Reingeniería de un proceso asistencial. Reducción de la lista de espera de varices

Identifier:  TDX:627

Handle: https://hdl.handle.net/20.500.11797/TDX627

Authors:  Hernández Osma, Esteban

Abstract:
Introduction. Most vascular surgery services are affected by the problem of the length of the waiting lists for treatment of varicose veins. A number of approaches can be used to handle these lists, including organisational-type measures that are oriented towards enhancing efficiency by implementing a more suitable method of managing them. Process re-engineering techniques are one of these measures that can help us to establish a more adequate way of managing such waiting lists. Aim. To redesign the therapy process in order to reduce the waiting lists for treatment of varicose veins in a vascular surgery service. Materials and methods. The number of patients on the waiting list for surgery to correct varicose veins was 305. To deal with this waiting list, the process used in varicose vein therapy was redesigned in three phases: analysis of the varicose vein therapy process and determination of its critical points; implementation of strategies for the creation of the new varicose process and evaluation of the new process as regards its efficacy (reduction in the length of the waiting list), efficiency (average time of access to clinic, average time of access to surgery and mean stay), effectiveness (test for quality of life) and technical quality (complications, re-admissions and relapses).Results. Efficay: in one year a total of 335 operations were carried out to treat varicose veins in 323 patients, with a theatre compliance rate of 95.7%; efficiency: average time access to clinic 35.7 days (r=20-65), average time access to surgery 95.2 days (r=15-170), mean stay 1.7 days (r=0-11); effectiveness: at one year follow-up, the overall quality of life of the patients who had undergone surgery had increased by 5 points; and technical quality: in all there were nine complications (2.6%). There were five readmissions (1.4%) and three relapses at one year (0.9%). Conclusions. Applying a re-engineering programme enabled us to reduce our waiting lists for treatment of varicose veins in an effective manner. Key words. Quality of life. Redesign. Re-engineering. Varicose veins. Waiting list.