Implementação de um programa de navegação na especialidade de cirurgia cardiovascular

Abstract

Introduction: Patient navigation, introduced in 1990 by Harold Freeman, aims to facilitate access to healthcare, with a focus on chronic diseases. When conducted by a nurse, it is described as an intervention to reduce delays in accessing healthcare services and to provide personalized care throughout the treatment journey. It is an expanding model, contributing to the patient journey. Although little studied in cardiology, some studies have shown benefits in care, as evidenced by a 2017 study in the USA, which reported a reduction in 30-day readmission rates after discharge of patients with heart failure through a patient-centered approach. This raises the question: what are the main components for building a patient navigation program for individuals undergoing cardiovascular surgery? Objectives: To implement a navigation program in the cardiovascular surgery specialty, targeting patients undergoing myocardial revascularization and valve replacement. Methodology: This is a participatory action research study, structured into four main phases: problem identification, planning, action, and evaluation. Results: Of the 46 patients who participated in the study, 71% had comorbidities, 67% had a family history of heart disease, and 87% had not undergone previous surgical interventions. All patients (100%) were assessed and classified as needing navigation through the implemented program. As part of the proposed interventions, four Standard Operating Procedures were developed and validated, in addition to three informational flyers, which aimed to support the standardization and qualification of the care provided. Patient satisfaction with the program was 94.5%, and a significant reduction in preoperative waiting time was observed, decreasing from 10 to 2 days. Conclusion: The patient navigation program in the cardiovascular surgery specialty was able to reduce preoperative time and showed a high satisfaction rate among patients.