Social Responsibility Report


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Social Responsibility Report

  1. 1. (Address of the President of Medicina Clinic Grigory Efimovich Roytberg)Dear patients, partners and colleagues,Creating a serious and interdisciplinary clinic is a long and multi-stage process. Since 1990 Medicina Clinic has beenconsecutively developing in order to change patients’ perception of the quality of health care provided. We combinethe experience of the best Russian and foreign hospitals thanks to the key value of serving our patients. Introduction ofthe world’s best practices aims to help the Clinic to change, improve and always go ahead by keeping the dialoguewith patients going and taking into consideration the issues that are really important for them.It is not accidental that Medicina JSC is the first Russian clinic accredited by the Joint Commission International (JCI).Currently, there are a bit more than 440 foreign hospitals that are accredited according to JCI standards, i.e. meet theworld’s highest standards. Joint Commission International Accreditation is the most objective and prestigious healthcare certification, which serves as the evidence of conformance of a medical institution to medical and administrativestandards approved at the international level and, also, to the requirements for securing international patient safetygoals.In 2010 the Clinic became a laureate of the Russian Government Quality Award. Medicina JSC is certified accordingto international standards (its Quality management system is certified according to ISO 9001:2008; it is also a winnerof a Recognized for Excellence ***** (5 stars) Award according to the European Foundation for Quality Management(EFQM) Excellence Model.The Clinic’ activities are characterized by unprecedented openness and the dialogue we keep with our patients.Patients can review their health records online, receive videos of surgeries and examinations on DVDs and assessdoctors’ activities at The demand for such dialog is steadily growing.Medicina Clinic is an organization whose activities are aimed at ensuring social accountability, i.e. accountability forthe quality of patients’ life and tranquility of your near and dear ones as well as accountability for introduction of themost effective diagnostic and treatment methods that are currently applied throughout the world and for creation of afavorable environment that would contribute to a treatment process. We give people the opportunity to choose thequality and service in health care and, what is even more important, the attitude to their health. Certainly, our servicesare not affordable for everyone. However, if we speak about the services provided to people living nearby undermandatory health insurance programs, they are rendered at lower rates and are free for patients.It is not only care for patients’ desires and demands that characterizes “health care with a human face”. It is importantthat the Clinic supports the community where it works. In the first place, we orient towards creating favorable laborconditions for our staff. Medicina Clinic provides unique opportunities for professional growth and research work. Ouremployees get free medical treatment at the clinic. 1
  2. 2. We respect the professional medical community, which is like a source of manpower for us, i.e., our colleagues whocontrol the quality of treatment at our Clinic and our partners. We organize free workshops for doctors from variousmedical institutions.We realize that being among the industry’s leaders we have a real opportunity to help those in need. And, what ismore, we have a big desire to do it. In 2011 the Clinic established a charity foundation providing assistance to medicalprofessionals - “Healthcare Fraternity”. Its uniqueness lies in the fact that a decision re. the recipients of aid is made bymedical staff on a voting basis.The areas for the Clinic’s development are chosen on the basis of society’s demands. Thus, to improve Russian cancerdiagnostic and treatment standards it has been agreed that an oncology center of Medicina JSC should be established.Early 2012 a new building comprising a hi-tech cancer center that is being built with the methodical support of leadingforeign clinics (Memorial Sloan-Cancer Center, USA, and Rabin Medical Center — Davidoff Center, Israel) will beput into operation. This is going to be a model center that will incorporate all world’s recent innovative cancertreatment technologies.Innovations in ensuring the quality of medical care are the result of systematic work performed in all the areas of theClinic’s activities and an impetus for further development and improvement. Medicina Clinic’s achievements arerecognized by the most reputable foreign and Russian experts.I would like to emphasize that all our achievements, awards and diplomas are only the tip of the iceberg at the base ofwhich there is every day work performed by hundreds of people that are united by an interest in something new, careabout patients and the desire to contribute to tailoring to patients’ needs. The most important thing about it is theongoing impetus to become better which makes you go ahead. Such impetus for us is the opinion of our patients.Therefore, we have been making our best efforts to establish a dialogue with patients, using all possiblecommunications, for many years.With thanks and kind regards,Grigory E. RoytbergPresident, Medicina JSCRAMS academician, M.D., ProfessorHonored doctor of the Russian FederationLaureate of the Russian Government Education AwardHead of Therapy and Family Medicine Chair, RSMU 2
  3. 3. (History of success)History of the ClinicMedicina Clinic was established in the early 90s of the 20th century. At first it was a small medical cooperative called“Pulse” (“Puls”) whose doctors were providing emergency medical services using two ambulance vehicles. Then in1993 after winning tender Medicina JSC moved to the 8-storey building in the heart of Moscow and has neverchanged its location since that time. The building was redesigned and rebuilt; now it is a medical center comprisingtwo buildings, which is equipped with state-of-the-art facilities and which provides all major types of specializedmedical services to patients.In 2011 Medicina JSC celebrated its 21st birthday. Throughout all the years of its existence caring about health,extending longevity and improving the quality of life of Muscovites have been the No.1 tasks of the Clinic. To executethese tasks we have been constantly improving our work and developing. We provide highly qualified medical care topatients by using the best treatment traditions and most advanced technologies and study and adopt the experience ofthe world’s best medical institutions.Milestones1990 Establishment of “Pulse” cooperative providing emergency medical services.1991 Incorporation of Medicina Joint stock company at 31A Mosfilmovskaya St., Moscow1993 Relocation to a building at 10, 2nd Tverskoy-Yamskoy per. No. of staff: 130 doctors. Opening of departments specializing in therapeutics, ophthalmology, X-ray and radiation diagnostics, physiotherapy and exercise therapy, dentistry, medical emergency care, laboratory, ENT.1994 Opening of an acupuncture cabinet and introduction of a computer control system for 24 hour control and management over equipment and technological parameters of engineering systems.1995 Opening of functional and ultrasound diagnostic departments, a pediatric section, a new pharmacy.1996 Opening of an inpatient facility and surgery, which allowed the Clinic to get inpatient and polyclinic treatments interconnected; starting interaction with strategic partners – insurance companies.1998 Launch of Magnetic Resonance Imaging machine, opening of a Health Center. Therapy and Family Medicine Chair of the Russian State Medical University (RSMU) is created on the basis of the clinical resources of Medicina JSC.1999 Opening of the following new departments: Family doctor and Outpatient trauma, Surgery and Emergency care. Patients’ health records – kept electronically thanks to a new computer program.2000 Completing the construction of a 3-storey superstructure of the Clinic’s building, opening of an inpatient facility and a surgery unit on the 9th floor, an inpatient section for children as well as increasing the number of beds for adults and starting oxygen barotherapy practice.2001 Opening of an International Fertility and IVF Centre, a Trichology department, an Intravenous laser therapy room and an Ophthalmology center. Hi tech cardio-surgeries, extracorporal fertilization and 3
  4. 4. auxiliary reproductive technologies – performed and implemented. The parties concerned start to elaborate and agree on the main areas of strategic development.2002 Electronic health records system – fully implemented; statistic reporting – systemized; elaboration of own program “Medical Care Quality Management” based on BSC elements – in progress. Launch of charity densitometry program.2003 Medical and economic standards were incorporated into the “Electronic health record” program. Territorial principle of rendering medical aid – introduced. Continuity principle (“One doctor – one patient at the Polyclinic and at the Inpatient section”) – elaborated and implemented. The following methods were introduced: PCR (Polymerase chain reaction), CT (Computer tomography), genetic studies, laser treatment methods for ENT, ophthalmology, extracorporal shock wave therapy and IVF. The Clinic started to organize round table talks with insurance companies. The President of Medicina JSC delivered his first report re. review of results and prospects for growth.2004 Management structure reorganization: upsizing medical services, creating a Service and Information Support Section, Purchasing and Quality Management Methodology Departments. The Clinic launched external respiratory function tests, virtual and capsule endoscopy, new laboratory methods and cryotherapy at RMD of the Clinic. Special gym equipment was installed at the Cardio Rehabilitation Center.2005 Introduction of a health screening program for employees. Providing psychiatric aid and inpatient psychiatric treatment to this category of patients. Competition-based staff recruitment; launch of a “self-learning company” program. ISO 9001:2000 certification. “Designer Clinic” – “theater for single spectator”, all repairs are done with the involvement of a designer.2006 Introduction of new medical technologies becomes a systematic process.2007 “Swiss” Clinic in Moscow. In 2007 Medicina JSC successfully passed an international audit and became an official member of the Swiss Leading Hospitals Association. This milestone event serves as the evidence of the high quality of medical services that are rendered by Medicina JSC and meet European and international standards as recognized by Swiss experts.2007 The Clinic started to use EFQM Model as a tool for improving its management system on the way to excellence: we study and use the world’s best practices, compare our activities with the best European and international clinics, introduce the best management models and technologies. This model helps us to evaluate our work using qualitative and quantitative approaches.2008 Full-time member of the European Foundation for Quality (EFQM), confirmed its Recognized for Excellence 5* level according to the EFQM Business Excellence Model. “Dialogue with a patient” program.2008 The Clinic obtained Recognized for Excellence 5* recognition according to the EFQM Excellence Model (the first and only five-star clinic in Russia).2009 Laureate of the Russian Government Quality Award.2009 Winner of the 5th International Quality Tournament among Central and Eastern European countries.2009 The first and only Russian clinic that received “Russian quality” Diploma and Mark. This is a nationwide certificate confirming the high quality of services provided by Medicina JSC.2010 The Clinic confirmed its Recognized for Excellence 5* level when it took part in ЕЕА EFQM contest.2010 The Clinic’s audit to confirm its compliance with SLH (Swiss Leading Hospitals Association) membership criteria. One of Switzerland’s leading auditors Mr. Zinniger congratulated all the employees of Medicina JSC on passing the successful audit and the score exceeding 85% at the final meeting. The Clinic has reconfirmed its rights to be a member of the Swiss Leading Hospitals Association.2011 The first and only Russian Clinic was accredited to the most reliable medical care standards of Joint Commission International. As of today, only 440 clinics throughout the world have got this accreditation. 4
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  7. 7. ABOUT THE CLINIC.International recognition of qualityMedicina JSC is a private interdisciplinary clinic that has provided a wide range of outpatient and inpatient medicalservices to patients since 1990. Medicina JSC is the only clinic in Russia accredited by Joint Commission International(JCI). Currently, there are a bit more than 440 hospitals round the world that are accredited to JCI standards, i.e. meetthe highest world’s standards. JCI Accreditation is the most objective and prestigious international health carecertification which proves the conformance of a medical institution to international healthcare and administrativestandards and its compliance with international patient safety requirements.For the Clinic’s activities it is important and relevant that Russian and international experts admit that the quality ofhealth care services provided by the Clinic is high and that the Clinic ensures a high level of safety and protection ofits patients’ rights: long-term compliance with international management quality standards requirements (ISO9001:2000, ISO 9001:2008), membership in the Swiss Leading Hospitals Association, Recognized for Excellence 5*level awarded by the European Foundation for Quality Management.Medicina Clinic is the first and only Russian clinic that has received “Russian quality” Diploma and the right to use the “Russian quality” mark. become a winner of the 5th International Quality Tournament among Central and Eastern European countries organized by EFQM. received the Russian Government Quality Award for 2010. obtained Recognized for Excellence 5* recognition level (based on EFQM Awards results for 2010).In its activities the Clinic implements advanced achievements of the world’s healthcare system and performs systemicwork to apply innovative technologies. Medicina JSC is a clinical base for the Chair of Therapy and Family Medicineof the Doctors Improvement Faculty of N.I.Pirogov Russian National Research Medical University (RNIMU). It isincluded into the list of innovatively active healthcare institutions of Moscow on whose base clinical research can beconducted.Range of medical services provided by the Clinic.The Clinic comprises over 20 departments and centers that render a full scope of medical care, namely: polyclinic services, incl. therapy and pediatrics; diagnostic services, including laboratory, functional, ultrasound and radiation diagnostics and endoscopy; family medicine services; ambulance services; supplementary services, such as a pharmacy and opticians’.Striving for excellence we are always studying and analyzing society’s demands, patients’ satisfaction and the qualityof medical services we render. It allows the Clinic to constantly compare the results of its activities with the indicatorsof the world’s leading clinics. By achieving the highest results we set new far reaching goals and criteria for theassessment of medical care quality and patients’ satisfaction. Aspirations for excellence have no boundaries in time orspace and are viewed as an ongoing impetus for development.The Clinic’s specialists carry out patients’ examination and treatment in accordance with Medical and EconomicStandards (MES) under WHO recommendations. The quality of treatment and diagnostics is always high, no matterwhich expert is visited by the patient. It is all written down in “Guarantees provided by Medicina JSC booklet which isfreely accessible in the Clinic.Hundreds of big Russian and western companies entrust care about the health of their employees to our doctors.Patients of Medicina JSC are the clients of more than 90 insurance companies, employees of embassies andorganizations, individuals, many Russian artists, businessmen and politiciansFacts and figures Over 2,000 outpatient appointments at the Clinic per day. Over 58,000 people get medical care at the Clinic per year. 7
  8. 8.  2,000 patients per year receive medical care at the inpatient facility of Medicina JSC. Over 2,600 citizens of the Central Administrative Okrug of Moscow obtain medical treatment at Medicina JSC under obligatory health insurance programs that are free for patients.Our teamBeing highly competent and friendly the Clinic’s employees make up a strong team whose task is to make the visit ofeach patient to Medicina JSC maximally comfortable and effective. All the doctors are first rate health careprofessionals that graduated from the world’s best institutions and attended training at American, Israeli and Europeanclinics.Medicina JSC is one of the flagships and leaders of Russian socially accountable private medical institutions, which isconfirmed by the numerous diplomas, awards and quality marks it has received. 2001 Badge of honor “Enterprise with a well-organized accounting system, a note of acknowledgement from the Mayor of Moscow for successful work connected with rendering highly qualified medical care to Muscovites. 2002 A note of acknowledgement from the Rector of M.V. Lomonosov Moscow State University for providing highly qualified and free medical care services to students and employees of the University. 2003 Certificate of Merit from Moscow Healthcare Committee for work connected with rendering highly qualified medical services to Muscovites. Letter of thanks from Svyatoslav Fedorov’s Fund for organizing “Healthy eyes for everyone” campaign. 2005 Diploma of high consumer evaluation of the quality of provided services. “VERIFIED. Russian Consumers Union”, Diploma issued by Russian and Moscow Consumer Protection Funds for active involvement in the establishment of a civilized consumer market in Russia. Medicina Clinic is the first Russian Clinic certified according to ISO. 2006 Certificate issued by Russian Consumer Protection Fund for active participation in “The Best in Russia” contest; Certificate issued by Moscow Consumer Protection Fund: on the basis of a decision made by the public council of experts Medicina JSC gets an award as a participant of “The Best in Moscow” contest. 2007 Certificate of Merit from Moscow Healthcare Committee presented to Professor Grigory E. Roytberg for his considerable contribution to practical medical care rendered to Muscovites. Certificate of membership in the Swiss Leading Hospitals Association. 2008 President of Medicina JSC Grigory E. Roytberg became a laureate of the “Russian quality leader” tournament. 2009 Diplomas issued by Russian Quality Organization (RQO): quality of inpatient and polyclinic services meets the highest level of quality envisaged in RQO’s working program. Winner of the 5th International Quality Tournament among Central and Eastern European countries. 2011 The first and only Russian clinic accredited according to the most reliable Joint Commission International medical care standards.Specialists of Medicina JSC take part in joint scientific projects in collaboration with employees of foreignuniversities, publish scientific articles and theses, organize and participate in international conferences. Moreover, theClinic’s experts conduct free educational workshops for doctors from Moscow and free seminars on maintaininghealth and improving the quality of life for the Clinic’s patients.Medical careIntegrated approach to maintaining patients’ health is reflected in the structure of rendered medical care. 95% ofmedical services are provided to patients of Medicina JSC at the polyclinic, including specialists’ appointments (bydisease and for preventive purposes), outpatient surgery, dental services, diagnostics (diagnostic equipment andlaboratory diagnostics), rehabilitation and restorative care. Inpatient services make up 4% of all services provided byMedicina JSC. The existing inpatient facilities will be considerably expanded after the new building of the Clinic isput into operation in early 2012. In addition to hi-tech treatment and diagnostic procedures, the Clinic’s patients alsoget domiciliary care services (by disease, diagnostics and preventive examination) which make up 0.6% of the totalnumber of medical services rendered, and ambulance medical care (0.4%). Share of Medicina JSC in Moscow’sprivate health care facilities sector is 2.34%. 8
  9. 9. The Clinic implements advanced achievements of the world’s healthcare system in its activities, which is confirmedby international health care experts, and performs systemic work to apply innovative technologies. 9
  10. 10. Medicina Clinic.All the best in medicine.MissionMission of Medicina JSC is to provide patients with complex personified medical care on condition of partnership andactive involvement of patients in making decisions on their health and well-being. Ensuring that patients have accessto complete and trustworthy information. Meeting requirements re. maintaining and improving health and quality oflife.VisionWe establish a clinic of international acclaim, which retains its leadership position on the Russian private medicalmarket. Following changes in society’s demands we are constantly mastering all the aspects of our activities in orderto ensure the maximum customer satisfaction level and the ideal quality of medical services. By achieving the highestresults we set new criteria for the assessment of medical care quality and patients’ satisfaction. Studying and analyzingsociety’s demands and patients’ satisfaction. Studying and analyzing society’s demands, patients’ satisfaction and thequality of rendered medical services allows the Clinic to constantly compare the results of its activities with theindicators of the world’s leading clinics. Aspirations for excellence have no boundaries in time or space and areviewed as an ongoing impetus for development.Values/principles for improvementServing patients’ needs: perceiving patients and their families as partners in the process of treatment; constant sincere wish to help each and every patient; providing to patients access to the information about the type, diagnostics and treatment of their diseases; interaction with patients in support of their intention to be well-informed when making decisions about their health and well-being; truthfulness and sincerity in our every action; exceeding the expectations of patients and their families.Commitment to quality: constant aspiration for the ideal quality of services; ongoing improvement of all processes ensuring the highest quality (professionalism, quality of service, technologies expertise, management quality); everlasting aspiration to achieve the highest results in every action (measuring, monitoring and reporting as regards services and quality standards and customer satisfaction, comparison with the best representatives in the group). 10
  11. 11. Team work: interaction of specialists providing medical assistance to patients as a team of highly qualified and committed professionals having common corporate culture; joint work in the spirit of cooperation, with active participation of everyone and encouragement of personal initiatives; implementing the succession principle when treating patients; constant interest in professional development of each employee; establishing and supporting close working relations among employees, with partners and other public institutions.Social accountability: work for good of mankind, preserving and improving the health of population and raising the quality of life; support of the communities where we live and work; support of the needy and assistance in hard financial conditions; desire to change in response to the changing demands of society.Finances and control: using a systemic approach to choose and finance projects that contribute to higher efficiency and effectiveness of business and help to achieve goals supporting this mission; functioning not for mere wealth, but for ensuring sufficient financial feedback, given current and future needs and demands; achieving high performance results by effectively using resources, including intangible resources; reporting re. resources used at all the levels of the company.Challenges and strategies.Currently, investments into health are becoming one of the most reliable types of investment, which can have animpact on long-term demand growth prospects. Medicina JSC orients towards the continuous improvement of medicalcare quality and service by attracting the expertise of the world’s best healthcare institutions. By competing withRussian as well as with the world’s best clinics the Clinic responds to today’s macroeconomic challenges. MedicinaJSC has become a real alternative to foreign clinics for CIS citizens in connection with its accreditation according tothe most reliable international JCI medical care standards in 2011.Nowadays the Company has three strategic goals:1. Constant improvement of the Clinic’s activities in order to satisfy patients’ demands in full and retaining leadershippositions for quality in the Russian private medicine market through improvement of a management system.2. Ensuring a steady growth of the Company’s revenue and income.3. Well-balanced growth in the scope of rendered medical services, including a wider range of hospital services inconnection with the construction of a new building.Construction of the Clinic’s new building.Currently, we are implementing a project of the building’s reconstruction on the territory adjacent to the existingbuilding, which was started at the end of 2009. The project’s implementation will considerably expand the Clinic’sopportunities connected with the provision of full-scale medical care to patients and ensure that the Clinic will becomeone of the best clinics in Europe as regards the applied technologies, including IT technologies penetrating into andsecuring all production processes.The new treatment facility of Medicina JSC occupying over 20,000 m² will house a 100-bed inpatient section with 4surgeries, including a cardiovascular hybrid operating room, a big intensive care unit, admissions, single and doubleoccupancy wards, a VIP section for 5 wards, Therapy and Family Medicine Chair of RSMU and other supportservices. A cardiovascular hybrid operating room combines the opportunities of an operating room for cardiacintervention treatments and open heart surgeries. At this type of operating room one can simultaneously perform suchsurgeries as balloon angioplasty, stenting and heart bypass operations. Hi-tech cardiac surgery is one of the mostimportant areas of the Clinic’s development. 11
  12. 12. Moreover, the new building will also house advanced medical equipment: 2 MRI scans of the latest generation, aPositron Emission Tomography machine and a robotized set of laboratory equipment. The old and the new buildingswill be connected by a sheltered underpass.The new building will be put into operation step by step in 2012, given the balanced growth of its capacities with aview to reaching the expected targets within a year from the launch of the inpatient facility.Business strategy.The strategy of Medicina JSC is based on mastering its socially accountable activities.1. Serving patients’ needs. The most important customer-oriented target is to ensure that patients are provided withhigh quality medical care and service. For evaluation purposes, we introduced customer satisfaction ratios re. thequality of service rendered at the polyclinic and at the inpatient facility. We reach our targets by following our ownquality standards and using the best medical practice achievements (MES “Same day practice”, “Doctor-supervisor,individual assignment of doctors to patients, hospitalizations, patients’ feedback”, Continuity, Health examination,“Completed case”, “Relation of recurrent appointments to initial appointments”, “Lines”). We exercise control andreview the implementation of JCI international standards re. the quality and safety of medical care; control and analyzeconformity with claims and complaints regulations; have introduced performance indicators for doctors and nurses;control the operation of medical devices; arrange infection, laboratory and radiation safety management as well asmanagement over the storage and use of pharmaceuticals. The task of the Advertising and Marketing Departments isto increase the Clinic’s recognition among patients. We monitor the recognition ratio using the Business Starmethodology and hope to reach 10% by 2014. We connect recognition with the use of innovative solutions in ouractivities to ensure patients’ well-being2. Commitment to quality. The targets of this prospect for ensuring leadership with regard to the quality of medicalservices aim at the improvement of internal processes. The targets of this group of goals are implemented throughmeasures aimed at the development of the Clinic’s innovative potential, use of the quality criteria of the “Universityclinic” and introduction of a system that controls and reviews the extent of achieved results. The KPI system ensuressystematic control and individual evaluation of each employee’s performance (be it a doctor or a nurse), review of theextent of achieved results and creation of educational programs for employees. There are 4 types of control: control ofthe 2nd, 3rd, 4th levels (daily, monthly, quarterly control) and control as per check lists. The results are summarized bythe Quality Committee. Based on these results, we elaborate plans for improvement and training programs. Controlmeasures take account of the percentage of negative marks and their share in the List of comments. The biggestpercentage of comments affects the form of a training program. Medicina Clinic serves as the base for the Chair ofTherapy and Family Medicine of N.I.Pirogov Russian National Research Medical University (RNIMU), with trainingprovided to doctors specializing in “Therapy” and “General practice” (Family medicine). In collaboration with theIowa State University the Clinic organizes international symposiums and scientific and practical internationalconferences.3. Teamwork/Staff/Development. The targets of this prospect aim at increasing employees’ loyalty and commitment.Indicators: employees’ satisfaction and stability (turnover, percentage of employees working for 7+years),improvement of staff’s qualifications. The targets are implemented via a system of motivation, considerable increasein discounts for medical services for employees (additional services) and their family members, social benefits, 100%health examination, vaccinations. Institute of Consultants started its development as a school of medical art.Consultants are involved in rounds, councils, consultations, training and scientific events. An attestation programensuring the employee’s individual growth has been adopted. The Clinic supports 4 types of training; over the recentyear internal education has come to the foreground. Also, the important indicator is the ratio of doctors of the highestcategory as well as the ratio of candidates and doctors of medical sciences.4. Social accountability. Social development targets are aimed at ensuring the Clinic’s steady development as asocially accountable company. We create our social strategy on the basis of the 4 following success factors:- Transparency, openness and social accountability. An open report incorporating socially relevant targets andindicators is available at The Clinic has been granted “The Best Moscow Employer” Award.-. Free will to establish relations with professional communities. We reach our targets by disseminating accumulatedknowledge and organizing free lectures and workshops for Moscow doctors. We invite leading Moscow specialists toprovide consultations. Doctors have the opportunity to participate in Clinic’s rounds, clinical debates and conferences.The Chair’s employees ensure the activities of a free “school of health”. 12
  13. 13. - Guarantees of quality combined with best practice standards. Any medical care is rendered in accordance with thestandards of medical care guarantees, which practically secures an equal number of medical services for variouscategories of patients. In order to improve the quality of our patients’ life we introduce recent and most advancedmedical technologies. The indicators of innovations are taken into consideration in all areas of medical activities andeach new area represents a new area for consumers.- Charity. “Healthcare Fraternity” Foundation was established. The Clinic takes part in “Fedorov’s days” Moscowcharity program and helps to equip a district hospital. The charity program orients towards the areas where we aremost competent and where the maximum results for society can be achieved.5. Finances and control. The main financial targets of the Clinic are company value growth (income and revenueindicators), capitalization via reinvesting income into the Clinic’s development (min. 50% of net income is investedinto further development of the Clinic), ensuring high profitability and increase in the share of high tech servicesprovided by the Clinic (since 2011).Innovative SMART-clinic projectIn 2012 Medicina JSC will put into operation a new building whose area exceeds 20,000 m2. The new building is notonly a tool for expanding the scope of rendered services and reaching the best financial results. It is related to theintroduction of qualitative changes in our activities and turning into reality our dream of the Clinic of the 21st century.In the run up to the opening of a new building, development of technological opportunities and provision of the newquality of services Medicina JSC has been implementing a smart clinic project in collaboration with IT leaders. Thisproject is based on a Data Processing Center (DPC) designed in accordance with reliability, safety and fault-tolerancerequirements. The smart clinic project underlies centralized management over the engineering and IT infrastructure ofthe building. This is a pilot project that has no analogues in Russia.The new premises will be used to expand the inpatient section and house a diagnostic department, Therapy and FamilyMedicine Chairs of RSMU, engineering services and a cancer center of the international level. These projects shouldbe implemented in those areas of medicine that lag behind the world’ best practice as far as Russia and Moscow areconcerned. We trust that our choice will improve the quality of life of our patients and will give them hope inresolving their problems.An interdisciplinary inpatient facility at the new building of the Clinic is intended for 100 beds. It is going to have 4modern operating rooms, including a hybrid operating room, and an intensive care unit. Smart operating rooms thatwill be put into operation at the new building of the Clinic serve as a vivid example of how hi tech technologies areimplemented in the healthcare sector. In particular, an automatic anesthesia control system is envisaged to be used atsuch operating rooms. Once a surgeon enters a smart operating room all the equipment is already adjusted according tohis/her preferences, which cannot but contribute to a successful result of any surgery. Cancer centre of Medicina JSC 13
  14. 14. In 2012 Medicina JSC will put into operation a new building with a high tech cancer center that is being built withmethodological assistance of foreign clinics (Memorial Sloan Cancer Center, USA, and Rabin Medical Center —Davidoff Center,Israel). This is a socially relevant project. The Cancer center of Medicina JSC will be a role modeland will implement all the world’s known existing innovative technologies for diagnosis and treatment of cancerpatients.The cancer center is intended for: Improvement and implementation of new radiation technologies for diagnosis and treatment of the most serious diseases. Provision of a full scope of hi tech treatment and diagnostic services to population.The cancer center of Medicina JSC will house a Radiation Detection Department (using the first in Moscow PET/CTGemini TF Philips and Bright View Gamma Camera), a Radiation Therapy Department equipped with two linearaccelerators of the revolutionary new TrueBeam model produced by VARIAN (the first in Russia) and aChemotherapy Department for 25 posts combined with a laboratory preparing chemical agents and an outpatientcenter for cancer patients.Radiation healthcare technologies (diagnostic and therapeutic) are widely used in practically all countries of the world.As soon as a cancer center of Medicina JSC is put into operation it will allow Medicina JSC to reduce the cancer deathrate by 25%.We plan to provide high tech treatment to patients suffering from malignant tumors (main localizations) and cardio-vascular diseases. Treatment of cancer pathologies will be provided both as a separate solution for radical or palliativecare and can be also used as a stage of combined and complex treatment of malignant tumors (main localizations).The cancer center of Medicina JSC will become a part of a bigger clinical complex. This not just an advantage, this isa necessity. It is very important for any patient to undergo diagnostics and get treatment at an interdisciplinary clinic,since any person has his/her own peculiarities as well as aggravating and ancillary diseases. At our center we willchoose the optimal and individual approach to treatment of our patients.Medicina Clinic implements state-of-the-art visualization technologies with the help of the most advanced equipment:CT scans, MRI and PET/CT machines that can provide all the information required for treatment recommendations,including the latest single cancericide dose technology.Radiotherapy plays an important role in treatment of various types of cancer. Even now cancer patients have toundergo long radiotherapy procedures that might take 4-6 weeks. This is pretty tiring. We are introducing a technologythat could allow us to reduce the number of sessions from 30-40 to 1. The doctors of the cancer center attendedtraining in the US and Israel. F.e., among our employees are unique specialists – medical physicists that haveundergone serious studies abroad.Our approach to diagnostics, treatment and rehabilitation at the cancer center of Medicina Clinic is substantiallydifferent from the common approach. Diagnostics would take 24-28 hours, i.e. we will perform all requiredexaminations, incl. morphology and biopsy, within two days. Afterwards the council of doctors of various specialties,with the best foreign consultants involved, if necessary, will work out an individual treatment plan. Then we will keepan eye on the patient who will get all types of treatment until his/her recovery or disease remittance.By applying the most effective diagnostic methods and providing integrated treatment of cancer we do our best toextend the longevity and improve the quality of life of patients. Thus, in Moscow and other metropolises the averageage of men who are diagnosed cancer is 61 years. In Germany and other developed countries they live 12.5-14 yearsafterwards, while the figure for Russia is as low as 2.5 years. So, we have been fighting for these 12 years.Benefits of Medicina Clinic.In its activities the Clinic implements advanced achievements of the world’s healthcare system, which is confirmed byinternational health care experts. 14
  15. 15. Quality of medical care in accordance with the world’s best standards.Medicina JSC is the only clinic in Russia accredited according to Joint Commission International (JCI). This is themost objective and prestigious international healthcare certification which serves as the evidence of conformance of amedical institution to the world’s healthcare and administrative standards and, also, to the requirements for securinginternational patient safety goals.In 2010 the Clinic became a laureate of the Russian Government Quality Award. This Award is granted on acompetitive basis for considerable achievements as regards the quality of products and services, ensuring their safetyand introducing highly effective quality management methods.Moreover, Medicina Clinic is a laureate of the “Russian Quality” program. Having successfully passed the evaluationof medical services carried out by independent experts in 2009 the Clinic was the first Russian organization to havereceived the Certificate of the Russian Quality Organization and “Russian Quality” Diploma as well as the right to usethe “Russian Quality” Mark which is the replica of the Quality mark used in the USSR. RQO takes responsibility forthe quality of medical services provided by the Clinic and therefore reconfirms its right to use the “Russian Quality”Mark on an annual basis.As far back as in 2005 the conformance of Medicina Clinic to ISO 9001:2000 requirements was approved by thecertifying organization TNO-Sertification (Netherlands). The Clinic successfully undergoes annual compliance auditsтo prove its conformance to the requirements of the Quality Management System (QMS) ISO 9001:2000. In 2009during recertification audit the certifying organization Moody International Group acknowledged the conformance ofthe Clinic’s quality management to the requirements of QMS standards ISO 9001:2008.Medicina Clinic has received a Recognized for Excellence ***** (5 stars) Award from the European Foundation forQuality Management (EFQM). In order to maintain this 5* level, we study and use the world’s advanced experienceand introduce the best practices and management technologies. By establishing relationships with partnerorganizations we adhere to the principle of commitment to quality. We are constantly making our best efforts toimprove our work and raise the quality of our health care services on the basis of a dialogue with patients. In 2009 theClinic became the winner of the 5th International Quality Tournament among Central and Eastern European countries.In September 2007 Medicina Clinic joined the Swiss Leading Hospitals Association. SLH members are substantiallydifferent from ordinary clinics, since they ensure the highest European and world’s quality of health care services and,what is more, such guarantees apply to both medical care and the highest quality of service. Medicina JSC reconfirmsits right to be a member of such an honored association once in 3 years during compliance audits.Dialogue with a patient. Clinic’s guarantees. We strive to interact with patients as our partners in order to maintainand improve their health and anticipate their expectations. Medicina Clinic offers its patients detailed Guarantees(quality evaluation criteria) and is ready to take responsibility for its commitments. Guarantees provided by MedicinaClinic ensure rights observance and patients’ safety. Guarantees are real obligations for the performance of which theClinic can be responsible (material and reputation responsibility). Information on guarantees is open to public.Best doctors and medical staff. We have established a system for training doctors and exchanging experience withthe world’s best clinics. When medical staff are employed by the Clinic we strictly check their qualifications.Medicina JSC is a clinical base for the Chair of Therapy and Family Medicine of N.I.Pirogov Russian NationalResearch Medical University (RNIMU). The building of Medicina JSC houses a training and laboratory base of theChair. Medicina Clinic is an interdisciplinary University clinic whose clinical, training and laboratory bases are usedfor scientific and clinical developments in various fields of medicine. Within the framework of the Institute ofConsultants (advisory body to ensure agreed actions when resolving medical care provision tasks) consultations areprovided by academicians and corresponding members of RAMS, Professors and leading specialists in various fieldsof medicine. President of Medicina JSC Grigory Efimovich Roytberg is a practising physician, RAMS Academician,Professor, M.D. and Honored doctor of the Russian Federation. He is also a laureate of the Russian GovernmentEducation Award.Openness to patients. To some extent, the Clinic’s openness is stipulated by the requirements of internationalstandards. We meet the criteria of the best international clinics, as our readiness to keep the conversation going andour care about patients have become the philosophy of our Clinic. Thus, any patient can evaluate the Clinic’s doctors 15
  16. 16. according to several criteria at the Clinic’s web-site. The doctors rating, open to public, is made up in the real timeformat. The Clinic’s web-site and medical information system are interconnected. That is why patients can make anappointment at the web-site and look through their health records, examination results and tests in the Personal cabinetsection. Patients can get a DVD with their examination results in order to receive the so-called second opinion ofdoctors from other medical institutions. Patients’ feedback is very important to us, this is the reason why we pay closeattention to consideration of patients’ proposals and questions received via the web-site, when patients refer to theClinic’s employees as well as those left at special log books that are kept with cashier-administrators. Registered userscan review the stages of their referral to the Clinic online. Any online visitor can ask doctors his/her question bycalling the “hot line”, receive information using SKYPE, calculate the cost of the annual health contract and pay forthe Clinic’s services with a bank card via the Internet.Full range of medical care services with a view to saving patients’ life and improving its quality: polyclinic,diagnostics, interdisciplinary inpatient facility, cancer center.Organizing medical care. For the purpose of ensuring safety and high effectiveness of treatment, we follow theprinciple put forward by the Academician N.A.Semashko “One patient – one physician”. A supervising physiciantreats the patient as a family doctor, therapist or pediatrician, coordinates treatment assigned by other specialists and isinvolved in treating his/her patients at the inpatient section.Medical activities are tied to meeting medical and economic standards of rendering medical care existing in Russia.Patients’ consultations are documented in electronic health records and the results of diagnostic tests carried out by hitech equipment are recorded and given to patients on a DVD. Thus, the patient can present a medical assessmentreport based on the results of the examination and a video of the examination on a visit to another clinic.Hi tech medical care. IT-infrastructure. In its activities the Clinic implements advanced achievements of theworld’s healthcare system and performs systemic work to apply innovative technologies. Medicina JSC belongs to thelist of innovatively active healthcare institutions of Moscow whose base can be used for performing clinical research.Having the best treatment and diagnostic base in Moscow we offer our patients a full range of medical services. Wepay close attention to the introduction of state-of-the-art IT technologies contributing to the improvement of thequality of medical care provided. The Clinic uses an electronic health record system (EHR) and has also launcheddigital archives solutions allowing it to store screening results obtained with the help of various medical devices (CTscan, MRI scan, X-ray machines, ultrasound and endoscopic equipment). Medicina JSC is implementing a smart clinicproject. This project is based on a Data Processing Center (DPC) designed in accordance with reliability, safety andfault-tolerance requirements. The modern data transmission network is intended for the transmission of large volumesof information and meets safety requirements stipulated by law. Smart operating rooms are a vivid example of how hitech technologies are implemented in the healthcare sector, f.e. an automatic anesthesia control system. Once asurgeon enters a smart operating room all the equipment is already adjusted according to his/her preferences, whichcannot but contribute to a successful result of any surgery. The smart clinic project underlies centralized managementover the engineering and IT infrastructure of the building. This is a pilot project that has no analogues in Russia.Atmosphere of comfort, care and friendliness. We do our best to make our patients feel comfortable. Care aboutpatients is the core of any our activity. Patients are met by friendly and caring employees that escort them around theClinic to the office they need, help to get the required documents prepared and to obtain a desired consultation. Itusually takes no more than 24 hours from the moment when the patient visits the doctor for the first time until themoment when he/she receives the results of his tests, examinations and doctor recommendations. The styles of theClinic’s interiors are developed by designers for individualization of various departments and patients’ comfort.Clinic’s guaranteesMedicina JSC offers its patients detailed GUARANTEES and quality evaluation criteria and is ready to take materialand moral responsibility for its commitments.Upon a visit to our Clinic each patient is guaranteed: Medical examination in full compliance with medical standards. Personal supervising physician Escorting around the Clinic Lack of lines Written recommendations 16
  17. 17. Provision of personal access to health records via the Internet Provision of all test results and videos of surgeries under anesthesia on a CD Provision of information on medications used Consideration of patients’ enquiries to the Clinic’s administration, with a written response guaranteed Material compensation for unjustified claims or the Clinic’s non-fulfillment of aforementioned guaranteesGuarantees of Medicina Clinic ensure the observance of patients’ rights and security of patients. Clinic guarantees areconcrete obligations for whose performance the Clinic bears material and reputation responsibility. Information aboutguarantees is publicly available.Strengths of Medicina JSCThe Clinic can ensure the stable quality of medical care at its inpatient facility and polyclinic for the followingreasons: The Clinic provides medical services in practically all areas of medicine. Services provision organization and quality management system are standardized. We are constantly performing work to introduce and use state-of-the-art technologies and advanced treatment methods. Our doctors have graduate degrees, have been assigned the highest or first qualification categories. All our employees are always improving their qualifications. F.e., doctors and nurses attend training in foreign clinics. Medical documentation is maintained in the electronic format, which is convenient for patients and facilitates doctors’ activities. All offices where patients are admitted are equipped with the latest appliances and conform to hygiene rules and regulations as well as to medical esthetics requirements. Medical services are rendered in accordance with MES, with regular control exercised over the treatment and diagnostic process. Medications and medical products are purchased only from reliable suppliers on condition of the availability of all necessary quality certificates, etc. Patients have the opportunity to access their health records online.Future of the ClinicWe establish a clinic of international acclaim, which retains its leadership position on the Russian healthcare market.Following changes in society’s demands we are constantly mastering all the aspects of our activities in order to ensurethe maximum customer satisfaction level and the ideal quality of medical services.By achieving the highest results we set new criteria for the assessment of medical care quality and patients’satisfaction. Studying and analyzing society’s demands, patients’ satisfaction and the quality of rendered medicalservices allows the Clinic to constantly compare the results of its activities with the indicators of the world’s leadingclinics. Aspirations for excellence have no boundaries in time or space and are viewed as an ongoing impetus fordevelopment.Impact on societyThe interaction of Medicina JSC with society is established on the basis of social accountability. The specific featureof the Clinic’s activities is in its essence connected with preserving and improving population’s health and raising thequality of life. The Clinic supports the communities where we live and work. In the first place, it orients towardscreating favorable labor conditions for staff, which is confirmed by its regular recognition as the “Attractiveemployer” by the Superjob portal. The Clinic has organized and regularly conducts free “Schools of health”, training sessions in thefollowing areas: gastrointestinal diseases; carbohydrate metabolism disruptions and cardiovascular diseases (subject tochange depending on consumers’ demands). The annual budget is min. RUR 6,5 mil. The Clinic’s interaction with municipal authorities in the area of science, industrial policy and healthcare of Moscow underlies R&D activities under state contracts (clinics for performing various types of works arechosen on a tender basis), providing specific scope of hi tech expensive medical care to the population of Moscow, 17
  18. 18. elaborating a scientific and technical base for the use of advanced medical technologies in practical activities ofMoscow’s treatment facilities. The Clinic gives charity donations to non-for-profit public organizations. Under the Order of theHealthcare Department of Medicina JSC has been implementing a number of socially important charity programs forthe citizens of Moscow on a contractual basis, namely: CT scanning for patients as per the referrals from Moscow’s healthcare facilities – 1260 examinations performed. MRI scanning for patients as per the referrals from Moscow’s healthcare facilities – 5037 examinations performed. X-ray bone densitometry (536 female patients) and genetic tests to diagnose osteoporosis (5 female patients) as per the referrals from all maternity welfare centers of the Central Administrative District of Moscow (for free). Hi tech cardiac surgery to low-income citizens of the Central Administrative District of Moscow (16 surgeries). Charity Foundation “Medical Fraternity” The Clinic renders assistance and support to those in need. A specific area of such assistance issupport provided to Russian medical community. In 2011 the Clinic founded Charity Foundation “MedicalFraternity” providing assistance to health workers (the Foundation’s capital for 2011-2012 is 10 mil. RUR and itscapital for 2014 is 40 mil. RUR). This is a unique Foundation, as decisions on whom assistance should be rendered aremade by medical staff on the basis of voting. Doctors that save lives often find themselves in a predicament. CharityFoundation “Medical Fraternity” has been set up by Medicina Clinic to help health workers of Russia. This is a uniquecharity project that unites representatives of the medical community, patients, medical institutions and bestorganizations of the country. This is a venue where charity providers interested in the development of the Russianhealthcare system and health workers needing help and support meet. It is charity providers, patients andrepresentatives of the medical society that influence the Foundation’s decision on whom aid should be rendered on avoting basis.The basis of any charity project is people developing this project, who are not indifferent. Charity Foundation“Medical Fraternity” has been set up by Professor Grigory Roytberg. As a doctor he knows the problems of healthworkers from inside out; as the organizer of a health care company and the general manager of one of Russia’s mostsuccessful private clinics he can transform general “petty little things” into the powerful stream of support that canchange the situation in the Russian healthcare sector for the better. The Clinic’s activities are characterized by unprecedented openness and dialogue with a patient.Patients can look through their health records online, get videos of surgeries and examinations on DVDs and evaluatethe activities performed by the Clinic’s doctors at Free workshops for doctors from Moscow’s healthcare facilities and their attendance by min. 600people per annum. 18
  19. 19. Opening the cancer center of Medicina JSC with Radiation Detection, Radiation Therapy andChemotherapy Departments in September 2011. The new cancer center will allow to increase the number of newlydetected malignant tumors by 15-20%; improve the quality of diagnostics of cardio-vascular diseases by 30-40%;achieve a five-eightfold reduction in the number of cancer recurrence; achieve cure of locally advanced prostate cancerin 95-99% cases; reduce cancer neglect rates by 15-20%; reduce cancer death rates by 5-30%. Providing services to people living nearby under mandatory health insurance programs, at lower rates and on a free basis for patients. Contribution to the development of the social infrastructure of Moscow (2006-2011) Okrug residents This diagram shows the number of residents of the Central Administrative Okrug of Moscow that obtain the Clinic’sservices under mandatory insurance programs. Under mandatory insurance programs, i.e. on a free basis, the Clinicprovides its services to residents of the Central Administrative Okrug of Moscow. The number of residents of Central Administrative Okrug is going down due to the natural decline of the population and its migration, changes in preferences re. the place of residence (relocation from the city center to Moscow region suburbs) A few research and development projects under the City’s order have been implemented (non-for-profit activities). F.e., medical equipment was handed over to Taruss hospital and Hospital No.82 for free. 19
  20. 20. Medicina Clinic provides dispensary services to World War veterans and invalids.1- Total, WWV, dispensary services, 2 – Obtained dispensary treatment, 3 – Obtained health resort treatment.20
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  22. 22. HR POLICY AND ORGANIZATIONAL CULTUREHR Policy Medicina JSC’s HR policy allows each employee to understand his/her role in the Clinic, feel involved in thesystem of values created there and in the Company’s mission, adhere to single standards of behavior andcommunication with partners, clients and colleagues and obey corporate culture principles. Our patients are people whose life’s top priority is health. We are responsible to our patients, whether adults orchildren. By providing highest quality medical aid and applying the widest range of medical services and advancedtechnologies we improve our patients’ health, lengthen their life and improve their lifestyle. We do our best to make all our employees interested in the successful development of Medicina JSC byconsidering it as their professional and personal success, being sure of their future and socially protected. Ourcommitment is to make labor compensation fair and reflecting the partnership between Medicina JSC and itsemployees. Our objective is efficient management. Understanding our responsibility for work in the permanently changingenvironment we use best efforts to constantly improve and perfect our activity. We are open for stable and efficient partnership and ready for fair competition. We respect and strictly adhere to State laws. We are open for partnership with parties and social movementswhose activity is aimed at social health.Basic Corporate Culture ProvisionsProfessionalism The fundamentals of our work are competency, responsibility and experience. Medicina JSC is a company ofprofessionals. All our clients are sure to receive maximum attention to their problems. We do not divide clients intomore or less important ones. Each client will receive high quality medical services and may always rely upon thecompetent help and consulting of our specialists.Stability Medicina JSC has been working in the medical service market for more than a decade. Our sustaineddevelopment throughout the Company’s entire history and the vast experience we have accumulated ensure ourdecisive forward movement in the dynamically developing market conditions. Medicina JSC does not target achieving short-term success or raising fast money. We prefer establishing long-term mutually favorable relationships with reliable partners and employees because we plan working in this marketlong and stable.Reliability Medicina JSC regularly monitors the market of medical services to be able to competently predict possiblechanges in the financial, economic and social segments and work successfully in the new conditions. Being keen for its perfect business reputation, Medicina JSC has always fulfilled and will always fulfill all itsobligations to its clients, employees and partners. People trust us, and this trust is well deserved.Openness Practice shows that to be trustworthy a company should be clear and understood for its clients, employees andpartners in it activity. We are therefore committed to maximum possible openness in providing medical aid.Social Orientation The main value of Medicina JSC are people who have trusted it with their careers. The fundamental principleof the Company’s HR policy is to develop the optimum conditions for the complete implementation of its employees’capabilities, competence and skills and provide deserved compensation for their work. Medicina JSC is a unified team. Success of each employee is a component of the success and prosperity of theentire Company. Medicina JSC has deserved the trust and recognition among its clientele thanks to the principles all itsemployees abide by.Medicina JSC’s General Ethics and Activity Principles Medicina JSC’s professional activity is based on the following principles:  applicable legislation of the Russian Federation, regulatory documents and standards of the Ministry of Health and Social Development of the Russian Federation, Department of Health and State Sanitary and Epidemiological Supervising Body of Moscow and Moscow State Fund for Mandatory Medical Insurance that govern the activity of health institutions; 22
  23. 23.  understanding of the civil and professional duty before the society, state and Russian citizens;  improvement of corporate management and in-house control;  absolute fulfillment of all the obligations and guaranteed high quality of services;  full responsibility for the quality and results of our work;  fair competition and active opposition to unfair players in the market of medical services. Medicina JSC does not accept in its activity:  violations of applicable legislation, moral rules and business ethics;  infringement of rights, lawful interests and dignity of shareholders, clients and partners and inflicting damage to Company’s image.Medicina JSC Firm Style Medicina JSC has a unified standard style of all printed media and souvenirs making our Companyrecognizable, a standard procedure of service provision in all the departments and a regulated procedure of applyingthe firm logo and name of Medicina JSC. Business printed media of the Company’s departments (forms, envelopes and personnel business cards) areproduced to a unified style using the officially registered symbols and color design. Medicina JSC’s departments arenot allowed to make modifications to the firm logo and the unified form and style of the Company’s business printedmedia. The design of the Company’s logo and name on the advertising and souvenir media (pens, calendars,notebooks, leaflets, booklets, ads etc.) conforms to the officially registered reference of the firm logo and the fontstyle. Firm dress style is another component of our corporate culture which is of special importance for medics andcontact persons.Socio-Psychological Climate Medicina JSC’s in-house communication standard is confidence and high mutual exactingness between ourstaff members, benevolent and practical criticism, freedom of expressing one’s opinion when discussing matersimportant for the entire Company, managerial right to make decisions that are important for respective divisions,sufficient awareness of employees and satisfaction of being part of the team. The establishment of a good business climate in Medicina JSC favored by the employees’ exact knowledge oftheir respective responsibility areas which excludes any possible conflicts arising thereupon. The open policy andtransparency of compensations further reinforces the favorable socio-psychological climate of Medicina JSC.Conflict of Interests Management Principles The main conflict management principle employed by Medicina JSC is to prevent a conflict or avoid itsaggravation. Should some conflict develop, our managers attempt to make use of it for the Company and encouragepractical criticism and proposals from employees. A conflict can be taken under control if employees have the will andexperience of such work. The Company manages possible conflicts using the conflict party functional separation method and internalrestructuring of the conflict situation. Conflicts are resolved using the ‘through confrontation to cooperation’ approach(negotiations).Medicina JSC Employee Business Behavior Code It is a good practice in Medicina JSC to respect other colleagues regardless of their position. The Company’sManagement is responsible to its personnel. The Company’s Management builds its relationships with the personnelbased on the following fundamental principles:  the Management observes the Labor Code and other laws regulating labor relationships with employees;  the Management observes applicable occupational health and safety standards; 23
  24. 24.  the Company does not apply any discriminating rules to employee hiring, compensation and promotion. All employees have equal career opportunities in accordance with their competence;  the Management grants all the employees equal rights and opportunities in developing and expressing their capabilities;  the Management consults employees on labor conditions and other issues affecting the Company’s personnel;  the rules relating to compensations, discounts, promotion and other labor conditions have been defined clearly and distinctly for all employees;  the Management fulfills its obligations relating to making contributions to retirement funds;  the Management has the right to enforce discipline among the employees by any lawful means including dismissal of employees in breach of discipline in accordance with the applicable legislation;  the Management takes into account the opinion and personal values of employees;  the Management builds its relationships with the employees based on collectiveness and cooperation principles.Medical Service Quality Management There are many definitions of what quality is, yet there’s been no universal one. We believe that in whatconcerns medical activity quality should include the following two equivalent components:  first, this is about every medical aspect such as necessary competence of doctors, low medical error risk, a system allowing timely identification and correction of situations bearing the threat of medical errors (e.g. mammary gland X-ray images are necessarily analyzed by two radiologists in order to avoid breast cancer omission), and a medical and economic standard compliance control system;  second, these are deontological aspects, i.e. the patients’ perception of medical aid, including its service component – this is what patients can evaluate on their own (being not specialists in medicine they cannot judge on the correctness of therapeutic approach). Furthermore, to ensure sufficient in-house business process quality control, Medicina JSC uses the followingprocedures: regulated in-house audit procedures, weekly managerial supervision, systematic checks of sanitary andepidemic control and medication expiry dates, personnel competency checks and monthly personnel work qualityevaluation. For outsourced processes Medicina JSC appoints the so-called ‘Process Owners’ to bear responsibility fortendering, contract preparation and partner interaction and ensure necessary controls and contract obligationfulfillment. The management of such processes is documented. 24
  25. 25. Clinic’s guarantees.Looking through patients’ eyesThe major problem on the way to excellence encountered by everyone who has ever worked in this field is to look atyour company through your customers’ eyes, through your patients’ eyes, in our case. We can improve in variousaspects of our activities. However, if our patients do not feel it, it means that we have either chosen the wrong strategyor the wrong tactics. For us to be confident that we have chosen the proper and effective way we have been constantlymonitoring our patients’ satisfaction. A satisfaction review is carried out regularly. Moreover, we are doing our best toget rid of many negative moments and are being a success in this respect. During 20 years we asked our patientsquestions about the factors that determined their choice, studied the world’s best health practice and improved ouractivities to ensure our patients the maximum level of safety and protection of their rights. As of today, we haveelaborated the system “Guarantees provided by Medicina JSC on the basis of which our patients can evaluate ourclinic.GUARANTEES re. the scope of medical care You will be offered a full and sufficient range of diagnostic and treatment programs allowing one to make a diagnosis and ensure the high quality of treatment at an interdisciplinary University clinic for adults and children, including a polyclinic, an inpatient section and emergency care. Over 340 physicians and consultants, including 60 academicians, corresponding members of the Russian Academy of Medical Sciences and Professors – leading medical experts - take an active part in your recovery process. Annual health programs provided by Medicina JSC offer the widest range of medical services in Moscow as compared to their counterparts.GUARANTEES re. the organization of medical care Our physicians treat a patient rather than a disease. Patients are provided with highly qualified medical assistance in accordance with medical standards, and the doctor explains what it means for patients. We follow the principle put forward by the Academician N.A.Semashko “One patient – one physician”. A supervising physician treats the patient as a family doctor, GP or pediatrician, controls treatment assigned by other specialists and takes part in treating his/her patients at inpatient facilities. Consultations provided to customers are documented in a reliable electronic medical record system. Patients can get access to their personal medical records on line via Personal Cabinet at the Clinic’s web-site. After the appointment the doctor is obliged to provide the patient with written recommendations. The results of diagnostic tests carried out with the use of hi-tech equipment are recorded on CDs and provided to patients. It gives them the opportunity to obtain a second opinion and present both a Medical assessment report based on the results of the examination and a video of the examination on a visit to another clinic.GUARANTEES re the quality of service 25
  26. 26. One of the elements of our customer service style is the escorting of patients. Our employee takes a patient to therequired office and helps with directions.We save our patients’ time and do our best to render them required medical services as soon as possible, namely:  ensure the opportunity of providing all necessary services on the day of visit.  see to it that patients visit the doctor, undergo assigned diagnostic tests required for making a diagnosis and recurrently visit their ailing physician within 24 hours;  guarantee that patients will not have to wait for their appointments for more than 20 minutes.We create and sustain the atmosphere of care, commitment and consideration for your comfort and tranquility whilstin Clinic.GUARANTEES re. safety Patients can be assured that all medical equipment, furniture and appliances we use are in good working order. The territory of the Clinic is under security surveillance. In addition, we pay special attention to infection control, origin of medicines and safety of applied technologies.GUARANTEES to be heard out We do recognize that it is our patients who are our final arbiters that evaluate the quality of our services. All their wishes, recommendations and opinions will be taken into consideration; not a single enquiry would remain unattended. We guarantee that in case a patient raises a well-grounded claim or the Clinic fails to execute the above mentioned guarantees a patient can be entitled to a material compensation.Certified quality management programSince 2005, on the annual basis, Medicina JSC has successfully passed certification according to ISO 9001:2000 andsince 2009 – certification according to ISO 9001:2008.Interaction with the Swiss Leading Hospitals Association allows us to receive and analyze information on state-of-the-art management methods. Awaiting admittance to the SLH Association in 2006-2007 Medicina Clinic carried out self-evaluation according to the proposed criteria, which then pushed us to conduct further self-evaluation under EFQMcriteria and afterwards helped us to obtain the Russian Government Quality Award.By implementing our strategic goals and striving for excellence, the Clinic has started to carry out self-evaluation onthe basis of the EFQM model with a view to finding the areas for improvement and reaching the best results, ascompared to others.The corporate culture of Medicina JSC and principles all the employees follow imply the perception of patients andtheir families as partners in the process of treatment, a constant and sincere with to help each and every patient,contribution to patients in their desire to be well aware when making decisions concerning their health and well-beingand honesty and sincerity with regard to patient-related activities.By following these principles Medicina JSC is constantly striving for the ideal quality of services, ongoingimprovement of all processes that can ensure high quality: professional skills, quality of service, technology craft,quality of management; achievement of high results: measurement, monitoring and reporting re. services and standardsof quality, patients’ satisfaction, comparison with the best representatives of the group. 26
  27. 27. Corporate social responsibilityThe Clinic’s management views corporate social responsibility as one of the most important principles of adherence tothe concept of sustained economic growth in cooperation with its employees, their families, population and entiresociety with a view to improving their life.Social policy of Medicina JSCManagement of Medicina JSC voluntarily undertakes a social responsibility obligation with regard to its staff andcreates necessary conditions for highly productive activities, study of advanced experience and achievements inscience and technology, ensures relevant pay for their work, rest and safe labor conditions, takes measures aimed atthe reduction of the impact of harmful factors on employees’ health, organizes retraining and qualificationimprovement programs, secures the insurance of professional risks and other social rights and guarantees.To establish employees’ assurance of tomorrow Medicina JSC has elaborated a system of measures aimed at ensuringheir social support guarantees. As a rule, such measures relate to staff-related social measures concerning beyond setlegislative requirements and department regulations.Medicina JSC provides its employees stable work at a clinic of the European level which is conveniently located in theheart of Moscow and equipped with state-of-the-art medical appliances, which can ensure the provision of medicalcare with the use of the most advanced technologies in all areas of medical activities and which has well-equippedoffices and nice interior design. 27
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  29. 29. PERSONNEL SOCIAL RIGHTS1. Salary In accordance with the requirements of the Labor Code of the Russian Federation, the Clinic has aPersonnel Compensation and Incentive Provision. This document regulates the fundamentals of laborcompensation, calculation of compensation amounts and labor evaluation criteria and procedures. Salaries are paid in cash either through the Clinic’s cash department or by transferring to personnel’saccounts, at least twice a month on the dates specified by the duly approved In-House Labor Rules (theadvance payment for the first half of the ensuing month is paid on the last day of the current month, and theremainder of the monthly salary is paid on the 15th day of the ensuing month less the advance paymentamount). Salary deductions are only allowed in cases stipulated by the Labor Code of the Russian Federationor other Federal Laws. After the calculation of their monthly salaries, Company’s employees receive thecomplete information on their salary components, each employee receiving a past month payroll. Company’s personnel salary consists of two components: - the basis component, i.e. the official salary, is the guaranteed monetary compensation paid to thepersonnel for the fulfillment of their respective job duties depending on the skills level and the quantity andquality of labor; - the bonus component which can be paid as a reward for high quality labor and remarkable results. Personnel labor results are evaluated by their respective direct managers, and any bonus paymentdecisions are made by department directors and approved by Company’s President or Financial Director.2. Working Day Duration Workloads for different personnel categories have been designed depending on business processstructure and type of work and adhere to the applicable regulatory limitations, i.e. max. 40 hours weekly(further regulated by Medicina JSC’s In-House Labor Rules). The following hour workloads have beendesigned for different personnel categories:  40 h week for administrative personnel;  39 h week for medics, paramedical personnel and ultrasonographers;  36 h week for pharmacists and infectiologists;  35 h week for underage (no such personnel in the Clinic);  33 h week for dentists;  30 h week for radiologists and manual therapists;  20 h week for the logopedist. Workloads have been designed in accordance with the following applicable industry regulatorydocuments:Order of the Health and Social Development Ministry of Russia No. 588N as of 13.08.2009, Approval of Workload Standard Calculation Procedure for SpecificCalendar Terms (Month, Quarter, Year) Depending on Approved Weekly Workload Standard.Directive of the Labor Ministry of Russia No. 41 as of 30.06.2003, Job Combination Rules for Pedagogical, Medical, Pharmaceutical and Culture Workers.Directive of the Government of Russia No. 101 as of 14.02.2003, Workloads of Medical Workers Depending on Position and/or Speciality.Directive of the Health and Social Development Ministry of Russia No. 41 as of 30.06.2003, Job Combination Rules for Pedagogical, Medical, Pharmaceutical andCulture Workers.3. Disciplinary Punishment The Clinic does not apply or support disciplinary punishments implying any types of oppression orpersonal offense. Company’s Management has the right to apply the following types of disciplinary punishment fordisciplinary violations, failure to fulfill or undue fulfillment of job duties: - reprimands; - reproofs; - dismissal for appropriate reasons (Labor Code of the Russian Federation, Article 192). The application of disciplinary punishment is strictly limited by the existing labor legislation (LaborCode of the Russian Federation, Articles 189-195). 29
  30. 30. 4. Non-Discriminative Provision Company’s hiring, compensation, education access granting, promotion, upgrading, dismissal andretirement procedures clearly exclude and disapprove any race, nationality, confession, limited capability,gender, skin color, language, organization participation, political opinion, age or domicile related personneldiscrimination. The Company does not hinder its employees’ endeavors to abide by their existential concepts orhabits or fulfill their race, nationality, confession, limited capability, gender, organization participation orpolitical opinion related requirements to the extent that this does not compromise their and other employees’ability to fulfill their job duties and does not violate other employees’ rights. The main personnel admission criteria are conformity of a candidate’s education and competency tothe job requirements, professional capabilities, business qualities and the availability of necessarydocuments.5. Occupational Health and Safety The Company has established an occupational health management system aimed at protecting the lifeand health of its personnel. The Clinic has the Occupational Health Arrangement Provision – an enterprise standard regulatingthe in-house occupational health management system, the functional duties of the occupational healthofficers, the occupational health training procedure and the occupational health and safety monitoring andsupervision arrangements. Workplace Evaluation Workplace labor condition evaluations have been scheduled as per Article 209 of the Labor Code ofthe Russian Federation and Order of the Health and Social Development Ministry of Russia No. 569 as of31.08.2007, Approval of the Workplace Labor Condition Evaluation Procedure. 2009-2011 Workplace Labor Condition Evaluation Statistics Total Number Number of Workplaces Evaluated, Including by Year of Name of Structural Divisions where Workplace of Workplaces Labor Condition Categories: Evaluation Labor Condition Evaluation was Conducted Evaluated Total 1 & 2 Cats. 3.1 3.2 2009 Diagnostic Department 77 13 6 7 - 2 Diagnostic Department 15 10 5 - Reconstructive Department 23 15 8 - Dental Department 24 20 2 2 1 Clinical Department 2 2 - - 2010 In-Patient Department 44 5 34 5 Family Medicine Department 10 10 - - Information Service Department 41 36 5 - Security Department 6 5 1 - 149 Information Technology Department 10 10 - - 2 Clinical Department 8 8 - - 2 Diagnostic Department 4 - 4 - 3 Clinical Department 24 21 3 - Medical Service Office 5 5 - - 1 Clinical Department 30 21 4 5 2 Clinical Department 50 36 13 1 3 Clinical Department 17 13 4 - 30
  31. 31. Total Number Number of Workplaces Evaluated, Including by Year of Name of Structural Divisions where Workplace of Workplaces Labor Condition Categories: Evaluation Labor Condition Evaluation was Conducted Evaluated Total 1 & 2 Cats. 3.1 3.2 2011 Executive Department 138 2 2 - - Engineering and Security Department 9 8 1 - Procurement Department 20 1 8 - Financial and Economic Department 5 2 3 - Workplace evaluation statistics: a total of 518 workplaces were evaluated (100% of the overallnumber), of which 179 were evaluated repeatedly (once in 5 years) in 2010-2011. Laboratory measurements and workplace hazardous factor assessments were contracted to theLaboratory Center of the Labor Research Institute. The results were included in hazardous occupationalfactor assessment reports, workplace evaluation cards and hazardous occupational factor assessment tables.The tests showed that most workplaces have optimum labor conditions (1 & 2 Categories). Assessmentresults were used for the development and implementation of Cat. 3 workplace labor condition improvementannual schedules. Workplace evaluation cards were made available for personnel upon the completion ofworkplace evaluation and for newly hired employees during the admission safety drill. Occupational health and safety proposals made by Medicina JSC’s personnel generally seekimprovement of labor conditions in specific divisions (development of optimum microclimate andtemperature and laboratory measurement of hazardous occupational factors e.g. noise, vibration, illuminationetc.). All proposals are analyzed by the Clinic’s Management and forwarded as memo requests torespective utility departments for execution. In 2011 the Medicina Clinic won the District Stage of the City’sBest Occupational Health and Safety Arrangement Competition under the nomination Moscow’s BestOccupational Health and Safety Non-Production Organization.Health and safety proposal statistics 2009 2010 2011Number of health and safety proposals 84 125 64All these proposals have been implemented.Occupational Accident Statistics and Cooperation with Occupational Health and Safety SupervisingBodiesNo occupational health and safety related comments or recommendations have been received from thesupervising bodies over the reported period. Occupational accident statistics are summarized in the Tablebelow: Number of Number of Affected Number of Sick Year Occupational Type of Accident Accident Severity Persons Leave Days Accidents 2009 1 Falling on stairs 1 40 Slight 2010 1 Falling on even surface 1 72 Slight 2011 0 - - - - Accident analysis suggests that the origin of the injuries is human factor, i.e. incautious behavior ofthe affected persons. All the accidents have been investigated as per Article 229 of the Labor Code of the RussianFederation and the Provision for Occupational Accident Investigation in Industries and Organizationsapproved by Order of the Russian Ministry of Labor No. 73 as of 24.10.2002. The sick leave periods werecompensated to the affected persons at the 100% monthly salary rate. 31
  32. 32. In compliance with the Labor Legislation of the Russian Federation, Medicina JSC’s personnel havebeen fully insured against occupational accidents and job related diseases through the Social Insurance Fund. To prevent occupational accidents, heads of the Clinic’s divisions carry out occupational health andsafety drills with all the employees following the approved workplace drill schedules and in accordance withhealth and safety instructions for each job.Health and Safety Costs 2009 2010 2011 Health and Safety 212,005 222,706 226,050 Costs, Rbls.6. Maternity Support 2008 2009 2010 2011 No. of No. Amount No. No. Amount No. No. Amount No. No. Amount Days of Paid, of of Paid, of of Paid, of of Paid, Perso Rbls. Days Perso Rbls. Days Pers Rbls. Days Pers Rbls. ns ns ons ons Maternity 2252 16 1,640,321 3316 23 2,494,226 3644 26 3,390,551 2686 19 2,654,005 Leave<1.5 Yr. OldChild Support 397 44 2,381,681 307 41 2,030,050 398 47 3,899,503 321 50 3,475,330 TemporaryDisability Pay 4988 758 2,336,172 4651 873 2,798,760 8375 965 6,637,255 4298 628 6,691,3207. Labor Legislation Comments and Claims from Supervising Bodies No occupational health and safety related remarks were received from the State Occupational SafetySupervising Office in 2011. PERSONNEL SOCIAL GUARANTEESPersonnel Social Guarantee Objectives and ProgramsPersonnel social guarantee programs include Clinic Management’s initiatives for the implementation offurther personnel social support measures in addition to the regulatory ones, i.e.:  in-house job combination options;  annual work result bonuses;  career possibilities;  medical error responsibility insurance;  central catering at reduced prices;  free beverages (coffee, chocolate, tea);  medical servicing at the Clinic;  medicines at reduced prices;  annual medical examination;  sanatorium and child health camp vouchers;  free vaccination;  payments on jubilees, retirement, child birth and other occasions;  certification and upgrading at the Clinic’s expense;  training opportunities in leading European, US and Israel clinics;  research, Ph.D. and Dr. Med. thesis opportunities;  Russian and international conference, seminar and workshop participation opportunities; 32