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Dr. María Eugenia Arosemena is a physician with a master's degree in Hospital Management. While she was in the CAHI Fellows Program, she worked in the office of the Minister of Health for Panama, where she was responsible for high-priority projects related to the most important goals of the institution.


Santo Tomás Hospital in Panama is the largest hospital in the Ministry of Health (MINSA) system, which serves the entire population of Panama City and the interior of Panama. Within this context, Dr. Arosemena identified a problem that required immediate action: the emergency department was frequently over-capacity, which prevented prompt attention to patients’ urgent needs.

The process is complex. There are a set of protocols that must be followed from the moment a patient is admitted to the hospital’s emergency room. Triage, an assessment of the degree of urgency of a patient’s condition, is used to determine the required level of medical attention. Once triaged, a patient is assigned to specific care protocol that must be executed efficiently, both to care for the patient’s immediate needs, and ensure that the emergency room can continue receiving new patients.

Dr. Arosemena identified a patient-flow analysis as the most important step to understand the situation. This allowed her to identify complications and delays in the workflow and to understand what was preventing prompt, appropriate attention to patients, according to established procedures and norms. The objective of this analysis is to resolve these bottlenecks so patients receive prompt, appropriate attention in the emergency room and thereby, improve the efficiency and medical outcomes at the hospital.

“We have been studying why these patients are not getting the healthcare they need on time, by identifying what type of exams take longer. We generate weekly reports that are presented to the hospital's medical director, which allows us not only to know where the problems are, but to make the necessary corrections more quickly and efficiently.”



Dr. María Eugenia Arosemena says that participating in the CAHI Fellows program has broadened and transformed her perspective on healthcare services in the region, reinforcing her sense of solidarity and opening up greater possibilities for collaboration with CAHI Fellows in other countries.


“This program has been extremely important to me, especially because of the leadership development aspect, because the lessons are very applicable to my work. From the approaches to public policies, to the development of processes, I can see everything occurring in my daily work and apply it to the projects I manage. I can now see things more clearly, and I do better analyses to help others organize their perspective in a better way. I think that is a very important contribution.”

Dr. Arosemena says the CAHI Fellows network is very supportive, which is reflected by the constant communication, and in the cooperation provided from the other fellows. As an example, she mentions the replication of the ‘Day Hospital Project’, which was originally implemented in Costa Rica and is now being replicated in Panama by Dr. De Gracia. She also shared that the CAHI Fellows Network has been very supportive of their colleagues in Nicaragua as that country passed through a period of political turmoil in 2018.

For her, the key is in the balance between the technical knowledge, ethics, the strengthening of values, and finally the connection between the members of the network, which today has more than 100 members throughout Central America. She sees the importance of the CAHI Fellows Program and its potential to have an impact locally, nationally, and finally, broadly across Central America.

As a vision for the region, she says, “I feel that we have to better understand what is happening in the other countries of Central America, to understand that the challenges we face are very similar and that we must unite to be stronger in the face of these challenges, to be better, and to continue reinforcing our values ​​and improving medical care for our population as a whole. I am also convinced, thanks to the experience I have had as a CAHI Fellow, that we need to train younger leaders, that resident physicians need leadership training and ethics training. That is our challenge for the future.”

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