Understanding the role of physicians within the managerial structure of Russian hospitals

Kuhlmann, Ellen; Shishkin, Sergey; Richardson, Erica; Иванов, И В; Швабский, О Р; Минулин, И Б; Shcheblykina, A.A.; Kontsevaya, A. V.; Bates, Katie; McKee, Martin

doi:10.1016/j.healthpol.2019.05.020

Cited by 10 publications

(11 citation statements)

References 21 publications

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“…This board, which can be called the board of trustees, the governing board, or the board of directors (27,32,42,48,51,56,58). This structure can have members of medical staff or have a counterpart structure called the council of medical staff (16,27,35,36,42,44,55,58,62). The presence of the patient and community representatives is necessary for the hospitals' governance structure because the general hospital cannot be indifferent to the social stakeholders (31,33,35,37,55).…”

Section: Resultsmentioning

confidence: 99%

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Hospital governance accountability structure: a scoping review

Jalilvand

Raeisi

Shaarbafchizadeh

2023

Preprint

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Introduction: hospital, as a complex organization with clinical, financial, and social functions, faces different barriers to providing high-quality and safe services at reasonable costs. Various initiatives have been carried out in hospital governance to improve quality, safety, and accountability. This research aims to identify the structures and dimensions that make hospital governance accountable. Methods: The research used Arksey and O'Malley's scoping review framework to examine the research literature on hospital governance structure and accountability. The literature review included PubMed, Web of Science, Embase, Scopus ProQuest, Google search engine, and Google Scholar databases from 2010 to 2023. Data were analyzed using content analysis method. Results: excluding the unrelated and duplicate sources, 40 articles and reports were included in the study. The studies were reviewed and analyzed based on organizational type, type of source, year of publication, objectives, and key findings. Accountable governance features extracted from the selected articles and reports. Four main themes including inclusive governance, Commitment to accountability, Planning for accountability, and autonomous governance. Thirteen sub-themes were extracted from the study literature. Conclusion: Various initiatives have been implemented regarding the reform of the governance structure of public hospitals in different countries. Many of these reforms aim to improve financial and clinical accountability. The study results could be used to identify the structures and dimensions that make hospital governance accountable.

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Section: Resultsmentioning

confidence: 99%

“…Employees must be accounting for these structures regarding their performance (28, 35,38,46,55,56,58).…”

Section: Autonomymentioning

confidence: 99%

Hospital governance accountability structure: a scoping review

Jalilvand

Raeisi

Shaarbafchizadeh

2023

Preprint

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“…The gaps in continuous professional development for managers, the lack of open dialogue and discussion on the priorities and challenges of service provision (in addition to the limited evidence available and published results on the perception of quality in health care) seem to be regional peculiarities. One recent study [ 34 ] describes the lack of horizontal exchanges, the almost absent learning culture to prevent mistakes in the neighboring countries to happen in Ukraine as well. However, we observe that there is attention to the perception of quality among health care managers, and health care professionals (and evidence that confirm the developed quality management systems) in other contexts [ 11 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

The perception of health care quality by primary health care managers in Ukraine

Anufriyeva

Pavlova

Степурко

et al. 2022

BMC Health Serv Res

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Background Ukraine is reforming its health care system to improve quality of health care. Insight into how primary health care managers perceive quality is important for the ongoing reform as well as for the improvement of medical services. Methods An online survey was conducted as part of the Ukrainian-Swiss project “Medical Educational Development” in April–May 2019 based on the contact list of USAID project “Health Reform Support”, and additionally on the database of the National Health Service of Ukraine and other channels. Data were analyzed using descriptive statistics and qualitative data analysis. Results In total, 302 health care managers took part in the study. The majority of primary health care managers perceive quality in health care as process quality. They associate quality mostly with compliance to standards. At the same time, primary health care managers prefer to assess outcome quality via a system of indicators and feedback. There appears to be a lack of consensus about health care quality. This may be due to a lack of awareness of the national strategy for better quality of health care service. Conclusions Our study provides new insights into primary care managers' perceptions of health care quality in Ukraine. The absence of a clear consensus about quality complicates the discussion about quality and how to measure quality in health care. This appears to be one of the obstacles to system-wide quality improvement.

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“…These have been described in a recent review, which documented a high level of commitment to better quality care but also very limited evaluations, reflecting the lack of capacity for health services research in Russia 16. However, a further challenge is the persisting siloed and hierarchical management structure in many Russian hospitals, something that is deeply embedded in the system and will be difficult to overcome 17…”

Section: Discussionmentioning

confidence: 99%

Management of patients with acute ST-segment elevation myocardial infarction in Russian hospitals adheres to international guidelines

et al. 2020

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ObjectiveRussia has one of the highest cardiovascular mortality rates. Modernisation of the Russian health system has been accompanied by a substantial increase in uptake of percutaneous coronary intervention (PCI), which substantially reduces the risk of mortality in patients with acute ST-elevation myocardial infarction (STEMI). This paper aims to describe contemporary Hospital treatment of acute STEMI among patients in a range of hospitals in the Russian Federation.MethodsThis study used data from a prospective observational cohort of 1128 suspected patients with myocardial infarction recruited in both PCI and non-PCI hospitals across 13 regions and multiple levels of the health system in Russia. The primary objective was to examine the use of reperfusion strategies in patients with STEMI.ResultsAmong patients reaching PCI centres within 12 hours of symptom onset, the vast majority received angiography and PCI, regardless of age, sex and comorbidity, in line with current European Society of Cardiology guidelines.ConclusionPatients reaching Russian hospitals are very likely to receive appropriate treatment, although performance varies. The best hospitals can serve as beacons of good practice as PCI facilities continue to expand across Russia where geography allows.

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Understanding the role of physicians within the managerial structure of Russian hospitals

Cited by 10 publications

References 21 publications

Hospital governance accountability structure: a scoping review

Hospital governance accountability structure: a scoping review

The perception of health care quality by primary health care managers in Ukraine

Management of patients with acute ST-segment elevation myocardial infarction in Russian hospitals adheres to international guidelines

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