Melhoria da cultura da segurança do paciente em um serviço de oncologia

Abstract

Introduction: It is undeniable that concern for patient safety should be one of the main focuses of attention in health services and the safety culture in these institutions has a strong influence on the theme, as it is the product of individual and group values, attitudes, perceptual abilities, and behavioral patterns that determine commitment to patient safety management, style and proficiency. In recent decades, there has been a significant mobilization around patient quality and safety programs in health organizations, but the implementation of a Patient Safety Program (PSP) in a systematic way, taking into account the high attributes level of safety culture, especially in outpatient oncology services, is still a poorly debated topic. Objectives: To improve the safety culture of the patient in an oncology service and to evaluate the effect of the implantation of a PSP on the culture of the institution. Methodology: A quasi-experimental study, with no control group, performed from July 2017 to April 2018 in an outpatient oncology service in the city of Ponta Grossa - Paraná. The questionnaire for the Hospital for Patient Safety Culture (HSOPSC), prepared by the Agency for Healthcare Research and Quality (AHRQ), was applied to health professionals before and after the implementation of the PSP in the aforementioned service. data from the safety culture served as a basis for the design of the improvement cycle consisting of multidisciplinary meetings, definition of responsibilities, training and training program, implementation and adoption of policies and protocols, definition and measurement of structure, process and results indicators, among others. Results: The 60 professionals working at the institution were invited to participate in the study, of which 43 answered the questionnaire in the two temporal phases. In the pre-implantation stage of PSP, there was a predominance of a negative result for six (43%) of the 14 dimensions, four dimensions showed predominance of neutrality and the other four dimensions with predominance of positive results. When the post-implantation phase of the PSP was evaluated, there was a significant improvement in all dimensions of the patient's safety culture, which assumed a positive predominance. Conclusions: The improvement of the safety culture of an institution is directly related to quality management, and the measurement of the safety culture was an important quality improvement tool, insofar as it identified the fragilities of the organization, providing planning and assertive actions taken in the patient safety program. This provided a shift in the scenario in the patient's safety culture in the oncology service surveyed, making their commitment to quality health care more robust.