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Custo direto dos erros pré-analíticos num serviço de patologia clínica hospitalar – estudo de caso
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Abstract(s)
Os objetivos deste trabalho foram determinar os indicadores com baixo desempenho referentes aos erros pré-analíticos, que ocorrem no início do processo laboratorial originando desperdício de recursos económicos, e a estimativa dos seus custos diretos. Apresenta-se como estudo qualitativo (estudo de caso), cuja metodologia contemplou na primeira etapa o levantamento retrospetivo dos erros pré-analíticos extra-laboratoriais, entre os anos de 2018 e 2022, e a determinação e análise dos seus indicadores de desempenho. Na segunda etapa, após o apuramento do indicador com baixo desempenho, foi realizado o mapeamento do processo
para levantamento dos tempos consumidos pelas atividades e dos materiais diretos utilizados no processo intra-laboratorial através de observações diretas, apurando-se os custos diretos referentes a 2022. Como resultado, o indicador de amostras contaminadas, especificamente a contaminação de hemoculturas, foi o único que apresentou o desempenho fora dos limites de aceitabilidade estipulados. A taxa de contaminação foi 3,74%, valor acima do limite definido internacionalmente. Este erro custou no mínimo à organização 10.104 euros, o triplo do custo direto que o mesmo número de hemoculturas negativas teria, representando ainda uma perda de 248 horas de trabalho para os profissionais do Serviço de Patologia Clínica com atividades
extra. Conclui-se que a minimização destes erros tem o potencial de resultar na redução substancial do desperdício laboratorial, com benefício simultâneo na eficiência do Serviço de Patologia Clínica e nos cuidados prestados ao utente. Espera-se que os resultados alcançados contribuam para a consciencialização da existência destes erros, assim como do impacto que representam e que, futuramente, possam servir de base a ações de melhoria a desenvolver na organização.
This work aims to determinate the low performance indicators regarding pre-analytical errors, which occur at the beginning of laboratory process, causing waste of economic resources and to estimate their direct costs. It is presented as a qualitative study (case study), whose methodology first included a retrospective survey of extra-laboratory pre-analytical errors between 2018 and 2022, followed by the determination and analysis of their performance indicators. Secondly, after calculating the low performance indicator, the process was mapped to survey the amount of time taken up by the activities and the direct materials used in the intra laboratory process through direct observations, aimed at assessing the direct costs in 2022. The indicator of contaminated samples, specifically blood culture contamination, was the only one that performed outside the stipulated acceptability limits. The contamination rate was 3.74%, above the internationally defined limit. This error cost the organization at least 10.104 euros, approximately three times more the direct cost of the same number of negative blood cultures would have, representing a loss of 248 hours of work for laboratory professionals with extra activities. It is concluded that minimizing these errors has the potential to result in a substantial reduction in laboratory waste, with simultaneous benefit in the efficiency of laboratory and the service provided to the user. It is expected that the results achieved will contribute to raising awareness of the existence of these errors and also the impact they represent, with the purpose that they can serve as a basis for improvement actions to be developed in the organization in the future.
This work aims to determinate the low performance indicators regarding pre-analytical errors, which occur at the beginning of laboratory process, causing waste of economic resources and to estimate their direct costs. It is presented as a qualitative study (case study), whose methodology first included a retrospective survey of extra-laboratory pre-analytical errors between 2018 and 2022, followed by the determination and analysis of their performance indicators. Secondly, after calculating the low performance indicator, the process was mapped to survey the amount of time taken up by the activities and the direct materials used in the intra laboratory process through direct observations, aimed at assessing the direct costs in 2022. The indicator of contaminated samples, specifically blood culture contamination, was the only one that performed outside the stipulated acceptability limits. The contamination rate was 3.74%, above the internationally defined limit. This error cost the organization at least 10.104 euros, approximately three times more the direct cost of the same number of negative blood cultures would have, representing a loss of 248 hours of work for laboratory professionals with extra activities. It is concluded that minimizing these errors has the potential to result in a substantial reduction in laboratory waste, with simultaneous benefit in the efficiency of laboratory and the service provided to the user. It is expected that the results achieved will contribute to raising awareness of the existence of these errors and also the impact they represent, with the purpose that they can serve as a basis for improvement actions to be developed in the organization in the future.
Description
Dissertação, Mestrado, Gestão de Unidades de Saúde, Instituto Politécnico de Santarém, Escola Superior de Gestão e Tecnologia, 2024
Keywords
Erros Pré-analíticos Patologia clínica/Laboratório Indicador de desempenho Custo do erro Processo Pre-analytical Error Clinical/Laboratory Pathology Performance Indicator Error Cost Process
Citation
Santos, L. (2024). Custo direto dos erros pré-analíticos num serviço de patologia clínica hospitalar : estudo de caso (Mestrado). Escola Superior de Gestão e Tecnologia, Santarém. Disponível na WWW em: <http://hdl.handle.net/10400.15/5028>