Aplicação de componentes do modelo adaptado de gestão de qualidade espanhol na análise dos processos de transplantes de órgãos e tecidos em um hospital universitário

Abstract

Brazil is the country that has the largest public transplant program in the world, however it is still not able to meet the needs of its population, which is perceived in data released by the Brazil association transplants (2018) in the last 4 year. In the state of Maranhão, the reality appears to be worse, since in the year 2022, there were only 12 multiple organ donors, a number far from the number of recipients who were active and waiting for transplants in the same year, which reached the peak of 1022 subscribers on the list. Among the 1022 registered, the organs required for transplants were kidneys, liver and corneas, the only types of transplants that Maranhão performs, so if we were to count the other types of transplants that the local population needs, the number would be higher. So, when there is a need to transplant other organs, such as lungs and hearts, the individual is referred to another unit of the federation, to receive the treatment. When analyzing the number of donors versus the number of active recipients in line, we observed that the state met just over 1% of its population's need, between the years 2018 to 2022, which leaves no doubt of the state's urgency to enable more donors. This work proposes to know the reality about the ability to identify possible donors of the only transplant hospital in the state of Maranhão, the University Hospital Presidente Dutra, also known as HUUFMA, the abbreviation that we will use. To obtain the information, we used the instrument of quality in transplants from ONT - National Organization of Transplants of Spain, we chose this instrument because the Spanish transplant program, which is considered one of the best models of transplants in the world and has extensive experience with quality programs, and the instrument already has an official Brazilian version validated. The instrument consists of a flowchart with directed questions that allow an audit of the medical records of patients who died in the adult ICU of the university hospital. The period analyzed were the years 2018 and 2019, these years were chosen because the period preceded the COVID 19 pandemic, so the sample was not affected by the pandemic. 312 medical records were evaluated between the years 2018 and 2019, and for each of these, instrument I was applied, which allows a screening based on clinical criteria. So, after applying instrument I, we selected 21 medical records in 2018 and 17 medical records in 2019, all with clinical signs of BD, totaling 38 records with BD signs in the two years.