Estratégia de gestão para reduzir demanda e melhorar a qualidade do atendimento em um pronto atendimento do Noroeste do Paraná

Abstract

The organization of urgency and emergency care services is one of the main challenges of the Brazilian Unified Health System (SUS), especially in small municipalities, where high demand, overcrowding, limited resources, and the lack of standardized clinical protocols compromise the quality of care and patient safety. This dissertation aimed to develop, validate, and implement a clinical protocol for the urgency and emergency care unit of a Pronto Atendimento in the municipality of Mandaguaçu, located in Northwestern Paraná, integrating theoretical foundations, situational diagnosis, and analysis of the impacts of implementing the technical product. This is a methodological, applied study with a qualitative approach, conducted in four stages: situational diagnosis of the service based on the analysis of care organization and the perceptions of the multidisciplinary team; development and content validation of the clinical protocol by expert judges using the Content Validity Index (CVI) and Cronbach’s alpha coefficient; staff training and implementation of the protocol. Physicians, nurses, and nursing technicians participated in the study through convenience sampling. The situational diagnosis revealed structural and organizational weaknesses related to overcrowding, high demand, the absence of institutionalized clinical protocols, and insufficient continuous professional training. The developed protocol showed excellent content validity (overall CVI=0.92) and adequate internal reliability, demonstrating technical robustness and practical applicability. Staff training resulted in an average increase of 38% in participants’ knowledge, indicating a positive impact on the improvement of work processes. The integrated analysis of the results allowed for a discussion on the contributions of the protocol to standardizing clinical practices, improving care flow, supporting clinical decision-making, and strengthening patient safety, highlighting its potential as a management and innovation tool to enhance urgency and emergency care services in small municipalities.