25 YEARS OF EXPERIENCE OF REGIONAL CLINICAL CENTER OF MINERS’ HEALTH PROTECTION Agadzhanyan V.V.
Regional Clinical Center of Miners’ Health Protection, Leninsk-Kuznetsky, Russia
In August 2018, Regional Clinical Center of Miner’s Health Protection will hold 25th anniversary from the day of opening.
Center of Miners’ Health Protection is the biggest Russian medical, scientific and educational facility, which constantly externalizes the advanced domestic and foreign experience in decreasing incidence of diseases among residents of the coal industry regions.
Everything began in 1988, when the USSR Cabinet had made a decision on construction of the big medical facility. It was built by means of realization of above-target coal of Kuznetsk basin. That is why, miners and their families are patients of the center.
25 years ago, in September 1993, the hospital admitted the first patients, and the first surgery was carried out in January 1994. The hospital was named as State Scientific Clinical Center of Miners’ Health Protection.
The Center was restructured for several times: State Scientific Clinical Center of Miners’ Health Protection became Federal Scientific Clinical Center of Miners’ Health Protection for creation of the main facility for centralization and extension of specialized medical care for workers of Kuzbass coal enterprises and their families, and in 2015 – Regional Clinical Center of Miners’ Health Protection.
During 25 years, 400,000 patients were treated, 150,000 operations were conducted, including 12,000 high tech operations, more than 6 million visits were registered, with 2 million miners and 1.9 million children.
The center provides the realization of medical programs for increasing efficiency of treatment of miners and their families, veterans and older people, extensive support and treatment of children. The center has been realizing some social programs, including ones for treatment of hip in older patients. Owing to these programs, medical care was given to more than 4,000 veterans and older people, 5,000 retired miners and 10,000 children.
The center has been actively developing and extending that increases its competitive performance, separates it among other clinics and attracts the patients from various regions of the Western and Eastern Siberia.
The center includes 26 clinical units with 515 beds, 6 diagnostic units, polyclinics for children and adults with 1,000 visits, the occupational pathology center, outpatient surgery center, the evacuation teams of the regional center of disaster medicine (medical evacuation unit), pathologic anatomy department and emergency medical care unit.
There are more than 1,400 employees including 200 physicians (12 PhD (1 academician of Russian Academy of Natural Sciences, 3 professors, 6 corresponding members of Russian Academy of Natural Sciences) and 28 candidates of medical science), 610 nurses, 50 specialists with university education, 40 medical attendants, 591 other specialists.
10 physicians have the honored title the Honored Physician of RF, 19 employees – outstanding specialists in healthcare.
For 25 years of working activity, a lot of good traditions has appeared in the center, particularly, tradition of domesticity in common cause of devotion to medicine which is passed on from generation to generation. The representatives of 26 professional dynasties including 12 medical ones work in the center.
There are 5 winners of the All-Russian competition the Best Doctor of the Year. They are PhD in medicine Agadzhanyan Vagram Vaganovich (2001), Afanasyev Leonid Mikhaylovich (2005), Khokhlova Olga Ivanovna (2008), Novokshonov Aleksandr Vasilyevich (2011), Yakovleva Natalya Vyacheslavovna (2016).
Galina Petrovna Krasulina, candidate of medical science, has made a lot of mental and physical activity for realization of the architectural project of the hospital in the territory of the city. She also managed its construction.
Vagram Vaganovich Agadzhanyan, the Honored Doctor of RF, PhD, professor, academician of Russian Academy of Natural Sciences has been leading the center. Establishment and development of this biggest multi-profile facility had been proceeding under his leadership.
Thanks to rare energetic potential and professionalism of the hereditary doctor, administrator-strategist, tactician and practioner, Vagram Vaganovich Agadzhanyan has saved the center in the difficult 90s and has got above the previous achievements. The present generally accepted success of the center is mainly determined by the experience by the employees, ability to cooperative creative work and commitment to excellence.
The following scientists have been made the great contribution into development and formation of scientific directions of the center and have been continuing the traditions of their teachers: the professors V.V. Agadzhanyan, I.M. Ustyantseva, PhD A.A. Pronskikh, A.Yu. Milyukov, S.A. Kravtsov, O.I. Khokhlova, V.A. Semenikhin, A.V. Shatalin, N.V. Yakovleva, candidates of medical science A.Kh. Agalaryan, N.V. Agafonova, E.A. Belogortseva, S.V. Bogdanov, E.V. Varyushkina, S.V. Vlasov, I.V. Vlasova, Ya.Kh. Gilev, O.V. Kobyakova, G.P. Krasulina, A.N. Kornev, A.S. Nikolaev, O.V. Odintseva, O.V. Petukhova, E.A. Rotkin, N.S. Sinitsa, L.V. Smirnova, M.Yu. Fedorov, Yu.S. Fedorov, O.P. Khayretdinova, V.N. Tsuryupa, E.V. Chelyshev, O.A. Yakushin.
The uniqueness of activity of the facility consists in the flexible system of diagnostics and treatment in concordance with the last scientific projects and techniques which allows the complex approach to management of difficult categories of patients. The center realizes the full cycle of diagnostics and treatment, including outpatient and consultative attendance, inhospital stage of treatment with use of all subdivisions of the hospital including the medical rehabilitation department.
The system for rendering specialized medical care for patients with multiple associated injury (polytrauma) has been developed and implemented in the center.
Provision of the closed cycle of medical care is realized with the main factors:
- availability of specialists in all main medical fields: surgery, traumatology and orthopedics, neurosurgery, cardiology, gynecology, pediatric surgery, anesthesiology and intensive care;
- extensive diagnostic basis including radiological, laboratory and functional diagnostics.
All of it allows excluding the necessity for attraction of consultants from other medical facilities and promotes the decrease in time of realization of specialized medical care.
There is continuity in activity of the center with the Center of Rehabilitation of Social Insurance Center of the Russian Federation “Topaz”, where rehabilitation of patients with industrial injuries is continued up to recovery of working capability.
The priority direction in activity of the center is arrangement of urgent care for persons who suffer in mining enterprises. For this reason, the medical evacuation service has been initiated. It includes eight modern reanimobiles with medical equipment for support of vital organs and systems over the distance of 500 km. Medical evacuation of patients is carried out from other medical facilities and from sites of technogenic disasters. Medical evacuation for the distance more than 1,000 km is realized with participation of aviation. There is a helicopter platform for urgent receive of patients in the territory of the center.
112 miners were admitted from the underground mines (Yubileynaya, Raspadskaya, Pervomayskaya and others) to the center for the last 5 years. More than 700 patients (employees of coal enterprises and their relatives) were transported from the medical facilities. It reduced the mortality from 35 to 14 %.
In 2000-2018, the medical evacuation unit has transported 3,350 patients including 1,592 patients with industrial injuries, and 10 patients from Khakassia, Tyva and Altay region.
The system of preventive procedures for occupational diseases in coal miners includes several key directions:
- complex diagnostics of occupational diseases, treatment, rehabilitation and health survey for coal industry workers;
- assessment and analysis of occupational diseases in miners of the region;
- control of quality of preliminary and periodical medical surveys in coal industry of the region;
- development of procedures for prevention and decrease in occupational diseases in the region.
Each year, more than 12,000 miners are treated in the occupational pathology center. Inhospital medical care is annually given to more than 600 workers.
As result of activity of the occupational pathology center, the rate of occupational diseases has decreased by 20 %, and the level of occupational diseases has stabilized.
The use of the advanced medical technologies is the main principle of activity of the team.
Since 1994, the center has been realizing the research program for solution of the medical and biological problems in Siberia.
The main directions in the scientific researches of the center were and still are the issues of arrangement of the system for monitoring of health of coal industry specialists, development of new methods for diagnosis and treatment of polytrauma, diseases of cardiovascular and bronchopulmonary diseases, and occupational pathology.
The innovative technologies have been developed and effectively tested in the clinic:
1. The complex system for arrangement of specialized medical care for patients with polytrauma (multiple and associated injury).
2. Arrangement of urgent care for persons with industrial injuries. The medical evacuation service including the modern reanimobiles has been initiated for this reason.
3. Optimization of the system of preventive measures for occupational and industrial diseases in employees of coal industry of Kuzbass.
4. Kuzbass is the first region where the system of personal provision of pharmaceuticals has been developed and implemented. It allowed the distribution and the implementation of the system in the medical facilities of Kuzbass (Novokuznetsk City Clinical Hospital No.1, Kemerovo Regional Clinical Hospital No.1, Kemerovo Regional Perinatal Center, Kemerovo City Clinical Hospital No.3).
5. The medical information system (MIS) Electronic Case History of Regional Clinical Center of Miners’ Health Protection has been developed and implemented.
6. The innovative technology of automation of the clinical diagnostic laboratory with the laboratory information system (LIS) has been developed and implemented. It increased the capability and economic efficiency of the laboratory.
7. The quality management system has been implemented for urgent and planned inhospital and outhospital polyclinic medical care in concordance with the requirements of ISO 9001:2008 international standard.
8. In cooperation with National Research Center Kurchatovskiy Institute and Novosibirsk Institute of Organic Chemistry named after N.N. Vorozhtsov, the scientific works for creation of domestic biodegradable nanostructured polymer and nanocomposite materials and products for general and reconstructive plastic surgery, traumatology and orthopedics are conducted.
9. The first domestic production of X-ray contrast surgical drapes has been initiated under supervision of the scientists.
10. The evidence-based system Safety of Patients for prevention of hospital infections has been developed and implemented into practice. It protects patients from hospital infections. This system is based on the standards of the system of epidemiological survey, monitoring of agents, development of strategy and tactics of administration of antibiotics and estimation of economic efficiency of procedures. The non-contact sensor dispensers are installed before the entries of all departments. After closing somebody’s hands to the dispenser, it sprays the disinfecting agent. The little spray-flacons with the fluid are in the pockets of each employee and near the beds of patients.
11. The Hospital Logistics system has been developed and implemented. It is the system for management of centralized platforms for delivery of pharmaceuticals, nutrition, disinfecting agents and housewares to the structural divisions of the clinical center.
12. The Medical Waste Management system with the special device has been developed and implemented (the patent for an invention No.2430798, October 10, 2011), which allows management of surgical drapes, dressing, shoe covers and others.
13 PhD and 79 candidate’s dissertations have been written and defended, 7 monographies and more than 4,500 scientific works have been published, 142 patents of RF have been received, and 21 All-Russian scientific-practical conferences have been organized and conducted in cooperation with the general committee of Siberian department of Russian Academy of Sciences (the materials have been published in the collections of materials of the conferences 1996-2018 (ISBN 978-5-904-430-18-4).
The results of the scientific studies are constantly reported during the weekly conferences in the center, in the forums of various levels – from Russian (more than 3,000 reports) to international (more than 300 reports). The scientific practical journal Polytrauma has been founded with the initiative by V.V. Agadzhanyan, the main editor. The journal is being published since 2006. It is published in Russian and English. The journal is referenced in the List of Publications of State Commission for Academic Degrees and Titles, All-Union Institute of Scientific and Technical Information, Russian Science Citation Index and in the international reference database SCOPUS (June 2016) and Ulrich’s International Periodicals Directory.
The center is the educational basis with the postgraduate education departments Integrative Traumatology (the chairman V.V. Agadzhanyan, PhD, professor) and Occupational Pathology (the chairman V.A. Semenikhin) of Kemerovo State Medical University. The departments have been opened in 1998.
In 2017, with the aim of realization of the scientific research, professional and educational programs for medical staff, the Kuzbass department of Novosibirsk Research Institute named after Ya.L. Tsyvyan has been opened.
The library has been created in 1993. Today it is the main book storage of medical and imaginative literature in Leninsk-Kuznetsky. There are more than 32,000 copies: more than 14,000 medical books, 17,000 medical journals in different languages.
The administration of the center pays the great attention to improvement in staff. Young specialists are invited each year.
The center has a program for improvement of hospital stay of patients: reconstructions of the rooms, arrangement of individual nutrition for patients, special cloths, staff discipline and adherence to ethical standards. Near the hospital, the free comfortable car parking has been opened for patients. The cozy garden zone with 4 waterworks creates the conditions for rest and fast recovery of patients. The picture gallery includes more than 300 copies.
Today the patients are not satisfied only with knowledge of advanced techniques, modern methods of management and import equipment. The name Regional Clinical Center of Miners’ Health Protection supposes that the clinic is troubleproof and one can rely on it.
Preservation of annual innovative development of science and practice, traditions of high level of medical care, constant aspiration to get another level – all these features put the center into the range of the leading medical facilities in the region