EXPERIENCE IN IMPLEMENTATION OF THE PROJECT «POLYCLINIC WITHOUT QUEUES» IN THE TOMSK REGIONAL ONCOLOGY CENTER

The problem of queues in polyclinics and hospitals is a deterrent to ensuring access to oncological care. In order to optimize anti-cancer control there were shortened timelines both for the diagnosis and the beginning of the specific treatment. Since 2012, in the Tomsk Regional Oncology Center a new concept of the polyclinic organization on the profile of «oncology» was formed. The key aspects of this concept were: 1) standardization of the medical staff work; 2) the rules for the routing of patients with the execution of the first medical appointment booking for visiting doctor through the registry, for the second visit - by an oncologist and with the differentiation of the streams of patients for medical care in the framework of MHI and medical services on a fee basis; 3) intensification of the provision with outpatient specialized care with the staff reinforcement: the regime of the polyclinic is organized in two shifts and 6 days a week, the number of doctors and nurses is increased by 60.8%, the number of medical registrars - by 7 times. To coordinate their work, the position of the senior medical registrator was introduced; 4) modernization of all workplaces of doctors, nurses, medical registrars with the provision of modern medical equipment, communications and information support; 5) logistics of the registry: the division of its zone into a «front office» - were the office-medical registrator communicates with patients only as «face-to-face» and «call center» - with a dialogue by phone. 6) quality control of the clinic work with evaluation of video and audio recordings of interaction between registrars and patients, visitors questioning. 7) the reform of the oncological consultation on an ongoing basis regulations; 8) increasing the comfort of waiting for patients with the organization of comfortable seats, coolers with glasses, air conditioners, corporate identity and logo. The result of the implemented activities was a reduction in the start of specialized treatment by 68.3%, increased coverage of antitumor therapy by 16.4%, including among rural residents. This contributed to the improvement of the situation in a number of indices: the increase in the share of early forms of malignant neoplasms, active detectability by 21.6% and 164.7%, respectively, a decrease in one-year mortality rate, neglect by 25.2% and 8.6%, respectively. Population satisfaction with the provision of cancer care increased.