The System of Epidemiological Safety of Medical Activities in Conditions of High Biological Risks, a Multimodal Approach to Organization and Effectiveness Assessment

Relevance. In the context of modern biological risks, the existing system of epidemiological safety of medical activities requires a certain revision and optimization based on innovative approaches to organization and modern technological solutions. Aim. In conditions of high biological risks, using proprietary metrics, evaluate the effectiveness of the proposed system of epidemiological safety of medical activities based on a multimodal approach to its organization. Materials and methods. The epidemiological safety system proposed by the authors was developed in the context of the COVID-19 pandemic and is based on a multimodal approach to its organization, including optimization of personnel, documentation, information, engineering, hygiene, organizational, laboratory and digital support for medical activities and procedures for identification, analysis and risk management in the institution. The effectiveness of the system was assessed on two models of medical organizations using metrics: the risks of infection of employees with SARS-CoV-2 according to PCR studies (n=5216), the level of their commitment to vaccine prevention, the psycho-emotional state of employees (according to pulse surveys of 1024 people) and a comprehensive risk assessment in the institution based on the results of the use of special software a product based on the author's online checklist and its analysis protocols. The study used epidemiological, molecular biological, sociological and statistical research methods. Results and discussion. The effectiveness of the proposed system of epidemiological safety of medical activity is demonstrated. The work of employees in an institution where a multimodal approach was not implemented increased the risk of their infection with SARS-CoV-2 by 1.6 times (OR=1,567, 95 % CI: 1,165-2,108), low adherence to vaccination by 1.5 times (OR = 1,464, 95 % CI: 1,040–2,060), psychoemotional destabilization – 3 times (OR = 3.015, 95 % CI: 2.278–3.991). The use of a special software product showed that in model No. 1, where a multimodal approach was used, the risk of complication of the epidemiological situation both as a whole and when analyzing the results separately for each of the checklist items was acceptable. In model No. 2, the risk of complications of the epidemiological situation was unacceptable for 7 out of 10 assessed sections of the checklist. Conclusion. The improvement of the epidemiological safety system using a multimodal approach has shown its effectiveness according to the assessment of a set of metrics, which must be taken into account when determining the readiness of medical organizations to modern infectious threats and epidemiological challenges.

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