Medical services have not yet returned to normal: everyone is forced to adapt to a new reality

We will not go back to the previous order yet

“We are very pleased that the polyclinics have responsibly started to renew their activities quickly and to the maximum. Many people eagerly awaited these changes, – commented Birutė Kavaliauskienė, Advisor to the Department of Personal Health of the Department of Primary Health Care and Nursing SAM – However, we must not forget that after quarantine we do not return to the old tracks. On the contrary, medical institutions have to adapt to the so-called new reality. “

A SAM spokeswoman says this means that maximum safety must be guaranteed for both ambulatory staff and patients when they provide services. The organization of the work of the polyclinics must comply with the principles of infection control approved by the Order of the Minister of Health no. V-1504.

The SAM has established principles for reopening outpatient clinics (including flow management), and each individual institution establishes specific measures based on available resources: how many doctors, in which offices, what interruptions for disinfection, ventilation, etc. that is, report to the ministry.

“In organizing the delivery of medical services, the remote way of providing services will continue to be prioritized. This means that the medical institution chooses the method of providing the health care service that best meets the patient’s interests,” says B Kavaliauskienė.

Through reception without a referral, the patient will be able to remotely register for the services of the following physicians:

• a member of the GP team,
• a member of the team that provides primary outpatient mental health care,
• a member of the team providing primary outpatient dental services,
• a specialist doctor who monitors long-term health of patients with chronic diseases.

“Direct contact treatment service is provided when the decision of the specialist who provided the service to the patient remotely or the decision of the doctor who provided the remote consultation between physicians makes it impossible to provide the service remotely due to the state of the patient’s health or the need for further investigation. Furthermore, the new thing is that the patient will be able to register for the contact consultation only with an electronic referral or will be registered by the referring physician, “said a SAM representative.

It is a great challenge for polyclinics.

According to Evaldas Navickas, director of the Antakalnis Polyclinic in Vilnius, the information was constantly changing during the quarantine, so the staff and administration had to adapt to the changes and constantly follow all the news.

“But there were also conflicting decisions, for example, when one legislation contradicted another,” Navick said.

– However, we are pleased that when the agencies were allowed to resume the delivery of scheduled services, we were the first to develop a plan for the resumption of services. We understood the need for patients to receive services immediately, so we immediately tried to mobilize the entire team. Of course, the biggest challenge was the requirement that medical personnel work in cycles. So we have not been able to resume the services of some specialists. “

The director of the Antakalnis Polyclinic says that the number of services updated by the institution is monitored every week. “For example, from June 15 to 19. Data, compared to the same week in 2019, we had updated 103 percent. Services. Of course, it is important to mention that 24 percent. Services are provided remotely (drug extensions, medical assistance, etc.), “said E. Navickas.

The director says that work at the polyclinic is currently organized somewhat differently than it was before quarantine.

“There are checkpoints at the door (they check if the patient is really registered with the doctor and if his temperature is measured), patients enter the polyclinic no more than 10 minutes before. until the time of his visit, said E. Navickas. “All of these changes are causing some patient dissatisfaction, but we all understand that this is for the safety of patients and staff.”

The head of the institution says that all these lessons learned brought the entire team together. “If we have to face a similar challenge in the near future, we will be much better prepared for it,” said Navick.

In clinics: maximum control

Representatives from the Kaunas clinics say that in early May, this institution was one of the first to renew planned personal health care services. However, some restrictions remained on inpatient and outpatient treatment, patient care. Health professionals continue to work in cycles to ensure the safety of patients and staff. Each patient has more time: after each consultation, the office is cleaned, disinfected and ventilated.

Starting July 1, planned healthcare services will be gradually renewed and workloads at Kaunas clinics will increase. Patients can register independently for a consultation with a specialist doctor by phone and through the sergu.lt registration system.

For inpatient services, a COVID-19 test is performed at Kaunas clinics for patients who develop symptoms of COVID-19 or who meet the epidemiological criteria for COVID-19, or at the discretion of the physician. For patients who can come to the study in advance, the sample is taken on an outpatient basis (no more than 48 hours before hospitalization) or the patient has a response to a COVID-19 study performed elsewhere (no more than 48 hours before hospitalization). For patients who cannot attend the COVID-19 outpatient study, the sample is taken on the day of hospitalization at the hospital.

Although quarantine has been lifted due to COVID-19 infection in Lithuania, the maximum recommendations for infection control are followed in Kaunas clinics. For example, wearing masks on Kaunas clinic facilities is necessary for all employees, patients, visitors, and others.

According to representatives of the Kaunas clinics, the employees of this institution do everything possible to ensure that all patients receive the necessary health care services and gradually increase the workload. However, it is recognized that it is difficult to predict when hospitals in Lithuania will be able to operate at a completely normal pace.

Representatives of the Kaunas clinics say that not only in Lithuania, but also around the world, medical institutions are becoming hotbeds of COVID-19. To avoid this scenario and think about a possible second wave of COVID-19 in Lithuania, representatives of the clinics say that one of the most important priorities is the safety of employees and patients.