MIL OSI Translation. Region: Russian Federation –
Now, almost three thousand doctors on duty and about the same number of nurses and administrators work in shifts in special departments for receiving patients with SARS, created in polyclinics.
The city will allocate 1.5 billion rubles for bonuses to the staff of the capital’s polyclinics, who work in the department for receiving patients with SARS and COVID-19, as well as for purchases for outpatient services. Told about it Sergei Sobyaninduring a visit to polyclinic No. 68.
“Most of the therapists today did not receive city allowances, they worked as usual. I have made a decision to allocate one and a half billion rubles to pay material incentives to employees and cover operating expenses,” he said. “I would like to thank you very much for your work, your work, your stoic fulfillment of your duty to Muscovites, to the sick.”
Sergei Sobyanin stressed that the capital’s health care is facing new unprecedented challenges in the fight against COVID-19: “The stationary link is operating at the level of peak values of previous waves, which in itself is very difficult. The outpatient department generally faced such a flow of patients that has never happened in the history of Moscow healthcare.”
1.5 billion rubles will be allocated from the reserve fund provided for in the city budget for 2022. Part of the funds will be directed to additional bonuses for employees of polyclinics. Doctors, nurses and administrators working in the departments for patients with symptoms of SARS, in the telemedicine service and the home visit service of all city polyclinics will receive an additional bonus. The amount of the bonus will be determined taking into account the real situation in specific clinics and the personal contribution of each employee.
The other part of the funds will be spent on the wages of additionally hired personnel, transport services, the purchase of consumables and personal protective equipment.
According to the results of 2021, the average salary of polyclinic doctors amounted to 146 thousand rubles a month, nurses – 76.5 thousand rubles. With the onset of the pandemic, additional incentive payments were established for polyclinic workers at the expense of the federal and city budgets. For doctors working directly with patients with COVID-19, the amount of payments is 120,000 rubles a month, for doctors in clinics who see patients with symptoms of SARS, 50,000 rubles. The amount of payments for nursing staff working directly with patients with COVID-19 is 75 thousand rubles a month, for those working with patients with SARS – 25 thousand rubles.
In addition, employees of medical organizations participating in the vaccination (revaccination) of the adult population are paid in the amount of:
– 200 rubles for one vaccinated aged 18 to 60 from among the population attached to a medical organization and one vaccinated from among Russian citizens insured under compulsory medical insurance, from among employees of labor collectives;
– 400 rubles for one vaccinated over the age of 60 from among the population attached to a medical organization.
In September-December 2021, incentive payments were made in the amount of 75.1 million rubles.
How is the reception in the departments for patients with SARS
Due to the rapid spread of the omicron strain in polyclinics, special departments were urgently deployed to receive patients with acute respiratory viral infections. Almost three thousand doctors on duty and about the same number of nurses and administrators work in shifts. In total, 1473 offices are open for citizens.
“In order to cope with the flow of ARVI and COVID-19 patients, six thousand medical workers receive Muscovites daily, providing all the necessary assistance, support, diagnostics, and routing of these patients. In addition to creating special departments for patients with acute respiratory viral infections and coronavirus, which are allocated from the areas of polyclinics as separate boxes, a telemedicine service has been created in each polyclinic, Sergei Sobyanin noted. “The 122 service has been strengthened several times, and today calls are being received there in the planned normal mode.”
Patients are admitted daily, both by appointment and on a first-come, first-served basis, from 08:00 to 20:00, but in fact often until the last visitor to arrive.
The new routing standard affects the entire path of the patient, from the front door to the exit from the clinic. For people with symptoms of a viral infection, separate entrances are organized, as well as rooms isolated from other parts of the medical facility.
At the entrance and in the halls of the polyclinic, administrators work, including employees of the My Documents offices. They advise patients and help to breed human flows. Visitors are given respirators that provide better protection against the virus compared to medical masks.
Before admission, patients are given a rapid test for COVID-19. This allows you to understand which doctor to refer a person to, and determine the tactics of treatment before receiving the results of the PCR test, as well as immediately prescribe the necessary medications. Patients with positive and negative rapid test results are separated into different blocks or floors to avoid overlapping.
Patients are also given a PCR test, the result of which appears in the electronic medical record the next day. In addition, before the doctor’s examination, pressure, temperature, saturation level are measured and, if necessary, an ECG is done.
Based on the results of the examination, the doctor prescribes a treatment regimen, dispenses medications and, if necessary, issues a certificate of incapacity for work. All information about this is transferred to the patient’s electronic medical record.
Since January 17, more than 490,000 people have been admitted to the departments for patients with acute respiratory viral infections in city clinics.
According to the Mayor of Moscow, this week there has been some stabilization of the dynamics of the incidence of COVID-19. This allows us to hope that there will no longer be a sharp increase in the number of patients. “Despite the huge flow of patients, the explosive growth of omicron in Moscow, I think that Moscow healthcare has coped with such a load. Moreover, we see that we have a reserve of power in the event of an increase in this wave,” he said.
Telemedicine options have been expanded for patients diagnosed with COVID-19 and SARS who are being treated at home.
After making a diagnosis, they can apply for a telemedicine consultation by signing up in the EMIAS: Telemedicine application. Access to the service (login and password) comes via SMS.
During the consultation, doctors assess the condition of patients, identify symptoms of improvement or deterioration in well-being, give recommendations, adjust treatment if necessary, and answer questions. The results of the consultation are drawn up in the form of protocols and reflected in electronic medical records.
Since January 25, more than 17,000 people diagnosed with SARS or COVID-19 have used telemedicine services.
Special departments for receiving patients with acute respiratory viral infections and a telemedicine service will operate until the epidemiological situation stabilizes and a steady decrease in the incidence of acute respiratory viral infections and COVID-19, in particular, the omicron strain.
Remote registration of sick leave
From January 28, Muscovites who have contracted SARS or become infected with coronavirus can apply for sick leave remotely (without a visit to the clinic). This is stated in the corresponding decree of the Mayor of Moscow.
Residents of the capital with SARS can fill out an application on the mos.ru portal. The doctor will independently contact the patient, hold a consultation, issue an electronic prescription for medicines and open a sick leave for seven days.
“This helps to reduce unnecessary trips of people to polyclinics as much as possible, because it is uncomfortable for them, and doctors have an additional burden,” Sergei Sobyanin added.
Doctors contact patients with confirmed COVID-19 themselves. Depending on the state of the person, they conduct an audio consultation and remotely open a sick leave or issue a house call and write out a certificate of incapacity for work during the visit.
Contact persons can leave an application for opening a sick leave on the website of the Metropolitan Department of Health. Before this, you need to make sure that the sick person or his employer has confirmed the fact of contact.
Muscovites who have been in contact with the sick person can ask him to report this by filling out an electronic form. If the contact occurred at work, it should be clarified whether the employer transferred this information to the Moscow operational headquarters.
Citizens who have had less than six months since the moment of vaccination or suffered COVID-19 should not observe quarantine due to contact with the sick person, and in this case, sick leave will not be issued.
Closing sick leave in all cases occurs remotely. In case of SARS and COVID-19, the doctor will contact the patient again, clarify how he feels and make a decision on discharge or extension of the sick leave. Contact sick leave will be automatically closed after seven days. It cannot be extended, but if symptoms of SARS appear, you can consult a doctor. Closed sick leave will be automatically sent to employers and available in electronic medical records.
If a patient needs a face-to-face consultation with a doctor, he can contact the doctor on duty at any nearest clinic or make an appointment at his own without an appointment. If it is difficult to get to the clinic due to your health condition, you need to call a doctor at home by calling 122.
City Polyclinic No. 68
The main building of polyclinic No. 68 is located at the address: Malaya Yakimanka street, house 22, building 1. The institution also includes four branches. The total area of buildings is 18.7 thousand square meters. It employs 534 people, including 182 doctors, 205 nurses and 147 other staff. Patients are about 146 thousand residents of Khamovniki, Zamoskvorechye and Yakimanka. The polyclinic is designed for 1.5 thousand visits per shift.
During the pandemic, the institution formed 11 mobile teams to help patients at home. They make 150-200 trips a day.
4012 patients with COVID-19 are under outpatient supervision, including 38 people who continue treatment in hospitals.
Natalya Kuzenkova, head physician of City Polyclinic No. 68, said that the clinic had to completely restructure its work during the coronavirus outbreak. Now it is an independent institution where the patient can immediately take a test for coronavirus infection, an express blood test, receive a referral for hospitalization or recommendations for home treatment.
“In fact, a new functional model of the polyclinic was created. And this is not only a department for receiving patients with acute respiratory viral infections – this is a complete redistribution of flows, redistribution of routes, organization of such spaces where our flows would not intersect, ”she said.
Since April 11, 2020, an outpatient CT center has been organized on the basis of the head building, in which about 20.9 thousand studies have been done. Since November 22, 2021, a day hospital has been operating under him for pre-emptive pathogenetic therapy with Levilimab — 177 patients have received it.
There is also an ELISA center in the polyclinic, more than 86.3 thousand people have been tested for the presence of antibodies in it.
According to Natalya Kuzenkova, patients come to the doctor already examined, which significantly saves time for specialists. She called the remote opening and closing of sick leave certificates another important innovation. Audio and telemedicine consultations allow monitoring such patients.
“Our doctors are proactive when they leave a request, call patients. They have an electronic medical record in front of them, and during video communication, they find out the condition and either correct the treatment, or change it in some way,” the head physician added.
On January 17 of this year, departments were urgently deployed in the head building and branches to receive patients with symptoms of SARS. 11 offices have been opened, 22 doctors, 10 nurses and 31 administrators are working, including 16 employees of public service centers. During these days they received more than 4.2 thousand people. In case of an increase in the number of patients with symptoms of SARS, the departments can be expanded.
EDITOR’S NOTE: This article is a translation. Apologies should the grammar and or sentence structure not be perfect.