ONA lança manual de Certificação de Cirurgia Cardíaca
POR LARISSA SCHNEID BUENO – ASCOM/LN COMUNICAÇÃO ((imprensalncomunicacao@gmail.com)
A ONA – Organização Nacional de Acreditação – lança o Manual de Certificação para Serviços de Cirurgia Cardiovascular com a proposta de padronizar protocolos, reduzir falhas assistenciais e aumentar a segurança do paciente em todo o país. A iniciativa surge em um cenário preocupante: o Brasil registrou entre 2016-2025, 9.487 mortes após cirurgias cardíacas eletivas em adultos (média anual de 949 mortes). Em 2025 o número saltou para 1.224 (↑29%), segundo dados do Ministério da Saúde (Sistema de Informações hospitalares – SIH/SUS). Dados que representam uma média de 6,3% na mortalidade hospitalar e de 11,2 dias no tempo de internação em cirurgias cardíacas eletivas no país. Indicadores modificáveis que merecem atenção, mas que, infelizmente, permanecem iguais há mais de 10 anos.
“O lançamento deste manual representa um avanço decisivo para a segurança do paciente no país. Ao padronizar protocolos ao longo de toda a jornada — do acolhimento ao pós-operatório — conseguimos reduzir falhas no atendimento, diminuir riscos e tornar o cuidado mais seguro e previsível. Isso tem impacto direto nos desfechos clínicos e, principalmente, naquilo que mais importa: salvar vidas”, ressalta a gerente geral de Operações da ONA – Organização Nacional de Acreditação, Gilvane Lolato.
Na prática, o manual chama atenção para um ponto central: a qualidade da assistência não depende apenas da complexidade da cirurgia, mas de toda a organização do cuidado ao longo da jornada do paciente.
Atendimento rápido pode salvar vidas – Desde o primeiro contato com o paciente, a adoção de protocolos de acolhimento e classificação de risco é essencial para identificar rapidamente quadros mais graves, oportunidade de otimização e garantir acesso prioritário ao diagnóstico e à cirurgia. “Em cirurgia cardíaca, o tempo é determinante. Quando vem indicada, precisa de correção após otimização. Se houver atraso na triagem ou na decisão, o risco aumenta significativamente”, afirma o professor em Cirurgia Torácica e Cardiovascular pela FMUSP e especialista convidado da ONA, Omar Asdrubal Vilca Mejia.
Falta de organização ainda atrasa cirurgias – Outro ponto crítico é a organização interna dos serviços de saúde. A integração entre leitos, agendas cirúrgicas, equipes e unidades como UTI, centro cirúrgico e enfermaria evitam atrasos, cancelamentos e falta de recursos no momento do procedimento. O manual reforça que previsibilidade e priorização por gravidade são fundamentais para garantir segurança e melhores resultados.
Decisão baseada em evidência reduz erros – O documento também destaca a importância de decisões clínicas baseadas em evidência científica, com protocolos que orientam desde a solicitação de exames até a definição da cirurgia. A discussão multiprofissional ganha espaço, principalmente em casos complexos, ao permitir decisões mais seguras e alinhadas ao perfil do paciente. “Quando há integração entre as equipes, o risco diminui e a qualidade aumenta”, destaca o doutor.
Checklist e protocolo evitam falhas graves – Dentro do centro cirúrgico, o cumprimento rigoroso de protocolos de segurança é indispensável. A confirmação da identidade do paciente, a verificação do procedimento e o monitoramento contínuo são medidas simples, mas que reduzem significativamente eventos adversos. O manual também reforça a necessidade de resposta rápida diante de qualquer intercorrência e o trabalho em equipe feita por profissionais capacitados
Complicações ainda acontecem no pós-operatório – O cuidado não termina na cirurgia. O pós-operatório é uma fase crítica, que exige monitoramento constante para identificar sinais de deterioração clínica, como infecções, sangramentos ou piora do quadro. Protocolos de resposta rápida e equipes treinadas fazem diferença direta na redução de mortes evitáveis, conhecida como falha no resgate. Este se torna o melhor indicador para avaliar o desempenho de hospitais em relação a infraestrutura e trabalho em equipe.
Alta sem orientação aumenta risco de voltar ao hospital – Outro alerta está no momento da alta. Sem orientações claras e acompanhamento estruturado, aumentam as chances de complicações e reinternações. O manual recomenda que o paciente saia com informações detalhadas, sinais de alerta e retorno já programado.
Sem medir, não dá para melhorar – O documento também reforça a importância de acompanhar indicadores como mortalidade, complicações e tempo de espera. A análise desses dados permite identificar falhas e corrigir processos. “Protocolo não pode ficar no papel. Precisa ser aplicado, monitorado e ajustado continuamente”, conclui o especialista.
Com foco na padronização, na segurança e na tomada de decisão baseada em evidência, o novo manual surge como uma ferramenta estratégica para enfrentar dois maiores desafios da saúde no país: reduzir as mortes nas filas cirúrgica e as mortes evitáveis após cirurgia cardíaca garantindo um cuidado mais seguro, de qualidade e eficiente.
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