1. Participation |
Managers participate in social participation departments and there are instances which allow participation of all parts involved |
10 |
Participated in 3 or more instances: CES, CIB, meetings for creation/monitoring of PES, technical meetings at CONASS |
7.5 |
Green |
State management developed strategies or created instances for the participation of all parts involved with CEAF: a strategy with association of patients |
2. Transparency |
Information is published about medication out of stock and the prices paid for medication |
10 |
State-level management developed strategies or created instances for the participation of all those involved with CEAF: a strategy with association of patients |
5.0 |
Yellow |
The prices paid by the State for CEAF medication (group 1B and 2), are disclosed and made available for the population through the Farmanet digital system (online) |
3. Planning |
Inclusion of CEAF actions in PES. Existence of planning meetings specific for CEAF |
10 |
In PES, there are specific actions related to pharmaceutical care that involve matters related to CEAF |
5.0 |
Yellow |
CEAF managers do not hold strategic planning meetings |
4.Monitoring and evaluation of actions |
There are indicators and their monitoring is used for planning actions |
10 |
Indicators for monitoring actions related to CEAF are not used for planning actions or there are no indications of monitoring |
0.0 |
Red |
5.Partnerships |
Partnerships with other institutions for the development of CEAF activities |
10 |
There are partnerships with other institutions to decentralize care for the patients, and some partnerships are not formalized |
5.0 |
Yellow |
6. Regulamentation |
There are regulated flows for the evaluation of requests and guidelines on the processes of work in the units |
10 |
In the state, there is no established flow (documented) for the evaluation of CEAF medication requests |
0.0 |
Red |
There are established guidelines (documented) for work processes only for one execution phase, at the units which develop CEAF activities |
7. Institutionalization |
There is an institutionalized instance responsible for all the CEAF activities |
10 |
In the administrative structure of the SES, there is an institutionalized instance (and formalized by means of publication) related to pharmaceutical care, and its competence involves only technical issues related to CEAF management. Administrative issues are handled by another coordination department. |
5.0 |
Yellow |
8.Decentralized access |
Users receive care in the town where they reside |
10 |
CEAF activities related to care for the users (requests, renewals, delivery) are decentralized for 95% of the State’s municipalities, so users can receive care in the town where they reside (state units or municipal units) |
10.0 |
Green |
Results of the dimension |
- |
37.5 |
Orange |
Laranja |
Operational Dimension |
1. Communication |
Communication between units |
10 |
53% of the units - FME and Central Warehouse consider the communication with the central team good or very good. (score of 4 or 5) |
5.0 |
Yellow |
2. Complementarity |
Concern with addressing the lines of care |
10 |
There is no agreement on key medication (minimum list of CEAF Group 3) for the first line of care |
5.0 |
Yellow |
Formalization in APAC is done for the delivery of Group 2 medication |
3.Normative conditions |
Units have legal and sanitary conditions to perform their activities |
10 |
50% of the units (FME and Central Warehouse) have a current sanitary permit |
1.8 |
Red |
State management does not monitor updating of sanitary permits for the units which handle CEAF medication |
44% of the units (FME and Central Warehouse) have a current PGRSS |
State management does not monitor the updating of the PGRSS of the units that handle CEAF medication |
68% of the units (FME and Central Warehouse) have a current technical regularity certification issued by the CRF |
State management does not monitor the updating of the technical regularity certification issued by the CRF for the units which handle CEAF medication |
4. Infrastructure |
There is investment in the units, and they have the minimum infrastructure conditions |
10 |
The current PPA does not include investment in infrastructure of the pharmacies (which includes those which deliver CEAF medication |
1.3 |
Red |
35% of the units (FME and Central Warehouse) declare having 75% or more of the necessary infrastructure items |
5. Centers for application of medication/SR |
There are SR in several places in the State |
10 |
64% of the units declare having 75% or more of the SR of centers for application of medication researched |
5.0 |
Yellow |
6.Information systems |
There are information systems for the development of activities |
10 |
The informatized system(s) cover every activity: logistics, patient requests and management archives, except for clinical activities. |
5.0 |
Yellow |
The system(s) used for registering CEAF activities feeds the national databank |
The system(s) does/do not interface with other systems at municipal level (ex., prescription, case files, CBAF distribution |
7. Human Resources |
There are Human Resources, and there is interest in continuous capacitation |
10 |
Has capacitation training twice a year or more for pharmacists and once a year for professionals other than pharmacists who work with CEAF |
5.0 |
Yellow |
8. Financing |
Capacity to apply strategies for financial balance and availability of resources |
10 |
The state has budget planning and financial availability to cover CEAF’s acquisition needs |
10.0 |
Green |
CEAF’s state management has a rate of 0.21% of failed purchases of APAC, in relation to the totality of APAC generated by the state management of CEAF |
The state management monitors the transfer of federal funds, referring to Group 1B, in relation to the accountability generated |
9. Programing/Acquisition of Medicines |
There are systems which qualify programming and acquisition of medicines |
10 |
There is an established tool/method for the process of programing CEAF medication (of purchases centralized by the Ministry of Health and of purchases by state management) |
10.0 |
Green |
The State always succeeds in creating tax exemptions (ICMS) for the acquisition of CEAF medication |
The State always succeeds in applying the CAP for the acquisition of CEAF medication |
There are systems of penalization, established in official publications and/or contracts for the providers who do not fulfill the established criteria, and they are always applied. |
State management develops formal and informal strategies to deal with problems in the process of acquisition of CEAF medication. |
10. Best Practices in Logistics |
There are systems which qualify the distribution and control of the supply of medication |
10 |
State management provides guidelines for the Central Warehouse, aimed at achieving best practices in transportation of medication to the units which develop CEAF activities |
9.0 |
Green |
There is an established chronogram for supplying medication for the units and extra flow chronogram |
Central Warehouse does periodic physical inventories |
94% of the FME do periodic physical inventories |
11. Availability of Medication |
There is interest in providing opportune care for the users |
10 |
37.4% of the medication from Group 1B and 2 were missing for more than a month out of the year |
6.5 |
Yellow |
The State has strategic stock in the units which develop execution activities for CEAF of the Central Warehouse |
There is no evaluation by a Pharmacy Council to select CEAF medication by line of care, aimed at producing/updating the state’s list |
76% of the FME do not detect delays in medication distribution due to HR fault and/or infrastructure deficiencies in caring for the users (in case there is medication available) |
Results of the dimension |
110 |
- |
63.5 |
Yellow |
Sustainability dimension |
1.Social Control |
Inclusion of CEAF in CES discussions |
10 |
During the last year, CEAF matters were not brought to CES for discussion. The team attended the CES only to clarify information |
0.0 |
Red |
2. Manager’s profile |
There is a manager of pharmaceutical assistance position, formally instituted, responsible for the management of CEAF, who receives qualification |
10 |
There is the position of coordinator/director/manager of pharmaceutical care, who is formally appointed; however, he/she is not responsible for full CEAF management (in technical and administrative terms) |
7.5 |
Green |
The coordinator/director/manager of pharmaceutical care is educated in the area of management and has experience in pharmaceutical care |
3 Accessibility |
Time required to provide the needs of the users, existence of litigation, and systems for avoiding litigations |
10 |
Only 13.5% of the patients who sought the “Acessa SUS” program in the last year were eligible for the CEAF |
9.0 |
Green |
The average time lapse between registering the process and the first delivery (of medication) for the 10 most frequent diseases in the State is 6 to 20 days |
91% of the patients registered in the last year received care |
4.Relationship between services |
Actions of follow-up at the units, periodical provision of orientation, and relationship between management and other areas of the healthcare network |
10 |
Manager (central level): considers that he/she provides orientation, regarding CEAF execution, and does follow-up actions at the units. FME: 91% reported having received orientation from the central CEAF manager on execution and only 9% reported having received an in-house, technical, follow-up visit |
3.5 |
Orange |
State management does not discuss CEAF demands (consultations, exams, absences, basic care) with other services of the healthcare network |
5. Clinical Aspects |
There is treatment follow-up and provision of first care by pharmacist |
10 |
In only 21% of the units, the first distribution (of every medication or for Hepatitis C and other specific pathologies) to the patient is done by a pharmacist |
0.0 |
Red |
0.7% of the clinical aspects dealt with by the PCDT are registered in an information system |
6. Relationship with the users |
Management shows concern with the users’ satisfaction, through evaluations and Ombudsman services |
10 |
30% of the FME did surveys of customer satisfaction in the last year |
3.8 |
Orange |
27% of the FME used data obtained from customer satisfaction surveys to improve their services |
There are Ombudsman services, which receive patient opinions concerning the services provided by CEAF state-level management; however, the management does not use the information obtained for planning purposes |
Results of the dimension |
60 |
- |
23.8 |
Orange |
Total score for the protocol |
250 |
- |
125 |
- |