MIL OSI Translation. Region: Russian Federation –
More than 100 thousand people receive help at the Botkin Hospital every year, over 60 thousand operations are performed.
In building number 28 of the city clinical hospital named after S.P. Botkin in September, overhaul work was completed. The building was almost completely rebuilt. Now it will open an outpatient oncological care center for residents of the Western Administrative District.
“Major serious work has been completed. As I understand it, not only the technological component is quite advanced here, but the design itself, the environment itself are as comfortable as possible for the patients of the clinic and doctors, ”said
Sergei Sobyaninduring a visit to the Botkin Hospital.
According to him, this year the reconstruction of two more similar outpatient centers will be completed – in the city clinical hospital No. 40 and in the city clinical oncological hospital No. 1.
The development of the material base of medical centers, as well as the construction and reconstruction of hospital buildings throughout the city, has a serious positive effect on the capital’s healthcare system. At the same time, people need to take care of their health themselves.
“We ourselves must be on the alert and undergo examinations that are available today. An endoscopy center, the most powerful center in Europe, has now been launched, thousands of studies have already been carried out, and three dozen oncological diseases have been identified. Most importantly, more than 60 cases of the disease in the initial stage have been detected. The patients received assistance within the framework of the day hospital through minimally invasive surgery, and they can already live and work normally, ”said Sergei Sobyanin.
Full cycle of diagnostics and treatment
Overhaul of building No. 28, built in 1951, began in June 2020. The structures in the building were reinforced and the facade was insulated, the roof was repaired, utilities, floor slabs, internal partitions and floor screeds, door and window blocks were replaced. A barrier-free environment has been created for people with limited mobility: a lifting platform has been installed, there are ramps and handrails, and clear logistics inside the building is provided.
An outpatient oncological care center is located in a modernized five-story building with an area of 3.7 thousand square meters. This will allow organizing a full cycle of diagnostics and treatment of specialized patients at the Botkin Hospital: doctors will be able to diagnose, carry out surgical treatment, drug or chemotherapy, rehabilitation and observation.
The renovated building will be able to receive twice as many people as before, as well as conduct up to 160 thousand consultations per year. Patients will get an appointment with an oncologist as soon as possible, without delays or queues.
In accordance with the new standard for the provision of oncological care, the center will provide a wide range of medical and diagnostic procedures, including biopsy (examination by the method of tissue and cell sampling), ultrasound and functional diagnostics (USDG, ECHO-KG, ECG), dermatoscopy (examination of lesions leather using special equipment) and others.
In the offices of highly specialized specialists – oncourologists, oncogynecologists, oncomammologists – equipment is installed for conducting specialized examinations of the highest quality. For example, in a mammologist’s manipulation oncomologist, the doctor will be able to perform a breast biopsy already during the initial appointment.
Our own operating room with a wake-up ward for four beds for performing biopsies and minor surgeries will significantly speed up the confirmation or refutation of a preliminary diagnosis in patients with suspected cancer.
The day hospital for 22 beds is designed for up to 25 thousand courses of chemotherapy annually. In a specialized pain management room, effective minimally invasive techniques will be used. The necessary analyzes will be carried out in a state-of-the-art molecular biological laboratory located in building 33 of the Botkin Hospital.
The telemedicine systems installed in the center are designed to hold oncological consultations to discuss complex clinical cases with specialists from other clinics.
On all floors of the building for patients and accompanying persons there are places for comfortable waiting in a cozy and calm atmosphere – with comfortable furniture and designer interiors, soft lighting and air conditioning, Wi-Fi and TV.
The center of outpatient oncological care is to receive the first patients on September 27. It will operate daily, seven days a week, from 08:00 to 20:00.
Specialists from four oncological departments, which were previously located in different districts of the Western Administrative District, will be transferred to the new institution. These are polyclinic No. 195 (Krylatskiye Holmy street, building 30, building 2), polyclinic No. 8 (Michurinsky prospect, Olympic Village, building 16, building 1), polyclinic No. 212 (Skulptor Mukhina street, building 14), consultative and diagnostic center No. 4 (Fizkulturny proezd, house 6).
“The trend towards the creation of high-flow centers has become worldwide. To date, it has been proven that the concentration of material and intellectual resources in one place can improve the quality of care and reduce costs, ”said the chief freelance oncologist of the Moscow Healthcare Department, director of the A.S. Loginova Igor Khatkov.
According to him, such centers are created as part of large oncological hospitals – in them, the patient is monitored at all stages, starting from the moment the disease is suspected. This allows for the provision of better quality specialized medical care.
“Patients receive highly qualified care in one place. They don’t have to go anywhere. It used to be like this: chemotherapy in one building, and an oncologist in another, a therapist in a third. Everything here is concentrated in one place, ”said Dmitry Kanner, head physician of the Moscow City Cancer Hospital No. 62.
Such an approach, according to Dmitry Kanner, is able to improve the quality of cancer treatment, since it is possible to simultaneously involve different narrow-profile specialists for diagnosis and treatment. In addition, an oncologist can improve his qualifications when he sees a large number of patients with different pathologies.
Department of Traumatology and Nutrition
In the surgical building No. 7, built in 1970 and recently renovated, after a complete re-equipment, there will be a department of purulent traumatology for 30 beds with a specialized operating room and an intensive care unit for six beds. This will increase the number of patients treated from 2025 to 5000 per year and the number of operated patients from 1355 to 4200.
Also, a short-term hospital for 12 beds with three operating rooms will be opened in the building. Here it will be possible to receive a full cycle of preoperative and inpatient diagnostics and treatment, followed by dynamic observation. This will increase the number of surgical interventions by 2.5-3 times – up to 10 thousand operations using video endoscopic equipment in 90 percent of cases. An increase in the flow of patients in the hospital will make it possible to free up round-the-clock beds for patients in a more serious condition.
Another building, where the renovation was carried out, is building No. 8. It was built in 1909. It is a two storey building with a basement. Its area is three thousand square meters.
The case has not been used since 2006. Now it will house a modern catering unit with a food tablet line, modern refrigerating machines and equipment for preparing food for 1,800 patients six times a day.
Modernization of the Botkin Hospital
City Clinical Hospital named after S.P. Botkin is the largest multidisciplinary hospital in Moscow and Russia. More than 100 thousand people receive help in it every year, over 60 thousand operations are carried out.
11 city medical specialized centers operate on the basis of the hospital. In addition, the medical institution is a clinical base for 24 departments of six leading medical research centers and universities in Russia.
In Moscow, a program of comprehensive modernization of the S.P. Botkin. In 2015, the largest medical simulation center in Europe was opened here, where you can get training in 230 programs and 50 specialties.
In 2016, the Moscow Organ Donation Coordination Center was opened. At the same time, a helipad was built to evacuate patients to the hospital using medical helicopters.
In 2017, after a major overhaul, building No. 21 was put into operation again, where a regional vascular center was deployed. In 2019, the Moscow City Ophthalmological Center with 145 beds was opened on the basis of the Botkin Hospital. It has four inpatient ophthalmological departments, including a unique department of ophthalmic oncology (treatment of intraocular and eyelid tumors), departments for the treatment of glaucoma, retinal dystrophy and other eye diseases.
A major overhaul was carried out in the pathological and anatomical building. A powerful modern oncomorphological and molecular laboratory was created, as well as the largest thanatological center in Moscow.
In 2020, a major overhaul of a 120-bed hematology building was completed, in which departments for the treatment of patients with blood diseases operate. The building accepts up to six thousand patients a year, which is almost a third more than before the renovation. Doctors perform over 150 vital bone marrow transplants per year.
Medical Simulation Center of Botkin Hospital turns five years old The largest in the city: how the Moscow ophthalmological center works Patients with blood diseases will be able to receive treatment at the level of world standards in the Botkin Hospital
By the end of 2021, it is planned to put in order two more buildings. Building No. 6 will be repaired. The building was built in 1911 and is an architectural monument. Its area is 0.98 thousand square meters.
The palliative department will be located here. Patients will be able to receive the necessary medical care in the most comfortable conditions, they will be surrounded by doctors and specially trained nurses.
Also, work will be carried out in building No. 11. The three-storey building with an area of 6.5 thousand square meters was built in 1911 and is an architectural monument. After the completion of the overhaul, an intercircular nephrological center with 66 beds will be opened in the building. In particular, there will be a nephrology department, a hemodialysis and peritoneal dialysis laboratory, and a day hospital (nephrology).
Currently, these units are scattered across the different buildings of the hospital. Their merger in building No. 11 will increase the number of hemodialysis procedures by 20 percent, and the number of patients treated with peritoneal dialysis – by 25 percent.
Outpatients with chronic kidney disease – residents of three administrative districts of Moscow: Central, North and North-West (today the hospital accepts outpatients only from the CAO) will undergo dynamic observation and treatment at the interdistrict nephrology center.
The next stage in the implementation of the comprehensive development program of the Botkin Hospital, designed for 2022–2023, will be the overhaul of five more buildings.
Buildings No. 8, 9 and 10 were built in 1911, the buildings are architectural monuments. The area of building No. 8 is about two thousand square meters. A therapeutic department will be opened here.
After the renovation, a surgery department with 10 beds, as well as a short-term hospital (for surgery and gynecology) with 18 beds will be opened in building No. 9. The building area is 2.9 thousand square meters.
The area of building No. 10 is 6.9 thousand square meters. Today, the building houses the departments of anesthesiology and resuscitation, which will continue to work even after major repairs. Also, 24 departments of leading medical research centers and universities will be transferred here, which are now scattered across different buildings of the hospital.
The building will be equipped with transformable lecture halls and auditoriums with modern media systems, where specialists and students of medical universities will be able to watch online broadcasts from the operating rooms of the Botkin Hospital.
It is planned to carry out work in building No. 2. It was built in 1912 and is an architectural monument. The area is 3.3 thousand square meters. After the modernization, it will house a number of departments, including therapeutic (30 beds), pulmonology (30 beds) and radiology (15 beds).
And in building 20 will open the Moscow Urological Center for 160 beds with six operating rooms, including four robotic surgical complexes, as well as 12 intensive care beds, an outpatient center for urological patients and a wide diagnostic base (MRI, CT, X-ray -cabinet).
The building to be renovated was built in 1966, with a total area of 8.8 thousand square meters. Now the building houses the departments of hemodialysis, palliative medicine, cardiology for patients with acute myocardial infarction and others.
In addition, one of the largest projects for the coming years is the construction modern stationary ambulance building(admission department) Botkin hospital.
In it, patients who require emergency assistance will receive the entire range of medical care: diagnostics, surgery, resuscitation measures – all within the first day after hospitalization. Then, doctors will assess the patient’s condition and make a decision on whether to be discharged home or transferred to specialized departments.
Within the framework of the comprehensive development program of the hospital, additional funds were also allocated for the design and construction of closed overground passages between the hospital buildings. In particular, the transition will be organized between the building No. 28, the medical building No. 22, which is being built by the ambulance stationary complex, the surgical building No. 7 and others.
A new standard for cancer care
Moscow is the Russian leader in the use of modern technologies and methods of cancer treatment. In 2019, Sergei Sobyanin approved a new standard for cancer care. Last year, its main provisions were introduced into the Moscow healthcare system.
The Mayor of Moscow noted that today the outline of a new oncological service, which has been discussed for many years, is emerging in the city.
“We came to the creation of a unified structure of oncological care, including multidisciplinary centers, first-class laboratories, outpatient centers. In fact, the patient comes to you and remains under your supervision for life. It is very important for a person to feel constant care and control over what is happening to him, ”said Sergei Sobyanin.
On the basis of the largest hospitals, six multidisciplinary oncological centers have been organized, which include a clinic, a pathomorphological laboratory and an outpatient oncological care center. Each cancer center is assigned one or two administrative districts of the capital.
Cancer centers are located:
– in the city clinical hospital № 57 named after D.D. Pletneva;
– at the Moscow Clinical Scientific Center named after A.S. Loginova;
– at the Moscow City Oncological Hospital No. 62;
– in the city clinical hospital named after S.P. Botkin;
– in the city clinical hospital No. 40;
– in the city clinical oncological hospital No. 1.
The cancer centers provide assistance at all stages of treatment, which include diagnostics, surgical treatment, drug therapy, and dispensary observation. This allows you to shorten the time of making a diagnosis, increase its accuracy and start treatment faster. The total number of beds for cancer patients is 1776, including 255 radiological beds.
Moscow invests heavily in helping cancer patients. “It is very important that drugs, the therapy that we conduct, chemotherapy are delivered to patients in the right volume and in the right quality, and most importantly, in strict accordance with the indications of laboratory studies, so that this process is constantly renewed, adjusted so as to obtain the greatest effect, ”added Sergei Sobyanin.
He stressed that, despite the difficulties caused by the pandemic, the volume of planned assistance provided in the capital increased.
“We have increased the amount of assistance in all areas: chemotherapy, surgery, general diagnostics, and so on,” said the Moscow Mayor. “This suggests that the powerful centers we are building can withstand such challenges.”
Also in the capital, the standard of an outpatient oncological care center is being introduced, which allows you to perform all diagnostic tests to make or exclude a diagnosis. In total, eight outpatient oncological care centers have been created on the basis of six multidisciplinary oncological centers.
Last year, there were 286,288 hospitalizations, 9,132 courses using radiation therapy and 248,012 courses of chemotherapy. In 2019, there were 214,742 hospitalizations, 8142 courses of radiation therapy and 164,106 courses of chemotherapy.
During the six months of this year, 150,921 hospitalizations, 6168 courses of radiation therapy and 130,826 courses of chemotherapy were carried out.
In all multidisciplinary oncological centers, a state-of-the-art pathomorphological laboratory has been created. In 2019-2020, a large-scale re-equipment of cancer centers was carried out – more than 300 units of medical equipment were purchased for them. Thanks to this, the centers can now:
– conduct research for the individual selection of targeted and immune therapy for patients;
– to reduce the time for conducting pathomorphological studies;
– to automate the process of processing the diagnostic material as much as possible;
– digitize images and archive them;
– to consult on complex and controversial cases with experts from other cancer centers;
– provide advice to the regions, as well as exchange experience with colleagues from Europe and the United States.
Thanks to modern equipment, the number of studies for the selection of targeted and immune therapy for cancer patients has increased. Last year, the number of histological studies increased by 12 percent (to 1.23 million), molecular genetic studies – by 93 percent (to 14.45 thousand), immunohistochemical studies – by 15 percent (to 140.14 thousand).
For six months of this year, specialists have carried out 749,549 histological studies, including 9738 molecular genetic studies and 96,951 immunohistochemical studies. The number of studies for the selection of targeted and immune therapy for cancer patients has grown by 1.5 times. This allows you to select the most effective treatment tactics using modern drugs.
In August, a project was launched on the early detection and prevention of colorectal and stomach cancer. On the basis of the city clinical hospital named after S.P. Botkin, a modern endoscopy center was created, equipped with modern expert-class equipment. As the head of the Moscow Department of Healthcare Alexei Khripun noted, another center will open in the V.M. Buyanova. Together, both centers will be able to do up to a thousand studies per day.
Endoscopic examinations are performed for people at risk. These are dispensary patients with precancerous diseases, patients with genetic and family risks, people of age. All examinations are carried out in a comfortable environment under mild sedation.
Since the beginning of the project, 36 malignant neoplasms of the gastrointestinal tract have been identified.
Moscow became the first region in Russia to adopt new federal clinical guidelines for the treatment of the most common types of cancer three years ahead of schedule. From April 1, 2019, patients are prescribed the most effective targeted and immune drugs.
Modern medicines allow:
– to achieve control over the tumor, which increases the chances of saving the patient even with those cancers that were previously considered fatal;
– selectively affect certain types of malignant tumors, thereby avoiding many side effects;
– to influence certain mechanisms of malignant cells through the immune system, increasing resistance to cancer and protecting a person from various diseases and infections;
– to make the treatment process more comfortable for the patient, because the drugs can be used in a day hospital.
During the six months of this year, 27,776 patients received drugs to carry out drug therapy for six types of cancer (breast and prostate, kidney, rectum, lung, melanoma). For the entire 2020 – 34,745 patients.
In total, in the first half of 2021, 34,153 patients were provided with drug therapy for oncological diseases (in 2020 – 43,188 patients). 266 patients received monetary compensation for the purchase of medicines (in 2020 – 675 patients).
From January 1, 2022, drug therapy will be available for four more types of cancer – bladder, ovary, stomach, head and neck.
Moscow City Cancer Register
In August last year, the integration of the Moscow City Cancer Register and the Unified Medical Information and Analytical System (UMIAS) began. This made it possible to combine data on cancer patients, which were previously stored in different information systems.
Data on the current stage of treatment or dispensary observation of the patient, information on the dynamics of the disease, performed laboratory and instrumental diagnostic methods, consultations of specialists are displayed in the patient’s oncological passport in UMIAS and are available to oncologists of outpatient oncological care centers.
In August last year, a pilot project “Personal Assistant” was released. Within its framework, specialists from the My Documents offices help patients with oncological diseases make appointments with doctors, for examinations, remind them of their upcoming visit, enter information into the city cancer registry, and solve emerging problems.
They talk about the possibility of personal accompaniment in polyclinics when referring to an oncologist. If agreed, the patient is given a card with the personal assistant’s phone number.
The Personal Assistant project covers patients with suspected or confirmed cancer. It employs 63 specialists who have already provided assistance to about 27 thousand Muscovites.
High-tech medical care
Most types of specialized oncological care are included in the basic compulsory medical insurance program. In addition, 3D and 4D radiation therapy is provided free of charge in 14 city, federal and private medical clinics.
Proton therapy is carried out at the S. Berezin Medical Institute. Since the beginning of the year, 37 patients have been treated there, in 2020 – 44 patients.
During the six months of this year, 6168 completed cases of treatment within the framework of 3D and 4D radiation therapy were performed.
City Cancer Council
The city oncology council is attended by leading oncologists of city and federal centers, and the chairman is the chief freelance oncologist of Moscow Igor Khatkov. If necessary, doctors of related specialties are involved.
The consultation allows doctors to quickly find non-standard methods of treatment for the most difficult patients, to accumulate the experience of the best specialists in the city for the selection of therapy for patients with a complex clinical picture.
The tasks of the council include making decisions on prescribing drugs to patients in cases where a non-standard clinical approach or prescribing drugs that are not provided for by clinical guidelines or are not included in the list of drugs for additional provision is required.
During the work of the oncoconsilium, 39 meetings were held, 190 clinical cases of 175 unique patients were examined.
EDITOR’S NOTE: This article is a translation. Apologies should the grammar and or sentence structure not be perfect.