Marajó Hospital Optimizes Access to Orthopedics with Open Demand Care
The initiative seeks greater agility in care, especially in urgent situations, strengthening an increasingly humanized and resolutive service
The Regional Public Hospital of Marajó (HRPM), located in Breves, in the southwest of Marajó Island, offers a wide range of medical specialties, with a focus on orthopedics and traumatology. This year, with the aim of expanding and facilitating community access to specialized services, HRPM, in conjunction with the Pará State Department of Public Health (Sespa), reorganized the open demand care model, also known as "open door" for orthopedics.
With this measure, the Regional Hospital of Marajó reaffirms its commitment to the public health of the Marajoara population by improving care flows, ensuring that patients can be welcomed spontaneously, without the need for prior scheduling, or through referrals from Pre-Hospital Care (APH) services.
The initiative aims to ensure greater agility in care, especially in urgent situations, strengthening a service that is increasingly accessible, humanized, and resolutive. The nurse from the Emergency Room (P.A) of HRPM, Silas Campos, explains that "after an initial assessment and the performance of exams in the municipality of origin, the user will be directed to the orthopedic doctor for telemedicine. With this, the doctor can determine the need for the patient to come to the emergency room for a surgical procedure or issue a medical opinion with guidelines to the attending physician in the municipality of origin, who is caring for the patient in the municipality of origin."
Silas Campos emphasized that this approach helps to alleviate the non-urgent demand at the Regional Hospital, allowing other procedures to be performed locally, with guidance for outpatient follow-up with the orthopedic doctor at HRPM.
Data - With the new flow, only in April 2025, HRPM attended to 191 requests. Of these, 95 users were admitted via the Internal Regulation Center (NIR) for surgery with specialists at the Regional Hospital of Marajó. The other 96 users were treated conservatively in their municipalities of origin, meaning no need for referral for surgery.
According to the physician and technical director of HRPM, Marcello Ferreira, no surgeries were canceled due to lack of non-critical beds, highlighting a significant improvement in the management of hospital resources, which allowed for an increase of 100 elective surgeries in April and contributed to the reduction of the waiting list.
The management also observed a series of important operational benefits, such as: improvement in the flow of the Emergency Room, with faster and more effective care; increased bed turnover, allowing more patients to be treated in less time; reduction in the time between entry into the Emergency Room and referral to the Surgical Center (ER x SC); and a decrease in the average length of stay of patients in the hospital, which contributes to the efficiency of the system as a whole.
“Now, in cases where conservative treatments can be performed in the municipality, we can avoid having patients come to the hospital just for immobilization, which is often simple. This has greatly improved the flow here at the hospital, prioritizing surgical cases, avoiding costs for both the user and health agencies,” pointed out orthopedic doctor Hercules Ferreira.
Approval – After suffering a boating accident, Everton Castro Pereira, 18 years old, was referred to HRPM for an evaluation with the orthopedic doctor. A resident of the municipality of Curralinho, he reports that upon arriving at the hospital, he was promptly welcomed by the multiprofessional team and received the necessary care.
“They are providing excellent care, everyone is attentive. I am very satisfied, I feel safe during the care, as the professionals are qualified and the hospital is excellent, we can be worry-free with this competent team,” praised student Ewerton Pereira.
The Regional Public Hospital of Marajó is a health unit of the State Government, managed by the National Institute of Social and Human Development (INDSH), in partnership with the State Department of Public Health (Sespa). The unit provides medium and high complexity assistance to the population of the southwest region of the Marajó archipelago and is located at Avenida Rio Branco, No. 1,266, in the center of Breves.
Text by Pedro Amorim
