upa PADI esf esf pse Management Report Summary SOCIAL REPORT upas 2009, 2010, 2011 and 2012 FAMILY HEALTH CLINICS FAMILY HEALTH CLINICS

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1 Management Report Summary SOCIAL REPORT 2009, 2010, 2011 and Establishment of upa LOCAL MEDICAL EMERGENCY UNIT The PADI (HOME CARE SERVICES FOR SENIORS) AGREEMENT Opening of 3 FAMILY HEALTH CLINICS The esf (FAMILY HEALTH STRATEGY) AGREEMENT AP 5.1 and 5.2 Opening of 4 upas (LOCAL EMERGENCY UNITs) 2011 The esf (FAMILY HEALTH STRATEGY) AGREEMENT AP 4.0 Opening of 9 FAMILY HEALTH CLINICS The ESF (family health strategy) is implemented in 6 healthcare centres The pse (Health Program at Schools) Agreement 2012 Opening of 7 FAMILY HEALTH CLINICS

2 Introduction Each year, IABAS moves forward to reach high level of excellence in public health care services. Our mission is to work together with Rio s health authorities to ensure excellency and care of patients, prevent diseases and integrate services to ensure the well-being of the population of Rio de Janeiro at the Family Health Clinics and Local Medical Emergency Units (UPA Unidade de Pronto Atendimento), and through the Home Care Services for Seniors (PADI Programa de Atenc a o Domiciliar do Idoso) program and the Health Program at Schools (PSE Programa de Sau de nas Escolas). There were many achievements in We opened new Family Health Clinics (four in January and three in July), and the City Health Centres (CMS Centros Municipais de Sau de) were renovated or altered, for improved and more humanised health care services to all users. Since 2009, when we took over the management an important percentage of the city s health care centres, more than three million people have had access to quality heath care services. By investing in sustainability, we implemented a waste management system at the Family Health Clinics and the Local Medical Emergency Units (UPAs), and an efficiency system at the Institute head office, for efficient use of energy, water and paper. We have been doing our part to preserve the environment and ensure a better future to the planet. 3 YEARS of management, since 12/ employees OVER 3,700,000 As these achievements were only possible with the effort of everyone working at IABAS, we have again invested in training our staff, allowing for the professional development of each employee in their field. After all, it is through education that we will be able to ensure that the staff has the technical skills needed to provide each time better health care services to the population of Rio de Janeiro. With planned actions and working in an ethical and transparent manner, our next step is to exceed contract goals. We are aware of the challenges; however, our willingness to show more and more dignity and respect towards our users is what motivates us. 2 Management Report - Summary 2009, 2010, 2011 and 2012

3 ESF - Family Health Strategy In the Family Health Strategy program, the health care providers work on promoting, preventing, and bettering the health of patients. Family members are assisted by a cross-functional health care team, which is comprised of physicians, nurses and dentists, and have access to the health care initiatives and services that will meet the needs of the family. PROGRAMMATIC AREAS (AP) COVERED BY IABAS CITY OF RIO DE JANEIRO AP 5.3 AP 5.2 AP 5.1 AP 4.0 AP 3.3 AP 3.1 AP 3.2 AP 2.2 AP 1 AP 2.1 Programmatic Area 4.0 Covers the following suburbs: Jacarepaguá, Anil, Gardênia Azul, Cidade de Deus, Curicica, Freguesia (Jacarepaguá), Pechincha, Taquara, Tanque, Prac a Seca, Vila Valqueire, Joá, Itanhangá, Barra da Tijuca, Camorim, Vargem Pequena, Vargem Grande, Recreio dos Bandeirantes, Grumari. Programmatic Area 5.1 Covers the following suburbs: Deodoro, Vila Militar, Campo dos Afonsos, Jardim Sulacap, Magalha es Bastos, Realengo, Padre Miguel, Bangu, Gericinó, Senador Camará. Programmatic Area 5.2 Covers the following suburbs: Santíssimo, Campo Grande, Senador Vasconcelos, Inhoaíba, Cosmos, Guaratiba, Barra de Guaratiba, Pedra de Guaratiba. Management Report - Summary 2009, 2010, 2011 and

4 ESF - Family Health Strategy Family health - prog. area 4.0 Family health - prog. area 5.1 COVERED SUBURBS Jacarepaguá, Anil, Gardênia Azul, Cidade de Deus, Curicica, Freguesia, Pechincha, Taquara, Tanque, Prac a Seca, Vila Valqueire, Joá, Itanhangá, Barra da Tijuca, Camorim, Vargem Pequena, Vargem Grande, Recreio dos Bandeirantes and Grumari. over 170,000 in 2 years COVERED SUBURBS Deodoro, Vila Militar, Campos dos Afonsos, Jardim Sulacap, Magalha es Bastos, Realengo, Padre Miguel, Bangu, Gericinó, Senador Camará Gericinó over 380,000 in 3 years Magalha es Bastos Cidade de Deus Realengo Vila Militar Bangu Tanque Deodoro Senador Camará Campo dos Afonsos Recreio dos Bandeirantes Padre Miguel Sulacap Family health coverage Family health coverage 10.20% 15.01% 50.50% 54.41% 2.90% 22.51% Source: VITACARE Electronic Medical Records (PEP VITACARE). Source: PEP VITACARE. Total medical Total medical 118, ,162 6,244 52,259 74,472 86, Source: PEP VITACARE. Source: PEP VITACARE. 4 Management Report - Summary 2009, 2010, 2011 and 2012

5 Family health - prog. area 5.2 COVERED SUBURBS Santíssimo, Campo Grande, Senador Vasconcelos, Inhoaíba, Cosmos, Guaratiba, Barra de Guaratiba, Pedra de Guaratiba. over 640,000 in 3 years Campo Grande Santíssimo Senador Vasconcelos Inhoaíba Cosmos Pedra de Guaratiba Guaratiba Barra de Guaratiba Family health coverage 54.70% 58.99% 42.60% Source: PEP VITACARE. Total medical 361, ,920 79, Source: PEP VITACARE. Management Report - Summary 2009, 2010, 2011 and

6 ESF - Family Health Strategy Fitness centre Fitness centres were opened in 32 heath care centres administered by IABAS. The objective of the fitness centres is to provide the population of Rio with a space where they can have a regular gym practice, which will lead to increased health and wellbeing. There are skilled physical educators at all times to guide and support users, and some of the Family Health Clinics have sessions for seniors. Units equipped with a fitness centre 4.0 CF Prof. Maury Alves de Pinho CF Padre José de Azevedo Tiu ba CF Otto Alves de Carvalho CMS Harvey Ribeiro de Souza Filho 5.1 Policlínica Manoel Guilherme da Silveira Filho CMS Athayde José da Fonseca CMS Dr. Henrique Monat CMS Sylvio Barbosa CMS Prof. Masao Goto CMS Waldyr Franco CMS Eithel Pinheiro CF Olímpia Esteves CF Kelly Cristina de Sá CF Pe John Cribbin CF Mario Dias Alencar CF Antonio Gonc alves da Silva CF Rosino Baccarini 5.2 CMS Dr. Mario Rodrigues Cid CMS Prof. Manoel de Abreu CMS Belizário Penna CMS Edgar Magalha es Gomes CAPS Profeta Gentileza CMS Alvimar de Carvalho CF Dr. Hans Jurgen Fernando Dohmann CF Alkindar Soares Pereira CF Agenor de Miranda Arau jo Neto (Cazuza) CMS Mário Vitor de Assis CMS Ada o Pereira Nunes CMS Vila do Céu CF José de Paula Lopes Pontes CMS Dr. Oswaldo Vilella CMS Raul Barroso UNITS WITH A FITNESS CENTRE TOTAL NUMBER OF PHYSICAL EDUCATORS NUMBER OF USERS 4.0 1, ,406 3, Source: PEP VITACARE. Source: PEP VITACARE. Source: PEP VITACARE. 6 Management Report - Summary 2009, 2010, 2011 and 2012

7 Family Health Clinics - New Openings CF Padre José de Azevedo Tiúba 4.0 CF MÁrio Dias Alencar 5.1 Date: 01/11/2012 Date: 01/13/2012 CF AntÔnio Gonçalves da Silva 5.1 CF Otto Alves de carvalho 4.0 Date: 01/18/2012 Date: 01/26/2012 CF Rosino Baccarini 5.1 CF Antonio Gonçalves Villa Sobrinho 5.2 Date: 07/05/2012 Date: 07/05/2012 CF Sonia Maria Ferreira Machado 5.2 Date: 07/05/2012 Management Report - Summary 2009, 2010, 2011 and

8 Constructions and improvements - City Health Centres CMS Adão Pereira Nunes (AP 5.2) CMS Carlos Alberto Nascimento (AP 5.2) CMS Mourão Filho (AP 5.2) CMS Raul Barroso (AP 5.2) CMS Vila do Céu (AP 5.2) CMS Woodrow Pimentel Pantoja (AP 5.2) Clínica da Família OlÍmpia Esteves (AP 5.1) CMS Eithel Pinheiro (AP 5.1) CMS Dr. Henrique Monat (AP 5.1) CMS Buá Borges Boanerges (AP 5.1) CMS Waldyr Franco (AP 5.1) CMS Padre Miguel (AP 5.1) Policlínica Manoel Guilherme da Silveira Filho (AP 5.1) CMS Professor Masao Goto (AP 5.1) CMS Alexander Fleming (AP 5.1) CMS CATIRI (AP 5.1) CMS Athayde da Fonseca (AP 5.1) CMS Santa Maria (AP 4.0) 8 Management Report - Summary 2009, 2010, 2011 and 2012

9 PSE - Health Program at Schools In partnership with the City Health Department and City Education Department, IABAS manages the Health Program at Schools, covering 151 schools of tomorrow (a program that invests in quality education in Rio s most violent suburbs). Through this partnership, the Institute provides care for over 100,000 students only in A link between the city s schools and day-care centres and the Family Health Strategy, the program offers activities that ensure that school communities will have access to health care services, benefiting students who study and live in poorer and low Human Development Index (HDI) areas. PSE figures 5,120 per month 8,000 health checks per month 13,000 students per group (approximately) 6,000 teachers and staff PSE TEAM 1 General Coordinator 5 Public Health Coordinators 9 Health Analysts 6 Administrative Assistants 160 Education and Health Assistants 9 Mobile health care units Cross-functional health care team: 18 Doctors 18 Dentists 9 Psychologists 9 Nurses 9 Dental Assistants Schools served by iabas CITY OF RIO DE JANEIRO 160 schools served over 109,000 students served per month Management Report - Summary 2009, 2010, 2011 and

10 UPA - Local Medical Emergency Unit The Local Medical Emergency Units (UPA - Unidades de Pronto Atendimento) operate 24 x 7, providing emergency health care services. In the areas served by a Local Medical Emergency Unit (UPA), 97% of the cases are solved in the emergency unit, contributing to less patients queuing at hospital emergency rooms, and shorter hospitalization length. These Local Medical Emergency Units (UPAs) rely on a team of doctors on duty and are equipped with all the equipment needed to serve the population. Structure of a UPA 1,300 m 2 patient evaluation room suture room procedure room pathology laboratory digital radiography electrocardiography device pharmacy instrument sterilisation room AREAS SERVED BY IABAS-ADMINISTERED UPAS CITY OF RIO JANEIRO UPA Vila Kennedy UPA Costa Barros AP 5.1 AP 3.3 AP 3.1 UPA Complexo do Alema o UPA Madureira AP 4.0 UPA Cidade de Deus over 1,000, Management Report - Summary 2009, 2010, 2011 and 2012

11 upas TOTAL CONSULTATIONS , , ,301 6,047 66,013 95,063 87,932 72, , ,670 31, , , ,022 2, ,941 vila complexo cidade madureira costa kennedy do alemão de deus barros Source: PEP VITACARE. UPA - Objective To provide the population with improved health care services for emergency cases. To reduce the demand for hospital emergency rooms. To provide the population with improved health care services for emergency cases. Management Report - Summary 2009, 2010, 2011 and

12 PADI - Home Care Services for Seniors The Home Care Services for Seniors (PADI) is a health care program for the elderly. It provides home care services for, mainly, people over 60 years and is focused on reducing the number of hospital admissions; promoting and regenerating health; and preventing diseases. The objective is to improve hospital bed turnover, reduce the patient s risk of infections, and shorten hospitalisation. In 2012, there were more than 5,400 and over 35,000 visits to follow-up patients. PADI TEAM Doctor Registered Nurse Social Worker Nutritionist Physiotherapist Speech Therapist Occupational Therapist Psychologist Practical Nurse Administrative Assistant Total number of through the padi program 25,885 20,864 24,663 salgado souza miguel filho aguiar couto Source: IABAS records. AREAS SERVED BY IABAS-ADMINISTERED PADI CITY OF RIO DE JANEIRO PADI Salgado Filho OVER 70,000 PADI Miguel Couto PADI Souza Aguiar 12 Management Report - Summary 2009, 2010, 2011 and 2012

13 IABAS Staff The IABAS staff is comprised of skilled health care practitioners, such as doctors, nurses, nursing assistants, physiotherapists, dentists, pharmacists and social workers. The staff is also comprised of administrative professionals (technicians, assistants, managers and receptionists). There are currently 4,484 staff members: 87 at the head office; 810 at the Local Medical Emergency Units; 3,267 working on the Family Health Strategy program; 75 working on the Home Care Services for Seniors program, and 245 working on the Health Program at Schools. They are all dedicated and committed to social organisation. Total training sessions conducted 54 For the following areas and programs AP 5.2, 5.1, 4.0, PADI, PSE, head office Total number ofemployees trained 1,675 TOTAL NUMBER OF EMPLOYEES 3,786 4,484 2, Source: IABAS records. Management Report - Summary 2009, 2010, 2011 and

14 Innovations IABAS was launched with the objective of providing innovative and efficient management in public health. ELETRONIC PANEL The electronic panel enables managers from each unit to monitor the location, attendance and non-attendance of staff members in all projects and units administered by IABAS. BENEFITS This tool enables an unit to work on finding the best solution in case of non-attendance of a worker in a certain division, ensuring strategic management decisions for the benefit of the population being served. It allows the routine of each unit to be monitored more closely, enabling relocation of staff, amongst other measures, in case of shortage of staff in a particular unit and/or in emergency situations, for instance. HOW IT WORKS Through a fingerprint time clock, employees record when they start and finish their work day, as per legislation in force. The manager of each unit sends these records to the electronic panel system, which has a database that is updated several times a day. nites The Health Information and Technology Centre (NITES Nu cleo de Informac a o e Tecnologia em Sau de) is an alternative tool to gather, in an appropriate place, several information related to the projects managed by IABAS. Therefore, analysis can be conducted,as for example to assess the health conditions in a particular region, to form a specific family health team, among others. The objective of this tool is to ensure the management of information flow, develop actions to improve the quality of health care and assist managers in their decision making. 14 Management Report - Summary 2009, 2010, 2011 and 2012

15 SUSTAINABILITY The Sustainability Program promotes the rational use of natural resources, improving population s quality of life, and ecosystem protection, according to the new ANVISA (Brazilian Health Surveillance Agency) guidelines. This initiative is aligned with the current restructuring process of the public health in Rio de Janeiro. Efficient energy use: reduced energy use with the aid of a sustainable technology. Solid Waste Management, promoting responsible waste reduction, reutilisation and recycling. Environmental Education with practical sessions, workshops and talks, aiming at changing the population s and staff`s behaviour towards the environment. Supply Chain sustainability through evaluation and qualification of suppliers. WASTE MANAGEMENT In 2012, actions were taken to comply with the National Policy on Solid Waste Management, that regulates the handling of waste within medical centres. The implementation of the Solid Waste Management Plan allows for a reduction of up to 50% of the waste produced, reducing by half the costs associated with waste collection and final disposal, and promoting financial economy. Medical units using waste management Medical unit name Programmatic area 4.0 CMS Cecília Donnangelo CF Maury Alves Pinho CMS Canal do Anil CF Padre José de Azevedo Tiuba CF Otto Alves de Carvalho Programmatic area 5.1 CF Olímpia Esteves CF Fiorello Raimundo CF Kelly Cristina Programmatic area 5.2 salgado filho Medical unit address Estr. dos Bandeirantes, nº Vargem Grande Estr. dos Bandeirantes, nº Vargem Pequena Av. Canal do Anil - Rua Melo, nº 2 - Anil Prac a Ludovia - Jacarepaguá Rua Eng. Souza Filho - Rio das Pedras - Jacarepaguá Rua Francisco Brício, s/nº - Padre Miguel Rua Ac afra o, s/nº - Bangu Av. Carlos Sampaio Correia, s/nº CF Hans Dohmann CF Dalmir de Abreu Salgado CF José Lopes Pontes CF David Capistrano CF Rogério Rocco CF Alkindar Soares Filho CF Agenor (Cazuza) Estr. do Piai, s/nº - Pedra de Guaratiba Estr. do Magarc a, nº Guaratiba Rua Jaburu, s/nº - Jardim Maravilha Av. Cesário de Mello, s/nº - Campo Grande Estr. do Encantamento, s/nº - Santa Margarida Estr. da Pedra, s/nº - Pedra de Guaratiba Estr. do Mato Alto, s/nº (ao lado da Michelin) - Guaratiba Management Report - Summary 2009, 2010, 2011 and

16 Rio de Janeiro Office Av. Luiz Carlos Prestes, 350, loja C - salas 111 a 115 Barra da Tijuca/RJ - Cep: Tel: (21) iabas.rj@iabas.org.br São Paulo Office Rua Diogo de Farias, 66-6º andar - Vila Mariana Sa o Paulo - SP - CEP: Telefone: (11) iabas@iabas.org.br