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Melhoria das operações de um serviço hospitalar com base nos princípios do Modelo Shingo
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A eficiência na gestão de processos hospitalares e a transparência na comunicação entre serviços
são fatores críticos para a qualidade do cuidado prestado e para a segurança dos pacientes. No
contexto da Unidade de Reprocessamento de Dispositivos Médicos da Unidade Local de Saúde do
Alto Minho, a presente investigação procurou responder à questão: “De que forma os princípios
baseados no Modelo Shingo podem apoiar a melhoria do desempenho organizacional na Unidade
de Reprocessamento da ULSAM?”.
A metodologia adotada seguiu uma abordagem de investigação-ação, combinando um inquérito
dirigido aos colaboradores do serviço, baseado nos princípios do Modelo Shingo, com a observação
direta dos processos. O inquérito, constituído por 244 questões avaliadas numa escala de 1 a 5,
evidenciou que 22 questões registaram médias entre 4,5 e 5, 13 obtiveram média igual ou inferior
a 3,5, indicando as áreas com maior potencial de melhoria, e 209 questões apresentam médias no
intervalo. A categoria Frequência foi a melhor avaliada, enquanto Alcance apresentou a menor
média. Verificou-se ainda que os Enfermeiros atribuíram classificações mais baixas do que os
Técnicos Auxiliares de Saúde em todas as dimensões avaliadas.
No decurso da análise, identificaram-se lacunas na comunicação de incidentes, na rastreabilidade
de informação na valorização das opiniões dos colaboradores, assim como ineficiências nos
processos que comprometiam o alinhamento organizacional e a eficácia operacional. O Modelo
Shingo foi utilizado com referencial de excelência operacional e melhoria contínua, garantindo que
as soluções propostas respeitam o alinhamento empresarial, a melhoria contínua e facilitadores
culturais.
Depois de analisados os resultados, foi desenvolvida e implementada, em contexto real, a
funcionalidade “Reclamações” na aplicação Instacount, centralizando o registo e acompanhamento
de ocorrências, eliminando falhas de comunicação informal e promovendo a transparência e
acessibilidade a todos os interessados, aspetos críticos detetados. Para apoiar a utilização do
sistema, foram elaborados três manuais, totalmente guiados para realizar a inserção de novos
incidentes, alteração da base de dados e a gestão dos incidentes. A intervenção foi validada pelos
colaboradores, confirmando que a solução respondia a necessidades reais do serviço, mostrandose
relevante e alinhada aos princípios do Modelo Shingo.
Este trabalho contribuiu para a consolidação de uma cultura de melhoria contínua, promoção da
transparência, padronização e otimização da gestão de reclamações, reforçando a aplicabilidade
dos princípios baseados no Modelo Shingo no contexto hospitalar.
Efficiency in hospital process management and transparency in communication between services are critical factors for the quality of care provided and patient safety. In the context of the Medical Device Reprocessing Unit of the Alto Minho Local Health Unit, this research sought to answer the question: “How can the principles based on the Shingo Model support the improvement of organisational performance in the ULSAM Reprocessing Unit?” The methodology adopted followed an action research approach, combining a survey of service employees, based on the principles of the Shingo Model, with direct observation of the processes. The survey, consisting of 244 questions rated on a scale of 1 to 5, showed that 22 questions scored between 4,5 and 5, 13 scored 3,5 or below, indicating the areas with the greatest potential for improvement, and 209 questions scored in between. The Frequency category was the highest rated, while Scope had the lowest average. It was also found that Nurses gave lower ratings than Healthcare Assistants in all dimensions assessed. During the analysis, gaps were identified in incident reporting, information traceability, and the valuing of employee opinions, as well as inefficiencies in processes that compromised organisational alignment and operational effectiveness. The Shingo Model was used as a benchmark for operational excellence and continuous improvement, ensuring that the proposed solutions respect business alignment, continuous improvement, and cultural facilitators. After analysing the results, the ‘Complaints’ feature was developed and implemented in a real context in the Instacount application, centralising the recording and monitoring of incidents, eliminating informal communication failures and promoting transparency and accessibility to all stakeholders, which were critical issues that had been identified. To support the use of the system, three manuals were produced, providing full guidance on entering new incidents, changing the database and managing incidents. The intervention was validated by employees, confirming that the solution responded to the real needs of the service, proving to be relevant and aligned with the principles of the Shingo Model. This work contributed to the consolidation of a culture of continuous improvement, promoting transparency, standardisation and optimisation of complaint management, reinforcing the applicability of the principles based on the Shingo Model in the hospital context.
Efficiency in hospital process management and transparency in communication between services are critical factors for the quality of care provided and patient safety. In the context of the Medical Device Reprocessing Unit of the Alto Minho Local Health Unit, this research sought to answer the question: “How can the principles based on the Shingo Model support the improvement of organisational performance in the ULSAM Reprocessing Unit?” The methodology adopted followed an action research approach, combining a survey of service employees, based on the principles of the Shingo Model, with direct observation of the processes. The survey, consisting of 244 questions rated on a scale of 1 to 5, showed that 22 questions scored between 4,5 and 5, 13 scored 3,5 or below, indicating the areas with the greatest potential for improvement, and 209 questions scored in between. The Frequency category was the highest rated, while Scope had the lowest average. It was also found that Nurses gave lower ratings than Healthcare Assistants in all dimensions assessed. During the analysis, gaps were identified in incident reporting, information traceability, and the valuing of employee opinions, as well as inefficiencies in processes that compromised organisational alignment and operational effectiveness. The Shingo Model was used as a benchmark for operational excellence and continuous improvement, ensuring that the proposed solutions respect business alignment, continuous improvement, and cultural facilitators. After analysing the results, the ‘Complaints’ feature was developed and implemented in a real context in the Instacount application, centralising the recording and monitoring of incidents, eliminating informal communication failures and promoting transparency and accessibility to all stakeholders, which were critical issues that had been identified. To support the use of the system, three manuals were produced, providing full guidance on entering new incidents, changing the database and managing incidents. The intervention was validated by employees, confirming that the solution responded to the real needs of the service, proving to be relevant and aligned with the principles of the Shingo Model. This work contributed to the consolidation of a culture of continuous improvement, promoting transparency, standardisation and optimisation of complaint management, reinforcing the applicability of the principles based on the Shingo Model in the hospital context.
Descrição
Palavras-chave
Shingo Model Medical Device Reprocessing Unit Continuous Improvement Complaints Management Operational Culture Modelo Shingo Unidade de Reprocessamento de Dispositivos Médicos Melhoria Contínua Gestão de Reclamações Cultura Operacional