The paper summarizes a 5-year experience of evaluating the safety of anesthetic management of patients with thermal lesions treated at the department of thermal lesions of Vishnevsky's Institute of Surgery, Russia's Academy of Medical Sciences. Regular internal auditings, based on the principles of registering the critical incidents, the course of 1473 general anesthesia managements was analyzed in 168 patients. The conclusion is that the introduction of protocols of anesthetic management as well as a regular monitoring over meeting the fixed targets cut the total frequency of critical incidents from 2.85 to 1.19 as estimated per one general anesthesia. Finally the authors suggest a concept whose essence in that the operation of the modern anesthesiology department must be based on a scientifically substantiated technology of anesthetic management.
The study defines the issues of expert evaluation of the quality of medical care for rural patients with myocardial infarction at hospitals of different specialization levels. "A card of expert evaluation of the quality of medical care rendered to patients hospitalized for myocardial infarction" has been worked out and included data on 252 hospitalized patients with myocardial infarction. Experts were chosen among the staff of the Chair of Therapy at the Medical Institute. It has been found that the status of medical care rendered to rural patients with myocardial infarction suggests the necessity of raising its quality and improving the forms of organisation.
A methodical approach to the hygienic assessment of the educational environment in children's educational institutions was developed and tested for the objective determination of the level ofsanitary and epidemiological welfare and effective planning of preventive measures with bearing in mind environmental factors which have the most negative impact on children's health.
Results of treatment of 571 patients with gastric cancer as well as errors committed during palliative and radical surgery were analysed. General surgeons not infrequently performed distal resection of the stomach for cancer of its proximal part whereas in cases of gastrectomy the distal part of the esophagus was not removed when indicated. On the contrary, in patients with cancer of the distal part of the stomach, surgeons aspired to save as much of the organ as possible, as would be done for the treatment of gastric ulcer. Principles of radical surgery for cancer were violated in those cases.