Portuguese primary healthcare – sustainability through quality management

Abstract

Purpose The purpose of this paper is 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.

Design/methodology/approach The development of the integrated accreditation model was based on a literature review, complemented with observation and analysis of the usual working methods in a Local Health Trust (Western Oporto Health Trust).

Findings Local Health Trusts include not only clinical management units but also non-clinical administrative units. Therefore, the National Model for Accreditation of HealthCare Institutions is not easily or directly applicable to them. To overcome this problem, the model proposed in this study incorporates ISO 9001 principles, widely accepted regarding organizational management. The success of the application of this model is highly dependent on the ability of public Primary HealthCare organizations to deal with potential problems such as resistance to change, lack of leadership and inadequate people management and involvement.

Originality/value 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 toward sustainability.