Aim. In this study, we carry out a problem and critical analysis of the process of implementing the 5S lean manufacturing methodology in the Healthcare System of the Russian Federation.Materials. 33 Russian and foreign literature sources indexed in the RSCI, Scopus, Web of Science and PubMed databases were reviewed.Results. This article scrutinizes 5 consecutive steps of the 5S lean manufacturing method for organizing a workplace. This method, which is based on interrelated principles, is being actively introduced into the Russian Healthcare System with the purpose of identifying, reducing and preventing various types of losses.Conclusion. It is shown that the practical realization of the 5S method is hampered by the specifi cs of medical personnel work and the peculiarities of legislative regulation in RF medical organizations. The application of the 5S methodology, taking into account the existing regulatory framework in the fi eld of healthcare, can increase the manageability of workplaces and create conditions for the effective work of medical personnel.

Currently, the primary health care system is undergoing active reformation. Lean manufacturing technologies are being introduced into the activities of medical organizations that help reduce the loss of medical and auxiliary processes. One of the main methods of lean production is visualization, which is implemented in the operational management of a medical organization in the form of creating information centers (InfoCenters) that reflect the main parameters of the activity of a medical organization in the SQDCM system: safety, quality, order execution, costs and a comfortable environment. Criteria of safety of medical activity most relevant for the national healthcare system are parameters of epidemiological safety. A parameter most difficult for indication, but necessary for reflection of epidemiological diagnostics in the InfoCenter is the accident rate at work. Aim. Generalization of literature data on the possibility of including epidemiological safety parameters into the operational assessment of the InfoCenter. Epidemiological studies conducted in our country in medical organizations of various profiles show an increasing rate of emergency situations among the medical personnel. With this, the system of indication and identification of all emergency cases still remains imperfect, and medical personnel often hide cases of emergency situations. Conclusion. Introduction of criteria of epidemiological safety into the practical activity of a medical organization as a component of the operational management unit of the InfoCenter will contribute to the formation of functioning and constantly improving system of analysis of the activity of medical organizations, to the control of provision of medical care, and to standardization of invasive procedures to ensure epidemiological safety. The key tasks of the InfoCenter are: focusing the attention of medical organization employees on problems, prompt response to emerging problems and risks, and also ensuring effective communication of all participants of operational meetings in a single information space.

The article presents the results of a review of literature on the possibility of visualization in the health care system of the Russian Federation as one of the main methods of implementation of lean production. The historical aspect of the use of various imaging techniques in medicine is reflected in detail, as well as the advantages of some visualization tools in the organization of medical care. The existing legal and methodological framework for the use of visualization in the activities of medical organizations of various profiles is analyzed. Search publications carried out on the bases e-library, Medline, Scopus, Pub Med, The Cochrane Library and RINC.

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Aim. To evaluate the main results of work of specialized stroke units and departments and implementation of educational campaigns on secondary stroke prevention in Tyumen district in 2011-2017.Material and methods. Work efficacy of specialized stroke units and departments in Tyumen district was evaluated according to standard measures (length of hospital stay, compliance with patient routing rules, timely diagnostic measures, frequency and efficacy of thrombolysis). The results of work of schools for stroke patients and their caregivers were evaluated using questionnaires distributed after the end of each educational program.Results. We demonstrated an improvement of main efficacy measures of stroke units and departments, with most of them reaching target values for Russian Federation. There was a high attendance of educational programs on secondary stroke prevention (8254 persons during the study period). A total of 2200 distributed questionnaires demonstrated a high level of satisfaction with the results of educational programs and the quality of education organization.Conclusion. Implementation of specialized stroke units in Tyumen district enabled an increase of the number of patients receiving systemic thrombolytic therapy, a decrease of mortality and an improvement of functional outcomes. Educational programs for stroke patients and their relatives increased the level of stroke awareness in the target population.