| Provide health actions and services according to the needs of the population. |
Support the local health authority in decision-making processes. |
Creation of a PHC service portfolio.
The service portfolio was implemented in all the municipality's PCCs. This measure was important for guiding PHC actions and included a strong emphasis on interprofessional clinical practice. The portfolio broadened the scope of PHC practices in line with Ministry of Health guidelines, leading to a reduction in referrals to specialized care and urgent services. It constitutes an important care management tool. |
Creation of the Patient Notebook to record and follow-up procedures and health services.
The Patient Notebook acts as a passport to the health network, recording patient pathways through the municipality's HCN; it includes appointments and other patient health information and provides details of HCN and services. |
| Increase funding for PHC. |
Review of terms of reference and contracts with service providers.
The review showed that amounts paid to a major service provider had increased substantially while the number of procedures had decreased, meaning more was being paid for less services.
The respective contracts were renegotiated and quantitative and qualitative targets were set, leading to a rise in the number of procedures and consequent increase in funding of R$7,368,817.97 and resources allocated to PHC.
Coverage of the FHS increased from 52% to 75%.
Adherence to ministerial orders increased, resulting in an increase in funding and expansion of access to health services. |
| Not applicable. |
Legal and accounting guidance provided to support decision making. |
| Guarantee adequate physical infrastructure, technology and supplies, and a comfortable environment for the effective functioning of primary care centers. |
|
Support for innovations and provision of equipment and supplies necessary for implementing proposed changes: residents' and preceptors' kits; student insurance, basic care kits for PCCs.
The equipment and supplies enabled improvements in work processes. The kits included stethoscopes, sphygmomanometers, personal protective equipment, measuring tapes, flashlights, backpacks, squeezy bottles, flash drives, pulse oximeters, peak flow meters, fetal dopplers, vascular dopplers, glucometers, urine test strips, portable digital scales, digital thermometers, and otoscope kits with ophthalmoscopes. Books were also supplied to the library for training support.
Mapping of the physical infrastructure of health centers, cost analysis of the necessary infrastructure improvements and development of budget worksheets for renovation planning.
Development of architectural plans outlining the improvements to the physical infrastructure of health centers.
Production of an Environment Manual for family health centers.
Development of a standardized layout for PCCs in accordance with Ministry of Health guidelines.
Improvements to health centers to comply with physical infrastructure standards and provide an adequate environment, understood as a social and professional space. For example, a common problem in the PCCs was the physical infrastructure of the pharmacies. Modifications were made to these areas to improve storage and customer service, thus strengthening pharmaceutical assistance and, consequently, patient care.
Reorganization of the SESAU's stockroom, including layout modifications and standardization of work processes. Control of incoming and outgoing supplies and expiration date monitoring.
These actions led to greater effectiveness in the allocation of supplies and resources and reduced waste. |
| Develop a regulatory system centered on PHC. |
Reorganization of the work processes in the SESAU's regulatory system (SISREG) to integrate processes and PHC.
PHC doctors are scheduling procedures and appointments in other services of the HCN, streamlining appointment scheduling, reducing queues and reducing inequities in access to health care. |
Strengthen PHC professionals' care technology skills.
Broaden the clinical-care role of the professional groups that make up PHC teams using interprofessional protocols
based on the best available science. |
Build the capacity of primary care teams. |
Meetings with health teams attended by all professionals and residents; training activities, such as clinical meetings and seminars (face-to-face and virtual during the pandemic).
The teams conducted a status appraisal of the health regions and their responsibilities.
Actions to enhance welcoming; all health team professionals incorporated into regional health surveillance; implementation of pharmaceutical appointments.
Procedures previously performed in specialized or urgent care services now performed in primary care services, for example: cantoplasty, ear lavage, IUD insertion, management of hypertensive crises.
Increased PHC resolvability and reduced turnover.
Reorganization of oral health team work processes, including: shared care between family and oral health teams; construction of an access flow diagram, considering clinical factors and social vulnerability and paying more attention to patients who need home visits/appointments; welcoming for all patients seeking dental treatment, including risk screening; participatory strategic planning; information analysis and management support for oral health teams - e-SUS and SISREG.
Increase in the productivity of oral health teams, resulting in improved access to oral health services.
Advances in the coordination of care and monitoring of therapeutic itineraries in different oral health services.
INOVAAPS seminar; cycle of debates (thematic meetings between professionals); training across the entire municipal HCN (currently online due to the pandemic).
Presentation and debate seven months after the initiation of INOVAAPS. Proposed actions include a review of work processes and team training. |
| Develop a PHC professional training plan |
Restructure the Family and Community Health Residency Program. |
Restructuring of the Family and Community Medicine Residency Program The program previously offered only a small number of annual positions, for which there was little demand. The restructuring of the program led to a considerable increase in the number of positions and qualified preceptors and differentiated resident remuneration.
Increase in the number of PHC doctors (38 family and community medicine residents), resulting in a significant increase in coverage and scope of PHC practice. It is expected that by the end of the program residents will be qualified to perform PHC procedures and have a series of tools at their disposal, enabling them to resolve 90% of the population's health problems, including both acute and chronic conditions. |
| Develop a PHC professional training plan. |
Structure the Interprofessional Family Health Residency Program. |
Implementation of the Interprofessional Family Health Residency Program, offering a significant number of positions: 77 residents from 7 different professional groups employed in the municipality's PHC services.
The interprofessional and family and community residency programs triggered the development of new work processes, including: territorialization; team welcoming; implementation of the electronic information system e-SUS AB; strengthening of nursing appointments; creation of a care hub and teleconsultation; reorganization of access to oral health care; pharmacological appointments; resumption of team meetings; improvements in the quality of clinical records in the electronic health records system; Patient Notebook; and rehabilitation after COVID-19. |
| Not applicable. |
Support strategic health surveillance actions. |
Contribution to the development of an action plan designed to integrate PHC and health surveillance.
PHC and health surveillance integration and health promotion workshops.
Support provided to regional offices to promote the integration of health surveillance actions into primary care by health surveillance specialists.
Platform for the real-time analysis of data from the national notifiable diseases information system (SINAN), with feedback to family health teams or care centers. |
| Promote strategies to defend and strengthen PHC, including the generation of scientific knowledge and dissemination of successful innovative experiences. |
Implement the Campo Grande Observatory on Primary Health Care to help family health teams manage the health region. |
Implementation of the Campo Grande Observatory for Information and Communications Technology in Health Systems and Services (OTICS-Campo Grande).
Creation of an open-access platform providing comprehensive information about INOVAAPS and project actions, documents, reports, manuals, protocols, activities schedule, among others. The platform has a "Where to get care" resource, through which patients can obtain the address, contact details and opening times of their referral center (https://labinovaapsfiocruz.com.br/portal/#/).
All materials from the seminars are available on the platform. |
| Promote the mediating role of PHC. |
Selection and training of 7 supporters (1 per health district) to develop actions to promote the integration of PHC and health surveillance.
Monitoring of health indicators.
Guidance and support provided to health districts. |
| Broaden forms of access to PHC. |
Implement the telemedicine service and diagnostic support. |
Implementation of Teleconsultation and Teleinfectology services during the COVID-19 pandemic.
The Teleconsultation service offers patients the opportunity to book telephone appointments.
The Teleinfectology services was implemented to offer clinical support provided by infectologists to health professionals across the country during the COVID-19 pandemic. |
| Promote strategies to defend and strengthen PHC, including the generation of scientific knowledge and dissemination of successful innovative experiences. |
Undertake evaluations of PHC using the PCAT. |
Study titled "Presence and extent of primary care attributes based on the experiences of adult users of public primary care services in Campo Grande, Mato Grosso do Sul". The aim of the study was to verify the strength of primary care orientation in the municipality's primary care services.
First phase of the study concluded. The findings show that essential and general scores were below 6.6. Family health clinics achieved better scores than family care centers. The findings show that there is still a way to go to achieve strong primary care orientation in the municipality's PHC services. |
| Conduct surveys of SUS workers. |
Survey of SUS workers in Campo Grande.
The survey investigated health professionals' perceptions of the factors influencing their performance and motivation. The findings showed a number of key issues that need to be addressed, including improving the workplace environment, communication, transparency and work processes. |
Broaden the clinical-care role of the professional groups that make up PHC teams using interprofessional protocols based on the best available science.
Strengthen PHC professionals' care technology skills. |
Support the local health authority in decision-making processes.
Support strategic health surveillance actions. |
Creation of a Care Hub for suspected cases of COVID-19.
Development of a proposal to maintain patient affiliation during the pandemic: organization or maintenance of user registration; definition of vulnerable service users; special attention to mental health; remote contacting of service users.
Definition of a separate area for seeing suspected cases of COVID-19.
Implementation of World Health Organization recommendations on patient management during the COVID-19 pandemic. |
Thumbnail
