Performance hospitalar

Fonte: aqui.

Ordenados na saúde na Grã-Bretanha

A saúde está difícil, para os doentes, para os pagadores (Estado e Segurados), e até os profissionais de saúde se queixam.

Vejamos o panorama dos ordenados na saúde, na Grã-Bretanha, segundo vemos aqui:

• The U.K.'s National Health Service, the state-run system that provides medical care to residents of England and Wales, paid specialist doctors about 112,000 pounds ($228,000) this year, an increase of 16 percent since 2004.
• while qualified ambulance staff earned 32,100 pounds and qualified nurses earned 26,100 pounds, the Information Centre, an independent body that collects and analyzes health statistics.
• Consultants' salaries don't include all the private work that they undertake outside of the NHS.

A propósito desta notícia, o que diz a British Medical Association: ``It takes over 15 years of intensive training to become a consultant,'' . ``They are highly skilled and their salaries reflect the intensity and responsibility of their work.''

Notas: 1 euro = 1,37 dolares; 1 euro = 0,67 libras britânicas.

Patient Flow: Reducing Delay in Healthcare Delivery

Editora: Springer Science+Business Media, LLC

The system of health care can be evaluated from four perspectives: macro, regional, center, and department. In each case, reduction of patient delay dependes on improving interfaces as patients are transferred from activity to activity or department to department. This chapter presents basic tools for resolving delays at interfaces, through mapping the processes by which patients are served, and by developing and implementing measures of system performance. These tools are demonstrated through a case study of the Los Angeles County/University of South California Hospital.

Key words: Process charts, performance measurement, healthcare systems.

Os problemas globais dos serviços de saúde

É habitual, nós falarmos mal dos serviços de saúde, em Portugal. E também é normal, nós exigirmos mais dos serviços de saúde, em Portugal. Não é que fiquemos satisfeitos com a miséria alheia, mas é sempre importante compararmos a nossa situação, para o bem e para o mal, com os outros, sobretudo com aqueles que nós percepcionamos como melhores.

O serviço nacional de saúde Britânico (NHS) é habitualmente considerado como bom, em termos internacionais. Contudo reparem nisto:

• Some NHS patients are waiting two years for treatment.
• Some patients needing orthopaedic surgery are waiting more than two years for treatment, according to new Government figures.

O governo Blair quer, no entanto, mais e melhor:

• By the end of 2008, the Government wants nobody to wait more than 18 weeks from referral to the start of treatment, whether they are an in-patient or an out-patient.

Mas, hoje, as estatísticas são estas:

• most specialities - including gynaecology, dermatology and cardiology - treat between 30 per cent and 50 per cent of in-patients within 18 weeks.
• However, that figure falls to below 20 per cent in trauma and orthopaedics, which includes hip replacements, broken bones and limb disorders. The average patient in that speciality waits an average of 39 weeks for treatment.
• A quarter (23 per cent) wait between 52 weeks and 104 weeks for treatment, while 3 per cent wait longer than 104 weeks.
• The overall figures released today showed that an average of 70 to 80 per cent of patients who do not require hospital admission are treated within 18 weeks.
• But when it comes to patients needing hospital admission, just 35 per cent are seen within the target.

O Ministro da Saúde Britânico remata de uma forma, no mínimo, fleumática: Doing more of the same is not the answer - we know that traditional tactics to reduce waiting times will not be enough this time.

ISQUA - London - 2006

Uma das melhores Conferencias Científicas do mundo, decorreu em Londres, entre 22 e 25 de Outubro de 2006, promovida pela International Society for Quality in Health Care - ISQUA.

A superior qualidade da referida Conferência, obrigou-nos a uma demorada escolha, sobre que caso mostrar aqui. Optámos por trazer um resumo de uma apresentação, sobre um tema crucial para nós em Portugal: os indicadores de desempenho na saúde e a sua implementação.

The implementation of the indicator system ‘Navigator’ in general hospitals: Impact on quality
management
De Paepe L., Vleugels A., Quaethoven P.

Objective:
The purpose of the study was to explore the dynamics induced by the implementation of a recently developed indicator system - ‘Navigator’ - in 22 general hospitals and more particularly its effectiveness in terms of its impact on quality management and on the quality of care.

Results:
First, a conceptual framework for a useful clinical and organisational performance indicator system for health
care facilities was described, including the determination of its basic characteristics and its components.
These components are:

• Well-structured appropriate indicator sets for general hospitals, psychiatric hospitals and nursing homes, each containing a number of well-defined, rate-based indicators.
• A supporting software programme, enabling online data transfer (data entry & feedback information) on a quarterly basis.
• An interactive website for dissemination of information and mutual communication.
• An inter- and intra-facility network.

Conclusions:
Performance indicators are the prominent basis for monitoring quality of care. In order to make indicators a useful tool for health care facilities, they should be part of an integrated and dynamic performance system. “Navigator” is such a system. Its use by 59 Flemish health care facilities, only two year after its introduction, which may be seen as an indication of its usefulness as such. Qualitative research has led to conclusions in terms of “navigator” being an effective steering tool for quality management.