Diseño de un instrumento de auditoría basado en los estándares de acreditación internacional Canadá para los centros de salud tipo c del ministerio de salud pública del Ecuador

Abstract

This research work has the structure and information of an Audit instrument based on the Canada Accreditation Standards for Type C Health Centers of the Ministry of Public Health of Ecuador. The current Ecuadorian Health System is based on the Model of Integral Care in Family, Community and Intercultural Health "MAIS" to which this Ministry has generated several regulations to achieve compliance, whose challenge is to work with families, create new relational forms, locate the user in the center of attention, installing new practices that develop interventions oriented to results of improvement of effectiveness, decision making and social impact.

The instrument that has been obtained through this research work, poses a path to the implementation of standards that help identify improvements in health facilities of type C of the Ministry of Public Health of Ecuador.

Our country has a broad legal and regulatory framework related to the guarantee of the right to health, the structure of the National Health System and the protection of vulnerable groups; Likewise, International Agreements have been signed to guide the comprehensive health care of the population; However, by not having an instrument of this type, which accommodates structured standards in a compliance matrix, does not allow comprehensive management to be measured by international standards, which makes it difficult to measure the Public Health Service.

By knowing the reality of the Canada International Accreditation process that some hospitals in our country had to undergo, we saw the need to accept the model that allows us to design the Audit Instrument for Type C Health Centers; therefore, through the executed study, the legal requirement of the Ecuadorian legislation was adapted to each standard of the different services, which was subsequently validated by expert professionals considering the dimensions of readability, relevance, coherence and sufficiency, this first survey was carried out 8 processes that are part of this type of health center, to which 3 processes raised in the study were associated as a complement "Proposal of an instrument for the audit of diagnostic support services of type C health centers Ministry of Public Health of Ecuador based on the International Accreditation Standards Canada ", in this way a total of 11 processes were generated, each one of them with its respective matrix, the processes are: Processes applicable to the entire system

1. Control and Prevention of Infection 2. Management of the medication 3. Leadership 4. Preparation for Emergencies and Disasters

Process of direct provision of care 1. Medical Services 2. Biomedical Laboratory Services 3. Diagnostic Imaging 4. Reprocessing and Sterilization of Reusable Medical Devices 5. Emergency Services 6. Care of Outpatient Services 7. Obstetric Services

The 11 final matrices of the instrument were applied in a pilot test in the Tabacundo Health Center type C, belonging to the District Directorate 17D10 - Cayambe - Pedro Moncayo - HEALTH of the Ministry of Public Health of Ecuador, achieving a broader scope of qualitative character , which was subsequently validated its construct according to the dimensions of efficiency, effectiveness, decision making and social impact.

In this way the Design of an audit instrument based on the International Accreditation Canada standards was obtained for the type C health centers of the Ministry of Public Health of Ecuador, whose validation of both content and construct exceed the values ​​of 0.7, which indicates that the instrument is valid and reliable.