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The definitive exit from the SNS occurred in 1995. He was called by the administrator, who asked him what it would take for him to move permanently to Infante Santo: “On three A4 sheets I drew an ENT service. A service that would have to have – at that time we were three – at least six more doctors, physical space and it would have to be of sufficient quality to be suitable for the Order of Doctors, to awaken the attention of the universities one day later and have students ”.
Two weeks later, to the astonishment of João Paço, they agreed to his request and the specialist began working exclusively at the hospital where he himself was born in 1948, three years after the inauguration. Although the hospital was designed to serve the 80,000 employees and relatives of Companhia União Fabril (CUF), he explains, “from the beginning it also had a private aspect”.
“From the beginning, there was a great concern for quality, for innovation and this has been demonstrated throughout the history of CUF”, contextualizes João Paço to the Observer. Now, the focus on innovation is once again present at CUF Tejo. Based on a building created from scratch, With an area of more than 75 thousand square meters, the hospital will have more than 1,700 professionals, 178 clinics and consulting rooms, 213 beds in nine hospitalization rooms, 14 intensive care beds and 10 operating rooms, including a hybrid room, which allows the use of imaging examinations during procedures, one for robotic surgery and another “with spectator” , where professionals can see the surgeries of their colleagues, as we are used to seeing in the American series on hospitals.
One of the CUF Tejo hospital rooms
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CUF Tejo, which results from an investment of more than 170 million euros, will also have a 24-hour adult emergency service, a pediatric emergency service, which will operate from Monday to Saturday, from 8:30 a.m. to 9:00 p.m. , two day hospitals – one oncology and one doctor, and an imaging service. The latter is one of the services that will begin to receive patients from Monday. For this reason, as the Observer passes, the diagnostic technicians are finalizing the last details, from the devices, which, as 95% of the unit’s equipment is new. “They are testing the clinical potential of the team,” explains Marco Costa, Radiology coordinating technician, with a background drill.
A volunteer is lying on one of the MRI machines while, on the other side of the glass, three techniques lean over the computer screen to analyze the collected images. A few meters away, another group of technicians looking at the images from the computer. In another next room there is an even larger group, but back from the images from one of the CT scans. This device, which, according to the coordinating technician, is unique in Portugal, achieves 80% less radiation and, in some exams, approaches the radiation levels of an X-ray. “We could do [uma imagem] of a whole body between 0.3 and 0.9 seconds ”, says Marco Costa, adding that, as a general rule, the time in another machine varies between three and 10 seconds.
With the volunteer inside the MRI, the techniques analyze the images on the computer screen.
4 pictures
Another unique equipment in Portugal is in Otorhinolaryngology and is called “dynamic computed posturography”. This device uses virtual reality for the rehabilitation of patients with vertigo problems and balance changes. The patient is trapped in a kind of harness and places his feet on a small platform that moves and produces sudden movements, both forwards and backwards. “The novelty is the virtual part, in which Images are projected to simulate scenarios in which the patient is forced to perform certain movements“, Explains the Otolaryngology technician Francisco Paço to the Observer, adding that there are five sessions, on alternate days, and then the patient is reevaluated.
One of the scenarios simulates a supermarket aisle, in which the patient has to bend down to “go to the shelves” to look for products, which allows him to put his balance skills to the test. Another scenario is that of an airplane in motion. The patient has to “direct” the plane towards the objectives, which are circles that appear in the image. If the patient has balance problems, he cannot achieve the goals exactly.
The outpatient clinic will also begin receiving patients from Monday. For now, the three floors of the offices, with large balconies and glass to let in natural light, are not finished yet and there are boxes and plastic against the wall. The rooms that are ready to open, most with chairs, cupboards, desk and table arranged in the correct places, are distinguished from the others by the notice on the doors: “Final cleaning finished. Do not enter without protective footwear ”. In the waiting rooms, in front of the Palácio das Necessidades, the chairs are still covered in plastic, as are the screens installed next to the ceiling. No cap, just the sale and coffee and they are already operational.
An Otorhinolaryngology office at CUF Tejo
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One of the characteristics of the hospital, highlighted by the clinical director, is its organization by 14 clinical centers, where 24 specialties are integrated: Center for Surgery and Digestive Pathology, Center for Children and Adolescents, Center for Women, Center for Dermatology, Plastic and Aesthetic Surgery, Neuroscience Center, Oncology Center, Lung Center, among others.
According to João Paço, this organization, with several centers on the same floor, Facilitate a multidisciplinary approach to cases.. Something that did not happen so easily at CUF Infante Santo, since the hospital was divided into two poles: “For example, neurosurgery must be close to neurology, which must be close to sleep studies and electromyography. The new CUF Tejo building, its architecture and shape, is made in such a way that these weddings are done very easily ”.
It will be up to the hospital, not the patient, to bridge the gap between the various specialties. who need to be involved in the treatment of a pathology: “I see a patient who has facial paralysis, he has to undergo ENT treatment, because the facial nerve passes through the ear. This patient must have a neurology appointment, must have a consultation [Cirurgia] Plastic for facial reconstruction and psychology consultation, possibly to balance it. Instead of being the person who hits several chapels, we are the ones who hit for it. “
In addition to this multidisciplinary approach, CUF Tejo stands out as a hospital “designed for the diseases of the future”, focused on the patient, family members and caregivers. João Paço highlights three pathologies, which are associated with the aging of the population: “Heart problems”, “Neurodegenerative diseases and cancer problems”, which often involves the participation of various specialties. “They are basically the three great things that afflict the Portuguese population, these are the diseases of the future. We managed to prevent some of these diseases, through the Center for Medicine and Prevention, but there are others that we have to treat ”, underlines the clinical director.
And it is especially in these pathologies where the focus on the family arises: “If you have someone with Alzheimer’s, you have to treat the patient and you have to treat the family as well. This is the rapprochement with the family and the caregivers ”, explains João Paço, highlighting that the figure of the nurse “Navigator”, that is, nurses who will monitor the patient, not only in clinical terms, facilitating their follow-up through the various specialties, but also when they return home, and who will also monitor the family.
The new hospital is also assumed to be a “Teaching Hospital”. Currently, CUF Infante Santo is trained to train interns in the specialties of Otolaryngology, Oncology and Radiology. The clinical director hopes that The hospital, next year, requests three more specialties, one of them Anesthesiology. “It is part of the genesis of the doctor to teach,” says João Paço, considering that the private sector must become more involved in medical training. “It does not mean that private hospitals have everything, but there are areas that deserve it, because there is so much surgery that is so good, there is so much specialty so good, that they deserve education. Sometimes I don’t say it’s a full boarding school, but having a part (three years, four years) later [o interno] back to the mother house. “
