Banca de DEFESA: NAYANA NAYLA VASCONCELOS ROCHA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : NAYANA NAYLA VASCONCELOS ROCHA
DATE: 11/02/2025
TIME: 13:00
LOCAL: Online
TITLE:

EFFECTS OF A MULTIFACETED INTERVENTION TO IMPROVE THE IMPLEMENTATION OF THE THERAPEUTIC PLAN IN A PUBLIC HOSPITAL IN CEARÁ

KEY WORDS:

Patient Care Planning; Hospital Care; Quality Improvement; Healthcare Quality.

PAGES: 44
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

INTRODUCTION – The therapeutic plan organizes care delivery, enhances interprofessional communication, guides treatment decisions, and ensures individualized patient care. At the Hospital Regional do Sertão Central, its implementation faces challenges related to execution, professional engagement, and organizational structure, which compromise its effectiveness. Optimizing this process may enhance the quality of care provided.

OBJECTIVE – To evaluate the effect of a multifaceted intervention on improving the implementation of the therapeutic plan in a public hospital in Ceará.

METHODS – This study, conducted from January 2023 to April 2024, followed the SQUIRE 2.0 model with a quasi-experimental pre-post design. A group of professionals from the institution led the improvement cycle, analyzing the root causes of the problem and targeting modifiable factors. Data collection was based on a random sample of medical records, and interventions were planned using the Pareto Principle. Post-intervention evaluation was performed in two phases, analyzing point estimates, confidence intervals, absolute and relative improvements to assess the effectiveness of the implemented actions.

RESULTS – The interventions included the development of flowcharts, the provision of standardized therapeutic plan forms, the restructuring of clinical rounds, the revision of care processes, team training sessions, and the reorganization of monitoring mechanisms. Implementation led to significant improvements in compliance with key criteria, particularly in the documentation of discharge planning (absolute improvement of 15%, p=0.042), inclusion of medical goals (47%, p<0.001) and multidisciplinary team goals (22%, p=0.001), timely goal evaluation (22%, p=0.007), and the execution of rounds for therapeutic plan assessment (70%, p<0.001). The analysis also demonstrated a reduction in nonconformities (from 250 to 136) and the sustainability of changes over time.

CONCLUSION – The multifaceted intervention demonstrated the potential to enhance the implementation of the therapeutic plan, fostering more coordinated and patient-centered care. However, the sustainability of these improvements may depend on contextual factors, highlighting the need for further studies to confirm the intervention’s effectiveness in different settings.

COMMITTEE MEMBERS:
Presidente - 1868020 - ZENEWTON ANDRÉ DA SILVA GAMA
Interna - 1020269 - PETALA TUANI CANDIDO DE OLIVEIRA SALVADOR
Externa à Instituição - LAURA MARIA CÉSAR SCHIESARI - FGV