Ryazan Minister of Health: They often call an ambulance for minor reasons, but at this time someone else really needs to save their life. Opinion: Minister of Health of the Ryazan Region Andrey Prilutsky "Medical assistance to the population"

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Born on September 14, 1959 in Moscow. In 1976 he entered and in 1982 graduated from the Faculty of Instrumentation of the Moscow Higher Technical School. N.E. Bauman, specializing in radio-electronic devices. From 1982 to 2013, he worked at the Research Institute of Long-Range Radio Communications, Moscow, progressing from an engineer to Deputy General Designer-Head of a Thematic Center. From 2013 to 2016, he worked at JSC NPP Pulsar, Moscow, as the head of the Center for Space Technologies. Currently he works at the Federal State Unitary Enterprise NPO im. S.A. Lavochkin", Khimki. He is the scientific supervisor of a number of research and development works in the field of complex antenna systems and remote sensing radar systems. In 1991, he completed his postgraduate studies at the Central Research and Production Association "Vympel" and defended his thesis on the topic "Phased array antennas from slot emitters at the ends of waveguides." In 2012, he defended his doctoral dissertation on the topic "Wide-angle scanning methods in radio remote sensing systems" at the dissertation council at the Scientific and Technical Center for Unique Instrumentation of the Russian Academy of Sciences, specialty 01.04.01. In 2013, he was elected a corresponding member of the RAE, in Elected full member of the RAE in 2015. Area of ​​research: theory of antennas, reconfigurable electrodynamic structures, structures with controlled surface impedance, remote sensing of natural environments in the radio range. Author of more than 70 scientific publications and patents, including: “Interaction of microwave radiation with multilayer metal-dielectric-semiconductor (MDS) structures”, “Scanning reflective antenna with an impedance cylindrical reflector in the form of a layered semiconductor-dielectric-metal structure with optocoupler control”, “Reconfigurable antennas” and others. He took part and made presentations at a number of international, all-Russian, regional and republican conferences. He is the scientific director of the section “Generation, emission, propagation of ultra-wideband signals and ultrashort pulses” of the International Conference “Acousto-optic and radar methods of measurement and information processing” (ARMIMP). Honorary radio operator of the Russian Federation. He has scientific awards from RAE and ESIC: Silver medal of V.I. Vernadsky, Gold medal "European Quality", medal "Wilhelm Leibniz", medal "LABORE ET SCIENTIA", Order of Peter the Great. In 2013, he was awarded the title “Honored Worker of Science and Education” of the Russian Academy of Economics.

Scientific publications:

1. Auto. certificate 1561134 (USSR), MKI4 (51)5 H 01 Q 3/26, 21/00/ Phased array antenna/ G.A. Evstropov, A.A. Prilutsky; application 01/03/1990; publ. 04/30/90, Bulletin. image No. 16;

2. Patent RU, 2480788 C2, IPC G01S13/90 (2006.01) / Radar system for remote sensing of the earth / Prilutsky Andrey Alekseevich, Detkov Alexander Nikolaevich, Nitsak Dmitry Anatolyevich

3. Patent RU, 119527 U1, IPC, H01Q3/44 (2006.01) Emitter-phase shifter of a reflective antenna array / Prilutsky Andrey Alekseevich, Bogdanov Sergey Vladimirovich, Zheksenov Marat Andreevich;

4. Prilutsky A.A. Interaction of microwave radiation with multilayer metal-insulator-semiconductor (MDS) structures // Advances in modern radio electronics. – 2009. – No. 9. – P. 74 – 80.

5. Prilutsky A.A. Scanning reflective antenna with an impedance cylindrical reflector in the form of a layered semiconductor-dielectric-metal structure with optocoupler control // Advances in modern radio electronics. – 2011. – No. 4. – P.53 –59.

6. Prilutsky A.A. Intelligent antenna for cellular networks of the 3rd generation // Antennas. – 2005. – Issue. 10. – pp. 52 – 54.

7. Prilutsky A.A., Detkov A.N., Zherebtsov S.I., Zhornik V.V., Nitsak D.A., Tomozov D.A., Frantsev V.V. Helicopter radar sensor of millimeter wave radio wave range with continuous radiation // Advances of modern radio electronics. – 2012. – No. 2. – P. 26 – 33.

8.Andrey A. Prilutskiy Mathematical Model of the Phased Open Ended Waveguides Array Antenna with Multilayered Grids from Cylindrical Conductors before the Aperture // Progress in Electromagnetics Research Symposium (PIERS 2009), Moscow, Russia, August 18-21, 2009, The Electromagnetics Academy, Cambridge, Massachusetts, USA, Draft proceedings.-PP. 1402-1406.

8.Andrey A. Prilutskiy Mathematical model of an infinite periodic open ended slot lines array antenna // Progress in Electromagnetics Research Symposium (PIERS 2009), Moscow, Russia, August 18-21, 2009, The Electromagnetics Academy, Cambridge, Massachusetts, USA ,Draft abstracts.-PP. 166-166.

9. Andrey A. Prilutskiy Mathematical model of an infinite periodic open ended waveguide array antenna with multilayered dielectric filling in a cross section // Progress in Electromagnetics Research Symposium (PIERS 2009), Moscow, Russia, August 18-21, 2009, The Electromagnetics Academy, Cambridge, Massachusetts, USA, Draft abstracts.- PP.167-167.

10.Andrey A. Prilutskiy The Scanning Reflective Antenna with an Impedance Conformal Reflector in the Form of Laminated Structure of the Semiconductor-dielectric-metal with Photonic Control // Progress in Electromagnetics Research Symposium (PIERS 2012), Moscow, Russia, August 19-23 , 2012, The Electromagnetics Academy, Cambridge, Massachusetts, USA, Draft abstracts.- PP.62-62.

11. Andrey A. Prilutskiy, Alexander N. Detkov, Dmitriy A. Nitsak Optimum Algorithm of Formation of Radar-tracing Images in CW SAR // Progress in Electromagnetics Research Symposium (PIERS 2012), Moscow, Russia, August 19-23, 2012 ,The Electromagnetics Academy, Cambridge, Massachusetts, USA, Draft abstracts.- PP.17-17.

12. Prilutsky A.A. Modeling the transmission of images of specific means of remote sensing of the Earth via digital communication channels / A.A. Prilutsky, A.N. Detkov, I.A. Makarov, I.V. Kozlov // Electromagnetic waves and electronic systems. - 2010. -No. 1.- P. 4 - 8.

13. Prilutsky A.A. Method for modeling polarization portraits of small-sized artificial radar objects / A.A. Prilutsky, A.N. Detkov, D.A. Nitsak //Electromagnetic waves and electronic systems. – 2011. – T.16.- No. 10. – P. 19 – 26.

14. Prilutsky A.A. Use of aviation polarimetric SAR to detect the descent module of the Phobos-Grunt project against the background of the earth's surface / Rodin A.L., A.A. Prilutsky, A.N. Detkov, D.A. Nitsak // Bulletin of the Federal State Unitary Enterprise “NPO im. S.A. Lavochkin. – 2011. – No. 4. – P. 50 – 57.

15. Prilutsky A.A. Compensation of phase noise on a synchronous detector / A.S. Petrov, A.A. Prilutsky, O.A. Zalevsky // Electromagnetic waves and electronic systems. – 2008. – No. 11. – P. 49 – 53.

16. Prilutsky A.A. Antenna arrays of slot emitters at the ends of rectangular waveguides / G.A. Evstropov, A.A. Prilutsky // News of universities. Radiophysics. – 1988. – No. 10. – P. 49 – 52.

The Ryazan region became one of the first subjects of the Russian Federation in which an effective system of preventive medical care was organized for the population. The Minister of Health of the Ryazan Region, Andrei Prilutsky, spoke about how such results were achieved.

Andrey Aleksandrovich, a project is being implemented in the region to promote a healthy lifestyle for the population and comprehensive prevention of non-communicable diseases among the population. What has already been done in this direction?

In our region, work to promote a healthy lifestyle covers all categories of the population. For this purpose, a developed system of preventive medical care has been created and operates quite effectively, which includes the Ryazan Regional Center for Medical Prevention, 7 Health Centers, 15 departments and 27 medical prevention rooms. In addition, we now have 188 so-called health schools, where children can get an idea of ​​how to lead a healthy lifestyle. Medical examinations are carried out in the region on an ongoing basis, which is the most important factor in maintaining the health of the population.

And it is worth noting that every year the population of the region takes this process more and more responsibly. So last year, almost 200 thousand of the adult population of the Ryazan region were covered by medical examination. This is almost 100% of our annual plan, while on average in Russia this figure does not exceed 90%. I am sure that such results were achieved, including through active preventive work, which is carried out jointly by healthcare with teachers, employees of cultural institutions, sports organizations, the media, the public, etc.

Ryazan Governor Oleg Kovalev is a supporter of a healthy lifestyle and takes issues of medicine and health in the region very seriously. Thanks to his initiative, the Ryazan region was one of the first to introduce “know-how” - the “Care and Health” social road train. Will the project continue this year?

This year, the “Care and Health” road train will visit remote areas of our region for the fourth time to conduct preventive examinations of villagers. The project will be implemented from May to September. Over the past three years, our doctors from mobile teams have examined almost 9 thousand people and conducted over 20 thousand consultations with adults and children. This is a very important project for the region, since rural residents, many of whom find it difficult to get to regional hospitals or outpatient clinics, were able to undergo examination by two dozen specialists in one day in one place. In addition, the road train includes mobile units: mammography, fluorography, dental, ophthalmology, mini-laboratories and portable ultrasound equipment.

In 2015, given that the year passes under the auspices of the fight against cardiovascular diseases, during the social project “Care and Health” we will pay great attention to the prevention of diseases of the circulatory system.

The network of general practitioners' offices is actively expanding throughout the Ryazan region. What do you see as the advantages of this format of organizing primary health care?

The development of a network of medical practice offices makes it possible to bring medical care closer to patients’ places of residence, especially where transport links are not yet sufficiently developed. At the same time, the economic efficiency of the outpatient clinic service system increases. After all, general practitioners not only carry out the functions of carrying out a complex of health-improving, therapeutic, diagnostic and rehabilitation measures for the assigned population, but also provide assistance in solving medical and social problems of the family. These are the so-called “family” doctors. In addition, in addition to therapeutic care, general practitioners perform obstetric-gynecological, neurological, surgical care, instrumental examinations of the visual organs, ENT organs, which reduces the burden on the clinic’s specialist doctors.

The further development of general practitioners' offices is a promising direction for improving primary health care and makes it possible to improve the quality and availability of medical care for the assigned population, and to apply a holistic approach to the treatment and prevention of diseases. In the Ryazan region, it is planned to carry out work to create GP offices in rural areas and in the city of Ryazan in microdistricts and new buildings remote from the base clinic.

There are currently 20 general practitioner offices open in the region. Plans for 2015 include opening four more similar offices.

What aspects of activity will be affected by the “modernization” of emergency medical services planned in the region?

We have formed a “road map” for improving the activities of the emergency medical service in the region for 2015-2016. One of the main problems of the service is personnel shortage. Working with regional universities will help solve it. We have entered into targeted agreements with the Ryazan State Medical University named after. acad. I.P. Pavlova with the specialty “Emergency Medical Doctor” and targeted agreements with the Ryazan Medical and Social College with the specialty “General Medicine”. In March, we have already held a number of meetings with students of final and pre-graduation courses of Ryazan State Medical University and college, as well as with high school students and their parents of the Ryazan region on career guidance. And work to eliminate the shortage of medical personnel has already entered an active stage. In 2014, we concluded 16 targeted agreements with graduates of the medical and social college, and this year 6 more paramedics will come to work at the station.

In addition, our “modernization” plan includes improving the qualifications of medical personnel of mobile teams, concluding agreements with employees on the principle of effective contracts, updating emergency vehicles, and continuity in work with outpatient services. We have already begun to develop regulations for the interaction of emergency medical services and emergency services at the outpatient clinic level. We hope that our innovations will be able to improve the quality of emergency medical care for the benefit of Ryazan residents. After all, in 2014 alone, almost 190 thousand calls were serviced in the city of Ryazan.

Andrey Aleksandrovich, how is work in rural healthcare being improved? In particular, the provision of specialized medical care?

In the Ryazan region, 5 inter-district centers are successfully operating, where specialized medical care is provided in the main profiles. The equipment, structure and staff of interdistrict centers make it possible to provide inpatient and outpatient medical care to patients from the assigned districts, both on a planned and emergency basis, to ensure the implementation of the principle of phasing and continuity of medical care. As a matter of priority, interdistrict centers are equipped with medical equipment and staffed.

The region has built a management system for medical organizations on an inter-district principle, and this will allow for the correct concentration of technological capabilities in managing medical care, which, in turn, will solve strategic problems of reducing mortality and morbidity in the population and increasing the birth rate. In addition, a coordination council of chief freelance specialists has been created under the ministry for interdisciplinary interaction to achieve the main indicators of the health of the population of the Ryazan region. Supervision of districts by specialists from the regional center has been intensified. We are making every effort to ensure that work to control the quality of provision and accessibility of medical care to patients and improve the demographic situation in the Ryazan region is carried out even more effectively.

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In an interview with KP, Andrei Prilutsky told what conclusions he made after working as a paramedic in an ambulance

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On May 20, some Ryazan residents who needed an ambulance, without knowing it, received the Minister of Health of the Ryazan Region, Andrei Prilutsky. For the first time, the head of the regional Ministry of Health joined the work of the brigade and personally helped save Ryazan residents. Komsomolskaya Pravda met with Andrei Aleksandrovich to find out what problems he saw from the inside and how he intended to solve them.

COURSES FOR DISPATCHERS, CONFLICTOLOGY FOR PHARMACEUTICALS

– Andrey Aleksandrovich, this is the first time such experience has been used in the region. What prompted the decision to go with the ambulance?

– Recently, the load on the emergency medical service station has increased significantly, and Governor Nikolai Lyubimov gave instructions to find out what is causing this. We decided to look at the work of all services of the ambulance station: the control room, doctors, paramedics, drivers... It was also necessary to see the work of the emergency rooms and doctors on duty. In order not to embarrass the patients, I put on my uniform and joined the team. The head physician of the ambulance station, Sergei Leonchenko, also took part in the trips. No one except the brigade itself was informed who was working on the call.

– What role did you play in the brigade?

– I was a paramedic, they weren’t allowed to see a doctor (laughs). By the way, sometimes a doctor is not required for emergency calls. A paramedic arrives and decides whether a doctor’s help is needed. It was interesting to discuss the symptoms of patients and remember my everyday life as a doctor (Andrey Aleksandrovich worked as a surgeon for more than 20 years - Ed.).

– What calls did you personally go to with the ambulance crew?

“We responded to four calls, three of which were urgent. On an emergency call, we provided assistance to a man with suspected cerebrovascular accident. Another patient, a student, suffered pain for a week and a half, but did not contact the doctors. And on Sunday we had to call an ambulance. This increases the load on ambulances. It is necessary to improve preventive work with patients.

Let me give you an example. Two years ago, we were preparing for a flu epidemic: we staffed primary care, recruited students and residents. Over the weekend, the number of doctors on duty was doubled. But there are no patients - they are all at home waiting for an ambulance. There were 1000 calls when the norm is 300–400 per day. The consumer attitude of people towards ambulance is a nationwide problem. Some call an ambulance for minor reasons, including to go for a bandage or to pick up prescriptions. The scary thing is that at this time someone else really needs saving their life. Healthcare is an area where problems need to be approached comprehensively.

– What health complaints do people mostly call 03 with?

– Cases have become more frequent when people come in with a low temperature, for example 37.2 degrees, prolonged pain in the joints, sore throat, i.e. for those urgent reasons for which you need to contact a therapist. We have strengthened the local service – it is more than 90% staffed. And our task is to convey to people that in mild cases they should first go to the local police officer, and not to the ambulance.

– How unusual was it for you to immerse yourself in the work of ordinary doctors?

– Similar work is carried out constantly. Government representatives also go to medical organizations incognito, look at them and tell us about problems. At the Ministry of Health, we have been going to clinics in Ryazan and the region on weekends for two years now. We see how patients are received, we monitor the queues at the reception. Without any introduction, we talk to patients to find out the weak points of the clinic. Such trips provide valuable experience.

– What problems did you see when you immersed yourself in ambulance work?

– Such trips give a lot: we are convinced where our “bottlenecks” are. In the near future we will conduct courses for dispatchers at the Ryazan Medical University. First of all, they need to learn how to correctly determine the order of calls. It is important to understand which call is an emergency and which is an urgent one. The provision of timely, high-quality medical care depends on this. For example, if a dispatcher heard a complaint about a headache, he should ask a series of clarifying questions, because the person may have signs of a stroke. We saw that

75% of calls are urgent, that is, they do not require emergency assistance. Our task is to shift the maximum possible number of such calls to emergency departments of clinics.

– Does the level of doctors and paramedics require adjustment?

– Line brigade No. 18, with which I traveled, is distinguished by its high professionalism and ability to communicate with patients. In this regard, I liked them. We continuously conduct training seminars with paramedics and doctors, including on conflict management. Patients are often irritable, and therefore doctors need to be more stress-resistant.

“POSSIBLY THERE WILL BE AN INCREASE IN DRIVERS’ SALARY”

– How can you characterize the condition of ambulances? Is there necessary equipment for diagnosis and treatment?

– Our vehicle fleet has been updated by more than half. These are new, good cars, equipped with everything you need. With further receipts of funds, we will complete the fleet.

– Recently, ambulance drivers raised the issue of increasing their salaries. Will there be indexing?

– We will discuss this issue at the regional government level, the possibility of increasing drivers’ salaries will be considered. Although their salaries are now at a good level, compared with salaries in other regions, we are fifth in the Central Federal District in terms of this indicator. The salaries of doctors and paramedics are also at a sufficient level.

– An ambulance must reach a patient for an emergency call in 20 minutes. Is this realistic in our road conditions?

– We have a high arrival rate within 20 minutes, because the cars do not necessarily leave the station, but collect calls along the way when they are free. In my case, we left the station and did not return until we had completed all 4 calls. After one call, the car does not return to the base, but moves on to other calls. The car runs around the city, so efficiency is high. It should be recalled that 20 minutes are deducted from the moment the dispatcher transfers the call to the brigade.

– In Ryazan, there are frequent cases of disrespect for an ambulance: drivers do not allow cars with a siren to pass, blocking the passage. How did they react to you on the roads?

– We went in the evening, when the city was unloaded. But I talked with the driver of my crew, and he noted that now there are fewer cases of disrespectful behavior towards crews going to or from calls. We are helped by preventive work carried out in the media. People understand that by letting a car pass, they are helping someone, and that their relative may be in the same place. I would like to note the professionalism of the ambulance drivers, who pass within a centimeter of cars parked in yards. Motorists, when parking their cars at night, should not forget that force majeure is possible, and special equipment will need to pass. In our case, we drove where the fire department could not. The drivers’ work is also made difficult by the poor numbering on the houses – we spent a long time looking for some addresses.

“GRANDMOTHERS USED TO COMMUNICATE ON BENCHES NEAR THE HOUSES, AND NOW IN HOSPITALS”

– Some Ryazan residents have questions for the ambulance crews, who, without putting on shoe covers and without washing their hands, go straight to the patient. Who is right in this case?

– Neither the doctor nor the paramedic is required to put on shoe covers or take off their shoes. People must understand that a medical team is rushing to them to provide emergency medical care. In my opinion, it is incorrect to pay attention to such details. And if they have to carry a stretcher, how will they put on shoes with a patient in their arms? As for clean hands, each team has disposable wipes and disinfectant sprays. People simply don’t notice how doctors sanitize their hands on the way to the patient. In addition, disposable gloves are worn during manipulations. That's why doctors don't go to the bathroom like they used to.

– Queues at clinics worry Ryazan residents no less than questions for the ambulance...

– I personally visit clinics and interview people waiting outside the office. It turned out that queues are sometimes created artificially. Patients arrive an hour or more before the time indicated on the ticket. The older generation comes to chat. Previously, grandmothers talked on benches near houses, but now - in hospitals.

– What measures are you taking to reduce queues?

– The implementation of a lean production system in clinics helps us. We are connecting city clinics, a clinic at the Regional Clinical Hospital, and a skin care clinic to this project.

– Another pressing issue is the lack of specialized specialists. How do you intend to solve this problem?

– There has always been a problem with narrow specialists. University graduates do not strive to get a job in a clinic - this is considered unprestigious. Everyone wants to go to the hospital, and hospitals are staffed with neurologists, ENT specialists, urologists, obstetricians... This problem can only be solved by rethinking the attitude of patients. In all developed countries, you can only get an appointment with a specialist through a therapist. Only he can determine whether the patient needs an ophthalmologist, a surgeon, an ENT specialist... In the 10th and 2nd clinics they use this approach, but people don’t like it, although the queues are reduced by half. Probably, you just need to survive this situation, convince people that this is how it’s supposed to be.

– What will be the result of your work trip?

– Based on the results of the trip, I will report to the governor: about the conclusions drawn and the plan of activities that we will take to solve problems.

– Are you still planning to leave with an ambulance?

– I’ll definitely go to check the results.

HAVE AN OPINION

Elizaveta STEBLEVSKAYA, paramedic:

– I work at both Ryazan and Moscow ambulance stations, and I see the differences. Ryazan dispatchers accept all calls in a row, for example, with a temperature of 37 degrees or pain in the arm, and in Moscow such complaints are transferred to the ambulance. The problem is that many simply cannot explain what hurts them. In winter, our ambulances are under a lot of pressure, and sometimes there aren’t enough crews. But in the Moscow region there is also such a problem. There is also the problem of transportation - an ambulance is sometimes called as a taxi. And doctors and paramedics are treated like loaders, and not like health workers. If we need to move a patient heavier than 90 kg, the Ministry of Emergency Situations helps us. In general, with the arrival of the new chief physician, we began to work according to Moscow standards.