Estruturação de um Sistema de Medição de Desempenho em centros cirúrgicos para apoiar iniciativas de >i<Lean Healthcare>/i<

Abstract

como o mapeamento do fluxo de valor e quadros de gestão visual). Assim, um framework para SMD pode ser estruturado, unindo aspectos teóricos e práticos da pesquisa, de modo a alinhar e promover a medição, melhoria e gestão das operações e estratégias de um centro cirúrgico.Além do framework, um roteiro de seis fases para sua implementação foi desenvolvido, de modo a apoiar futuras replicações do SMD. Espera-se que a presente pesquisa apoie novos estudos teóricos e práticos sobre a gestão de operações na área da saúde, em especial no centro cirúrgico, de forma a aprimorar as práticas atuais e promover benefícios para pesquisas futuras.Palavras-chave: Lean. Sistema de medição de desempenho. Indicador de desempenho. Centro Cirúrgico. Sala cirúrgica.The use of Lean can improve production in order to increase process efficiency and quality.Systems, such as hospitals, have been using an approach named Lean Healthcare to create more value to their services delivered to patients, to reduce process wastes and to increase quality of care. In this setting, improvement opportunities in surgical centers and operating rooms, which are responsible for a relevant volume of hospital procedures and a significant share of revenue and costs structure, can be identified. In this context, performance measurement, as well as performance indicators management, have been shown as a tough task, and studies highlighted its relevance in Lean healthcare initiatives, which could support process improvement and provide relevant decision making based on precise and reliable information. From this premise, this research proposes the structuring of a Performance Measurement System (PMS) to support Lean practices introduction in surgical centers. This PMS was supported by a conceptual model based on eight requirements coming from theoretical aspects, such as literature reviews about the relationship of surgical centers management with Lean and performance measurement practices. The conceptual model made it possible to exemplify the requirements through a case study in a surgical center of a Brazilian hospital. Based on this case, practical aspects were observed and used to ground the proposed PMS, such as the development of five performance indicators categories (surgical volume, surgical processes, financial sustainability, resource management and stakeholders) and Lean practices tests (such as value stream mapping and visual management boards). Then, a PMS framework was structured, joining theoretical and practical aspects of the research, in order to align and to promote measurement, improvement and management of a surgical center's operations and strategies. Besides the framework, a sixphase implementation guide was developed, in order to support future replications of this PMS.It is expected that this research supports theoretical and practical studies in healthcare operations management, in order to improve the current practices and promote benefits for future research.

Proposição de um >i<framework>/i< para criação de células de trabalho em compras hospitalares: estudo de caso único em um hospital público

“…A fim de apoiar a gestão em ambientes de serviço, as abordagens e práticas derivadas da filosofia Lean podem auxiliar na melhoria do desempenho, especificamente em ambiente de escritório, como no Departamento de Legislação e Normas de uma universidade (GONÇALVES et al, 2015), no escritório de um setor público (MONTEIRO et al, 2015), em setores de serviços de construtoras (COSTA et al, 2013;KEMMER et al, 2009), e em ambientes de saúde (SERAPHIM; SILVA; AGOSTINHO, 2010;ULHOA, 2019).…”