Banca de DEFESA: JOSÉ FERREIRA LIMA

 QUALITY IMPROVEMENT IN THE SURGICAL CIRCUIT

Elective Surgical Procedures, Quality Improvement, Quality of Health Care.

Introduction: Surgical procedures may be responsible for improving the quality of life of thousands of Brazilians who need this intervention to solve their health problems. However, until it can be performed, a series of obstacles can hinder this walk on the way through a virtual queue, which involves different stages, many comings and goings to the health unit that will be responsible for carrying out the procedure, waiting, anguish, hope, annoyances and disagreements. Many of the problems are caused by the difficulty in establishing an assertive communication process in the surgical circuit, both between professionals and patients, as well as between the different areas they will attend. In the university hospital that is the target of the field of study, the medical record is in a hybrid format (electronic part and documental part), which makes the communication process difficult, as there is nothing to guide the flow of communication or standardize the information. There are professionals who register in the computerized system of the medical record and others fill in the information in request forms or even in “pieces of paper” so that the patient can hand it over to another team that will organize the next stage of care. Objective: Improve the processes that make up the Surgical Circuit of a university hospital. Methodology: This is a quantitative study, with a quasi-experimental design, before-after type and without a control group, to improve the quality of communication processes within the surgical circuit. Results: To face this problem, it became necessary to develop intervention strategies focused on quality management in healthcare, with before and after assessments to quantify the degree of improvement achieved, in addition to building a protocol, process flowchart and a risk matrix. the path taken by the patient to improve effective communication, especially in the hospital's outpatient department, where the pre-surgical stages take place. Two evaluations of four criteria were carried out, one being the registration of the National Health Card in the AGHU computerized system and the other three being the recording of information in the electronic medical record. It was observed that, in absolute numbers, there were 44 non-compliances in the first assessment, compared to 19 in the second assessment, accounting for a reduction of 25 “quality defects”. This represented an absolute improvement of 56.81% through the improvement cycle. Conclusion: The application of the process improvement cycle in the Surgical Circuit proved to be a useful and effective quality tool, highly recommended for health services of any type. The significant improvement achieved in most quality criteria led to the inclusion of good practices in recording information in the electronic medical record, minimizing existing risks that could delay the steps in the Circuit, avoiding further delays in resolving the patients' health problems.