CURRENT CHALLENGES FOR THE HEALTH CARE SYSTEM DUE TO THE LACK OF MEDICAL STAFF AND THE CONTINUOUS PROFESSIONAL DEVELOPMENT OF DOCTORS.

OBJECTIVE: The aim: Research of the ways of adequate solving of problems with understuffed healthcare system and problems with continuous professional development of doctors. PATIENTS AND METHODS: Materials and methods: We have used a official statistical data for the period from 2009-2020 years. This data was analyzed with usage of systemic approach and statistical epidemiological analysis. RESULTS: Results: According to the data from Ministry of Health of Ukraine during the first year of the pandemic (2020) the quantity of our doctors has diminished by 6.9 thousands, and quantity of nurses - by 22,5 thousands which is much bigger deficit then in period of 2018-2019 years. The insufficiency of pediatric doctors in Ukraine has reached 1000 vacancies, general physicians - 1700, family doctors - more than 3000 vacancies, surgeons - more than 950 vacancies. It is also important to involve medical experts and medical associations and unions in the process of accreditation and licensing of providers of continuous medical education. CONCLUSION: Conclusions: Existing deficit of medical personnel should be replenished by increasing of medical education of students in medical universities and colleges funded by government. Existing system of continuous professional development of doctors requires a lot of changes (additional activities, new technologies) which must be implied with the help of professional medical associations and unions.

COVID-19 AS A STRESS TEST OF HEALTHCARE ESTABLISHMENTS EFFECTIVENESS AND RELIABILITY MEASURED NATIONALLY AND GLOBALLY.

OBJECTIVE: The aim: The authors aimed to estimate the healthcare environment risks and safety problems of the medical staff and patients, methods of neutralizing the negative public health effects and to suggest the new approaches to improved effectiveness and reliability of the healthcare establishments functioning under the emergencies. PATIENTS AND METHODS: Materials and methods: The study includes data of questioning of 163 healthcare workers of certain institutions in Ukraine using the questionnaire of the Agency for Healthcare Research and Quality ( the USA) on adherence to the patients' safety culture. In this study only the data on the patients' safety culture "response to mistakes" are represented. The more positive answers the respondents gave, the less they are aware that their mistakes and reports do not influence them negatively. RESULTS: Results: Hospital environment reprsents a complex multi-component system, in which specific medical and social tasks are executed, with their fulfillment accompanied with hazardous and unsafe biological, psycho-physiological, chemical, physical and social effects on the staff, patients and the environment. The joined effect of the hospital environment negative factors on the staff is stipulated for the stress and functional tiredness accumulation; it leads to increase in medical mistakes occurrence, which, in its turn, increases probability of occupational catching COVID-19, thus, raising the hospital environment risks under the COVID-19 circumstances both for the medical staff and the patients. CONCLUSION: Conclusions: The COVID-19 pandemics turned to be a helpful factor to define critical issues in the hospital environment safety, proving the necessity of further studies, aimed at transforming the safe hospital environment notion from its theoretical meaning into the working paradigm, minimizing practical risk in hospital establishments.

SAFETY OF PATIENTS AND MEDICAL STAFF IN CURRICULA AND TRAINING PROGRAMS FOR MEDICAL PROFESSIONALS IN UKRAINE.

OBJECTIVE: The aim: The Canada and Poland experience in the educational field in the practical implementation of international practices for the prevention of patient safety incidents is significant, taking into consideration the effectiveness of health care models. We have to analyze the documents on the training of medical professionals in terms of safety as a first step in introducing into the domestic (Ukrainian) medical educational practice of existing international experience in teaching patient safety. PATIENTS AND METHODS: Materials and methods: The research was based on international documents on patient safety, thematic scientific publications, plans, and programs for the training of medical professionals in Ukraine. Bibliosemantic, systems analysis, mathematical (relative values) research methods were used in the study. CONCLUSION: Conclusions: The analysis of thematic plans of separate disciplines in "Nursing" specialty has shown, that according to experts, questions of safety of patients should contain more than in 70% of subjects; on the topics of classes safety issues are provided in the range from 45.1% (basics of nursing) to 0.0% (anesthesiology and resuscitation); the actual content of educational and methodical materials was from 14.6% (basics of nursing) to 0.0% (anesthesiology and resuscitation). The time allotted to study disciplines related to occupational safety and health of health workers (life safety, basics of bioethics and biosafety, as well as occupational safety in the industry) is six times higher than the hours of study of the discipline (medical law) related to patient safety in the Working Curriculum (second (master's) level of higher education in the field of knowledge 22 "health" specialty 222 "medicine"). As a result of the analysis of work programs of educational disciplines at all levels of medical specialists training, a sharp discrepancy in the new information support of the educational process was revealed in terms of patient safety.