ADVANCED ACCESS VERSUS AGENDA MANAGEMENT IN PRIMARY CARE: BENEFITS AND CHALLENGES OF FAMILY AND COMMUNITY MEDICINE RESIDENTS

INTRODUCTION and OBJECTIVE: Towards the changes in primary health care in Rio de Janeiro, through services reorganization and territories coverage expansion, users access has become a widely debated topic. With the Medical Residence Program implementation in the Family Clinic Anthídio Dias da Silveira, two teams, one using the scheduling appointments method (team 1) and other advanced access (team 2) were studied through critical analysis of work process. METHODS: Data from two teams were analyzed through the electronic medical record, which stores the records made by the team members and the experience of each resident during their first year of service. RESULTS AND CONCLUSION: There were a grater number of appointments on team 2, besides the lower absenteeism. On the other hand, on the resident’s perspective, with the agenda management was possible to learn consultation timing and practice person-centered medicine techniques, besides it allowed previous cases studies. Team 1 reception group promotes an integrated multidisciplinary appointment that allows better information exchange among technical team. However there is dissatisfaction of patients regarding the waiting time, which does not happen in the Team 2, since it ensures the appointment for the day or the date chosen by the user. Thus, it is undeniable the benefits of advanced access to the community, but an organized schedule can provide better learning opportunities for the resident.