Elaboration and Adoption of Clinical Protocols, and Assessment of Care Quality • HRB4096

 

RESPONSIBLE PROFESSORS:

Gerson Alves Pereira Júnior

Alessandra Mazzo

Airton Tetelbom Stein

Cristiano Tonello

 

CREDITS: 3

 

WORKLOAD:

Theoretical
(per week)
Practical
(per week)
Studies
(per week)
Duration Total
3h 1h 1h 9 weeks 45h

OBJECTIVES:

To enable the student to understand the processes involved in the elaboration and adoption of clinical protocols, as well as the use of criteria to evaluate the quality of care.

Within each protocol, the sequence of events in the care process should be described through a series of results that may occur throughout the evolution of the clinical situation using the best available scientific evidence.  

The student should also be able to develop strategies for adherence to the use of protocols. 

 

RATIONALE:

Society is increasingly demanding the quality of services provided, mainly by public agencies. This requirement makes it essential to create norms and mechanisms for evaluation, and control of quality care.

The health service, the area of the pre or in-hospital environment, is often not adequately responding to the population’s health needs, mainly due to the lack and / or inefficiency of the work process. Management practice is a critical factor in this process and it is incumbent upon it to define the role of the service and its level of care within the health care network of the municipality or its region.

Knowledge of the concepts related to the evaluation and quality of health services is of great importance for the safety of health care provided and for the management of services and the health system.

The health care process involves a series of decisions by health professionals and the algorithm is an illustration of how these decisions are ranked and prioritized and addressed to specific patient conditions, setting the appropriate responses for the best outcome. 

The primary benefit of a well-developed algorithm is to ensure the health professional’s focus on critical decision points and, specifically, to list the parameters that drive this decision. These critical care decisions need to be clearly defined. Next, the alternatives and decision options must be precise. The possible results for each alternative should be considered. 

The mismatch between the care needs of some patients and the isolated prescription of evaluations, examinations and procedures imposed by a network with fragmented clinical actions, without coordination and ordering generates dissatisfaction, delay in treatment and waste of resources. 

 

CONTENT:

Concepts and strategies for health care assessment; models for health assessment; evaluation of health systems and policies: effectiveness and efficiency, Quality in health, quality indicators, selection of indicators, evaluation as an instrument of decision, Clinical protocols, Guidelines, Strategies of implementation.

 

BIBLIOGRAPHY:

Brent Graham. Clinical Practice Guidelines: What Are They and How Should They Be Disseminated? Hand Clinics 2014, Vol. 30 (3), August, pag. 361–365.


Kate Nellans, Jennifer F. Waljee. Health Services Research: Evolution and Applications. Hand Clinics 2014, Vol. 30 (3), August, pag. 259-268.

Kötter et al.: Methods for the guideline-based development of quality indicators–a systematic review. Implementation Science 2012 7:21.


Stelfox HT, Bobranska-Artiuch B, Nathens A, Straus SE. Quality Indicators for Evaluating Trauma Care: A Scoping Review. Arch Surg. 2010;145(3):286-295.

Shahangian S & Snyder SR. Laboratory Medicine Quality Indicators: A Review of the Literature. Am J Clin Pathol 2009;131:418-431.


Dansa AM et al. Assessing equity in clinical practice guidelines. Journal of Clinical Epidemiology 2007, 60: 540-546.

Prior M et al. The effectiveness of clinical guideline implementation strategies – a synthesis of systematic review findings. Journal of Evaluation in Clinical Practice 2008, 14: 888–897.

Barosi G. Strategies for dissemination and implementation of guidelines. Neurol Sci 2006, 27:S231–S234.

C Main, T Moxham, JC Wyatt, J Kay, R Anderson and K Stein. Computerised decision support systems in order communication for diagnostic, screening or monitoring test ordering: systematic reviews of the effects and cost-effectiveness of systems. Health Technology Assessment 2010; Vol. 14: No. 48.

Ahmadiana L et al. The role of standardized data and terminological systems in computerized clinical decision support systems: Literature review and survey. International journal of medical informatics 2011, 80: 81–93.


SANTOS, J. S. et al. Protocolos clínicos e de regulação: acesso à rede de saúde. Rio de Janeiro. Elsevier, 2012. 1311p.

 

 

 

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Seção de Pós-Graduação HRAC-USP

Horário de atendimento: de segunda a sexta-feira, das 8h às 18h (exceto feriados) | e-mail: secpghrac@usp.br