Service and implementation flow review for the reception and screening station: emergency unit inserted in the sus [single health service] context

Abstract

The urgency and emergency services are extensively and wrongly sought after by low-complexity patients. The referred emergency unit (REU) at HC/Unicamp reached the 400 services/day average, leading to the improper occupation of noble areas with simple cases, with overpopulation and neglect. Goal: Describe the REU's first service flow. Method: A descriptive study reports the experience with the creation of a service flow for patients at REU. The reception started being made in an external area to REU, by a multidisciplinary team made up by security guards, administrative technicians, nurses, physicians and social workers. There were consensus meetings between all people involved (physicians, nurses, social service, school, superintendency, city halls, etc); physical structure adaptation; change of team culture and training. Results: The pilot project took place in April 2015 and the implementation in May. A fall in the number of services performed in the implementation month (approximately 10,000 in 05/2014 and 6,000 in 05/2015) was observed. The following was also observed: decrease on the waiting time for service; increase of user and employee satisfaction; conflict decrease; improvement on the teaching and service environment. Discussion: The next actions to make viable the referred service of severe patients will be: the physical unit block; the improvement on the HC complex' internal flows; and the focus maintenance on the reference system. Conclusion: The service flow definition is an efficient tool to organize the referred emergency services, as a way to ensure a high-class assistance.