Improving the organization of primary health care based on lean manufacturing technologies is an urgent task of modern medicine.
PURPOSE OF THE STUDY
To determine the problems and prospects for the further development of primary health care in St. Petersburg based on the results of an expert assessment of the activities of the chief physicians of polyclinics who apply lean management strategies and technologies to improve the work of the outpatient service.
MATERIAL AND METHODS
A survey was conducted of the chief physicians of polyclinics (n=56) participating in the implementation of the project «A new model of a medical organization providing primary health care». The questionnaire included 43 questions related to the introduction of lean technologies in the activities of outpatient clinics in St. Petersburg.
RESULTS
Among the main work processes that need to be improved, the experts singled out the work of the radiology department (71.5%), the registry (61.2%), the blood collection point (53.0%); medical and diagnostic appointment with a specialist doctor (51.0%); medical examination of certain groups of the adult population (28.5%); dispensary observation (26.5%). Among the main problems that arise in the implementation of projects to improve work processes, the heads of medical organizations noted the difficulties of involving the team (85.7%), the lack of knowledge for the implementation of improvement projects (40.8%); difficulties in mapping processes (34.7%); inconsistency of opinions regarding the project implementation plan (22.4%). Among the topical directions of the strategic development of primary health care, 44.9% of the heads of city polyclinics noted the elimination of the shortage of personnel; 30.6% — healthcare informatization; 26.5% — introduction of telemedicine technologies into wide medical practice; 12.3% — effective management of the quality and safety of medical activities.
CONCLUSION
Expert analysis allows obtaining additional information necessary for the formation of a strategy for the development of primary health care at the regional level.