1. The Patient Support and Internal Audit Service at the Kostanay Regional Center for Prevention and Control of AIDS operates in accordance with clause 3 of Article 35 of the Code of the Republic of Kazakhstan No. 360-VI “On People's Health and the Healthcare System” dated July 7, 2020; 
2. The structure and composition of this service is approved, supplemented and/or amended by the head of the organization;
3. The procedure for conducting an internal evaluation of the quality of medical services is regulated by the Order of the Ministry of Healthcare of the Republic of Kazakhstan No.ҚР-ДСМ-230/2020 “On Approval of the Rules for Organizing and Conducting Internal and External Examinations of the Quality of Medical Services (Care)” dated December 3, 2020;

1. The main principles of internal audit are:

Consistency – quality of medical services is examined on an ongoing basis, based on indicators of the structure, process and result;
Objectivity - quality of medical services is examined using standards in the field of healthcare;
Openness - examination is conducted with the participation of the head of the structural unit or in the presence of a doctor responsible for the quality of medical services that are the subject of the audit.

1. Tasks of the Patient Support Service and Internal Audit:

- ongoing analysis of the organization of medical care;
- analysis of the clinical activity of a medical organization;
- identification of violations of the order of medical care and standards, medical incident;
- consideration of patients’ appeals within a period not exceeding five calendar days;
- consideration and analysis of other cases related to gross violation of the internal regulations, the charter and the working hours of the organization.

1. The following employees are working:

Chairman: A.G. Chizhkov, Deputy Chief Medical Officer;
Deputy Chairman: M.V. Shevyreva, Infectious Diseases Doctor;
Secretary for the Service: A.D. Ashukhanova, Epidemiologist;  
Members of the Commission:
S.N. Rudy, Head of the Department of Medical and Preventive Care and Medical Examination;
N.A. Tashetova, Head of the Organizational and Methodological Department;
N.A. Lavrenko, Head of the Epidemiological Department;
A.K. Kairbayeva, Head of the Department of Preventive Work;
Yu.V. Feofilaktova, Quality Manager;
G.U. Nurmagambetova, Legal Adviser;
O.N. Simanchuk, Psychologist.
   
2.1. The Patient Support and Internal Audit Service is based on the following levels of control:  
- self-control;
- control at the level of the Head of the Department;
- control conducted by the Chairman of the Internal Audit.
2.2. The quality of medical care at the self-control level is assessed by the doctor and an average advanced practice nurse (the first stage of the assessment).
2.3. At the department level, control over the quality of medical care is carried out by the head of the department, and the senior nurse or senior laboratory assistant (the second stage of expertise).
2.4. At the organizational level, quality control is carried out by the Deputy Chief Medical Officer for Internal Audit.
2.5. The Chairman of the internal audit service determines the structural approach to ensuring the quality of medical care as a whole in the organization (the third stage of expertise).
2.6. Complaints and appeals of patients are subject to mandatory commission consideration.
2.7. The following cases are subject to mandatory control and commission review:
2.7.1. Cases accompanied by complaints from patients or their relatives; cases of gross violation and/or non-fulfilment by employees of the organization of their direct functional duties, which entailed circumstances related to the deterioration of the quality of medical services and care provided to patients, as well as resulting in deterioration of the production process and/or causing material damage;
2.7.2. All cases of epidemiological significance:
- cases of mother-to-child transmission of HIV, including retrospectively identified cases;
- cases of occupational infection of medical workers;
- cases of intra-institutional HIV infection in the Department of the Penal Correction System (DPCS);
- cases with an unidentified transmission path;
2.7.3. All cases related to the difficulty of diagnosis, the antiretroviral therapy or other medical care provided for by the Regulations on the Activities of the Centers for the Prevention and Control of AIDS;
2.7.4. All other cases that resulted in a violation/suspension of the workflow.
2.8. Quality control over the rendered medical care is conducted by daily operational management at morning conferences, rounding the head of department, monitoring the maintenance of medical records.
 
 
 
 
 
   
3.1. Consideration of applications and appeals of citizens and their relatives (written, verbal and telephone appeals) by specialists of the patient support and internal audit service should be aimed at protecting the rights and legitimate interests of patients in the process of receiving medical care within the guaranteed volume of free medical care.

3.2. In the order of consideration of complaints and appeals of citizens, the specialist of the Patient Support and Internal Audit Service is guided by the Law of the Republic of Kazakhstan “On the procedure for consideration of appeals of individuals and legal entities”, the Constitution of the Republic of Kazakhstan and other regulatory acts of the Republic of Kazakhstan.

3.3 The main principles when working with applications and appeals of citizens are:

1. Compliance with the laws of the Republic of Kazakhstan;
2. Unity of requirements for all applications and appeals;
3. Guarantee of observance of the rights, freedoms and legitimate interests of citizens;
4. Inadmissibility of the manifestation of bureaucracy when considering appeals;
5. Equality of all persons who applied to the Patient Support Service and Internal Audit.     

3.4. Guided by the Law of the Republic of Kazakhstan “On the procedure for consideration of appeals of individuals and legal entities”, appeals that may be left without consideration include:
- Anonymous appeals (except for those that pose a threat to the safety of citizens who are in the polyclinic);
- An appeal that does not state the essence of the issue.
3.5. If the conditions that served as the basis for leaving the appeal without consideration are eliminated, this appeal must be reviewed by specialists of the Patient Support and Internal Audit Service;
3.6. Responses to appeals must be justified and motivated in content, in the state language or the language of the appeal with reference to the legislation of the Republic of Kazakhstan, as well as the responses should contain specific facts refuting or confirming the applicant, with an explanation of their right to appeal the decision.
   

4.1. The main type of correction of the level of quality of medical care are:

1. Educational measures (talks, lectures, seminars, workshop sessions, study on advanced training cycles, etc.);
2. Organizational measures;
3. Disciplinary measures.

The assessment of the quality and efficiency of medical care is a way to identify defects in work and a measure to improve its level.
Therefore, each identified defect and each case of discrepancies in the quality assessment at various stages of the examination, as well as significant deviations from the standard costs, should be discussed in order to increase the level of knowledge of medical professionals and develop optimal approaches to the treatment and diagnostic process.
The system for assessing the quality and efficiency of medical care should function continuously, which will allow to quickly obtain the information necessary for management.

If you have any questions or suggestions regarding the quality of medical services rendered by the SME “Kostanay Regional Center for Prevention and Control of AIDS”, you can always contact the Patient Support and Internal Audit Service by the following phone number 8 (7142)–37–05-90, write a letter to the blog of the chief medical officer or send an e-mail: kst_oc_aids@mail.ru