ГОСУДАРСТВЕННОЕ УПРАВЛЕНИЕ/2.Современные технологии управления.

Abdraimova G.K., k.e.s., associate professor

Tlepbergen N.T., master of the group MH-21NP

Karaganda economic university Kazpotrebsoyuz, Kazakhstan

SOME OF THE PROBLEMS OF TRAINING AND DEVELOPMENT OF PERSONNEL IN THE HEALTH CARE OF THE REPUBLIC OF KAZAKHSTAN

Kazakhstan has determined by an important state priority of investment into the human capital. The special attention to quality of personnel potential of health care is paid by the Head of our state Nursultan Abishevich Nazarbayev. It finds reflection in his annual Messages to the people of Kazakhstan.

Improvement of health of citizens of Kazakhstan for ensuring sustainable social and demographic development of the country - a main objective of the State program of development of health care of the Republic of Kazakhstan of "Salamatta Kazakhstan" for 2011 - 2015 and Concepts of development of personnel resources of health care for 2012 - 2020.

The medicine of the XXI century is an alloy of high technologies and experts of the top skills. To provide with the qualified personnel capable to work at the modern hi-tech equipment, - the main task which the health care needs to solve. With emergence in the domestic market of the latest technologies there was a requirement of creation and widespread introduction of innovative approach to training and professional retraining of personnel. Acquisition of practical skills by young specialists has to be safe both for patients and for trainees, and increase of level of practical training of specialists, decrease in medical errors, reduction of complications and improvement of quality of medical care to the population in general is possible by means of simulyatsionny education.

So far essential experience of application the simulyatsionnykh of technologies is around the world saved already up. In this connection, simulyatsionny training is around the world recognized as one of the advanced methods of preparation of medical shots, and its efficiency is confirmed by inclusion in the USA, Canada, Norway, Sweden of this method in the obligatory list of the training programs of training of doctors and average medical personnel.

One of the directions of a state policy of the country is improvement of quality of medical services and development of hi-tech health system. Quality includes providing appropriate and economically effective medical services and depends on a set of factors among which an important role is played by the level of professionalism and motivation of experts of health care to his increase, introduction of modern technologies of management of processes of the organization and delivery of health care, introduction of effective methods of payment of medical care, material equipment of the medical organizations and others.

One of important components of strengthening of health systems are strategy of development of personnel resources. Around the world efficiency of health systems and quality of medical services depend on indicators of activity of workers which are defined by their knowledge, abilities and motivation [1].

The international experience, in particular experience of World Health Organization (further - WHO), demonstrates that among the organizational changes concerning increase of efficiency of health systems, the greatest success is achieved by actions taken in the field of personnel administration.

There is a set of the data confirming positive influence of quantity, quality of training of workers of health care, density of their distribution to results of various actions in health sector and in general on human health.

According to definition of WHO, workers of health care are people whose primary activity is directed to improvement of health. Their number includes the experts rendering medical services (doctors, nurses, druggists and laboratory assistants) and also administrative and auxiliary workers. In the world there are about 60 million workers of health care. About two thirds from them render medical services (providers), and one third carries out administrative and support functions.

Personnel crisis in health care admits the world community. Modern problems of development of shots of health care in the world are connected with deficiency of the personnel providing primary medical care, surplus of experts of a narrow profile, an imbalance of number of doctors and the nursing and obstetric staff, excessive concentration of health workers in the large cities.

It is proved that there is direct link between the relation of number of workers of health care to population and health indicators.

Global shortage of workers is aggravated with the available imbalance within the country. In rural areas in comparison with the cities deficiency of competent staff is observed.

By estimates of WHO, completion of shortage requires, at least, 2 360 000 health workers and 1 890 000 administrative and auxiliary workers, that is, in total, 4 250 000 workers of health care.

A variety in a skill level, in the ratio the number of the junior medical staff to the number of doctors is characteristic of the different countries. Also essential are disproportions in a range of the main specialties and qualifications.

The most problem in personnel health sector are questions of the correct planning of personnel resources, their number, elimination of disproportions in structure of distribution of skilled workers.

For the last 30 years in the majority of industrialized countries there was a strengthening of a role of administrative workers, economists in the sphere of medical care. For example, in many countries clinics the professional administrators who don't have medical education usually direct.

The modern policy of development of shots of health care in many countries is formed on joint responsibility of the state and society, including professional medical associations. The government tries to regulate, define, satisfy real needs for health care shots, and also to support, direct and control actions in the field of training and training and productive use by their society [2].

The regional observatories of personnel resources created by WHO strengthen, develop and support the knowledge base for a health care manpower in different regions. Observatories provide actual data for adoption of political decisions for the purpose of strengthening of health systems and improvement of medical care. They trace practical techniques and the saved-up experience and exchange them.

Thus, personnel policy of the developed countries is directed to introduction of methods of management of efficiency of the available resources, strengthening of a role of administrative workers, fast evolution of a sisterly profession and expansion of functions of average medical personnel, training of specialists in the sphere of public health care, by increase of requirements to the sphere of preparation and retraining of personnel.

Distinctive features of personnel resources of health care of Kazakhstan are higher rates of security with medical shots, along with smaller indicators of security with average personnel in comparison with world data. The average value of security with medical shots of urban population more than by 3 times exceeds that in rural areas.

The control system of personnel resources, shortage of the qualified administrative potential, the outdated principles of work of HR departments, shortcoming of experts in the field of management and economy of health care, social workers are a serious barrier on the way of creation of effective potential.

The existing problems connected with a staff deficit, uneven geographical and territorial distribution, and also a structural personnel imbalance are burdened by also insufficient qualification of the available shots often defining poor quality of medical services.

The situation is aggravated with the fact that the operating system of forecasting and planning of shots is a little effective. Planning of personnel resources historically wasn't a policy priority in health sector.

Today it is also necessary to note that lack of clear state personnel policy in health sector has led to quantitative and high-quality crisis of a manpower. Absence of motivational incentives to work, the low wage, insufficient social security of workers of health care have led to decrease in inflow of young shots to branch of health care and "aging" of medical shots. Rather seriously the situation is with attraction and preservation of shots in rural regions.

The insufficient hardware of workplaces, weak support from supervision manpower are problem, the outdated principles of work of HR departments, unattractive social infrastructure of rural settlements.

It should be noted the positive tendencies which were outlined in the branches concerning development of the sphere of medical and pharmaceutical education of the republic. In 2010 implementation of the Concept of reforming of medical and pharmaceutical education – the first stage of transformations in this sphere is complete. The new model of preparation of medical and pharmaceutical shots, new educational standards and technologies based on the best international practice is introduced. The created educational clinical centers have allowed to place emphasis on clinical training of students and interns. Are developed and successfully national standards of institutional accreditation of medical schools take root. Achievement of the quality of the medical and pharmaceutical education corresponding to the best international practice and providing effective development of domestic health care – are the main priorities of the Concept of development of medical and pharmaceutical education approved in 2011 for 2011-2015.

In recent years active work on training of specialists of public health care, managers of health care, nursing staff with the higher education has begun. Work on improvement of regulatory legal base of shots of health care is begun – the nomenclature of specialties and positions, and also qualification requirements and characteristics to them are developed. Requirements to an assessment of level of qualifications of medical shots are revised.

For implementation of the present Concept there are favorable opportunities to which number it is possible to carry: continuous growth of financing in a share from GDP of the country on health care; recognition as one of strategic tasks the State program of development of health care of the Republic of Kazakhstan of "Salamatta Kazakhstan" for 2011-2015 need of creation of competitive personnel capacity of branch; implementation of the joint "Transfer of Technologies and Carrying Out Institutional Reform in Sector of Health Care of the Republic of Kazakhstan" project with the World bank; emergence of new effective methods of management in the field of health care; development of information technologies in health care sector, etc.

At the same time it is necessary to consider threats and risks for successful implementation of the Concept. It is possible to carry to their number: the increasing growth of requirements to a skill level of medical shots; emergence of new medical technologies, the prompt updating of information connected with development of medical science and new technologies; demographic (aging of the population) and the epidemiological tendencies (growth of chronic diseases) which are followed by change of need for medical care and reorientation from rendering "medical care" to rendering "medico-social services"; migration of medical shots, etc.

Implementation of the present Concept of development of personnel resources of health care is intended for the period from 2012 to 2020.

At the first stage (2012-2014):

1) it is created effective standardly - legal base in the field of development of personnel resources;

2) methods and tools for realization of personnel policy are developed and introduced effective;

3) the national Observatory of personnel resources of health care as the coordinating center for questions of personnel policy and researches in this sphere is created;

4) the modular and accumulative system of continuous professional education of shots of health care is introduced;

5) the institute of professional managers of health care is introduced;

6) the institute of an independent assessment of a skill level of medical shots is introduced

7) professional associations are actively involved in the solution of problems of KRZ;

At the second stage (2015-2017) actions of the first stage will be continued, monitoring and an assessment of efficiency of the measures realized at the first stage will be carried out, and also:

1) HR departments of bodies and the organizations of health care are modernized;

2) functions on development of KRZ are partially transferred to professional associations.

At the third stage (2018 - 2020) will be:

1) the regional Observatory of personnel resources of health care is created with assistance of WHO;

2) effective methods and tools for realization of personnel policy of resources in compliance with the best international practice are developed and introduced;

3) joint actions with the international organizations, including with WHO, and also the organizations by donors for carrying out researches in the field of personnel resources of health care, to questions of development of personnel resources of health care are realized [3].

Additional education is carried out in the medical and pharmaceutical organizations and the sciences realizing educational training programs of additional education.

1. Professional development of shots – the form of additional education allowing to support, expand, deepen and improve earlier acquired professional knowledge, skills.

Professional development is provided for the shots with the higher medical education which were trained in internship, and (or) clinical internship, and (or) residency and (or) retraining in the specialty, and also for the shots with the higher pharmaceutical education including which have passed retraining in the specialty.

For professional development of shots with an average professional (technical and professional) education by the previous education level is average (technical and professional) medical or pharmaceutical education and (or) retraining in the specialty.

Certified cycle – a professional development cycle for listeners with the highest and average (technical and professional) medical education, applying for assignment of qualification category.

2. Retraining of personnel – the form of additional education allowing to master respectively other medical or pharmaceutical specialty.

The purpose of retraining of personnel is acquisition of the new knowledge, skills necessary for performance of professional activity on new specialty.

3. Within programs of professional development and retraining events for scientific information exchange, seminars, trainings (master classes), self-education, training at practice are held (training on a workplace).

Seminar, training (master class) – forms of theoretical or practical professional development of shots.

Simulyatsionny technologies – the modern technologies of training and an assessment of skills of shots including elaboration of automatically repeated actions, the expeditious adoption of adequate decisions based on modeling of clinical and other situations the, including urgent situations as close as possible to real situations.

4. Development of programs of additional education is carried out with a separation or with a partial separation from work. In cases with a partial separation from work shots perform work on the terms of part-time and in parallel are trained in one of forms of additional education, in that with application of remote educational technologies, in the order established by Rules of the organization of educational process for the remote educational technologies approved by the order of the Minister of Education and Science of the Republic of Kazakhstan of March 20, 2015 No. 137 registered in the Register of the state registration of regulations for No. 10768.

Training in programs of additional education is carried out at the expense of budget funds, the employer, and (or) from other sources which aren't forbidden by the legislation.

5. For determination of initial (initial) level of knowledge of listeners of cycles of professional development lasting from 54 hours and more, and also retraining cycles, it is carried out basic, during training – current, upon termination of training – total control.

Control is carried out in the form of testing, interview, use the simulyatsionnykh of technologies, and also works with patients under the leadership of the teacher of a cycle of professional development, retraining. The form of total control on cycles of professional development is defined by the training organization independently.

Total control on cycles of retraining is exercised in two stages:

- testing (not less than 100 questions);

- an assessment of practical skills on a specialty profile with application the simmulyatsionnykh of technologies.

Total control includes control of development of classroom and out-of-class (independent) work of the listener.

Literature:

1. Krasnova N. V. Staff development of the company. Practical guide. DS market, 2011.

2. The decree of the President of the Republic of Kazakhstan of November 29, 2010 No. 1113 " On approval of the State Program "Salamatty Kazakhstan" for Health Development of the Republic of Kazakhstan for 2011-2015 years ".

3. The decree of the President of the Republic of Kazakhstan of December 7, 2010 No. 1118 " On approval of the State Program for Education Development of the Republic of Kazakhstan for 2011-2020 years ".