A pioneering CAP for blind people: "It's a necessity for the entire healthcare system."

BarcelonaMaite has a 79% visual impairment and has been visiting the Cerdeña Primary Care Team (EAP) in the Horta-Guinardó district (Barcelona) for twenty-one years. In recent months, this center has launched a pioneering initiative in Catalonia: a comprehensive care protocol for blind or severely visually impaired people who care for me. "When I come in, someone is in charge of accompanying me wherever I go, whether in the consultation room or any other room. It's changed my life," explains Maite, who, despite having a certain degree of autonomy because she has always lived with blindness, assures that any help is welcome.

The fact that many social care centers use screens to indicate when they should enter the consultation room poses a problem for those with vision problems. When the EAP Cerdeña became aware of this shortcoming, they established a partnership with ONCE (National Commission for the Protection of Visual Impairment) to provide a solution. "It wasn't about inventing the protocol at the center itself, but rather talking with experts—in this case, ONCE (National Commission for the Protection of Visual Impairment)—to develop it. They conducted training for the administrative and nursing staff to teach them how to deal with blind people," explains Jaume Sellarès, a family doctor and director of the center.

The protocol consists of accompanying those patients with visual difficulties who wish to be accompanied at all times, except when they are inside the consultation room, for privacy reasons. "All social and healthcare centres could do this, because this service is already available at airports. We're not reinventing the wheel," says Sellarès, who is clear that this is an easy-to-implement system that doesn't require large financial investments, as has been the case with the centre he directs. Furthermore, the Sardenya Primary Care Centre also provides specialist care to people with hearing difficulties, how to speak louder if necessary or maintain eye contact the entire time so they can lip read.

This way, when Maite arrives at the doors of the Cerdeña EAP, there's already someone waiting to help her with the procedures for entering the center—which are done on a screen at the entrance—and escorts her to the appointment. "The problem wasn't with the appointments, but with the entire process leading up to them, which is where we've been able to provide solutions," the center's director celebrates. In total, around fifteen staff members followed the ONCE training, although all employees are familiar with the protocol.

Sellarès comments that it took them only six months to complete it and offers a positive assessment. In fact, he believes all centers in Catalonia should "reflect" and implement a protocol of this type. "It's a need for the entire healthcare system," he adds. Maite also hopes to see more of this type of initiative. In this regard, she explains that she recently went to the hospital and, once inside the building, had difficulty knowing where to go. This is the usual pattern for people with visual impairments, who, when they go to a healthcare center, only receive directions such as "Follow the blue arrow" or "Go to this floor as indicated on the sign." These are difficult tasks if they don't know the center well or don't receive guidance.

A phased protocol

Patient monitoring is the first phase of the protocol, but additional facilities will be provided. In the second phase, a system will be implemented to detect via Bluetooth when a patient who requires and desires specialized care—as they may prefer to assert their independence—enters the center. Finally, it is expected that before the end of the year, the entrance device will include a voice recognition system based on artificial intelligence, which will make it easier for people with visual impairments to complete the relevant procedures.

The Sardenya EAP is a public healthcare center not affiliated with the Catalan Institute of Health (ICS), which, according to the director, allows a certain degree of freedom to carry out projects like this one. Although it focuses on a small number of patients, as the center serves an area of 20,000 people, he argues that they should have the tools and facilities to be treated like other patients. "It's a matter of sensitivity," he concludes.