PREREQUISITES AND OPPORTUNITIES FOR TRANSITION TO A TEAM-BASED ORGANIZATION OF PRIMARY CARE DELIVERY. ANALYTICAL REVIEW OF REGULATORY DOCUMENTS
Significance. Recent years have seen an increasing interest in solutions related to the expended functions of nursing staff and their more active participation in care delivery. In general, expended functions of nursing staff brings positive results. It can be expected that a clear definition of the performed functions and areas of responsibility of each employee, including nursing staff, and organization of their cooperation could improve outcomes of care delivery. This approach corresponds to the team-based work organization - primary care delivery in our case. The purpose of the study: to conduct an analytical review of regulatory legal acts regarding distribution of functions between doctors and nurses in primary care delivery in line with their competences and the possibility of transition to a team-based work organization. Material and methods. Content analysis of the orders of the Ministry of Health, Ministry of Labor and Social Protection, Ministry of Science and Higher Education of the Russian Federation regulating organization of primary care delivery, professional and educational standards of employees providing primary medical and primary pre-medical care. Results. The range of various tasks of the district health care requires participation of employees with different qualifications. There is a logical need for a clear distribution of functions between doctors and nurses. This is especially important in case of an imbalance between the number of doctors and nurses. At the same time, the current documents regulating organization of primary care delivery, professional and educational standards make it possible to determine functions that can be delegated to nursing staff, thus creating grounds for the team-based organization of care delivery by primary medical and primary pre-medical care specialists. Conclusions. The educational standards include competencies that provide for the possible to expand responsibility of nursing staff in care delivery to the attached population. The possibility of distributing responsibility between employees working at the unit (therapeutic, pediatric, general medical practice) makes it possible to organize work on the basis of district teams. Transition of the team-based organization of work at the primary level meets the principles of scientific work organization and can be considered as a promising direction for primary care development in terms of compliance with conditions of specific territories and district care management. Scope of application: development of organizational models of primary care with expanded responsibilities of nursing staff and introduction of the team-based organization of care delivery to the attached population