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Introduction: Currently the operation management system and continual reference filed against problems such as: inadequate coordination between different levels of care, ill-founded references contrarreferencias insufficient, deficient information and guidance for patients, lack of facilitators system mechanism at state, jurisdictional and operational level and inadequate and inappropriate monitoring of cases. The renewal of the current care system is necessary to gradually establish programs to facilitate the timeliness, quality and continuity of patient care; along with education for self-care for patients, training for primary care level through academic courses and seminars aimed at the detection and early diagnosis of major cardiac diseases and a preventive approach them. In addition, it is intended that the primary care physician to remain continuously trained to carry out effective and efficient monitoring of patients and thus improve the continuity care of them. General Objective: Set a document by which formalize and standardize the procedures for reference and counter of patients between medical units consolidating integrated care networks and training of clinical management units that allow us on the one hand, improve the resolving power of the two levels of care and on the other, ensuring that care is timely, comprehensive, integrated, continuous quality and warmth. Specific Objectives: Standardize operating mechanisms of our system of reference and counter reference. Promote coordination and communication between the administrative and operational levels of the units. Establish clinical management modules to enhance the resolving power units. Facilitate the transfer of critically ill patients or urgent care medical units between first level and second or third level of care to promote continuity of care. Optimize human and material resources available to avoid duplication and waste of resources consultations. Implementation: Engaging stakeholders in steering management and the coordination of expertise, reference and Emergency Regional Hospital and Clinic Lindavista, to form the "SIRECO committee" to evaluate the inter-level problems and identify root problems which derives the lack of resoluteness of our reference system and contrarreferecia. we have come to make significant agreements to enhance communication and conduct the start of integrated care programs among institutions mentioned. In session every fifteen days and shaping the activities in a minute according to a general plan covering the following strategies: Reorganization and coordination Training Prevention Results: The committee began its sessions two months ago, during which we have maintained communication and dialogue between management units, which did not exist. Initially creating a care path, as a pilot, of the cardiology resolution and to give continuity to patients requiring pacemakers and catheterization. We have made three placements pacemaker and three catheterizations without actually duplicating consultation as previously patients requiring request a consultation cardiology tertiary only to realize the authorization procedure, which generated conflicts medically indicated between specialists and saturation agendas and lag. From this change, we can reduce the saturacón agendas, reduce procedure time from four weeks to two weeks, ensuring continuity of care and strengthen longuitudinalidad of the primary care unit. And, to reorganize agendas, the development of a module cardiology image for echocardiograms realizatr dobutamine echocardiography transthoracic through internal management was implemented to avoid unnecessary spending on budget items of subrogacón services achieving reduced by one month to 60 % of spending. Conlusiones: Strengthening dialogue management and clinical management units created to encourage communication; you can start the foundations of our integrated health system and develop strategies that promote continuity and person centered care attention. We have found that the rigid administrative management of the institutions generates resistance to change, but that through the development of leadership makers decisions and bilateral strategic planning is possible to perform a change (albeit small) in current models of health. It is expected that in the long term, we manage to continue implementing new strategies and reaffirming care network and generate the appropriate measuring instruments. [ABSTRACT FROM AUTHOR]