Dr Cecilia Rodríguez Castillejos: Inspired to implement multidisciplinary care

In 2016, Dr Cecilia Rodríguez Castillejos from the State of Mexico’s Maternal-Infant ISSEMyM hospital was clear that a multidisciplinary team would bring multiple benefits to people with haemophilia.

Firstly, Dr Rodriguez Castillejos wanted haemophilia care to be holistic. This meant looking at what care would benefit the whole family as well as the individual, and at which other specialities could contribute to the person’s health and well-being. She wanted to improve the confidence of healthcare professionals who were sometimes uncertain on how to effectively provide care for people with haemophilia. Most importantly her objective was to ensure that people with haemophilia, who were sometimes travelling for up to four hours to reach the hospital, were gaining the maximum benefit from each visit and avoiding multiple trips wherever possible.

To find the best way to achieve these outcomes, Dr Rodríguez sought inspiration from elsewhere in Mexico and further afield. “I had the chance to visit the UT Physicians Gulf States Hemophilia and Thrombophilia Center in Houston, with Dr Escobar, and I learned that patients stayed in one place but the physicians rotated instead. In Tabasco, it is designed so that all doctors converge around a patient. In Monterrey there’s a designated clinic day, and on that day, all specialists see patients with haemophilia. I just went looking for the arrangement that would fit us best. Kind of like searching for a dress!” she recalls.

Through the Mexico 5 project activities which started in 2018, Dr Rodríguez is implementing a single consultation model, where multiple trained specialists consult with the person with haemophilia and family members in one single visit, based on this search. She has continued to utilise expertise from outside of the state. For example, Lic Marion Echenagucia from Venezuela trained lab technicians in Mexico, a physiotherapist, social workers and nurses were trained at the University Hospital in Monterrey and most recently, Dr Rodríguez and an orthopaedist received training at UNICAMP in Campinas, Brazil.

The single consultation model is proving beneficial for all concerned. “We have optimised time for ourselves, time for patients and in general, time for the institution,” explains Dr Rodríguez. As for people with haemophilia and their parents: “They have liked it a lot. The moment we introduced the idea, it was received with immediate acceptance. For them it meant less travel time, they knew that in a single appointment they’d be able to integrate several visits into one. When their treatment is taken to multidisciplinary meetings, patients can hear stories from other people in their same condition. They can meet adults who have become professionals and have their condition. This helps them create a goal.”