Quality Indicators in Ambulatory Surgery: A Literature Review Comparing Portuguese and International Systems
- PMID: 30189171
- DOI: 10.20344/amp.10416
Quality Indicators in Ambulatory Surgery: A Literature Review Comparing Portuguese and International Systems
Abstract
Introduction: According to several studies conducted in North America and Europe, ambulatory surgery is a practice that has grown over the years, and both the number of more complex surgical procedures deemed suitable for ambulatory surgery and the number of patients with different co-morbidities which are now suitable for this type of procedure have been increasing. In order to respond to the increased number of day surgeries, as well as to avoid a potential proportional increase in perioperative morbidity, quality control systems must be adopted to enable continuous improvement and minimise predicted risks. The purpose of this study is to review global quality indicators used in ambulatory surgery and compare them with those used in Portugal.
Material and methods: The authors conducted a comprehensive search of medical databases, using MeSH words. Limits were applied to include only studies published after 1998 written in Portuguese, English and Spanish. Ambulatory surgery indicators for Portugal were also obtained.
Results: Twenty-one different quality indicators for ambulatory surgery were identified. The Portuguese Healthcare Regulation Authority has defined seven quality indicators for ambulatory surgery.
Discussion: The Portuguese quality indicators for ambulatory surgery are generally well adapted to current international practices. Nevertheless, after analysing the relevant international literature based on this study, it is important to consider two additional indicators for ambulatory surgery - same day surgery cancellations and patient satisfaction.
Conclusion: On the literature review, same day surgery cancellations and patient satisfaction should be included in the National Health Assessment System created by the Portuguese Healthcare Regulation Authority.
Introdução: A cirurgia de ambulatório é uma prática crescente ao longo dos últimos anos, traduzida não só num número crescente de procedimentos cirúrgicos, bem como num aumento de complexidade dos mesmos. Para responder ao aumento do número de cirurgias diárias, bem como para evitar um possível aumento proporcional da morbidade peri-operatória, é essencial adotar sistemas de controlo de qualidade, permitindo um processo contínuo de melhoria e minimizando riscos esperáveis. O objetivo deste trabalho é rever os indicadores de qualidade utilizados em todo o mundo em cirurgia de ambulatório e compará-los com a realidade portuguesa. Material e Métodos: Realizamos uma pesquisa abrangente em bases de dados, usando palavras-chave (MeSH). Foram aplicados limites para incluir apenas estudos publicados depois de 1998 e de língua portuguesa, inglesa e espanhola. Foram também obtidos os indicadores de cirurgia ambulatória habitualmente usados em Portugal. Resultados: Identificamos vinte e um indicadores de qualidade diferentes para cirurgia de ambulatório. A Entidade Reguladora da saúde definiu sete indicadores. Discussão: Os indicadores de qualidade portugueses para cirurgia de ambulatório estão globalmente bem adaptados às atuais práticas internacionais. No entanto, depois de analisar a literatura internacional relevante, considera-se importante incluir dois novos indicadores, sendo estes os cancelamentos de cirurgia no mesmo dia e a satisfação do paciente. Conclusão: Na opinião dos autores, os indicadores “cancelamentos da cirurgia no mesmo dia” e “satisfação dos doentes deverão ser incluídos no Sistema Nacional de Avaliação de Saúde criado pela Entidade Reguladora da Saúde.
Keywords: Ambulatory Surgical Procedures; Outcome Assessment (Health Care); Portugal; Quality Indicators, Health Care; Quality of Health Care.
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