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The new standard of emergency medical care in Moscow will increase its quality and efficiency

📅 31 August 2022

More than a thousand ambulance teams are on duty in Moscow, helping 10 thousand Muscovites every day. And in a year the ambulance makes more than four million trips. More than a million patients receive emergency care in hospitals every year. But technological and logistics solutions for providing emergency care in a number of capital hospitals are not unified. In this regard, doctors in Moscow are developing a new unified standard for emergency care, which will help improve its quality, speed and efficiency.

The new standard takes into account all aspects — the new infrastructure of ambulance complexes, their modern equipment, clear algorithms for each emergency case, a unique training program for health workers and psychological assistance for patients and their relatives.

The creation of the standard began four years ago and is taking place in several stages. Since 2018, the design and construction of six new emergency hospitals with a total area of 100 thousand square meters has been underway. These are unique medical institutions that have no analogues in Russia. They are focused only on providing emergency medical care, include helipads, high-tech operating rooms, comfortable conditions for patients, their relatives and staff, as well as a doctor-to-patient concept for diagnostics at the patient's bedside.

At the second stage (2021-2022), specialists develop and test a new standard, and also form teams of ambulance complexes. Leading doctors of various specializations have worked out detailed algorithms for each member of the interdisciplinary team — from a nurse to a neurosurgeon — in each of the possible cases of emergency care. The standard also provides for requirements for the level of professional training of health workers, training and skills development at a special training site.

The third stage is planned for 2023 — the actual transition of new medical institutions to work according to the standard. This means two thousand new employees, more than 600 beds (half of them are intensive care units), the ability to receive more than 1,500 patients per day (more than 500 thousand patients per year).

One of the new ambulance complexes is being built on the territory of the V. M. Buyanov City Clinical Hospital. Igor Vlasov, deputy for emergency care at the medical institution, said that the principles and algorithms of the standard will allow emergency medical care in the city to be brought to a qualitatively new level

“The multidisciplinary approach of the new standard will allow for an individual approach to the treatment of each patient. After all, any of the patients coming to us may have some kind of concomitant disease. And the most important thing in this case is to competently organize the interaction of all specialists to help one person,” Vlasov said.

What is the new Moscow standard of emergency care:

1. Unified medical algorithms — include a clear mechanism of action for each health worker, uniform standards for diagnosis and research in any emergency situation. This will help employees understand who should do what at what time. The algorithms are developed taking into account the use of digital solutions and the latest equipment of ambulance complexes. Each of the algorithms will be worked out to the point of automation, which will make it possible to provide assistance more effectively.

2. High professionalism in teamwork is an interdisciplinary approach, uniform requirements for the professional training of employees, a specially created standard of the educational program for training new employees and strong communication skills of everyone.

3. A unified standard of equipment — more than 10 thousand units of the latest medical equipment: CT, MRI, angiographs, hybrid complexes for operating rooms, expert-class ultrasound, navigation systems, endoscopic and laboratory equipment, equipment for the intensive care unit. There are also 60 high-tech operating rooms, some of which are unique hybrid ones that have no analogues in Russia. They are necessary to perform complex surgical, neurosurgical, vascular, trauma and cardiac surgery. The possibilities for carrying out such operations will increase several times.

4. Advanced digital solutions are a unified digital platform for Moscow healthcare with the integration of ambulance, disaster medicine center, air ambulance, hospitals and outpatient services. The principle of a “digital hospital”, when all medical documentation is kept electronically with doctor access to it at any time of the day. A digital patient assessment system that helps doctors determine the severity of incoming patients. Artificial intelligence technologies and telemedicine consultations with augmented reality with doctors from the critical care center will also be introduced.

5. The standard for organizing emergency care complexes is the unified principles of distributing patients into functional areas depending on the severity of the condition, performing all diagnostic procedures at the patient’s bedside without moving the patient between rooms, as well as a convenient layout of the premises, their interior and intuitive navigation systems.

6. Patient focus – for the first time, hospital teams will have social coordinators to perform non-medical functions. In addition, a special visual analogue scale will help assess pain, and the most modern protocols will be used for pain relief — skin, local anesthesia, painkillers in the form of a nasal spray and injections.

The standard also provides for psychological assistance for patients, assistance in solving important everyday issues during hospitalization, assessment of the need for social assistance after discharge and, if necessary, the ability to call a taxi.

As part of the patient-oriented approach, the functions of the standard are also aimed at relatives of patients, namely: a contact center for obtaining information about the condition and planned manipulations with the patient, comfortable waiting areas, cafes and psychological support rooms.

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