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.