Home » The node of the waiting lists, the shortage of personnel: the ballast of health care

The node of the waiting lists, the shortage of personnel: the ballast of health care

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The node of the waiting lists, the shortage of personnel: the ballast of health care

LECCE – Over 300 participants, in presence and remotely, in the Conference of services with which ASL Lecce wanted to take a picture of the state of the art of the healthcare offer and pose the priority issues for the near future.

The appointment was organized in the morning around three major themes – Hospital and University; Territory and Pnrr; Telemedicine, Screening and Waiting Lists; – while for the afternoon session there will be working groups with the participation of citizens and associations dealing with patients’ rights and public health issues.

Waiting lists: the reasons for a severe shortage

The node of the waiting lists is central and represents one of the heaviest burdens, not the only certain one, of the health system in the province of Lecce. The general manager, Stefano Rossi, explained: “They tell me that within a few months we have recovered a share equal to 10 percent of the performance at the district clinics. However, we have found some flaws: many slots are lost because the computer system is unable to correctly allocate the many requests, but we also lose many hours of specialist services because many diaries are closed without due consultation with the general management. A lot of performance is also lost because users don’t go to appointments and leave slots unopted: this factor has a lot of impact”.

Rossi then added: “The meeting between supply and demand still needs to improve, the issue of personnel issues remains intact which, here as elsewhere, is insufficient. There are few doctors compared to the exponential growth in the health needs of an increasingly elderly society, increasingly struggling with chronic pathologies, which therefore absorbs many health resources which must correspond to a number of doctors who cannot be the one we pay today with the expenditure in 2004 reduced by 1.4 percent which is the ceiling we are allowed for personnel”.

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According to the administrative director, Yanko Tedeschi, a big hand can come from information systems: “They are the crux of the matter. We try to make the best use of what we pay. To intervene on waiting lists it is necessary to know the data, to acquire a whole series of information. We are working hard on this to understand what are the best actions to implement. The director was referring to the percentage of people who don’t show up for the visit and who don’t bother to cancel: this doesn’t allow us to be able to replace them, so the time set for that service is lost. Taking corrective actions on the percentage increase in hours and on the reduction of times means recovering performance. The computer data itself does not tell us anything, but if we use it to define strategies it becomes fundamental. It is not in this area that there is a waste of resources, but there is inefficiency if we do not use that wealth of information”.

Recruiting doctors: the role of the polyclinic

Another enormous and chronic issue is that of the lack of personnel, starting with the medical staff. On this point, the medical director, Antonio Bray, declared: “We are outlining the recruitment needs, we are commensurating them with the most requested specialties. We are also activating a centralized operations room of the Cup which allows us to optimize the fairness and proximity of the offer also through control parameters on the methods of delivery on the workloads of each waiting list. In this way we can have the pulse of the situation”.

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The director general underlined how the activation of university courses in Medicine is also aimed at recruiting personnel: “The polyclinic will serve as an incentive to come and work in Lecce. Human resources are scarce, therefore the qualitative level of services must be raised because where research is carried out, services are better. The goal is to retain those who study here to make them stay. Trainees are the lifeblood of any medical department because they are young professionals who enter the world of work with enthusiasm and often with a know-how of technological knowledge that the older doctor may not have. We are already in the second year of medicine: the more we go on, the more we will have teachers who will populate the chairs and innervate the fabric of the offer”.

Pnrr and telemedicine: opportunities to be seized

An opportunity to make up for the many delays accumulated over the decades is now given by the resources of the Pnrr. Tedeschi went into detail: “There are 79 million euros for 24 community houses in this province, six community hospitals and seven territorial operations centres: these are the three pillars on which to build the new model of territorial assistance. Interventions are also planned for the digitization of administrative processes at second and first level facilities and 13 million euros for the purchase of 34 large machines that will be located within hospitals and districts. All of this has already been mapped out within the Institutional Development Contract which was signed by the Region which is the implementing body. We are monitoring the progress with respect to all these actions in order to be able to guarantee, within the terms established by the European Union, the implementation and entry into force”.

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Another accelerator of the quality of assistance is undoubtedly telemedicine: “We are working – said Bray – on optimizing the emergency assistance networks – stroke, trauma, cardiology and perinatal -. At Fazzi we have an IT platform that we are using above all for time-dependent pathologies, but we are also focusing on telemedicine for chronic conditions, therefore the oncological network, the rheumatological network and those for the assistance of unstable patients. We are working to make this platform ubiquitous and we are developing a system of direct afference with artificial intelligence in setting up an electronic health record”.

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