Clinic work organization: structure and services of the clinic, general principles of work organization

The health care system has not been created from scratch. It is based on a specific organization. To understand what and how it works, it is necessary to study the structure and tasks performed, to master the methodology for assessing general performance indicators so that in the future the information received can be used for analysis and planning. And in this, feasible help will be provided by the organization of the clinic's work.

Introductory information

Start here from a distance. Speaking about what a polyclinic is, the structure and organization of its work, it is necessary to initially affect primary health care (PHC). This is the first level of public contact with the entire health care system. Its feature is the maximum proximity to the place of residence and work of people.

It is at the first stage of an ongoing health process for individuals. Their territorial accessibility is ensured thanks to the rational distribution of medical facilities, and at the same time, the prevailing system of people settlement, prospects, and other various factors are taken into account. Primary care is formed from outpatient, emergency and general. It is designed to meet the following needs: to promote health, provide treatment, rehabilitation, health education. The greatest interest in the article is a clinic for adults and children. The principles on which their work is built are relevant here:

1. Compulsory health insurance for all citizens who live in the country.
2. The unity of preventive and therapeutic measures.
3. General Availability of PHC.
4. Dispensary method of activity.
5. The principle of plots. About him a little more. Sites can be: territorial, workshop, general practice, family, gynecological, pediatric and rural.

What can be polyclinics?

First of all, it should be remembered that this is a multidisciplinary universal medical institution. It is intended to provide medical care to people in need. The organization of the clinic should certainly take this into account. Moreover, it is necessary to ensure that work is carried out at the prehospital stage, and measures are taken to improve the health of people. On an organizational basis, they are divided into those that include a hospital, and those that are not combined with it. In terms of coverage, they are:

1. I category. Provide 1,200 visitors per shift. Used to serve 100-120 thousand people.
2. II category. 750-1200 visitors per shift. Used to service 80-100 thousand people.
3. III category. 500-750 visitors per shift. Used in servicing 50-79 thousand of the population.
4. IV category. 250-500 visitors per shift. Used in the service of 18-49 thousand of the population.
5. V category. Up to 250 visitors per shift. Provided for settlements in which live up to 17 thousand of the served population.

Such a separation allows you to select the required number of specialists, providing them, as well as additional functionality - for example, a hospital.

How do they work?

The regime for medical institutions is established by the local authority in whose subordinate territory it is located. This takes into account the ability of the population to visit the clinic in their free time. The most rational is work from 08:00 a.m. to 20:00 p.m. on weekdays, and on weekends and holidays from 09:00 to 16: 00-18: 00 hours. However, a six-day workweek is most preferred.

This approach allows you to create favorable conditions for the distribution of people attendance by day of the week in an even amount. The work of the on-site therapist, specialist doctors, as well as auxiliary diagnostic and treatment services are envisaged. But what about on weekdays? In such cases, the schedule of nursing staff and doctors is formed on a two and three-shift mode of operation, as well as on a rolling schedule. This is to ensure that the population is provided with emergency medical care at a convenient time.

What tasks are performed?

The organization of the clinic should be carried out in such a way that the following tasks are solved:

1. Providing in the clinic and at home qualified and specialized medical care.
2. Organization and implementation of preventive measures - sanitary-educational work, medical examination of the population, anti-epidemic campaigns, promotion and promotion of a healthy lifestyle.
3. High-quality implementation of clinical expert work - temporary examination and identification of signs of persistent disability of individuals.
4. Timely hospitalization of people who need in-patient treatment during the preliminary maximum examination.
5. Maintaining continuity with other health care facilities.

Carrying out all these tasks, the clinic provides first and emergency medical care to needy patients in case of acute and sudden illnesses, poisoning, injuries and other accidents. She can organize the provision of medical care to patients at home who, due to their health and the nature of the disease, cannot visit the institution and need bed rest. In this case, systematic medical supervision or hospitalization is necessary. Separately, it is worth noting the early detection of diseases, which is possible thanks to a qualified and complete examination of all those people who go to the clinic.

About the difference in target groups

Separately, it is worth mentioning the institutions that should work with children and adults. Such a separation is carried out due to the difference in the observed problems, the required attention to the sick, and many other reasons. Thus, the organization of work of an adult clinic is easier because of the less capriciousness of patients and their greater organization. At the same time, it is necessary to take into account that there are more adults, and many diseases can be classified as those that appear with age.

While the organization of the children's clinic requires a more careful approach. In babies and in adolescence, the first symptoms often manifest, and if they can be eliminated in time along with the causes, then often a person is saved from a sad fate for his whole life. Therefore, they are planned to be given more attention and time to examine and identify even the smallest hints of possible problems. The organization of the children's clinic requires that all health deviations can be determined and resolved promptly. That is, when problems are identified, they must be eliminated. If it is difficult to make an accurate diagnosis, but there is suspicion or confidence that something bad is expected, the child is sent for an additional examination.

What about the structure?

It includes an administrative, medical and preventive and economic part. The first refers to the offices of the head physician, his deputies, head nurse, medical statistics, accounting and the personnel department.

Who provides the main leadership? This responsibility is assigned to the chief physician. Its main tasks: to organize qualified and specialized medical care for people. In addition, he is responsible for the implementation of measures aimed at preventing and reducing infectious and general morbidity, disability, temporary disability, mortality and improving forms of service for people who apply.

The organization of the work of the clinic in terms of the treatment and preventive part is arranged in such a way that it begins with the registry. In it there is an urgent and preliminary appointment of sick people for an appointment with the right doctors. The organization of the clinic's registry work suggests the ability to do this both by telephone and in person. This approach allows you to regulate the flow of people seeking medical help. And as a result, a uniform load of doctors is created. In addition, a number of organizational issues are being addressed. For example, timely collection is carried out with the subsequent delivery of medical records to the doctors office, as well as their correct layout in the store. The main and, as a rule, the first doctor who is contacted by people is a local therapist. This post is assigned to specialists who have received higher medical education in the specialties "Pediatrics" and "General Medicine".

So what's next?

The organization of the work of the doctor in the clinic is designed in such a way that therapists initially determine which area the existing problem belongs to. And then they were already referred to specialized specialists (if necessary) or treatment was prescribed (if this is within their competence).

At the same time, the organization of the work of the nurse of the clinic is important, the presence of which can greatly simplify and speed up the process of serving the population and considering their health complaints. You can shift bureaucratic moments onto it, such as filling out a visit journal, extracting documents, and the like.

If necessary, the patient is referred for diagnosis or inpatient / outpatient treatment. For example, in the manipulation room. If a significant problem is observed and, according to local experts, it is not possible to solve it in the existing conditions, then a choice is made in favor of centers for the study of pathologies. The economic part is engaged in ensuring all this activity, which deals with the supply of everything necessary. These include accounting, as well as the department of material support. It should be noted that often all functions are assigned to one person. This is due to the fact that you have to maintain a not very large organizational structure. Thanks to this, there is no need to keep a large staff for all needs.

Case Study

Let's pay attention to how and what needs to be provided in order to ensure the full implementation of professional duties. As an example, the organization of work of the vaccination room of the clinic will be considered.

Disease prevention is an important matter. Some can be fought by tempering and leading a healthy lifestyle. With others, this does not work, and the only possible way is vaccination. They imply the introduction of weakened or dead causative agents of the disease, so that the body "in the conditions of the sandbox" practiced to kill them. Therefore, the organization of work of the vaccination room of the clinic includes, at a minimum, the provision of necessary drugs. In addition, you need to take care of more syringes, cotton, medical alcohol. But often this is not carried out, and similar articles of expenses fall on the shoulders of the people themselves who are vaccinated. The best situation in this regard is when serving children. If you need to check them, then, as a rule, there is pretty good provision here. For example, organizing the work of the vaccination room of a children's clinic when leaving for school for Pirke’s test (Mantoux test), provides for the delivery of not only drugs, but also aids for their administration (the same syringes, fleece, alcohol). Injections are a fairly simple, but very understandable example, which allows us to imagine how things are going in this area.

How do individual specialized structures work?

When it comes to a clinic, first of all thoughts come to mind about the institution in which doctors from different directions are located. But it's not always the case. A simple example is the dental clinic. Of course, a specialist in teeth can also be found in other structures, but they are usually designed for the most insignificant and simple operations, such as repairing minor injuries, brushing your teeth or even just examining them. If there is a significant problem (it is necessary to clean the canals, the inflammation is clear, caries has left almost nothing from the bone unit), then specialized multifunctional equipment or the services of specialized specialists may be needed. For example, dental surgeons.

The organization of the dental clinic is fundamentally similar to a regular institution. Differences arise to a greater extent when ensuring its activities. So, for example, the question is about the purchase of specialized equipment, medications, painkillers and many other similar issues. For example, an x-ray device for a dental jaw. And in all other aspects: the head doctor and nurse, reception desk, housekeeping - all this is no different.

Conclusion

So it was examined how the work of these institutions was established, what services are involved, their activities, as well as certain specific points. As you can see, they are focused on a large population. If it is not enough, then instead of polyclinics, feldsher points or family doctor's offices are often used. Therefore, when they talk about her, they always mean that she is not in the village. It is more correct to talk about what the organization of the city polyclinic's work is, but since they are all located in large settlements, then making such a clarification is superfluous. Although maybe someone does not agree with this. Here is a clinic. The structure and organization of work of this institution are quite understandable and have been discussed above.