Determinación de las causas especiales que afectan la estabilidad de calidad del proceso de facturación del procedimiento de la cirugía revascularización miocárdica

Abstract

The purpose of this project is to determine the special causes that affect the stability of quality in the process of coronary artery bypass surgery in a health entity. for the realization of this research a study, where the surgical medical elements used in each of the surgeries were recorded, allowing to make comparisons between the invoice generated by the system of the entity and the bill taken in real time by students group. This activity allowed evidence that one of the shortcomings reflected in the variation in costs, which is attributed to the defects presented in the surgery observed through a detailed and comprehensive analysis of quality control. In order to determine the special causes that affect the stability of the quality of coronary artery bypass surgery procedure. The identification process was conducted by an induction provided from the responsible in charge of operating room floor four of the entity, which whom the group proceeded to make a diagnosis in order to establish the current state of the situation with a short explanatory and quantitative study, determining a sampling established by the month with the highest incidence in surgeries performed in the first half of 2015, obtaining 24 surgeries which are only able to take 23 due to non-constant frequency of the programming of these surgeries, because during the second two months of the year the schedules are lower. Based on the diagnosis made and through formats designed by the students group, with the committee in charge of the health institution for this research, the defect was identified critical. Leading to a further sampling, collecting only 15 samples during a period of approximately five weeks (not counting the days when this type of surgery was not scheduled) in the area in which the defect identified was located. Then a prioritization of recurring defects was performed using quality tools, a fishbone and prioritization matrix in which the potential causes of the process where described. Continuing to implement a plan of action that would mitigate the impact of the defect found in billings, by applying control charts with their respective analysis of the special causes that affect the process, in order to make a proposal of the improvement plan. The investigation was aligned with the different procedures, times and internal policies of the entity health.