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The Lombardy Region adopts the Seven Lakes system


Asst Sette Laghi emergency room wait times are improving. Since last May, when the average wait times for a bed on the ward were 28 hours at Circolo, 22 at Tradate, 18 at Luino, 8 at Cittiglio and 13 at Angera, things have improved. In the latest survey presented by the medical director Lorenzo Maffioli we are talking about 10 a.m. at the Club (28 hours is now only the maximum time), 4.6 hours to Cittiglio, 6.5 hours to Galmarini to Tradate, 6.7 hours to Confalonieri to Luino, 4.5 hours to Angera and 3.5 hours to Del Ponte.
A clear improvement also in the light of return from very high accesses, like at the Varèse hospital where people now travel with “pre covid” numbers with 170/180 people who ask for listening and support every day.

The Lombardy Region’s recipe for improving the times and methods of patient care therefore comes at a time when Varèse seems to have overcome, once again, the PS bottleneck problem where the number of patients waiting for a bed is increasing.

What was the strategy that allowed these results?

“We introduced a dynamic bed management in PS – explains Dr. Maffioli – The specialists assess the case and organize either hospitalization or discharge with a therapeutic course. In case of internal pathology, the specialist from the Medicine department, present every day in the emergency room, immediately takes care of the patient and organizes all the necessary checks, in order to speed up the start of treatment. In this way, hospitalization times are also accelerated”.

Among the receipts indicated by the Lombardy Region in the last resolution, there are also the “Bed manager”, the “corporate medical hospitalization management unit” and the beds in each department reserved for PS including holidays. Every day, including public holidays, each hospital must send a report with the saturation rate of beds, places dedicated to emergencies and PS flows.

From the bed manager to the “Quick door point” to the operating theater plan

For the Varese-based company, all regional indications are now part of the decisions made in the past: from bed manager to “Quick Gate Point” to progressive PS pressure containment plans which involves the gradual blocking of scheduled surgical activities and the postponement of waiting lists. Measures which, in the hardest times like those of covid but also flu peaks, have indeed led to the total cessation of surgical activities (except those urgent and in case of emergency).

The reduction of waiting times among the objectives set by the Region for the general managers

The real novelty of the Lombardy Region plan is that the improvements in waiting times in the DPs will be between the objectives of the general managers, who absolutely must obtain results. The other side of the coin, after many years of attempts and “innovative” recipes to solve the problems of the Lombard (but also national) PS, all with mediocre results, the fear is that the coat of paint that will have to be put on the PS will lead to some problems in the “back” of the hospitals. Let’s hope we’re wrong because, as you know, the cover is short!

The Sept Lacs developments in the overpopulation containment plan

For the Varese hospital, the results recorded in recent months could be improved extend the experimentation of “anticipated” care in the PS to all departments and not only to Medicine. Just as they can systematize the experiments, hitherto timid, in the admissions room (obtaining in the PS area of ​​a reception area for patients to be hospitalized with the management of the service) e the “dump room”an area in each ward where discharged patients can wait for relatives to pick them up, freeing up the hospital bed.

Since the last competition 8 new specialists in emergency medicine

A breath of fresh air also comes from the last competition for emergency doctors they entered 8 specialists as well as about ten fifth, fourth and third year doctoral students that the company can conclude contracts from the training course, ensuring the future turnover (always very high). “The inclusion of these medical specialists – explains the director Maffioli – will allow us to free emergency surgeons currently helping. So we can move them in operating theaters, including peripherals, where there is a strong demand to get rid of waiting lists”. Having specialized personnel is an important result for Sette Laghi, who can afford to recover the surgeons from the department headed by Professor Giulio Carcano who can thus return to focus on eliminating waiting lists.


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