Lusine Danielyan Yerevan State Medical University Head of Therapeutic and Preventive Medicine Department, Ph.D.

Lusine Danielyan Yerevan State Medical University Head of Therapeutic and Preventive Medicine Department, Ph.D.

Jönköping Your country is wonderful and I am very happy to be hosted here

@M2014 YSMU Clinics Ակնաբուժական կլինիկա Վնասվածքաբանության և օրթոպեդիայի կլինիկա

«Heratsi» N1 Hospital Complex Clinics Number of beds 1 Clinic of Surgery 24 2 Clinic of Traumatology and Orthopedics 16 3 Clinic of General and Endovascular Neurosurgery 15 4 Clinic of General and Invasive Cardiology 43 5 Clinic of Anesthesiology and Intensive Care 19 6 Clinic of Maxillofacial Surgery and ENT diseases 11 7 Clinic of Plastic Surgery and Microsurgery 16 8 Clinic of Allergology and Clinical Immunology 20 9 Clinic of Therapy 18 10 Clinic of Ophthalmology 16 11 Clinic of Urology 4 12 Emergency department 4 Total 206

«Muratsan» University Hospital Clinics Number beds 1 Clinic of Endocrinology 17 2 Clinic of Pediatric Traumatology and Orthopedics 12 3 Clinic of Paediatrics N1 37 4 Clinic of Paediatrics N2 28 5 Clinic of Therapy 12 6 Clinic of Cardiology and Intensive Care 23 7 Clinic of Chemotherapy 26 8 Clinic of Toxicology and Paediatric Reanimation 14 9 Clinic of Pediatric Maxillofacial Surgery and ENT diseases 13 10 Clinic of Paediatric Surgery 12 11 Clinic of Pediatric and Neonatal Reanimation 29 12 Emergency department 7 Total 230 of

Ensures the clinical network between different departments Checks the medical records Analyzes the results of medical records Evaluates the quality of care Coordinates the contribution of e- health program Participates in the development of methodological guidelines Makes different records and reports Makes the scientific research

to analyze medical records and evaluate the quality of care at University Clinics

The end of 2013

surgery, therapy, general and invasive cardiology, allergology and immunology, plastic and microsurgery, traumatology and orthopedics, maxillofacial surgery, general and endovascular neurosurgery, ophthalmology.

The following defects were identified: Low quality of collecting anamnesis -32% Incomplete volume of patients physical examinations -28% Laboratory and instrumental methods of examination were implemented not in full scale and not in due time -15% In some cases there was no recorded diagnosis on the course of treatments -17 % Anesthesiologist s checkup before surgical procedure wasn't recorded - 9% Correction of therapeutic actions after the performed round and examination of the patient weren't indicated -7%.

«Heratsi» N1 Hospital Complex 2014 % 2015 % Clinic of Surgery 30 22,2 Clinic of General and endovascular neurosurgery 56 38,4 Clinic of Traumatology and Orthopedics 37,5 16,6 Clinic of Maxillofacial Surgery and ENT diseases 20 9 Clinic of General and Invasive Cardiology 29,7 20 Clinic of Maxillofacial Surgery and ENT diseases 21,9 8,6 Clinic of Therapy 55,1 6,6 Clinic of Allergology and Clinical Immunology 42,2 28,5 Clinic of Ophthalmology 11,2 5,5

Based on the results of the integrated evaluation of medical care quality, the more common errors have been identified: low-quality collection of anamnesis -32%, insufficient quality of documentation -34%, lengthening the period of inpatient treatment -7%.

According to the research, work organization level rises in case of medical records continuous review, since the amount of incomplete medical histories has decreased for 33.1% due to continuous reviews. 120 100 80 60 40 20 0 2014 2015 2014 2015

Continually reviewing medical records gives an opportunity to prevent possible problems in medical, administrative-legal and financial fields.

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Highly important is the fact that it provides with an opportunity to not only correct, but also to prevent the errors.

OUR PERSPECTIVE To have a quality we need a long journey and we will always be on the way Those balloons are our Microsystems and we make a big and beautiful tree with our improvement work.

For continuing improvement work we need To find new solutions we need to look at the existing problems with new eyes

Thank you for your attention and hospitality! Lusine Danielyan