Browsing by Author "Vinci, André Luiz Teixeira"
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- Development and proposal of a reference tool for semi-structured interviews for the characterization of the management in mental health networksPublication . Vinci, André Luiz Teixeira; Rijo, Rui Pedro Charters Lopes; Marques, João Mazzoncini de Azevedo; Alves, DomingosIn 2011, Brazil’s mental health care networks were instituted; nevertheless, standardized arrangements or indicators for network evaluation and management were not established. Hence, a proposed model to evaluate municipal and regional management of such networks was elaborated. One of its steps consists of semi-structured interviews aiming the network management knowledge. Therefore, this paper aimed the development and validation of a reference tool for conducting interviews focusing on assessment of mental health care network management. Methods comprised definition of interest topics, questions elaboration for each topic, preliminary script preparation, script validation, script adequacy and definition of final script. Thus, the developed script consisted of 29 questions and 8 follow-up questions divided over 8 topics (interviewee characterization, legislation, decision-making processes, network structure, management participants, information systems, indicators, and knowledge of external experiences). The script also added individualized field reports and interview planning and execution guidelines. After validation, it was concluded that chosen topics were relevant and appropriate, despite minor modifications; and estimated average interview time remained close to prior established. Therefore, the developed tool can assist collecting information to help managers evaluate the network and improving population health. Moreover, the tool could be used in other localities or adapted for other networks.
- Development and validation of a pharmacoeconomic tool for decision making in the implementation of pharmaceutical care for hypertensive patients in the Brazilian public health system (SUS)Publication . Cazarim, Maurílio de Souza; Reis, Rodrigo; Wu, Olívia; Rijo, Rui Pedro Charters Lopes; Vinci, André Luiz Teixeira; Alves, Domingos; Pereira, Leonardo Régis LeiraSystemic Arterial Hypertension (SAH) is a risk factor for 9.4 million deaths worldwide. In Brazil, the condition attributes an annual cost of approximately USD640,000,000 to the SUS. The epidemiological and economic analysis of Pharmaceutical Care (PC) in the management of hypertensive patients showed an improvement in blood pressure control, a reduction of the risk of SAH complications, and an investment return of over USD1.7 million after ten years. Therefore, this article aims to present a pharmacoeconomic tool capable of assisting decision making in the implementation of PC in the SUS. A systematic review is being conducted for the robustness of the estimation of clinical and epidemiological impact of SAH, its results will be tabulated and applied in the improvement of the tool together with the direct medical and non-medical costs, indirect costs and costs of the SAH. In addition, a Markov model will be designed to estimate the incidence of cardiovascular diseases and SAH’s associated diseases by studies of proteomics that address the Human Network Disease. We hope to validate this auxiliary tool and thus to improve blood pressure control among hypertensive patients, quality of life, to reduce comorbidities and deaths, as well as optimizing the use of health resources.
- The process of outpatient care of children and adolescents in a tertiary‐level hospital specializing in pediatrics: A case study focused on identifying opportunities for improvement with the aid of modeling using BPMNPublication . Vinci, André Luiz Teixeira; Barbosa, Francisco; Silvia Inês Dallavalle de Pádua; Rijo, Rui, Rui Pedro Charters Lopes; Alves, DomingosIntroduction Business process management has gained importance in organizations for providing improved productivity and cost reduction, with process modeling being the central role. Usually, with reduced resources, the health area can benefit from good management of its processes. Objective To identify proposals for improvements in the process of outpatient care of children and adolescents in a tertiary-level—the most specialized and complex—pediatric hospital. Methods A bibliographic survey on the subject and a case study with in loco observation of the processes with semistructured interviews with the professionals involved were carried out. Alpha Hospital was chosen for this study, and the modeling of the process was performed using Business Process Model and Notation. Results Twelve relevant articles were identified. The “AS-IS” model of the process was obtained as a result and presents the existing 4 subprocesses (patient reception, preconsultation, consultation, and postconsultation). Specifically, the following improvement opportunities were identified: (a) process monitoring through indicators; (b) adequacy of the information system; (c) creation of service evaluation mechanisms; and (d) definition and application of training sessions for whenever a new professional begins working in a specific sector. The problem with the waiting time for patient care was also identified, but with no obvious solution; further studies should be carried to solve the problem. Conclusion The use of the business process modeling approach and process analysis allowed the hospital team awareness of the process and the identification of an improved set that can be helpful to Alpha Hospital or be used by other hospitals.
- Proposal of an Evaluation Model for Mental Health Care Networks Using Information Technologies for its ManagementPublication . Vinci, André Luiz Teixeira; Rijo, Rui Pedro Charters Lopes; Marques, João Mazzoncini de Azevedo; Alves, DomingosThe Brazilian public health system instituted the mental health care networks in 2011. Thus, the goal of this paper is to describe the research methods used as basis for a proposal of an evaluation model of municipal and regional management of a Mental Health Care Network that comprises computerized information systems and specific indicators. Proposed steps include: Review of Brazilian legislation on management in mental health care networks, Formulation of questions about how is mental health care management in the region; Semi-structured interviews with stakeholders about the performance of the network; Study of existing indicators in mental health field used in universal public health systems; Selection of indicators for implementation and availability in a web information system; Monitoring the system's access to obtain indicators’ usage; Another set of semi-structured interviews to evaluate effective use of the provided indicators in management of mental health care. The results obtained will be evaluated qualitatively and quantitatively to compare the final overview with the initial one, regarding mental health care network management, and if the use of computerized indicators influenced it. The use of the proposed methods in specific localities will enable expansion of local knowledge improving management and health care quality.
- A web-based information system for a regional public mental healthcare service network in BrazilPublication . Yoshiura, Vinicius Tohoru; Azevedo-Marques, João Mazzoncini de; Rzewuska, Magdalena; Vinci, André Luiz Teixeira; Sasso, Ariane Morassi; Miyoshi, Newton Shydeo Brandão; Furegato, Antonia Regina Ferreira; Rijo, Rui Pedro Charters Lopes; Del-Ben, Cristina Marta; Alves, DomingosBackground: Regional networking between services that provide mental health care in Brazil’s decentralized public health system is challenging, partly due to the simultaneous existence of services managed by municipal and state authorities and a lack of efficient and transparent mechanisms for continuous and updated communication between them. Since 2011, the Ribeirao Preto Medical School and the XIII Regional Health Department of the Sao Paulo state, Brazil, have been developing and implementing a web-based information system to facilitate an integrated care throughout a public regional mental health care network. Case presentation: After a profound on-site analysis, the structure of the network was identified and a web-based information system for psychiatric admissions and discharges was developed and implemented using a socio-technical approach. An information technology team liaised with mental health professionals, health-service managers, municipal and state health secretariats and judicial authorities. Primary care, specialized community services, general emergency and psychiatric wards services, that comprise the regional mental healthcare network, were identified and the system flow was delineated. The web-based system overcame the fragmentation of the healthcare system and addressed service specific needs, enabling: detailed patient information sharing; active coordination of the processes of psychiatric admissions and discharges; real-time monitoring; the patients’ status reports; the evaluation of the performance of each service and the whole network. During a 2-year period of operation, it registered 137 services, 480 health care professionals and 4271 patients, with a mean number of 2835 accesses per month. To date the system is successfully operating and further expanding. Conclusion: We have successfully developed and implemented an acceptable, useful and transparent web-based information system for a regional mental healthcare service network in a medium-income country with a decentralized public health system. Systematic collaboration between an information technology team and a wide range of stakeholders is essential for the system development and implementation.