The rapid growth of medical science, new challenges of the time, new challenges facing the healthcare industry dictated the urgent need to review the level and quality of medical care to the population [1, 2]. Important issues were the introduction of new competitive medical services and effective methods of medical care for the population [3], including individual socio-professional groups [4]. In this context, the priority issues were strategic planning and development, modernization of the activities of medical institutions, optimization of management and restructuring in hospital organizations [5, 6].
It is known that in the provision of medical care for many years there was no complete management system for the implementation of the innovation management system. In this regard, it can be noted that currently many new developments and projects in healthcare certainly belong only to the category of innovative technologies in medicine, the main task of which is to organize and manage measures to ensure and improve the quality of medical care for patients. At the same time, the problems of developing new innovative technologies are dealt with by health care workers in all countries. It is known from the literature that the leaders of innovative developments in medicine in the world are the USA, Great Britain, Switzerland, Sweden. China and India were next in this ranking [7, 8].
In recent years, investment and innovation management technologies have been developed at an accelerated pace in the medical care sector of the Republic of Kazakhstan [9]. According to many authors, the main functions of innovation management include: initiation – decision-making on the start of activities; planning – determination of goals and success criteria, as well as ways to achieve them; implementation – coordination of resources to complete tasks; analysis – determination of compliance with the plan and execution, decision-making on corrective measures; management – determination of necessary adjustments, their coordination, approval and application [4, 9].
Currently, the situation in the healthcare system of Kazakhstan is characterized, on the one hand, by high innovation of all types of medical activities and, as a result, significant rates of their development, on the other hand, by the growing demand of the population for quality medical care at an optimal price level. This contradiction gives rise to a scientific problem: the need to develop theoretical and methodological foundations for improving the efficiency of core activities, allowing to optimize and modernize the existing system.
According to some scientists, ensuring the quality of medical services is the result of several important components: the integrity of the healthcare system; the adequacy of the actions of service providers; proper management; qualified and component labor resources; provision of timely and full-fledged financing; availability of information systems that allow constant monitoring of the quality of medical care; provision of medicines; equipment of medical organizations [3, 10, 11, 12]. Within the above-said aims, it should be pointed out that at present there is a noticeable increase in interest in improving the management process of high-quality and safe medical care, especially hospital services, since its contribution to social development is mainly determined by the economic significance of preserving human capital and the social results of the system’s activities while effective management ensures improvement of its main functions under constant observation and response [13,14]. For this reason, in recent years, scientific research has been devoted to the study of the quality of inpatient care for the population. Another serious issue is the assessment of patient satisfaction with the medical services provided, which is receiving increasing attention, as it is considered one of the most important issues of modern public health [15].
Thus, the results of the analysis of modern literature show that by now there are a number of problematic issues in the healthcare organization system and a coherent mechanism of innovation management in this area has not yet been created.
The Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan as a modern multidisciplinary clinical hospital due to its departmental category, is characterized by a fairly high staffing level, a good level of equipment with modern equipment, the possibility of providing specialized and high-tech medical care. In this regard, this clinic can become a certain testing ground for scientific research to improve the entire therapeutic and diagnostic process. Taking into account modern requirements, multidisciplinary hospitals, like any healthcare system organizations, need organizational and functional improvement of their core activities, indicating the topicality of this problem.
The purpose of this study is to develop an innovative model for improving the main activity of the hospital, which can be recommended to healthcare organizations regardless of departmental affiliation and organizational and legal status.
Materials and methods of research
The base of the study was the Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, which is a large multidisciplinary clinic designed to provide medical care to the attached contingent and the entire population. The materials of the study were hospital data on personnel, beds, material-and-technical, medico-technological resources, the availability of modern medical and diagnostic and information technologies. The research methods were the analysis of the actual use of available resources and technologies and, on this basis, the development of measures to improve the main activities of the hospital, taking into account the principles of innovative management to improve the level and quality of medical care.
Results of the research and discussions
Strategic planning and improvement of the main activities of medical organizations and innovation management associated with it should become a universal norm and a natural style of work in hospital management. At the same time, the objective consideration for the main priorities of modernization should be concerned with the need for organizational and technological improvement of the main activities of the hospital within the framework of the current and future problems solution.
The results of our analytical studies were the basis for the development of innovative technology for improving the organizational and functional activities of a modern multidisciplinary hospital.
At the same time, the main structural and functional elements of this organizational technology are:
1. Improving the level of professional competence of medical personnel.
2. Modernization of the material and technical and medical-technological basis.
3. Introduction of modern clinical technologies for prevention, diagnosis, treatment and medical rehabilitation.
4. Ensuring high quality and safety of medical services provided to the attached contingent and the population.
5. Creation of high-tech jobs and automation of basic medical and technological processes.
6. Restructuring of the bed fund and introduction of effective hospital management technologies.
7. Use of modern technologies for employees’ economic interest in the final results of labor.
8. Achieving high competitiveness in the market of public and private medical services.
On the basis of this technology, a program for improving and innovative development of the main activities of the hospital was developed. At the same time, a conceptual approach based on the following principles was used:
– strategic approach to the progressive development of the hospital;
– use of the current regulatory framework of organizational and functional activities;
– modeling of technological management components, establishing areas of responsibility of management entities in the implementation of individual sections of modernization; determining the performance indicators of each stage, creating a monitoring system, analysis and correction of interim results:
– organizational support of the processes of introducing new organizational technologies by creating the appropriate infrastructure and team;
– a rational combination of centralization and decentralization in the management of organizational implementation processes, involving the delegation of a number of tasks and functions to the level of direct performers;
– training of participants involved in the process based on the development of the best clinical practice and the application of modern hospital management technologies.
In order to implement the program for improving the hospital's activities, a logical and reliable system of interaction was built, having vertical and horizontal connections, ensuring the movement of the necessary intellectual (long-term planning), managerial (medium-term and operational planning) and ideological (mission and objectives of the hospital) processes.
The main methodological principle for determining the effectiveness of planned measures was to take into account the most significant consequences of organizational and innovative activities, the specific interests of all participants in the process, orientation by the criterion for determining medical, social and economic efficiency.
At the same time, the choice of an innovative development path affects many important aspects of the functioning of the hospital and the existing relationships. Its implementation requires the formation of an appropriate environment, which is a set of functional elements necessary for the development of the organizational and innovative infrastructure of a multidisciplinary hospital (table).
Improvement of the main activity of the hospital becomes effective if it consists of the following organizational and functional blocks: increasing the level of professional competence of medical personnel; modernization of the material-and-technical and medical-technological base; introduction of modern technologies for prevention, diagnosis, treatment and rehabilitation; ensuring high quality and safety of services provided to the population; creation of high-tech jobs and automation of the main medical and technological processes; restructuring of the bed fund and introduction of effective organizational and innovative technologies of hospital management; application of modern methods of promoting economic interest of employees in the final results of labor and achievement of high competitiveness in the market of medical services.
Functional elements of the development of organizational and innovative infrastructure of a modern multidisciplinary hospital
|
Elements |
Activity |
System-forming elements |
Actions |
|
Personnel |
System of training qualified personnel |
Study in the near and far abroad |
Providing staff training, creating a link between science and practice, attracting specialists to innovation |
|
Organizational |
Management system, system of program and project evaluation |
Leading specialized organizations, chief specialists, experts |
Improving the mechanisms of interaction of participants in innovation activities |
|
Informational |
Information support system |
Information and analytical center, consulting groups |
Creation of a data bank, cooperation with information funds |
|
Financial |
Financial support system |
Authorized body, Medical center, subordinate organizations |
Development and preparation of development programs, attraction of investments |
|
Technological (productive)) |
System for creating new technologies |
Cooperation with national centers, scientific institutes, universities, as well as individual innovators |
Initiation, development and testing of ideas and new technologies |
|
Application |
Innovation promotion system |
National centers, scientific institutes and universities, as well as other innovatively interested medical agencies |
Creating an innovative environment, studying the best medical practice |
Implementation of the main directions of the above measures (the program) contributed to raising the policy of innovation management to a qualitatively new level, contributing to the systematic development and improvement of organizational and functional activities of hospitals. In order to implement this program, a logical system of interaction was built, having vertical and horizontal connections, ensuring the movement of the necessary intellectual, managerial and ideological processes. In the implementation of the main objectives of the program, the modernization of the marketing activities of hospitals was of crucial importance, the main purpose of which was to study in-depth the ever-changing demand on the medical services market and provide competitive offers.
In our opinion, the developed program for improving the main activities of hospitals based on modern innovative management reflects a systematic principle and ensures their organizational and functional development.
Thus, all the measures outlined as a complex should bring on a significant breakthrough in increasing the volume, range and quality of medical services provided to the population.
Conclusion
The development of the hospital along an organizational and innovative path will allow in a short time to bring the quality level of medical care closer to global standards, to reorient the hospital to achieve socially significant results of its core activities. The main result of this organizational and innovative technology is to improve the quality of medical services, as well as to achieve high competitiveness of the hospital on the market of relevant services. The developed technology can be used by organizations of the general medical network system.