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Análise do desempenho de um centro de reprocessamento de dispositivos médicos recorrendo à simulação
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Orientador(es)
Resumo(s)
Uma das atividades com maior impacto operacional nas unidades de saúde, i.e., nas clínicas e nos
hospitais, é o reprocessamento de dispositivos médicos que, muito sucintamente, são instrumentos
utilizados por profissionais de saúde para prevenir, diagnosticar ou tratar uma doença humana. Nos
últimos anos, as unidades de saúde têm optado, de uma forma crescente, pela subcontratação desta
atividade a centros de reprocessamento de dispositivos médicos (RUMEDs), pelos benefícios
económicos e de segurança associados. Os RUMEDs têm como missão (i) garantir a fiabilidade e
aptidão para uso de um dispositivo médico estéril e (ii) transportar tais dispositivos desde as unidades
de saúde até às suas instalações. Atualmente, os RUMEDs enfrentam desafios de eficiência
relacionados com a previsibilidade do que chega às suas instalações, sincronização dos processos de
reprocessamento e elevados tempos de espera.
O estudo de caso apresentado incide sobre um RUMED sediado em Lisboa e tem como objetivo avaliar
o seu desempenho atual no que diz respeito ao cumprimento do nível de serviço acordado com as
unidades de saúde suas clientes. Com base nesta avaliação, ainda era objetivo melhorar o
desempenho global do reprocessamento de dispositivos médios.
A simulação foi a ferramenta utilizada para avaliar o desempenho atual do RUMED e testar o impacto
das propostas de melhoria.
As propostas de melhoria desenvolvidas baseiam-se na filosofia Lean, assentes na eliminação de
desperdícios, como os tempos de espera, e foram agregadas em seis cenários de três tipos.
O Cenário do tipo A tem como base o nivelamento das chegadas dos dispositivos médicos ao RUMED
e os Cenários do tipo B e C têm como finalidade testar a resposta do RUMED ao aumento do número
de técnicos operacionais de esterilização nas zonas de descontaminação e de inspeção e
embalamento, respetivamente.
O cenário que, do ponto de vista operacional, mais beneficia o RUMED propõe (i) o nivelamento das
chegadas dos dispositivos médicos; (ii) a alocação de mais dois técnicos operacionais de esterilização
à zona de descontaminação para os turnos da manhã e noite face à situação atual e (iii) a alocação de
apenas sete técnicos operacionais de esterilização à zona de inspeção e embalamento nos 3 turnos.
Estima-se que ao adotar estas propostas, o RUMED cumpra o nível de serviço acordado com todas as
unidades de saúde. No final, é realizada uma análise crítica dos cenários à luz dos objetivos enunciados
e são propostas sugestões para utilizar em trabalhos futuros.
Over the last years, reprocessing procedures have loomed to be the achilles heel of healthcare providers and facilities. This has forged many healthcare facilities to seek reprocessing units for medical devices. Medical devices can very briefly be defined as instruments used by healthcare professionals to prevent, diagnosis and treat a medical condition. These are specialized centers that have in place appropriate policies and procedures that are consistent with current healthcare standards and guidelines. Their mission is to (i) guarantee reliability and aptitude of sterile medical devices and (ii) to secure a safe transportation to their corresponded healthcare unit. Currently, reprocessing units for medical devices challenges are related to predictability of what arrives at its centers, synchronization of reprocessing processes and long waiting times. The present study aimed to investigate a reprocessing unit for medical devices based in Lisbon, on its service-level agreement with costumer healthcare units. The work sought to determine if the agreement between the two parties, the reprocessing unit for medical devices and the healthcare unit, was fulfilled, to what extent and potential refinement strategies. Considering the previous evaluation, further research was conducted to improve the global performance of the reprocessing of medical devices. Simulation was the tool used to appraise reprocessing unit for medical devices’ actual execution and the impact that improvement proposals. The proposals were developed using a Lean-based methodology which is based on one guiding tenet, creating value to the customer by optimizing resources. This means reducing waste and adding customer defined value to products and services, such as the waiting time. The proposals were grouped into six scenarios of three types. The type A Scenario is established on levelling medical devices arrivals to the reprocessing unit for medical devices, while Scenarios from types B and C intend to test the reprocessing unit for medical devices’ response to an increase in the number of operational sterilization technicians in the decontamination, inspection and packaging zones, respectively. The scenario that proved to be the most beneficial to the reprocessing unit for medical devices proposes (i) levelling medical devices arrivals to the reprocessing unit for medical devices; (ii) the allocation of two more operational sterilization technicians to the decontamination zone, for the morning and night shifts and (iii) the allocation of only seven operational sterilization technicians to the inspection and packaging area during the 3 shifts. We anticipate that by adopting the proposals comprised, the reprocessing unit for medical devices is able to comply with the service level agreement agreed between all healthcare units. To conclude, a critical analysis of the scenarios was carried out emphasizing the work objectives and suggestions for future work were proposed.
Over the last years, reprocessing procedures have loomed to be the achilles heel of healthcare providers and facilities. This has forged many healthcare facilities to seek reprocessing units for medical devices. Medical devices can very briefly be defined as instruments used by healthcare professionals to prevent, diagnosis and treat a medical condition. These are specialized centers that have in place appropriate policies and procedures that are consistent with current healthcare standards and guidelines. Their mission is to (i) guarantee reliability and aptitude of sterile medical devices and (ii) to secure a safe transportation to their corresponded healthcare unit. Currently, reprocessing units for medical devices challenges are related to predictability of what arrives at its centers, synchronization of reprocessing processes and long waiting times. The present study aimed to investigate a reprocessing unit for medical devices based in Lisbon, on its service-level agreement with costumer healthcare units. The work sought to determine if the agreement between the two parties, the reprocessing unit for medical devices and the healthcare unit, was fulfilled, to what extent and potential refinement strategies. Considering the previous evaluation, further research was conducted to improve the global performance of the reprocessing of medical devices. Simulation was the tool used to appraise reprocessing unit for medical devices’ actual execution and the impact that improvement proposals. The proposals were developed using a Lean-based methodology which is based on one guiding tenet, creating value to the customer by optimizing resources. This means reducing waste and adding customer defined value to products and services, such as the waiting time. The proposals were grouped into six scenarios of three types. The type A Scenario is established on levelling medical devices arrivals to the reprocessing unit for medical devices, while Scenarios from types B and C intend to test the reprocessing unit for medical devices’ response to an increase in the number of operational sterilization technicians in the decontamination, inspection and packaging zones, respectively. The scenario that proved to be the most beneficial to the reprocessing unit for medical devices proposes (i) levelling medical devices arrivals to the reprocessing unit for medical devices; (ii) the allocation of two more operational sterilization technicians to the decontamination zone, for the morning and night shifts and (iii) the allocation of only seven operational sterilization technicians to the inspection and packaging area during the 3 shifts. We anticipate that by adopting the proposals comprised, the reprocessing unit for medical devices is able to comply with the service level agreement agreed between all healthcare units. To conclude, a critical analysis of the scenarios was carried out emphasizing the work objectives and suggestions for future work were proposed.
Descrição
Palavras-chave
Dispositivos médicos Centro de reprocessamento de dispositivos médicos Filosofia Lean simulação