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O impacto financeiro das ineficiências nos blocos operatórios de hospitais públicos : estudo de caso e propostas de melhoria
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Atualmente, os gestores das organizações de saúde enfrentam grandes desafios num contexto de tensões socioeconómicas, exigindo-se cada vez um maior nível de eficiência sem que isso comprometa a qualidade dos cuidados de saúde prestados.
Neste sentido, a sensibilização dos profissionais de saúde para a racionalização dos recursos e a otimização do fluxo hospitalar é fulcral, mas não é suficiente. É importante a implementação de sistemas de controlo de gestão robustos que permitam monitorizar os principais indicadores operacionais e financeiros, para agir em conformidade.
No Bloco Operatório verifica-se um elevado volume de gastos devido ao grande número de profissionais envolvidos e à utilização de materiais e equipamentos dispendiosos.
O Hospital X, analisado neste trabalho, compreendeu a necessidade de implementar um modelo de melhoria contínua no Bloco Operatório, dada a degradação nos últimos anos dos seus indicadores operacionais e financeiros e, por isso, contratou a Lean Health, empresa especializada em melhoria continua (Lean) no setor hospitalar.
Por sua vez, a Lean Health e o Hospital X aceitaram colaborar neste projeto que pretende quantificar financeiramente as principais ineficiências do bloco operatório e propor medidas que permitam ao hospital ser mais eficiente e produtivo.
Após a realização de várias reuniões com os responsáveis do Bloco Operatório do Hospital X e Lean Health, bem como analisados diversos dados operacionais e financeiros, foram identificados dois problemas centrais: - Elevado nº de salas de operações encerradas por falta de Anestesiologistas; - Nº excessivo de cancelamentos de cirurgias programadas.
Com isto, foram então elaboradas três propostas para tentar minimizar as consequências das duas situações acima descritas, e estimados os respetivos impactos financeiros:
1) Aplicação de sistema de incentivos para os profissionais de saúde com base no Balanced Scorecard;
2) Aplicação da metodologia Lean para melhorar a eficiência do bloco operatório;
3) Análise custo-benefício da contratação de anestesiologistas por via do aumento do valor /hora (acima da tabela de remunerações da função pública).
Currently, managers of health care organizations face great challenges in a context of socioeconomic tensions, demanding an higher level of efficiency without compromising the quality of health care provided. In this sense, the awareness of health care professionals to rationalize resources and optimize hospital flow is crucial, but it is not enough. It’s very important implement robust management control systems that allows the monitoring of the main operational and financial indicators, in order to act accordingly. In the Operating Room, there is a high volume of expenses due to the large number of professionals involved and the use of expensive materials and equipment. Hospital X, analyzed here, understood the need to implement a model of continuous improvement in the Operating Room, given the degradation in the last years of its operational and financial indicators and, for this reason, it hired Lean Health, a company specialized in continuous improvement (Lean) in the health care sector. In turn, Lean Health and Hospital X agreed to collaborate on this project, which aims to financially quantify the main inefficiencies of the operating room and propose measures that allow the hospital to be more efficient and productive. After several meetings with the heads of the Operating Room at Hospital X and Lean Health, as well as analyzing various operational and financial data, two central problems were identified: - High number of operating rooms closed due to lack of anesthesiologists; - Excessive number of scheduled surgery cancellations. With this, three proposals were made to try to minimize the consequences of the two situations described above, and the respective financial impacts were estimated: 1) Application of an incentive system directed to health care professionals based on Balanced Scorecard; 2) Application of Lean methodology to improve the efficiency of the operating room; 3) Cost-benefit analysis of hiring anesthesiologists by increasing the cost/hour.
Currently, managers of health care organizations face great challenges in a context of socioeconomic tensions, demanding an higher level of efficiency without compromising the quality of health care provided. In this sense, the awareness of health care professionals to rationalize resources and optimize hospital flow is crucial, but it is not enough. It’s very important implement robust management control systems that allows the monitoring of the main operational and financial indicators, in order to act accordingly. In the Operating Room, there is a high volume of expenses due to the large number of professionals involved and the use of expensive materials and equipment. Hospital X, analyzed here, understood the need to implement a model of continuous improvement in the Operating Room, given the degradation in the last years of its operational and financial indicators and, for this reason, it hired Lean Health, a company specialized in continuous improvement (Lean) in the health care sector. In turn, Lean Health and Hospital X agreed to collaborate on this project, which aims to financially quantify the main inefficiencies of the operating room and propose measures that allow the hospital to be more efficient and productive. After several meetings with the heads of the Operating Room at Hospital X and Lean Health, as well as analyzing various operational and financial data, two central problems were identified: - High number of operating rooms closed due to lack of anesthesiologists; - Excessive number of scheduled surgery cancellations. With this, three proposals were made to try to minimize the consequences of the two situations described above, and the respective financial impacts were estimated: 1) Application of an incentive system directed to health care professionals based on Balanced Scorecard; 2) Application of Lean methodology to improve the efficiency of the operating room; 3) Cost-benefit analysis of hiring anesthesiologists by increasing the cost/hour.
Descrição
Mestrado Bolonha em Contabilidade, Fiscalidade e Finanças Empresariais
Palavras-chave
Balanced Scorecard Lean Service Kaizen melhoria contínua bloco operatório eficiência operacional Balanced Scorecard Lean Service Kaizen Healthcare Operational Efficiency Operating Room
Contexto Educativo
Citação
Simões, Bruno Daniel Ribeiro (2020). “O impacto financeiro das ineficiências nos blocos operatórios de hospitais públicos : estudo de caso e propostas de melhoria”. Dissertação de Mestrado. Universidade de Lisboa. Instituto Superior de Economia e Gestão
Editora
Instituto Superior de Economia e Gestão