IPH - Institute of Hospital Research

Publications IPH Magazine IPH Magazine 13th: Annals Management

Capa revista 13
Management Veruska Amorim Ramalheiro
The Regional Hospital of the Lower Amazon is in a very restricted area when it comes to geographical access and its population has many cultural characteristics. Implementing a health service of high efficiency based on assumptions of quality and safety of patient eventually becomes a challenge. The output for the Regional Lower Amazon Hospital found to be currently considered a center of reference and excellence in health management in their state and region was due to projects based on and written into the strategic institution planning with main focus on humanized care, implementation and support processes, people development and sustainability. The mix of these elements treated as strategic objectives and being monitored regularly resulted in an innovative and solid culture with very positive results for all patients, employees and the local community.

Within the strategic map of the Hospital, they defined specific goals that led to the establishment of targets concerning the execution of tasks, the projects were defined and all the planning took place. Currently, the Regional Hospital of the Lower Amazon can, through their innovation projects and sustainability, attain results that increase the efficiency with focus on safe care. Here are three projects with satisfactory results:

  • Composting and Vegetable Garden's HRBA (Sustainability): The Regional Hospital Lower Amazon (HRBA) implemented a pioneering environmental project in the region, in order to reuse the organic waste generated by the unit. Less than six months later, 25% of waste are no longer dumped in the municipal landfill to become fertilizer for the garden unit. Currently, they are growing sweet potato, caruru and macaxeira, as well as herbs such as lemongrass, fennel and mint. The Regional Hospital generates an average of four tons of organic waste. With the project of compost and garden, almost a ton is reused. To expand the planting area in the hospital, a donation  campaign of seedlings and seeds will be held.
  • Putting yourself in patients' shoes (Customer / Humanization): The objective of the project is to improve the sensitivity of employees to provide humane care to users of the Unified Health System (SUS). For this, the receptionists and attendants were subjected to anxiety and stress, so they could feel and distress and suffering experienced daily by those who need care. After the first stage of implementation of the project, we could verify user satisfaction indicators with an increase in its results and positive projection. The program took place in three stages. The first was the choice of participants. They were told about the methodology of training and signed a term of participation, as well as guaranteed to keep secret among colleagues. In the second step, the simulations occurred in different areas of the hospital. The third stage in the auditorium of the unit. Workers told the experience to colleagues and scored what could be improved so that users feel more welcomed and receive a humanized care.
  • Risk Management (Patient Safety): The Regional Lower Amazon Hospital works with mapping and managing risks of all areas of the hospital, currently 55 areas are mapped by adding 134 risk managed with 1,326 control practices performed daily to minimize the likelihood of such risks. The HRBA is running its eleventh risk audit cycle occurring every six months through the internal auditing team. The compliance rate of risk management audit was an increase of 42%, this means that at the beginning of the risk management activities the Hospital had 65.5% practices controls evaluated in full compliance, currently in its last cycle audit the hospital reached a rate of 93.21% in control practices implemented correctly, in short this means that the probability of occurrence of the mapped risks are much lower now than at the beginning of its activities; another positive impact application of this tool are the adverse event rates that decreased their recurrence through the proper management and execution of control practices, thus ensuring a safer service for users of the Hospital.




Veruska Amorim Ramalheiro
Business Administrator for the Esperança Institute of Higher Education, graduate degree in Hospital Administration by UNINTER, has extensive experience in managing production processes.
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