Gestión del BQ
La actividad quirúrgica adquiere una dimensión de enorme importancia en la actividad asistencial. La cirugía es la única razón de admisión para muchos pacientes que ingresan en el hospital tanto en España como en los países occidentales desarrollados.
En España se realizan alrededor de 4.500.000 de procedimientos quirúrgicos al año con un incremento anual de un 6-7% en los últimos años. La frecuentación quirúrgica en España fue, en 2005, de 95,7 por mil habitantes, siendo de 49,6 por mil habitantes para las intervenciones quirúrgicas con hospitalización y de 22,7 por mil habitantes para las intervenciones de cirugía mayor ambulatoria. Esta enorme actividad es fruto de varios factores: la mejora de los resultados en los procedimientos quirúrgicos por los avances de la cirugía y la anestesia, una menor agresividad por la generalización de técnicas mínimamente invasivas, la cirugía mayor ambulatoria, una mayor accesibilidad de la población a la asistencia sanitaria y el envejecimiento demográfico.
La gestión de las áreas quirúrgicas ha evolucionado intensamente en los últimos años. Desde los años sesenta, en que los hospitales construían quirófanos sin una excesiva preocupación por los costes que ocasionaban, el incremento del gasto quirúrgico ha sido motivo de debate y, actualmente, es una exigencia contar con un bloque quirúrgico eficiente. En este curso se revisan los principios generales de organización y gestión clínica de bloques quirúrgicos en el contexto de los hospitales públicos españoles, desde un punto de vista práctico y asistencial. Considerando el acto quirúrgico como uno más en el largo proceso asistencial de un paciente, desde que es remitido por un médico de cabecera y visitado en la consulta de cirugía hasta que es dado de alta definitivamente tras la intervención, la gestión del bloque quirúrgico (BQ) debe ser global y atender a múltiples ramificaciones o actividades colaterales en el proceso. A efectos prácticos, sin embargo, cabe destacar tres grandes ámbitos de gestión: de la actividad quirúrgica, de los procesos y circuitos perioperatorios y del material quirúrgico.
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