Banca de DEFESA: MARCIA MEYRE GOMES DE SOUZA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : MARCIA MEYRE GOMES DE SOUZA
DATE: 16/12/2025
TIME: 14:30
LOCAL: Departamento de Saúde Coletiva
TITLE:

EVALUATION OF THE EFFECT OF INTERVENTIONS IN THE MANAGEMENT OF PRE-OPERATIVE CARE FOR BARIATRIC SURGERY

KEY WORDS:

Bariatric surgery; Continuous Quality Improvement; Quality Indicators in Health Care; Management.

PAGES: 68
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUBÁREA: Saúde Pública
SUMMARY:

Introduction: Obesity is a chronic disease characterized by the excessive accumulation of

adipose tissue in the body, listed by the World Health Organization as the 5th leading cause of
death worldwide. Therefore, an implemented care pathway is important, as is quality
management in healthcare services, in order to promote safety and effectiveness in patient
care. One of the treatments offered within this pathway is bariatric surgery, indicated for
patients with severe obesity who have not been successful with traditional weight loss
methods, such as diet and exercise. Bariatric surgery has shown positive results in weight
reduction and improvement of comorbidities associated with obesity, such as type 2 diabetes
mellitus and hypertension. Objective: To evaluate the effect of multifaceted interventions to
improve care management in the preoperative period of bariatric surgery at a university
hospital in Northeast Brazil. Methodology: A quasi-experimental before-and-after study,
without a control group, with a quantitative approach, to be carried out through the
application of a quality improvement cycle in a university hospital in Northeast Brazil. This
study was approved by the Research Ethics Committee with Human Beings, CAAE:
83813924.5.0000.5292. The following steps were taken: identification and prioritization of
the quality problem; analysis of the causes of the problem; and definition of criteria. Results:
In the first evaluation, low performance was identified in most quality criteria, especially in
criteria C2 and C4, which showed 0% compliance. Criteria C1(a) (21.6%), C6 (45%), and C3
(58.3%) were also considered insufficient. Only C1(b) obtained an excellent result, with
100% compliance. The Pareto Diagram showed that criteria C2, C4, C1(a), and C6
concentrated 84.48% of the nonconformities, and were defined as a priority focus. In light of
this, structured interventions were implemented, such as: standardization of the pre-operative
flow, training of multidisciplinary teams, strengthening of communication with primary care,
reorganization of care processes, and sending formal guidelines to the originating units. These
actions sought to reduce variability, correct flaws, and improve the quality of network
collaboration. In the second evaluation, a significant improvement was observed, with a
reduction in non-conformities from 248 to 57, representing an absolute improvement of 77%.
There was a redistribution of the main problems, and criteria C2 and C4 ceased to be the most
critical. In addition, criteria such as C5, C1(c), and C1(d) began to show high performance,
indicating consolidation of the improvements. Final considerations: The implementation of
multifaceted interventions in pre-operative care for bariatric surgery proved to be effective in
improving process management, strengthening multidisciplinary action, and promoting
sustainable changes, serving as a model for improving the care pathway within the context of
the Brazilian Unified Health System (SUS). Thus, it is concluded that the implemented
improvement cycle was able to promote sustainable changes in the work process and can
serve as a model for other institutions seeking to improve the care pathway for obesity and
bariatric surgery within the Brazilian Unified Health System (SUS).

 

COMMITTEE MEMBERS:
Presidente - 1222022 - CECILIA OLIVIA PARAGUAI DE OLIVEIRA SARAIVA
Interna - 2553720 - KATIA REGINA BARROS RIBEIRO
Externa à Instituição - MANUELA PINTO TIBURCIO - UFRN