Transformation

Step taken: the first clinical academic departments created

In accordance with the Nazarbayev University Strategy and pursuant to the UMC Strategic and Operational plans for 2019-2023, as well as being guided by the recommendations of The University of Pittsburgh Medical Center (UPMC) strategic partner for transforming the UMC into an academic medical center (AMC), work continues on the first stage of the transformation of UMC into AMC. In this regard, changes have made to the structure of the UMC: from May 1, 2019, 2 Clinical academic departments (CAD) have created as a pilot project: the Women’s Health CAD and the Pediatrics CAD.

The creation of the CAD is based on the main components of integration:

  • Joint management;
  • Effective organizational structure of AMC;
  • Unified information system, programs;
  • Unified and flexible financing system;
  • Human resources management system.

In the April of next year, the following five CADs will have also created in a pilot mode on the basis of the Republican Diagnostic Center and the National Research Center for Maternal and Child Health:

  1. Clinical academic department “Surgery”;
  2. Clinical academic department “Internal Medicine”;
  3. Clinical academic department “Laboratory Medicine and Pathology”;
  4. Clinical academic department “Radiology and Nuclear Medicine”;
  5. Clinical academic department “Anesthesiology and Intensive Care”;

A separate service will be allocated – Nursing.

CAD will have headed by a director (chair) – the most experienced and qualified employee with a higher medical education with specialization corresponding to the profile of the CAD. A director will have appointed following an open tender.

Depending on the scale, it is planned to envisage the posts of clinical activity deputies, executive administrator, and managers in each CAD. The number of deputies for the head of the CAD is from 0 to 3 units, managers are 1-2 units. At the same time, “double” posts are provided.

CAD is a functional structure that combines the clinical departments of the hospital and outpatient care according to the profile of medical services.

Currently, the functions of the directors of the CADs are performed by the heads of departments – acting, who carry out all the necessary activities within the framework of the transformation:

Within the framework of the activity of the CAD, in order to improve the quality of clinical activity on the basis of international and national standards of quality and safety of patients, the most important areas of development of each CAD are identified – “Growth points”. In total, about 45 Growth points were determined for all the CADs.

From April, 2020, it is planned to operate all the CADs, for that based on matrix management the UMC structure draft has been prepared.

To reduce managerial risks when introducing a new structure in the remaining period until the end of this year, a number of measures will be required:

  • Redistribute the flows of business processes, excluding their duplication (planning, quality control, finance, procurement of medicines, medical devices, medical equipment, reports);
  • Redistribution of functions and staff of doctors, nurses, other personnel, taking into account the unification and coordination of the activities of clinicians in the CAD;
  • Rational distribution of functions for the implementation of educational and research programs in the directions of the CADs;
  • Carrying out the current analysis of the activity of the CAD;
  • Refining and implementing CADs’ strategies;
  • Development of issues related to the integration of information technology and electronic medical records;
  • Testing the system (information) management for the schedule of doctors and other medical personnel, performance evaluation of structural units;
  • Development of retention and recruiting systems for medical and administrative personnel;
  • Determining the priority amount of financial resources required to launch and develop services at Growth points with a clear plan (roadmap) for launching and developing new services;
  • Implementation of continuous monitoring and control of the implementation of roadmaps.

All ongoing activities are based on the general ideology of the CAD, as a key mechanism in the construction of an academic medical center.

The planned reforms will allow reaching a qualitatively new level and ensuring the training of highly specialized competitive specialists in the field of healthcare through the implementation of advanced educational technologies; effective clinical activities based on international and national standards of quality and patient safety; development of research capacity.

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Close and productive collaboration with UPMC

Since 2018, the “Nazarbayev University” Autonomous organization of education (hereinafter referred to as the University), together with University of Pittsburgh Medical Center (UPMC), began cooperation on the transformation of “University Medical Center” Corporate Fund (UMC) into the Academic Medical Center.

UPMC is one of the leading Academic Medical Centers in the USA and its development experience will certainly be very useful for creating such a center at the University based on UMC.

In the United States, as the competitiveness of the national and global economies increases, the emphasis in the field of healthcare is shifting more and more towards public health and economically viable treatment. These changes have led to the transformation of the healthcare model from a fragmented into a systemic, aimed at a coordinated, value-oriented model.

The Academic Medical Center (AMC) is a solution for all components of the value system in the field of healthcare, namely: high quality, positive treatment results, reduced costs and improved access to medical care. AMC is characterized as an institution that performs the threefold task of training, research and medical work. AMC includes one or several academic clinics and a school of medicine and is a center for training medical students and medical training for residents, undergraduates, and doctoral students. In addition, in order to improve medical care, AMC receives patients from the hospital system for conducting scientific and / or commercial studies in humans in compliance with the strictest international ethical rules.

At AMC, the scope of services where the patient can receive various directions within the hospital throughout the course of treatment is expanding. Moreover, representatives of numerous multidisciplinary groups, taking into account the results of the most relevant studies, thereby reducing the discrepancies in the clinical practice of various medical institutions and individual doctors, as well as developing treatment algorithms based on data analysis and the achievements of evidence-based medicine, make decisions. Due to the fact that medical education and training are an integral part of AMC services, a culture of continuous education and research is being formed, which creates a favorable atmosphere for innovation and progress.

The advantages of the AMC model are also convincing from the point of view of the healthcare system. Resources that are more powerful provide the opportunity for diversified development and elimination of the risk associated with dependence on a small number of services offered. The larger scale of the system will help to reduce costs in the procurement of supplies, technologies and services of suppliers. AMC provides an opportunity to solve many of the existing health problems in advance.

In 2018, specialists from the University, UMC and UPMC worked on a new UMC Strategic plan for the period 2019-2023, a draft for roadmap implementation, discussed the creation of clinical academic departments, preparation of residency programs in basic clinical specialties (therapy, surgery, obstetrics and gynecology, pediatrics), improving the activities of the nursing service.

In 2019, UPMC collaborates with the University and UMC in improving and strengthening the corporate governance system, including the development and updating of corporate governance policies, in the implementation of a new organizational structure for UMC, which centralizes certain functions to optimize cost reduction and increase efficiency. With the support of UPMC, quality improvement and standardization of the UMC personnel management function are planned. UPMC will also develop a financial strategy for UMC, which will allow it to become a financially sustainable organization.

This year, work to create clinical academic departments at the UMC in the main directions of the medical services provided as specialized clinical units designed to ensure the integration of clinical, educational and research activities is being carried out. Based on the created departments, academic and scientific activities will have carried out jointly with the School of Medicine and other schools, research centers of the University and the republic. In the future, this experience will have broadcasted to other university clinics in the country. Based on the established clinical academic departments, a financial responsibility mechanism will have implemented, which will improve the motivational mechanisms for remuneration of medical personnel.

As part of the partnership, a joint development of the concept and a feasibility study is carrying out to create a clinical translation research center based on UMC, which will allow testing relevant biomedical technologies in the world with the subsequent dissemination of successful results.

The University plans to launch UMC-based interventional pharmaceutical clinical trials with UPMC.

The realization of the program to improve the quality of treatment and patient safety is a separate priority of the University and UMC. One of the ways to achieve this goal is to improve and develop nursing care.

 Collaboration with UPMC will have continued with the goal of transforming UMC into an academic medical center close to the best international standards.

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