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25 YEARS OF EXPERIENCE OF REGIONAL CLINICAL CENTER OF MINERS’ HEALTH PROTECTION
Agadzhanyan V.V.
Regional Clinical Center of Miners’ Health Protection, Leninsk-Kuznetsky, Russia
In August 2018, Regional Clinical Center
of Miner’s Health Protection will hold 25th anniversary from the day of
opening.
Center of Miners’ Health Protection
is the biggest Russian medical, scientific and educational facility, which
constantly externalizes the advanced domestic and foreign experience in
decreasing incidence of diseases among residents of the coal industry regions.
Everything began in 1988, when the USSR
Cabinet had made a decision on construction of the big medical facility. It was
built by means of realization of above-target coal of Kuznetsk basin. That is
why, miners and their families are patients of the center.
25 years ago, in September 1993, the
hospital admitted the first patients, and the first surgery was carried out in
January 1994. The hospital was named as State Scientific Clinical Center of
Miners’ Health Protection.
The Center was restructured for
several times: State Scientific Clinical Center of Miners’ Health Protection
became Federal Scientific Clinical Center of Miners’ Health Protection for
creation of the main facility for centralization and extension of specialized
medical care for workers of Kuzbass coal enterprises and their families, and in
2015 – Regional Clinical Center of Miners’ Health Protection.
During 25 years, 400,000 patients
were treated, 150,000 operations were conducted, including 12,000 high tech
operations, more than 6 million visits were registered, with 2 million miners
and 1.9 million children.
The center provides the realization
of medical programs for increasing efficiency of treatment of miners and their
families, veterans and older people, extensive support and treatment of
children. The center has been realizing some social programs, including ones
for treatment of hip in older patients. Owing to these programs, medical care
was given to more than 4,000 veterans and older people, 5,000 retired miners
and 10,000 children.
The
center has been actively developing and extending that increases its competitive
performance, separates it among other clinics and attracts the patients from
various regions of the Western and Eastern Siberia.
The center includes 26 clinical units
with 515 beds, 6 diagnostic units, polyclinics for children and adults with
1,000 visits, the occupational pathology center, outpatient surgery center, the
evacuation teams of the regional center of disaster medicine (medical
evacuation unit), pathologic anatomy department and emergency medical care
unit.
There are more than 1,400 employees
including 200 physicians (12 PhD (1 academician of Russian Academy of Natural
Sciences, 3 professors, 6 corresponding members of Russian Academy of Natural
Sciences) and 28 candidates of medical science), 610 nurses, 50 specialists
with university education, 40 medical attendants, 591 other specialists.
10 physicians have the honored title the Honored Physician of RF, 19 employees
– outstanding specialists in healthcare.
For 25 years of working activity, a
lot of good traditions has appeared in the center, particularly, tradition of domesticity
in common cause of devotion to medicine which is passed on from generation to
generation. The representatives of 26 professional dynasties including 12 medical
ones work in the center.
There are 5 winners of the
All-Russian competition the Best Doctor of the Year. They are PhD in medicine
Agadzhanyan Vagram Vaganovich (2001), Afanasyev Leonid Mikhaylovich (2005),
Khokhlova Olga Ivanovna (2008), Novokshonov Aleksandr Vasilyevich (2011),
Yakovleva Natalya Vyacheslavovna (2016).
Galina Petrovna Krasulina, candidate
of medical science, has made a lot of mental and physical activity for realization
of the architectural project of the hospital in the territory of the city. She
also managed its construction.
Vagram Vaganovich Agadzhanyan, the
Honored Doctor of RF, PhD, professor, academician of Russian Academy of Natural
Sciences has been leading the center. Establishment and development of this
biggest multi-profile facility had been proceeding under his leadership.
Thanks to rare energetic potential
and professionalism of the hereditary doctor, administrator-strategist, tactician
and practioner, Vagram Vaganovich Agadzhanyan has saved the center in the
difficult 90s and has got above the previous achievements. The present
generally accepted success of the center is mainly determined by the experience
by the employees, ability to cooperative creative work and commitment to
excellence.
The following
scientists have been made the great contribution into development and formation
of scientific directions of the center and have been continuing the traditions
of their teachers: the professors V.V. Agadzhanyan, I.M. Ustyantseva, PhD A.A.
Pronskikh, A.Yu. Milyukov, S.A. Kravtsov, O.I. Khokhlova, V.A. Semenikhin, A.V.
Shatalin, N.V. Yakovleva, candidates of medical science A.Kh. Agalaryan, N.V.
Agafonova, E.A. Belogortseva, S.V. Bogdanov, E.V. Varyushkina, S.V. Vlasov,
I.V. Vlasova, Ya.Kh. Gilev, O.V. Kobyakova, G.P. Krasulina, A.N. Kornev, A.S.
Nikolaev, O.V. Odintseva, O.V. Petukhova, E.A. Rotkin, N.S. Sinitsa, L.V.
Smirnova, M.Yu. Fedorov, Yu.S. Fedorov, O.P. Khayretdinova, V.N. Tsuryupa, E.V.
Chelyshev, O.A. Yakushin.
The uniqueness
of activity of the facility consists in the flexible system of diagnostics and
treatment in concordance with the last scientific projects and techniques which
allows the complex approach to management of difficult categories of patients.
The center realizes the full cycle of diagnostics and treatment, including
outpatient and consultative attendance, inhospital stage of treatment with use
of all subdivisions of the hospital including the medical rehabilitation
department.
The system
for rendering specialized medical care for patients with multiple associated
injury (polytrauma) has been developed and implemented in the center.
Provision of
the closed cycle of medical care is realized with the main factors:
-
availability of specialists in all main medical fields: surgery, traumatology
and orthopedics, neurosurgery, cardiology, gynecology, pediatric surgery, anesthesiology
and intensive care;
- extensive
diagnostic basis including radiological, laboratory and functional diagnostics.
All of it
allows excluding the necessity for attraction of consultants from other medical
facilities and promotes the decrease in time of realization of specialized
medical care.
There is continuity
in activity of the center with the Center of Rehabilitation of Social Insurance
Center of the Russian Federation “Topaz”, where rehabilitation of patients with
industrial injuries is continued up to recovery of working capability.
The priority
direction in activity of the center is arrangement of urgent care for persons
who suffer in mining enterprises. For this reason, the medical evacuation
service has been initiated. It includes eight modern reanimobiles with medical
equipment for support of vital organs and systems over the distance of 500 km.
Medical evacuation of patients is carried out from other medical facilities and
from sites of technogenic disasters. Medical evacuation for the distance more
than 1,000 km is realized with participation of aviation. There is a helicopter
platform for urgent receive of patients in the territory of the center.
112 miners
were admitted from the underground mines (Yubileynaya, Raspadskaya,
Pervomayskaya and others) to the center for the last 5 years. More than 700
patients (employees of coal enterprises and their relatives) were transported
from the medical facilities. It reduced the mortality from 35 to 14 %.
In 2000-2018,
the medical evacuation unit has transported 3,350 patients including 1,592
patients with industrial injuries, and 10 patients from Khakassia, Tyva and Altay
region.
The system of
preventive procedures for occupational diseases in coal miners includes several
key directions:
- complex
diagnostics of occupational diseases, treatment, rehabilitation and health
survey for coal industry workers;
-
assessment and analysis of occupational diseases in miners of the region;
-
control of quality of preliminary and periodical medical surveys in coal
industry of the region;
-
development of procedures for prevention and decrease in occupational diseases
in the region.
Each year, more than 12,000 miners
are treated in the occupational pathology center. Inhospital medical care is
annually given to more than 600 workers.
As result of activity of
the occupational pathology center, the rate of occupational diseases has decreased
by 20 %, and the level of occupational diseases has stabilized.
The use of the advanced
medical technologies is the main principle of activity of the team.
Since 1994, the center
has been realizing the research program for solution of the medical and biological
problems in Siberia.
The main directions in
the scientific researches of the center were and still are the issues of
arrangement of the system for monitoring of health of coal industry
specialists, development of new methods for diagnosis and treatment of
polytrauma, diseases of cardiovascular and bronchopulmonary diseases, and
occupational pathology.
The innovative
technologies have been developed and effectively tested in the clinic:
1. The complex system for
arrangement of specialized medical care for patients with polytrauma (multiple
and associated injury).
2. Arrangement of urgent
care for persons with industrial injuries. The medical evacuation service
including the modern reanimobiles has been initiated for this reason.
3. Optimization of the
system of preventive measures for occupational and industrial diseases in
employees of coal industry of Kuzbass.
4. Kuzbass is the first
region where the system of personal provision of pharmaceuticals has been
developed and implemented. It allowed the distribution and the implementation
of the system in the medical facilities of Kuzbass (Novokuznetsk City Clinical
Hospital No.1, Kemerovo Regional Clinical Hospital No.1, Kemerovo Regional
Perinatal Center, Kemerovo City Clinical Hospital No.3).
5. The medical
information system (MIS) Electronic Case History of Regional Clinical Center of
Miners’ Health Protection has been developed and implemented.
6. The innovative technology
of automation of the clinical diagnostic laboratory with the laboratory information
system (LIS) has been developed and implemented. It increased the capability
and economic efficiency of the laboratory.
7. The quality management
system has been implemented for urgent and planned inhospital and outhospital
polyclinic medical care in concordance with the requirements of ISO 9001:2008
international standard.
8. In cooperation with
National Research Center Kurchatovskiy Institute and Novosibirsk Institute of
Organic Chemistry named after N.N. Vorozhtsov, the scientific works for creation
of domestic biodegradable nanostructured polymer and nanocomposite materials
and products for general and reconstructive plastic surgery, traumatology and
orthopedics are conducted.
9. The first domestic
production of X-ray contrast surgical drapes has been initiated under
supervision of the scientists.
10. The evidence-based
system Safety of Patients for prevention of hospital infections has been
developed and implemented into practice. It protects patients from hospital
infections. This system is based on the standards of the system of
epidemiological survey, monitoring of agents, development of strategy and
tactics of administration of antibiotics and estimation of economic efficiency
of procedures. The non-contact sensor dispensers are installed before the
entries of all departments. After closing somebody’s hands to the dispenser, it
sprays the disinfecting agent. The little spray-flacons with the fluid are in
the pockets of each employee and near the beds of patients.
11. The Hospital
Logistics system has been developed and implemented. It is the system for
management of centralized platforms for delivery of pharmaceuticals, nutrition,
disinfecting agents and housewares to the structural divisions of the clinical
center.
12. The Medical Waste
Management system with the special device has been developed and implemented
(the patent for an invention No.2430798, October 10, 2011), which allows
management of surgical drapes, dressing, shoe covers and others.
13 PhD and 79 candidate’s
dissertations have been written and defended, 7 monographies and more than
4,500 scientific works have been published, 142 patents of RF have been
received, and 21 All-Russian scientific-practical conferences have been
organized and conducted in cooperation with the general committee of Siberian
department of Russian Academy of Sciences (the materials have been published in
the collections of materials of the conferences 1996-2018 (ISBN 978-5-904-430-18-4).
The results of the
scientific studies are constantly reported during the weekly conferences in the
center, in the forums of various levels – from Russian (more than 3,000
reports) to international (more than 300 reports). The scientific practical
journal Polytrauma has been founded
with the initiative by V.V. Agadzhanyan, the main editor. The journal is being
published since 2006. It is published in Russian and English. The journal is
referenced in the List of Publications of State Commission for Academic Degrees
and Titles, All-Union Institute of Scientific and Technical Information, Russian
Science Citation Index and in the international reference database SCOPUS (June
2016) and Ulrich’s International Periodicals Directory.
The center is the educational basis
with the postgraduate education departments Integrative Traumatology (the
chairman V.V. Agadzhanyan, PhD, professor) and Occupational Pathology (the
chairman V.A. Semenikhin) of Kemerovo State Medical University. The departments
have been opened in 1998.
In
2017, with the aim of realization of the scientific research, professional and
educational programs for medical staff, the Kuzbass department of Novosibirsk
Research Institute named after Ya.L. Tsyvyan has been opened.
The library has been created in 1993. Today it is the main book storage
of medical and imaginative literature in Leninsk-Kuznetsky. There are more than
32,000 copies: more than 14,000 medical books, 17,000 medical journals in
different languages.
The administration of the center pays the great attention to improvement
in staff. Young specialists are invited each year.
The center has a program for improvement of hospital stay of patients:
reconstructions of the rooms, arrangement of individual nutrition for patients,
special cloths, staff discipline and adherence to ethical standards. Near the
hospital, the free comfortable car parking has been opened for patients. The
cozy garden zone with 4 waterworks creates the conditions for rest and fast
recovery of patients. The picture gallery includes more than 300
copies.
Today the patients are not satisfied only with knowledge of advanced
techniques, modern methods of management and import equipment. The name
Regional Clinical Center of Miners’ Health Protection supposes that the clinic
is troubleproof and one can rely on it.
Preservation of annual innovative development of science and practice,
traditions of high level of medical care, constant aspiration to get another
level – all these features put the center into the range of the leading medical
facilities in the region.
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