of literature were collected. Many reports suggest that only a fraction of the patients who are treated in emergency departments following disasters arrive via ambulance, particularly in the early postincident stages of an event. Our 25 years of aggregate data suggest that only 36% of disaster victims are transported to hospitals via ambulance, whereas 63% use alternate means to seek emergency medical care.Conclusions:Hospitals should evaluate their emergency plans to consider the implications of alternate referral patterns of patients during a disaster. Additional consideration should be given to mass triage, site security, and the potential need for decontamination after a major incident.(Disaster Med Public Health Preparedness. 2010;4:226-231)

scholarly journals Evaluation of a Rural Emergency Medical Service Project in Germany: Protocol for a Multimethod and Multiperspective Longitudinal Analysis

10.2196/14358 ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. e14358 ◽  
Author(s):  
Camilla Metelmann ◽  
Bibiana Metelmann ◽  
Dorothea Kohnen ◽  
Clara Prasser ◽  
Rebekka Süss ◽  
...  
Keyword(s):  
Health Care ◽  
Cardiac Arrest ◽  
Rural Areas ◽  
Statutory Health Insurance ◽  
First Aid ◽  
Medical Services ◽  
Emergency Medical Care ◽  
Free Interval ◽  
Emergency Medical

Background German emergency medical services are a 2-tiered system with paramedic-staffed ambulances as the primary response, supported by prehospital emergency doctors for life-threatening conditions. As in all European health care systems, German medical practitioners are in short supply, whereas the demand for timely emergency medical care is constantly growing. In rural areas, this has led to critical delays in the provision of emergency medical care. In particular, in cases of cardiac arrest, time is of the essence because, with each passing minute, the chance of survival with good neurological outcome decreases. Objective The project has 4 main objectives: (1) reduce the therapy-free interval through widespread reinforcement of resuscitation skills and motivating the public to provide help (ie, bystander cardiopulmonary resuscitation), (2) provide faster professional first aid in addition to rescue services through alerting trained first aiders by mobile phone, (3) make more emergency physicians available more quickly through introducing the tele-emergency physician system, and (4) enhance emergency care through improving the cooperation between statutory health insurance on-call medical services (German: Kassenärztlicher Bereitschaftsdienst) and emergency medical services. Methods We will evaluate project implementation in a tripartite prospective and intervention study. First, in medical evaluation, we will assess the influences of various project measures on quality of care using multiple methods. Second, the economic evaluation will mainly focus on the valuation of inputs and outcomes of the different measures while considering various relevant indicators. Third, as part of the work and organizational analysis, we will assess important work- and occupational-related parameters, as well as network and regional indexes. Results We started the project in 2017 and will complete enrollment in 2020. We finished the preanalysis phase in September 2018. Conclusions Overall, implementation of the project will entail realigning emergency medicine in rural areas and enhancing the quality of medical emergency care in the long term. We expect the project to lead to a measurable increase in medical laypersons’ individual motivation to provide resuscitation, to strengthen resuscitation skills, and to result in medical laypersons providing first aid much more frequently. Furthermore, we intend the project to decrease the therapy-free interval in cases of cardiac arrest by dispatching first aiders via mobile phones. Previous projects in urban regions have shown that the tele-emergency physician system can provide a higher availability and quality of emergency call-outs in regular health care. We expect a closer interrelation of emergency practices of statutory health insurance physicians with the rescue service to lead to better coordination of rescue and on-call services. International Registered Report Identifier (IRRID) DERR1-10.2196/14358

scholarly journals Digital Infrastructure as a Component of Emergency Medical Services Transformation

2020 ◽  
Vol 47 (4) ◽  
pp. 138-146
Author(s):  
Svitlana MALONOHA
Keyword(s):  
Health Care ◽  
Emergency Medical Services ◽  
Information Transfer ◽  
Medical Services ◽  
Modular Architecture ◽  
Public Authorities ◽  
Digital Infrastructure ◽  
Emergency Medical ◽  
Patient Health ◽  
Definition Of

The importance of digital infrastructure for the transformation of emergency medical services as one of the priority areas of public policy and public authorities are considered. Some approaches to the definition of digital infrastructure are studied. This study made it possible to identify the components of the digital infrastructure of emergency medical services and outline its role in the health care ecosystem. The approach to the application of the modular architecture of the digital infrastructure of emergency medical services as a conceptual basis for the integration of information systems of different departments into a single emergency system is considered. Exist two groups of mechanisms that influence the formation of the digital infrastructure of emergency medical services and indicate the causal links that explain how their use can lead to the transformation of emergency medical services. The range of tasks that are solve due to the digital infrastructure aimed at improving the efficiency, accuracy of diagnosis and provision of emergency medical services is outlined. New opportunities are opening up to improve the quality of emergency medical services provision in a human-centered health care system based on a digital infrastructure, the central elements of which are the exchange of information contained in electronic records and patient health cards and mobile digital devices, diagnostics and information transfer. The list of problems on the way of emergency medical services transformation is formulated and some recommendations for their solution are offered, the formulation of which is based on the analysis of existing practices and own long-term experience at the emergency medical services system.

scholarly journals On the Question Concerning the Creation of Unified Accounting Data Form “The Protocol of Cardiopulmonary Resuscitation” for Mobile Teams of Emergency Medical Services

2020 ◽  
Vol 8 (4) ◽  
pp. 379-383
Author(s):  
A. A. Birkun
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Medical Care ◽  
Prehospital Care ◽  
Emergency Medical Care ◽  
Accounting Data ◽  
Emergency Medical ◽  
Data Form ◽  
And Performance ◽  
Integrated Program ◽  
Hospital Cardiac Arrest

Significant decrease in death rates from out-of-hospital cardiac arrest (OHCA) can be achieved by developing and implementing an integrated program of administrative interventions focused on improvements in the provision of the first aid and emergency medical care. However, both identification of the foreground and reasonable components of the program, and evaluation of its efficiency are impossible in the absence of reliable tools for collecting and analyzing data on epidemiology of OHCA and performance of the prehospital care system. This paper discusses the development of unified form for collecting data on cases of OHCA with attempted cardiopulmonary resuscitation (CPR), addresses the promising data form “The protocol of CPR” that is recommended by the Specialized Board on Emergency Medical Care of the Ministry of Health of Russia, and offers a set of proposals for optimizing the form with consideration for the international guidelines for uniform reporting of data from OHCA.Author declare lack of the conflicts of interests.

THE INFLUENCE OF THE SCHOOL OF HEALTH ON THE TREATMENT OF PATIENTS ON THE EXAMPLE OF ARTERIAL HYPERTENSION

2021 ◽  
pp. 43-46
Author(s):  
К.Ю. Досмаганбетова ◽  
А.Б. Исса ◽  
И.Е. Михайлова
Keyword(s):  
Arterial Hypertension ◽  
Medical Care ◽  
Well Being ◽  
Statistical Information ◽  
Emergency Medical Care ◽  
Dynamic Changes ◽  
National Medical ◽  
Definition Of ◽  
Medical University

В статье «Влияние школы здоровья на лечение пациентов на примере артериальной гипертензии», написанной интернами 7го курса НАО «Национального Медицинского Университета им. С.Д. Асфендиярова» Досмаганбетовой К.Е., Иса А.Б под кураторством ассистента кафедры ВОП2 Михайловой И.Е., представлен обзор на школу здоровья, а именно на ее часть, занимающуюся артериальной гипертензией. Собраны статистические сведения об участниках, дано определение термина «школа здоровья» и рассмотрено её влияние на качество лечения пациентов. На основе полученных данных проведен анализ динамических изменений по части грамотности населения в вопросах «управления» артериальной гипертензией, самочувствия пациентов, частоты обращения за «скорой медицинской помощью» и развития осложнений The article "The infiuence of the School of Health on the treatment of patients on the example of Arterial Hypertension", written by interns of the 7th year of the JSC "S.D. Asfendiyarov National Medical University" Dosmaganbetova K.Y., Issa A. B. under the supervision of the assistant of the GPM-2 department Mikhailova I.E., provides an overview of the school of health, namely, its department dealing with arterial hypertension. The article includes statistical information about the participants, definition of the term "school of health", and information about its impact on the quality of treatment. On the basis of the obtained data, the analysis of dynamic changes in the population's literacy in issues of "management" of arterial hypertension, the well-being of patients, the frequency of seeking "emergency medical care" and the development of complications was carried out.

scholarly journals The New Japanese Postgraduate Medical Education and Quality of Emergency Medical Care

2012 ◽  
Vol 43 (3) ◽  
pp. 494-501 ◽  
Author(s):  
Yasuharu Tokuda ◽  
Eiji Goto ◽  
Junji Otaki ◽  
Fumio Omata ◽  
Mina Shapiro ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Care ◽  
Postgraduate Medical Education ◽  
Emergency Medical Care ◽  
Emergency Medical

scholarly journals Evaluation of the Quality of Medical Care to the Population at the Level of Day Stations and Emergency Stations

2022 ◽  
Vol 8 (1) ◽  
pp. 114-121
Author(s):  
B. Niyazov ◽  
S. Niyazovа
Keyword(s):  
Medical Care ◽  
Emergency Medical Services ◽  
Chronic Diseases ◽  
Emergency Care ◽  
Rural Population ◽  
Medical Services ◽  
Emergency Medical ◽  
Medical Institutions ◽  
Quality Of Medical Care

Insufficient availability of emergency medical services to the rural population is noted. The dynamics of the growth of calls to emergency medical services testifies to the fact that emergency medical institutions have taken over part of inpatient services for the provision of emergency care to patients with chronic diseases and acute colds.

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