Of Luca Patrassi
For seven years Giovanna Faccenda has been the director of the Territory sector of Ast, that is, she supervises the organization of basic health services. University and specialist training in Ancona, teacher for decades at the Polytechnic University of Marche.
He leads a particularly complex sector beyond the simple reference word, Territory. Tell us how the activity is structured…
«The district is configured as the system which is recognized as responsible for governing demand (procurement role, evaluating which services for which health needs) and for ensuring the management of local health services (production role), assistance primary, including continuity of care. The methods must include coordination, in the clinic and at home, between general practitioners, paediatricians of free choice, medical on-call services at night and on holidays and specialist outpatient facilities; the provision of socio-health services with high health integration, as well as social services of health importance delegated by the Municipalities. These activities require strong integration between different health and social figures such as social territorial areas and municipalities”.
On one side the hospital network, on the other the territorial network: apparently distant and divided worlds. It is said that the territorial network does not act as a filter for the hospital network, is this true or is there a lack of recognition of a role for those who work outside of hospitals?
«Since my arrival in 2017, in addition to guaranteeing the institutional activity (single access point, medical clinic for exemptions, authorizations for devices and prostheses, rare diseases, activation of integrated home care and preparation of the individualized home care plan) I have tried to create bridges in particular between the territory and the hospital in order to bring specialist services as close as possible to the patient’s home, a need that has become more acute after the Covid pandemic. Medical-nursing clinic for ostomates: with two nurses who carry out outpatient training activities and home consultations. Since the arrival of Dr. Elena Lucaroni we have restored outpatient and home surgical consultations; telemedicine activities, home ECG and Rp with remote reporting by specialists; Home radiology in telemedicine, home X-rays for non-ambulatory users; vascular access management and Midline positioning at home and in the local area; collaboration of the Adi nursing staff with the hospital’s anesthesia service for changing tracheostomies of patients with rare diseases at home; difficult wounds medical-nursing clinic, with the collaboration of the hospital’s Dermatology department; improvement project for the integration of the home palliative care and ADI service; collaboration/integration of the nurse with the multidisciplinary diabetic foot screening clinic; improvement project for the management of pressure ulcers in protected residences for the purpose of improving the quality of life of frail guests; implementation of telemedicine through the activation of health points (some already open and others soon to open) in Mogliano, Montecassiano, Passo Sant’Angelo, San Ginesio, Sarnano; activation/implementation of community houses, among others those of Treia, Corridonia, Macerata”.
He has been a point of reference for Ast for years. What have been the greatest satisfactions and what are the objectives you set yourself?
«I am certainly satisfied with the quality of the services we provide as a District and we can see this in the oral and written expressions of appreciation from users, even if the objective is continuous improvement. The objectives I set myself in the short term are those linked to the application of decree 77 such as the community nursing project for the territories of the Macerata district which has a very large mountain territory with an elderly population, located in small municipalities not always easy to reach, the opening of community houses including that of Macerata, the activation of the territorial operations center in the Macerata District. Furthermore, we are preparing a multidisciplinary path, both outpatient and at home, for the diagnosis of dysphagia and for the appropriateness of the connected therapeutic care path. Lastly, increase the number of beds for out-of-hospital residential care (RSA, Intermediate Care) with the reactivation of the Corridonia and Tolentino facilities to facilitate hospital discharges by freeing up beds for acute care and facilitating the patient’s return to their home”.
There is a shortage of doctors, especially specialists. Is it just a problem of incorrect planning or do young people prefer to go to work abroad attracted by a stronger meritocracy, lower legal risks and higher salaries?
«There is certainly a shortage of doctors today as a result of incorrect planning in the past. For a couple of years there has been a great effort on the part of the Region to increase both scholarships for specialists and for doctors in training for Medicine General, there will certainly be a lag time but in a few years the number of doctors on the job market will increase. Among the reasons that push doctors to move abroad are the higher remuneration and benefits granted, the problem of legal protection and meritocracy can also be an incentive to prefer other shores”.
Roberto Procaccini and “his” Orthopedics «Our excellence is human capital»
Pierandrei has been leading Medicine for over 20 years «Strengthening the relationship with the territory. Ours is proximity healthcare”
The doctor who leads Geriatrics: «Teamwork guarantees quality. Rebalancing solidarity between generations”
Pucci, the excellence of Allergology: «Revolution with biotechnological drugs. University education is inadequate”
Emanuele Rossi leads the Emergency Department: «Over 100 daily accesses but the department is only 50% staffed»
Marco Sigona, the Dermatology guide: «Attractive services and professional teams. Patients more attentive to skin care”
Ast, the head of Urology Lucilla Servi: «I lead a young, high-level team. An excellent investment? The surgical robot»
Sopranzi, the face of healthcare that works: «Nephrology, a new era with many prospects for patients»
The youngest head doctor in the Marche region: «Positive impact with Macerata. The problem is the lack of staff»
