Abstract
Objective To evaluate, through care indicators, the quality of services rendered to patients considered urgency and emergency cases at an advanced emergency care unit.Methods We analyzed data from managerial reports of 64,891 medical visits performed in the Emergency Care Unit of the Ibirapuera Unit at Care during the period from June 1st, 2012 through May 31st, 2013. The proposed indicators for the assessment of care were rate of death in the emergency care unit; average length of stay of patients in the unit; rate of unplanned return visits; admission rate for patients screened as level 1 according to the Emergency Severity Index; rate of non-finalized medical consultations; rate of complaints; and door-to-electrocardiogram time.Results The rate of death in the emergency care unit was zero. Five of the 22 patients classified as Emergency Severity Index 1 (22.7%) arrived presenting cardiac arrest. All were treated with cardiopulmonary resuscitation and reestablishment of vital functions. The average length of stay of patients in the unit was 3 hours, 33 minutes, and 7 seconds. The rate of unscheduled return visits at the emergency care unit of the Ibirapuera unit was 13.64%. Rate of complaints was 2.8/1,000 patients seen during the periodConclusion The model of urgency and emergency care in advanced units provides an efficient and efficaious service to patients. Both critically ill patients and those considered less complex can receive proper treatment for their needs.
Highlights
One of the greatest difficulties for the healthcare manager is to objectively assess the quality of care given
Advanced units: quality measures in urgency and emergency care 493 work routine, the care team is focused on the best care possible, but the perception of quality on the part of the patients and family members may be very different from the feeling of good services delivered by the healthcare professionals
The Advanced Unit of Emergency Care is open for 2 hours a day with services in Internal Medicine, General Surgery, and Pediatrics
Summary
One of the greatest difficulties for the healthcare manager is to objectively assess the quality of care given. Donabedian[3,4] was one of the first authors to try to define measurement indexes for medical care. He observed that simple measurement indexes could be related to highly complex situations (such as those that occur in surgical procedures) and are representative of the problem (validation of the indicators). The author suggested that if the manager did not know where he/she wanted to get, they would not get there. This theory perfectly demonstrates the methodology of indicators and goals used constantly at healthcare services
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