Referrals are not denied here

Basically we will meet everyone because it is difficult to judge on the basis of referrals. Trond Ari says it’s better for people to meet a doctor who can say something about what’s appropriate to do than receive a cold rejection letter in the mail.

He’s been arguing for years for all of the patients who were referred to mental health care treatment to be admitted for an interview. “Why do we reject patients?” Mantra Sounds from Nordfjord.

We don’t have any secret internal queues here, no.

Trond Ari

About the foundation

Waiting lists have been closed on Thursdays for several years, beginning with a presentation he gave to the board last year.

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I have made a smaller clinic, can this be done for a bigger clinic?

– I cannot understand that the scale is a point in itself. I know the training teams are very large. There are also big differences within our company. But we are financing per capita catchment area, so access to resources is the same. Then you almost have to explain the differences with the modus operandi and the position.

The question, he adds, is probably how you want it.

Refusals in mental health care have remained stable for years at around 20 percent, for adults, children, and youth alike.

R notes that for years he believed the problem wasn’t access to resources in the first place.

– This is the job post that we’re going to do.

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We must be prepared to do a good job setting priorities. If we all consider it, there has to be a part that we cannot follow and instead need another good offices. Perhaps some of those receiving long-term treatment should have had a shorter period if the resources were distributed equitably.

The fact that all employees should be involved and committed to setting business priorities is an important starting point. But this is not often the case.

Priorities cannot be set on their own
The leader is solely responsible for setting priorities. this is not working. We have over 500 patient cases open at all times. Not everyone can get an overview of this on their own, so here the individual employee has to figure out what’s most important with its participants and set reasonable priorities. I don’t think anyone can criticize us anymore because we don’t have time to do everything at all. But we need to make sure we do the most important thing first.

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– No waiting lists, what do you do?

We evaluate and distribute everyone to the therapist at the same time. The plan, Ari says, is to make an appointment for patients next week.

– No secret cows
Figures from the Norwegian Patient Registry show that more than 10,000 agreements with patients have been delayed – that is, the hospital has passed the internal deadline when the company believes the patient should be treated after the first hour – 10,000 times.

Patients with these similarities can in some cases be multiple patients – and thus are in effect on a separate “in-hospital” waiting list, the so-called inpatient row, as Dagens Medisin previously mentioned.

– How do you make sure that patients do not build up in an internal queue – that is, they are given the first hour to be “in” quickly, but have to wait – after they arrive quickly?

We don’t have any secret internal queues here, no. When a patient is clinically evaluated, all cases, including mine, are discussed in a multidisciplinary team. There we take a position on what to pursue – and what the treatment should be. Problems do not wait for further treatment. We have an overview that this is not happening.

Nordfjord is the only place in the West that does this?

People do things in different ways. Hui (Health Minister Bint Hui, Editor’s note) must have been upset that things are going differently.

Perhaps there is no strong interest in our field to read about good solutions, and then do the same yourself. It’s also true for us: When we hear about others who have done something smart, we like to say, “We’re special, and it might not work here.”

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It’s been several years since the Nordfjord DPS queues were closed.

Our goal has always been that the average waiting time in the outpatient setting should not exceed 20 days. However, a 24-hour stay has a longer waiting time.

Don’t understand that anyone dares

It is customary in several places to contact a patient when the deadline approaches to ask if he will be on the waiting list a little longer rather than taking him to Helfo. Many think this is a form of deception to make the numbers look better. What do you think?

– I have two opinions on this. The first is a mindset when you intentionally approach deadlines; How do you get to the point where you approach the deadline? how is that possible? When we obtain a referral, we are required to set a deadline based on the appropriate medical evaluation. When you say the longest reasonably waiting period is 12 weeks, you are saying that it is unreasonable to wait 13 weeks.

– when I serve you with my eyes open; I don’t understand how it is.

As a department head, I cannot see myself in the mirror if we treat people irresponsibly. As the deadline approaches, the question is, who will be asked to work overtime tonight to solve this problem? Because I have decided something else is untenable. I do not understand that anyone would dare.

But there are also more “technical” deadlines where issues have been considered but not yet addressed adequately. Then it should be reasonable for patients to be able to choose for themselves whether they want treatment locally – or refer them to others. But – too much of this can quickly hinder people from relinquishing their rights, rather than making us hard. It was stupid for people wanting a local show to accept Helfo’s shows.

Politicians are impatient?
Incidentally, there is nothing in the prioritization guide that patients should wait as long as possible. We don’t have to start with the maximum waiting time, but with the minimum waiting time. Bring people home – and rate them. If it is believed that the patient somehow deserves health care, then the job must be done. So why not do it right away?

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Ari says he was surprised at how impatience the politicians were:

If you look at the wait times they want us to meet, which are 35 days for kids and teens, I think that’s still a very long wait. 35 working days are seven weeks, so children and youth in need have to wait an average of seven days for an evaluation. Strangely, politicians don’t hone the tone and come out in smaller numbers.

I note how the intentions of the ministry and the administration do not change the practice. It may seem to me that more severe penalties are needed. Because there are orders, but in reality you are free to follow them or not. We need more committed local government in these areas, says R.

Loud: – inspiring

However, Minister of Health and Welfare Bint Hui (h) thinks the guidelines are already very clear, and there is no point in imposing tougher penalties, says Ari:

What Nordfjord DPS does is inspiring, but asking everyone to organize in this way will severely affect individual DPS. It is a goal to reduce the number of rejections, and last but not least, it is important to inform the surrogate when someone is rejected. This is a priority area in new health organizations and is being worked on in mental health package operations, Høie tells Dagens Medisin.

  • Figures from Nordfjord DPS show that in 2019, 14 of the 399 referrals they received were rejected: of rejected referrals, three were sent incorrectly, two were sent incorrectly, two were due to a doctor unresponsive and five closed cases where nothing new was found. . Happened, and the two were looking for a treatment that Nordfjord DPS couldn’t provide. Additionally, one referral was withdrawn – one patient was already undergoing treatment when the referral came.

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