Business game “High-tech Pediatric Surgery”: Modeling of management decisions in children’s health protection in the Far Eastern Federal District

Abstract

BACKGROUND: The difference in the levels of total infant mortality in certain administrative territorial entities of the country is an acute medical and social problem of domestic healthcare, which indicates the absence of a single standard of accessibility and quality of medical care. This indicator in the Far Eastern Federal District significantly exceeds the corresponding indicators in the Central and Northwestern districts.

AIM: This study aimed to identify unresolved problems and identify ways to improve the availability and quality of surgical care for children by modeling the process of making administrative and clinical decisions by employees of medical organizations and heads of healthcare in the Far Eastern Federal District in the interests of children in need of specialized, including high-tech, medical care, including medical evacuation.

MATERIALS AND METHODS: A “business game” with simultaneous implementation of the simulation process in 11 regions of the Far Eastern Federal District was conducted using distributed communication channels and technical capabilities of audiovisual fixation of the opinions of the study participants. A series of five business games on the following profiles were implemented: neonatal surgery, thoracic surgery, neurosurgery, oncology, and combustiology. The scenarios of the games were prepared by the organizers of the study: “Russian Association of Pediatric Surgeons” (LLC) and “Agency for Strategic Initiatives to promote new projects” (ANO). The moderators of the games were leading specialists from specialized federal medical organizations. The game participants were regional teams of the subjects of the Far Eastern Federal District. The observers of the games were representatives of federal legislative and executive authorities and healthcare experts.

RESULTS: In this study, 9–11 regions of the Far Eastern Federal District participated in a series of five games. The total number of participants in business games ranged from 126 to 151, and the number of connection points was 42–66. The identified problematic issues included organizational (9), personnel (8), transport (7), equipment (7), and financial (6) aspects.

CONCLUSIONS: The ideology of the interregional centers of specialized surgical care for children corresponds to the vision of representatives of the professional community and organizers of territorial healthcare as a promising way to increase the availability and quality of medical care to the pediatric population.

Keywords

experimental game / children / child mortality / organizational model / health services administration / quality of health care / transportation of patients

References

[1] Belchikov JM, Birshtein MM. Business games. Riga: Avots, 1989. 304 p. (In Russ.)

[2] Бельчиков Я.М., Бирштейн М.М. Деловые игры. Рига: Авотс, 1989. 304 с.

[3] Belchikov JM, Birshtein MM. Business games. Riga: Avots, 1989. 304 p. (In Russ.)

[4] Berne E. The games people play. Psychology of human relationships. People who play games. Psychology of human destiny. Transl. from Engl. Moscow: Progress, 1988. (In Russ.)

[5] Берн Э. Игры, в которые играют люди. Психология человеческих взаимоотношений. Люди, которые играют в игры. Психология человеческой судьбы / пер. с англ. Москва: Прогресс, 1988.

[6] Berne E. The games people play. Psychology of human relationships. People who play games. Psychology of human destiny. Transl. from Engl. Moscow: Progress, 1988. (In Russ.)

[7] Simulation management game: Great Russian Encyclopedia: 35 volumes / Rep. ed. S.L. Kravets. Moscow: Great Russian Encyclopedia, 2004–2017. Vol. 11. (In Russ.)

[8] Имитационная управленческая игра. Большая российская энциклопедия. В 35 т. / Отв. ред.: С.Л. Кравец. Москва: Большая российская энциклопедия, 2004–2017. Т. 11.

[9] Simulation management game: Great Russian Encyclopedia: 35 volumes / Rep. ed. S.L. Kravets. Moscow: Great Russian Encyclopedia, 2004–2017. Vol. 11. (In Russ.)

[10] Shchedrovitsky GP. Organizational-activity game. Collection of texts. Moscow: Nasledie MMK, 2004. 288 p. (In Russ.)

[11] Щедровицкий Г.П. Организационно-деятельностная игра. Сборник текстов. Москва: Наследие ММК, 2004. 288 с.

[12] Shchedrovitsky GP. Organizational-activity game. Collection of texts. Moscow: Nasledie MMK, 2004. 288 p. (In Russ.)

[13] Panova AN. History of development of business game as one of the methods of active learning. Psychology and pedagogy: methodology and problems of practical application. 2010;(17):327–332. (In Russ.)

[14] Панова А.Н. История развития деловой игры как одного из методов активного обучения // Психология и педагогика: методика и проблемы практического применения. 2010. № 17. С. 327–332.

[15] Panova AN. History of development of business game as one of the methods of active learning. Psychology and pedagogy: methodology and problems of practical application. 2010;(17):327–332. (In Russ.)

[16] Shoigu SK, editor; Ministry of Emergency Situations of Russia. Civil defense: encyclopedia in 4 vol. Vol. II (K-O). Moscow: ZAO FID «Delovoi ehkspress», 2007. (In Russ.)

[17] Гражданская защита: энциклопедия в 4-х т. Т. II (К–О) / под ред. С.К. Шойгу; МЧС России. Москва: ЗАО ФИД «Деловой экспресс», 2007.

[18] Shoigu SK, editor; Ministry of Emergency Situations of Russia. Civil defense: encyclopedia in 4 vol. Vol. II (K-O). Moscow: ZAO FID «Delovoi ehkspress», 2007. (In Russ.)

[19] Rozinov VM, Morozov DA, Rumyantsev SA, et al. Interregional centers of high-tech children’s surgery – mortgage of accessibility and quality of medical care for Russian children. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(3):6–17. DOI: 10.30946/2219-4061-2018-8-3-6-17

[20] Розинов В.М., Морозов Д.А., Румянцев С.А., и др. Межрегиональные центры высокотехнологичной детской хирургии — залог доступности и качества медицинской помощи детям России // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2018. Т. 8, № 3. С. 6–17. DOI: 10.30946/2219-4061-2018-8-3-6-17

[21] Rozinov VM, Morozov DA, Rumyantsev SA, et al. Interregional centers of high-tech children’s surgery – mortgage of accessibility and quality of medical care for Russian children. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(3):6–17. DOI: 10.30946/2219-4061-2018-8-3-6-17

[22] Rozinov VM, Morozov DA, Rumyantsev SA, et al. Interregional centers for specialized pediatric surgical aid in Russia — profile and dislocation. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2019;9(1):8–16. DOI: 10.30946/2219-4061-2019-9-1-8-16

[23] Розинов В.М., Морозов Д.А., Румянцев С.А., и др. Межрегиональные центры специализированной хирургической помощи детям России — профиль и дислокация // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2019. Т. 9, № 1. С. 8–16. DOI: 10.30946/2219-4061-2019-9-1-8-16

[24] Rozinov VM, Morozov DA, Rumyantsev SA, et al. Interregional centers for specialized pediatric surgical aid in Russia — profile and dislocation. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2019;9(1):8–16. DOI: 10.30946/2219-4061-2019-9-1-8-16

[25] Rozinov VM, Morozov DA, Rumyantsev SA, et al. The rationale for dislocation of interregional specialized surgical care centers for children in the Russian Federation. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(3):263–274. DOI: 10.17816/psaic694

[26] Розинов В.М., Морозов Д.А., Румянцев С.А., и др. Обоснование дислокации межрегиональных центров специализированной хирургической помощи детям в Российской Федерации // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2020. Т. 10, № 3. С. 263–274. DOI: 10.17816/psaic694

[27] Rozinov VM, Morozov DA, Rumyantsev SA, et al. The rationale for dislocation of interregional specialized surgical care centers for children in the Russian Federation. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2020;10(3):263–274. DOI: 10.17816/psaic694

[28] Isakov YuF. Modern aspects of pediatric surgery. Act speech. Moscow: AMN SSSR, 1978.

[29] Исаков Ю.Ф. Современные аспекты детской хирургии. Актовая речь. Москва: АМН СССР, 1978.

[30] Isakov YuF. Modern aspects of pediatric surgery. Act speech. Moscow: AMN SSSR, 1978.

[31] Kassif E, Weissbach T, Kushnir A, et al. Esophageal atresia and tracheoesophageal fistula: prenatal sonographic manifestation from early to late pregnancy. Ultrasound Obstet Gynecol. 2021;58(1):92–98. DOI: 10.1002/uog.22050

[32] Kassif E., Weissbach T., Kushnir A., et al. Esophageal atresia and tracheoesophageal fistula: prenatal sonographic manifestation from early to late pregnancy // Ultrasound Obstet Gynecol. 2021. Vol. 58, No. 1. P. 92–98. DOI: 10.1002/uog.22050

[33] Kassif E, Weissbach T, Kushnir A, et al. Esophageal atresia and tracheoesophageal fistula: prenatal sonographic manifestation from early to late pregnancy. Ultrasound Obstet Gynecol. 2021;58(1):92–98. DOI: 10.1002/uog.22050

[34] Pedersen RN, Calzolari E, Husby S, et al. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch Dis Child. 2012;97(3):227–232. DOI: 10.1136/archdischild-2011-300597

[35] Pedersen R.N., Calzolari E., Husby S., et al. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions // Arch Dis Child. 2012. Vol. 97, No. 3. P. 227–232. DOI: 10.1136/archdischild-2011-300597

[36] Pedersen RN, Calzolari E, Husby S, et al. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch Dis Child. 2012;97(3):227–232. DOI: 10.1136/archdischild-2011-300597

[37] Moulton SL, Recicar JF Jr, Bensard DD. The system of care for injured children in the state of Colorado and the rocky mountain region of the Western United States. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(4):6–13. DOI: 10.30946/2219-4061-2018-8-4-6-13

[38] Moulton S.L., Recicar J.F. Jr., Bensard D.D. Система организации травматологической помощи детям в регионе Скалистых гор на западе США // Российский вестник детской хирургии, анестезиологии и реаниматологии. 2018. Т. 8, № 4. С. 6–13. DOI: 10.30946/2219-4061-2018-8-4-6-13

[39] Moulton SL, Recicar JF Jr, Bensard DD. The system of care for injured children in the state of Colorado and the rocky mountain region of the Western United States. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2018;8(4):6–13. DOI: 10.30946/2219-4061-2018-8-4-6-13

Funding

НКО «Агентство стратегических инициатив по продвижению новых проектов» и осуществлена при организационно-технологической поддержке ОООNGO “Agency for Strategic Initiatives”NGO “Agency for Strategic Initiatives”

ООО «Мобильная медицина»Mobile Medicine LLCMobile Medicine LLC

Ассоциации ФБМFBM AssociationFBM Association

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