QUALITY IMPROVEMENT CYCLE IN THE MANAGEMENT OF CARE FOR DIFFICULT-TO-HEAL WOUNDS IN A HIGH-COMPLEXITY HOSPITAL
Continuous Quality Improvement. Health Management. Quality of Health Care. Wound Healing. Patient Safety.
Introduction: Hard-to-heal wounds, also referred to as complex wounds, represent a significant challenge for health systems, as they are associated with prolonged hospital stays, increased risk of infection, higher healthcare costs, and impacts on patient safety. In the hospital context, the absence of standardized protocols, defined care pathways, systematic monitoring, and institutional organization of processes compromises the quality of care and hinders evidence-based management. In this scenario, the implementation of quality improvement cycles stands out as a strategy to organize care, reduce variability in clinical practice, and strengthen an institutional culture oriented toward safety and continuous improvement. Objective: To assess the degree of implementation of organizational practices and to develop a quality improvement cycle aimed at standardizing care processes. Methods: This is a quality improvement study with a quantitative approach and a quasi-experimental before-and-after design, to be conducted in a public general hospital located in Maceió, Alagoas, Brazil. The study will be carried out within a specialized wound care service, focusing on the analysis and reorganization of institutional processes related to the management of these conditions. The study population will consist of healthcare professionals linked to the service and to institutional quality and patient safety units. The intervention will involve the implementation of a structured quality improvement cycle, including situational diagnosis, reorganization of care processes, standardization of protocols, and monitoring of institutional practices. Data collection will be conducted using a structured checklist based on the quality model proposed by Avedis Donabedian and on Pedro Saturno’s quality assessment approach, encompassing the dimensions of structure, process, and outcomes. The instrument will be applied before and after the intervention. Document analysis will be institutional in nature, with no access to identifiable patient clinical data. Expected Results: The study is expected to contribute to strengthening quality management, standardizing care practices, and consolidating a safe and sustainable model of care.