Development of a Model of the System of Organizational Development of Treatment and Diagnostic Processes of a Multidisciplinary Hospital

The most important factor in improving the quality of medical services at present is the continuous improvement of all aspects of the activities of a medical organization, which determines the appropriateness of using modern approaches to organizational development in medical institutions with their appropriate adaptation.

The paper presents the results of the analysis of 16 known models of organizational development, as well as the performance indicators of the Kaidzen proposal system at 19 Russian and foreign enterprises in various industries. An analysis of the authors’ long-term experience of working with small groups on standardization of treatment and diagnostic processes at the N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department was conducted, which confirmed the assumption that medical personnel of all categories have a large number of ideas for improving the organization’s work and are willing to participate in their implementation.

The article presents the author’s model of the system of organizational development of treatment and diagnostic processes of a multidisciplinary hospital, which is based on the concept of personnel orientation and the basic principles developed by the authors.

In the part of the model detailing, a developed system of classification features is presented, which allows determining the belonging of a proposal for improvement to a certain group or class, as well as the approach proposed by the authors to sorting proposals at various stages of working with them.

The paper presents the results of testing the described approach using the example of proposals for improvement formulated by a pilot group of nurses of the operating unit of the N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department. Conclusions are made on the possibilities of applying the presented research results for medical organizations, as well as promising areas for the development of the presented approach.

1. Federal’nyy zakon ot 21.11.2011 No 323-FZ (red. ot 26.05.2021) “Ob osnovakh okhrany zdorov’ya grazhdan v Rossiyskoy Federatsii”. (In Russ.) Available at: https://minzdrav.gov.ru/documents/7025 [Accessed Dec 12, 2023]

2. Adizes IK. Managing Corporate Lifecycles. In 2 vol. Vol. 1: How Organizations Grow, Age and Die. CA: The Adizes Institute, 2016. (Russ. Ed.: Adizes IK. Upravlenie zhiznennym tsiklom kompanii. Kak organizatsii rastut, razvivayutsya i umirayut i chto s etim delat’. Moscow: Alpina Publisher; 2022.)

3. Solov’ev VS. Polnoe sobranie sochineniy i pisem v dvadtsati tomakh. Sochineniya v pyatnadtsati tomakh. Vol. 2: Sochineniya, 1875–1877. Moscow: Nauka Publ.; 2000. (In Russ.)

4. Mihnevich S. On Some Trends in the World Economy in the Era of Digital Globalization. Trade Policy. 2019;1(17):120–140. https://doi.org/10.17323/2499-9415-2019-1-17-120-140

5. Drucker PF. Management Challenges for the 21st Century. Routledge, 2007. (Russ. Ed.: Druker P. Zadachi menedzhmenta v XXI veke. Moscow: ID Vil’yams Publ.; 2007)

6. Bono E. Serious creativity. N.Y.: HarperCollins publishers, 1997. (Russ. Ed.: Bono E. Ser’eznoe tvorcheskoe myshlenie. Minsk: Poppuri Publ.; 2005.)

7. Serebryakova GV, Nezamaykin IV. Modeli upravleniya razvitiem organizatsii. Cheboksary: Sreda Publ.; 2022. (In Russ.)

8. Pascale RT, Athos AG. The art of Japanese management. N.Y.: Simon & Schuster, 1981. (Russ. Ed.: Paskal’ R, Etos E. Iskusstvo yaponskogo menedzhmenta. Moscow: Olimp-Biznes Publ.; 2006.)

9. Mishchenko IK. Osnovy planirovaniya deyatel’nosti predpriyatiya. Barnaul: Izdatel’stvo Altayskogo gosudarstvennogo universiteta Publ.; 2008. (In Russ.)

10. Porter ME. Competitive Strategy: Techniques for Analyzing Industries and Competitors. Simon and Schuster, 2008. (Russ. Ed.: Porter ME. Konkurentnaya strategiya: metodika analiza otrasley i konkurentov. Moscow: Alpina Publisher; 2019.)

11. Borisenko IL, Elfimova IF, Kablashova IV, Logunova IV. Osnovy menedzhmenta: praktikum. Voronezh: FGBOU VPO Voronezhskiy gosudarstvennyy tekhnicheskiy universitet Publ.; 2011. (In Russ.)

12. Mintzberg H, Ahlstrand B, Lampel J. Strategy Safari: A Guided Tour Through the Wilds of Strategic Management. Free Press, 1998. (Russ. Ed.: Mintsberg G, Al’strand B, Lampel’ Zh. Strategicheskoe safari: Ekskursiya po debryam strategicheskogo menedzhmenta. Moscow: Alpina Publisher, 2013.)

13. Hanna D. Leadership for the Ages: Delivering Today’s Results, Building Tomorrow’s Legacy. Executive Excellence Pub, 2001 (Russ. Ed.: Khenna D. Liderstvo na vse vremena. Rezul’taty segodnya – nasledie na veka. Moscow: Alpina Publisher, 2014)

14. Ivanova IA, Sergeev AM. Menedzhment. Moscow: Yurayt Publ., 2018. (In Russ.)

15. Bugakova MS, Grigor’yants IA. Model’ izmeneniy Kurta Levina. In: Sovremennye podkhody v upravlenii ekonomicheskimi sistemami v usloviyakh global’nykh preobrazovaniy: sb. materialov I mezhdunar.

16. Upravlenie organizatsionnymi izmeneniyami. Saint Petersburg: Izdatel’skiy dom Sankt-Peterburgskogo gosudarstvennogo universiteta Publ.; 2005. (In Russ.)

17. Menedzhment organizatsii v usloviyakh strategicheskikh izmeneniy. Barnaul: Izdatel’stvo Altayskogo universiteta Publ.; 2009. (In Russ.)

18. Gotsdanker A. Biznes-psikhologiya: Pochemu sotrudniki vsegda protiv izmeneniy. Izdatel’skie resheniya Publ., 2015. (In Russ.)

19. Zazygin SP. Algoritmy upravleniya izmeneniyami v organizatsii. ESCIO. 2021;3(54):393–400. (In Russ.)

20. Satir V, Banmen J, Gerber J, Gomori M. The Satir Model: Family Therapy and Beyond. Palo Alto, California: Science and Behavior Books;1991.

21. Maurer R. Beyond the Wall of Resistance: Unconventional Strategies that Build Support for Change. Bard, 1996. (Russ. Ed.: Maurer R. Za stenoy soprotivleniya. Austin: Bard Books, 1996.)

22. Upravlenie izmeneniyami v pervichnoy mediko-sanitarnoy pomoshchi: issledovatel’skie kompetentsii vrachey i kriticheskoe myshlenie. Moscow: GBU «NIIOZMM DZM» Publ., 2023. (In Russ.) Available at: https://niioz.ru/upload/iblock/16d/16d600199781bc3f82efb61e7151f8e2.pdf [Accessed Feb 05, 2024]

23. Kotter JP. Leading Change. Harvard Business Press, 2012. (Russ. Ed.: Kotter DP. Vperedi peremen. Moscow: Olimp-Biznes Publ., 2014.)

24. Imai M. Kaizen: The Key to Japan’s Competitive Success. McGrawHill Education, 1986. (Russ. Ed.: Imai M. Kaydzen. Klyuch k uspekhu yaponskikh kompaniy. Moscow: Alpina Publisher, 2016.)

25. Imai M. Gemba kaizen. New York: McGraw-Hill Publishing Company, 1997. (Russ. Ed.: Imai M. Gemba Kaydzen: Put’ k snizheniyu zatrat i povysheniyu kachestva. Moscow: Al’pina Biznes Buks Publ.; 2005.)

26. Perminov AY, Fomenko NS, Petrikov SS, Navzadi FM. Organizational and Methodological Approach to the Description and Standardization of Treatment and Diagnostic Processes in a Multidisciplinary Hospital. Russian Sklifosovsky Journal Emergency Medical Care. 2021;10(1):153– 160. https://doi.org/10.23934/2223-9022-2021-10-1-153-160

27. Fomenko NS, Perminov AY, Petrikov SS. Experience of Implementation of an Organizational and Methodological Approach to the Description and Standardization of Treatment and Diagnostic Processes in N.V. Sklifosovsky Research Institute for Emergency Medicine. Russian Sklifosovsky Journal Emergency Medical Care. 2021;10(2):367–376. https://doi.org/10.23934/2223-9022-2021-10-2-367-376

28. Perminov AYu, Fomenko NS, Petrikov SS; NII SP im. N. V. Sklifosovskogo. Metodicheskie rekomendatsii po opisaniyu i normirovaniyu lechebnodiagnosticheskikh protsessov: metodicheskie rekomendatsii No 65. Moscow, 2022. (In Russ.)

29. Prikaz Departamenta zdravookhraneniya goroda Moskvy ot 10.02.2017 No 79 “O dal’neyshem sovershenstvovanii organizatsii okazaniya meditsinskoy pomoshchi bol’nym s ostrymi narusheniyami mozgovogo krovoobrashcheniya v meditsinskikh organizatsiyakh gosudarstvennoy sistemy zdravookhraneniya goroda Moskvy”. (In Russ.) Available at: https://base.garant.ru/71628284/ [Accessed Feb 5, 2024]

30. Subbotin AL. Klassifikatsiya. Moscow: IF RAN Publ., 2001 (In Russ.)

31. Filosofskaya entsiklopediya: in 5 vol. Vol. 2. Moscow: Sovetskaya entsiklopediya Publ., 1962. pp. 488–489.

32. Fasetnaya klassifikatsiya. (In Russ.) Available at: https://ru.wikipedia.org/wiki/Фасетная_классификация [Accessed Feb 5, 2024]