Process management improves quality and reduces costs: the case of the orthopedics and trauma unit at the hospital das clínicas at the Federal University of Pernambuco

Abstract

This paper aims to verify to which extent the use of a medical-hospital treatment protocol can promote quality improvement in the services provided by means of process standardization, while at the same time reducing surgical and inpatient costs directly related to the procedure under protocol. The study took place at the Orthopedics Department of the Hospital das Clínicas at the Federal University of Pernambuco and referred to a knee arthroplasty or prosthetic knee replacement procedure. Data was collected during the period from 2004 to 2005 regarding quality indicators and direct surgical and inpatient costs for 89 patients submitted to the procedure under observation. The study looked at two distinct time periods: before and after the implementation of the protocol that involved the entire medical and administrative processes, ranging from the initial contact of the patient at the outpatient service up to the surgery and discharge from the hospital ward. Statistical data analysis made it evident that the protocol implemented at the hospital promoted a reduction in the mean waiting period of three days from time of admission to surgery, of seven days in the overall length of the patient' stay, a mean reduction of 20 minutes in the time of surgery, although no significant cost reduction in the materials consumed during the surgery itself was observed. It also proportioned a reduction in all direct cost categories related to the inpatient period.