Innovation in service – Rede Bem Cuidar reveals a new concept of healthcare

                                                              

Innovation in service – Rede Bem Cuidar reveals a new concept of healthcare

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Solution proposed by: 
Comunitas, Pelotas City Hall and Tellus Institute
In a Nutshell: 
An innovative model of healthcare, focused on continuous caring and empowerment of users and employees. It was developed with participation of local community and is aimed at health promotion and prevention, improving the quality of life of users. The program has been implemented in three units up to now.
Where and When: 
It has been implemented since January 2014 until now, in the city of Pelotas, which is located in the state of Rio Grande do Sul, Brazil.
Challenges: 
With about 300,000 inhabitants, Pelotas is the third most populous city in its state. In spite of having a relatively large municipal health service, there was the need for system qualification. The creation of the Rede Bem Cuidar (Well Care Network) sought to improve the service offered in the UBSs (Basic Health Units), which are responsible for the primary healthcare. The program challenges include much more than the physical renovation of the units and the purchase of suitable furniture, but also the qualification of care, innovation in services, the best host the user and the appreciation of the server
Innovation: 
Rede Bem Cuidar was developed through a co-creation process, in which government, servers and community joined to create new health services. To learn more about the difficulties faced by the population, doctors, nurses, servers and local community have become "patients" for a day. Based on these experiments, the services were adapted in order to better assist the population. Amongst the main innovations is the District Pharmacy, which facilitated the population's access to medicines distributed by the Unified Health System in Brazil, including the continued use medications, such as insulin, and costly remedies. Another novelty is the psychological health care assistance.
Concept: 
Rede Bem Cuidar is a result of the program Juntos Pelo Desenvolvimento Sustentável (Together For Sustainable Development), an initiative lead by Comunitas. The program is a coalition of Brazilian great business leaders focused on innovating and improving local government. It brings together social investment, technical expertise and public leadership to develop new services, designed and co-created for and together with citizens. The Comunitas enlisted the expertise of specialized consultants that add to the process as technical partners able to build a proposal for the reality of each municipality. To launch the initiative Comunitas had the support of Tellus, a Brazilian design thinking agency focused on public services. Tellus was responsible for involving users, public servants and managers in the co-creation processes of Rede, while generating engagement and internationalization of the solutions developed. Rede has the continuous care as a fundamental concept. The program results from the constant practice of five key actions: to ensure the necessary infrastructure for health care; facilitating user access to services; the dissemination of knowledge about health, with a focus on encouraging good practice; the monitoring user with the practice of preventive actions; and the involvement of all stakeholders, seeking shared responsibility.
Description: 
The first health care unit to integrate Rede Bem Cuidar was UBS Bom Jesus, that began operating in Pelotas on January 2015. It took six months of physical reform and restructuring of the service, which turned the old post in a health center and wellness. The unit was the first in the city to offer psychological support and and computerized attendance system with the use of passwords and electronic panel, which optimized the waiting time. Among the improvements are still the district pharmacy, baby changing, community garden, experimental kitchen, outdoor gym, bike rack, 24 hour security, dispensing of condoms, playroom, waiting room with educational TV programming and internet access. In addition to the basic areas of medicine (general medicine, pediatrics and gynecology) the program also features nutritionist, physical educator and community health workers. The Bom Jesus unit has the first totem of Clique Saúde (Click Health), an online system which gathers information from all municipal health service, developed by Saútil, a technical partner of Comunitas. Yet in 2015 the city was able, with the support of Comunitas and Juntos, to launch a second unit of Rede program, the UBS Simões Lopes. And in January this year, was initiated the works of renovation and expansion of other one: UBS Guabiroba, that’s located in one of the most populous neighborhoods of the city. The Rede is a strong example that private initiative, society and municipalities can invest in innovative partnerships that strengthen public management, promote local development and improve community services.
Impacts: 
The Rede has gained national recognition for its innovative service model and continuous care. In Bom Jesus, the first unit to be part of the program, the number of daily attendance increased by 50% in the first year and the number of procedures performed per day had a 33% increase. About one hundread people received psychological counseling. This medical service had never been offered in a basic health unit before. The district pharmacy began to serve an average of 200 people a day, who left to travel to the city center to get medicines.

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photo credits: Eduardo Belkeske
photo credits: Eduardo Belkeske .
photo credits: Eduardo Belkeske .