Gestão da qualidade em hemocentros coordenadores: análise documental a partir de dois estados de diferentes regiões do Brasil.

Abstract

Quality is an increasing demand in the healthcare sector, reflecting humanity’s ability to adapt and meet its needs. In the context of hemotherapy, quality management becomes vital to ensure transfusion safety and the effectiveness of services provided. This study aims to: discuss quality management and aspects of its implementation in coordinating blood centers in two Brazilian regions. The specific objectives are: to characterize quality management in coordinating blood centers in two regions of Brazil; to identify initiatives, strategies, and actions developed by quality management in these centers; and to produce a synthesis of recommendations to improve quality and promote the implementation of a Quality Management System (QMS) in blood centers. This is an exploratory study with a qualitative approach, involving state coordinating blood centers from two Brazilian regions. It was developed through document review (State Health Plan, Blood Master Plan), as well as content searches on digital media (institutional websites of the respective state blood networks). The analysis plan for this study consisted of a set of aspects or components related to quality management: organizational structure of the blood centers; infrastructure (physical resources); digitalization and information systems; Quality Management System (QMS); contracting; risk management; transfusion safety; patient safety; quality of care and assistance (hemotherapy and hematology); continuing education; monitoring and indicators/evaluation. The results for Ceará indicated consistent progress in the quality management of the Coordinating Blood Center, highlighting the integration of hemotherapy into the SUS healthcare network, the requirement for good practices and structural sanitary conditions, the implementation of traceability to reduce adverse events, and the adoption of ISO 9001 certification. Additionally, actions focused on continuing education, digitalization of transfusion processes, and contracting based on efficiency and quality criteria were observed. Transfusion safety practices were consolidated through exams and protocols based on national regulations. In Minas Gerais, the Hemominas Foundation stands out for its decentralized and hierarchical organizational structure, aligned with a clear institutional mission and a strategic map that values innovation, excellence, and safety. The state network has expanded physical infrastructure that meets sanitary requirements, clinical protocols for patient safety, and indicators of transfusion effectiveness. The quality management system is strengthened by international certifications, with the participation of local committees and units, and supported by continuing education and ongoing training initiatives. Digitalization is a structural axis, encompassing the “Blood Cycle” system and electronic medical records, while contracting with private hemotherapy services contributes to ensuring efficiency and effectiveness of the model. Transfusion safety practices are also reinforced by protocols and active participation in transfusion committees. The recommendations produced as a technical output of this study were synthesized from the results to promote quality improvement and the implementation of the Quality Management System in blood centers. Finally, this research highlighted the relevance of the various aspects that characterize and determine the quality of hemotherapy services offered to the population.