Creating and sustainable development of specialized centers as a way to improve quality of medical care

Quality of care is evaluated on the completeness of the survey, the correct diagnosis, treatment efficacy, and its duration. Improving the quality and efficiency of medical care for children with paroxysmal disorders of consciousness is one of topical problems of neurology.

Aim. The aim of the work is to justify the relationship between improving the quality of health care and sustainable development in the modern conditions of specialized medical centers on the example of the work on the identification and treatment of children with paroxysmal disorders of consciousness of the Center for diagnosis and treatment of epilepsy, and sleep disorders in children and adolescents at the department neurology, neurosurgery and medical genetics SPbGPMU.

Materials and methods. For more accurate diagnosis and treatment at the Center conducted a comprehensive examination, including video-EEG оf 527 children aged 1 month to 18 years. A clinical trial study included medical cases, assessment of neurological and somatic status, the study of seizure types and forms of the disease. Instrumental methods of examination were determined by EEG and MRI studies of the brain.

Main results. Comprehensive survey of sick children with monitoring video-EEG revealed that 317 children (60,1%) had epileptic paroxysms and 210 children (39,8%) – non-epileptic paroxysms. Correction treatment was performed in 284 (89,5%) children with epileptic paroxysms and altered the treatment in 190 (90,4%) children with epileptic paroxysms.

Conclusion. The presented clinical data show the high effectiveness of the Centre in the diagnosis and treatment of children with paroxysmal disorders of consciousness. The accumulated experience in the Center confirms the relevance of the creation of the structure of scientific and educational institutions specialized centers in which patients will be given to high-quality medical care.

1. Guzeva O.V., Majzel’ A.I. Perspektivy razvitija medicinskih centrov v Rossii [The prospects for development of medical centers in Russian Federation] Materialy IV Mezhdunarodnoj mezhvuzovskoj nauchno-prakticheskoj konferencii studentov magistratury 22 aprelja 2015 g. [Proceedings IV International Interuniversity Scientific and Practical Conference graduate students April 22, 2015] Part 1. SPb.: SPbSEU Publ., 2015: 35–39 (in Russian).

2. Guzeva V. I. , Belousova E.D., Karlov V. A., Muhin K.Ju., Petruhin A.S., Guzeva O.V., Guzeva V.V., Egiazarova I.I., Volkov I.V. Klinicheskie rekomendacii po diagnostike i lecheniju epilepsii u detej [Clinical guidelines for the diagnosis and treatment of epilepsy in children] Detskaja nevrologija. Klinicheskie rekomendacii [Pediatric Neurology: Clinical recommendations] Issue 1. Ed. V.I. Guzeva. M.: MK Publ., 2014: 265–327.

3. Guzeva O.V. Optimizacija diagnostiki i obosnovanie personificirovannoj terapii epilepsii u detej [Optimization of diagnostics and personalized therapy study of epilepsy in children] Avtoref. dis. … dokt med. nauk. SPb., Abstract MD Publ., 2014: 35.

4. Guzeva V.I. Rukovodstvo po detskoj nevrologii [Manual of Pediatric Neurology] 3 izd. M.: Med. Inf. Agency Publ., 2009: 640.

5. Guzeva V.I., Guzeva V.V., Guzeva O.V. Nejepilepticheskie paroksizmal’nye rasstrojstva soznanija u detej [Nonepileptic paroxysmal disorders of consciousness in children] Nejrohirurgija i nevrologija detskogo vozrasta – Neurosurgery and Neurology of Childhood. 2013; № 2 (36): 98–110.

6. Guzeva V.I., Guzeva V.V., Guzeva O.V. Medikosocial’nye problemy i kachestvo zhizni u detej s epilepsiej [Medico-social problems and quality of life in children with epilepsy] Epilepsija: fundamental’nye, klinicheskie i social’nye aspekty [Epilepsy: fundamental, clinical and social aspects] Ed. E. I. Guseva, A.V. Geht. M., 2013: 661–668.

7. Guzeva V.I., Guzeva V.V., Guzeva O.V. Obshhie svedenija ob jepilepsii i metodah ee diagnostiki (dlja samostojatel’noj podgotovki studentov) [General information about epilepsy and its diagnostic methods (for self-preparation of students)] Metodicheskie rekomendacii. SPb., 2013: 29.

8. Guzeva V.I., Guzeva V.V., Guzeva O.V. Osnovnye aktual’nye problemy i perspektivy razvitija detskoj nevrologii [Main current problems and prospects of development of Child Neurology] Epileptologija v sisteme nejronauk: Sbornik materialov konferencii – Epileptology in neurosciences system: Proceedings of the conference. Spb., 2015: 9–13.

9. Guzeva V.I., Guzeva V.V., Guzeva O.V. Znachenie kompleksnogo obsledovanija, vkljuchaja video-EEG, v diagnostike i obosnovanii lechenija neepilepticheskih paroksizmov u detej [The value of a comprehensive survey% 2C including video-EEG% 2C in the diagnosis and treatment of non-epileptic paroxysms justification in children] Rossijskaja shkola po detskoj nevrologii i smezhnym special’nostjam v ramkah Baltijskogo kongressa po detskoj nevrologii [Russian school of pediatric neurologyand related disciplines in the framework of the Baltic Child] Neurology Congress: Abstracts. Spb., 2014: 72–73.

10. Guzeva V.I., Guzeva V.V., Guzeva O.V. Tehnika zapisi, vozrastnye osobennosti i klinicheskoe znachenie EEG v nevrologii [Recording Equipment% 2C age features and clinical significance of EEG in neurology] SPb.: SPbSPMU Publ., 2013: 73.

11. Guzeva V.I., Guzeva V.V., Guzeva O.V., Ejbog E.S. Differencial’nyj diagnoz jepilepticheskih pristupov i parasomnij [Differential diagnosis of epileptic seizures and parasomnias] Rossijskaja shkola po detskoj nevrologii i smezhnym special’nostjam v ramkah Baltijskogo kongressa po detskoj nevrologii [Russian school of pediatric neurology and related disciplines in the framework of the Baltic Child]

12. eurology Congress: Abstracts. Spb, 2014: 69–70.