Sometimes, existing conditions are not appropriate for providing excellent quality services. The lack of resources, a heavy structure, and the lack of commitment on the part of the team can be decisive factors. But, all this can be fought. The story of the Hospital of Tacuarembó is proof of that.
Tacuarembó is the largest province of the country and, according to Ciro Ferreira -Director of the Hospital of Tacuarembó-, "a place where very basic needs are largely unsatisfied". In the conference delivered at the XVI GeneXus International Event, Ferreira explained that "for us the change started 15 years ago with the International Cooperation Agency GTZ". With the support of this agency, the general operation of the Institution was improved. "8 years ago we were distinguished as the first "Hospital Amigo de la Infancia" (Hospital Close to Children), and 7 years ago we were distinguished as the first Healthy Community of Uruguay".
In 2000, the User Services Unit was created, allowing that family members who receive care at the Hospital no longer have to sleep in the corridors. In particular, bearing in mind that 70% of the patients are from rural areas and of a middle-low and low socioeconomic level.
As part of this process, 5 years ago the Regional Neurosurgery Centre of Tacuarembó (Centro Regional de Neurocirugía de Tacuarembó, Cerenet) was created bringing a change in the flow of patients. Before, all neurosurgery patients were transferred to Montevideo, which involved an average 8 hour drive. This is currently reduced to barely 2 hours, since they are operated in Tacuarembó. This saves the Ministry of Public Health over 500 thousand dollars, and has reduced the rate of mortality by 82%, due mainly to the time formerly spent in transferring patients, as well as the probability of secondary injuries.
In the last 5 years 1,052 neurological patients suffering from brain cancer, spine injury, or newborns with congenital malformations underwent surgery, cutting the cost of ICU use, which was an average of 800 dollars in Montevideo, to 332 in Tacuarembó. Over 1 million dollars were saved by not using additional beds from private ICUs.
According to Hospital technicians, the efficient organization and the exclusive dedication of neurosurgeons are the key elements that make this the hospital with lowest average hospitalization rate in the country.
In 2004, a Milk Bank was created, with an ISO 9001 certification, and since then no newborn has died prematurely due to malnutrition. We are currently building a Rehabilitation Centre and a short time ago the first Quality Management Technicians were graduated.
What is the secret?
According to Ciro Ferreira the origin of all this was "the unfeasibility of a vertical organization chart in our case. We had to flatten it, and a Control Unit was created. Nowadays employees have a feeling of belonging to the Hospital and are proud of Cerenet". Not only doctors: in a survey carried out at the hospital- as part of a scheme to increase patient participation- 90% of the patients surveyed said the care they receive is good or very good.
Ferreira explained that a paramount element in overcoming the initial difficulties that impeded a better service was "cooperation instead of competition. That is precisely the development of knowledge".