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2019, Number 3

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Revista Cubana de Salud Pública 2019; 45 (3)

Diagnosis of hospitals processes’ variability in Cuba

Orellana GA
Full text How to cite this article

Language: Spanish
References: 26
Page: 1-23
PDF size: 465.84 Kb.


Key words:

process analysis, diagnosis, hospital processes, variability in clinical practice, Cuba.

ABSTRACT

Introduction: Health processes are frequently subject to changing environments and are governed by professionals with different backgrounds and criteria, whose decisions influence the practices. Variability negatively impacts on important managerial functions such as planning, management, control of resources and the quality of services.
Objective: To perform a diagnosis on the current state of the variability in the implementation of hospital’s processes in Cuba.
Methods: A research was carried out from January to May, 2016 and institutions of national subordination also participated. There were interviewed 49 specialists with experience in hospital management and 29 business process analysts. As methodological tool for diagnosis, it was used research-action, and there were applied techniques as: interviews, surveys, analysis of force fields, focal group, the tool of cause-effect’s diagram, and the method of cases study. Documentary analysis was used to identify the main causes that limit the detection of variability in the implementation of hospitals processes.
Results: The most relevant results allow ensuring that it is not possible to effectively contribute to the planning, control and management of resources without detecting and reducing variability. The methods currently used in Cuba are not enough to analyze and understand the behavior of hospital variability.
Conclusions: The modeling techniques and the existing methods to reduce variability are not effective in the Cuban health environments, due to the high variability in the processes and the complexity that these techniques present. In Cuba there is a need to detect the variability in hospital processes to support the decision making in this regard.


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Revista Cubana de Salud Pública. 2019;45