Aim This study's aim was to describe the development of new management structures for nursing services in pilot public healthcare organizations in the Republic of Kazakhstan by focusing on cultural change from the former Soviet system to the modern nursing management system. Background Because organizational culture plays an essential role in developing nursing management processes, the challenge in Kazakhstan is to change the deep‐rooted Soviet administration practices, such as top‐down management and the absence of a career structure in nursing, to meet the new public management system's requirements. Method Participatory method was used to generate organizational culture change in 31 pilot organizations. Results The organizational structures were reorganized with new nursing positions. Changes concerning nurses' job descriptions and educational requirements were introduced to the legislation. Workforce planning and work division between the healthcare professionals were suggested, allowing new operational functions for nurses. The implemented changes facilitate the culture change in the healthcare and nursing service system. Conclusion The shift of healthcare organizations towards a modern nursing management system has started in Kazakhstan. Implications for Nursing Management Good understanding and competence of cultural issues related to the change processes are critical in countries that are undergoing fundamental reforms in their healthcare systems.
Background Employment of graduates of medical universities is one of the traditional problems of health care in the Republic of Kazakhstan (RK). The annual graduation of medical universities of RK exceeds 4500 young specialists. Despite this, as well as the positive dynamics of employment, the health care industry continues to experience a shortage of medical personnel. Methods To take effective measures to improve the employment performance of graduates of medical education organizations, to cover the shortage of medical personnel, an analysis was made of the employment of graduates of internship programs at 8 medical universities for the period from 2014-15 to 2016-17 school years Results For three years, medical schools of RK prepared 12019 people, of whom 8921 people studied under the state and 1343 under the rural grant. The total number of employed was slightly more than half of the graduates-6533, which amounted to 54.4%. At the same time, the number of those employed in urban hospitals is 1.5 times higher than the number of those employed in rural medical organizations. High percentages are persons who have continued their studies in residency/magistracy, and this figure tends to increase every year. The trend towards an increase is maintained by the free distribution index for pregnant women and people caring for children under the age of 3 years, for a total of three years it was 1,452 (12.1%) of a person. At the same time, those employed in rural health facilities are only 19.1% of those who studied under the grant and 31.5% of those who studied according to the rural quota. Conclusions Thus, the percentage of employed graduates, as well as graduates who studied under the state and rural grant, barely exceeds 50%. Even the employment of persons trained in rural quotas in rural health care facilities is only 31.5%. Universities do not fully monitor the employment of graduates, especially those who studied under a state or a rural grant. Key messages To create and implement an electronic platform with a complete database of students and graduates. To monitor employment and track the graduate’s work route; to organize employment services at universities.
Issue/problem Since 2019, Kazakhstan has been implementing a project to develop standards for nursing services. The aim of project is support of practical nurses with the latest available evidence via development of clinical nursing guidelines (CPG) as well as standard operational procedures (SOP), sustainable development of this area. Description of the problem As part of reforming the system of nursing education in Kazakhstan, applied baccalaureate for nurses was introduced. Shortcomings of current nursing education, the introduction of digitalization and e-health, poor quality of medical services, justified need of standardization. Within the framework of the project, development groups including nurses and medical specialists were organized. The following priority topics were selected: management of diabetes, asthma, CHF, prevention of CVD. Development group uses a guide for adaptation which was prepared by project international partners from Finland. Three trainings were conducted for nursing professionals. These trainings step by step provide comprehensive knowledge on adaptation process. recommendations to local conditions. Results The main outcome of the joint work is the training of a nursing research committee, who will be responsible for sustainable development of this direction. The second result is guidelines for nurses, which are very demanded in the field. The third outcome is reflexing and gaining experience in overcoming barriers for further work. Lessons Adaptation of CPG is preferred approach for countries with a low level of socio-economic development because of less resource, time consuming. The adaptation process requires work commitment, a sufficient level of English proficiency, respect of authorship, but taking into account local conditions. Key messages Adaptation of nursing CPGs is an important part of standardization of medical services in order to improve the quality of medical care. Thorough planning of the process, training of development group will allow overcome barriers to implementation.
Issue/problem Nurses play a key role in the system of public health. The total number of nurses in Kazakhstan is 105,441 people (January 1, 2019), which is over 40% of all health workers in the health system of Kazakhstan. The continuing problem of insufficiently effective nursing service (NS) in the country prompted us to develop policy options to increase the NS effectiveness. Description of the problem Key problems of the NS in Kazakhstan include the ineffective management of NS in health organizations, which is associated with an underestimation of the role of nurses in the therapeutic and diagnostic process. There is also a discrepancy in the functioning of the system of nursing education, research and practice with European directives. There are inadequate regulatory acts governing the activities of nurses (including the lack of national guidelines, nursing standards, etc.). Results As a result of analyzing the current situation in the country and summarizing the data from systematic reviews, we were developed the Policy Brief on the issues of implementation of a new model of the NS management. As the key policy options, we proposed: 1. Improving the NS management in health organizations based on a revision of the role of nursing staff in the treatment and diagnostic process; 2. Improving the sectoral qualifications system of nursing specialists in accordance with European directives; 3. Ensuring the development of evidence-based nursing practices with the implementation of generally accepted international standards and models, the development of national guidelines and standards for NS. Lessons The proposed measures found support from the Ministry of Health and were included in the action plans. Each of these policy options contributes to increasing the effectiveness of NS in the health system of Kazakhstan, but these options provide more substantial achievement of the goal of enhancing the role and status of a nurse with their combined implementation. Key messages Implementation of a new model of the NS management in which nurses and physicions work on an equal footing and independently can significantly improve the efficiency of NS. Implementation of evidence-based approaches to the formation of a policy in the field of the NS development gives possibility to increase the effectiveness of the reforms in this field.
CIS-R and WHODAS 2.0). Excluding death, the utility values of the therapeutic areas most often modelled like infectious diseases, ophthalmology, endocrine disorders and oncology, ranged from 0-1, 0.18-0.99, 0.55-0.87 and 0.5-0.94, respectively. For the rest of the therapeutic areas, such as blood disorders, mental disorders, nephrology and neurology, utility values ranged from 0.61-0.93, 0.82-0.84, 0.39-0.71 and -0.495-0.9, respectively. Conclusions: This systematic review provides a set of published health state utility values of different therapeutic areas modelled in cost utility evaluations conducted from Indian perspective. It also provides an overview of the methods and the instruments employed to retrieve the utility values
What is the problem? • Lack of a permanent body for the coordination and development of the sectoral qualifications system (SQS) in the healthcare system of the Republic of Kazakhstan; • Lack of the SQS’s expert community, expert and analytical structures for the development of professional qualifications in the field of healthcare; • Decisions (that are made in matters of the SQS development) are often based on the opinion of individuals and do not have a sufficient evidence base and agreement with the professional community; • Lack of systematic information on the state and development of USC in the field of health care; • Formation of the basic elements of the sectoral qualifications system (sectoral qualifications framework (SQF) and professional standards (PS)) is carried out on the basis of the implementation of single ("one-off") projects, without further regular updating and support for further implementation of these documents. Policy options • Option 1. Creation of the Sectoral Council for Professional Qualifications in Healthcare (SСPQ) by: o Adoption of an appropriate normative act on the establishment of the Council for Professional Qualifications with the inclusion of all interested parties (representatives of the Ministry of Health of the Republic of Kazakhstan, associations of employers, workers, educational organizations, organizations for assessing professional qualifications, etc.) o Anchoring in the Regulation of the SСPQ and other normative acts and regulations of the role and powers of the SСPQ in the development of the SQS (monitoring the development of the SQS and evidence-informed policymaking in the field of qualifications, developing and updating, introducing and evaluating the effectiveness of using the SQF and PS); o Determination of the SСPQ working body responsible for the methodological and organizational support of the SСPQ work, allocating funding to support the SСPQ activities and conducting research and development in the field of the SQS; o Development of a Strategy and a Roadmap for the progress of the SQS in the field of health, defining the priority directions and mechanisms for the SQS development, quality assurance and regulation of the qualifications market with the involvement of all stakeholders. • Option 2. Formation of the expert community of the sectoral qualifications system in the context of all specialties and specializations in the field of health care, by: o Development and launch of standardized modular courses for training experts on the development of SQS; o Training and formation of the register of experts on the SQS development in the context of all specialties and specializations in the field of health care; o Creation of committees for professional qualifications in key specialties at the SCPQ, including the most experienced and authoritative specialists in the relevant specialty. • Option 3. Ensuring transparency and accessibility for all stakeholders of information on the state and development of the SQS by: o Launch of a single on-line resource about the SQS in the field of health care (administered by the SCPQ working body); o Developing the SCPQ and its health working body as a Knowledge Translation Platform for professional qualifications in health policy making; o Introduction of the practice of regular (annually or once every two years) publication of a report on the state of the SQS in the field of health care; o Conducting forums on a regular basis and organizing dialogue platforms on the development of the SQS; o Establishing close interaction and dialogue between the SCPQ in the field of health care and the SCPQ of other sectors, whose specialists contribute to the formation of public health.
Issue In modern conditions of the labor market, there is a need to implement an effective system of continuous professional development (CPD) of health workers (HWs) in accordance with existing and emerging health care needs. The system of CPD of HWs should be aimed at maintaining and improving the competencies (knowledge, skills, abilities) of each individual specialist, important to meet the changing needs of patients and the health system. Description of the Problem The lack of effectiveness of the CPD system of HWs in the Kazakhstan is due to the lack of accounting for many types of training activities in the system for confirming the qualifications of HWs (with certification of HWs every 5 years). So at present, when confirming a certificate, only formal additional education courses are taken into account, however, they do not correspond to the qualification level of a HW. Such types of activities in the CPD are not taken into account: non-formal education (fellowships, master classes, online trainings, etc.), activities that are aimed at developing and maintaining professional competencies such as mentoring young specialists, publication articles, participation in conferences, etc. Changes: We have developed a new system for the CPD of HWs, harmonized with the procedure for regularly confirming the certificate of a HW (physician, nurse, pharmaceutical worker, specialist of the sanitary and epidemiological service), which gives access to professional work. The new CPD system is based on the credit accumulation mechanism in which Professional Development Units are assigned for each type of activity of formal and non-formal additional education and other types of activity aimed at professional development (mentoring, articles, conferences, expert activities, etc.). Lessons The introduction of a new CPD system allows for the effective maintenance and improvement of the qualifications of health workers. Key messages The lack of effectiveness of the CPD system of HWs is a serious barrier to maintaining the HWs qualifications at a sufficient level. The introduction of credit accumulation mechanisms for recording achievements in non-formal and non-formal additional education has enabled the formation of an effective system for the CPD of HWs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.