Implantação do sistema acolhimento com Classificação e Avaliação de Risco e uso do Fluxograma Analisador

Abstract

DEPLOYMENT OF THE SYSTEM USER EMBRACEMENT WITH CLASSIFICATION AND RISK ASSESMENT AND THE USE FLOWCHAT ANALYZERABSTRACT: This study had as objective to describe the process of implementing the system User Embracement with Classification and Risk Assesment and the use of Flowchat Analyzer in Emergency Hospital Service of Santa Casa de Misericórdia de Ourinhos, state of São Paulo. The deployment of the system was subdivided into stages: professional awareness, readjustment of resources, implementation of planning and evaluation. For the organization of patient flow, Funcional Flowcharts were used which, after some adjustments, resulted in a Flowchat Analyzer. The resulting Flowchat Analyser provided a graphic display of the stages of care and directed all non-emergeny patients with injuries to the nursing consultation. It is concluded that the Flowchart Analyser was as essential tool in the process of implementation of the User Embracement with Classification and Risk Assesment because, in defining the steps of the flow to the service, the service became more organized, humane and safe. DESCRIPTORS:Nursing. User embracement. Emergency hospital service. Quality of helth care. Management. IMPLANTAÇÃO DEL SISTEMA ACOGIMIENTO CON CLASIFICACIÓN Y EVALUACIÓN DE RIESGOS Y USO DEL FLUJOGRAMA ANALIZADOR RESUMEN:Este estúdio tuvo como objetivo describir el proceso de implementación del sistema Acogimiento con Clasificación y Evaluación de Riesgos y uso del Flujograma Analizador y su uso en el Servicio de Urgencias del Hospital Santa Casa de Misericordia de Ourinhos, estado de São Paulo. El despliegue del sistema se divide en etapas: la sensibilización de los profesionales, el reajuste de los recursos, la ejecución de planificación y evaluación. Para la organización del flujo de pacientes, se utilizaron Flujogramas Funcionales que, con algunos ajustes, se tradujo en un Flujograma Analizador. El Flujograma Analizador resultante proporciona una representación gráfica de las etapas de lo atención dirigida a todos los pacientes que no ha lesiones de emergencia en la consulta de enfermería. Se concluye que el Flujograma Analizador es una herramienta esencial en el proceso de aplicación del Acogimiento con Clasificación y Evaluación de Riesgos, ya que, en la definición de los pasos del flujo con el servicio, el servicio se convirtió en más organizado, humano y seguro. DESCRIPTORES:Enfermería. Acogimiento. Servicio de urgencia en hospital. Calidad de la atención de salud. Gerencia.

<b>Qualidade do atendimento pré-hospitalar móvel de urgência na perspectiva dos profissionais/ Quality of emergency in mobile prehospital care in the perspective of professionals<b>

“…O acolhimento dispensado durante o atendimento, também avaliado majoritariamente como satisfatório e apropriado, corresponde ao entendimento de que acolher é uma ação técnico-assistencial, ou seja, processo de escuta qualificada direcionado à assistência, que implica mudanças na relação profissional-usuário, facilita a reorganização dos serviços e melhora a qualidade assistencial, tendo o paciente como eixo principal e participante ativo (18) . Igualmente, o respeito e a privacidade durante o atendimento foram avaliados como satisfatórios, indicando que tal cuidado é adequado.…”

Assessment of user embracement with risk rating in emergency hospital services

“…Improvement in the referral and counter-referral systems between hospitals and primary care services is urgent. However, this process is still under adaptation and improvement, for it is a relatively recent strategy, created in 1990 by the Brazilian Ministry of Health (MS), as an operational guideline of the National Policy for Humanization(PNH) (15)(16) . An example of the above considerations, a study conducted in Rio Grande do Sul, in 2005, with the purpose of learning about the labor conditions of professionals who perform their duties emergency care, reported that the EHS investigated was an entry point for patients because, despite the advances in the reorganization of the health care model, the primary health care network was not able to meet the needs of the population (16) .…”

“…An example of the above considerations, a study conducted in Rio Grande do Sul, in 2005, with the purpose of learning about the labor conditions of professionals who perform their duties emergency care, reported that the EHS investigated was an entry point for patients because, despite the advances in the reorganization of the health care model, the primary health care network was not able to meet the needs of the population (16) . It is worth stressing that indiscriminate access of patients to the EHS signifi cantly increases demand and, thus, the physical structure cannot provide appropriate care to users and their companions (15)(16)(17) . This was also observed in the present study, with the item "Physical space provides comfort to patients' companions" obtaining the second worst result (Chart 1, item 05).…”

“…The physical structure of the EHS should provide adequate conditions for patients and their companions, for this is one of the essential requirements proposed by the PNH (15)(16)(17) . Thus, the result "Precarious" observed in this study involves the need to confer dignity to the physical space.…”

User Embracement With Risk Classification: Perceptions of the Service Users of an Emergency Care Unit

“…8 In relation to the benefits aimed for by the ACCR, although scarce, the literature indicates difficulties for its effective implementation and operationalization, due to the high number of service users who seek urgent/emergency attendance but who present clinical situations which could be resolved in primary care, the need for contracting more nursing professionals to work at peak hours, and the need for investment for adjustment of the environment. 9 In addition to this, from the service users' perspective, there is a need to establish permanent pacts between the services and the community. 10 As this is a contemporary, socially constructed process, the need is evidenced for studies on the ACCR in the services which have implanted this system in their care routine, because the results of studies could provide a basis for the (re-)planning of the system so as to promote the humanization and quality of the care.…”