Acerto Project: Impact on Assistance of a Public Emergency Hospital

Abstract

Background: In Brazil, the goal-based approach was named Project ACERTO and has obtained good results when applied in elective surgeries with shorter hospitalization time, earlier return to activities without increased morbidity and mortality. Aim: To analyze the impact of ACERTO on emergency surgery care. Methods: An intervention study was performed at a trauma hospital. Were compared 452 patients undergoing emergency surgery and followed up by the general surgery service from October to December 2018 (pre-ACERTO, n=243) and from March to June 2019 (post-ACERTO, n=209). Dietary reintroduction, volume of infused postoperative venous hydration, duration of use of catheters, probes and drains, postoperative analgesia, prevention of postoperative vomiting, early mobilization and physiotherapy were evaluated. Results: After the ACERTO implantation there was earlier reintroduction of the diet, the earlier optimal caloric intake, earlier venous hydration withdrawal, higher postoperative analgesia prescription, postoperative vomiting prophylaxis and higher physiotherapy and mobilization prescription were achieved early in all (p<0.01); in the multivariate analysis there was no change in the complication rates observed before and after ACERTO (10.7% vs. 7.7% (p=0.268) and there was a decrease in the length of hospitalization after ACERTO (8,5 vs. 6,1 dias (p=0.008). Conclusion: The implementation of the ACERTO project decreased the length of hospital stay, improved medical care provided without increasing the rates of complications evaluated.

Multiprofessional Electronic Protocol for Digestive Surgery Validation

“…Information and communication technologies have made it possible to change the characteristics of the practice of Medicine and related areas, as they allow the large volume of information that is generated continuously to be made available 6 , 8 . Ferreira (1996) 9 points out that “Systems must be modeled according to users, with the nature of their information needs and with their behavioral patterns in the search and use of information”.…”

“…In addition to the protocols already created and which are stored in SINPE © , any others can be created at the wish of the attending physician and who wishes to do individual research. (1996) 9 points out that "Systems must be modeled according to users, with the nature of their information needs and with their behavioral patterns in the search and use of information". Health informatics, in addition to data storage, also includes the production of studies with large series of patients containing reliable information; consequently, the production of meta-analyzes and guidelines has produced good results.…”