Civitavecchia – Magnetic resonance imaging, the clarification of the Director General

The Corporate management, in reference to articles that have appeared in recent days in the local press regarding the upcoming activation of the Magnetic resonance imaging, intervenes on the ongoing querelle:

It’s all too obvious that the Director General of the ASL ROMA F has continuous contact, even by telephone, with all the mayors of the reference territory, and even more so with the mayor of Civitavecchia who is also the president of the Conference of Mayors: indeed of the constant and fruitful interlocution with the representatives of the territory, Dr. M. Quintavalle has always intended to build, and for many years, the figure of its institutional work.

The wards of St. Paul's, far from falling (as claimed by some) into pejorative states, have been enjoying in recent years a substantial series of integral renovations, and operational reorganizations that are before the eyes of the citizens, so much so that many are shouting for a ‘rebirth’ of St. Paul's, to which even the Lazio Region has not spared in recent times functional, logistical and instrumental expansions.

The need for an’MRI equipment has been well on the agenda of Dr. M. M. R. M., who has been in charge of the MRI department for many years. Quintavalle, so much so that its purchase was one of the first acts carried out by the’current General Director since he was appointed Extraordinary Commissioner at the end of 2012, with the’intent of meeting the increasingly pressing diagnostic needs of the entire company’s territory.

As for the highly specialized personnel, who will have to ensure the’operation of the new equipment, the Corporate Management is already preparing an adequate and sufficient organization chart to cover both the detected and foreseeable needs, without neglecting the necessary training of operators for the best management of this important diagnostic tool.

However, it should be noted that the reconfiguration of hospital care in the Lazio Region sees the merger of the two ASL RM/F Hospitals, San Paolo in Civitavecchia and Padre Pio in Bracciano, into a unified Hospital Pole, also for the purpose of overcoming a localistic and fragmented management of care activities, particularly surgical and orthopedic.

The new Corporate Act fully incorporates these innovative programmatic lines, already anticipated in the Strategic Plan, in order to reorganize and make more efficient the system of delivering health care services to citizens, indispensable in the context of the Recovery Plan, which requires an increasing shift of available resources from the Hospital to the Territory.

And precisely in this key of interpretation should be considered the reshaping of the activities of Nuclear Magnetic Resonance.

In fact, this high-tech radiology uses equipment located in a hospital setting but essentially provides elective, i.e., programmable, services for the clarification of specialized diagnostic questions.

Its use is therefore aimed at examinations of outpatients or patients already hospitalized. Otherwise, it does not find use in emergency cases, for which the use of CT scans is instead specifically indicated, which cannot be replaced by MRI in such emergency functions for technical reasons (as, for example, is the case at the Belcolle Hospital in Viterbo, which is equipped with equipment exactly identical to that of the Civitavecchia Hospital).

For this reason, too, in fact, the General Director of the ASL RM/F, at the last Conference of Mayors, in response to a specific request from the Mayor of Civitavecchia, confirmed the use of the CT scan at the San Paolo Hospital mainly for the needs of the Hospital itself, with priority given to emergencies in the Emergency Room and to inpatients.

With regard to the operational management of the MRI, it should be clarified, rather, that it concerns not only the new Total-Body equipment at the Civitavecchia Hospital but also the Artroscan equipment with which the Radiology of the same Hospital has already been equipped since 2009, which is in fact very under-utilized, as well as the Artroscan in District F4, in the Capena Outpatient Clinic, which is also under-utilized.

The initiative adopted by the ASL RM/F with the new Corporate Act regarding MRI is, in fact, more comprehensive and is aimed at the start-up and implementation of the use of MRI technology throughout the Hospital-Territory area, to ensure the real and fair usability of examinations and the reduction of related waiting times for citizens, according to the most recent regional indications (Determination G 18397 of 19/12/2014), which see, precisely, CT and MRI in the first place in the intervention of reorganization of the system of prescription, booking and provision of services.

Incidentally, as a side note, the CT-RMN organizational model has been unanimously approved twice in the technical headquarters at the ASL RM/F, both by the Board of Management – of which all the Directors of Complex Structures (Chiefs) are members – and by the Board of Health, as well as by the Labor Organizations of the Management (doctors) and the Sector (radiology technicians and nurses).

It remains clear that the management of the MRI, as with all other radiological equipment and technologies, will remain entirely public, and as for the possible assignment of tasks in relation to the new Corporate Act, it seems quite clear that the relevant assignments can only be made in compliance with the relevant legal and contractual regulations.