Geographic sectorization of hospitalized patients to health care teams. Impact on teamwork and patient satisfaction

Abstract

Historically, the wards of hospitals were divided by services such as medicine, surgery and traumatology, among others. To optimize the use of beds, undifferentiated medical surgical services were implemented in different hospitals in the country. This work organization had consequences in several areas, such as teamwork, the sense of belonging, the quality of teaching and travel times, among other factors. In 2018, at a Clinical hospital, we started a quality improvement project that consisted of assigning low complexity internal medicine teams to limited geographic areas, aiming to have sectorized teams. Through some Plan-Study-Do-Act (PDSA) cycles of continuous improvement, more than 80% of the patients were quickly sectorized, however there were multiple threats during the project. Pre- and post-implementation surveys were conducted with nurses, internal medicine residents, and medical Staff, highlighting an improvement in multiple aspects concerning the quality of communication, interdisciplinary work, the time of visits, and satisfaction, among others.