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Introduction. Lean process improvements are needed to meet the increased adult demand for COVID-19 vaccinations. The purpose of the study is to develop interventions to improve adult vaccination against COVID-19 based on lean manufacturing strategies. Material and methods. We conducted 200 timings of the COVID-19 vaccination process and surveyed 200 vaccinated people. The time of the process, the time of creation of the value stream was calculated, production losses were analyzed. Results. After optimizing the COVID-19 vaccination process, the process time decreased by 2.3 times (from 5474.3 ± 127.3 to 2354.6 ± 22.5 sec; p < 0.01). The time for the prophylactic vaccination against COVID-19 in the vaccination room was reduced by 3 times (from 600.6 ± 23.3 to 181.3 ± 25.6 sec; p < 0.01). Production losses in the form of overproduction, excessive data processing, and unnecessary movements are excluded from the activities of the doctor and the nurse at the vaccination room. The time to value stream creation during vaccination increased from 68% to 97% (p < 0.01). Limitations. The research materials are limited to the results of scientific research of the North-Western State Medical University named after I.I. Mechnikov received over 2021. Conclusion. The use of lean manufacturing technologies made it possible to identify the nature of production losses and analyze the causes of their occurrence in the process of vaccination of the adult population against COVID-19. The organizational measures taken in the form of patient flow management, standardization of work processes, redistribution of functional responsibilities, elimination of production losses contributed to a significant increase in the throughput of the vaccination room in the context of the COVID-19 pandemic.

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The article analyses the main directions of development of human resource management in the health sector, both in Russia and abroad. Through the example of the Russian and foreign health care service it shows that the main problem is the deficit of nurses and physicians. The world experience in solving this problem is analysed in the article. The research shows the current classification of availability of medical personnel and characterises system of training of medical personnel in Russia. In conclusion the prospects of development of human resources policy and medical personnel management on the basis of strategic planning in health care are given.

To ensure the availability of primary health care compliance with regulatory requirements, taking into account population density, and personnel stability are very important. Methods. According to the reporting form №30 analyzed accordance staffing table one of the polyclinic of St. Petersburg regulatory and target indicators, presented in the Orders of medical care. Analyzed frequency of layoffs of doctors from polyclinic throughout the year, taking into account the duration of the employment relationship. Results. The population living in the polyclinic area of health care, is extremely insufficient provided by dentists, rheumatologists, urologists, oncologists and psychotherapists, as their numbers on 57,5-80,8% below the regulatory and target indicators. Insignificant shortage of staff identified among allergist, cardiologists, gastroenterologists, infectious disease specialists, general practitioners and otolaryngologists precinct because the lack of individuals working in these fields, is 10-30%. There is no shortage of such specialists as endocrinologists, ophthalmologists and neurologists. Over the last year 20,5% of doctors quit from a polyclinic and the newly employed at 1,5% less than retired from work. Conclusion. The current staffing table does not fully meet the regulatory requirements on the number of posts and the number of actually working doctors on 10 thousand of population. Another problem is the turnover of medical staff, which exacerbates the staffing imbalance.