55 Lietuvos gydymo įstaigos dalyvavo bandomuosiuose projektuose, skirtuose pagerinti sveikatos priežiūros paslaugų kokybę ir prieinamumą pacientams, kuriems diagnozuotos dvi arba daugiau lėtinių neinfekcinių ligų. Įvertinusi vykdytų projektų rezultatus, gerąją praktiką ir kilusius iššūkius, Sveikatos apsaugos ministerija (SAM) planuoja pasiteisinusius diagnostikos ir gydymo modelius diegti į kasdienę praktiką visoje Lietuvoje.
„Pačių gydymo įstaigų parengti ir išbandyti diagnostikos bei gydymo algoritmai padėjo užtikrinti kompleksišką, nuoseklią ir individualizuotą pacientų sveikatos priežiūrą, sutrumpinti konsultacijų ir paslaugų laukimo laiką, stipriau motyvuoti pacientus ir įtraukti juos į gydymo procesą. Ši geroji praktika bei iššūkiai, su kuriais susidūrė projekto dalyviai, bus įvertinti ir išanalizuoti, kad ateityje poliligotiems pacientams paslaugos taptų prieinamos dar greičiau ir paprasčiau“, – sako SAM Asmens sveikatos departamento direktorė Odeta Vitkūnienė.
Projektus 2020–2023 m. įgyvendino 14 Lietuvos gydymo įstaigų, bendradarbiaudamos su kitomis gydymo įstaigomis kaip partnerėmis – iš viso 55 įstaigos. Projektų metu buvo apmokyta 890 sveikatos priežiūros specialistų, o projektų veiklose dalyvavo daugiau nei 4,6 tūkst. pacientų, kuriems diagnozuotos dvi arba daugiau lėtinių neinfekcinių ligų – cukrinis diabetas, hipertenzija, bronchinė astma, širdies nepakankamumas ir kitos.
Vykdant projektus sveikatos priežiūros specialistai gilino žinias ir įgijo naujų šiuolaikiškos, integruotos, į pacientą orientuotos priežiūros kompetencijų bei sustiprino komunikacijos ir bendradarbiavimo tarp sveikatos priežiūros specialistų komandų, pacientų ir jų artimųjų gebėjimus. Specialistai įsitikino, kad siekiant gerų gydymo rezultatų, svarbu atsižvelgti ne tik į fizinę, tačiau ir į emocinę bei psichologinę paciento būklę, jo lūkesčius, poreikius ir socialinę aplinką, edukuoti pacientus ligų kontrolės klausimais, gerinti jų savirūpos įgūdžius.
Mokymuose dalyvavo daugiadalykės komandos, kurias sudarė šeimos gydytojai, bendrosios praktikos slaugytojai, gydytojai kardiologai, gydytojai endokrinologai, kineziterapeutai, socialiniai darbuotojai, visuomenės sveikatos, gyvensenos medicinos ir kiti specialistai.
Iš skirtingų specialistų sudaryta gydytojų komanda kiekvienam projekto veiklose dalyvavusiam pacientui užtikrino visapusišką, reguliarų ir tęstinį ištyrimą bei sudarė individualizuotą sveikatos priežiūros planą. Atvejo vadybininkas padėjo užtikrinti, kad būtų laikomasi numatyto priežiūros plano. Jis rūpinosi, kad projekto dalyviui tinkamu laiku būtų atliekami reikalingi tyrimai, pagal poreikį vykdomos gydytojų specialistų konsultacijos ir, įvertinus rezultatus, jei reikia – peržiūrimas numatytas gydymo planas. Paslaugos buvo organizuojamos pirmenybiniu „žaliojo koridoriaus“ principu, užtikrinant pacientui galimybę jas gauti laiku, siekiant išvengti ligos paūmėjimo ar galimų komplikacijų.
Projektų metu buvo sėkmingai išbandyta nuotolinė pacientų sveikatos rodiklių stebėsena, naudojant išmaniuosius įrenginius, tokius kaip pulso ir kraujospūdžio matuokliai, spirometrai ar svarstyklės su „Bluetooth“ funkcija, nuolatinės gliukozės kiekio matavimo sistemos jutikliai. Šios inovatyvios technologijos leido pacientui nuotoliniu būdu pateikti savo sveikatos rodiklius, o atvejo vadybininkai ir gydytojai, nustatę paciento sveikatos rodiklių pokyčius, galėjo peržiūrėti ir koreguoti individualius sveikatos priežiūros planus, keisti ligos gydymo taktiką. Savo sveikatos rodiklių pokyčių stebėjimas stiprino ir pacientų motyvaciją domėtis savo sveikata bei skatino labiau įsitraukti į gydymo procesą.
„Projekto veiklose dalyvavę pacientai aktyviai įsitraukė į savo ligos valdymą, savirūpą ir noriai bendradarbiavo priimant bendrus sprendimus. Tinkamas ambulatorines paslaugas gaudami laiku, projekto dalyviai rečiau kvietė greitąją medicinos pagalbą ar pateko į ligoninę. Dauguma baigusių projektą dalyvių pasidalino, kad jų gyvenimo kokybė ir pasitikėjimas savo jėgomis pagėrėjo, jie tapo savarankiškesni, sąmoningesni savo ligos atžvilgiu, išmoko akyliau stebėti savo sveikatos būklę, greičiau sureaguoti į pokyčius ir lengviau prisitaikyti prie ligos keliamų iššūkių“, – teigė Vilniaus miesto VšĮ Centro poliklinikos gydytoja endokrinologė doc. dr. Lina Zabulienė.
Kauno miesto poliklinikos direktoriaus pavaduotoja kokybės valdymui Loreta Marmienė taip pat teigė iš pacientų sulaukusi nemažai padėkų ir palankių atsiliepimų.
„Projekto metu, konsultuojant skirtingiems specialistams, vienai pacientei buvo diagnozuota dar viena liga, apie kurią pacientė net neįtarė. Daugelis pacientų džiaugėsi atvejo vadybininkais, kurie pasidomėdavo, kaip pacientui sekasi laikytis numatyto sveikatos priežiūros plano, užregistruodavo pas gydytojus specialistus, apmokė kaip naudotis mobilia programėle bei primindavo, kada reikėtų atlikti tyrimus ir apsilankyti pas gydytoją“, – teigė L. Marmienė.
Projektų vykdymą finansavo Europos socialinio fondo agentūra. Pagal priemonę „Sveikatos priežiūros kokybės ir prieinamumo gerinimas tikslinėms gyventojų grupėms įgyvendinant inovatyvius ir efektyvius sveikatos priežiūros modelius“ įgyvendinta 14 projektų, jų įgyvendinimui skirta 10,5 mln. eurų.
SAM Komunikacijos skyrius
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