OPERATIONAL EFFICIENCY PROJECT ON THE PHYSICAL THERAPY DEPARTMENT FROM A BRAZILIAN HOSPITAL

¹Hospital Samaritano de São Paulo, Physical Therapy, São Paulo, Brazil

Background: Ensure productivity and quality of care while controlling costs are major challenges of health institutions.

Purpose: In this context, the Physiotherapy Service developed a score with basis on patients clinical signs and their use of therapeutic resources to define eligibility of the care delivered for critical or non-critical patients, associated with a methodology for its use.

Methods: The program was constructed with inspiration on "Value-based Healthcare" methodology and effective communication. We conducted a 7-steps iterative cycle evolving from the situational diagnosis, care delivery analysis, identification of best practices, action and team leading, change of individual and group behavior, individual and group feedback, and continuous learning for improvement.

Results: There was 16% of increasing in overall production, with a decrease of 8.2% in commitment of total gross revenue for fixed costs payment, supporting the annual financial result of the department. Main individual productivity increased (2014 = 2,558 proc./year vs. 2015 = 2,754 proc./year, P 0.05). Homogeneous distribution of calls between professionals, using better the time spend by physiotherapists on all shifts, allowing accomplishment of prescriptions and therapeutic planning, without staff increasing or reducing service quality.

Conclusion(s): The analysis of a physical therapy service characteristics using well-defined methodological approach, seems to be essential for better operational organization and to achieve positive results.

Implications: Value-based healthcare concept proposes to deliver a high quality service to the patient, with the same or lower cost. Run full situational diagnosis, allowed us to assess closely the operational steps and to find the gaps in communication and in the distribution of calls, resulting in significant decreasing of not performed physical therapy interventions.

Funding acknowledgements: This work was unfunded.

Topic: Professional issues

Ethics approval: This work had no need for ethics approval.

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