Development and present state of staffing of St. Petersburg traumatological and orthopedic services
A retrospective analysis of the traumatologic and orthopedic services personnel maintenance in Leningrad - St. Petersburg since 1985 and its modern condition was carried out. Some features of the provision ofin- and outpatient medical facilities by traumatologic and orthopedic doctors and nurses staff were revealed. An assessment of employment and staffing positions, ratio of specialists in hospitals and outpatient clinics was carried out. It was found that both in outpatient and hospital facilities a steady increase of traumatologic and orthopedic doctors and nurses staff positions was marked, accompanied with a steady growth in the number of occupied positions and constant ratio of staff positions in hospital and outpatient facilities. Level of occupied doctors and nurses positions is close to 100%, but the rate of job sharing remains high. Structural indicators of traumatologic and orthopedic doctors' qualification and their dynamics, as well as other parameters describing personnel environ in the city traumatologic and orthopedic services were analyzed. Percentages of doctors with first and highest qualification rates and certified specialist are low, and both indicators show a negative trend during last 5 years. Excessive intensity of work in a number of hospitals leads to a decrease in the care quality of trauma and orthopedic patients. It is found that the effectiveness of traumatologic and orthopedic services in St. Petersburg is mostly determined by its personnel structure and rational technologies of its use to provide specialized medical aid for residents of the city. A complex of measures for conservation and sustainable development of human resources of traumatological services in St. Petersburg was developed: higher wages, social support, regular training out and in the workplace, forming conditions for professional networking etc.