The revolution is being completed; the Casualty Department is changing gear

The last important revolution in Casualty in Varese is starting in the middle of January. Following the logistical improvements for casualty patients, a number precautions for the safety of patients and staff, with the wireless bell and the opening of the day surgery, the management of the hospital is ready to complete the revolution in the department run by Francesco Perlasca. 

TODAY   Surgical patient   Casualty Department		FROM JANUARY   Surgical patient   Casualty Department
Surgery	Internal medicine (15 patients per day)	Surgery   SSSH: + 12 beds	Internal medicine   12 beds per day available for internal medicine patients in Casualty

 

At the beginning of next year, the new surgical short stay hospital will open, under the management of Dr Giulio Carcano, where patients will be admitted (12 beds) for quick assessment for surgery. “They won’t be emergency cases that can be resolved within a few hours, but urgent cases that require investigation before going quickly on to surgery,” the Medical Director, Gianluca Avanzi, explained. To speed up the acceptance procedure, the work of the operating theatres has also been reorganised, which has resulted in 5 extra operating sessions per week. These will be taken up above all by oncology cases.

The new organisation will be completed with the transformation of the current Casualty Department into beds reserved for neurology and the stoke unit (12 plus 4 beds). One third of the extra beds (from 8 to 12) will also go to haematology, which will take advantage of the greater space on the sixth floor.

The new model should help to shorten admission times, but, above all, to improve the quality of the response. “We currently have at least 15 surgical patients on the internal medicine ward,” Avanzi said. “By opening the day surgery, we’ll be able to have better procedures, which will also enable us to shorten the length of stays. In this way, the spaces in the internal medicine ward, which is usually very crowded, will become free.”

 

Patients waiting for a bed in the Casualty Department for more than one day:

Days	May 13	June 13	July 13	Aug 13	Sept 13
>1	95	123	151	143	220

 

Days	May 14	June 14	July 14	Aug 14	Sept 14
>1	56	83	74	47	84

 

Over these first few months, the changes have already produced important results with respect to those of last year; the number of people waiting for a bed in Casualty for more than 24 hours has fallen, from 123 in June 2013 to 83 in June of this year, from 154 in August 2013 to 47 in August 2014, and from 220 in September 2014, to 84 in September 2014. The improvement in the work of the Casualty Department is also due to the different procedure for the out-patient examinations after you enter Casualty. In the past, you had to return to the same department in order to run medical tests. Now, you leave Casualty with an appointment for a particular out-patient department; this innovation has drastically reduced the number of repeated accesses, from 344 in April, to 126 in September.

 

Active bed averages at the “Circolo” Hospital for ordinary stays *

 

Beds	2013	2014	Difference
May	527.73	537.1	+9.37
June	500.26	492.33	-7.93
July	451	471	+20
August	436.03	475.58	+39.55
September	455.03	507.04	+52.01
October	499.45	539.42	+39.97
November	508.13	541.5	+33.37

 

 

So, the manager, Callisto Bravi, is launching the new reception line at the “Circolo” in preparation for the winter, and the flu; the hospital is also getting ready for the Christmas holidays, reducing the closures decided last year by thirty beds, in order to allow the staff to enjoy their holidays. The situation has also improved thanks to the increase in the number of beds, linked also to the employment of 70 new nurses, which has been made possible by funds that Councillor Mantovani had promised the hospital. Compared to November 2013, the overall number of beds has increased from 508 to 541.5 (there were 537 in May, which fell to 471 in July).

Thus defined, the admission procedure in the Casualty Department should be better, although no one can guarantee that everything will be perfect. "We can’t give guarantees in health,” the medical director explained. “We’re working to improve, fix and adapt things, but the unexpected and innovations are always just around the corner.”

Indeed, the model is already showing some imperfections; an agreement has not yet been reached for the staff working in the Casualty Department, so, will they be strong enough to guarantee a better admission? Will they be distributed to the new departments? The revolution is important and will take a substantial period of adjustment. "I’d like to thank Dr Perlasca for his collaboration,” the General Manager, Callisto Bravi, said. “These changes involve the whole hospital, which now has new tasks and roles. No one can claim not to be involved."

 

Read all of the articles on the changes at the Casualty Department of the “Circolo” Hospital