Health demand management in primary health care on OSI Donostialdea

Abstract

Introduction: The creation of the Integrated Sanitary Organization (OSI) Donostialdea in 2015, involves the approach of new lines of work, to give coherence and take advantage of synergies between the different care levels. Within the action plans, the Health Demand Management Plan for Primary Care emerges. OSI Donostialdea, after the work done by the Health Demand Management group, establishes a management plan at the administrative, medical and nursing levels, in all Primary Care Centers. For the first time, the plan involves all workers and all Primary Care Centers. Policy context: This plan aims to undertake actions that improve the Primary Care model, in the current context and in the future, marked by an increasingly high proportion of chronic diseases and dependency, under the new model of Integrated Care. Also integrates the changes produced by the important professional generational change in the coming years. The management of patients with acute pathology, who come in search of an immediate solution to their health problem, is systematized in the population covered by OSI Donostialdea. Working objectives: - Manage health and administrative attention, focusing on the need of the users and increasing the quality of care. Strengthen the role of nursing and administrative staff by developing the portfolio of services and training professionals to guide and solve this demand. Outcomes and transferability: The most important achievement, have been the ability to take under all the workers, divided in different categories, and working in 20 different Primary Care Centers, establishing only one actuation model for the Health Care Management. The efficiency of the system has been improved, with a homogeneous and complementary service offer. In the comparison of the period between January and August of 2017 and the same period of 2018, a decrease of 29.37% can be seen in the forced telephone consultations, what means more administrative efficiency. And in the period from January to August 2018, the nurses resolved 47% of the indemorable health demand, without needing to date the doctor urgently. This results, united to other organization changes, means more time for attending other health processes for primary health doctors. Conclusions: In order to manage the demand, we select the professional, the moment and the way in which we can better solve the user's health problem. This contributes to the best use of resources, but it must be accompanied by a change in the professionals working models, and ensure that patients assume the part of managing their own health. Looking at the capacity of resolution of administrative and nursing, in the future, the portfolio of their services, will assume these roles as their own; administrative problems and self-limited and mild health problems, leaving medical attention, for complex processes. After the training, the results show an improvement in the system's efficiency, reproducible, making possible its implantation in other Sanitary Systems.