Russian experience and perspectives of quality assurance in healthcare through standards of care
The main reform of healthcare system in Russia had begun by introduction of compulsory healthcare insurance in 1993. Since this time, Russia went through number of steps of healthcare system modernization. Most attention was paid to the resource allocation, medical equipment and drug provision, the problem of the low quality of care was repeatedly addressed. Major direction of the efforts was the creation of obligatory technical standards of care.
I studied the volume of publication found in MEDLINE for period 1991-2014 and in the relevant Russian journals not covered by MEDLINE as well as legislation on health care introduced since 1991.
The reviewfound that despite some increase in volume of funding of health care system, and provision of incentives for quality, the progress with health care quality assurance is slow. The methodology of development of evidence based guidelines is not accepted. The control over conflict of interest of participants of the development of the guiding documents is not introduced. Economic factors are not systematically addressed in decisions on provision of health care interventions. The practice of the health technology assessment does not exist. The system of financial incentives for the quality of care dominates and is developing without evidence based criteria and evidence of its efficacy.
The documents prescribing quality healthcare are developing non-systematically in Russia. The acceptance of the modern methodology of guideline development, health technology assessment and control over conflict of interest is needed as a minimum prerequisite for the progress in the quality assurance.
In the internal medicine wide spectrum the gastroenterology is one of the chapters, less enlightened by the scientific evidence. It does not mean that the practice of the grasntroenterology may ot be improved by the systematic use of the approaches of the evidence based medicine
Today the increasing number of constant consumers is a strategic aim for any organization which is possible to be achieved only under condition of continuous perfection of organizational activity quality. If the service representation doesn't correspond to the consumers’ expectations they lose their interest to the service organization, if it does correspond or surpass their expectations they probably would readdress to service provider. For this reason the service organization should more precisely reveal consumers requirements and expectations, namely provider should constantly measure its service quality.
In the given work approaches by the Russian and foreign researchers in the field of quality management are studied and analyzed in details, namely:
- approaches to the «service quality» definition;
- the basic components of service quality management process;
- service organization quality model.
The purpose of research work consists of ISQM (Innovation System of Quality Management) model creation taking into account features of TCS providing, which, in turn, is targeted on TCS company purposes achievement in the field of quality by means of:
- setting the control values of TCS quality indicators;
- measuring of the reached results and their comparison with expected results;
- effective management decision making as a result of carrying out the analysis of managerial activity in the field of quality on the basis of the report containing recommendations for the company activity improvement, prepared due to the results of measuring and collecting quality indicators.
A global focusing on a sustainable economy requires redirection of corporate governance toward sustainability. One of the important ways for management is a quality management as it is focused on continuous improvement of all business processes and therefore – contribute to long-term performance. The basic problems in this case are the searching for the most effective organizational model of quality achievement and the reasons for firm to implement quality management system (QMS) which is relevant to its sustainable business perspective. Insufficiency of the problem development of companies’ stimulation to implement QMS ISO 9000, make the paper urgent. The purpose of the study is an examination of the motivation for QMS ISO 9000 implementation for the emerging economies firms. The informational base of empirical cross country analysis was 2002–2009 data of Business Environment and Enterprise Performance Survey (BEEPS) of WB and the European Bank for Reconstruction and Development (EBRD). Study targets are the firms, which have implemented QMS ISO 9000 and located in the three groups of countries: the Commonwealth of Independent States (CIS), new members of the EU countries and countries of the Southern Europe - not EU members. The main finding is the identification of similarities and differences in motivations of firms from the tree groups emerging economies, which has implemented QMS ISO 9000.
Preface The world of healthcare is very challenging. Resource-constrained services, creeping bureaucratic requirements, new patient populations with greater needs than ever before, demand in excess of supply, clinician overload, major and minor breaches of patient safety, politicized workplaces, and ideology masquerading as systems planning: everywhere you look, the barriers to the provision of high-quality care are considerable, and often daunting. In the midst of all these problems, where can we turn for help? One answer is to change the focus and shift from the negatives to the positives. The very countries in which these types of problems reside always contain examples which have risen above the adversity, and provide solutions to problems. These are success stories that overcome difficulties, surmount obstacles, and deliver an accomplishment worthy of study in its own right. Professor Jeffrey Braithwaite, as health reform series editor, has led a team of internationally renowned scholars to deliver a compendium of work with precisely this focus. Regional experts Professors Russell Mannion (Europe), Yukihiro Matsuyama (South-East Asia), Paul Shekelle (the Americas), Stuart Whittaker (Africa), Samir Al-Adawi (Eastern Mediterranean), and Jeffrey Braithwaite (the Western Pacific) have made a concerted effort to harness the energies, expertise, and analytic ability of 161 authors who have combined to articulate positive messages about healthcare improvement in 60 countries. Rich and poor, northern and southern hemisphere, publicly or privately funded, technologically sophisticated or focused on the basics: the range of health systems examples, and their differing characteristics, is truly impressive. As you will see, each team of authors presents a single case example, which narrates a story of accomplishment in their home health system. The sheer diversity of case examples is testament to the range of things that can go right in healthcare. They provide plenty of lessons for those who want to improve care in their own system. Collectively, they act as a set of blueprints for what success looks like across many settings, sectors, and initiatives. That every country enrolled in the project, no matter how politically, financially, or logistically challenged, could adduce a shining example of success, is a reminder of what can be done by inspiring people who are determined to provide better services to their patient populations. In addition to being inspiring, this volume, the second in the Taylor & Francis health reform series, is instructive and practically relevant. It is jampacked with the expertise of many far-thinking and generous people across the world who take the task of improving the system they work in or on, very seriously indeed. For those of us whose appetite for reform and improvement can occasionally flag, or in cases when we become reform weary, this book is just the tonic needed. In a word, it’ s energizing. As the most extensive anthology of health system success stories ever assembled, we commend this book to you.
This article is intended to summarize the key works on Quality Management in order to obtain a unified theoretical basis. Applicability to Russian companies is discussed. Differences between the classic quality paradigm and the TQM ideas are focused and studied thoroughly. Basing on the most recognized works of Crosby, Juran and Deming, the history of Quality Management ideas development is shown. Mechanisms of impact of implemented quality management systems on company results are shown, since it is required in order to perform an empirical study of quality management effectiveness. Also several aims for empirical studies are proposed. Possibility of Quality Management implementation for Russian companies is also discussed.
The Conference is focused on the actual problems in the field of Quality Management, Transport and Information Security, Information Technologies (Navigation and Information Systems, Information Security Systems and Computer Security, Transport Security Management, Information and Communication Technologies in Education, Scientific Research and Economy, Automation of Business Processes, Automated Systems of Control and Quality Management, Quality Management Systems including Integrated Systems of Quality Management of Information Systems (Implementation, Certification, Auditing), Engineering Management, IT Service Management, Management of Projects and Risks as well as other issues related to the field). Previous Conferences on these topics revealed great interest of both Russian and foreign researchers in this issues. Organizing and hosting the 2016 IEEE Conference on Quality Management, Transport and Information Security, Information Technologies (IT&MQ&IS) in Russia is of great value for exchange of research ideas and practical results in this field, for discovering new problems and development trends, for development of new effective practical methods and tools targeted on solving complex practical problems. During the IT&MQ&IS 2016 Conference sessions, it is expected and planned to discuss a wide range of issues, both of theoretical and practical value. One of the key Conference aims is also attracting young researchers and practitioners to discussions and exchange of ideas with the professional community.
Market growth of personal medical device comes from a number of factors: • Aging population requiring more attention; • Patients with chronic diseases may measure blood pressure and blood glucose at home; • Reducing the cost of these devices; • Ease of use and availability of medical devices; • Risen cost of a series of medical tests. This article discusses the new challenges that arise in the relationship doctor - patient in the remote Monitoring human healthcare. With the advent of a greater variety of low-cost medical devices, as well as low-cost high-quality mobile communication system will allow the system to tell the Remote Healthcare Monitoring System has also become possible. This system should be as ready to doctors and patients themselves. there is a new quality in the interaction between doctor and patient. Considers a new model of doctor-patient relationship in the light of the transfer of active interaction to the virtual world.
This prototype development explains the challenges encountered during the ISO/IEEE 11073 standard implementation process. The complexity of the standard and the consequent heavy requirements, which have not encouraged software engineers to adopt the standard. The developing complexity evaluation drives us to propose two possible implementation strategies that cover almost all possible use cases and eases handling the standard by non-expert users. The first one is focused on medical devices (MD) and proposes a low-memory and low-processor usage technique. It is based on message patterns that allow simple functions to generate ISO/IEEE 11073 messages and to process them easily. MD act as X73 agent. Second one is focused on more powerful device X73 manager, which do not have the MDs' memory and processor usage constraints. The protocol between Agent and Manager is point-to-point and we can distribute the functionality between devices.
Developed both implementation X73 Agent and Manager will cut developing time for applications based on ISO/EEE 11073.
The Working Paper examines the peculiarities of the Russian model of corporate governance and control in the banking sector. The study relies upon theoretical as well as applied research of corporate governance in Russian commercial banks featuring different forms of ownership. We focus on real interests of all stakeholders, namely bank and stock market regulators, bank owners, investors, top managers and other insiders. The Anglo-American concept of corporate governance, based on agency theory and implying outside investors’ control over banks through stock market, is found to bear limited relevance. We suggest some ways of overcoming the gap between formal institutions of governance and the real life.
We address the external effects on public sector efficiency measures acquired using Data Envelopment Analysis. We use the health care system in Russian regions in 2011 to evaluate modern approaches to accounting for external effects. We propose a promising method of correcting DEA efficiency measures. Despite the multiple advantages DEA offers, the usage of this approach carries with it a number of methodological difficulties. Accounting for multiple factors of efficiency calls for more complex methods, among which the most promising are DMU clustering and calculating local production possibility frontiers. Using regression models for estimate correction requires further study due to possible systematic errors during estimation. A mixture of data correction and DMU clustering together with multi-stage DEA seems most promising at the moment. Analyzing several stages of transforming society’s resources into social welfare will allow for picking out the weak points in a state agency’s work.
One of the most important indicators of company's success is the increase of its value. The article investigates traditional methods of company's value assessment and the evidence that the application of these methods is incorrect in the new stage of economy. So it is necessary to create a new method of valuation based on the new main sources of company's success that is its intellectual capital.