Committing to Continuity: Primary Care Practices During COVID-19 in an Urban Brazilian Neighborhood.

Decreased engagement in preventive services, including vaccination, during the COVID-19 pandemic represents a grave threat to global health. We use the case of the Bom Retiro Public Health Clinic in São Paulo, Brazil, to underscore how continuity of care is not only feasible, but a crucial part of health as a human right. The long-standing relationship between the clinic and neighborhood residents has facilitated ongoing management of physical and mental health conditions. Furthermore, we demonstrate how the clinic's history of confronting infectious diseases has equipped it to adapt preventive services to meet patients' needs during the pandemic. Our academic-community partnership used a multidisciplinary approach, relying on analysis of historical data, ethnographic data, and direct clinical experience. We identify specific prevention strategies alongside areas for improvement. We conclude that the clinic serves as a model for continuity of care in urban settings during a pandemic.

Programa SOS Emergências: um olhar para a gestão e a experiência para qualificar a emergência / SOS Emergencies Program: a look at the management and experience to assess emergencies

Este estudo objetivou visualizar a dinâmica da porta de entrada, saída e processo de trabalho em um serviço de emergência que integra o Programa SOS Emergências. O método utilizado foi o descritivo/ retrospectivo, desenvolvido no Pronto-Socorro Central da Irmandade da Santa Casa de Misericórdia de São Paulo (PSC-ISCMSP). A amostra foi coletada por meio de fichas de atendimentos e prontuários, na experiência de um dia na emergência. Dos 392 atendimentos, 76% foram liberados nas primeiras 24 horas, considerando a demanda de porta e os classificados como “pouco urgente” (22,3%) que permaneceram em observação. Dos 8 usuários que permaneceram internados na emergência após 72 horas, a maioria era por indisponibilidade de leito de retaguarda. Conclui-se que o Programa SOS Emergências tem alcançado resultados positivos na gestão de leitos, da qualidade da assistência e do acesso aos usuários, porém falta melhorar a gestão das portas de entrada e dos processos de saída.

This study aimed to observe the dynamics of the input, throughout and output in an emergency service thatis part of the SOS Emergencies Program. It was used a descriptive/retrospective method, developed at the Emergency Department of Santa Casa de São Paulo. The sample was collected using data sheets andmedical records, during one day in the emergency room. In the total of 392 calls, 76% were discharged within the first 24 hours, considering the demand and those classified as “not urgent (22.3%) who remained under observation. Regarding the eight members who remained hospitalized in emergency after 72 hours, most of them were due to lack of bed in other departments. It is concluded that the SOS Emergencies Program has achieved positive results in the management of beds, quality of care and access to users but it could improve the management of input and output processes.