Organisation of Internal Control for the Quality and Safety of Medical Activities in State Medaical Organizations

This master’s thesis explores the organization of internal quality and safety control in public healthcare institutions. The relevance of the study stems from the need to improve the effectiveness of the healthcare system by implementing robust control mechanisms aimed at minimizing risks and ensuring patient safety. The quality and safety of medical care are key performance indicators for medical institutions, especially under the mandatory health insurance system. Federal Law No. 323-FZ “On the Basics of Health Protection of Citizens in the Russian Federation” mandates the implementation of internal control systems. Russia employs a three-tier quality control model that includes licensing, ongoing monitoring, and subsequent supervision. However, in practice, inconsistencies and violations often emerge, requiring systematic intervention. The thesis emphasizes the importance of adverse event prevention and risk management as primary elements of internal control. Major sources of risk include diagnostic and treatment errors, as well as violations of infection control protocols. A systematic approach is proposed, which incorporates staff training, regular audits, and transparent reporting. The author analyzes the current legal and regulatory framework, including federal laws and orders from the Ministry of Health of Russia, that define the structure and principles of internal quality control. The research includes both theoretical and empirical analysis, featuring interviews with physicians and health experts, as well as a case study conducted at City Clinical Hospital No. 67 named after L.A. Vorokhobov. The primary goal of the study is to develop recommendations for improving the organization and implementation of internal quality and safety control in public medical institutions. Specific objectives include analyzing the regulatory framework, identifying current issues, evaluating the assessment criteria in use, and offering strategies to enhance the patient safety culture. The research findings can be valuable for healthcare administrators, policy developers, and medical institution leaders seeking to design and implement effective internal control systems.