Banca de DEFESA: NATHALY SILVA DE SANTANA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : NATHALY SILVA DE SANTANA
DATE: 14/10/2020
TIME: 15:00
LOCAL: Videoconferência
TITLE:
KEY WORDS:
PAGES: 167
BIG AREA: Engenharias
AREA: Engenharia de Produção
SUMMARY:

Urgent care using mobile units is significant and of great importance worldwide, especially in large cities. These pre-hospital care are crucial to stabilize the victim's health and save lives in a very short period of time. More and more communication is crucial in collective work activities, especially when it comes to people who work as a team and in urgent and / or highly complex activities, as is the case with the Mobile Emergency Service - SAMU. The work in the emergency department is configured as a collective work process in which a multiprofessional team is responsible for articulating the different actions that involve the care of patients in urgent situations. Thus, the promotion of teamwork is one of the main skills expected by the professionals who make up the service teams in the management of patient care in urgent situations, aiming at the quality of the service provided. The present work aims to analyze how communications between members of SAMU emergency teams, and between them and other operators, interfere in the cooperation actions between them and in their coordination and impact on the efficiency of this service provided to the population of city of Natal-RN, Brazil. For that, the participative and situated method of Ergonomic Analysis of Work-AET was adopted, which was characterized by the application of observational and interactional techniques in the collection of field data. This sought to identify factors that influence the communication, cooperation, coordination and activities of SAMU teams and to propose indications of improvement in work situations, in order to favor the improvement of the quality of communication, cooperation and the coordination of actions , aiming at service efficiency and, consequently, patient safety. The main problems observed, related to the work of the SAMU teams, which interfere with the work of the mobile service team, were the following: a) failures in radio transmissions between the regulation center and the assistance teams (mobile service); b) the occurrence of long waits in the telephone contacts made by the Medical Regulation Assistant Assistants - TARMs with the health units of the patient's final destination; c) delay of the patient's final destination unit to receive the SAMU mobile care team and, consequently, to receive the patient, increasing the time to start the continuity of the patient's hospital care; d) failures in closed loop communication practices, as prescribed in protocols PE-3 and PE-4. In the activities of the teams, some aspects that positively contribute to the efficiency of the activity were also identified, such as: a) the existence of cooperation between the members of the mobile service team, between the members of the Regulation Central team and between the teams ; b) the daily coexistence between the members of the same escalated mobile service team, increasing the experience, the efficiency of communication and cooperation and the synergy developed by the mobile service team over time; c) communication as a fundamental factor for the coordination of the mobile service teams, through the radios and telephones of the Regulation Center. The main measures recommended to improve communication between teams and, therefore, the coordination of actions, cooperation between them and patient safety, are as follows: a) offer team communication training for members of the mobile care team, between them and the members of the Central Regulation team, between the members of the Central Regulation team and the health units of destination of the patients, highlighting their importance for the efficiency of the service and the safety of the patient; and b) encourage the use of closed loop communication practice, as it reduces the risk of failure to understand the statements and actions; c) to establish fixed mobile care teams as a strategy to improve cooperation and synergy between team members and health care, but, periodically, make changes in the formation of teams so that these new formations also acquire the ability to cooperate and the minimum necessary synergy; d) expand the distribution of radio antennas in the city, to improve the signal and reduce failures in transmissions; e) hold quarterly meetings with the teams of the Regulation and Mobile Service Center, in which they learn about the service's response time and seek to know the causal factors that lead to this indicator, so that strategies can be established to minimize rational of this time. The main limitation of this work lies in the fact that the field data collection was not carried out directly, because it was not authorized by the SAMU-Natal Board of Directors to carry out the monitoring of SAMU ambulance teams during mobile calls. Another limitation concerns the existence of few scientific publications on the mobile Pre-Hospital Care Service (APH) that directly address the themes of team communication and cooperation. Thus, it is suggested to carry out further research aimed at this theme, considering mobile services in different cities and / or states to make a comparative assessment of team building, communication and cooperation between its members with the impacts on service quality.

 

BANKING MEMBERS:
Presidente - 1217772 - RICARDO JOSE MATOS DE CARVALHO
Interno - 2329932 - JULIO FRANCISCO DANTAS DE REZENDE
Externa à Instituição - MARIA CHRISTINE WERBA SALDANHA - UFPB
Externo à Instituição - PAULO VICTOR RODRIGUES DE CARVALHO - MCTI