Palavras-chave
Indicadores de Qualidade da Atenção à Saúde
Qualidade da Atenção à Saúde
Qualidade
Acesso e Avaliação da Atenção à Saúde
Revisão Sistemática
Como Citar
Resumo
Introdução. A gestão e as políticas de saúde devem privilegiar a eficiência e os resultados em saúde, actualizando constantemente as práticas e os procedimentos de intervenção e avaliação em saúde.
Objetivo. Conceber uma proposta teórico-metodológica para sistematizar os resultados da utilização das metodologias Lean na saúde e aplicar o modelo no sector da saúde ocidental.
Metodologia. Foi concebido um instrumento teórico-metodológico que combina os sistemas de indicadores do modelo de Donobedian, do Sistema Nacional de Saúde e do modelo de Value-Based Healthcare. O mapa analítico-concetual criado foi aplicado à revisão sistemática de estudos empíricos quantitativos e mistos publicados nos últimos cinco anos sobre o impacto do Lean na saúde.
Resultados. Os 33 estudos analisados, maioritariamente de conceção quantitativa pré-pós, descreveram e avaliaram o impacto de várias intervenções Lean (fluxo de valor, ciclo PDSA/PDCA, Lean Six Sigma e evento Kaizen), com o objetivo de melhorar a eficiência e a qualidade dos cuidados. A maior parte dos estudos concentrou-se em contextos hospitalares (blocos operatórios, cuidados intensivos e farmácia) e em medidas centradas no eixo organizacional (prestação de serviços e acessibilidade, gestão do tempo e organização do trabalho, redução de custos, eficiência e segurança), com menos atenção aos aspectos centrados no valor para o doente (resultados em termos de saúde, satisfação e efeitos a longo prazo).
Conclusões. A análise estruturada com base no mapeamento analítico-concetual permitiu dimensionar os resultados Lean em saúde, identificando as áreas da gestão e da qualidade com maior aplicação e impacto Lean, e apontando a necessidade de mais investigação no eixo do valor para o doente.
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