Aplicação de conceitos de lean para aperfeiçoar o fluxo dos pacientes internados e externos no setor de tomografia computadorizada em um hospital universitário

Abstract

The study, considering the growing importance of computed tomography inside the university hospitals, was made with the intention to apply the Lean methodology to identify opportunities for optimize the flow of inpatients and outpatients. It researched the possibility to improve the tomography service by adopting the stractegies, concepts and techniques to analyse the flow of patients, broaden the understanding about processes, establish systemic view of the service and planning focused on the patient, in order to the quality and greater resolution. The main research methodology was the exploratory and descriptive case studies, where data collection took place through observation, interactions and document analyse, aiming to extract information. The extraction occurred in four phases in an orderly manner by Deming Cycle: Plan, Do, Check e Action method. After had built the value stream map to create the flow of the external patient, errors and points of retaining were identified, and they was faced as oportunities of improvement. So, changes in procedure were propose by the researcher, such as the creation of the service desk; reduction of absenteeism with the inclusion of one more patient per day; opening of the agenda on Saturdays and Sundays, delivery of the ICF at the time of scheduling, use the 4-channel CT scanner and organize the distribution of reports to physicians. For the hospitalized patient, there were several points that showed possibilities for improvements, such as scheduling via the system, reducing absenteeism with the inclusion of one more patient per day, starting the schedule with an external patient, calling patients from the emergency room because they arrive faster, distributing the nursing team in two to use the 4-channel machine more and relocating more doctors to the report. Considering the time scheduling, waiting, getting around, examing, in projection, the proposed changes can bring a time saving from the current flow and eliminate of waste, highlighting the reduce the waiting time. The results of this study leads us to conclude that Lean methodology, created at the automotive industry, is applicable to the hospital administration, arena where it is able to promote gains in the efficiency of the processes, include in the tomography sector, and may contribute to reduce the waiting for treatment.