"Although it will force me, I'll never say that everything past was better. Tomorrow is better. "Beyond its institutional goal, maybe this kind of declaration of principles handed down by 'flaco' Spinetta more than four decades is the engine that drives the control bodies to review their old reports, to see if those observations, once alarming, were improved over the years.

That was how the Auditor General of the City of Buenos Aires returned last year to the Santojanni Hospital for what is known as a follow-up report, namely, collating the status of various aspects of the health center with the findings collected in an earlier investigation on 2006 data.

First, the agency found that Santojanni has less operating rooms than eight years ago. It is that in the survey carried out in 2006, which also was published in The Auditor.info; it said that the hospital had "11 operating rooms, eight for general surgery, two for outpatient and emergency. Of that total, three were used as deposits for lack of equipment, such as laparoscopy tower, multiparameter monitors and anesthesiology tables.

In addition, surgical instruments are 'old', and both disposable items, such as clothing available, are insufficient. "

This means that at that time it had eight spaces available for operations. Already in its latest research, approved in December of last year, the AGCBA, for its acronym in Spanish concluded: "In 2013 the number of operating rooms is less than that observed in the source report, due to breakage of equipment (anesthesia table and lack of parametric in another), and the use of two rooms hemodynamics (as manifested by the hospital management) resulting in five available and while hours increased availability of anesthesiology, observation remains."
 
With regard to this proviso, it is worth remembering that in the 2006 the report warned that the lack of anesthetists generated that the area of Santojanni surgery "did not have a real waiting list," and that the transactions were made in light of the urgency of patients, with average delays of three to four months. "

Furthermore, the research done eight years ago also developed statistics related to the degree of satisfaction of patients attending the health center in the neighborhood of Mataderos. In this regard, it was noted that this index reached the "weighted average of 44.6%," which "is low relative to the reference values, such as the Hospital of Oncology Maria Curie, with 72.5%."

This time, the Audit added that this situation "affects the time that spontaneous patient should attend for one shift (between 5 am and 7 am); poor care and mistreatment expressed by the administrative staff; the excessive time that the patient must wait assigned shift from reaching the hospital until it receives medical care (1 to 2 hours) and discomfort in the waiting for consultation. It also analyzed the complaints book; stand out those related to the abuse of administrative staff (61% weighted average)."

It is as if time had no passed. Even the AGCBA says: "In terms of both administrative and professional care it should improve the behavior of users, in terms of care and management shifts. The progress is satisfactory only in relation to comfort in the waiting rooms. Therefore, the observation remains" of 2006.

Directly linked to the issue of care, the Watchdog found that there were no improvements in the rates of absenteeism among the workers at the Santojanni Hospital, be it for leave or truancy.

The study done eight years ago, affirmed that the absenteeism resulting of the long leave treatment were “high”, and that “the Hospital has to face this.” However, an index stood out because it was “even worse”: those of truancy. The City Watchdog analyzed 680 samples and concluded that of these only half had the appropriate discounts. 

"This proportion increases over the years," observes the AGCBA and details: "For the year 2007 only communicated for discount 16% of the surveyed cases (221 cases on a sample of 1,340 cases). It also verified that there was not one discount for cases of late arrival. This points to the inefficiency of the control systems and the lack of reliability of the information handled and reports the Hospital."
 
The Care

In 2006, the Audit pointed out that the demand attended outpatient (in outpatient) was "poor, making weak Hospital healthcare activity, in terms of promotion and health prevention."

When the audit would examine the progress of this observation it came across the fact that it was "unable to evaluate the percentage of absenteeism in patients and actual production of professional," because there are no cross-checks between the forms of care implemented by the administrative area and records manual carrying doctors themselves, detecting inconsistencies. Against this, the watchdog considered "unsatisfactory" the progress of observation.

As a result of "poor" access to outpatient clinics, the AGCBA found that demand increases in the Santojanni emergency, which, moreover, "increases the costs of the health system and low quality of care, from those they do need urgent consultation," says the research.

Of Personnel and Cleaning Staff

The 2006 report warned of the deficit suffered by the Santojanni staff, especially in the areas of nursing, anesthesiology, intensive care, gastroenterology, nephrology and dialysis, orthopedics, traumatology and surgery.

However, this shortcoming it was also expressed regarding the hygiene of the health center. The Audit explains that "the Hospital has a total area of 26,000 square meters, which is required (approximately) 124 cleaning agents. The company hired for this task is the company Indaltec SA; and, according to Head of Department (company) provides only 90 employees." But that is not all of that only staff reports to work an average of 80 agents, "for reasons of absenteeism."

To wonder how the presentism of these workers is audited, the AGCBA revealed that "because of the limited information received, failed to note how much control the cleaning staff who attends the hospital on a daily bases to each of the areas, and what is their level of training in cleaning techniques of the premises."

In the same vein, the auditors said that "training is lacking" for those employees regarding "preparation, use, dilution and conservation" of the work items; and added the "absence of written guidelines for hospital hygiene, poor quality control system for cleaning and maintenance.”

Also in the health service, the report notes the "delay in the development of new tender documents" and, in return, reveals that for the hiring, other agencies such as city hospital- lies in the "misuse" mechanism provisions of Decree 1370-1301, which enabled urgent disbursement but only when the real need to do so is justified.

Regarding the management of medical waste, the AGCBA states that "there is no systematic and permanent control on compliance" with the regulations related to this topic Act and its Regulatory Decree 154/99, the 1,886 / 01.

Beyond the formal issues, technical narrated that where the pathogenic wastes are stored "does not meet the legal requirements set forth in current legislation, since it is also used also as tank Liquid Waste, the environment does not have the and proper lighting or ventilation smoke detector, thus increasing the risks."