Construção De Programa De Segurança Do Paciente Em Hospital Público De Ensino: Pesquisa Documental

Abstract

Pesquisa documental sobre a trajetória de um hospital público de ensino na construção de Programa de Segurança do Paciente. Foram consultados 200 documentos do período de 2004 a 2012, em um hospital público federal do sul do Brasil, com dados coletados entre maio de 2012 a abril de 2013. A análise documental evidencia estratégias essenciais à implantação de um programa. Entre elas, diagnóstico situacional com utilização de ferramentas da qualidade; auditorias internas com instrumentos customizados; profissionais com dedicação exclusiva e expertise na área da qualidade; capacitações direcionadas à equipe multiprofissional; incentivo à construção coletiva, o apoio da direção e o envolvimento de lideranças. O programa foi vanguardista entre os hospitais públicos federais. Desenvolvido previamente à legislação brasileira que normatiza a matéria, cumpriu em grande parte com as demandas da Resolução de Diretoria Colegiada n° 36 de 25 de julho de 2013 do Ministério da Saúde.

Effect of the Administrative Transition of Hospital Management on the Safety Culture in Surgical Units

“…However, the managerial change also led to the hiring of new professionals and, regardless of their working time, underreporting can be related with the difficulty in understanding that an incident or event is indeed notifiable. 16 The participants assessed surgical patient safety as excellent/good, corroborating with professionals working in surgical departments of 19 Chinese hospitals (54.4%, n=425). 38 However, it is worth noting the several items of the safety culture signaled as negative by the professionals, showing the existence of safety problems.…”

“…In the overall analysis of the study results for the two management periods, it is supposed that the study hospital has a "calculated" maturity level regarding the safety culture, due to the existence of systematic measures to manage quality and patient safety, such as: patient safety program; active patient safety center; system for the notification and investigation of incidents whose data feed health indicators; protocols to prevent incidents, especially those proposed in the six international patient safety goals; internal audits; and decentralization of the safety actions by means of internal groups of quality assessment. 16 However, in large hospitals, such as the one assessed in this study, maturity levels can vary among the units, that is to say, one sector can be reactive or pathological while another can be more evolved, and the predominant safety culture can be that of proactivity, for example. 13 This partially explains differentiated practices across professionals and sectors, which can result in different clinical outcomes when considering the existing relationship between positive culture and patient safety scores.…”

“…In 2002, the directors of the hospital under study progressively adopted a care theoretical model that included the creation of administrative or health care units known as Management Units, 15 and have been developing several actions aimed at obtaining an accreditation certificate by the Brazilian Accreditation System -National Accreditation Organization since 2010. 16 The hospital has been experiencing a management transition since 2014, with changes in political orientation, culminating in the signing of an official contract with the EBSERH in that same year. Although the 4/17 current administration has not fully taken office, the transition to the proposed new organizational structure favored discontinuity in the actions aimed at quality and patient safety and required for hospital accreditation.…”

Conciliação de medicamentos em um hospital de ensino de Sergipe: lições aprendidas na implementação de um serviço

“…A etapa de exploração, caracterizada pelo diagnóstico situacional, pode ser considerada como alicerce de todo o processo, visto que é uma ferramenta que permite conhecer como é a organização dos serviços de saúde [16]. Rocha et al (2016) [29] destacaram que o diagnóstico situacional associado a ferramentas de qualidade foi essencial para a construção de um Programa de Segurança do Paciente em um hospital público de ensino. Caso esta etapa fosse negligenciada, e apenas as publicações na literatura fossem observadas [24,25], provavelmente outro setor do hospital teria sido priorizado na implementação.…”