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Hospital management and Nursing
Gestão hospitalar e Enfermagem
António José Lopes de Almeida (Lisbon - Portugal)
|Nurse; M...
Cost
Objects –
Products Cost
Resource
Consumption
Costs
Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divid...
Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divid...
Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divid...
Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divid...
Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divid...
Quality Cost
The quality control related cost in production, logistics of a
product or service.
Quality costs can be divid...
Centro Hospitalar
Universitário de
Lisboa Central, EPE
Reducing Costs
Collaborating on the solution of health care
dilemma:
maintain quality
and
contain or reduce costs
HOW TO
INNOVATE?
BASIC CONCEPTS
Systems
Organization
Management
Management
systems
Quality
Strategies
Management in intensive care: concepts and innovations
Gestão em terapia intensiva: conceitos e inovações
COSTS MANAGEMENT
Costs in
intensive care
continue to rise
(since 1970 that
began his
accounting)
The question
"how much
do...
STRATEGIC MANAGEMENT
Patient
satisfaction
"Retaining
talents"
Continuous
improvement
Financial
success
QUALITY MANAGEMENT
Equity
Legitimacy
Acceptability
of assistance
optimization
effectiveness
effciency
Management of the Intensive Care Unit
Caregiving is subject to a number of
factors that may contribute to failure:
• Lack ...
Antibiotics represent a high-consumption item and
hospitals, particularly in the more severe patient’s unit,
such as ICUs....
12 Breaking chain contagion
1 1 Isolate the pathogen
10 Interrupt when cured
9 Know how to say "no" to the vanco
8 Treatin...
Professional training as a preventive culture
and the role of the nurse in the development
of infection prevention and con...
Good Nursing Practices pass:
• urinary infection associated with urinary
catheterization
• intravascular catheterization r...
urinary infection
associated with
urinary
catheterization
intravascular
catheterization related
infection
Mechanical
Ventilation-
associated
Pneumonia
Skin Flora of the
Sick
Fluids
contaminated
Colonization
Of the catheter
Hands of
professionals
Contamination
During insert...
Standardize measures to
prevent the dissemination /
propagation of infections
within the hospital
Handwashing
BACTERIA OF THE
APPARATUS TO THE
HANDS
MOBILE PHYSICIAN, SOURCE
OF INFECTIONS
...) The surface of the telephones
serves as...
Hands that lead to
healing can not
transmit death
but allows
Save lifes,
improve the quality and safety of
care and reduce the final costs of
providing health care
The prev...
Three levels of care:
Level I, II and III
Depends on pharmacological support
And technology support
To monitor the load of...
The nurse / patient ratio can be adapted taking into
account the competencies of the professional
To monitor the load of N...
Various levels of care can be
integrated into an ICU.
The calculation of the capacity of the
ICU should be based on the ab...
There are no "magic or miracle" solutions to managing a complex and expensive
industry. On the other hand, a simple and ef...
Different dimensions highlight an attitude of
proactivity towards the future and the
formulation of new challenges
Technological
plan
tecnology
Knowledge
inovation
Videoconferência-
Apoio Telemáticoà
GenéticaMédica
Videoconference -
TelematicSupport
for Medical
Genetics
Center for
Clinical Genetics
(CGC)
Information and
Communication
Technologies (ICT)
electronic patient
card
6 steps to
reduce costs
Development and implementation of
care protocols
It changes the conduct of the professionals leading to the reduction
of e...
Greater security in decision making
Use of
information
technology
Simplification and standardization of
administrative processes
Numerous paying sources lead to a bureaucratic increase and...
Encouraging competition and
transparency of prices and results
Professional fees and contract clauses
Integration of the
various levels of
assistance, especially
with regard to the
sharing of care
information
The number of d...
Punitive action by the justice system against abusive
and fraudulent practices in the health system
The intentional provis...
Hospital management and Nurse
Gestão hospitalar e Enfermagem
What makes a work
environment healthy?
O que torna um ambiente de trabalho saudável?
Skilled Communication
Habilidades nacomunicação
Be as proficient in communication skills as you are in clinical
skills
True
Collaboration
Verdadeiracolaboração
Be relentless in seeking and
promoting true collaboration
Effective Decision Making
Tomada dedecisão eficaz
Being a committed partner in policy making, directing and evaluating
cli...
Appropriate
Staffing
Pessoaladequado
Ensure effective matching
between patient needs and
nursing competencies
Meaningful
Recognition
Reconhecimentosignificativo
Be recognized and recognize others for
the value that each brings to th...
Authentic Leadership
Liderançaautêntica
Fully embrace the imperative of an authentic healthy work
environment, live and en...
Interdependece
of healthy work,
environmente
clinical
excellence, and
optimal patient
outcomes
Let's take care
of who cares
antonioalmeidalx@gmail.com
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
Hospital management and nursing
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Hospital management and nursing

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Hospital management is always based on its quality cost structure, which
are the costs linked to quality control in the production, logistics of a product or
service. It should be borne in mind that it is necessary to maintain permanent
investments not only to acquire quality and to maintain it. The costs of intensive care
continue to rise (since the 1970s).
The implementation of protocols results in reduction of costs / gains for the patient,
evidence-based practice results in gain, protocols for prevention of catheter-related
infections and associated pneumonia Mechanical ventilation, use of sedation and
analgesia in the ICU, associated with weaning and inadequate use of antibiotics and
nutritional support.
Strategic management involves patient satisfaction, through "talent retention"
(specialist nurse maintenance) in order to achieve continuous improvement through
training, in which alone it can achieve the success of an institution.
It should be noted that the technical qualifications of nurses must be taken into
account. The proportion of nurse / patient can be adjusted taking into account the
competencies or other health professionals.
Objective: to design basic knowledge in the area of ​​business management applied to
health, in the strategic planning approach of a nursing professional
Content: literature review including models studied in the human knowledge area, as
well as the basic requirements recommendations in the ICU as well as the structural
and organizational aspects
Conclusion: Professional training as a culture of prevention and the role of nurses in
the development of prevention and control of infection are highlighted. Education
continues with strategies to implement more effective measures in the quest for
quality of care. The basis of management is the education of the nurse and the care of
the caregiver.

Publicada em: Saúde e medicina
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Hospital management and nursing

  1. 1. Hospital management and Nursing Gestão hospitalar e Enfermagem António José Lopes de Almeida (Lisbon - Portugal) |Nurse; Master in Nursing| Nurse – Unidade de Cuidados Intensivos de Neurocríticos, Hospital de São José , CHULC, Lisboa Assistant professor – Escola Superior de Enfermagem de Lisboa (ESEL) Member of the Nursing Section - Portuguese Society of Intensive Care December 4, 2018
  2. 2. Cost Objects – Products Cost Resource Consumption Costs
  3. 3. Quality Cost The quality control related cost in production, logistics of a product or service. Quality costs can be divided into four groups: 1. prevention costs 2. inspection costs 3. costs of internal failures 4. costs of external failures https://pt.wikipedia.org/wiki/Custo
  4. 4. Quality Cost The quality control related cost in production, logistics of a product or service. Quality costs can be divided into four groups: 1. prevention costs 2. inspection costs 3. costs of internal failures 4. costs of external failures https://pt.wikipedia.org/wiki/Custo Are recorded all the expenses that the company incurred in order to avoid failures
  5. 5. Quality Cost The quality control related cost in production, logistics of a product or service. Quality costs can be divided into four groups: 1. prevention costs 2. inspection costs 3. costs of internal failures 4. costs of external failures https://pt.wikipedia.org/wiki/Custo The expenses related to the inspection activities carried out by the companies are recorded
  6. 6. Quality Cost The quality control related cost in production, logistics of a product or service. Quality costs can be divided into four groups: 1. prevention costs 2. inspection costs 3. costs of internal failures 4. costs of external failures https://pt.wikipedia.org/wiki/Custo Obligate the expenses related to the work activities. Therefore, if the inspection was not efficient, it will be in this group the costs that will be verified will be the expenses for the adequacy of the product
  7. 7. Quality Cost The quality control related cost in production, logistics of a product or service. Quality costs can be divided into four groups: 1. prevention costs 2. inspection costs 3. costs of internal failures 4. costs of external failures https://pt.wikipedia.org/wiki/Custo Relates to the costs related to failures discovered by consumers. Warranty covers, recall expenses, etc. are recorded. The company must keep in mind that it is necessary to maintain permanent investments not only to acquire the quality but for its maintenance
  8. 8. Quality Cost The quality control related cost in production, logistics of a product or service. Quality costs can be divided into four groups: 1. prevention costs, 2. inspection costs, 3. costs of internal failures, 4. costs of external failures https://pt.wikipedia.org/wiki/Custo The more investments in the first two smaller groups tend to be the costs of the last two groups over time
  9. 9. Centro Hospitalar Universitário de Lisboa Central, EPE
  10. 10. Reducing Costs Collaborating on the solution of health care dilemma: maintain quality and contain or reduce costs
  11. 11. HOW TO INNOVATE?
  12. 12. BASIC CONCEPTS Systems Organization Management Management systems Quality Strategies
  13. 13. Management in intensive care: concepts and innovations Gestão em terapia intensiva: conceitos e inovações
  14. 14. COSTS MANAGEMENT Costs in intensive care continue to rise (since 1970 that began his accounting) The question "how much does a life cost" may sound superficial, but is part of the reality experienced in an ICUs Implementation of protocols results in a reduction of costs / gains for the patient Evidence-based practice results in a gain Protocols for the prevention of infections related to catheters and Ventilation, use of sedation and analgesia in ICUs Inadequate use of antibiotics and nutritional support
  15. 15. STRATEGIC MANAGEMENT Patient satisfaction "Retaining talents" Continuous improvement Financial success
  16. 16. QUALITY MANAGEMENT Equity Legitimacy Acceptability of assistance optimization effectiveness effciency
  17. 17. Management of the Intensive Care Unit Caregiving is subject to a number of factors that may contribute to failure: • Lack of communication • Difficulty in handling data • Poor dialogue between different sectors • Lack of strategic planning
  18. 18. Antibiotics represent a high-consumption item and hospitals, particularly in the more severe patient’s unit, such as ICUs. The inadequacy, abusive use of ATB and the lack of criteria in the choice of empirical treatment rely on imperative determining conditions for the emergence of several resistant microorganisms in ICU (Couto RC e col. Epidemiologia, controle e tratamento, Editora Médica e Científica 2003)
  19. 19. 12 Breaking chain contagion 1 1 Isolate the pathogen 10 Interrupt when cured 9 Know how to say "no" to the vanco 8 Treating infection, not colonization 7 Treating infection, not contamination 6 Use local data 5 Use antibiotic control measures 4 Consult specialists 3 Identify the pathogen 2 Remove unnecessary catheters 1 Vaccinate Prevent transmission Using antimicrobials in a sensible way Diagnose and treat indeed Prevent infections Centers of Disease Control, 2002 12 Steps to Preventing Antibiotic Resistance: Adult Hospitalization Campaign to prevent antibiotic resistance in health care
  20. 20. Professional training as a preventive culture and the role of the nurse in the development of infection prevention and control actions are highlighted and continuing education with strategies to implement more effective measures in the search for quality of care Preventive culture Continuing education
  21. 21. Good Nursing Practices pass: • urinary infection associated with urinary catheterization • intravascular catheterization related infection • Mechanical Ventilation-associated Pneumonia • Surgical site / surgical wounds infection • Handwashing • Hygiene care for the bedridden patient
  22. 22. urinary infection associated with urinary catheterization
  23. 23. intravascular catheterization related infection
  24. 24. Mechanical Ventilation- associated Pneumonia
  25. 25. Skin Flora of the Sick Fluids contaminated Colonization Of the catheter Hands of professionals Contamination During insertion Dissemination by Bleeding tract Infection entrance doors
  26. 26. Standardize measures to prevent the dissemination / propagation of infections within the hospital
  27. 27. Handwashing
  28. 28. BACTERIA OF THE APPARATUS TO THE HANDS MOBILE PHYSICIAN, SOURCE OF INFECTIONS ...) The surface of the telephones serves as a reservoir for numerous hospital bacteria (...) (...) The toilets should clean the devices to not infect patients (...) Source: Elmundo.es Maria Valério Notícias » Saúde 6 / 03 / 2009 2:40(CET) BACTERIA OF THE APPARATUS TO THE HANDS
  29. 29. Hands that lead to healing can not transmit death
  30. 30. but allows Save lifes, improve the quality and safety of care and reduce the final costs of providing health care The prevention and control of Health Care Associated Diseases entails costs for the institutions
  31. 31. Three levels of care: Level I, II and III Depends on pharmacological support And technology support To monitor the load of Nursing work per shift in the ICU
  32. 32. The nurse / patient ratio can be adapted taking into account the competencies of the professional To monitor the load of Nursing work per shift in the ICU
  33. 33. Various levels of care can be integrated into an ICU. The calculation of the capacity of the ICU should be based on the ability to work and not on the bed number To monitor the load of Nursing work per shift in the ICU
  34. 34. There are no "magic or miracle" solutions to managing a complex and expensive industry. On the other hand, a simple and effective set of measures may be the answer to the future of Intensive Care Inovation
  35. 35. Different dimensions highlight an attitude of proactivity towards the future and the formulation of new challenges
  36. 36. Technological plan tecnology Knowledge inovation
  37. 37. Videoconferência- Apoio Telemáticoà GenéticaMédica Videoconference - TelematicSupport for Medical Genetics
  38. 38. Center for Clinical Genetics (CGC)
  39. 39. Information and Communication Technologies (ICT)
  40. 40. electronic patient card
  41. 41. 6 steps to reduce costs
  42. 42. Development and implementation of care protocols It changes the conduct of the professionals leading to the reduction of examinations and the increase of the prescription of medicines / treatments more cost-effective
  43. 43. Greater security in decision making Use of information technology
  44. 44. Simplification and standardization of administrative processes Numerous paying sources lead to a bureaucratic increase and the time spent by professionals
  45. 45. Encouraging competition and transparency of prices and results Professional fees and contract clauses
  46. 46. Integration of the various levels of assistance, especially with regard to the sharing of care information The number of day of hospitalization is related to the number of medical visits
  47. 47. Punitive action by the justice system against abusive and fraudulent practices in the health system The intentional provision of unnecessary or inadequate services Billing of services that are not provided, often involving patients in fraud or using deceased patient names Misrepresentation of the cost of health care by insurers and health plans Commission / Gratuity for referrals for unnecessary services False labeling of a drug by a pharmaceutical company Abuse of the health system by patients to receive services that may be harmful to their health
  48. 48. Hospital management and Nurse Gestão hospitalar e Enfermagem
  49. 49. What makes a work environment healthy? O que torna um ambiente de trabalho saudável?
  50. 50. Skilled Communication Habilidades nacomunicação Be as proficient in communication skills as you are in clinical skills
  51. 51. True Collaboration Verdadeiracolaboração Be relentless in seeking and promoting true collaboration
  52. 52. Effective Decision Making Tomada dedecisão eficaz Being a committed partner in policy making, directing and evaluating clinical care, and conducting organizational operations
  53. 53. Appropriate Staffing Pessoaladequado Ensure effective matching between patient needs and nursing competencies
  54. 54. Meaningful Recognition Reconhecimentosignificativo Be recognized and recognize others for the value that each brings to the work of the organization
  55. 55. Authentic Leadership Liderançaautêntica Fully embrace the imperative of an authentic healthy work environment, live and engage others in its realization
  56. 56. Interdependece of healthy work, environmente clinical excellence, and optimal patient outcomes
  57. 57. Let's take care of who cares
  58. 58. antonioalmeidalx@gmail.com

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