Management Report Summary SOCIAL REPORT 2009, 2010, 2011, 2012 and 2013

2009

Establishment of upa LOCAL MEDICAL EMERGENCY UNIT 2010

The The Opening of PADI Opening of esf (HOME CARE 3 (FAMILY HEALTH 4 SERVICES FOR FAMILY HEALTH STRATEGY) upas SENIORS) AGREEMENT (LOCAL EMERGENCY AGREEMENT CLINICS AP 5.1 and 5.2 UNITs)

2011

The The ESF (family Opening of health strategy) is The esf implemented in (FAMILY HEALTH 9 pse (Health Program STRATEGY) FAMILY HEALTH 6 AGREEMENT at Schools) CLINICS healthcare Agreement AP 4.0 centres

2012

Opening of 7 FAMILY HEALTH CLINICS Introduction

ach year, IABAS moves forward to reach high level of excellence in public health care services. Our mission is to work together with Rio’s E health authorities to ensure excellency and care of patients, prevent diseases and integrate services to ensure the well-being of the population of 4 YEARS at the Family Health Clinics and Local Medical Emergency Units of management, (UPA – Unidade de Pronto Atendimento), and through the Home Care Services since 12/2009 for Seniors (PADI – Programa de Atenção Domiciliar do Idoso) program and the Health Program at Schools (PSE – Programa de Saúde nas Escolas).

There were many achievements in 2013. We opened new Family Health Clinics 4.145 (four in January and three in July), and the City Health Centres (CMS – Centros employees Municipais de Saúde) were renovated or altered, for improved and more humanised health care services to all users. Since 2009, when we took over the management an important percentage of the city’s health care centres, more than OVER three million people have had access to quality heath care services. 7,000,000 By investing in sustainability, we implemented a waste management system at consultations the Family Health Clinics and the Local Medical Emergency Units (UPAs), and an energy, water and paper. We have been doing our part to preserve the environment and ensure a better future to the planet.

As these achievements were only possible with the effort of everyone working at IABAS, we have again invested in training our staff, allowing for the professional education that we will be able to ensure that the staff has the technical skills needed to provide each time better health care services to the population of Rio de Janeiro.

With planned actions and working in an ethical and transparent manner, our next step is to exceed contract goals. We are aware of the challenges; however, our willingness to show more and more dignity and respect towards our users is what motivates us.

2 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) Introduction ESF - Family Health Strategy

ach year, IABAS moves forward to reach high level of excellence in n the Family Health Strategy public health care services. Our mission is to work together with Rio’s program, the health care providers E health authorities to ensure excellency and care of patients, prevent I work on promoting, preventing, and diseases and integrate services to ensure the well-being of the population of 4 YEARS bettering the health of patients. Rio de Janeiro at the Family Health Clinics and Local Medical Emergency Units of management, (UPA – Unidade de Pronto Atendimento), and through the Home Care Services since 12/2009 Family members are assisted by a for Seniors (PADI – Programa de Atenção Domiciliar do Idoso) program and the cross-functional health care team, which Health Program at Schools (PSE – Programa de Saúde nas Escolas). is comprised of physicians, nurses and dentists, and have access to the health There were many achievements in 2013. We opened new Family Health Clinics 4.145 care initiatives and services that will (four in January and three in July), and the City Health Centres (CMS – Centros employees meet the needs of the family. Municipais de Saúde) were renovated or altered, for improved and more humanised health care services to all users. Since 2009, when we took over the management an important percentage of the city’s health care centres, more than OVER three million people have had access to quality heath care services. 7,000,000 PROGRAMMATIC AREAS (AP) COVERED BY IABAS By investing in sustainability, we implemented a waste management system at consultations the Family Health Clinics and the Local Medical Emergency Units (UPAs), and an energy, water and CITY OF RIO DE JANEIRO paper. We have been doing our part to preserve the environment and ensure a better future to the planet. AP 3.1 AP 3.3 As these achievements were only possible with the effort of everyone working at AP 5.1 IABAS, we have again invested in training our staff, allowing for the professional AP 3.2 education that AP 5.3 AP 1 we will be able to ensure that the staff has the technical skills needed to provide each time better health care services to the population of Rio de Janeiro. AP 5.2 AP 2.2 AP 4.0 AP 2.1 With planned actions and working in an ethical and transparent manner, our next step is to exceed contract goals. We are aware of the challenges; however, our willingness to show more and more dignity and respect towards our users is what motivates us.

Programmatic Area 4.0 Programmatic Area 5.1 Programmatic Area 5.2

Covers the following suburbs: Covers the following suburbs: Covers the following suburbs: Jacarepaguá, Anil, Gardênia Deodoro, , Campo Santíssimo, Campo Grande, Azul, Cidade de Deus, , dos Afonsos, , , Inhoaíba, (Jacarepaguá), Magalhães Bastos, , Cosmos, , Barra de , Taquara, , Padre Miguel, Bangu, Gericinó, Guaratiba, . Praça Seca, , Joá, Senador Camará. Itanhangá, Barra da , , , Vargem Grande, , .

2 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) (Copyright. Copying not allowed without IABAS authorisation) | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 3 ESF - Family Health Strategy

Family health - prog. area 4.0 Family health - prog. area 5.1

COVERED SUBURBS COVERED SUBURBS Jacarepaguá, Anil, over Deodoro, Vila Militar, over Gardênia Azul, Cidade de Campos dos Afonsos, Deus, Curicica, Freguesia, 200,000 Jardim Sulacap, Magalhães 450,000 Pechincha, Taquara, Tanque, Bastos, Realengo, Padre Praça Seca, Vila Valqueire, Joá, consultations Miguel, Bangu, Gericinó, consultations in 3 years in 4 years Itanhangá, , Senador Camará Camorim, Vargem Pequena, Vargem Grande, Recreio dos Bandeirantes and Grumari. Magalhães Gericinó Bastos

Vila Cidade de Deus Realengo Militar

Bangu

Deodoro Tanque

Campo dos Senador Afonsos Camará

Recreio dos Bandeirantes Sulacap Padre Miguel

Family health Family health coverage coverage

19.8 9% 54.41%

22.51% 2.90%

2010 2013 2010 2013

Source: VITACARE Electronic Medical Records (PEP VITACARE). Source: PEP VITACARE.

Total medical Total medical consultations consultations 208.684 495.839

74,472 6,244

2010 2013 2010 2013

Source: PEP VITACARE. Source: PEP VITACARE.

4 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) ESF - Family Health Strategy

Family health - prog. area 4.0 Family health - prog. area 5.1 Family health - prog. area 5.2

COVERED SUBURBS COVERED SUBURBS COVERED SUBURBS Jacarepaguá, Anil, over Deodoro, Vila Militar, over Santíssimo, Campo Grande, over Gardênia Azul, Cidade de Campos dos Afonsos, Senador Vasconcelos, Deus, Curicica, Freguesia, 200,000 Jardim Sulacap, Magalhães 450,000 Inhoaíba, Cosmos, 650,000 Pechincha, Taquara, Tanque, Bastos, Realengo, Padre Guaratiba, , Praça Seca, Vila Valqueire, Joá, consultations Miguel, Bangu, Gericinó, consultations Pedra de Guaratiba. consultations in 3 years in 4 years in 4 years Itanhangá, Barra da Tijuca, Senador Camará Camorim, Vargem Pequena, Vargem Grande, Recreio dos Campo Bandeirantes and Grumari. Magalhães Grande Gericinó Bastos

Vila Santíssimo Cidade de Deus Realengo Militar Senador Vasconcelos Bangu

Deodoro Tanque Inhoaíba Cosmos Campo dos Senador Afonsos Camará Guaratiba Pedra de Guaratiba Recreio dos Bandeirantes Sulacap Padre Miguel Barra de Guaratiba

Family health Family health Family health coverage coverage coverage

19.8 9% 58.99% 54.41% 42.60%

22.51% 2.90%

2010 2013 2010 2013 2010 2013

Source: VITACARE Electronic Medical Records (PEP VITACARE). Source: PEP VITACARE. Source: PEP VITACARE.

Total medical Total medical Total medical consultations consultations consultations 208.684 495.839 676.132

74,472 79,399 6,244

2010 2013 2010 2013 2010 2013

Source: PEP VITACARE. Source: PEP VITACARE. Source: PEP VITACARE.

4 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) (Copyright. Copying not allowed without IABAS authorisation) | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 5 ESF - Family Health Strategy

Fitness centre

Fitness centres were opened in 33 heath care centres administered by IABAS. The is to provide the population of Rio with a space where they can have a regular gym practice, which will lead to increased health and well- being. There are skilled physical educators at all times to guide and support users, and some of the Family Health Clinics have sessions for seniors.

Units equipped with a fitness centre

4.0 5.1 5.2

CF Prof. Maury Alves de Pinho Policlínica Manoel Guilherme CMS Dr. Mario Rodrigues Cid CF Padre José de Azevedo Tiúba da Silveira Filho CMS Prof. Manoel de Abreu CF Otto Alves de Carvalho CMS Athayde José da Fonseca CMS Belizário Penna CMS Harvey Ribeiro de Souza Filho CMS Dr. Henrique Monat CMS Edgar Magalhães Gomes CMS Sylvio Barbosa CAPS Profeta Gentileza CMS Prof. Masao Goto CMS Alvimar de Carvalho CMS Waldyr Franco CF Dr. Hans Jurgen Fernando Dohmann CMS Eithel Pinheiro CF Alkindar Soares Pereira CF Olímpia Esteves CF Agenor de Miranda Araújo Neto (Cazuza) CF Kelly Cristina de Sá CMS Mário Vitor de Assis CF Pe John Cribbin CMS Adão Pereira Nunes CF Mario Dias Alencar CMS Vila do Céu CF Antonio Gonçalves da Silva CF José de Paula Lopes Pontes CF Rosino Baccarini CMS Dr. Oswaldo Vilella CF Armando Palhares Aguinaga CMS Raul Barroso

UNITS WITH A TOTAL NUMBER OF NUMBER OF USERS FITNESS CENTRE PHYSICAL EDUCATORS 4.0 4.0 4.0

4 4 1,969

5.2 15 5.2 14 5.2 8,242 14 13 7,832 5.1 5.1 5.1

Source: PEP VITACARE. Source: PEP VITACARE. Source: PEP VITACARE.

6 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) ESF - Family Health Strategy Family Health Clinics - New Openings Fitness centre CF Padre José de Azevedo Tiúba – 4.0 CF MÁrio Dias Alencar – 5.1 Fitness centres were opened in 33 heath care centres administered by IABAS. The is to provide the population of Rio with a space where they can have a regular gym practice, which will lead to increased health and well- Date: 01/11/2012 Date: 01/13/2012 being. There are skilled physical educators at all times to guide and support users, CF AntÔnio Gonçalves da Silva – 5.1 CF Otto Alves de carvalho – 4.0 and some of the Family Health Clinics have sessions for seniors.

Units equipped with a fitness centre

4.0 5.1 5.2

CF Prof. Maury Alves de Pinho Policlínica Manoel Guilherme CMS Dr. Mario Rodrigues Cid Date: 01/18/2012 Date: 01/26/2012 CF Padre José de Azevedo Tiúba da Silveira Filho CMS Prof. Manoel de Abreu CF Otto Alves de Carvalho CMS Athayde José da Fonseca CMS Belizário Penna CMS Harvey Ribeiro de Souza Filho CMS Dr. Henrique Monat CMS Edgar Magalhães Gomes CMS Sylvio Barbosa CAPS Profeta Gentileza CF Rosino Baccarini – 5.1 CF Antonio Gonçalves Villa Sobrinho – 5.2 CMS Prof. Masao Goto CMS Alvimar de Carvalho CMS Waldyr Franco CF Dr. Hans Jurgen Fernando Dohmann CMS Eithel Pinheiro CF Alkindar Soares Pereira CF Olímpia Esteves CF Agenor de Miranda Araújo Neto (Cazuza) CF Kelly Cristina de Sá CMS Mário Vitor de Assis CF Pe John Cribbin CMS Adão Pereira Nunes CF Mario Dias Alencar CMS Vila do Céu CF Antonio Gonçalves da Silva CF José de Paula Lopes Pontes CF Rosino Baccarini CMS Dr. Oswaldo Vilella CF Armando Palhares Aguinaga CMS Raul Barroso

Date: 07/05/2012 Date: 07/05/2012 UNITS WITH A TOTAL NUMBER OF NUMBER OF USERS FITNESS CENTRE PHYSICAL EDUCATORS CF Sonia Maria Ferreira Machado – 5.2 CF armando Palhares Aguinaga – 5.1 4.0 4.0 4.0

4 4 1,969

5.2 15 5.2 14 5.2 8,242 14 13 7,832 5.1 5.1 5.1

Date: 07/05/2012 Date: 13/08/2013 Source: PEP VITACARE. Source: PEP VITACARE. Source: PEP VITACARE.

6 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) (Copyright. Copying not allowed without IABAS authorisation) | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 7 Constructions and improvements - City Health Centres

CMS Adão Pereira Nunes (AP 5.2) CMS Carlos Alberto Nascimento (AP 5.2) CMS Mourão Filho (AP 5.2)

CMS Raul Barroso (AP 5.2) CMS Vila do Céu (AP 5.2) CMS Woodrow Pimentel Pantoja (AP 5.2)

Clínica da Família OlÍmpia Esteves (AP 5.1) CMS Eithel Pinheiro (AP 5.1) CMS Dr. Henrique Monat (AP 5.1)

CMS Buá Borges Boanerges (AP 5.1) CMS Waldyr Franco (AP 5.1) CMS Padre Miguel (AP 5.1)

Policlínica Manoel Guilherme da Silveira Filho (AP 5.1) CMS Professor Masao Goto (AP 5.1) CMS Alexander Fleming (AP 5.1)

CMS CATIRI (AP 5.1) CMS Athayde da Fonseca (AP 5.1) CMS Santa Maria (AP 4.0)

8 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) Constructions and improvements - City Health Centres PSE - Health Program at Schools

CMS Adão Pereira Nunes (AP 5.2) CMS Carlos Alberto Nascimento (AP 5.2) CMS Mourão Filho (AP 5.2) n partnership with the City Health Department and City Education Department, IABAS manages the Health Program at Schools, covering 151 “schools of PSE TEAM I tomorrow” (a program that invests in quality education in Rio’s most violent suburbs). Through this partnership, the Institute provides care for over 100,000 1 students only in 2013. General Coordinator 5 A link between the city’s schools and day-care centres and the Family Health Public Health Coordinators Strategy, the program offers activities that ensure that school communities will have

CMS Raul Barroso (AP 5.2) CMS Vila do Céu (AP 5.2) CMS Woodrow Pimentel Pantoja (AP 5.2) live in poorer and 9 Health Analysts low Human Development Index (HDI) areas. 6 Administrative Assistants

160 PSE figures Education and Health Assistants

9 Clínica da Família OlÍmpia Esteves (AP 5.1) CMS Eithel Pinheiro (AP 5.1) CMS Dr. Henrique Monat (AP 5.1) 5,120 Mobile health care units consultations per month Cross-functional health care team:

18 8,000 Doctors health checks per month 18 Dentists

13,000 9 students per group Psychologists CMS Buá Borges Boanerges (AP 5.1) CMS Waldyr Franco (AP 5.1) CMS Padre Miguel (AP 5.1) (approximately) 9 Nurses

6,000 9 teachers Dental Assistants and staff

Policlínica Manoel Guilherme da Silveira Filho (AP 5.1) CMS Professor Masao Goto (AP 5.1) CMS Alexander Fleming (AP 5.1) Schools served by iabas

CITY OF RIO DE JANEIRO 160 schools served

CMS CATIRI (AP 5.1) CMS Athayde da Fonseca (AP 5.1) CMS Santa Maria (AP 4.0) over 109,000 students served per month

8 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) (Copyright. Copying not allowed without IABAS authorisation) | Manage ment Report - Summary | 2009, 2010, 2011, 2012 and 2013 9 UPA - Local Medical Emergency Unit

he Local Medical Emergency Units (UPA - Unidades de Pronto Atendimento) operate 24 x 7, T providing emergency health care services. Structure of a UPA

In the areas served by a Local Medical Emergency Unit • 1,300 m2 (UPA), 97% of the cases are solved in the emergency • patient evaluation room unit, contributing to less patients queuing at hospital • suture room emergency rooms, and shorter hospitalization length. • procedure room • pathology laboratory • digital radiography These Local Medical Emergency Units (UPAs) rely on a • electrocardiography device team of doctors on duty and are equipped with all the • pharmacy equipment needed to serve the population. • instrument sterilisation room

AREAS SERVED BY IABAS-ADMINISTERED UPAS

CITY OF RIO JANEIRO UPA UPA

AP 3.1 UPA Complexo AP 3.3 do Alemão AP 5.1 UPA Madureira

AP 4.0 over 1,500,000 consultations UPA Cidade de Deus

10 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) UPA - Local Medical Emergency Unit

he Local Medical Emergency Units (UPA - Unidades de Pronto Atendimento) operate 24 x 7, T providing emergency health care services. Structure of a UPA

In the areas served by a Local Medical Emergency Unit • 1,300 m2 (UPA), 97% of the cases are solved in the emergency • patient evaluation room unit, contributing to less patients queuing at hospital • suture room emergency rooms, and shorter hospitalization length. • procedure room • pathology laboratory • digital radiography These Local Medical Emergency Units (UPAs) rely on a • electrocardiography device team of doctors on duty and are equipped with all the • pharmacy equipment needed to serve the population. • instrument sterilisation room

upas

TOTAL CONSULTATIONS AREAS SERVED BY IABAS-ADMINISTERED UPAS 2013 2012 UPA UPA 2011 CITY OF RIO JANEIRO Costa Barros 2010

Vila Kennedy 105.076

109.665 2009 1 102.018 .3 0 1 9 1 67 0

AP 3.1 1 3 38 . 59.524 3 1 UPA Complexo . 1 4 AP 3.3 80.460 9 do Alemão 1 932 6 7 .

AP 5.1 87 . 1 0 2 UPA Madureira 6 9 4 1 4

. 2 1 0 1 35 . 063 1 60 2 . 5 95 . 5 5 13 7 . 02 2 4 0 3 . 7 2 1 1 4 1 0 0 36 5 .

. .

AP 4.0 29 3 1 04 7 2 . . 1 7 6 3 2 over 6 VILA COMPLEXO CIDADE MADUREIRA COSTA 1,500,000 KENNEDY DO ALEMÃO DE DEUS BARROS consultations UPA Cidade de Deus Source: PEP VITACARE.

UPA - Objective

• To provide the population with improved health care services for emergency cases.

• To reduce the demand for hospital emer- gency rooms.

• To provide the population with improved health care services for emergency cases.

10 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) (Copyright. Copying not allowed without IABAS authorisation) | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 11 PADI - Home Care Services for Seniors

he Home Care Services for Seniors (PADI) is a health Total number of consultations T care program for the elderly. PADI TEAM through the padi program It provides home care services for, Doctor mainly, people over 60 years and is Registered Nurse focused on reducing the number of hospital admissions; promoting and Social Worker regenerating health; and preventing Nutritionist 25.855 diseases. The objective is to improve Physiotherapist hospital bed turnover, reduce the Speech Therapist patient’s risk of infections, and Occupational Therapist 7.118 shorten hospitalisation. In 2012, there Psychologist were more than 5,400 consultations Practical Nurse and over 35,000 visits to follow-up Administrative Assistant patients. 2010 2013

Source: IABAS records.

AREAS SERVED BY IABAS-ADMINISTERED PADI

PADI Salgado Filho CITY OF RIO DE JANEIRO

PADI Souza Aguiar OVER 70,000 consultations PADI Miguel Couto

12 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) PADI - Home Care Services for Seniors IABAS Staff

he Home Care Services for he IABAS staff is comprised of skilled health Seniors (PADI) is a health Total number of consultations care practitioners, such as doctors, nurses, Total training sessions conducted T care program for the elderly. PADI TEAM through the padi program T nursing assistants, physiotherapists, dentists, It provides home care services for, pharmacists and social workers. The staff is also Doctor mainly, people over 60 years and is comprised of administrative professionals (technicians, 144 Registered Nurse focused on reducing the number of assistants, managers and receptionists). Social Worker hospital admissions; promoting and For the following areas and programs regenerating health; and preventing Nutritionist 25.855 There are currently 4,145 staff members: 82 at the diseases. The objective is to improve Physiotherapist head office; 671 at the Local Medical Emergency Units; AP 5.2, 5.1, 4.0, PADI, PSE, hospital bed turnover, reduce the Speech Therapist 3,124 working on the Family Health Strategy program; head office patient’s risk of infections, and Occupational Therapist 7.118 47 working on the Home Care Services for Seniors shorten hospitalisation. In 2012, there Psychologist program, and 220 working on the Health Program at Total number ofemployees trained were more than 5,400 consultations Practical Nurse Schools. They are all dedicated and committed to and over 35,000 visits to follow-up Administrative social organisation. Assistant patients. 2010 2013 4,797

Source: IABAS records.

AREAS SERVED BY IABAS-ADMINISTERED PADI TOTAL NUMBER OF EMPLOYEES

PADI Salgado Filho CITY OF RIO DE JANEIRO 4,145

PADI Souza Aguiar OVER 135 70,000 consultations PADI 2009 2013 Miguel Couto

Source: IABAS records.

12 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) (Copyright. Copying not allowed without IABAS authorisation) | Man agement Report - Summary | 2009, 2010, 2011, 2012 and 2013 13 Innovations

ELETRONIC PANEL

The electronic panel enables managers from each unit to monitor the location, attendance and non-attendance of staff members in all projects and units administered by IABAS.

BENEFITS

n case of non-attendance of a worker in a certain division, ensuring being served. It allows the routine of each unit to be monitored more closely, enabling relocation of staff, amongst other measures, in case of shortage of staff in a particular unit and/or in emergency situations, for instance.

HOW IT WORKS

ger of each unit sends these records to the electronic panel system, which has a database that is updated several times a day.

nites

The Health Information and Technology Centre (NITES – Núcleo de Informação e Tecnologia em Saúde) is an alternative tool to gather, in an appropriate place, several information related to the projects managed by IABAS. Therefore, analysis can be conducted,as for example to assess the health conditions in a particular region, to

others.

The objective of this tool is to ensure the

actions to improve the quality of health care and assist managers in their decision making.

14 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) Innovations

SUSTAINABILITY

The Sustainability Program promotes the rational use of natural resources, improving population’s quality of life, and ecosystem protection, according to the new ANVISA (Brazilian Health Surveillance Agency) guidelines. This initiative is aligned ELETRONIC PANEL with the current restructuring process of the public health in Rio de Janeiro.

The electronic panel enables managers from each unit to monitor the location, attendance and non-attendance of staff reduced energy use with the aid of a sustainable technology. members in all projects and units administered by IABAS.

BENEFITS n Solid Waste Environmental case of non-attendance of a worker in a certain division, ensuring Management, Education with practical promoting sessions, workshops and responsible talks, aiming at changing being served. It allows the routine of each unit to be monitored waste reduction, the population’s and reutilisation and staff`s behaviour towards more closely, enabling relocation of staff, amongst other measures, recycling. the environment. in case of shortage of staff in a particular unit and/or in emergency situations, for instance.

HOW IT WORKS Supply Chain sustainability through evaluation and ger of each unit sends these records to the electronic panel system, which has a database that is updated several times a day. WASTE MANAGEMENT

In 2013, actions were taken to Medical units using waste management comply with the National Policy salgado filho nites on Solid Waste Management, that Medical unit name Medical unit address regulates the handling of waste Programmatic area 4.0 The Health Information and Technology within medical centres. Centre (NITES – Núcleo de Informação CMS Cecília Donnangelo Estr. dos Bandeirantes, nº 21.136 - Vargem Grande CF Maury Alves Pinho Estr. dos Bandeirantes, nº 11.227 - Vargem Pequena e Tecnologia em Saúde) is an alternative The implementation of the Solid CMS Canal do Anil Av. Canal do Anil - Rua Melo, nº 2 - Anil CF Padre José de Azevedo Tiuba Praça Ludovia - Jacarepaguá tool to gather, in an appropriate place, Waste Management Plan allows CF Otto Alves de Carvalho Rua Eng. Souza Filho - Rio das Pedras - Jacarepaguá several information related to the projects for a reduction of up to 50% of managed by IABAS. Therefore, analysis can the waste produced, reducing Programmatic area 5.1 be conducted,as for example to assess the by half the costs associated CF Olímpia Esteves Rua Francisco Brício, s/nº - Padre Miguel health conditions in a particular region, to CF Fiorello Raimundo Rua Açafrão, s/nº - Bangu CF Kelly Cristina Av. Carlos Sampaio Correia, s/nº others. economy. Programmatic area 5.2

The objective of this tool is to ensure the CF Hans Dohmann Estr. do Piai, s/nº - Pedra de Guaratiba CF Dalmir de Abreu Salgado Estr. do Magarça, nº 1.831 - Guaratiba CF José Lopes Pontes Rua Jaburu, s/nº - Jardim Maravilha CF David Capistrano Av. Cesário de Mello, s/nº - Campo Grande actions to improve the quality of health CF Rogério Rocco Estr. do Encantamento, s/nº - Santa Margarida care and assist managers in their decision CF Alkindar Soares Filho Estr. da Pedra, s/nº - Pedra de Guaratiba CF Agenor (Cazuza) Estr. do , s/nº (ao lado da Michelin) - Guaratiba making.

14 | Management Report - Summary | 2009, 2010, 2011, 2012 and 2013 (Copyright. Copying not allowed without IABAS authorisation) (Copyright. Copying not allowed without IABAS authorisation) | Man agement Report - Summary | 2009, 2010, 2011, 2012 and 2013 15 Av. Luiz Carlos Prestes, 350, loja C - salas 111 a 115 Barra da Tijuca/RJ - Cep: 22775-055 Tel: (21) 3550-3300 [email protected]

Rua Diogo de Farias, 66 - 6º andar - Vila Mariana São Paulo - SP - CEP: 04037-000 Telefone: (11) 5575-6930 [email protected]