Elective surgery joint effort will allow testing new model of care

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The program of the São Paulo State Department of Health, which foresees a group of elective surgeries held back by the coronavirus pandemic, should test a new model of care with the support of health teams from the Hospital das Clínicas (HC) at Unicamp.

The University's rectory and DRS-7 (Regional Health Directorate) discussed a proposal that envisages the displacement of HC teams to cities belonging to the regional health divisions served by the hospital. The teams would perform surgeries classified as medium complexity at the locations. 

Meeting discussed the possibilities of the joint effort for elective surgeries
Regional Health Director, Fernanda Vasconcelos met with the rector Antonio Meirelles: Teams would perform surgeries classified as medium complexity on site

The idea is to reduce the queue of surgeries and reserve the HC for highly complex care, respecting its original vocation, explained the dean of Unicamp, Antonio Meirelles. On Monday (6/6), he met with the new director of DRS -7, Fernanda Vasconcelos, to discuss the matter. DRS-7 brings together 42 municipalities.

According to Vasconcelos, with the joint effort, the State Department of Health intends to carry out, in four months, at least 70 thousand elective surgeries in the region. Public health institutions, philanthropic hospitals and, for the first time, private hospitals should be included in the program. The collective effort began on June 1st in philanthropic hospitals and those affiliated with the SUS and will reach private hospitals in July.

"The State government will pay an additional SUS fee for services that opt ​​for the joint effort, which will be financed by the municipality through the State Health Fund", explained the director of DRS-7.

the new model

Unicamp HC Assistance Coordinator, Elaine Ataide, detailed the project. "Our idea is to form a partnership with doctors and professors from HC, who, initially, would go with the general surgery residents to the cities to perform secondary level procedures, such as hernia and gallbladder surgeries."

According to the coordinator, even with professionals available for surgeries, there is often a lack of hospital beds for this type of patient at the HC. In other cities in the region, there is infrastructure and beds available, but there is a lack of personnel to perform the surgeries.  

"We work with a ward with more than 100% demand. We have patients waiting to be admitted. We are unable to admit them for surgery here, but in their city of origin, yes. I believe the partnership could be fruitful", he said. 

If the pilot project is successful, the procedure could become permanent. Ataide guarantees that there will be no absences in the HC teams. "The joint efforts would be carried out on weekends, with a team that would not be on duty", he explains. 

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Executive Director of the Health Area, Oswaldo Grassiotto and HC Assistance Coordinator, Elaine Ataide: New model and increased capillarity

Increased university capillarity

For the executive director of the Health Area at Unicamp, Oswaldo Grassiotto, the collective effort for elective surgeries is now a necessity, and the university's collaboration in this area is central. However, there would be more to be done.

"The joint effort responds to the crisis triggered by Covid, but also signals a line of action that would increase the university's reach among other municipalities," he said. According to him, the HC is currently working at 120% of its capacity. "The idea is to go to qualified hospitals in the region weekly, or fortnightly", he added.

According to Grassiotto, the action would be integrated into the university's extension project, without expanding its structure, which is already compromised. "We will carefully analyze the feasibility of team travel with the residency committee and hospital councils. We want to know the exact scope of the demand and the time to be dedicated to this", he added.

Reorganization of the health structure

According to the dean, the possibility of HC teams working in medium complexity hospitals in the region converges with the proposal for a new articulation of the Unicamp health complex, which should focus on high complexity. “We will evaluate the proposal carefully, but I have already announced our willingness to meet this demand, which also provides additional training possibilities for our residents,” he concluded.

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Audio description: in the operating room, medium distance and perspective image of 2 doctors standing, facing each other, operating on a patient who is positioned, lying down, between them. Each of them holds surgical instruments in their hands. They wear latex gloves, caps, masks and blue lab coats. Above them, lighting spotlights suitable for surgeries. On the right in the image, 2 monitors show line graphs and numbers. There are 2 other healthcare professionals in the room. Image 1 of 1.

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Writer and columnist, the sociologist was president of the National Association of Postgraduate Studies and Research in Social Sciences in the 2003-2004 biennium