Mapeamento do fluxo de valor em operações hospitalares: análise e simulação em um hospital oncológico
Palabras clave:
mapeamento do fluxo de valor, lean healthcare, simulação, produção enxutaResumen
O mapeamento do fluxo de valor unido à simulação de eventos discretos tem se mostrado de grande valia na análise de operações de serviços. A tendência ao aumento na demanda de serviços de oncologia para os próximos anos no Brasil, junto com um sistema de saúde que já apresenta deficiências, representam uma oportunidade ainda pouco explorada de aplicação de tais ferramentas no contexto hospitalar. Com o objetivo de propor melhorias ao setor ambulatorial de um hospital brasileiro especializado no tratamento de câncer, foram analisadas as atividades desenvolvidas neste ambiente através de visitas in loco, seguindo com o mapeamento do fluxo de valor do estado atual, a identificação de oportunidades de melhoria, e, por fim, a proposição e a simulação do estado futuro. Os principais problemas identificados no hospital foram as filas na triagem médica, o uso dos pacientes como meios de transferência de informação, perda de prontuários, agenda de quimioterapia não otimizada e longas esperas para realização de consultas. As propostas apresentadas para o desenvolvimento do mapa do estado futuro demonstraram oportunidades de redução do lead time médio do tratamento de 57 dias e 16 minutos para 33 dias e 6 minutos. A simulação de uma destas propostas para o ambulatório do hospital apresentou resultados promissores, com possibilidade de execução da melhoria sem investimentos em novos recursos. Por outro lado, a redução do período total do tratamento parece levar a um aumento expressivo nos tempos de espera e número médio de pacientes nas filas.Citas
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