Abstract

۱٫ Introduction

۲٫ Method

۳٫ Results

۴٫ Discussion

۵٫ Conclusions

References

Abstract

     We aim to present the use and viability of mental health indicators at a Brazilian reference psychiatric hospital. We elaborated a Business Process Model and Notation based model of the patients’ hospitalization process based on semi-structured interviews with managers and professionals of the hospital. We analyzed the model and selected a set of 6 mental health indicators, based on evidence-based practice from other countries, using information from several Health Information Systems regarding hospitalizations from 2013 to 2017. In Brazil, there is a lack of methods for the manager to measure the actions carried out in mental health. Thus, the method proposed in this article can be used as metrics to assess the impact of public policy implementation and to assist planning and decision-making based on evidence in mental health.

Introduction

     The 66th World Health Assembly, composed of 194 Member States, adopted the Comprehensive Mental Health Action Plan of the World Health Organization (WHO) for the period from 2013 to 2020. One of the main objectives presented in this plan was to strengthen Health Information Systems (HIS) evidence and research in mental health. More specifically, this objective proposed that the basic concept in the creation of a HIS was the use of quality indicators that could provide relevant information to estimate improvements in mental health management [1].

One of the ways to carry out such management is mapping and modeling of business processes within hospital services, to identify points, along a process, where raw data can be collected for the subsequent generation of indicators. Business Process Model and Notation (BPMN) is a technique used to illustrate procedure models in a simple and easily understandable way that visually represents the sequence of tasks completed to achieve the organization’s goal [2].

Psychiatric hospitalization remains an indispensable therapeutic resource for many patients, especially for those with more severe conditions [3]. In particular, the hospital sector must manage activities of high operational complexity, in which it is necessary to concentrate trained human resources, the latest technology and diversified processes [4]. The use of indicators that contemplate the processes involved in this environment can be of great use for the management of hospital organizations and their stakeholders. These indicators, when addressing both the financial perspective and the clinical evolution of patients, and their flow within the process, can support efficient and effective management, in addition to assisting the development of strategic public policies [5].

Conclusions

     In this article, we presented the results of a BPM-based method to collect data for mental health indicators in a reference hospital in Brazil. The method includes modeling a hospitalization process using BPMN, pointing out the places and the HIS that support this collecting, and describing the results obtained for selected mental health indicators. These show important information that can be used to improve decision-making, not only from the clinical perspective, but also from the management, organizational and technological ones. Results and discussion already provide some valuable insights on the collected data, and point out possible areas of improvement. The method proposed can be applied to other health indicators, to comply with practices long observed in developed countries. Mapping these indicators to existing processes and HIS proven also to be a non-intrusive way of collecting these relevant data.