Project approach to the control the process of the provision of the health care to cases with cardiovascular diseases at the outpatient level

Introduction. Many hospital departments are involved in a single technological cycle of ensuring the quality of medical care. The discrepancy between the work of any of the divisions and patient expectations affect the perception of the medical service provided as a whole. Implementing project approach in medical care delivery process ensures its effectiveness and increases patient satisfaction.

Aim: to describe the experience of using project approach to improve temporal characteristics of outpatient cardiological care services.

Material and methods. Primary medical sanitary service (PMSS) and cardiovascular care provided at the polyclinic were the object of the study. Problems affecting patient satisfaction were the subject of the study; the patients of the polyclinic were followed for the purposes of this study. Expert assessments, survey, mapping analytical and statistical methods were used in the study. The group of patients was formed according to the following criteria: undergoing scheduled appointment with a physician, having the following complaints including elevated blood pressure, periodic chest pain or heart arrhythmias, provided informed voluntary consent to participate in the study.

Results. According to the analysis of patients, opinion on the PMSS provided at the polyclinic — 20% of patients were “rather not satisfied” with services provided by a cardiologist, and 30% of patients were “rather not satisfied” with services provided by a physician. Patients reported the time spent waiting to a group of experts working on the National Social Initiatives. All types of patients, “time losses” were recorded in detail. Process mapping enabled us to establish the following stages: booking an appointment with a physician; undergoing examination; booking an appointment with a cardiologist and undergoing examination; follow-up examination; booking an appointment a cardiologist, undergoing examination, treatment prescription; follow-up examination. The experts identified the problems at each stage and formed proposals to increase the accessibility of outpatient care.

Limitations of the study. There are several limitations of this study: it was a short-term study, the patient assessments of the situation can be subjective, and there was a small number of events involved in the process mapping.

Conclusion. The project approach allows specialists to identify problems and their causes, identify areas for improvement, and develop and implement appropriate corrective measures.

Compliance with ethical standards. The needs of people in different life situations, and the obstacles that they face while trying to satisfy them were analyzed within the framework of the National Social Initiative (NSI) in the Kemerovo region. The study does not require the submission of approval of the Institutional Review Board or other similar documents (protocol dated 10.06.2020, No. 12). The survey of patients was conducted only in case of receiving their voluntary informed consent to participate in the study.

Contribution of the authors:
Artamonova G.V. — made substantial contributions to conception and design, revised the manuscript critically for important intellectual content;
Batsina E.A. — made substantial contributions to data acquisition and processing, drafted the article, participated in the project implementation;
Danilchenko Ya.V. — made substantial contributions to data acquisition and processing, drafted the article, participated in the project implementation;
Makarov S.A. — contributed to data acquisition and processing, participated in the project implementation;
Strokolskaya I.L. — contributed to data acquisition and processing, participated in the project implementation.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgement. The study had no sponsorship. 

Conflict of interest. The authors declare no conflict of interest.

Received: April 14, 2021
Accepted: October 14, 2021
Published: July 06, 2023