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Friday, April 8, 2011

A Little Bird Told Me...

In all my time here, I don't think I have CLEARLY explain the projects I am working on! So I thought what a better time than to do that.

Here in Belem, the group of physicians are creating a project called, Amazonia Transplante, where they are working on the decentralization of transplantation.  Equal to our system in the US, Amazonia Transplante is focusing on establishing a system with one major center and several smaller programs serving the Amazonian region.  The larger center will be for more complicated transplants, such as liver and pancreas, working congruently with several satellite centers for more straight forward transplants, such as kidneys and corneas. 

We currently have received approval from the State government to proceed and we are now working on the financial approval process.  Of course, I continue to work on the protocols and process for transplant.  It never stops.

As I explained earlier, in Sao Paulo I worked with a group called HEPATO. Partner of Amazonia Transplante, HEPATO has been working to create aTransplante sem Fronteiras (Transplant With Out Boarders) program here in Brazil.  In addition to their already established Transplant Program in the city, they dream to create transplant centers throughout the country, with a focus on the northern region  The team has spent countless years to lay the foundation for what is now happening.

So there you have it.  Summed up in a nice little bundle for you.  While I was working with HEPATO, I again focused on their current practices and shared our system.  This incredible exposure to all avenues of healthcare offered in Brazil has really opened up my eyes to the problems and the extent of change needed in this fast emerging country. 

Once I returned to Belem, I spent several days completing an observational analysis of the HEPATO program and the ICU at Hospital Bandeirantes.  I listed out similarities, differences, and of course my recommendations.  While the most important changes I suggested, appeared simple and common sense, they also highlighted the importance of practicing what we already know.  Starting a hand washing campaign, creating a system for documenting and implementing central line protocols and VAP bundles, the basic foundations of our nursing at the UW.  If anything I have learned the importance of nurses roles at the bedside.  The priceless benefit to patients and the ultimate cost effectiveness for healthcare.  Nurses help stop infections, nurses help improve patient outcomes, nurses save lives.  

Therefore, the majority of my recommendations were to bring nurses closer to the patients.  To help the staff at Hospital Bandeirantes save time with redundant documentation and make the nurses the central healthcare provider again.  

I think every program in this world has room to improve and room to learn from others.  It is why international exchanges are so crucial to improving practices at home.  Everyday our world becomes smaller and the one thing we share, independent of culture, is humanity.  It is our common drive to live and I believe to relieve the suffering of others.  I think a program shouldn't be measured by it's problems, but its ability to adapt, to change, and to grow.  That being said, a little bird told me yesterday, that big changes have already been brought from my observational analysis, with one (the one I am most proud of) being nurses presenting during rounds.  For all you NON-HOSPITAL friends and family of mine, that means...as the physicians visit the patient each day, the nurse presents the patient to the group.  She gives a summary of the last 24 hours by systems and problems.  She becomes the center of communication.  

I can't begin to explain the feeling of bringing big changes to an already well established and successful program.  If you close your eyes and listen closely...I think you can hear the world turning...

Soccer field in Sao Paulo.  You can find them anywhere.

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