0% reduction in waiting times and surgical interventions in the region. – 2024-04-05 15:01:32

The O’Higgins Health Service is ranked 22 out of 29 in the country, according to the results of an exhaustive evaluation of the Management Commitments (COMGES) of the Ministry of Health (Minsal) carried out in 2023. These commitments represent fundamental agreements between the Minsal and health services, designed to improve their quality and efficiency throughout the country. This positioning provides a critical vision of the performance of the regional health system in comparison with other regions of the country.

COMGES cover a wide range of areas, from medical care to citizen participation, with the aim of ensuring transparency, accountability and compliance with quality standards in the health system. However, in several commitments, the O’Higgins Health Service faces significant challenges to improve its position 22 out of 29 services in the country and meet established standards.

“PLACE 22 IS NOT A PLACE I WANT TO BE”

“The final cut, when we close the year 2023, is position 22. The COMGES are management commitments that health services have, where many areas are measured. There are topics that are specific clinical processes, such as administrative topics. More than one hundred indicators are measured,” said the Director of the O’Higgins Health Service, Jaime Gutiérrez.

The health authority was critical of the position the region occupies at the national level. “Place 22 is not a place I like to be. It is a challenge that we have as a service, we are working to improve that position, and that means not improving itself, it means that we are doing things better and we are somehow improving people’s health in a better way, because many of these indicators “They are sanitary.”

EVALUATED COMMITMENTS

The 2023 version consisted of 22 management commitments. There were two evaluations a year, first and second semester; and each of these evaluations represented 50% of the annual evaluation. The evaluation of each commitment represents 4.5% of the total evaluation, where the maximum compliance percentage is 100%. On the other hand, a COMGES has 1 to 6 indicators, where each one has the same weight in the evaluation of commitment.

Among the aspects evaluated in COMGES 2023, there was efficiency in resource management, the reduction of waiting times for consultations and procedures, as well as the strengthening of specific areas of health such as mental and oncological health, among others.

Although the O’Higgins Health Service highlights achievements in areas such as Budget Execution of Investment Projects and Citizen Participation with 100% compliance, there are concerns in critical areas such as the items of Reduction in Waiting Times in Interventions where it obtained a score of 0.0% compliance and Ambulatory Processes where only 25% compliance was noted.

The detailed analysis of the indicators reveals urgent areas of improvement, such as the Optimization of Surgical Processes, as well as the Organ Donation and Transplant Process, where in both it obtained 41% compliance. Added to this is the reduction of waiting times in new consultations for medical specialties (58%), strengthening of oncological health (58%), the emergency care process in the healthcare network (62%).

“WE FALL INTO SEVERAL THINGS”

“There are indicators that we do not meet,” said Gutiérrez emphatically, explaining that “One indicator says that you have to meet a certain number of specialties with less than 14% of NSP (patients who do not show up). And if there is a range that if met, it has 50%. If you comply less, you have 25%. And if you do more, you have 100%. We fell into several things, but we have been working on it. I periodically meet with the representatives of each of these indicators in the Health Service to see what actions we are taking to improve this indicator, to increase it, to comply,” said the director of the Health Service O’Higgins.

One of those that presents a low percentage are the Ambulatory Processes with 25% compliance “In the Ambulatory Process we have different problems, for example improving the way we schedule patients, because we have a high degree of NSP, we set the time patient disposition and patient No Show. So, we have to improve contactability with that person, overschedule, because if I know that out of every 10 consultations I am going to miss 2, I overschedule 2. And this way I don’t waste the doctor’s time, because the person does not arrive for different reasons, for different reasons. of locomotion or because we did not contact him. You have to be that raw. We have to improve both things. For that, we are working on overscheduling and improving summons management through WhatsApp, through contactability with the different media that exist to improve that.”

0% IN REDUCTION OF WAITING TIMES AND SURGICAL INTERVENTIONS

Regarding the management commitment to Reduction of Waiting Times and surgical intervention where the O’Higgins Health Service has 0% compliance, the director of the Service said: “if the waiting list increases it could not be so bad in the sense If I expect less. I may have many people waiting, but I can serve them in a short time. The important thing and what is being seen now is the time in which I react to that person. On the outpatient side, improving contactability, so that those hours that are very scarce, for example, in dermatology, when it is difficult for us to open the agenda, an hour cannot be wasted. So, we are rescheduling, we are making appointments in a better way, contacting patients,” said Gutiérrez.

“And in the surgical area – added the director – we are making interventions with the CRR (Regional Resolution Centers), which allows us to improve surgical activity and with that make more pavilions available to attend, to focus on older surgeries. Also, we have asked hospitals to focus their surgical activity on older patients. Because, sometimes, they fill their surgical table with new patients and leave the oldest ones behind. The instruction today is that the people with the longest waiting time are the ones who have priority to schedule in the pavilion.”

But why 0% on this item? I insist, to which the health director is critical and blunt in answering “Because we did not fulfill what we expected. A reduction percentage was requested and we were not able to meet that percentage, we were not able to meet the minimum to have a score in that indicator.”

Another of the items with low compliance is Surgical Processes, which reached 41%, where Gutiérrez explained “The first week of the CRR (Regional Resolution Centers) initiative, 33 users were operated on and there was 0% suspension. This means that the pre-surgery prepared well, that he contacted the patients well, the patients were well chosen, the supplies arrived, the anesthetist was not missing, the arsenal was not missing, that everything worked, that the chain worked. This tells me it can be done. “We have to replicate this in all 12 pavilions.”

There are several tasks that the O’Higgins Health Service has pending, and several items where it must improve and to correct these shortcomings the Director of the SSO said that to improve “We have to sink our teeth into the surgical processes, we have to improve the contactability of patients so that we do not miss outpatient processes, nor surgical processes, we have to increase our surgical capacity and our ability to offer hours. For our medical programming to be efficient, I have to improve my offer of both procedures and consultations, expand surgical capacity, improve contactability with our users, improve the oncological process, and all of this will reduce waiting times. I am worried that the waiting list will increase, but if the waiting list increases and average service times decrease, it is a good sign. “We are on the right path.”

Despite the obstacles identified, the authorities of the O’Higgins Health Service reaffirm their commitment to continuous improvement and the provision of quality health services to the community. Concrete actions are being implemented to address identified deficiencies, including improving appointment management and optimizing surgical processes. The objective is to move towards a more favorable position in the next evaluation of the Management Commitments and, more importantly, improve the health and well-being of the population served.

MANAGEMENT COMMITMENTS 2023 O’HIGGINS HEALTH SERVICE

The 2023 version consisted of 22 COMGES. There were two evaluations per year, first and second semester, and each of these represented 50% of the annual evaluation. The evaluation of each commitment represents 4.5% of the total, where the maximum compliance percentage is 100%.