Improving the organization of the management structure of the activities of multidisciplinary medical institutions. Organizational structure of LLC "Anmo" MC "Eurasia" Organizational structure of a medical institution
At Anmo LLC, Eurasia Medical Center, the management process is carried out on the basis of a linear-functional management structure.
The essence of the linear management structure is that control influences on an object can be transferred only by one dominant person - the manager, who receives official information only from his directly subordinate persons, makes decisions on all issues related to the part of the object he manages, and is responsible for responsibility for his work.
Figure - 1 Organizational structure of LLC "Anmo" MC "Eurasia"
Advantages of the organizational structure of the health center: clear division of responsibilities among services, control, subordination, effective management.
Anmo LLC has a linear organizational structure. The diagram of the organizational structure and the composition of its divisions are shown in Fig. 1. The number of management levels is three.
Let's look at each division in more detail.
The administrative service consists of 4 administrators. The service reports directly to the economist-manager. The administrative assistant reports to the shift administrator.
Functions, economist-manager of a health center: carry out work to implement the economic activities of the center, aimed at increasing efficiency and profitability, the quality of patient care and the development of new types of services, achieving high final results with the optimal use of material, labor and financial resources.
Functions of the administrator of the Eurasia health center:
- - answers incoming calls to a medical institution in accordance with the rules for conducting telephone conversations;
- - opens a medical record for a patient visiting the health center for the first time before the initial consultation;
- - concludes an agreement with patients who visit the health center for the first time. The contract is filled out in two copies: one is handed over to the patient, the other is pasted into the patient’s medical record;
- - invite the patient to sit down and wait until the doctor invites the patient to go into the office;
- - warn the doctor about the arrival of the next patient; coordinates the passage of patients to the wellness center;
- - registers patients for primary and repeated treatment, according to the established temporary rules for receiving patients. In the case of an appointment with two specialists, the appointment is made with the assistance of the attending physician;
- - records appointments for consultations of primary patients using specialized software;
- - strive to minimize downtime in the doctor’s schedule by keeping a tight record and filling the resulting downtime with calls from patients of various categories;
- - conducts telephone conversations with patients in order to invite patients who have applied for services to the health center to a preventive examination, as well as calling patients who have not completed the full course of treatment;
- - conducts telephone conversations with patients in order to confirm the patient’s appointment with a doctor. Confirmation of the appointment is carried out the day before the patient makes an appointment (in the evening from 16.00 to 20.00);
- - carries out mailings to regular patients with information on various areas of work, promotions and new products of the health center;
- - select cards of patients who have an appointment with a doctor the next day. Card selection is carried out daily in the evening from 16-00 to 18-00;
- - organizes the exchange of necessary information within the health center team;
- - carries out payments to patients and issues checks to them; controls the safety of documentation and cash;
- - attends meetings of administrators within the time limits specified by the management of the center;
- - monitors the cleanliness and order in the hall, porch and corridors of the wellness center;
- - arrives to work early before the center opens;
- - complies with safety regulations and industrial sanitation.
Consider the financial service.
Functions of the chief accountant: ensuring a rational document flow system, using progressive forms and methods of accounting, based on modern computer technology, allowing for strict control over the rational and economical use of material, labor and financial resources.
The chief accountant is prohibited from accepting for execution and registration documents on transactions that contradict the law and violate contractual and financial discipline; in the event of receiving an order from the head of the enterprise to perform such an action, the chief accountant, without carrying it out, is obliged in writing to draw the attention of the head to the illegality of the order given by him. Upon receipt of a repeated written order from the manager, the chief accountant executes it, and reports facts of gross violation of the law to the prosecutor's office. In this case, the head of the enterprise bears full responsibility for the transaction; ensuring regular informing of the council of the labor collective and the general meeting (conference) about the results of financial and economic activities, audits, inspections, identified violations, those responsible, as well as ways to eliminate shortcomings in financial and economic activities, strengthen economic accounting and the financial position of the enterprise ; providing ongoing assistance in studying the basics of accounting by workers, employees and specialists of the enterprise in order to widely apply this knowledge in practical work to control the economical use of resources.
Functions of an accountant-cashier-personnel officer: carry out operations for receiving, accounting, issuing and storing cash and securities with mandatory compliance with the rules ensuring their safety, maintain a cash book based on receipts and expenditure documents, verify the actual availability of cash and securities with the book the remainder, forming a stable working team, creating a personnel reserve, organizing a personnel accounting system.
Functions of an engineer for the operation and repair of buildings: develops long-term and current plans; (schedules) of various types of repairs of equipment and other fixed assets of the enterprise (buildings, water supply systems, sewerage systems, air ducts, etc.), as well as measures to improve their operation and maintenance, monitors the implementation of approved plans (schedules); carries out checks of the technical condition of equipment, the quality of repair work, as well as the acceptance of equipment newly arriving at the enterprise, and, if necessary, draws up documentation for its write-off or transfer to other enterprises; organizes the preparation of repair work, determines the need for spare parts for equipment repair, to provide them to the enterprise on the terms of cooperation; exercises control over compliance with the rules of operation, maintenance and supervision of the equipment used; draws up the necessary technical documentation and maintains established reporting.
At the Eurasia health center, the positions of director and chief physician of the clinic are combined, the functions of the director are:
- - manages the healthcare institution in accordance with current legislation;
- - represents the healthcare institution in government, judicial, insurance and arbitration bodies;
- - organizes the work of the team to provide timely and high-quality medical and medicinal assistance to the population;
- - ensures the organization of treatment, preventive, administrative, economic and financial activities of the institution;
- - carries out an analysis of the activities of a healthcare institution and, based on an assessment of its performance indicators, takes the necessary measures to improve the forms and methods of work of the institution;
- - reviews and approves regulations on the structural divisions of the institution and job descriptions of employees;
- - monitors compliance with the requirements of internal labor regulations, safety regulations, labor protection, technical operation of devices, equipment and mechanisms.
The chief physician has the right:
- - request necessary information and documents from employees;
- - give employees mandatory instructions;
- - make decisions on the imposition of material and disciplinary penalties on employees who do not fulfill or improperly perform their official duties and on encouraging distinguished employees; take part in meetings, conferences, sections where issues related to professional competence are discussed.
The chief physician is responsible for:
- - for improper performance or non-fulfillment of their official duties provided for by this job description - within the limits determined by the current labor legislation of the Russian Federation;
- - for offenses committed in the course of carrying out their activities, - within the limits determined by the current administrative, criminal and civil legislation of the Russian Federation;
- - for causing material damage - within the limits determined by the current labor and civil legislation of the Russian Federation.
Functions and responsibilities of the senior medical staff of LLC "Anmo" MC "Eurasia":
- - provides qualified medical care in his specialty, using modern methods of prevention, diagnosis, treatment and rehabilitation, approved for use in medical practice;
- - determines the tactics of patient management in accordance with established rules and standards;
- - develops a plan for examining the patient, clarifies the scope and rational methods of examining the patient in order to obtain complete and reliable diagnostic information in the shortest possible time;
- - based on clinical observations and examination, medical history, data from clinical, laboratory and instrumental studies, establishes (or confirms) a diagnosis;
- - in accordance with established rules and standards, prescribes and monitors the necessary treatment, organizes or independently carries out the necessary diagnostic, therapeutic, rehabilitation and preventive procedures and measures;
- - examines the patient daily in the hospital. Makes changes to the treatment plan depending on the patient’s condition and determines the need for additional examination methods;
- - provides advisory assistance to doctors of other departments of health care facilities in their specialty;
- - directs the work of the nursing and junior medical personnel subordinate to him (if any), facilitates the performance of his official duties;
- - monitors the correctness of diagnostic and therapeutic procedures, operation of instruments, apparatus and equipment, rational use of reagents and medications, compliance with safety and labor protection rules by mid-level and junior medical personnel;
- - participates in conducting classes to improve the qualifications of medical personnel;
- - plans his work and analyzes his performance indicators; ensures timely and high-quality execution of medical and other documentation in accordance with established rules;
- - carries out sanitary educational work. Complies with the rules and principles of medical ethics and deontology;
- - competently and timely executes orders, instructions and instructions from the management of the institution, as well as regulations on his professional activities;
- - complies with internal regulations, fire and safety regulations, sanitary and epidemiological regime;
- - promptly takes measures, including timely informing management, to eliminate violations of safety regulations, fire safety and sanitary rules that pose a threat to the activities of the healthcare institution, its employees, patients and visitors;
- - systematically improves his qualifications.
Functions and responsibilities of nursing staff:
- - fulfillment of duties provided for in the current job description;
- - providing medical care to the clinic’s clients (patients) in their specialty, using modern methods of prevention, diagnosis, treatment and rehabilitation accepted at the clinic;
- - in the absence of special knowledge and practical skills in the field of the latest methods and technological techniques introduced into the use of the clinic, active mastery of the specified knowledge and skills on the technological and methodological basis of the clinic, including through the acquisition of professional practical skills in the manner and under the conditions determined by internal local legal clinic standards;
- - compliance with the principles of medical ethics and deontology;
- - increasing professional level and qualifications;
- - careful attitude towards the property of the clinic and other employees;
- - management of the work of nursing staff;
- - performing tasks within his competence, corresponding to his specialty, qualifications and position, as well as orders (instructions) of the clinic administration;
- - maintaining medical confidentiality;
- - promoting the creation of a favorable business and moral climate in the clinic;
- - the obligation to maintain a business style of communication in communication with clients of the clinic, colleagues, nursing staff, other clinic personnel, and management of the clinic;
- - compliance with the terms of the employment contract and the current legislation of the Russian Federation;
- - compliance with the established Internal Labor Regulations, Regulations on the confidentiality of information constituting a trade secret of the clinic, production and financial discipline, and a conscientious attitude towards the performance of one’s official duties.
Our main priority is Human. We work with each of our patients as an individual. There cannot be two identical people, two identical problems, or standard diagnostic and treatment algorithms. Every Person is worthy of respect, understanding and compassion. This is the basis of successful treatment.
We are proud of our specialists. Our clinic is essentially an open, self-regulating system. This is a living organism. Every Person working with us is a professional and an individual capable of treating other people with respect and understanding. Our center welcomes healthy professional ambitions, but they do not run counter to universal human values. The disease makes a person vulnerable and vulnerable, therefore rudeness and profiteering with health are not acceptable in our center. Any thoughtless word, look, gesture can cause pain. Each of our employees, from the cleaner to the doctor, is a unique unit. These are people who come to us and stay for a long time.
The organizational structure of the medical center can be presented in the form of this table. Next we will look at each category in more detail.
Director
Responsible for the smooth operation of the center. Including responsibility for the risks associated with the work of the center in general and doctors in particular. Select this employee carefully, because it is he who will be indicated in the license to provide medical services.
Opening hours: Monday to Friday from 08:00 to 17:00. Saturday - from 10:00 to 14:00.
Salary - 50,000 rubles per month.
Deputy Director for Finance (Chief Accountant)
Supervises the work of the accounting department, conducts inventories, and carries out financial analytics of the enterprise’s activities.
Salary - 30,000 rubles per month.
Deputy Director for Technical Affairs (Chief Physician)
It is advisable that this position be occupied by the most qualified specialist in your clinic. With its impeccable reputation, it will create the status of your medical center. That is why constant professional development, an academic degree, as well as the organizational skills of the chief physician are your competitive advantages. This specialist must also have a certain immunity when communicating with pharmacological companies and be able to lobby the interests of patients. Thanks to the communication skills of your medical director, your medical center can get maximum discounts on the latest drugs.
Opening hours: on weekdays from 08:00 to 17:00.
Medical personnel (doctors)
All specialists in your center must have a diploma in medical education, at least 3 years of work experience, and excellent reviews from clients. To work effectively, the doctors of your center need to constantly improve their qualifications, and in this matter you must provide them with all the necessary conditions: financial incentives, specialized literature.
Work schedule: individual.
Salary - 40,000 rubles.
Nursing staff (nurses)
Since the nurse has the most interaction with the client, she must be competent, polite and tolerant towards each patient. Work experience and positive recommendations from a previous place of work are prerequisites before concluding an employment contract. The number of nursing staff is determined on a 1:2 basis, where the first digit is the number of doctors in the center.
Work schedule: 2 working days every 2 days off, working hours: from 08:00 to 20:00.
Salary - 25,000 rubles per month.
Junior medical staff (nurse)
Ensures cleanliness and order in all areas of the center.
Work schedule: 2 working days every 2 days off. Opening hours - from 08:00 to 20:00.
Deputy Director for Technical Issues (Chief Engineer)
Equipment, lighting and other technical issues should be under the jurisdiction of one person. Of course, maintenance of specific medical equipment must be carried out by hired specialists. However, monitoring the serviceability of equipment, searching for workers and managing the troubleshooting process should be carried out by the chief engineer. In addition, minor faults that do not require specialist intervention are resolved by this employee independently.
The engineer's work schedule is on weekdays from 08:00 to 17:00.
Salary - 25,000 rubles.
Registration (administrators)
At the initial stage of opening a center, these employees have many responsibilities: answering calls, recording patients, informing doctors about making appointments, meeting patients. Therefore, it is necessary to carefully monitor their workload: if at the initial stage of work administrators can even replace the cashier, then when the center’s capacity reaches full capacity, all these responsibilities should be shared by three employees: the administrator, the cashier, and the receptionist.
Administrator's work schedule: 2 days off after 2 working days, working hours - from 08:00 to 20:00.
Salary - 18,000 rubles.
Cash desk (cashier)
Acceptance of funds from patients based on documents, accounting of funds and collection. Work schedule: 2 working days every 2 days off. Opening hours - from 08:00 to 20:00.
Salary - 20,000 rubles.
Please keep in mind that absolutely all employees of the medical center must have personal medical records. This condition is mandatory when receiving a conclusion from the SES (sanitary and epidemiological station).
| Fixed expenses | Salary | Number of employees | Sum |
| Director | 50 000 | 1 | 50 000 |
| Chief physician | 40 000 | 1 | 40 000 |
| Chief Accountant | 30 000 | 1 | 30 000 |
| Deputy Director for Technical questions | 25 000 | 1 | 25 000 |
| Doctor | 40 000 | 2 | 80 000 |
| Nurse | 25 000 | 2 | 50 000 |
| Nurse | 18 000 | 2 | 36 000 |
| Administrator | 18 000 | 2 | 36 000 |
| Cashier | 20 000 | 1 | 20 000 |
| Total payroll | 477 100 |
The full calculation of the payroll, taking into account social security contributions, is presented in the financial model.
At the present stage of socio-economic development of health care in its overall system, the role of primary health care in the overall process of improving the health of the people is significantly increasing, on which the overall increase in labor productivity of the entire society ultimately depends. The basis for solving this problem should be the effective organization of healthcare management and, above all, its lower levels - treatment and preventive institutions.
The existing organizational structure for managing the activities of a multidisciplinary hospital is a typical system of a rigid administrative-command style of management. With this management system, functional lines of communication diverge from the center to peripheral units (vertical connections). The divisions do not have established connections among themselves, which means there are practically no lines of horizontal communication.
Current issues of the team's activities are regulated by official regulations on all types of inpatient institutions and regulations on officials working in them. The management of the hospital, the procedure for admitting and discharging patients, the rights and responsibilities of medical personnel are regulated by special state norms, regulations and instructions. However, these documents have an organizing influence mainly on the production (medical) activities of the team inside the hospital. Issues regarding the current activities of the unit that go beyond the current provisions can only be resolved by contacting a higher authority. Most of these issues are of a resource nature. In addition, the relations between department teams cannot be resolved practically without the intervention of higher authorities. Thus, the vertical lines of management communication under the current organizational system are unnecessarily overloaded. A significant part of this load represents issues that can be resolved between medical workers or departments on the basis of mutual obligations, that is, the active development of horizontal connections, and vertical management connections will be unloaded.
In turn, the freed up time of managers of various ranks can be aimed at solving promising problems, such as improving the organization of work of health workers, introducing best practices, expanding contacts with other organizations and enterprises, and forming business relationships with related and other possible partners.
According to established tradition, a multidisciplinary hospital has 4 main functional divisions: management, hospital, clinic and administrative part. Each functional unit in turn consists of a number of structural units. Thus, the management of the hospital, in addition to the chief physician and his deputies (for the hospital, clinic, organizational and methodological work, administrative and economic parts), includes accounting, the personnel department, the registry, the service of chief and senior nurses, etc. The hospital consists of an admissions department , specialized ward departments, an operating unit, etc., a polyclinic - from treatment and consulting rooms of specialists and therapeutic areas, as well as a day hospital. Treatment and diagnostic services are presented separately for both the hospital and the clinic and include various types of laboratories and rooms: diagnostic, x-ray, clinical laboratory, physiotherapy service, etc. The AChC includes a repair and maintenance group, catering department, laundry, warehouses, MTS, garage, commandant's office, etc. In connection with the assignment to the multidisciplinary hospital of the functions of managing all medical and preventive institutions in the region, an organizational and methodological department was additionally introduced into its structure, which includes methodological, statistical rooms and an archive. The basis for the creation of a new organizational structure for the management of a multidisciplinary hospital in the conditions of a new medical and economic mechanism was based on the following basic principles:
The principle of limiting the number of hierarchical levels. Replacing the three- and four-level management system (chief physician - deputy for medical department - head of department - treating department) with a two-level system (administration - treating department) can significantly simplify the current management system. At the same time, the relationship between the administration and the treating department of the hospital is regulated on the basis of mutual contractual obligations;
The principle of optimization of control or management. The main idea of this principle is to increase management efficiency by optimizing the number of direct subordinates. According to accepted standards, the total number of subordinates for heads of AUP and functional services should not exceed 7-9 people and be at least 5 (the so-called Muller number 7+ (-)2), and for heads of hospital departments should be set from 6 to 12 people depending on the volume and specifics of the work;
Principle of unity of command: no one person should receive orders from or report to more than one supervisor;
The principle of optimal division of labor. All operating functions of the hospital must be clearly divided between all structural units in order to eliminate their duplication, as well as the presence of “nobody’s” functions. Therefore, for effective management and elimination of duplication of management bodies at different levels, it is necessary to develop regulatory materials - regulations on institutions, their divisions, as well as job descriptions (regulations) for all hospital employees.
In the new conditions, in comparison with the current system of management organization, qualitatively new opportunities are opening up for solving the problems facing the team of medical workers. The scale of these opportunities is not a constantly given value, and with the development of superficial reserves of labor efficiency, subsequent deep-seated opportunities for its improvement and achievement of qualitatively new effective approaches will gradually be revealed. If such a development mechanism is correctly understood by every employee of the institution, then the desire of work collectives to quickly realize efficiency reserves at each workplace will develop objectively.
In turn, the development of initiative and activity of work collectives towards highly effective work cannot be carried out within the framework of a rigid administrative-command management system, when every movement or issue must be agreed upon and permission to be asked for its implementation from a higher organization. Such barriers must be removed and operational space must be provided for the development of independence. In this regard, the role of the democratic foundations of self-government is increasing with the gradual transition of management functions from the administration to the medical and auxiliary departments of the hospital.
An important structural unit of a multidisciplinary hospital is the Medical Council under the chief physician, which includes: the chief physician, his deputies, heads of departments, as well as a member of the deputy group on health care or a representative of the city administration, as well as representatives of enterprises, organizations and associations of the region.
The medical council under the chief physician is called upon to solve the following tasks aimed at developing the city’s healthcare:
1. Determine the prospects for the development of organizational forms of treatment and prevention of diseases,
2. Establish relationships and coordinate core activities with the activities of related institutions, form connections between the hospital and enterprises and organizations on the basis of creative collaboration and agreements.
3. Introduce the achievements of scientific and technical progress into the practice of the hospital,
4. Resolve issues of developing the hospital’s material and technical base, including placing applications for new medical equipment.
At this stage of development, such a hospital structure with the inclusion of a medical council under the chief physician is the most progressive and is capable of mobilizing the efforts of the team as an integral body to increase the efficiency of medical activities. The presented structure of the medical council will be flexible and dynamic if it is armed with regulations on its functioning, eliminating elements of duplication, ensuring the preservation of the independence of each of the structural divisions.
The gradual improvement of self-government ensures the active functioning of horizontal relationships, which means the interaction of departments without the intervention of the administration. These relationships must be based on objective, legalized norms and standards and be accompanied by a strictly thought-out system of accounting and control. An important condition for the effective functioning of the new system is a fairly clear understanding by each member of the large workforce about the working conditions and the implementation of relationships under the new system.
It is necessary to shift the center of gravity of organization and management from the administrative-command system to economic management methods.
One of the main points to improve the work of the hospital and expand the rights of the hospital will be the creation of a repair and maintenance cooperative. In this case, the relationship between the hospital and the cooperative is carried out on the basis of an agreement for certain types of work under the direct control and participation of the AHC. In turn, the reorganization and reduction of the ACh in connection with the delegation of some functions to the cooperative makes it possible for the hospital’s workforce to use the saved funds to develop the hospital’s material and technical base.
It is quite justified, in our opinion, to create an independent expert commission and legal service within the hospital structure to study issues of legal and social protection of the population of the region.
In connection with the transition to economic management methods, organizational management structures must be constantly improved and contribute to the gradual overcoming of managerial illiteracy of all members of the hospital team.
List of used literature:
1. Baida V.D. Quality management system of the medical process in a hospital // Scientific organization in a large multidisciplinary hospital: Abstract: All-Union Conference. Vroenezh, 1981.
2. Baida V.D., Pshenichkina V.D., Smelyanchuk L.I. and others. System of defect-free labor in a hospital. Kyiv: Health 1984-54 p.
3. Zhuzhanov O.T. Healthcare reforms in the Republic of Kazakhstan in market conditions. Dissertation for the degree of Doctor of Medical Sciences. - Orenburg, 1992.-48p.
4. Mirzabekov O.M., Ashimbaev B.U., Tompiev M.K. and others. Cost accounting and issues of efficiency of dental clinics of the Ministry of Health of the Kazakh SSR, Alma-Ata, KazNIINTI.-1990-No. 75-20p.
5. Problems of improving management and increasing production efficiency. Collection of scientific works.-M:ANKh under the Council of Ministers of the USSR-1983-234 p.
6. Reorganization of the healthcare structure in new economic conditions / Kucherenko V.Z., Mylnikova /, Soviet Medicine. - 1990. - No. 5. - pp. 60-63.
Abstract: The article examines and analyzes the basic principles of organizing the structure of management of the activities of multidisciplinary medical institutions in market conditions.
Abstract: The paper reviewed and analyzed the basic principles of structural organization, the management of multidisciplinary health care providers, market conditions.
Tuyin: Makalada naryktyk zhagdaydagi kop profili medicinaly k mekemelerdin qyzmetin baskar kurylymn yimdastyrudyn negizgi kagidalary talkylangan.
Appendix to the order
TFOMS of the Perm region
Table No. 1
Structure of a medical organization
MO registry code ___________
Attribute “separate structural unit” (1-OSP) | Name of the unit/department/site/point | Add. sign of separation | Level of medical care provision | Sign of participation in the formation of MO costs: | Branch type | Conditions for the provision of medical assistance in the registry (classifier V006) | Type of medical care provision (classifier V008) | Profile of medical care (for type of department 1 - “Treatment and prevention (Hospital) (classifier V002) | Source of financing (0 – compulsory medical insurance, 1 – budget, 2 – not included in the TP) | Attribute "Attachment allowed" (for sections, points) (1-yes; 0-no) | MO providing emergency medical services |
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divisions | departments | (1-PSO, RSC) | (1-first, 2-second, 3-third) | 1 - main (profitable), 2 - paraclinical auxiliary (costly), 3 - auxiliary (costly), 4 - hospital auxiliary (costly) | code of the department in which the costs are taken into account<*> | Name | Name | Name | Name | Name |
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<*>for departments/sections/points for which cost accounting is not separately maintained, the code of the department in which the costs are taken into account is filled in in accordance with the coding of the MO Structure: 6 digits (XXYYZZ), where XX is the department code, YY is the site code, ZZ - point code (for example, 010101 - department code 01, area code 01, point code 01).
Performer, tel.:
Table No. 2
Capacity of a medical organization
as of ______________________________
Name of the medical organization (short)__________________________________________
MO registry code ___________
Section 1. Bed capacity of departments with type 1 – “Treatment and prevention (Hospital)” | ||||||||
Branch code | Name of subdivision/branch/site/point | Department nomenclature<*> | Number of deployed beds | Bed profile<**> | ||||
Name | including compulsory medical insurance | Name | ||||||
Department 1 | Stationary | |||||||
Ward 2 | Stationary | |||||||
Ward 3 | ||||||||
<**>all bed profiles of a given department are indicated in several lines. |
Performer, tel:
Section 2. Capacity (number of beds) of departments with type 2 – “Treatment and preventive care (Day hospital)” | ||||||||||||||
Nomenclature of department/point | Number of seats | Number of shifts | Bed profile<*>(classifier V002) | VMP sign | ||||||||||
divisions | departments | Name | including compulsory medical insurance | Name | 1 – provides VMP; 0 – does not provide VMP | |||||||||
Department Day hospital 1 | ||||||||||||||
Day hospital department 2 | Day hospital for APP | |||||||||||||
Day hospital for AFP No. 1 | Day hospital in the emergency department | |||||||||||||
Performer, tel.: | ||||||||||||||
Section 3. Capacity (number of visits per shift) of departments with type 3 – “Therapeutic and preventive (TP)” |
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Name of subdivision/branch/site/point | Nomenclature of department/area/point<*> | Cabinet sign (1-yes, 2-no) | Planned number of visits per shift | Number of shifts | Speciality<**> (classifier V015) |
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divisions | departments | Name | Name |
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APP department 1 | Precinct | ||||||||||
APP Department 2 | Specialized | ||||||||||
APP Department 3 | ORP Center | ||||||||||
APP Department 4 | Health Center | ||||||||||
Department (office) APP 5 | Urgent | ||||||||||
Department (office) APP 6 | Prevention | ||||||||||
APP Department 7 | Medical rehabilitation | ||||||||||
Department (office) APP 9 | Dentistry | ||||||||||
APP Department 10 | Women's consultation | ||||||||||
APP Department 11 | Emergency room | ||||||||||
Department (office) APP 12 | School and preschool | ||||||||||
APP Department 13 | Radiological | ||||||||||
APP Department 14 | Exercise therapy, massage | ||||||||||
APP Department 16 | Palliative | ||||||||||
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<*>filled out on the basis of Appendix No. 2. | |||||||||||
<**>all specialties of this department are indicated in several lines. | |||||||||||
Performer, tel: | |||||||||||
Section 4. Capacity (number of brigades) of the SMP | |||||||||||
Name of division/branch/point | Nomenclature of department/point | Profile of EMS brigades<*> | Number of mobile teams (shifts) | ||||||||
departments | Name | ||||||||||
Substation 1 | |||||||||||
Substation 2 | |||||||||||
EMS department | |||||||||||
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<*>indicated in accordance with the data of the Industry Statistical Reporting Form No. 40. | |||||||||||
Performer, tel.: | |||||||||||
Appendix to the order
TFOMS of the Perm region
Nomenclature of departments, sites, points of medical organizations
1. Directory of department nomenclature
Nomenclature of structural units |
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Name | Name |
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department | Stationary |
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department | Anesthesiology and resuscitation |
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department | Operating unit |
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department | Medical rehabilitation |
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department | Day hospital at the Hospital |
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department | Day hospital for APP |
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department | Reception |
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department<*> | Precinct |
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department<*> | Specialized |
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department | ORP Center |
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department | Health Center |
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department<*> | Urgent |
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department<*> | Prevention |
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department<*> | Dentistry |
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department | Women's consultation |
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department | Emergency room |
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department<*> | School and preschool |
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department<*> | Radiological |
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department<*> | Exercise therapy, massage |
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department<*> | Alternative medicine |
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department | |||
department | Palliative |
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department<*> | Laboratory |
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department<*> | Radiation and X-ray diagnostics |
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department<*> | Functional-instrumental diagnostics |
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department<*> | Physiotherapeutic |
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department<*> | Transfusiology |
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department | Pathological |
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department<*> | First aid |
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department | Registry |
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department | Food department |
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department | Dairy kitchen |
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department | |||
department | Laundry |
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department | Sterilization |
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department<*> | |||
department<*> | AO other (garage, plumbing, gas ventilation services, etc.) |
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department<*> | Medical examination |
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department<*> | Other general hospital (medical archive, dormitory, library, museum, etc.) |
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Therapeutic |
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Pediatric |
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Complex |
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Attributed |
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Paramedic |
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Obstetric<**> |
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Health center<**> |
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Day hospital in the emergency department<**> |
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Mobile FAP |
<*>- department (office);
<**>
2. Directory of nomenclature of sites
Name | Decoding |
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Therapeutic | services for the adult population are provided by a local physician |
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Pediatric | services to the children's population are provided by a local pediatrician |
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services for adults and/or children are provided by a general practitioner (family) |
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Complex | a site is formed from the population of a medical organization site with an insufficient number of attached population (small-staffed site) or the population served by a general practitioner at a medical outpatient clinic, and the population served by feldsher-obstetric stations (paramedic health centers) |
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Attributed | services for the adult population are provided by the local physician-therapist of the workshop area |
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Paramedic | service to the population is provided by a paramedic (midwife) at a paramedic-midwife station |
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Obstetric | service by a gynecologist or midwife to the female population in the outpatient department |
3. Directory of item nomenclature
Name |
|
Health center |
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Day hospital in the emergency department |
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Mobile FAP |
<***>- the population served is not assigned.
Appendix to the order
TFOMS of the Perm region
Instructions for filling out the form “Structure of a medical organization”
1. The “Structure of Medical Organizations” form has been developed in accordance with:
Chapter 5 of the Federal Law - Federal Law “On the fundamentals of protecting the health of citizens in the Russian Federation”;
Article 44 of the Federal Law - Federal Law “On Compulsory Medical Insurance in the Russian Federation”;
Order of the Ministry of Health and Social Development of the Russian Federation No. “On approval of the Procedure for the provision of pediatric care”;
Order of the Ministry of Health and Social Development of the Russian Federation No. “On approval of the Regulations on the organization of the provision of primary health care to the adult population”;
Order of the Ministry of Health and Social Development of the Russian Federation No. “On approval of the nomenclature of hospital beds according to the profiles of medical care” (hereinafter referred to as Order of the Ministry of Health of the Russian Federation No.);
Order of the Federal Compulsory Medical Insurance Fund “On approval of the General principles for the construction and operation of information systems and the procedure for information interaction in the field of compulsory health insurance” (hereinafter referred to as the FFOMS order);
Law of the Perm Territory - PC “On the territorial program of state guarantees of free medical care to citizens for 2015 and for the planning period of 2016 and 2017” (hereinafter referred to as the TP compulsory medical insurance).
2. The form “Structure of medical organizations” is filled out by the Moscow Region in accordance with the procedures for providing medical care, regulatory legal acts in the field of healthcare of the Perm Territory, license and administrative documents of the Moscow Region (approved structure of the Moscow Region, staffing table, orders of the chief physician, etc.) , copies of which are available upon request to the TFOMS of the Perm Territory.
3. In the “MO Code” field (Table No. 1), the MO registration number is indicated - 6 digits: “59” plus 4 digits of the MO code in the TFOMS encoding of the Perm region.
4. In the columns “Division code”, “Department code”, “Site code”, “Point code” (Tables No. 1, 2) a code of no more than 2 digits is indicated;
It is allowed to use the numbering in force in the Moscow Region, provided that the codes of departments within one Moscow Region are unique and the codes of sections (points) are unique within one department (area), respectively.
The column “Division code” is also filled in for departments, areas, points included in this division.
The column “Branch Code” must be filled in: if there are branches in the Moscow Region, indicate the branch code that is unique to the Moscow Region. If there is no department level in the structure of the MO and there are simultaneous sections and/or points, the conditional department code 99 is indicated in the “Department Code” column, and the “Department Name” column is not filled in.
According to the “Site Code” column at the “Item” level for:
- “FAP”, one of the site codes must be indicated (if the order of the chief physician does not include a FAP attached to one of the medical sites of the Moscow Region, you must enter a line with the “Paramedic” site in the form, assign a code to it and attach all the FAP data to it) ;
- “Health center”, “Visiting specialized advisory team”, indicate the site code – “0”;
- “Day hospital in the emergency department”, indicate the code of the corresponding area “area”.
General manager manages the work of the clinic, resolves all financial issues related to the ongoing operation of the institution, and financial and organizational issues relating to the use of part of the profit and the directions of development of the club are resolved jointly with the founders of the company. Concludes contracts with customers for the provision of services.
Deputy General Director acts as director during his absence. Organizes the work of all company employees. Makes purchases at specified prices at previously determined supply locations.
Financial Director maintains the company's accounting records, removes the cash register, prepares financial reports together with the deputy general director, and pays salaries.
Administrator The clinic accepts applications from private clients and enterprises, compiles a list of everything necessary for purchase and transmits it to the deputy general. director. Provides information about the work of the clinic, if necessary, and makes payments to visitors.
Doctor The clinic provides a list of services that the clinic offers. Draws up a computer database in which information about the owners, medical history of the animal, services provided and diseases is entered. As well as carrying out sanitary and epidemiological work at the client.
Honey. sister and assistant assist the doctor, carry out tests together with him, perform simple manipulations, write prescriptions, and, if the doctor is busy, provide the necessary consultations.
Salesperson in a store carries out the sale of goods, at the end of the day hands over the proceeds to the accountant and compiles a list of what is necessary for purchase in the store and passes this list to the administrator.
Cleaning woman carry out cleaning of all premises of the clinic, removal of used materials and instruments from the offices. Carries out constant cleaning of restrooms, submits requests for necessary supplies for the premises to the supply manager.
Wardrobekeeper Receives and issues outerwear to clients and is hired to work from September to May.
The clinic's operating hours are from 10.00 to 19.00.
All employees who work directly with clients must have a neat appearance, and the doctor and other medical staff must have an appearance appropriate for their position. Management staff and accountants come to work every day. Medical staff comes to work in accordance with their work schedule. High qualification requirements are imposed on both the medical staff and the persons organizing and ensuring the work of the clinic.
All employees are paid a set salary depending on their position.
