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Advisor(s)
Abstract(s)
A implementação, monitorização e melhoria da qualidade são encaradas pelas unidades de saúde, tal como por qualquer outra organização, como uma prioridade. É através desta ferramenta que as instituições de saúde procuram garantir que estão a prestar de forma eficaz e, sobretudo eficiente, os cuidados de saúde aos utentes, indo ao encontro das suas reais necessidade e expectativas.
À luz da Estratégia Nacional para a Qualidade em Saúde (ENQS), já não basta às instituições de saúde demonstrar que se preocupam em implementar, monitorizar e melhorar a qualidade dos cuidados prestados, tornando-se necessário que seja possível quantificar o nível de qualidade atingido, por comparação com um padrão – acreditação. Existe já, no nosso pais, um Modelo Nacional para a Acreditação de Unidades de Saúde, que tem vindo a ser gradualmente implementado. No entanto, este modelo não é facilmente nem diretamente aplicável aos Agrupamentos de Centros de Saúde (ACeS), organizações que dirigem os cuidados de saúde primários, uma vez que estes são constituídos não só por unidades de gestão clínica, mas também por unidades de gestão não clínica, de cariz administrativo. Torna-se então necessário desenhar um modelo de acreditação integrada que inclua requisitos relativos à governação clínica e à governação organizacional, que promova a coesão das várias unidades funcionais do ACeS e que conduza a uma maior eficiência e qualidade do serviço prestado ao utente.
O objetivo deste estudo foi aplicar ferramentas e práticas de gestão da qualidade na definição de um modelo de acreditação integrada para ACeS. Seguindo as orientações da ENQS, o modelo proposto é uma adaptação do modelo da Agencia para la Calidad Sanitaria de Andaluzia (ACSA).
Espera-se que o modelo de acreditação integrada proposto neste estudo possa promover a coesão entre as várias unidades dos ACeS, encorajando a aplicação de práticas de gestão integrada da qualidade e de estratégias de melhoria contínua, conduzindo os ACeS, os Cuidados de Saúde Primários e o SNS de uma forma global, pelo caminho da sustentabilidade.
The implementation, control and quality improvement are seen by healthcare units, as a priority. It is through these tools that health institutions seek to ensure that they are providing effective and, above all, efficient, healthcare service to their users, aiming to fulfill their real needs and expectations, concerning healthcare. Under the National Strategy for Quality in Healthcare, it is no longer enough to show that healthcare institutions are implementing, controlling and improving the quality of care, making it now necessary to measure the quality level attained, by comparison with a standard - accreditation. Portugal already has a National Accreditation Model for HealthCare Units, which has been gradually implemented. However, this model is not easily nor directly applicable to Local Health Clusters, organizations that provide primary health care, as these have not only clinical management units, but also non-clinical management and administrative units. Then, the aim of this work, supported by the case study of the Western Oporto Local Trust, to draw a comprehensive accreditation model, including requirements relating to clinical governance and organizational governance, promoting the cohesion of the various functional units of the LHC and leading to greater efficiency and quality of the service provided to users. The aim of this research was to apply quality management tools and practices in the design of an integrated accreditation model for Local Health Trusts, in order to contribute to the sustainability of the Portuguese Primary HealthCare Service. Following the guidelines of the Portuguese Health Quality Strategy, the proposed model is an adaptation of the model from Agencia para la Calidad Sanitaria de Andaluzia (ACSA). The integrated accreditation model proposed in this research is expected to promote the cohesion of Local Health Trust units, encouraging integrated quality management practices and continuous improvement strategies, leading Local Health Trusts, Primary Care and HealthCare in a global perspective towards sustainability.
The implementation, control and quality improvement are seen by healthcare units, as a priority. It is through these tools that health institutions seek to ensure that they are providing effective and, above all, efficient, healthcare service to their users, aiming to fulfill their real needs and expectations, concerning healthcare. Under the National Strategy for Quality in Healthcare, it is no longer enough to show that healthcare institutions are implementing, controlling and improving the quality of care, making it now necessary to measure the quality level attained, by comparison with a standard - accreditation. Portugal already has a National Accreditation Model for HealthCare Units, which has been gradually implemented. However, this model is not easily nor directly applicable to Local Health Clusters, organizations that provide primary health care, as these have not only clinical management units, but also non-clinical management and administrative units. Then, the aim of this work, supported by the case study of the Western Oporto Local Trust, to draw a comprehensive accreditation model, including requirements relating to clinical governance and organizational governance, promoting the cohesion of the various functional units of the LHC and leading to greater efficiency and quality of the service provided to users. The aim of this research was to apply quality management tools and practices in the design of an integrated accreditation model for Local Health Trusts, in order to contribute to the sustainability of the Portuguese Primary HealthCare Service. Following the guidelines of the Portuguese Health Quality Strategy, the proposed model is an adaptation of the model from Agencia para la Calidad Sanitaria de Andaluzia (ACSA). The integrated accreditation model proposed in this research is expected to promote the cohesion of Local Health Trust units, encouraging integrated quality management practices and continuous improvement strategies, leading Local Health Trusts, Primary Care and HealthCare in a global perspective towards sustainability.
Description
Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para a obtenção do grau de Mestre em Gestão da Qualidade
Keywords
Acreditação Cuidados de saúde primários Agrupamentos de centros de saúde Gestão da qualidade Quality management Accreditation Primary healthcare services Health clusters