Policy responses for Montenegro - HSRM

Montenegro


Policy responses for Montenegro

2.2 Workforce

Initial availability
The initial number of doctors in the country was 2130, with 3323 nurses working in the public sector. No shortages were recorded in any departments. In the event of a large number of patients being admitted to a certain regional hospital, the Strategic Operative Plan (number 00-2/1; of 26 March 2020) envisages to mobilize specialists from other hospitals to come and help the colleagues in the affected regions (specialists in infectious diseases and internal medicine, as well as anaesthesiologists, and the appropriate nurses and technicians).

Designation of roles and tasks
In every institution, personal roles and tasks of every healthcare worker were clearly designated during the preparation for the COVID-19 epidemic. The hierarchy in the workplace is strictly adhered to, in order to avoid confusion and mistakes. There is also a clear hierarchy in the entire health system, with the Healthcare Crisis Response Team appointed by the Government of Montenegro being the coordinating body regarding institutional work, patient treatment, distribution of PPE and medical equipment, medicine-related public statements etc.

The healthcare workers in the country are considered a single unit, with possible interchanges between institutions. There were several examples for this kind of support. From the end of March to the beginning of April, for instance, 82 medical workers from the General Hospital Bar were ordered into self-isolation because of a contact with a suspected COVID-19 patient. During that period, colleagues from the Clinical Center of Montenegro successfully covered their work. Another example is that emergency healthcare workers in Andrijevica were ordered into self-isolation (because of the same issue), with colleagues from the neighbouring town of Berane covering for their colleagues.

Training
With support from WHO, doctors and nurses from the Clinical Center of Montenegro provided educational video materials for all healthcare workers in the country regarding donning and doffing PPE, treating COVID-19 patients, information on health system organization, handling deceased COVID-19 patients etc. The training materials are available online through the official website of the Clinical Center of Montenegro: http://www.kccg.me/vodic-za-pacijente/ 

Furthermore, the Healthcare Crisis Response Team mediated the WHO-organized online briefing on the clinical management of COVID-19 on March 27th, 2020. Also, every new piece of scientific information or experience which is received by any institution is promptly shared with others. Furthermore, the Institute of Public Health organized donning and doffing courses in healthcare institutions.

Redeployment
The extent of the COVID-19 epidemic in Montenegro did so far not require any redeployment of doctors from other specialties. A certain number of unemployed nurses was employed on a basis of a contract for services during the epidemic.

Interns
In order to facilitate the administrative process of interns becoming licensed doctors of medicine, the Ministry of Health organized online professional exams for medical interns across the country.

Financial incentives
The Government of Montenegro (through special decrees: number 07-2262 adopted on April 2nd 2020 and 07-2538 adopted on April 30th 2020) supported healthcare workers with a 15% pay rise in March and April.

Medical students
Medical students volunteer in the call center organized and led by the Institute of Public Health. The call center is designated to inform all people on the availability of testing (for all those who suspect that they had contact with an infected person, or those who have COVID-19-related symptoms), as well as provide general information and information on rules of behaviour during the epidemic.

Guidelines
In order to reduce the risk of healthcare professionals getting infected, there were many orders for all healthcare workers in the country regarding PPE use and restricting unnecessary gatherings and contacts in the workplace (as well as outside of it). One important order that was given to all institutions was to reduce the number of unnecessary workers in all departments (a team would work for a week and then rest afterwards, while the other team would replace them at work, etc.). Also, in order to reduce the risk of infecting their families, all healthcare workers who worked with COVID-19 patients stayed in private hotels (who donated their services to the country) throughout the entire epidemic.

Private sector
The public sector was supported by several private healthcare institutions in terms of healthcare workers, equipment and capacities.