RESUMEN
INTRODUCTION: The LEAN methodology is an integration of methods and tools developed in the 90s in the industrial sector. It aims to reduce waste (things that don't add value to the final product), add worth and work towards continuous quality improvement. METHODS: LEAN tools to improve the clinical practice of a health center include:5S methodology: helps organize, clean, develop and maintain a productive work environment;'Spaghetti' diagram: displays the movement and distance that a given element has to travel throughout the entire process; andTime and motion studies: measure the various times associated with the process and the associated motion. RESULTS: The LEAN methodology made it possible to manage space and time efficiently and optimally. There was a substantial reduction in both the time and number of trips for not only the health professionals but also for the patients. DISCUSSION: Clinical practice should focus on the permission of continuous quality improvement. The LEAN methodology, through its different tools, generates an increase in productivity and profitability. It promotes teamwork through multidisciplinary teams and the empowerment and training of employees. The implementation of the LEAN methodology improved the practices and strengthened the team spirit based on everyone's participation, because the whole is greater than the sum of the parts.
Asunto(s)
Personal de Salud , Mejoramiento de la Calidad , Humanos , Eficiencia Organizacional , Gestión de la Calidad TotalRESUMEN
INTRODUCTION: Climate change is a topic of growing interest and should guide our actions in society. Clinical practice must improve sustainability and ecological behavior as an opportunity. We intend to show how measures were implemented to reduce resource consumption in a health center in Gonçalo, a small village in the center of Portugal, with the support of local government spreading these practices across the community. METHODS: The first step was to account for daily resource use in Gonçalo's Health Center. Opportunities for improvement were listed in a multidisciplinary team meeting and subsequently implemented. Local government was very cooperative in the implementation of such measures, helping us spread the intervention to the community. RESULTS: A considerable reduction in resource consumption was verified, mainly the reduction of consumption of paper. Before this intervention, there was neither separation nor recycling of waste, which was initiated by this program. This change was implemented in the building of the Parish Council, at the Health Center and School Center of Gonçalo, where health education activities were promoted. DISCUSSION: In a rural area, the health center is an integral part of the life of the community in which it operates. Thus, their behaviors have the power to influence that same community. By showing our interventions and through practical examples, we intend to influence other health units to be an agent for change within their communities. By reducing, reusing and recycling, we intend to be a role model.
Asunto(s)
Educación en Salud , Humanos , Cambio Climático , Servicios de Salud Rural , Portugal , Desarrollo SostenibleRESUMEN
INTRODUCTION: Gonçalo, a village with 1316 inhabitants of which 573 are 65 years old or older, presents itself as the 'Cradle of Fine Basketry'. Its population, rich in culture and stories to tell, has the support of a day care center for the elderly, where around 20 elderly people spend their days and find social connection. These patients make individual trips to access medical and nursing consultations. METHODS: Creation of a monthly consultation at the day care center for the elderly patients there. RESULTS: Reduction in the number of individual trips by the elderly patients, through the displacement of the family team;Optimizing the management of each individual health plan with the support of the day center's technical director, including therapeutic management and carrying out complementary diagnostic tests;Observation of the elderly patients in a safer way, avoiding traveling and maintaining a familiar space;Closer ties between the elderly patients and healthcare team; and Training of day care center professionals. DISCUSSION: At the heart of the practice of a healthcare team is the health and well-being of each patient. Therefore, meeting their needs, reallocating resources and involving the community will lead to health gains. The 'Consultas em Dia' project reflects this same onjective: the need of each elderly person to have access to GP/family nurse consultations joined with the healthcare team's willingness to provide an adapted response. Together we improved access and care delivery we improved the health of our community!