УПРАВЛЕНИЕ РАЗВИТИЕМ МЕДИЦИНСКИХ ОРГАНИЗАЦИЙ

To develop a process model and an algorithm for managing the development of medical organizations. Material and Methods. We enrolled 94 medical organizations of primary healthcare which employed the five key principles of lean technology. Patient satisfaction as well as accessibility and quality of medical care were measured by direct observation and assessing duration of the healthcare procedures. Both patients and medical staff filled a specially designed questionnaire. The study included 610 patients, 460 physicians and 430 paramedical workers. Process model of medical organizations was developed using official records and system analysis. To develop an algorithm for managing medical organizations, we stratifed the priorities and suggested an improvement pipeline. Results. The implementation of the lean technology principles reduced the duration of the pediatric checkup (from 14.1 to 1.0 days, p = 0.001), adult medical checkup (from 8.0 to 3.0 days, p = 0.002), room waiting time for the vaccination procedure (from 117.0 to 45.3 minutes, p = 0.001), and room waiting time for the routine medical procedures (120.5 to 15.5 minutes, p = 0.001). Further, it increased the patient satisfaction rate regarding the register office (from 45.2% to 87.3%, p = 0.001) and decreased the equipment downtime in physiotherapy departments (from 12.5 hours to 2.0 hours, p = 0.001). Conclusion. The development of a process model and an algorithm for managing the development of medical organizations results in a significant reduction in time losses when receiving primary healthcare and increases the efficiency of equipment use.