Strategic management of a medical institution development
Assessment of the role of strategic development management in the practice of medical institutions. Justification of the importance of ensuring the continuity of strategic goals, the need to take into account the specifics of the health care industry.
| Рубрика | Менеджмент и трудовые отношения |
| Вид | статья |
| Язык | английский |
| Дата добавления | 12.12.2023 |
| Размер файла | 34,2 K |
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Petro Mohyla Black sea national university
Kruty heroes military institute of telecommunications and information technologies
Strategic management of a medical institution development
K. Netudyhata,
PhD in economics, associate professor of the department of management
T. Buzhykova,
lecturer of the department of foreign languages,
D. Ivanov,
master's student of the department of economic sciences
Mykolaiv
Kyiv
Abstract
The study confirms the decisive role of strategic management development in the practice of medical institutions. The authors' attention is drawn onto historical aspects and modern approaches to the characteristics of strategic development management. The importance of ensuring the continuity of strategic goals has been substantiated in the study. The conducted analysis made it possible to identify general and special features of strategic management of health care. The authors emphasize the necessity to take into account the specifics of the healthcare industry while using traditional methods of strategic management development. Analysis of existing tools and approaches to strategic management in health care proved their demand and confirmed the necessity of regulatory and organizational support of strategic management in this field. The last one ensures the unity and coherence of the organization's strategic goals.
Also, the conducted research allowed the authors to conclude that healthcare institutions have access to a large number of various methods of strategic management development, the implementation of which contributes to obtaining significant results and achieving the main goal - increasing the availability and quality of medical care provided to the population. There are all necessary organizational and legal grounds for the implementation of methods and tools of strategic management of development in the healthcare system. The presence of strategic documents creates a basis for formalizing the process of strategic management and ensuring the unity and continuity of the processes of achieving goals.
A system of strategic goals has been formed as a part of the improvement of strategic management development on the example of a medical institution in the town of Voznesensk, Mykolaiv region. It has been proposed to implement the «Lean Medical Institution» project. The social, medical and economic efficiency of the proposed measures has been revealed.
Modeling and substantiation of new mechanisms of strategic management based on the combination of already existing and tested methods, including relying on the best global practices, can become a promising direction of further scientific research.
Keywords: strategic management, strategic management development, medical institution, strategic management tools, health care, strategic goals.
Анотація
К.Л. Нетудихата,
к. е. н., доцент кафедри менеджменту,
Чорноморський національний університет імені Петра Могили,
м. Миколаїв, Україна Т.О. Бужикова,
викладач кафедри іноземних мов, Військовий інститут телекомунікацій та інформатизації імені Героїв Крут, м. Київ, Україна
Д.М. Іванов,
магістр факультету економічних наук, Чорноморський національний університет імені Петра Могили, м. Миколаїв, Україна
Стратегічне управління розвитком медичного закладу
Дослідження підтверджує визначальну роль стратегічного управління розвитком у практиці медичних закладів. Увага авторів звернена на історичні аспекти та сучасні підходи до характеристики стратегічного управління розвитком. У дослідженні обґрунтовано важливість забезпечення наступності стратегічних цілей. Проведений аналіз дозволив виділити загальні та особливі риси стратегічного управління охороною здоров'я. Автори наголошують на необхідності врахування специфіки галузі охорони здоров'я при використанні традиційних методів стратегічного управління розвитком. Аналіз існуючих інструментів та підходів до стратегічного управління в охороні здоров'я довів їх затребуваність та підтвердив обов'язковість нормативного та організаційного супроводу стратегічного управління у цій галузі. Останнє забезпечує єдність та узгодженість стратегічних цілей організації.
Також, проведене дослідження дозволило авторам зробити висновок про те, що на даний момент закладам охорони здоров'я доступна велика кількість різноманітних методик стратегічного управління розвитком, реалізація яких сприяє отриманню значущих результатів та досягненню головної мети - підвищенню доступності та якості медичної допомоги населенню, що надається. Для реалізації методів та інструментів стратегічного управління розвитком у системі охорони здоров'я є всі необхідні організаційні та правові підстави. Наявність стратегічних документів створюють основу для формалізації процесу стратегічного управління та забезпечення єдності та спадкоємності процесів досягнення цілей.
У рамках удосконалення стратегічного управління розвитком на прикладі медичного закладу м. Вознесенська, Миколаївської області. сформовано систему стратегічних цілей. Запропоновано реалізувати проекту «Ощадливий медичний заклад». Розкрито соціально-медичну та економічну ефективність запропонованих заходів.
Перспективним напрямом подальшого наукового пошуку може стати моделювання та обґрунтування нових механізмів стратегічного управління на основі комбінування вже існуючих та апробованих методів, у тому числі з опорою на найкращі світові практики.
Ключові слова: стратегічний менеджмент, стратегічне управління розвитком, медичний заклад, інструменти стратегічного управління, охорона здоров'я, стратегічні цілі.
Main part
strategic management medical health
Problem statement. A healthy society of Ukraine is an important marker of the demographic situation; in addition, it is a guarantee of stability and national security of a country. The state represents and protects the interests of citizens in the field of healthcare and social protection. The use of SMD (strategic management development) in medical institutions is an effective method that will increase the efficiency of management of medical institutions. SMD in medical institutions involves setting long-term goals and objectives, developing certain relationships between medical organizations and the environment, which correspond to their internal potential and allow maintaining responsiveness to external and internal requirements.
Analysis of publications. Such scientists as I.V. Zhalinska, N.I. Karpyshyn, V.M. Lekhan, I.V. Martusenko, I.V. Mykolaets, Yu. V. Samoilyk, Yu. M. Safonov, L.O. Pogrebnyak and others have made a significant contribution to the study of theoretical and practical issues of development and management of medical institutions. At the same time, the issues of strategic management of the development of these institutions remain unexplored and require considerable attention from scientists.
Purpose of the article is to reveal the theoretical foundations of strategic management of the development of a medical institution and to substantiate recommendations for its improvement on the example of a specific medical organization.
The main material research. The concept of «strategic management» is interpreted as management that is carried out at the highest level and differs from the level of current management in production. Changes in the current business situation have led to the separation of strategic management. The main idea of such management was to single out the company's environment as a center of attention for the management to respond to changes in it and to respond to the problems posed by the external environment quickly and efficiently. In the research process, three main approaches to strategy formation were identified, namely: target, way of acting, planning document (Table 1).
Table 1. Approaches to the essence of the concept «strategy»
|
Definition |
Approach |
|
|
Strategy is the determination of the main long-term goals of the enterprise and the adaptation of action courses and allocation of resources necessary to achieve the goals. |
Target |
|
|
Strategy is a set of rules and techniques that helps to achieve the goals of enterprise development. |
Way of acting |
|
|
Strategy is a way of acting that determines a well-defined and relatively stable line of behavior in a fairly long interval. |
Way of acting |
|
|
Strategy is best viewed «as a combination of planned actions and quick decisions on adaptation to new industry achievements and a new disposition on the competition field. |
Way of acting |
|
|
A company's strategy is an established set of activities (goals and ways of achieving them), which is revised to ensure sustainable differentiation and profitability. |
Way of acting |
|
|
Strategy is a unified plan that connects all constituent elements of the firm and various aspects of its activity. |
Planning document |
|
|
Strategy is a firm's plan of action to achieve market success and, if it is possible, to acquire a competitive advantage over rival firms. |
Planning document |
It's worth comparing strategic and operational management in the research process of the concepts and essence of strategic management (Table 2).
Table 2. Distinct characteristics of strategic and operational management
|
Characteristic |
Operational management |
Strategic management |
|
|
Purpose of existence, function, formed mission |
Creation and development of services and goods for profit and income. |
Prospective development of the organization in the long-term period with the help of harmonious work with the external environment, the entourage and solving the problems of the managers. |
|
|
Attention center |
It focuses on the internal component of the organization and internal problems. |
It focuses on the discovery of new opportunities, on the use of competition as a source of improvement, on the rapid response to changes in the environment and environmental factors. |
|
|
Setting the question |
What should be done? |
What needs to be achieved? |
|
|
Solution method |
According to economic activities. |
According to strategy elements. |
|
|
Functioning environment |
Stable, predictable. |
Dynamic, unpredictable. |
|
|
Time factor |
Short-term and medium-term perspective. |
Long-term perspective. |
Let's consider some theoretical definitions of strategic management formulated by the authors. The concept of «strategic management», according to many authors, is reduced to the process of defining and using strategic decisions, in which strategic choice is considered the main link, where the interaction of own resources with opportunities and threats characterizing the external environment is emphasized.
The term «strategy» can be defined «as the main connecting link between what the organization wants to achieve - Its goals and the line of behavior which was chosen to achieve these goals» [7, p. 162].
I. Zhalinska defines the concept of «strategic management» as the management of an organization based on the leading role of human potential. The functions of human potential are in conducting flexible regulation and in speed of reaction to changes in the organization, orientation according to the requests of consumers of production activity in response to challenges from the external environment, development of competitive advantages for the survival of the organization and in the achievement of long-term goals [2].
N. Karpyshyn connects the combination of strategic planning, analysis and selection of strategic positions, as well as real-time management with the concept of «strategic management» [3]. V. Lekhan characterizes the concept as «management style». He believes that consumers motivate and orient to the future, develop competition. According to the author, strategic management orients all employees and unites all departments' plans, methods and forms of interaction, synchronizes information for decision-making and planning to achieve long-term goals [4].
After considering the definition of strategic management, let's pay attention to the concept of «strategy». In many formulations, the concept of «strategy» combines such elements as a detailed perspective plan for the long-term perspective, which has flexibility and addressability, takes into account reorientation in case of unforeseen circumstances for the implementation of a strategic maneuver.
The study showed that all strategic goals and objectives are formed and implemented by the top managers of the organization. It is important to consider and take into account the surrounding factors of the external and internal environment when making managerial decisions, as they can affect the results of operations directly.
In order to implement strategic goals, it is necessary to develop operational goals that are implemented in the middle and lower management level of the organization. Operational goals are aimed at internal activities and are developed for a short-term period, but make it possible to solve strategic tasks. In the Table 3 it is carried out a review of the literature that helps to form strategic management. According to the table and considering the papers of foreign and native authors, a large number of methods, models and tools are used in strategic management. In most literary sources, the strategic model includes economic and mathematical methods that reflect processes and phenomena in the external and internal environment.
Thus, it can be distinguished that «strategic management» is impossible without a «strategic planning», there is a relationship, which consists in determining the management potential for solving the set tasks in terms of planning and their implementation. Strategic planning based on analytical procedures sets goals and objectives, and strategic management implements them using a set of methods and actions, as well as taking into account the variability of surrounding factors.
I. Martusenko defines the system of strategic management in medical institutions as «an effective development that ensures the achievement of promising activity indicators, monitors the implementation of a system of complex development measures, and also forms effective managers of Ukrainian healthcare» [5, p. 323]
In his scientific work, I. Mykolaets defines «medical management as the application of a complex of special principles, approaches, methods and means of strategic management by health care organizations of various forms of ownership based on strategic planning, taking into account the formation of an effective system of logical and informational connections between elements of organizational structure of the clinic» [6, p. 18].
Table 3. Analysis of the processed literature
|
Stages |
Characteristic |
Tool |
|
|
The first stage is the analysis of the environment |
The purpose of the stage is the formation of information about the external environment, identification of positive and negative factors, determination of strengths and weaknesses of the organization itself. |
Analytical tools such as SWOT - analysis, PEST-analysis, GAP - analysis, SNW-analysis are used to implement the first stage. |
|
|
The second stage is the development of the mission and long-term goals |
It consists in developing the purpose of the organization, specifying the content of the activity, and determining target orientations. A distinctive feature is coherence, consistency and comparability of the goal and mission. |
F. Kotler proposes to determine the mission and goals taking into account five factors: the history of the organization; actions and behavior style of managers; resources of the organization; internal state and key features of the organization. Phase setting and goal hierarchy are applied |
|
|
The third stage is the formulation of a development strategies |
The essence of the stage is the creation and development of options, alternatives and ways of development of the organization for the long term. |
It is customary to use the I. Ansoff matrix, the Boston Consultative Group (BCG) matrix, the Thompson and Strickland matrix, the D. Abel matrix, the McKinsey matrix, and the ADL matrix. |
|
|
The fourth stage is control |
The essence of this stage is to check the correctness of the the development strategy implementation. |
Selection of indicators: performance indicators; indicators of utilization, human capital; indicators characterizing the internal state of the organization and the external environment. Formation of the measurement and tracking system; market control systems |
With strategic management, it is necessary to determine strategic indicators, taking into account that the healthcare industry differs from other industries in terms of the purpose of activity and ways of achieving them, it is necessary to identify clearly the conditions affecting them.
As in any industry, there are external conditions in the healthcare system that will affect strategic indicators: political (public health protection); social; economic.
The strategic model of the healthcare system is based on the following:
- target strategic indicators, which are responsible for the activity of the healthcare system, formed at the state level;
- strategic indicators of the health care system structure, which are responsible for the level of functioning of state authorities directly with medical organizations;
- indicators of the strategic resources availability (financial, labor, intellectual, information), formed within the medical organization;
- strategic performance indicators of the health care system, which are responsible for the result, are formed in the controlling authorities of the healthcare system.
An important difference between SMD in medical institutions and industrial and commercial enterprises is a socially oriented approach. One of the main elements of the economic and social well-being of the country's society is medical care. In our country, the healthcare sector is one of the leading branches of the service sector. The formation, implementation of medical services and benefits, the purpose of which is to create and maintain the health of the population, is the functional significance of the healthcare system. Considering the fact that health care is a socially significant industry, all strategic goals, indicators and methods of use should be aimed at achieving social and economic results.
Social and economic result: improvement of performance indicators of medical organizations; increasing the life expectancy of the population throughout the country; increasing the life expectancy of the working population of the country, reducing the periods of temporary incapacity for work and reducing morbidity from all causes, improving the quality of life of citizens of various ages, developing and highlighting public health through the interaction of the state and citizens.
The mission of medical organizations is socially-oriented and differs from other organizations. An important difference in the mission of the medical organization is the preservation of the rights of the population in the field of healthcare and the implementation of state guarantees. The mission of healthcare institutions is to provide high-quality and affordable medical care, which should meet the needs of the population with the effective use of the organization's resources.
The strategic goals of healthcare institutions are formed in accordance with the requirements and goals of the state policy in the field of healthcare. They include established normative numerical indicators, such as, for example, the life expectancy of the country's population, mortality, birth rate, morbidity, and cover the priority areas of development of the quality and availability of providing the population with medical care. The main strategic tasks of medical organizations are to create conditions for the realization of the set goal.
The development of strategic volumes of medical care in the form of task plans, state tasks for budgetary medical organizations and resource provision in terms of: types, conditions and forms, in accordance with the territorial program of state guarantees of free medical care to the population and the program of mandatory medical insurance, is carried out with taking into account territorial regulations and the number of the population. Each provision of medical care is calculated for 1,000 people:
- cases of hospitalization in terms of clinical and statistical groups by types of medical care in the conditions of a 24-hour hospital for adults and children;
- cases of treatment in terms of clinical and statistical groups by types of medical care in dayly hospital conditions for adults and children;
- visits for preventive purposes, applications for diseases, emergency care, consultations with the use of information technologies, conditions of outpatient polyclinic institutions accoding to their specialty;
- certain types of medical and diagnostic services;
- ambulance calls.
The strategic development of the network of healthcare institutions on the subject's territory includes the calculation of normative volumes of medical care and their resource support, the distribution of volumes among medical organizations in accordance with their capacities and licensed types of medical care.
The application of strategic management of medical organizations is a system with certain characteristics, the use of which affects the success and development of management activities.
The success of strategic management in medical organizations is the protection and provision of rights to healthcare and free medical care for every citizen. Preservation of the population health is the main value and the main component of the labor and defense resource. It is also important for the population to fulfill their social duties and biological functions, which consist in the reproduction and brining up of a young healthy generation.
Thus, strategic management consists in the development of strategic goals and the assessment of their implementation, the analysis of the current medical organization activity to determine the development strategy. The conducted research, generalized existing principles of strategic management in medical organizations contributed to the formation of a refined and supplemented author's definition of the theoretical concept of «medical organizations' strategic management» to solve the tasks and reveal the research topic.
Strategic management of medical institutions is management that orients the indicators of activity and resource provision of a medical organization to achieve strategic targets, such as meeting the needs of patients (the population) and the requirements of the founders represented by the Ministry of Health; is based on a comprehensive analysis of the general conditions for the medical organizations functioning in the external environment (country), in the immediate environment (subject), as well as an analysis of the internal state of each medical organization. It includes flexible planning and forecasting of the strategic directions of the medical organization, taking into account the distribution of resources and control of the obtained results to achieve medium-term (from three years) and long-term indicators of development and implementation of the organization's activities with the aim of preserving the health of the population, reducing mortality and morbidity, increasing the level of reproductive health, preservation of the medical and demographic situation.
The presented definition has a clear interdependent and logically built structure, reveals the essence of strategic management of medical institutions, summarizes and systematizes the aim and methods, focuses on performance indicators and resource provision of the medical organization. In this definition, a distinctive feature is the clarification of strategic goals and elements of strategic management, taking into account the socially oriented approach and the specifics of the medical organization.
Using the example of the Municipal Enterprise «Municipal non-commercial enterprise Voznesensk City Centre of Primary Medical and Sanitary Aid (hereinafter referred to as the ME «MNE VCC PMSA»), we will provide recommendations on improving the SMD. It should be noted that the existing positive aspects in the healthcare institution can contribute to the introduction of new types of medical care. In order to implement «lean production» in the management and organizational activities of a medical institution, to implement the pilot project «Lean Healthcare Institution», a number of measures must be taken.
It should be noted that the concept of «lean production» is a fairly modern concept of business process rationalization. It is aimed at accelerating and smoothing by identifying and eliminating (optimizing) processes that do not add value to the product (service) and are the cause of the so-called «hidden losses» of the organization's activities. And it also assumes the involvement of almost every employee of the organization in the optimization processes and the maximum focus on the final consumer of products (services, in particular medical ones) [1].
In the healthcare institution of the ME «MNE VCC PMSA» it is proposed to consider and implement the following 4 directions: optimization of the process a therapist's appointment; increasing the accessibility of the environment for surgical patients and people with disabilities; organization of the work of the registry; optimization of the process of blood sampling and procedures in the treatment room (Table 4).
Table 4. Directions of the Medical Institution Development
|
Problems |
Recommendations |
|
|
Direction 1: Optimization of the process of a therapist appointment |
||
|
1. Intersection of flows of patients who need planned and emergency care. 2. The nurse's working time with the patient exceeds the doctor's working time, which delays the appointment of the next patient. 3. Patients who have not made an appointment join the general patient flow (to ask something, to find a medical record, and other questions). |
1. Creation and organization of the doctors on duty office 2. Organization of the nursing post office in 2 shifts (2-3 doctors); 3. Transferring the functions of issuing certificates, statements, sanatorium-resort cards and other documents to the pre-hospital room; 4. Creation and organization of a visiting nursing team. |
|
|
Direction 2: Increasing the accessibility of the environment for surgical patients and people with disabilities |
||
|
1. The absence of an elevator and a mechanical lift in the polyclinic building, difficulties for injured patients, patients with impaired motor function and disabled people when climbing to the 2nd floor; 2. Surgical patients waste time going up and down stairs. 3 The doorway of the surgical room is narrow for the entry of a wheelchair. |
1. Installation of a mechanical lift on the steps of the polyclinic. 2. Transfer of surgeons' offices to the ground floor. 3. Expansion of the doorway in the surgical room on the ground floor. 4. Transferring the issue of temporary disability to the ground floor. |
|
|
Direction 3: Organization of the work of the registry |
||
|
1. Insufficient number of places for waiting. 2. Waiting time for patient card selection. 3. Low share of preliminary and remote patient registration of about 65%. 4. Information on navigation and routing does not meet the requirements of regulatory documents. 5. There is no information on the polyclinic's information boads regarding making an appointment via the Internet. 6. Absence of marking medical cards according to the precinct principle |
1. Increasing the comfort of patients' stay in the polyclinic - creation of a waiting area. 2. Zoning of the registry room with a dedicated administrator's desk and file cabinet. 3. Organization of a preliminary appointment with a doctor and diagnostic tests. 4. Creation and placement of navigation and routing. 5. Posting information about the rules of work and making an appointment via the Internet. 6. Creation of labeling of patient cards according to the precinct principle. |
|
|
Direction 4: Optimization of the process of blood sampling and procedures in the treatment room |
||
|
1. A large patient flow for procedures: procedures are carried out at the same time as injections and manipulations of blood sampling from a vein. 2. Unpredicted patient flow. 3. A large and diverse volume of analyses. 4. A live queue, a large concentration of patients and a long stay. 5. No waiting area for patients. 6. Manual registration of patients. 7. Waste of time for transportation of biological material. |
1. Optimizing the time period for blood sampling and injections. 2. Division of work among medical personnel. 3. Entering vouchers indicating a certain time and date of taking the analysis. 4. Installation of couches in the corridor for waiting patients. 6. Installation of computer equipment for electronic document management. 7. Involvement of the operator in the work for registration of directions and transportation of biological material. |
The implementation of measures will lead to a reduction of significant time losses, optimization of work processes in the provision of medical services, improvement of organizational and management points in the activities of a medical organization.
In order to implement the directions of development, it is necessary to make changes in the organization:
Regarding personnel support:
- to introduce new full-time units of medical personnel in accordance with established staffing standards;
- to analyze the staff schedule and tariff lists of all personnel, as well as analyze the positions of other non-medical personnel (personnel monitoring) with the aim of reducing them;
- to develop new measures for remuneration of a stimulating nature for medical staff due to the reduction of other staff.
According to activity indicators:
- to plan the licensing and introduction of new types of medical care: palliative medical care and geriatrics in order to expand the range of medical services and increase the available financial support from the subject's budget and the mandatory medical insurance fund;
- increasing the amount of medical aid provided at the expense of mandatory medical insurance funds, taking into account the capacity and network indicators of the organization;
- increasing the amount of medical aid provided by extra-budgetary sources (paid activities) provided that the planned amount of free medical aid is fulfilled;
- development of specialized types of aid with financing from the state and regional budgets and other targeted programs.
As part of the strategic planning implementation in the ME «MNE VCC PMSA» a system of strategic goals is being formed (Table 5).
For each indicator of strategic goals, target values for the period of strategic planning are determined, based on the capabilities of the institution and the established values of the founders for 3 years. Then monthly and quarterly monitoring of indicators is carried out to fulfill the set strategic goals.
Table 5. System of strategic goals for ME «MNE VCC PMSA»
|
Strategic goals |
Strategic goal indicators |
Target values of indicators |
|||
|
2023 |
2024 |
2025 |
|||
|
Achieving a high income |
Net income from medical services |
UAH 75 |
UAH 90 |
UAH |
|
|
level |
million. |
million |
115 million |
||
|
Achieving an increase of |
The amount of financial result based |
UAH 2,8 |
UAH 4,3 |
UAH 5,7 |
|
|
a financial results level |
on net profit |
million |
million |
million. |
|
|
Achieving an increase of the cost optimization level |
The level of profitability |
5% |
5,6% |
6% |
|
|
Achieving an increase of the effectiveness level |
Mortality rate |
14% |
13% |
12% |
|
|
Incidence rate per 1000 people |
1200 |
1150 |
1100 |
||
|
Birth rate |
11% |
12% |
13% |
||
|
Achieving an increase of |
Total score |
6,8 |
7,2 |
7,5 |
|
|
the rating level among medical organizations |
Rating |
27 |
11 |
6 |
|
|
Achieving an increase of |
The average salary of doctor's staff |
UAH |
UAH |
UAH |
|
|
the level of remuneration |
25,000. |
35,000. |
45,000. |
||
|
of medical personnel |
The average salary level of the |
UAH |
UAH |
UAH |
|
|
middle medical staff |
20,000 |
25,000 |
34,000 |
||
|
The average salary level of junior |
UAH |
UAH |
UAH |
||
|
medical staff |
15,000 |
21,000 |
28,000 |
The main task of the ME «MNE VCC PMSA» is to preserve the health and life of the population, which contributes to the improvement of the quality of life. Therefore, it is important to improve the work of the ME «MNE VCC PMSA» to ensure high-quality, specialized, highly qualified and cost-effective treatment of the population of Voznesensk and the surrounding areas. ME «MNE VCC PMSA» has all the prerequisites to become one of the leading medical organizations for treatment and diagnostics, and has the opportunity to concentrate small health care institutions around it.
The development of a system for constant monitoring of patient satisfaction, monitoring of the dynamics of the volume of medical care, analysis of necessary medical services and expansion of their list, active assistance in improving the qualifications of medical personnel, as well as timely updating of medical equipment, will make it possible to become the best health care organization among competitive private medical organizations.
We compare the indicators of social and medical efficiency calculated in the ME «MNE VCC PMSA» before the implementation of the proposed measures (year 2022) and after the implementation of the proposed measures (expected for the end of 2023) (Table 6). It can be seen from the table that in 2023, as a result of the implementation of the proposed measures, social and medical efficiency will increase in terms of indicators to a significant extent, which indicates an increase in the quality of medical care as a result of the taken measures. The qualitative and quantitative characteristics of the degree of achievement of the set tasks in the organization in the field of prevention, diagnosis and treatment of diseases are raised.
Table 6. Analysis of social and medical efficiency ME «MNE VCC PMSA»
|
Indicators |
Periods |
Indicators of efficiency |
Absolute deviation |
|||
|
2022 |
2023 |
2022 |
2023 |
|||
|
Social efficiency = The number of patients satisfied with the service / total number of respondents x100% |
||||||
|
Satisfied with the quality of medical care in general |
26 |
35 |
41,9 |
50 |
8,1 |
|
|
How do you assess the attitude of the treating doctors towards you? |
52 |
55 |
83,9 |
78,56 |
-5,34 |
|
|
Are you satisfied with the institution's material and technical equipment? |
23 |
28 |
37,1 |
40 |
2,9 |
|
|
Medical effectiveness = Number of results achieved / total number of respondents x100% |
||||||
|
The number of medical care results achieved |
32 |
44 |
51,6 |
62,9 |
11,3 |
|
|
The achieved results of the institution's work |
26 |
39 |
41,9 |
55,7 |
13,8 |
Thus, it can be concluded from the obtained data that the increase in the social, medical and economic efficiency of the ME «MNE VCC PMSA» in 2023 - after the implementation of the developed measures indicates the minimization of costs and the maximization of the quality of services in the process of providing medical care.
Conclusions. As part of the implementation of strategic planning in the ME «MNE VCC PMSA», a system of strategic goals was formed. The work on the implementation of recommended measures within the the «Lean Healthcare Institution» project was carried out, also social, medical and economic efficiency was considered to evaluate the results after the measures were implemented.
Thus, the totality of all developed recommendations will make a significant contribution to the improvement of SMD in medical institutions. In addition, it will help to develop the local methodological recommendations that will take into account regional features and the peculiarities of each specific medical organization.
References
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7. Samoilyk, Yu. V. and Pogrebnyak, L.O. (2020). «The strategy of managing the development of health care institutions in the conditions of globalization changes». Investments: practice and experience, vol. 19-20, pp. 161166.
8. Safonov, Yu. M. and Borsch, V.I. (2019), «Strategic management of health care institutions: general principles and features of application in the field of health care of Ukraine», Aktual'niproblemyekonomiky, vol. 8 (218), pp. 62-69.
Література
1. Аналіз політики охорони здоров'я: навч. посіб. / Тетяна Семигіна. - Київ: ВПЦ НаУКМА, 2012. 479 с.
2. Жалінська І.В. Громадське здоров'я: методологія оцінювання та обгрунтування політики: автореф. дис…. канд. екон. наук: 08.00.07 / І. В. Жалінська; НАН України; Ін-т демографії та соц. дослідж. ім. М.В. Птухи. Київ, 2011. 20 с.
3. Карпишин Н.І. Фінансове забезпечення охорони здоров'я в реалізації державних функцій на ринку медичних послуг: автореф. дис… канд. екон. наук: 08.00.07 / Н.І. Карпишин; Терноп. держ. екон. ун-т. Тернопіль., 2006. 21 с.
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5. Мартусенко І. В. Трансформація фінансування системи охорони здоров'я в Україні та зарубіжних країн. Проблеми економіки. 2013. №1. С. 321-325.
6. Миколаєць І.В. Методи державного регулювання надання медичних послуг та управління якістю. Публічне управління та митне адміністрування. 2017. №2 (17). С. 17-21.
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