masterThesis
Impacto de um ciclo de melhoria na redução da suspensão cirúrgica em um hospital público
Fecha
2021-03-09Registro en:
VENÂNCIO, Lady Rosany Silva Almeida. Impacto de um ciclo de melhoria na redução da suspensão cirúrgica em um hospital público. 2021. 56f. Dissertação (Mestrado Profissional em Gestão da Qualidade em Serviços de Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2021.
Autor
Venâncio, Lady Rosany Silva Almeida
Resumen
Introduction: The admission to the surgical procedure, with shorter waiting time, is
crucial to guarantee the patient's quality of life and return to his socioeconomic
activities. Objective: To carry out an improvement cycle to reduce the rate of surgery
suspension in the operating room of a public hospital in Ceará. Methodology:
Quantitative quasi-experimental study, before and after, carried out in the 2019/2020
biennium, based on the Saturn improvement cycle and following the SQUIRE
guidelines. For the evaluation, four quality criteria related to the causes of surgical
suspension and fifteen sub-criteria related to criteria 1 and 2 were defined, to better
direct the evaluation and analysis of quality problems. The interventions were
planned and implemented in a participatory, multifaceted and data-based manner,
with the aim of reducing the causes of surgical suspension related to the quality
criteria. After the interventions, the criteria were reassessed to measure the results
and distributed on a Pareto chart. The behavior of the surgical suspension rate
indicator and the calculation of absolute and relative improvement after the
intervention were also analyzed. Statistical significance was tested using the onesided z-value test. Results: The results showed that, in the first evaluation, 88.2% of
the scheduled procedures were performed and in the reassessment, after
interventions, 93.3% of the scheduled procedures took place, demonstrating an
absolute improvement of 5.1% and a relative improvement of 43.2% in the
suspension of surgeries. Criteria 2 (comply with the surgical schedule) and 4
(absence of refusal to perform the procedure) showed an improvement in quality,
with compliance increasing from 92.5% to 97.3% and from 99.7% to 100%
respectively. The rate of surgical suspension decreased from 13% to 8% and then to
3%, following the rules of the Run chart, and has maintained this value ever since.
Conclusions: The improvement cycle carried out in this study represents a valuable
tool to intensify quality management, as it contributed to a significant reduction in
surgical cancellations. Based on the results achieved, the institution can disseminate
important contributions to other hospitals in the public health network, by
demonstrating that management measures bring gains to the population, which
benefits from the increase in the offer of services and to the institution, which makes
their most efficient processes.