Resource support of certified quality management systems of dental care
DOI:
https://doi.org/10.34287/MMT.1(52).2022.11Abstract
Abstract. Standards for quality management systems require support for the system resources: human, infrastructure, process environment, knowledge, competence, awareness, communication, documented information. Objective. To conduct a systematic analysis of resource management in certified quality management systems of dental institutions; suggest ways to improve it. Materials and Methods. Forms №№ 17, 20 of the state statistical reporting, internal documents of municipal non-profit enterprises: "Zhytomyr Regional Dental Medical Association"; Kharkiv Regional Council "Regional Dental Clinic"; "Chernihiv Regional Dental Clinic of the Chernihiv Regional Council" were used (a total of 37 units). Methods: medical and statistical; system approach; content and comparative analysis; graphic. Results. It has been established that the institutions are provided with highly qualified competent medical staff, but there are no dental hygienists among the positions and individuals of specialists, which overloads dentists with simpler preventive procedures. At the same time, preventive measures are important to prevent the development of caries, periodontitis and diseases of the oral mucosa. There is no widespread involvement of employees in freelance organizational structures, monitoring and internal audit of processes and quality management systems. Heads of institutions did not organize the development and implementation of local clinical protocols based on evidence data. Dental care technologies are regulated by industry standards developed in 2004 on the basis of professional consensus. Clinical pathway of the patient, as organizational regulations of dental care, are descriptive textual in nature, the direction of the patient's movement is not traced, as well as the sequence of interaction of structural units - participants in the treatment and diagnostic process. Clinical quality indicators are not implemented in institutions and are not subject to calculations and monitoring. This creates risks for the effectiveness of patient-centered dental care. External and internal interactions of institutions and their structural units are unclear; there is a shortage of medical equipment; modern digital technologies are used to a limited extent for internal and external communications. Conclusion. Opportunities for the implementation of quality management, laid down in the standard, in each dental institution in the real conditions of its operation are not fully used, which requires the attention of heads of institutions in problematic areas.
References
Handbook for national quality policy and strategy: a practical approach for developing policy and strategy to improve quality of care. WHO, 2018. 88 p.
Allen-Duck A, Robinson JC, Stewart MW. Healthcare Quality: A Concept Analysis. Nurs Forum. 2017; 52 (4): 377–386. doi: 10.1111/ nuf.12207.
Grøndahl VA, Kirchhoff JW, Andersen KL, [et al.]. Health care quality from the patients' perspective: a comparative study between an old and a new, high-tech hospital. J Multidiscip Healthc. 2018; 11: 591–600. Published 2018 Oct 18. doi: 10.2147/JMDH.S176630.
Internet-dokument SO9001:2015(en)Quality management systems – Requirements. https:// www.iso.org/obp/ui/#iso:std:iso:9001:ed- 5:v1:en. Accessed 2022 Jan 9.
Moradi T, Jafari M, Maleki MR, Naghdi S, Ghiasvand H. Quality Management Systems Implementation Compared With Organizational Maturity in Hospital. Glob J Health Sci. 2015; 8 (3): 174–182. Published 2015 Jul 27. doi:10.5539/ gjhs.v8n3p174.
Enders C, Lang GE, Lang GK, Werner JU. Zertifizierung des Qualitäts managements nach DIN EN ISO 9001:2015 [ISO 9001: 2015 Certification in Quality Management]. Klin Monbl Augenheilkd. 2017 Jul; 234 (7): 886–890. German.
doi: 10.1055/s-0043-111084. Epub 2017 Jul 25.
Montano D. Certifying leaders? high-quality management practices and healthy organisations: an ISO-9000 based standardisation approach. Ind Health. 2016; 54 (4): 324–336. doi:10.2486/ indhealth.2015-0178.
Pro vnesennja zmin do nakazu MOZ Ukrai'ny vid 14 bereznja 2011 roku № 142«Pro vdoskonalennja derzhavnoi' akredytacii' zakladiv ohorony zdorov'ja»: nakaz MOZ Ukrainy vid 20.12.2013 r. № 1116. [Internet] https://zakon.rada. gov.ua/laws/show/z0031-14 (data zvernennja: 09.01.2022).
Zvit Golovnoi' akredytacijnoi' komisii' pry MOZ Ukrai'ny za 2019 rik. [Internet] Ministerstvo okhorony zdorovia Ukrainy: vebsait. https://moz.gov.ua/uploads/5/26695- zvit_golovnoi_akreditacijnoi_komisii_pri_ moz_ukraini_za_2019_rik.pdf (data zvernennja: 09.01.2022).
Zvit Golovnoi' akredytacijnoi' komisii' pry MOZ Ukrai'ny za 2018 rik. [Internet] Ministerstvo okhorony zdorovia Ukrainy: vebsait. http://moz.gov.ua/uploads/2/10966-zvit_ gak_2018.pdf. (data zvernennja: 09.01.2022.
Zvit Golovnoi' akredytacijnoi' komisii' pry MOZ Ukrai'ny za 2017 rik. Ministerstvo okhorony zdorovia Ukrainy: vebsait. http://moz.gov.ua/uploads/1/5004-zvit_ gak_2017.pdf. (data zvernennja: 09.01.2022).
DSTU ISO 9001:2015 (ISO 9001:2015, IDT).Systemy upravlinnja jakistju. Vymogy. Kyiv DP«UkrNDNTs». 2016. 30 p
Low quality healthcare is increasing the burden of illness and health costs globally. WHO: website. Home/News. https:// www.who.int/news/item/05-07-2018-low-quality- healthcare-is-increasing-the-burden-of-illness- and-health-costs-globally Accessed 2022, Jan 9.
Jeve YB. Raising quality whilst reducing cost in health care: A retrospective cohort study. Int J Health Plann Manage. 2018;33(1): e228–e237. doi: 10.1002/hpm.2454. Epub 2017 Aug 31.
Beauvais B, Gilson G, Schwab S, Jaccaud B, Pearce T, Holmes T. Overpriced? Are Hospital Prices Associated with the Quality of Care? Healthcare (Basel). 2020;8(2):135. doi: 10.3390/healthcare8020135.
Sadoughi F, Nasiri S, Ahmadi H. The impact of health information exchange on healthcare quality and cost-effectiveness: A systematic literature review. Comput Methods Programs Biomed.2018;161:209–232. doi:10.1016/j.cmpb.2018.04.023. Epub 2018 Apr 28.
Dejaki pytannja nadannja medychnoi' subvencii' z derzhavnogo bjudzhetu misce- vym bjudzhetam. Verkhovna Rada Ukrainy: vebsait. Zakonodavstvo Ukrainy. [Internet] Postanova Kabinetu Ministriv Ukrainy vid 23 sichnia 2015 r. № 11. https://zakon.rada.gov.ua/laws/show/11-2015-%D0%BF#Text (data zvernennja: 09.01.2022).
Dejaki pytannja nadannja medychnoi' subvencii' z derzhavnogo bjudzhetu miscevym bjudzhetam na zdijsnennja zahodiv sprja- movanyh na rozvytok systemy ohorony zdorov’ja u sil's'kij miscevosti. [Internet] Verkhovna Rada Ukrainy: vebsait. Zakonodavstvo Ukrainy. Postanova Kabinetu Ministriv Ukrainy vid 6 hrudnia 2017r. № 983. https://zakon.rada.gov.ua/laws/ show/983-2017-%D0%BF#Text (data zvernennja: 09.01.2022).
Pro zatverdzhennja tabeliv osnashhennja medychnoju tehnikoju ta vyroba- my medychnogo pryznachennja strukturnyh pidroz- diliv likarni planovogo likuvannja. Verkhovna Rada Ukrainy: vebsait. Zakonodavstvo Ukrainy. [Internet]. Nakaz MOZ Ukrainy vid 31.10.2011 № 739. https://zakon.rada.gov.ua/rada/show/v0734282- 11#Text (data zvernennja: 09.01.2022).