Clinics available from 8 to 24 hours, 7 days a week, first level diagnostics in doctors’ offices. Reduction in the use of emergency rooms
Liguria healthcare – For general medicine we are moving towards a notable change, all foreseen by the agreement signed by the Liguria Region with the associations of general practitioners (Fimmg and Smi) which will become operational after the approval of the regional council.
Among the new features are clinics dedicated to low complexity in districts or community homes open from 8am to midnight, strengthening of the relationship between family doctor and specialist with real-time interaction, first level diagnostics in GP practices, training and updating of GPs family, secretarial and nursing staff dedicated to the activity of family doctors.
“As regards the agreement with general practitioners, the key element of this entire process is the most efficient and effective care of the patient – explains the Health Councilor Angelo Gratarola -. With this agreement, first of all, the family doctor can, if necessary, avail himself of the collaboration of a specialist operating in the local health authority of reference, through the teleconsultation formulas and the tools that are made available by the Region with specific platforms: the doctor places the question to the specialist who, with his intervention, completes the answers to be given to the patient, overcoming any diagnostic doubts. This mechanism translates into a reduction in waiting times, thanks to the path that allows you to give answers directly from the specialist, without going through a further visit to the hospital.”
“Fimmg – says Andrea Carraro, secretary of the Genoa federation – expresses his satisfaction with the Supplementary Agreement signed with the Liguria Region which will allow a relaunch of General Medicine in the Territory. The strengthening of the office staff, with the figures of secretaries and nurses, together with the possibility of carrying out first level diagnostics in the office, such as ECG and spirometry, and the activation of teleconsultation with the specialist will allow the strengthening of the Doctors’ abilities to Family to respond to the clinical needs of their patients. In this way it will be possible to reduce the inappropriate use of the emergency room and provide quicker responses to the needs of citizens directly in the area”.
“The Smi – adds the Ligurian secretary Daniele Gasparotti – while underlining that the Agreement just signed represents only a first step for the reorganization of healthcare in the Ligurian territory, it expresses its satisfaction at having seen some of the most important points forming part of its program accepted. In particular, we underline: the rationalization of the relationship between local doctors and specialist and hospital doctors, the opening to teleconsultation and tele-visits (of which the Smi was also an advocate at a national level), the reorganization of the territory and of our studies so that we can increasingly respond better to the needs of the chronic patient.”
“Even in the emergency room – explains Filippo Ansaldi, general manager of Alisa – paths dedicated to low complexity have been activated which improve the efficiency of the system. We are faced with a clear increase in demand: visits to emergency rooms in Liguria increased by 5% compared to 2023. Despite this, episodes of overcrowding have reduced. The strategy of diversified paths for patients who arrive in serious conditions and those who arrive in the emergency room with white and green codes allows us to reduce waiting times. Since the beginning of 2024, our hospitals and the Ligurian local health authorities have implemented diversified actions and paths that have made it possible to reduce the average wait of patients in the emergency room by two/three hours. We will continue on this path to respond in an increasingly punctual manner to the increase in demand, alongside the activities linked to continuity of care in the area”.
“Precisely because the emergency room is by its nature one of the most complex areas within a hospital structure – adds Marco Damonte Prioli general director of the San Martino Polyclinic Hospital – we have decided to implement a concerted effort to improve its pathways, activating, from February 2024, a specific clinic dedicated to the management of patients who have been assigned low intensity codes. This is a service active from Monday to Friday during the busiest hours, in our case from 8am to 2pm, where, to date, a total of 840 patients have been managed, including white and green codes, with a reduction in the average time waiting time for these people of 2-3 hours. An important action, which will allow us not only to optimize waiting times, ensuring these patients can benefit from assistance in a shorter time, but also to help, in the future, control overcrowding. Control which, however, I would like to remember, also takes place through all the fast-track paths already active in our Emergency Department, which allow us to direct low-complexity patients with ophthalmological, orthopaedic, dermatological, gynecological problems, through triage, directly to the relevant clinic. Particular thanks go, in addition to all the healthcare personnel involved in the emergency-urgency, also to our room assistants, currently 3 employees of the Polyclinic who are responsible for supporting professionals in the transfer of information between hospitalized patients and relatives and to the 4 Avo volunteers, for the assistance provided during meal times”.
“Already in November 2019 – explains Marta Caltabellotta, health director of ASL3 – at the Villa Scassi Hospital we had activated a pilot project for the separation of the routes of the white and green codes from those of greater severity, with encouraging results. At the time, this practice was interrupted in January 2020 due to the outbreak of the pandemic. Since March this year, the clinic for minor codes has been restored, with direct and separate access near the emergency room. This activity complements the fast-track protocols already present and dedicated to mono-specialist activities such as, for example, ophthalmology and urology, in addition to the orthopedic clinic. The first results are significant: on the 204 cases treated from mid-March to mid-April, for 95% of cases the initial coding of the triage nurse was confirmed as correct, detecting on average a decrease in the time between access and discharge of around two hours. The clinic is currently open 6 hours a day from Monday to Friday. Given the results, the objective is to increase it”.
This is how the differentiated path works
The patient who refers to the Villa Scassi ED with minor pathologies (small traumas, abrasions, pain, sciatica, small burns, small wounds or infections, arthralgias, etc.) is referred directly by the triage nurse to the Green Codes Clinic, where is treated by the dedicated doctor. If the pathology turns out to be more complex than expected, the patient would be re-evaluated with a code of greater severity and taken care of by the ED doctor. Otherwise, the necessary tests are carried out and the therapy is assigned and the patient is discharged.
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