A carregar...
Publicação
Estratégias de otimização para diminuição das taxas de cancelamento operatório nas últimas 24h
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 3.39 MB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
RESUMO - Introdução: Os cancelamentos operatórios no próprio dia podem constituir uma quebra importante no ciclo da eficiência hospitalar. Podem acarretar várias consequências negativas tanto para o utente, como para a instituição hospitalar e sociedade. Identificar as causas e reunir estratégias que possam contribuir para a diminuição da taxa de cancelamento operatório é fundamental para a otimização dos recursos existentes, redução dos custos, melhoria dos indicadores de qualidade e aumento da satisfação dos utentes e profissionais de saúde.
Objetivo: Este estudo tem como objetivo geral, identificados os 5 principais motivos de cancelamento de cirurgias eletivas nas últimas 24h, de um Hospital Público da Área Metropolitana de Lisboa, gerar recomendações e reunir o consenso de peritos, na área de Bloco Operatório, relativamente a estratégias para mitigar o cancelamento de tempos operatórios.
Metodologia: Estudo qualitativo, segundo Técnica Delphi, para a reunião de estratégias de ação que ajudem na mitigação da taxa de cancelamento operatório, através do consenso de peritos na área de bloco operatório, relativamente aos 5 principais motivos de cancelamento decorridos no período de 1 de janeiro de 2019 a 31 de dezembro de 2019 de um hospital público português. O nível de consenso estabelecido foi de 75% ao final de 3 rondas.
Resultados: Através de um Painel Delphi de 17 peritos foi alcançado o consenso positivo em 116 propostas de estratégias referente aos 5 principais motivos de cancelamento do ano de 2019: “Atraso nas cirurgias anteriores”; “Alteração do estado clínico do utente”,” Indisponibilidade da equipa”, (O doente) “Faltou à cirurgia” e “Recusa do utente com motivo plausível”.
Discussão / Conclusões: Os principais motivos de cancelamento identificados na instituição em estudo são corroborados pela evidência científica. As propostas de estratégias identificadas pelos peritos transversalmente passam pela melhoria do processo pré-operatório; melhoria dos canais de comunicação entre equipa multidisciplinar e entre utente/hospital; participação ativa do utente e como parte integrante da equipa e melhoria do processo de agendamento/planeamento em equipa multidisciplinar.
ABSTRACT - Introduction: Same-day surgery cancellations can be a major break in the hospital efficiency cycle. They can have several negative consequences for the patient, the hospital and society. Identifying the causes and putting together strategies that can contribute to reducing the rate of surgical cancellations is essential for optimizing existing resources, reducing costs, improving quality indicators and increasing the satisfaction of users and health professionals. Objectives: This study aims to identify the 5 main reasons for canceling elective surgeries in the last 24 hours of a Public Hospital in the Lisbon Metropolitan Area, to generate recommendations and to gather the consensus of experts in the Operating Room area regarding strategies to mitigate the cancellation of operative times. Methodology: Qualitative study, using the Delphi Technique, to gather action strategies to help mitigate the operative cancellation rate, through the consensus of experts in the operating room area, regarding the 5 main reasons for cancellation that occurred in the period from January 1, 2019 to December 31, 2019 of a Portuguese public hospital. The consensus level established was 75% at the end of 3 rounds. Results: Through a Delphi Panel of 17 experts, a positive consensus was reached in 116 strategy proposals regarding the 5 main reasons for cancellation in 2019: "Delay in previous surgeries"; "Change in the patient's clinical condition", "Unavailability of the team", (The patient) "Missed the surgery" and "Refusal of the patient with plausible reason". Discussion / Conclusions: The main reasons for cancellation identified in the institution under study are corroborated by scientific evidence. The proposed strategies identified by the experts include improving the preoperative process; improving communication channels between the multidisciplinary team and between the patient and the hospital; active participation of the patient as an integral part of the team and improving the scheduling/planning process in the multidisciplinary team.
ABSTRACT - Introduction: Same-day surgery cancellations can be a major break in the hospital efficiency cycle. They can have several negative consequences for the patient, the hospital and society. Identifying the causes and putting together strategies that can contribute to reducing the rate of surgical cancellations is essential for optimizing existing resources, reducing costs, improving quality indicators and increasing the satisfaction of users and health professionals. Objectives: This study aims to identify the 5 main reasons for canceling elective surgeries in the last 24 hours of a Public Hospital in the Lisbon Metropolitan Area, to generate recommendations and to gather the consensus of experts in the Operating Room area regarding strategies to mitigate the cancellation of operative times. Methodology: Qualitative study, using the Delphi Technique, to gather action strategies to help mitigate the operative cancellation rate, through the consensus of experts in the operating room area, regarding the 5 main reasons for cancellation that occurred in the period from January 1, 2019 to December 31, 2019 of a Portuguese public hospital. The consensus level established was 75% at the end of 3 rounds. Results: Through a Delphi Panel of 17 experts, a positive consensus was reached in 116 strategy proposals regarding the 5 main reasons for cancellation in 2019: "Delay in previous surgeries"; "Change in the patient's clinical condition", "Unavailability of the team", (The patient) "Missed the surgery" and "Refusal of the patient with plausible reason". Discussion / Conclusions: The main reasons for cancellation identified in the institution under study are corroborated by scientific evidence. The proposed strategies identified by the experts include improving the preoperative process; improving communication channels between the multidisciplinary team and between the patient and the hospital; active participation of the patient as an integral part of the team and improving the scheduling/planning process in the multidisciplinary team.
Descrição
Palavras-chave
bloco operatório cancelamento cirúrgico procedimentos cirúrgicos eletivos/organização e administração eficiência estratégias operating room surgical cancellation elective surgical procedures/organization and administration efficiency strategies