Aplicação do ciclo de melhoria para redução do tempo de atendimento em um serviço de emergência

Abstract

Introduction: The quality of products and services is related to the value perceived by the customer and not solely by the execution of its function and performance. In this sense, there is a need to understand the causes of problems that lead to dissatisfaction and reduce the added value of the service for the user. Therefore, the justification for this work is based on the need for a hospital institution with 24-hour emergency service to improve the degree of satisfaction of the patients they attend to by delivering a conclusive, safe, and value-added service to the customer in emergency care. Objective: To implement improvement cycles to reduce the waiting time in the emergency service of a private hospital. Methodology: This is a quantitative quality improvement study and a quasi-experimental time-series design. The research was conducted between January 2022 and July 2023. The study compared the levels of patient loyalty before and after a series of implemented improvement interventions in the institution. It followed the Standards for Quality Improvement Reporting Excellence 2.0 guidelines. In order to evaluate the improvement proposal, three quality assessment criteria were applied: two assessed the efficiency dimension, and one assessed the customer experience (loyalty) in the emergency service. The ethical requirements of resolution nº466/2012 were respected. Furthermore, all interventions were organized, planned, and executed by an improvement team defined for the study. Results: After the interventions, there was an average increase of 13% in customer loyalty, suggesting that the improvements had a positive impact on patient satisfaction. Additionally, there was a correlation between compliance with medical attendance times within 240 minutes and patient loyalty. The high demand period, especially due to arbovirus cases, temporarily affected the ability to maintain compliance. The study also highlighted the importance of timely recording of clinical discharge in the system and the involvement of the medical team to ensure the efficiency of care. The implementation of interventions showed consistent and positive results over time, although seasonal challenges could impact compliance with attendance times in certain periods.