Diagnosis of care improvement needs in ambulatory major surgery and surgery with short stay

Foundation: Major outpatient surgery and short stay surgery have undergone a remarkable development in the last decades; there are, however, difficulties in their execution, mainly due to poor communication and coordination between the primary and secondary care levels. Objective: to make a diagnosis of care improvement needs in ambulatory major surgery and short stay surgery. Methods: an observational and descriptive study was conducted from January to June 2012, at the Arnaldo Milian Castro University Hospital in Santa Clara, Villa Clara. Interviews and surveys were applied to surgeons, family doctors and nurses, patients and family members. The normative documents of the health sector were also analyzed. Results: the analysis of documents revealed the systemic conception approach in the care process in general, as well as in the particular case of the ambulatory major surgery and the short stay surgery, although the ways for this conception achievement are not explicit. There was a coincidence in the information provided by the interviews and surveys conducted, regarding the lack of coordination between the health care levels, the determining role of primary health care professionals in this process, the absence of regulatory instruments for that activity and the importance of the latter. Conclusion: the lack of coordination between the levels of primary and secondary care was evident, with respect to planning of major ambulatory and short-stay surgery interventions.