Propuesta de mejora para los sistemas de gestión de calidad en salud en las IPS de baja complejidad de la ciudad San José de Cúcuta
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2021
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Ediciones Universidad Simón Bolívar
Facultad de Administración y Negocios
Facultad de Administración y Negocios
Resumen
Antecedentes:
Las empresas del sector de la salud, que además de conformarse como entidades prestadoras de servicios, son consideradas organizaciones que requieren el planteamiento de estrategias encaminadas a cumplir sus objetivos. El sistema de salud colombiano exige mediante el Sistema Obligatorio de Garantía de la Calidad en Salud que las instituciones brinden una excelente atención en salud a los usuarios para contribuir al mejoramiento de su calidad de vida. Una implementación adecuada de los sistemas de gestión de la calidad en las instituciones de salud trae consigo el incremento de la satisfacción del usuario-familia, y el aumento de la ventaja competitiva de la institución frente al mercado. No se tiene registro de investigaciones a nivel local, que muestren el nivel de implementación de los sistemas de gestión de la calidad en las instituciones de salud.
Objetivo:
Definir una propuesta de mejora para los sistemas de gestión de calidad en salud en las IPS de baja complejidad de la ciudad de San José de Cúcuta, departamento Norte de Santander, Colombia, que pueda contribuir al fortalecimiento de su desempeño y, por ende, al mejoramiento de la atención en salud de los usuarios que reciben atención en este tipo de instituciones.
Materiales y Métodos:
Se diseñó y validó un instrumento para medir el estado actual de los sistemas de gestión de la calidad en 19 Ips de baja complejidad teniendo en cuenta los principios de gestión de la calidad: enfoque al cliente, liderazgo, compromiso de las personas, enfoque a procesos, mejora continua, toma de decisiones basada en la evidencia y gestión de las relaciones; posteriormente mediante análisis de los resultados, se identificaron las ventajas y oportunidades de mejora de estos sistemas y finalmente, se estructuró una propuesta de mejora que propone acciones para impactar positivamente en los sistemas de gestión de calidad en este tipo de instituciones de salud.
Resultados:
La implementación de los sistemas de gestión de la calidad de las Ips de baja complejidad de la ciudad de San José de Cúcuta, de acuerdo con los principios de gestión de la calidad, durante el segundo semestre del año 2021, registró un nivel básico con resultados entre 1,6 y 2,3 con un promedio de 2,0 frente a una meta esperada de 5. De acuerdo con el análisis de resultados se detectaron más oportunidades de mejora que fortalezas, congruentes con el grado de implementación básico detectado, en donde el principio Enfoque al cliente presenta mayores fortalezas, en contraste con el principio Liderazgo que registra el mayor número de oportunidades de mejora. Teniendo en cuenta los hallazgos encontrados y el contexto de las IPS de baja complejidad, se estructuró una propuesta de mejora que propone acciones en cinco frentes críticos: 1. Garantizar el compromiso del liderazgo con la calidad como factor vital del sostenimiento del sistema. 2.Gestar una cultura organizacional con orientación y participación del cliente, reconociendo que además del usuario-familia-comunidad los stakeholders o partes interesadas forman parte esencial en la sostenibilidad de la organización. 3. Continuar con el fortalecimiento de la gestión por procesos con enfoque sistémico. 4. Fomentar la cultura de la Mejora continua con implementación de herramientas de calidad pertinentes y efectivas. 5. Diseñar e implementar programas de formación, capacitación y desarrollo permanentes inmersos en mecanismos de comunicación efectivos y directos en todos los niveles de la organización.
Conclusiones:
Las Instituciones prestadoras de servicios de salud de baja complejidad en la ciudad de San José de Cúcuta presentan un nivel básico de implementación de sus sistemas de gestión de la calidad, a pesar que la normatividad colombiana tiene establecido un sistema obligatorio de garantía de la calidad que brinda herramientas estandarizadas para la búsqueda de servicios con calidad, lo que demuestra debilidades en los mecanismos de implementación utilizado. Estas instituciones se encuentran comprometidas con la atención centrada en el usuario, sin embargo, se hace necesario fortalecer el análisis y seguimiento de estos procesos que permitan la gestión del riesgo, la innovación y la fidelización del usuario. Se hace imperativo implementar estrategias para el fortalecimiento de la implantación de sistemas de gestión de la calidad en las IPS de baja complejidad que tenga en cuenta el compromiso del liderazgo con la calidad como factor vital del sostenimiento del sistema, la cultura organizacional con orientación y participación del cliente y partes interesadas, el fortalecimiento de la gestión por procesos con enfoque sistémico, el fomento de la cultura de mejora continua con implementación de herramientas de calidad pertinentes y efectivas y el diseño e implementación de programas de formación, capacitación y desarrollo en todos los niveles de la organización. En esta investigación no se detectaron diferencias considerables del nivel de implantación del sistema de gestión de calidad en las Ips certificadas con ISO 9001:2015 frente a las que no contaban con esta certificación.
Background: Companies in the health sector are not only service providers, but also organizations that demand strategies aimed to achieve their objectives. The Colombian Health System requires that institutions must provide excellent health care in order to contribute to their users’ quality-of-life betterment by taking into account the Health Quality Assurance System. An adequate implementation of quality management systems in health places brings with it an increase in user-family satisfaction, and a grow in the competitive advantage of the establishment in the market. There is no research record at local degree that shows the level of implementation of quality management systems in health institutions. Objective: To determine a proposal for the health quality management systems improvement in the low complexity health-care institutions of the city of San José de Cúcuta, Norte de Santander, Colombia, which will be able to contribute to the strengthening of their performance and as well as the developing of health care in users who receive it in this type of facilities. Materials and Methods: An research instrument was designed and validated to measure the current state of quality management systems in 19 of low complexity health-care institutions by taking into account the principles of quality management such as the customer focus, leadership, people commitment, process approach, continuous improvement, evidence-based decision making and relationship management; Subsequently, through an in-depth analysis of the results, the advantages and opportunities for improvement of these systems were identified. Finally, a developing proposal was structured with the purpose of propounding actions that will positively impact the quality management systems in this type of health institution. Results: The implementation of the quality management systems in the low complexity health-care institutions in the city of San José de Cúcuta, in accordance with the principles of quality administration, has registered a basic level with results between 1.6 and 2.3 during the second semester of the year 2021 with an average of 2.0 compared to an expected goal of 5. According to the analysis of results, more opportunities for enhancement were detected instead of strengths, they are consistent with the degree of basic implementation detected where The Customer Focus principle has greater fortitudes rather than the Leadership principle, which registers the greatest number of enhancement opportunities. Taking into account the findings found and the context of low complexity health-care institutions (IPS), a proposal was structured with the propose of applying positive actions on five critical fronts: Firstly, to guarantee the quality leadership's commitment as a vital factor at sustaining the system. Secondly, to manage an organizational culture based on orientation and client's participation as well as recognizing that the user-family-community, stakeholders and concerned parties are an essential part in the sustainability of the organization itself. Thirdly, to continue with the strengthening of management through processes with a systemic approach. Fourthly, to promote a continuous enhancement culture along with the application of relevant and effective quality tools. Finally, to design and apply permanent education, training and development programs immersed in effective and direct communication mechanisms at all organization levels. Conclusions: Institutions that provide low-complexity health services in the city of San José de Cúcuta has presented a basic level of implementation of their quality management systems despite the fact that Colombian regulations have established a mandatory quality assurance system that provides standardized tools for the search for quality services, which shows weaknesses in the appliance of the mechanisms used. These facilities are committed to user-centered care; nevertheless, it is necessary to strengthen the analysis and monitoring these processes that will allow risk management, innovation and user loyalty. It is imperative to implement strategies to build the implementation of quality management systems in low-complexity health-care institutions (IPS) that take into account the leadership's commitment to quality as a vital factor in sustaining the system, the organizational culture with guidance and participation of the client and interested parties, the strengthening of management by applying processes with a systemic approach, the promotion of a culture of continuous improvement with the implementation of pertinent and effective quality tools and the design and execution of training, qualification and development programs in all organization levels. In this research, no considerable differences were detected in the level of implementation of the quality management system in health-care institutions (IPS) certified with ISO 9001:2015 compared to those that did not have it yet.
Background: Companies in the health sector are not only service providers, but also organizations that demand strategies aimed to achieve their objectives. The Colombian Health System requires that institutions must provide excellent health care in order to contribute to their users’ quality-of-life betterment by taking into account the Health Quality Assurance System. An adequate implementation of quality management systems in health places brings with it an increase in user-family satisfaction, and a grow in the competitive advantage of the establishment in the market. There is no research record at local degree that shows the level of implementation of quality management systems in health institutions. Objective: To determine a proposal for the health quality management systems improvement in the low complexity health-care institutions of the city of San José de Cúcuta, Norte de Santander, Colombia, which will be able to contribute to the strengthening of their performance and as well as the developing of health care in users who receive it in this type of facilities. Materials and Methods: An research instrument was designed and validated to measure the current state of quality management systems in 19 of low complexity health-care institutions by taking into account the principles of quality management such as the customer focus, leadership, people commitment, process approach, continuous improvement, evidence-based decision making and relationship management; Subsequently, through an in-depth analysis of the results, the advantages and opportunities for improvement of these systems were identified. Finally, a developing proposal was structured with the purpose of propounding actions that will positively impact the quality management systems in this type of health institution. Results: The implementation of the quality management systems in the low complexity health-care institutions in the city of San José de Cúcuta, in accordance with the principles of quality administration, has registered a basic level with results between 1.6 and 2.3 during the second semester of the year 2021 with an average of 2.0 compared to an expected goal of 5. According to the analysis of results, more opportunities for enhancement were detected instead of strengths, they are consistent with the degree of basic implementation detected where The Customer Focus principle has greater fortitudes rather than the Leadership principle, which registers the greatest number of enhancement opportunities. Taking into account the findings found and the context of low complexity health-care institutions (IPS), a proposal was structured with the propose of applying positive actions on five critical fronts: Firstly, to guarantee the quality leadership's commitment as a vital factor at sustaining the system. Secondly, to manage an organizational culture based on orientation and client's participation as well as recognizing that the user-family-community, stakeholders and concerned parties are an essential part in the sustainability of the organization itself. Thirdly, to continue with the strengthening of management through processes with a systemic approach. Fourthly, to promote a continuous enhancement culture along with the application of relevant and effective quality tools. Finally, to design and apply permanent education, training and development programs immersed in effective and direct communication mechanisms at all organization levels. Conclusions: Institutions that provide low-complexity health services in the city of San José de Cúcuta has presented a basic level of implementation of their quality management systems despite the fact that Colombian regulations have established a mandatory quality assurance system that provides standardized tools for the search for quality services, which shows weaknesses in the appliance of the mechanisms used. These facilities are committed to user-centered care; nevertheless, it is necessary to strengthen the analysis and monitoring these processes that will allow risk management, innovation and user loyalty. It is imperative to implement strategies to build the implementation of quality management systems in low-complexity health-care institutions (IPS) that take into account the leadership's commitment to quality as a vital factor in sustaining the system, the organizational culture with guidance and participation of the client and interested parties, the strengthening of management by applying processes with a systemic approach, the promotion of a culture of continuous improvement with the implementation of pertinent and effective quality tools and the design and execution of training, qualification and development programs in all organization levels. In this research, no considerable differences were detected in the level of implementation of the quality management system in health-care institutions (IPS) certified with ISO 9001:2015 compared to those that did not have it yet.
Descripción
Palabras clave
Sistema, Gestión, Calidad, Salud, Mejora, System, Management, Quality, Health, Improvement
