We suggest to take as a basis a simple formula: «Private medical center = medicine + service ”, because when evaluating the effectiveness of such a medical center, it is important to consider not only the medical aspect, A and the quality of service delivery.
Consider the first component: medicine. In the context of the medical center of reproductive medicine, it is primarily about embryology and reproduction.
European Association of Human Reproduction and Embryology (ESHRE) developed and approved a list of key performance indicators (KPI) works of the embryological laboratory of the medical center of reproductive medicine. In addition to the criteria themselves, The Association provides acceptable and reference values (The first column is the criterion, The second is how to calculate it, The third is an acceptable value, The fourth is the reference value):
Source: ESHRE Special Interest Group of Embryology, Alpha Scientists in Reproductive Medicine, The Vienna consensus: report of an expert meeting on the development of art laboratory performance indicators, Human Reproduction Open, Volume 2017, Issue 2, 2017, hox011, https://doi.org/10.1093/hropen/hox011
Permanent control over these indicators is a very important step in the embryological laboratory, After all, you can not only see work efficiency, and and respond quickly to any changes. We show, What is it the appearance of us, in the medical center "Nadia Odesa". Before you screenshot from our medical information system (The sample period is indicated, The first column is an indicator, The second is the value in our laboratory, The third is an acceptable level on Eshre's recommendations, The fourth is the reference level by the same recommendations, Fifth - As it is calculated):
As you can see, with 10 indicators, 5 We have at the reference level, The rest is within an acceptable level and approximate to the reference. Let us note right away, When evaluating the efficiency of our embryology, we do not take into account the indicators, relevant purely for ivf, Since we do not perform IVF without ICSI. The calculations occur automated, In order to avoid a human factor.
The efficiency of reproduction in the medical center can also be calculated. Again turn to eshre. The percentage of clinical pregnanc (CPR). This indicator is equal to the ratio of embryo transfers, which ended in clinical pregnancy (When the ultrasound is confirmed by the presence of a fetal egg), to all transfer over a period of time, that is, allows to evaluate the work of a reproductivelogist. Eshre publishes average values, that may be acceptable (32.24 %) and reference (35.50 %), But he emphasizes, that these values are not clearly approved (Eshre participants did not reach a common opinion), and, in accordance, set these values worth for each country separately.
Source: ESHRE Clinic PI Working Group and others, The Maribor consensus: report of an expert meeting on the development of performance indicators for clinical practice in ART, Human Reproduction Open, Volume 2021, Issue 3, 2021, hoab022, https://doi.org/10.1093/hropen/hoab022
At the screenshot from our medical information system you see our current figure:
In reproductive medicine, different indicators of the effectiveness of DRT programs can be used. For example, pregnancy rate, or PR — shows the share of transfers, after which a positive hCG result was obtained. This indicator may also include biochemical pregnancies: situations, when pregnancy is confirmed by laboratory, but did not develop to clinical pregnancy.
Another indicator is the percentage of clinical pregnancies - clinical pregnancy rate, or CPR. It takes cases into account, when pregnancy is confirmed by ultrasound. PR зазвичай може бути вищим за CPR, оскільки охоплює ширшу групу випадків. Ago, comparing statistics, важливо дивитися не лише на сам відсоток, and to you, який саме показник використано, for which period it is calculated, which group of patients is included in the sample and which medical factors are taken into account.
Therefore, Let's summarize. ESHRE (European Association of Human Reproduction and Embryology) developed and approved a list of key performance indicators (KPI), With which even a person without medical education can be verified as the work of embryology and reproduction of the clinic of reproductive medicine: need to simply compare numbers. If the clinic has a medical information system, Ask your doctor to display these indicators for that period, which one want you.
Interesting fact: the effectiveness of reproductive treatment depends not only on the doctor's prescriptions, and also from that, how consistently patients follow them and what psychological state they have during treatment. In the materials of ESHRE it is noted, that psychosocial support, reduced stress and compliance may be associated with better treatment outcomes—specifically, a difference in 15% by individual indicators. At the same time, the result always depends on individual medical factors.
Source: ESHRE Psychology and Counselling Guideline Development Group, Routine psychosocial care in infertility and medically assisted reproduction — A guide for fertility staff, 2015 https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Psychosocial-care-guideline
Therefore, The service really matters. Again turn to eshre. Based on a large number of Eshre's research has developed a check-point of that, To which the patient should count in the clinic of reproductive medicine:
Source: ESHRE Psychology and Counselling Guideline Development Group, What psychosocial support should you get from your fertility clinic? Patient version of the ESHRE Guideline: Routine psychosocial care in infertility and medically assisted reproduction, 2015 https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Psychosocial-care-guideline
Let's consider each point in more detail in the context of our medical center.
The staff of our medical center shows understanding to patients and pays enough attention to their emotional state, And to check this we have a special person - a care manager. A care manager contacts patients some time after their visit to the health center, to get caught about them, morally support, and if necessary to help solve the issues and issues of patients. Before surgery and other emotional and extinguishing events, the contact center calls patients, to support them.
We are aware of the emotions and fears of our patients and that is why we realize social projects (absolutely free for patients of the medical center, and for just those who want) “Psychological Living Room“ Reliable Circle ” and «School of IVF. Psychological living room is a reproductive psychologist, School of IVF - reproductive specialist. Also weekly Our medical director Spend on your Instagram page the lines of "reproductive insights", During which he talks about his experience and also answers the questions of the audience.
Patients have a doctor's assistant phone number for medical and organizational issues, You can also always call or write in a contact center.
So that patients can feel more relaxed about the preservation and identification of their biological material - embryos, oocytes and spermatozoa — the automated MedTracker system is used in the "Nadia Odesa" medical center, developed by our engineers. It records the movement of biological material on 23 stages with photos- and video fixation: from material collection and the operating room to the embryological laboratory. Because the system was created taking into account the internal processes of our medical center, it helps to control exactly those stages, where accuracy is especially important, traceability and protection against human error. This gives patients additional confidence, and the team — a tool for more precise control of each important stage of work.
We also have an access control system: each employee has access only to those locations of the medical center, that is directly related to his scope.
Our medical center has introduced dosimetric control — a system of measures, aimed at monitoring compliance with radiation safety standards. We constantly monitor the radiation background in the medical center, as well as a thorough check of medicines and other materials, that come to us from the outside.
We have a powerful arsenal of effective tools to combat light shutdown (Three generators, Large reserves of water, Reserve access to the Internet and persistent staff), Air alarm can be waited in a temporary shelter on the basement floor (We have a cafe).
A video surveillance and security system operates on the territory of the medical center, which helps maintain a safe and controlled environment for patients, visitors and teams.
Therefore, We try to create an atmosphere of trust and comfort in every possible way, in which our patients will feel safe.
In our opinion, Conception of a baby is always the decision and responsibility of two. So we are very advised to come to Consultation of the reproductivelogist Both future parents. This will allow you to comfortably make an informed joint decision about the further treatment plan.
In our medical center, the patient is not a passive participant in the treatment. We take matters seriously, with which our patients apply, and we strive not just to provide medical care, and to choose a justified way of treatment taking into account medical indications, expectations and capabilities of the patient. This approach depends on the doctor's work and the conscious participation of the patient. Patient has the right to choose, and the doctor's task is to listen to the patient, explain possible options and help make an informed decision. In our medical center, the strategy of primary consultation has been approved, according to which priority and alternative ways of treatment are indicated in the doctor's medical report. We use modern methods of diagnosis and treatment of infertility within the scope of the center's work. If the patient is considering a particular treatment method or has their own preferences regarding the program, the doctor evaluates them from the point of view of medical indications, safety and expected effectiveness. If the option chosen by the patient is not suitable in a specific clinical situation, the doctor explains the reasons, discusses possible risks and suggests a safer or more reasonable course of treatment.
In our medical center, we have an automated time control system (Consultation begins, its duration and duration of each medical manipulation), which allows to minimize the waiting time for consultation. The duration of the visit we have also clearly fixed, for example, Primary consultation of a reproductiveist with pelvic organ ultrasound continues 70 minutes. Usually, the patient is observed by one doctor, which helps maintain treatment consistency and better take into account the individual history.
Nadiya Odesa as a brand created in 2019 year, however, specialists with experience in the field of DRT and embryology continue 20 years have gained trust in patients, Working in different units of Odessa National Medical University. Long years of work at ONMedU allowed to acquire not only significant practical experience, A and formed a system of professional values and views. Today we are a modern medical center with an area of 1500 m², in which a team of 70 specialists. The center is equipped with modern equipment, which helps to work with reproductive issues of various complexity and to select for patients a medically justified path of treatment taking into account their individual situation.
In our opinion, the task of a reproductive specialist is to help patients determine an understandable and medically justified path to the desired pregnancy, taking into account the diagnosis, state of health, examination results, personal wishes, possible risks and financial opportunities. Every person, Every couple, that appeals to us, is unique, And we are aware of it. That is why we adapt treatment programs for each patient, Given his emotional, medical and financial needs.
Infertility is treated in our medical center by a reproductive specialist - a doctor, which assesses not only the current state of health, and the patient's reproductive prospects. One of the important areas of such work is reproductive surgery. If in the course of treatment there is a need for surgical intervention, a reproductive specialist and a gynecologist-surgeon work as a single team: analyze the situation together, coordinate tactics and plan the scope of the operation taking into account future reproductive plans. For the patient, this means, that surgical treatment is not considered separately from her path to pregnancy, and is part of the overall medical strategy.
We have a reproductive psychologist. Consultations of a reproductive psychologist are included in each package IVF, Patients are also able to take consultations out of package. Since autumn, we plan to further enhance the psychological support of our patients and offer additional advice of a reproductive psychologist after the unsuccessful transfer of embryos (It's a pity, implement this now do not have a technical ability).
All the necessary medical documents and consultation results patient receives by e -mail. To do this, you need to sign the consent to the processing of personal data and write an application for medical documents for e -mail. Paper version the doctor prints at the end of the consultation and also issues a patient. Detailed Embryone cultivation protocols by the doctor after completion of the embryological stage (If there was a PGT, then after receiving the results).
Using the mobile application "Nadiya Odesa - Personal Cabinet" (Our own application for iOS and Android) Patient may not only view current and scheduled visits (and even see the cost of a future visit!) to the doctor, but also to see the results of the analyzes, just as soon as they will be ready. In this way, all medical documentation is automatically at hand.
Due to that, What do we allocate a lot of time to consult, Our doctors have the opportunity to explain in detail and answer all the questions of patients. This is also facilitated by our initial consultation strategy. According to her, The doctor is sure to analyze in detail the advantages and disadvantages of each treatment tactics, informs about the expected time, needed for treatment, assesses the chances of achieving the goal, provides necessary information about the safety and possible risks of the treatment, answers all patients' questions. Consultation Protocol, which we give out to the patient, reflects the clinical thinking and the course of the doctor's thoughts: anamnesis, diagnosis, Priority and alternative treatment tactics. The conclusion also indicates the chances of achieving the goal in view of the individual medical history of the patient. We designed it like this, so that the patient can resume the doctor's basic explanations after the consultation, understand the logic of the proposed tactics and have a step-by-step plan for further actions.
We have already noted the peculiarities of the reproductive psychologist in our clinic. We publish information about his activities on the clinic's website and on social networks, Doctors also speak on consultations.
In addition to the criteria, mentioned in the ESHRE guidelines, in our medical center, we also pay attention to the organization of the patient's route. For this, clinical routes have been developed and the role of each team member at different stages of treatment has been clearly defined. This helps to better coordinate the work of specialists, reduce uncertainty for the patient and make the program more clear and consistent.