Estudo observacional da clínica de prótese dentária da Odontoclínica Central da Marinha através da metodologia lean healthcare

Abstract

Introduction: Oral health plays an important role in people's quality of life. Most of the time, negligence in the oral health care process culminates in tooth loss or serious illness. Odontoclínica Central da Marinha is considered the largest in Latin America due to the large volume of daily consultations, with a monthly average of 16,000 patients and a monthly average of 14,798 procedures. The removable prosthesis clinic not reaching the goal of 100% of discharges established in the Plan of Goals and Evaluation of Results recommended by the Navy Health Board motivated the search for answers to the question: the service process at the removable prosthesis clinic needs adjustments to reach the target set by the Navy Health Board? Lean Thinking has been implemented in clinics, offices and hospitals, with the aim of achieving improvements in the processes of dental and oral health services, reducing waste, eliminating redundancies in activities and increasing care safety. Objective: To study the systematic care of patients at the dental prosthesis clinic of Odontoclínica Central da Marinha through the Lean Healthcare methodology. Materials and Methods: Between January and July 2022, at the Odontoclínica Central da Marinha (OCM), located in the First Naval District in the city of Rio de Janeiro, an observational, descriptive and prospective study was carried out, carried out through a case study with a quali-quantitative approach that emphasized its qualitative aspects, by virtue of suggesting alternative means to propose suggestions for improvements to the systematic care of patients in the removable dental prosthesis clinic of Odontoclínica Central da Marinha using the Lean Healthcare methodology, and presents, in terms of purposes, the character of applied research. Results: The discharge rate established was 100% and in the prosthesis clinic this rate was between 50 and 69%, being related to the number of repetitions due to the detection of several problems, the initial impression being the most frequent. A standard operating protocol was applied in the denture clinic consultations in order to avoid that the initial impression was repeated several times. The average age of users was 54 years old, the majority being female, white with high school education, dependent on the square and residents of the municipality of Duque de Caxias. The average treatment time was 230 days, with an average of 4 consultations. There were no absences or repetitions. The level of patient satisfaction was considered “very good”. Conclusions: The Lean methodology can result in significant improvements to the processes in several health organizations, reducing waste, increasing safety at work, promoting an improvement in patient care. However, more studies are needed to evaluate the effects of applying the Lean methodology in the dental services of Odontoclínica Central da Marinha.