DOCUMENT MANAGEMENT IN A UNIVERSITY HOSPITAL: A CYCLE OF IMPROVEMENT
Quality Improvement; Health Information Management; Patient safety; Communication.
Introduction: Document management is a set of actions that seeks to control all stages related to their life cycle. It
is noteworthy that these must be available and organized in order to raise the efficiency of the processes described
in them, thus making the implementation of document management in health institutions coherent, in order to
assist in the standardization of care and, therefore, strengthen effective communication in care institutions, in
order to promote safe and qualified care. Objective: Improve document management at the Ana Bezerra University
Hospital Methodology: a before-and-after quantitative study based on an improvement cycle, which involved the
evaluation of documents before the implementation of the Standard for the elaboration of documents, after the
implementation of the aforementioned norm and after the intervention, which consisted of the following actions:
construction of a flow for the elaboration and processing of documents in the hospital; development of software for
processing documents; training of those involved in each step that involves the flow, as well as in the use of the
software. The activities took place in the 1st quarter of 2022 and involved the multidisciplinary team of the
institution under study. The project was approved by the Ethics Committee of the Federal University of Rio
Grande do Norte under number 4.816244. To assess the quality, before and after the intervention proposal, the
point estimate and the confidence interval (CI= 95%) of the level of compliance with the adopted quality
criteria were calculated. The absolute and relative improvement of each criterion was estimated in order to
assess the effect of the intervention. To prove the statistical significance of the improvement detected, a
unilateral hypothesis test was performed through the calculation of the Z value, the absence of improvement
was considered null hypothesis, which was rejected when the p-value < 0.05. In addition, a graphic
representation of the main quality problems identified in the evaluations was prepared. Results: The
improvement can be observed from the implementation of Norm Zero, the 2nd evaluation, which showed
advances in most criteria, with excess of criterion 4. However, the great qualitative leap in the criteria was
established after the intervention stages, in this one evidenced improvement in all criteria, reaching 100%
compliance in Criteria 2 and 5, which in turn deals with the standardization of the body of the text. With this,
the improvement cycle proved to be efficient to improve the document management of the institution studied.