HEALTH CARE QUALITY MANAGEMENT IN INTENSIVE CARE UNITS
Keywords:
health care, health care quality, health care quality management, patient-centered health careAbstract
Healthcare is becoming increasingly important in modern high-tech and patient-focused healthcare. A modern and integrated quality management system is a "mix" of service processes and infrastructure, dominant values and culture, and patient-centered behavior. This means applying a 'patient-oriented' approach in which the patient is at the heart of all links between actors in the health system and at all levels of quality management: consumers, clinicians and regulators. In practical terms, this means providing safe, timely, effective, patient-oriented and fair healthcare. The coronavirus pandemic has exacerbated endemic problems in intensive care units, affecting the quality of health care.
Objective. To assess leading aspects of quality of care in intensive care units in the context of the concept of a patient-centered approach to quality management.
Materials and Methods. The informational basis of the study was data from a survey conducted by the author of 83 health care professionals working in intensive care units of multiprofile hospitals in the municipality of Varna and the city of Varna. The study was carried out in the period 08/11/2021 - 17/11/2021. The questionnaire provides data on the main aspects of the activity of providing quality health care. Sociological, documentary, statistical methods and graphical analysis of the results were used in the study.
Results and Discussion. The results of the survey show that there is an ageing of the medical professionals practicing in intensive care units, which limits the possibilities for creating a motivating environment for improving competencies and qualifications. Only 37% of nurses have the attitude to continue their education. The quality management systems used in the intensive care units of the studied hospitals are mostly based on ISO 9001-2000, which reflects on the "good care" methods applied. Covid-19 changes the focus of ICU activities, which influences the development of nursing algorithms/files and the thematic profile of the colleges. The importance of teamwork is increasing. Conclusions. The introduction of a patient-centered approach to the management of health care quality in intensive care units of hospitals improves the outcomes of the nursing process and generates long-term and benefits for all participants in the health system.
References
Атанасова, В. (2018). Качество на сестринските здравни грижи в неврологичната болнична помощ. Дисертационен труд за присъждане на ОНС „доктор“ по докторска програма „Социална медицина и организация на здравеопазването и фармацията“, МУ – София, ФОЗ (достъпно на: http://cml.mu-sofia.bg:8080/xmlui/bitstream/handle/ 10861/1450/Velichka_Atanasova-dis.pdf?sequence=1&isAllowed=y )
Борисова, С. (2013). Прилагане на сестринския процес в практиката на медицинската сестра. „Стено“, Варна
Воденичаров, Ц. (2006). Седемте разлики между медика и мениджъра. София
Вълков, А. (2014). Управление на качеството на здравните услуги: интегриране на производствената и потребителската ориентация. В Делчева, Е. и кол. (2014). Инструменти за повишаване на качеството на публичните услуги. ИК – УНСС, С., 2014, с. 149-191
Грънчарова, Г. (2005). Управление на здравните грижи. МУ – Плевен, Плевен
Димова, А. (2004). Управление на качеството в болницата. „Стено”, Варна
Димова, А. (2022). Здравна политика в криза. ПУБЛИЧНИ ПОЛИТИКИ.bg, vol. 13, (2), 2022, (достъпно на: http://ejpp.eu/index.php/ejpp/article/view/427)
Маринов, М. (1998). Качество на здравната помощ. Абагар. Велико Търново
Николова, В. (2020). Елементи и индикатори за качество на здравните услуги, използвани при оценка на функционирането на здравните системи. Здравна икономика и мениджмънт. Брой 75, с. 27-35
Попова, М. (2022). Управление на качеството и безопасността на пациентите в условията на пандемия. ПУБЛИЧНИ ПОЛИТИКИ.bg, vol. 13, (2), 2022, (достъпно на: http://ejpp.eu/index.php/ejpp/article/view/440)
Тончева, С. (2015). От традиционно сестринство към иновации и отговор на очакванията на пациента. Научни трудове на Русенски университет - 2015, том 54, сер. 8.3, с. 9-16 (достъпно на: http://conf.uni-ruse.bg/bg/docs/cp15/8.3/8.3-1.pdf)
Шаркова, М. (2016). Критерии за качествена медицинска помощ. Адвокатски преглед, бр. 12/2016, Висш адвокатски съвет, С., с. 37-45
Шаркова, М. (2018). Медицинският деликт. Център за обучение на адвокати „Кръстю Цончев“, Свищов
OECD/European Observatory on Health Systems and Policies (2021), България: Здравен профил на страната 2019 г., State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.
Valkov, A., & Stancheva, L. (2021). Интегриран подход към измерителите на качеството на здравните грижи. Knowledge, Internatiomal Journal, Scientific Papers, Vol. 46 (5), Institute of Knowledge Management, Skopje, 2021, pp. 823-834, ISSN: 1857-923X
Robbins, D. A., Curro, F. A., & Fox, C. H. (2013). Defining patient-centricity: opportunities, challenges, and implications for clinical care and research. Therapeutic Innovation & Regulatory Science, 47(3), 349-355
