Introduction. Many hospital departments are involved in a single technological cycle of ensuring the quality of medical care. The discrepancy between the work of any of the divisions and patient expectations affect the perception of the medical service provided as a whole. Implementing project approach in medical care delivery process ensures its effectiveness and increases patient satisfaction. Aim: to describe the experience of using project approach to improve temporal characteristics of outpatient cardiological care services. Material and methods. Primary medical sanitary service (PMSS) and cardiovascular care provided at the polyclinic were the object of the study. Problems affecting patient satisfaction were the subject of the study; the patients of the polyclinic were followed for the purposes of this study. Expert assessments, survey, mapping analytical and statistical methods were used in the study. The group of patients was formed according to the following criteria: undergoing scheduled appointment with a physician, having the following complaints including elevated blood pressure, periodic chest pain or heart arrhythmias, provided informed voluntary consent to participate in the study. Results. According to the analysis of patients, opinion on the PMSS provided at the polyclinic — 20% of patients were “rather not satisfied” with services provided by a cardiologist, and 30% of patients were “rather not satisfied” with services provided by a physician. Patients reported the time spent waiting to a group of experts working on the National Social Initiatives. All types of patients, “time losses” were recorded in detail. Process mapping enabled us to establish the following stages: booking an appointment with a physician; undergoing examination; booking an appointment with a cardiologist and undergoing examination; follow-up examination; booking an appointment a cardiologist, undergoing examination, treatment prescription; follow-up examination. The experts identified the problems at each stage and formed proposals to increase the accessibility of outpatient care. Limitations of the study. There are several limitations of this study: it was a short-term study, the patient assessments of the situation can be subjective, and there was a small number of events involved in the process mapping. Conclusion. The project approach allows specialists to identify problems and their causes, identify areas for improvement, and develop and implement appropriate corrective measures.

Highlights. Unique epidemiological data were obtained on the effectiveness of preventive services of healthcare organizations in relation to cardiovascular diseases, adherence to lifestyle modification recommendations, and presence of risk factors for cardiovascular diseases in these citizens.Aim. To assess healthcare services uptake in large industrial Siberian region, as well as the adherence of population to lifestyle modification recommendations (epidemiological data).Methods. The study included 729 residents of Kemerovo and Kemerovo region. The assessment of the main risk factors for cardiovascular diseases was carried out in accordance with the Russian recommendations for cardiovascular prevention. Uptake and adherence to lifestyle modification recommendations was assessed using the Health System Assessment Questionnaire of the International Prospective Study of Urban and Rural Epidemiology.Results. Among the 729 study participants, the urban population is represented by 67.3%, rural – 32.6%. The population was majority represented by women (69.7%). The mean age of participants was 59.0 (51.0; 65.0) years. Smokers accounted for 18.6% of the participants, the majority represented by men (p = 0.000). Excessive weight was more often observed in women (p = 0.013), the mean body mass index in women was 29.5 kg/m2 . The mean values of the analyzed laboratory parameters (cholesterol, low- and highdensity lipoprotein cholesterol, triglycerides, glucose) were within the range of normal values. Previously diagnosed hypertension was noted in 64.6% of the participants, diabetes in 12%, coronary heart disease in about 7%, stroke in 1.6% of the participants. Assessment of cardiovascular risk according to SCORE scale showed that 17% of participants were at low risk, 50% – moderate risk in, and 29.2% – high-very high risk. Upon visiting healthcare provider, only 38.1% of subjects received recommendations for lifestyle changes. Respondents were frequently given recommendations to adjust their diet, followed by recommendations regarding weight loss, increased physical activity; smoking cessation and lower alcohol consumption were recommended less often. Respondents changed their lifestyle significantly more often in accordance with the recommendations received at the time of visit (p = 0.000); out of them, 56.7% had moderate cardiovascular risk, 26.7% had high and very high risk, and low risk according to SCORE – 16.7%. However, study participants were more likely to not follow received recommendations (p = 0.000).Conclusion. Due to high uptake of healthcare services in the population, high prevalence of risk factors and low adherence of the population to prevention, it can be concluded that the current model of prevention does not work. Innovative tools are needed to manage risk factors for cardiovascular diseases and positively change a person`s lifestyle.