1994

1995

1996

1997

1998

1999

Overall

• The average length of stay at Sokolov decreased from 16.7 days in 1992 to 10.7 days in 1998 to 10.3 days in 1999 to 10 days in 2000.

Hospital Administration

• With the assistance of finance specialists from Louisville, Sokolov staff developed a corporate reorganization plan with subsidiaries and defined relationships to a holding company.
• Administrators at Sokolov completed an expanded marketing program and opened a hospital gift shop to increase revenue.
• Sokolov staff instituted guest relations, chaplaincy, and admitting programs.
• Sokolov staff developed a performance evaluation system with evaluation ratings, salary incentives, hospital-financed continuing education for personnel, and a re-organization program to increase cost effectiveness and improve outcomes.
• As a result of being the primary care provider for the Goodwill games, the Russian partners developed the clinical and administrative basis for an international polyclinic. Based on this international polyclinic, Sokolov established a permanent western-style micro-hospital unit with a nurse as the unit manager - the first nurse-manager of a clinical department at Sokolov. The NIS partners staffed the micro-hospital with nurses through a competitive process. The ratio of nurses to patients was set at 1:10. New patient history forms and protocols for nursing care were developed and implemented.
• At the micro-hospital, the NIS partners developed and implemented a fee-for-services system which includes a day/bed service charged based on the actual number of days, fees for diagnostics services, fees for physicians' services, and fees for other services (e.g., transportation, newspapers delivery, etc.). The fee-for-service system has proven very cost-effective. Revenues from the micro-hospital unit equal half of the total revenue received from the mandatory medical insurance, which pays for treatment in the rest of the hospital. In 1996 total micro-hospital revenue equaled $100,000; in 1997, $113,000; in 1998, $140,000; in 1999, $160,000; and in 2000, $180,000. These revenues from the micro-hospital unit cover the budget deficit of the mandatory medical insurance, which covers only 70 per cent of the costs associated with patients under its coverage.
• Analysis of the micro-hospital unit's performance for 1996 and 1997 indicated that the number of patients treated per staff member increased from 14 in 1996 to 17 in 1997. A total of 1,533 patients were treated in 1998, 1,690 patients in 1999, and 1,631 in 2000. This shows that the high quality of medical care provided at the unit attracts an increasing number people. Sokolov staff regularly carry out patient satisfaction surveys on the micro-hospital unit. The results show that on average 97% of patients are satisfied with the quality of care provided.
• The average patient length of stay in the micro-hospital unit has declined. In 1995 the average LOS was 12.1 days; in 1996 it was 11.0 days; in 1997 only 8.5 days; in 1998 7.0 days; in 1999 6.5 days; and in 2000 7.1 days. It is markedly lower than the overall average length of stay at the hospital, which is 14 days.
• The rate of Post-Operative Complications is 50% lower in the Micro-hospital than in other units at Sokolov.
• Sokolov Hospital has become a foreign affiliate of Premier Inc., a strategic alliance of hospital and healthcare systems which provides services such as group purchasing, clinical technology management and purchasing and physician practice management.
• As a result of partnership participation, Sokolov hospital created financial and business planning services for marketing the hospital, and promoting its health care product line.

Medical and Nursing Education

• A Learning Resource Center was established at Sokolov. In 1997 and 1998, Sokolov's Information Coordinator trained 68 health professionals to use the Internet for research and communication. With access to the Internet, these health professionals can now obtain the most up-to-date medical literature and use it in their clinical practice.
• Fifteen health professionals at Sokolov have used the hospital's Internet resources for their theses. Seven physicians have written research articles using the Internet-based health information.
• The partners developed a six-month post-graduate nursing course in clinical practice and management. This program has been successful in increasing the responsibilities of nurses at Sokolov in patient care and management.
• The partners' post-graduate nursing curriculum, which includes both clinical practice as well as management and leadership skills, has given Sokolov nurses the skills needed to assume managerial roles in the hospital and the program has become a model to be copied by other AIHA partners.
• A Nursing Resource Center was established at the partnership in fall 1997 and has served to enhance the nursing curriculum at Sokolov, providing faculty, students, and practitioners alike with alternative forms of learning.
• The advanced qualifications of nurses on the micro-hospital unit have gained physicians' respect.
• The US and NIS partnership representatives co-chaired AIHA's Nursing Task Force.

Women's Health

• The Women's Wellness Center at Sokolov, opened in Spring 1998, provides services that include family planning, diagnosis and treatment of sexually transmitted diseases, prenatal care, menopause and breast health. It serves as a highly visible model in the St. Petersburg region, for comprehensively addressing and managing the health care needs of women through health promotion, education, early diagnosis, treatment and follow up. In 1998, the WWC served over 1,100 patients; in 1999, 4,158 patients; and in 2000, 6,042 patients.

 
Infection Control

• In January 1995, US partners reported visible signs that infection control was improving. Both NIS partner hospitals began to use antibiotics prophylactically before surgery and for a shorter duration post-op. Hand washing techniques had also improved with more hand towels and soap available at hospitals.
• Over the course of the partnership infection rates for post-surgical emergency patients decreased from 9.8% of patients treated in 1992 to 1.5% in 1998.

Emergency/Disaster Medicine and Other Clinical Services

• The partners implemented a post-graduate EMS curriculum.
• Partners established a system of triage in the emergency room at Sokolov hospital enabling more efficient hospital admissions. Currently the system is serving over 100 patients per day.

Primary Care/Nursing Education

• Partners jointly developed a curriculum to enable nurses and managers to serve as case/care managers in order to implement critical paths, facilitate timely follow-up of care, and shorten length of stay.
• A free 24-hour hotline "Assistance 122" has been established to consult patients via phone, to advise them on the care needed, and, if necessary, to arrange patients for diagnosis and admission at Hospital 122.

Other

• Through the partnership's educational programs, Sokolov has expanded its service base by adding cardiovascular surgery, orthopedics and endoscopy.
• Sokolov began participating in AIHA's WHONET program in 1997. Sokolov staff have been gathering and analyzing antimicrobial resistance data since July 1997 with a goal to develop and implement mechanisms to control the use of broad-spectrum antimicrobial agents.
• As a result of the partnership programs, the hospital now charges for some services. This brought in approximately 68,000 leis in profit in 1997, which allowed them to compensate for the lack of government funding for day to day operations, Amount of income for paid service in 2000 for the City Ambulance Hospital was 2,300 000 leu - or $230,000.