Plan de mejora continua de los procesos de gestión de la farmacia comunitaria de Huépil, Región del Bío-Bío en el año 2022
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2022
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es
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Universidad Andrés Bello
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Resumen
Las Farmacias Comunales, tienen como principal objetivo mejorar el acceso a medicamentos en personas de escasos recursos y que viven en comunas que no cuentan con servicios farmacéuticos locales; este tipo de farmacias entregan precios bajos en comparación con las grandes cadenas farmacéuticas e independientes. No obstante, debido a la autonomía Municipal en materias de salud y desarrollo social en Chile, cada municipio, toma decisiones de manera independiente en torno al modelo de gestión a seguir en sus respectivas farmacias comunales. Esto implica que no existe un modelo único de gestión, más bien se genera una gran heterogeneidad de modelos de gestión de Farmacia Comunitaria.
En materia de lineamientos Centrales para Farmacias Comunitarias, a la fecha sólo se dispone del documento “Recomendaciones para Farmacias Populares” orientado en tópicos de abastecimiento, vinculación con la atención primaria en salud y uso racional de medicamentos. Lo anterior, supone un desafío al momento de mejorar las orientaciones técnicas relativas a la calidad asistencial centrada en el usuario y mejorar los procesos de gestión farmacéutica.
La experiencia internacional de Farmacias Comunitarias en procesos de Acreditación, nos demuestran que la aplicación de Estándares que midan buenas prácticas de los servicios farmacéuticos ha permitido implantar y garantizar servicios farmacéuticos de calidad que disminuyen los riesgos de tratamiento y otorgan satisfacción usuaria. Por tal motivo, se hace necesario adoptar estándares que permitan medir y mejorar la calidad de los servicios de las Farmacias Comunitarias, evitando así inconsistencias entre las mismas. En base a lo anterior, como plan piloto de un sistema de evaluación, se efectuó durante el año 2022, un diagnóstico situacional de los Procesos de Gestión de la Farmacia Comunitaria de Huépil, la que corresponde a un establecimiento de Salud Pública, ubicado en la comuna de Huépil, Región del Bío-Bío, que busca mejorar el acceso de medicamentos a los usuarios inscritos con residencia en las comunas de Huépil, Rucamanqui, Trupán, Polcura y Tucapel. Esta farmacia tiene actualmente 2.405 usuarios inscritos y validados; y se caracteriza por estar especializada en atención de población adulto mayor, ya que se encuentra anexa a un Centro Geriátrico. Cabe destacar, que esta farmacia es una de las pioneras en el área, ya que sus inicios se remontan al año 2016.
La relevancia de este estudio radica en la obtención de un diagnóstico situacional de los Procesos de Gestión de la Farmacia Comunitaria de Huépil llevados a cabo durante el año 2022 a raíz de un proceso de evaluación de estándares de calidad del servicio farmacéutico.
Para llevar a cabo este proceso de evaluación, se contempló la medición de estándares presentes en el “Manual de Estándares de Farmacia Comunitaria de la Agencia de Calidad Sanitaria de Andalucía” (ACSA), el cual aborda las siguientes dimensiones de la calidad asistencial: 1. Usuario como centro del sistema sanitario; 2. Organización de la actividad centrada en el usuario; 3. Profesionales; 4. Procesos de soporte y 5. Mejora continua. En virtud de que no se tuvo acceso a la Pauta de cotejo original aplicada por dicha agencia, este trabajo impulsó el diseño de la “Pauta de cotejo del Manual Estándar de Farmacia Comunitaria”, adaptada a la realidad Nacional y confeccionada en base a la estructura de las pautas de cotejo ya existentes en el proceso de Acreditación de Prestadores Institucionales en Chile, formulados por el Ministerio de Salud [MINSAL]. La aplicación de esta pauta de cotejo en un proceso de evaluación de estándares, hizo posible identificar falencias tanto en la calidad del servicio como en la gestión de procesos que brinda la Farmacia Comunitaria de Huépil. De acuerdo con los resultados obtenidos en el proceso de evaluación de la Farmacia comunitaria de Huépil, se encuentra categorizada en “Nivel de Desempeño Deficiente”. Por tanto, en base a estos resultados, las falencias detectadas fueron trabajadas sobre una matriz decisional de priorización, permitiendo seleccionar aquellos hallazgos con prioridad de resolución acorde a la realidad local del establecimiento. Una vez identificados los problemas prioritarios, se procede a buscar la causa-raíz que los originó haciendo uso de la herramienta Diagrama de Ishikawa (causa-efecto).
Finalmente, la motivación principal de este estudio radica en elaborar un Plan de Mejora Continua de los Procesos de Gestión de la Farmacia Comunitaria de Huépil, Región del Bío-Bío en el año 2022, el que permite diseñar estrategias de resolución de problemas garantizando la calidad de los servicios ofrecidos y contribuyendo a que ocurra un cambio conductual favorable y progresivo en los funcionarios; estableciendo un espíritu de mejora continua y trabajo en equipo.
Asimismo, este estudio pretende contribuir como marco de referencia para que las demás Farmacias Comunitarias del país se sometan a un proceso de Acreditación que evalúa tanto la gestión de procesos como la calidad del servicio.
The Communal Pharmacies, have like main objective improve the access to medicines in low income people and that live in communes that do not have pharmaceutical services venues; this type of pharmacies delivers low prices in comparison with the big pharmaceutical chains and independent. Nevertheless, because of the municipal autonomy in matters of health and social development in Chile, each municipality, takes decisions of independent way around the model of management to be followed in their respective communal pharmacies. This involves that it does not exist an only model of management, rather generates a big heterogeneity of models of management of Community Pharmacy. In matter of central guidelines for Community Pharmacies, to the date only the `Recommendations for Popular Pharmacies` document is available, oriented on supply topics, connection with primary health care attention and rational use of medicines. The previous, represents a challenge when it comes to improving technical guidelines related to quality of care focused on the user and improving pharmaceutical management processes. The international experience of Community Pharmacies in processes of accreditation, show us that the application of Standards that measure best practices of the pharmaceutical services have allowed to implant and guarantee pharmaceutical services of quality that diminish the risks of treatment and provide user satisfaction. By such reason, it is necessary to adopt standards that allow to measure and improve the quality of the services of the Community Pharmacies, this way avoiding inconsistencies between the same. Based on the above, as a pilot plan of a system of evaluation, was carried out during the year 2022, a situational diagnostic of the Processes of Management of the Community Pharmacy of Huépil, the one who corresponds to an establishment of Public Health, situated in the commune of Huépil, Region of the Bío-Bío, that looks for to improve the access of medicines to the users inscribed with residence in the communes of Huépil, Rucamanqui, Trupán, Polcura and Tucapel. This pharmacy currently has 2.405 users inscribed and validated; and it characterizes for being specialized in attention of older adult population, since it finds attaches to a Geriatric Center. It should be noted that this pharmacy is one of the pioneers in the area, since its beginnings go back to the year 2016. The relevance of this study lies in obtaining a situational diagnosis of the Processes of Management of the Community Pharmacy of Huépil carried out during the year 2022 as a result of a process of evaluation of standards of quality of the pharmaceutical service. To carry out this process of evaluation, the measurement standards present in the ´Manual of Standards of Community Pharmacy of the Agency of Quality of Andalucía´ (ACSA) was considered, which addresses the following dimensions of assistance quality: 1. User like center of the sanitary system; 2. Organization of the activity centered in the user; 3. Professionals; 4. Processes of support and 5. Continuous improvement. In virtue of not having access to the original Guideline applied by said agency, this work allowed to design a checklist of the Standard Manual of Community Pharmacy, adapted to the National reality and made in base to the structure of the existing checklists in the process of Accreditation of Institutional providers in Chile, published by the Superintendency of Health [SIH]. The application of this checklist in a process of evaluation of standards, made possible to identify shortcomings both in the quality of the service and in the management of processes provided by the Community Pharmacy of Huépil. According to the results obtained in the evaluation process, the Huépil Community Pharmacy is categorized in “Poor performance Level”. Therefore, in base to the results obtained, the shortcomings detected were worked on a prioritization decision matrix, allowing the selection of those findings with resolution priority according to the local reality of the establishment. Once identified the priority problems, proceeds to look for the root cause that originated them, doing use of the tool Ishikawa diagram (cause-effect). Finally, the main motivation of this study lies in elaborating a Plan of Continuous Improvement of the Processes of Management of the Community Pharmacy of Huépil, Region of the Bío-Bío in the year 2022, the one who allows designing problem-solving strategies guaranteeing the quality of the services offered and contributing to the occurrence of a favorable and progressive behavioral change in the workers, establishing a spirit of continuous improvement and teamwork. Likewise, this study pretends to contribute as a reference framework so that the other Community Pharmacies of the country subject to a process of Accreditation that evaluates process management and service quality
The Communal Pharmacies, have like main objective improve the access to medicines in low income people and that live in communes that do not have pharmaceutical services venues; this type of pharmacies delivers low prices in comparison with the big pharmaceutical chains and independent. Nevertheless, because of the municipal autonomy in matters of health and social development in Chile, each municipality, takes decisions of independent way around the model of management to be followed in their respective communal pharmacies. This involves that it does not exist an only model of management, rather generates a big heterogeneity of models of management of Community Pharmacy. In matter of central guidelines for Community Pharmacies, to the date only the `Recommendations for Popular Pharmacies` document is available, oriented on supply topics, connection with primary health care attention and rational use of medicines. The previous, represents a challenge when it comes to improving technical guidelines related to quality of care focused on the user and improving pharmaceutical management processes. The international experience of Community Pharmacies in processes of accreditation, show us that the application of Standards that measure best practices of the pharmaceutical services have allowed to implant and guarantee pharmaceutical services of quality that diminish the risks of treatment and provide user satisfaction. By such reason, it is necessary to adopt standards that allow to measure and improve the quality of the services of the Community Pharmacies, this way avoiding inconsistencies between the same. Based on the above, as a pilot plan of a system of evaluation, was carried out during the year 2022, a situational diagnostic of the Processes of Management of the Community Pharmacy of Huépil, the one who corresponds to an establishment of Public Health, situated in the commune of Huépil, Region of the Bío-Bío, that looks for to improve the access of medicines to the users inscribed with residence in the communes of Huépil, Rucamanqui, Trupán, Polcura and Tucapel. This pharmacy currently has 2.405 users inscribed and validated; and it characterizes for being specialized in attention of older adult population, since it finds attaches to a Geriatric Center. It should be noted that this pharmacy is one of the pioneers in the area, since its beginnings go back to the year 2016. The relevance of this study lies in obtaining a situational diagnosis of the Processes of Management of the Community Pharmacy of Huépil carried out during the year 2022 as a result of a process of evaluation of standards of quality of the pharmaceutical service. To carry out this process of evaluation, the measurement standards present in the ´Manual of Standards of Community Pharmacy of the Agency of Quality of Andalucía´ (ACSA) was considered, which addresses the following dimensions of assistance quality: 1. User like center of the sanitary system; 2. Organization of the activity centered in the user; 3. Professionals; 4. Processes of support and 5. Continuous improvement. In virtue of not having access to the original Guideline applied by said agency, this work allowed to design a checklist of the Standard Manual of Community Pharmacy, adapted to the National reality and made in base to the structure of the existing checklists in the process of Accreditation of Institutional providers in Chile, published by the Superintendency of Health [SIH]. The application of this checklist in a process of evaluation of standards, made possible to identify shortcomings both in the quality of the service and in the management of processes provided by the Community Pharmacy of Huépil. According to the results obtained in the evaluation process, the Huépil Community Pharmacy is categorized in “Poor performance Level”. Therefore, in base to the results obtained, the shortcomings detected were worked on a prioritization decision matrix, allowing the selection of those findings with resolution priority according to the local reality of the establishment. Once identified the priority problems, proceeds to look for the root cause that originated them, doing use of the tool Ishikawa diagram (cause-effect). Finally, the main motivation of this study lies in elaborating a Plan of Continuous Improvement of the Processes of Management of the Community Pharmacy of Huépil, Region of the Bío-Bío in the year 2022, the one who allows designing problem-solving strategies guaranteeing the quality of the services offered and contributing to the occurrence of a favorable and progressive behavioral change in the workers, establishing a spirit of continuous improvement and teamwork. Likewise, this study pretends to contribute as a reference framework so that the other Community Pharmacies of the country subject to a process of Accreditation that evaluates process management and service quality
Notas
Tesis (Magíster en Salud Pública)
Palabras clave
Farmacias, Mejora Contínua de Procesos, Atención Primaria de Salud, Chile, Región del Bío-Bío, Comuna de Hualpen