Reestruturação de uma comissão de cuidados com a pele em uma instituição oncológica na perspectiva do pensamento lean

In order to offer quality health care at the lowest possible cost, using and valuing the material resources and human potential existing in the institutions, it is believed that it is necessary to use a theoretical and methodological model that can support and subsidize the management implementation process. of health care with the skin. In this way, the general objective of the research was: to restructure the skin care commission in an oncology institution from the perspective of the theoretical and methodological framework of lean. Methodology: This is a descriptive research, with a participative qualitative approach that documented and systematically described the methodological path for the restructuring of a skin care commission, at the National Cancer Institute I, in the State of Rio de Janeiro, from an operational perspective, the study was developed in four stages: composition of the team and training of the collaborators who made up the team; mapping of the processes developed by the skin care committee and identification of problems related to the skin care committee, anchored in the lean methodology, from January 2019 to March 2020. The study participants were nurses from the skin care committee skin care at INCA. The research project was approved by CEP CAAE under number 08783919.9.0000.5243 and the participants signed an informed consent form. Results: The tools used to apply the lean methodology in the restructuring of the skin care commission are presented, which were: gemba, process mapping, 5S, visual management and work standardization; the composition of the team and subsequent training of its members on this methodology; elaboration of the macroprocess of the patient's flow into the institution for all sectors; identification and prioritization of problems related to the skin care processes of the cancer patient and the mapping of the current and future status, individually, of each patient's entrance door in the institution. Discussion: This study provided the elaboration of the macro process that allowed to highlight and prioritize the problems related to the skin care processes of cancer patients, enabling the application of lean tools in the restructuring of the skin care committee. Final considerations: With the application of the lean methodology, it was possible to plan the restructuring of the skin care commission based on the composition of the new team and management strategies to identify the problems, carry out relevant actions with the appropriate tools and selected with the nurses of the commission. . It was also possible to improve communication between the health team and patients, in addition to encouraging and motivating the effective participation of the team in the elaboration and management of care