Peculiarities of practical implementation of the internal quality control system in child psychiatry
Introduction. Statistical indicators and dissatisfaction of recipients of medical services indicate the low quality of mental health care for children. The provision of medical care to children with psychiatric disorders is an area with few regulatory documents, which, inter alia, could be used to organize and conduct internal quality control of specialized care at the level of the medical organization working on the profile "psychiatry". Materials and methods. The article describes the first steps in the implementation of an internal quality control system using the principles laid out in the practical recommendations of the Roszdravnadzor National Institute for Quality Control. In order to develop a separate version of the practice guidelines, sensitive to the specifics of child psychiatry, an expert review was performed by a multidisciplinary group of specialists. The experts were asked to conduct an informational analysis of the documents, to evaluate the data characterizing the state of child psychiatric care and the system of internal quality control in the medical organization, and to propose a vector for the development of the quality service. The "Ishikawa diagram" method was used to visualize and organize the data. Results. The group of experts identified 12 main directions in which the organization of internal quality control in child psychiatry was required, including "psychiatric safety", determined the stages of further implementation, the need to delegate the development of algorithms, procedures, and checklists to the teams of units. Discussion. An original solution with the allocation of four categories of subjects, to which the criteria of medical care quality should be applied in all 12 main directions: employees, patients (children), parents (legal representatives) and property (provision) was proposed. The focus on parents (legal representatives) corresponds to the chosen strategy of development of the medical organization of the G.E. Sukhareva Center, as focused on the family of a mentally ill child. Conclusions. When implementing the system of internal quality control it is necessary to take into account the specificity of activity and development strategy of the medical organization, it requires the participation of the management and a significant part of the staff, which allows to involve employees in the policy of quality.