Gorgiladze N, Zoidze E, Gerzmava O
Grigol Robakidze University, Tbilisi, Georgia.
Georgian Med News. 2020 Sep(306):188-193.
Accordingly, the purpose of the actions taken by the state services in the field of health care is mainly to avoid the negative consequences of healthcare services. Despite advances in modern medicine, millions of people around the world die each year as a result of medical errors, and patient safety remains a relevant and topical issue. Various regulations, guidelines, laws, standards and guidelines, effects of evidence-based medicine and Best Practice provided to improve patient safety. Data about medical errors show that 50-70.2% damage can be reduced with a systemic and sophisticated approach to patient safety. Like the rest of the world, providing high-quality healthcare services is one of the most significant and problematic issues in the healthcare system of Georgia. Despite the competitive environment in the healthcare market, there are no fundamental shifts in terms of quality assurance. There are several difficulties with the management and quality control of healthcare facilities. Unfortunately working on quality assurance, management and improvement is not a priority; For avoiding undesirable consequences, preventive measures are not considered as an essential approach; The directive standards and quality indicators almost are not created and what exists are sufficient. Effective interrelationships have not been achieved between critical components of quality assurance, such as technical competence, accessibility, efficiency, safety, effectiveness, continuity, etc. The structural units of the quality management system in the healthcare facilities are mainly focused on making the medical documentation under the norms required by the legislation. Methods for monitoring, measuring, analyzing and evaluating of the quality management system have not been well organized. In case of discrepancies, Instead of defensive measures to prevent the recurrence of the same defect, the main forces are directed to correct the unit cases and achieve compliance with the established norms. Establishment of a quality control system for healthcare organizations, development and implementation of quality indicators, and considering for continuous improvement requires a specific and multifaceted approach.
因此，国家卫生保健服务部门采取行动的目的主要是避免医疗服务产生负面后果。尽管现代医学取得了进步，但全球每年仍有数百万人因医疗差错死亡，患者安全仍然是一个相关且热门的问题。为提高患者安全，出台了各种法规、指南、法律、标准和准则，以及循证医学和最佳实践的成果。有关医疗差错的数据表明，采用系统且完善的患者安全方法可减少50%-70.2%的损害。与世界其他地区一样，提供高质量的医疗服务是格鲁吉亚医疗体系中最重要且最具问题的问题之一。尽管医疗市场存在竞争环境，但在质量保证方面并未发生根本性转变。医疗设施的管理和质量控制存在若干困难。不幸的是，致力于质量保证、管理和改进并非优先事项；为避免不良后果，预防措施未被视为基本方法；几乎未制定指令性标准和质量指标，现有的也不充分。质量保证的关键要素（如技术能力、可及性、效率、安全性、有效性、连续性等）之间尚未实现有效的相互关系。医疗设施质量管理体系的结构单元主要侧重于按照立法要求的规范制作医疗文件。质量管理体系的监测、测量、分析和评估方法组织得并不好。出现差异时，主要力量不是采取防御措施防止同一缺陷再次出现，而是用于纠正个别案例并使其符合既定规范。建立医疗组织的质量控制体系、制定和实施质量指标以及考虑持续改进需要采取具体且多方面的方法。
