Building an outpatient telemedicine care pilot using Scrum-like framework within a medical residency program

OBJECTIVES: A good health care does not only depend on good medical practice, but also needs great management of its resources, which are generally short. In this sense, PROAHSA has been training new health managers since 1972. With the arrival of the COVID-19 pandemic, it was clear that medicine will go through a new phase, where telehealth will be present in this "Improved Normal". This report is about how a pilot teleconsultation study was carried out for HCFMUSP patients through the Scrum-like framework. It is to deploy a pilot of remote assistance involving a doctor and a patient in the Ambulatory of Hepatology and Liver Transplantation of HCFMUSP. METHODS: We applied the Scrum-like framework to carry out this work with an interdisciplinary multifunctionality team. RESULTS: A full telemedicine service flow was implemented within eight weeks using existing infrastructure and resources implementing the Scrum methodology. Twenty-three teleconsultations were scheduled and eight guides built. CONCLUSION: Scrum framework has a great potential to improve the training of students and to conclude pilot projects.

Transplante de fígado intervivos: a vivência de doadores no processo de doação / Liver transplantation from living donors: the experience of donors in the donation process

Este estudo teve como objetivo desvelar a vivência de doadores no processo de doação para a realização do transplante de fígado intervivos (TXIV) em um hospital público. Para compreender o vivencial dos doadores optou-se por realizar uma pesquisa qualitativa, segundo a modalidade "estrutura do fenômeno situado". Como forma de desvelar o fenômeno foram entrevistados sete doadores utilizando as seguintes questões norteadoras: "Como vocês ficaram sabendo da possibilidade de realização do Transplante intervivos?", "Como foi para você tomar a decisão de ser doador?" e "Como foi o período de preparo e está sendo a espera para a realização do procedimento?". Após a obtenção das descrições, os discursos foram analisados individualmente, sendo feita a análise ideográfica, resgatando os seguintes temas: "A busca de uma solução", "O conhecimento da possibilidade de realização do TXIV", "A decisão de doar?", O preparo para a realizaçãp do TXIV", "A espera para a realização do TXIV" e "A importância da família". Buscou-se desvendar, pela análise nomotética, as convergências e divergências das unidades de significado interpretadas, em direção à estrutura geral do fenômeno. As proposições que emergiram revelaram que a essência do fenômeno "a vivência de doadores no processo de doação para a realização do transplante de fígado intervivos" foi desvendada como viver uma situação de buscas e dificuldades para encontrar a solução para a doença do filho, de certeza na decisão de doar parte do fígado para salvar o filho, de ansiedade no período de espera, de medo de perder o filho antes da realização do procedimento e de esperança no sucesso do transplante.

This study had the objetive to unveil the life experience of the donors in the process of donation for the Living Related Liver Transplantation in a public hospital. To understand the grasp of the life experience of the donors it was decided to realize a qualitative research, following the modality "structure of the situated phenomenon". The way this phenomenon was unveiled was the interview of seven donors using the following guided questions. "How did you get to know the possibility of doing a Living Related Liver Transplantation?", "How did you decide to become a donor?" and "How was it during the preparation and the waiting time before the transplant was realized?" After obtaining these answers they analyzed individually, by an ideographic analysis, calling attention for the following themes: "The search for a solution", "The knowledge of the possibility of doing a Living Related Liver Transplant", "The decision to donate", "The preparation for the liver transplant", "The time waiting for the Living Related Liver Transplant", "the importance of the family". By a nomotetic analysis, it was intended to reveal the convergences and divergences from the units of significance interpreted, directing the general structure of the phenomenon. The propositions that emerged revealed the essence of the phenomenon "the grasp of the life experience of donors in the process of donation in the Living Related Liver Transplant in a public hospital" was unveiled in how to live searching for a solution for the illness of his or her son or daughter, the difficulties during this search, the confidence in the decision to donate part of the liver to save the child, the anxious during the wait, the fear to loose the child before the procedure and hope in the success of the transplant.