Analysis of Service Maintenance of Medical Equipment in State Organizations of the Republic of Kazakhstan. Policy Brief

What are the problems? • Overestimation of the cost of service work at the "officials"; • Underpricing by unscrupulous suppliers who do not have the necessary knowledge and skills to service medical devices; • Deficit of financial resources between the actual need and the planned expenditures of budgetary funds for the maintenance of medical devices; • Lack of MI engineers in healthcare organizations; Lack of medical equipment on the basis of a medical organization on an ongoing basis. Quite often, medical technicians work in parallel in several medical organizations, which in turn leads to downtime of broken equipment that could be repaired immediately; • Insufficiently developed practice of training medical personnel on the basis of equipment manufacturers or an institution providing professional training in servicing relevant types of equipment; Policy options • Option 1. Amendments to the Normative legal acts of the Republic of Kazakhstan. • Option 2. Competent center, centrally dealing with the issues of medical equipment breakdowns. • Option 3. Implementation of a computerized maintenance management system for medical equipment. Key provisions Each of these policy options can contribute to the development of service provision for medical technology in the Republic of Kazakhstan. At the same time, in combination, they can lead to more effective changes. Key words: medical equipment, medical equipment, service, service of medical devices, Kazakhstan.

Building a Management System for a Medical Organization: Theoretical and Methodological Aspects

The viability of an organization and its effectiveness are directly proportional to its ability to adapt to the external environment, flexibility and focus on continuous improvement. This research discusses theoretical and methodological approaches to building an effective management system in medical organizations. The study’s methodology was based on both classical management theories of Frederick Winslow Taylor, Henri Fayol and Max Weber and on the modern management theories of Peter Drucker and Herbert Simon. Keywords: healthcare management, scientific management, administrative management, bureaucratic management.

Improvement of the Procedure for the Introduction of New Medical Technologies in Kazakhstan Based on the Extracorporeal Membrane Oxygenation

The process of introduction of new medical technologies in Kazakhstan is regulated by a number of normative and legal acts, and is aimed at allowing the use of drugs and medical devices that meet high standards of safety, quality and efficiency. This article examines the process of such introduction based on the extracorporeal membrane oxygenation technology, with an analysis of all stages of the process and recommendations for its improvement. Given the high efficiency of new medical technologies (on the example of extracorporeal membrane oxygenation), when their limited use is due to the lack of funds of a medical organization, the involvement of additional intellectual resources seems expedient. Key words: Health Technology Assessment, Extracorporeal Life Support, Extracorporeal Membrane Oxygenation, Health Service Assessment

Improvement of Measures for the Prevention and Treatment of Human Papillomavirus and Cervical Cancer in the Republic of Kazakhstan. Policy Brief

What is the problem? • pronounced tendency of rejuvenation of oncogynecological pathology of papillomavirus etiology in the Republic of Kazakhstan; • a high proportion of patients with advanced stages, especially in the group of women of early reproductive age; • high proportion of potential reproductive losses; • low sensitivity of the screening test; • shortage of personnel (doctors-cytologists, laboratory assistants-cytologists, midwives of examination rooms). Policy options • Option 1. Preventing diseases and HPV infection; • Option 2. Measures aimed at early detection of the disease and its cure at the stages of effective therapy. Vision for the implementation of scenarios / policy options Each of these policy options can be effective in reducing HPV infection and the subsequent increase in cervical cancer. Key words: human papillomavirus, pregnant women, cervical cancer, infections, vaccination, screening

Risk Identification System Based on an Incident Report in a Healthcare Organization

The aim: To assess the risk identification system based on the incident report, the existing incident reporting system, and factors affecting the structure of incidents in the healthcare organization. Methods. Within the framework of this study, personnel were questioned on the knowledge and use of the incident reporting system related to the provision of medical treatment and care. To collect primary information, a questionnaire was developed, statistical processing of the research results was carried out by the method of calculating the relative risk (RR) using the Stat Tech program, on the website "Medical statistics". Results. All employees (100%) are aware of the incident reporting system. Personnel were more likely to use the incident reporting system as a way to deal with business and organizational issues. The knowledge of events that must be reported were rated equally by the doctors and the nurse (70%; RR - 1.0; C1 0.83 - 1.19). The nurse was more afraid of criticism than doctors (56% versus 66%; RR - 1.18; CI 95%; C1 0.94 - 1.47). Doctors rated the priority of filling out a report lower than a nurse (52% versus 58%; RR - 0.89; CI 95%; C1 0.69 - 1.15). The value and convenience of filling out the report were assessed by the doctors and the nurse equally (64%; RR - 1.0; CI 95%; C1 0.82 - 1.23). Conclusion. Medical personnel have a positive view of the incident reporting system, however, lack of knowledge of specific reported events, poor safety culture, and lack of feedback are the main factors hindering the effectiveness of the system. Developing a list of specific health care events to be reported will enhance the effectiveness of incident reporting as a risk management tool. Keywords: healthcare system, risk management, patient safety, incident, incident report.

Improving the system of training Nursing specialists. Results of the strategic partnership between JAMK University of Applied Sciences, Finland, and medical colleges of the Republic of Kazakhstan

The material presents results of the strategic partnership between JAMK University of Applied Sciences, Finland, and medical colleges of the Republic of Kazakhstan. The systematic annual process of starting the development of new nursing clinical guidelines and of leading and coordinating the adaptation as well as preparing the trainings of national trainers for each set of guidelines has slowed down or even stopped and needs immediate attention. In addition, the development of corresponding evidence-based Standardized Operational Procedures must be organized. Our recommendation is that the Ministry of Healthcare and the Republican Center of Health Development would strengthen the national coordination and create a systematic roadmap for translating nursing clinical guidelines into nursing practice. In addition, nurses’ knowledge and skills in evidence-based nursing must be increased through capacity building activities. Key words: standardized operating procedures, clinical guidelines, nursing, strategic partnerships.

The Role of Professional Standards in Regulating the Professional Activities of Healthcare Professionals

This review is devoted to the analysis of the existing shortcomings in the sectoral qualifications system and the development of suggestions for improving the mechanisms for regulating the professional activities of healthcare professionals in the Republic of Kazakhstan. The main problems in the development of human resources for health care that require a systemic solution include the lack of compliance of training programs and the system of continuous professional development of workers in the industry, a system for assessing professional readiness and admission of health professionals for practical activities to the needs of practical health care, the lack of a clear delineation of the competencies of health professionals by levels qualifications. The above problems are based on the imperfection of the Sectoral Qualifications System due to the absence of the Sectoral Qualifications Framework (covering all professions and professional activities in the health sector) and professional standards (regulating in detail for each qualification level all those labor functions and professional tasks that are necessary for those working in the industry. specialists, as well as the skills, knowledge, and even personal competencies required for this). The implementation of professional standards in the development of educational programs at all levels of education, in the activities of organizations that assess the professional readinesss of healthcare professionals, in the personnel policy of the health system, regions and medical organizations, will ensure that the competencies of graduates of educational programs and specialists working in the health sector correspond to the real needs of practical healthcare. All this will make it possible to achieve greater labor productivity of healthcare professionals, improve the quality of medical and other services provided, reduce the costs of recruiting and enhance the competitiveness of both specialists working in healthcare organizations. Keywords: sectoral qualifications system, professional standards, healthcare professionals

Informed Voluntary Consent of the Patient

Informed consent is a patient's voluntary consent to a medical intervention, which is based on obtaining sufficient information from a medical professional in an understandable form about the options for this medical intervention, the proposed and alternative methods of diagnosis and treatment, and their health consequences. The principle of informed voluntary consent of the patient to medical intervention is one of the fundamental principles in the field of rule-making and law enforcement in the field of health protection. Keywords: informed consent, voluntary patient consent, medical intervention, patient rights, patient refusa

Assessment of the Quality of Life of Glaucoma Patients In Kazakhstan (on the Example of Balkhash)

The purpose of the study: analysis and assessment of the quality of life of glaucoma patients in Kazakhstan on the example of Balkhash. Methods. The study was conducted on the basis of the municipal state institution (KSU) "Polyclinic No. 2" of the city of Balkhash, Karaganda region in the period from 2019 to 2020. The study involved 46 men and 74 women. The average age of the respondents was ≥64 years. To determine the quality of life of glaucoma patients, we conducted a questionnaire compiled by ourselves and the NEI VFQ-25 questionnaire. The respondents were conditionally divided into three groups: group 1-patients who receive only conservative treatment; group 2 – patients who underwent laser correction in parallel with conservative treatment; group 3-patients who, in addition to previous types of treatment, were operated on. Results. Among the comparison groups, the values of indicators of dependence on the help of others (23.7) and role difficulties (23.9) and social activity (81.6) were significantly lower in patients receiving only conservative treatment. In this group, along with the physical and mental components, it was found that the gap in visual indicators is up to 4 times. Conclusions. The results of the study show that in glaucoma patients receiving only conservative treatment, the quality of life is low compared to the control groups according to all indicators of the scales. A significant impact on the decrease in the quality of life of patients receiving conservative treatment is caused by the discomfort associated with regular use of drugs prescribed for glaucoma and their side effects. Keywords: glaucoma, quality of life, NEI VFQ-256 questionnaire, Kazakhstan.

Assessment of the Effectiveness of Implemented State Programs in the Healthcare Sector of Kazakhstan

The aim: evaluate the effectiveness of the implemented state programs in the field of healthcare in Kazakhstan. Methods. The paper analyzes 4 state programs for the development of the healthcare system implemented in the years of independence of Kazakhstan and describes preliminary data on the program - "State Program for the Development of Healthcare of the Republic of Kazakhstan for 2020-2025". Results. As a result of the implementation of the state programs "Healthy Nation", the state programs for 2005-2010, "Salamatty Kazakhstan", "Densaulyk", maternal mortality decreased by 3,3 times, infant mortality decreased by 1,7 times, mortality from diseases of the circulatory system almost 3 times, mortality from malignant neoplasms by 1,4 times, mortality from tuberculosis by 8,4 times, as a result, life expectancy increased by 6,96 years and reached 73,18 years. Conclusion. Over the years of implementation of health development programs of the Republic of Kazakhstan, there has been a positive trend in indicators that characterize the health of the population, which in turn contributes to improving the quality and increasing the life expectancy of the country's population. Basic health indicators have been improved and health funding has been increased. However, despite these results, life expectancy and funding remain low compared to other countries. Keywords: state programs, strategic planning, healthcare system, Kazakhstan