The current model of healthcare delivery is far from ideal. There have been many constraints in recent years, but it is necessary to recognize that the Public Hospital has been tireless, revealing an extraordinary capacity to occasionally reinvent itself and innovate to provide the best healthcare, in the most efficient way possible.

Proof of this is Healthcare Excellence, which the Portuguese Association of Hospital Administrators (APAH) has been promoting since 2014 and which aims to reward good practices implemented in our healthcare institutions. Over these years, the adhesion to the Award has been growing, with a large number of candidate projects that clearly demonstrate the dynamics and quality of the work that is carried out every day in the units of the National Health Service (SNS).

Projects that seek to overcome limits, which turn out to be true cases of success, with relevant gains for patients. These are often apparently simple ideas, easy to adapt, requiring little or no financial investment, but generating a high return both for the sustainability of the NHS and for the well-being of patients and their families.

We are talking, for example, about practices implemented in health units that made it possible to reduce the average length of stay after surgery, speed up the rehabilitation process for stroke victims or facilitate access to health services for users through digital platforms.

We are aware that challenges are often common to the various health units. Well, if there are good healthcare practices with proven results, why not be the objective of Healthcare Excellence to promote their replication? This is the appeal we want to make to everyone: to look at the many good examples we have in Portugal and to implement projects that make sense in their institutions.

On October 19th, the winners of the 5th edition of Healthcare Excellence were announced. The National Institute of Medical Emergency (INEM) was the big winner of this edition. The project presented by INEM has as its first objective to increase the number of lives saved in situations of cardiorespiratory arrest. Unable to recover life, the project intends to preserve organs to increase the number of transplants.

The “Via Verde Reanimation” started as a pilot project in 2016, implemented at Centro Hospitalar de São João, in Porto. INEM was responsible for participating in the definition of the circuits, namely in the referral of patients in cardiorespiratory arrest, providing external cardiac compressors in medical resuscitation vehicles (VMER) and guaranteeing the training of medical professionals and nurses who man the VMERs and the doctors of the Guidance Centers of Urgent Patients (CODU).

In a year of pilot project, in 36 cases of cardiorespiratory arrest referred by INEM, 4 lives were recovered, 44 donations were made and 33 kidney transplants were performed.
Numbers that far exceeded the team's initial expectations.

After the success of the pilot project, the same methodology has already been applied in the Greater Lisbon region, involving two hospitals, and the project is planned to be implemented in the Hospital and University Center of Coimbra. In 2018, bearing in mind the national expansion of the “Via Verde Reanimação”, INEM also invested in the acquisition of compressors for all the SAV means in Mainland Portugal (42 VMER and four helicopters) and in the training of VMER, SHEM and doctors of the CODU.

The first honorable mention was for the project “Frequent Users of the Emergency Service of Hospital Garcia de Orta”, Hospital Garcia de Orta and the Group of Health Centers (ACeS) Almada-Seixal. This project consists in the implementation of an intervention plan to reduce the number of episodes of very frequent users of the emergency room (users who have more than 10 episodes in 12 months).

There was also the attribution of a second honorable mention to the Cova da Beira Hospital Center, which presented the project “Telemonitoring of patients with chronic heart failure (CHF)”.

The program consists of an innovative monitoring system and aims to improve the quality of life of patients. With the project, it has been possible to contribute to the early detection of episodes of decompensation, reduce and prevent hospitalizations, reduce financial costs by reducing episodes of emergencies, hospitalizations and face-to-face consultations.

The projects presented show that, despite all the difficulties imposed externally, we all work daily to ensure the improvement of healthcare. We hope that the ideas presented will serve as inspiration and that they will motivate other health institutions to replicate these projects.

Excellence in the Public Hospital exists – we have the proof, and it is recommended.

The article can be read at the Public Hospital in November 2018.
Distributed in all National Health Service hospitals, the Hospital Público newspaper promotes a transversal sharing of good practices and initiatives developed by professionals from public hospitals. It stands out for its extremely rich content, innovative concept and exceptional reach.