THE USE OF A RISK MANAGEMENT APPROACH BY A HEAD PHYSICIAN TO MANAGE MATERIAL AND TECHNICAL RESOURCES OF A MEDICAL ORGANIZATION
Authors:   Department of the Government of the Russian Federation, Moscow, Russia, Boenko Elena , Shikina Irina ,   Russian Research Institute of Health, Ministry of Health of the Russian Federation, Moscow, Russia
Published: August 2024

Significance. In modern conditions, the development vector of the Russian healthcare is determined by the state priorities of the increased birth rate, reduced mortality, improved quality of life and life expectancy, which can be implemented to expand the access to and quality of medical care, to ensure adequate conditions for its safe delivery, including updating and strengthening the material and technical resources of medical organizations using budget funds through construction (reconstruction) or major repairs. Identification of key factors (risks) and timely elimination of their negative impact on the provision of a medical organization with the necessary material and technical resources for its normal operation requires a direct involvement of head physicians in these processes as customers of design and construction works, responsible for maintenance of buildings and premises. Expanding competencies and increasing the level of knowledge of head physicians in the field of risk management is necessary for timely adjustment and effective management, opportunities to proactive potential problem solving, that hinder an effective medical and technical support for a medical organization. The purpose of the study was to analyze and identify risks, that negatively affect the current state of meeting the need for construction (reconstruction) and major repairs through using a risk management approach by a head physician of a medical organization to manage material and technical resources. Material and methods. The analysis and expert assessment of pre-project documentation, including tasks for the design of construction (reconstruction) and major repairs of buildings of medical organizations (technical task) of 20 state medical organizations, participating in programs on healthcare modernization in the Republics of Tatarstan and Crimea, city of Sevastopol; project documentation on the construction of two health care facilities in Sevastopol, as well as major repairs of the buildings of two infectious disease hospitals in the cities of Lugansk (Luhansk People’s Republic) and Genichesk (Kherson region) have been undertaken. Materials: data of the forms of the federal statistical observation No. 30 "Information on the medical organization" for 2021-2022. Methods of research: analytical, content analysis, statistical, analysis of the existing management measures, a generally accepted methodology of risk management, expert assessments. Results. The studies have identified risks with a negative impact on the current state of the need for construction (reconstruction) and major repairs of medical organizations, which can be directly controlled by the head physician of the medical organization and his team, manageable at the local level, which made it possible to develop a strategy of anti-risk measures and offer relevant management solutions. Conclusion. Analysis of the provision of the need for construction (reconstruction) and major repairs of medical organizations showed that effective management of the processes of updating and strengthening the material and technical resources through risk management tools, providing safe, accessible and high-quality health care to the population, is possible if risks are managed, preventing timely and high-quality preparation of pre-project and project estimates, construction and installation works, medical and technological equipment, that ensure introduction of a monitoring system, identification and risk assessment, development of measures to prevent and eliminate (minimize) their negative consequences. We consider the study of information about risks and technologies for responding to them to be necessary competencies of a head physician and members of his team, that are needed for performing tasks on developing material and technical resources of a medical organization.