Quality management in health institutions: unavoidable subject in the postgraduate course


Quality management in health institutions: unavoidable subject in the postgraduate course


Gestión de la calidad en instituciones de salud: tema ineludible en el posgrado



Damarys Olivera Cuadra, Matilde Cárdenas Carvajal, Fanny Rodríguez Aguilera, Mayrelis Alonso Reyes

Villa Clara University of Medical Sciences. Cuba.




Through this research paper the authors try to state the contribution of the postgraduate course "Quality management in health institutions", developed at Villa Clara University of Medical Sciences, which emerged as a felt need of the professionals graduated from careers in the health sciences in order to obtain the necessary knowledge and develop skills on how to organize health systems to raise their efficiency and effectiveness in the levels of well-being of workers and patients in their institutions with an strategic, professional approach and with the support of the deep concept of quality and public health, establishing the most appropriate management standards.

MeSH: quality of health care, total quality management, education, graduate, education, medical.


A través de la presente comunicación los autores procuran exponer la contribución del curso de posgrado "Gestión de la calidad en instituciones de salud", desarrollado en la Universidad de Ciencias Médicas de Villa Clara, el cual surgió como una necesidad sentida de los profesionales egresados de las carreras de las ciencias de la salud con el fin de obtener los conocimientos necesarios y desarrollar habilidades sobre la forma de organizar los sistemas de salud para elevar su eficiencia y eficacia en los niveles de bienestar de los trabajadores y pacientes en sus instituciones con un enfoque estratégico, profesional y con el sustento del concepto profundo de la calidad y salud pública, instaurando los estándares de gestión más apropiados.

DeSC: calidad de la atención de salud, gestión de la calidad total, educación de posgrado, educación médica.



There are several concepts regarding the quality of health care, however, according to the authors, two of the most accepted are those issued by Avedis Donabedian referenced by Sánchez Jaca,1 considered the highest authority in the field of quality of medical care , who defines it as the achievements of the greatest possible benefits of medical care with the lowest risks for patients; and that of the World Health Organization (WHO), which identifies it with a high level of professional excellence, related to the efficient use of resources, with minimum risks for the patient and a high degree of satisfaction of the patient (final impact on health).

The quality management system assumes the set of norms of an organization linked to each other, which are guidelines for effective management.2

Universities in Cuba have new and complex challenges to face, associated with extension and community work, to facilitate interaction with students and contribute through systematic educational activities, to guide them appropriately towards a social function to reach as far as possible, their personal and professional fulfillment.3

In a world marked by globalization, the waste of natural resources and the aggression to the environment, quality in some aspects of life has been affected. However, the human being maintains hope, and guides its ideas towards dignity as a cult, truth as a flag and respect for nature as a principle.4

The evolution of the quality of care provided in a health institution requires tools that contemplate its most important aspects and allow its monitoring. The evaluation by indicators is an instrument that has proved to be useful for this purpose. Quality must be approached according to the principles of scientific research, which must have as essential premises: design a plan, conceive questions, formulate hypotheses, obtain data, draw conclusions and justify compliance. It is a value intimately linked to the fundamental right of health; its daily management becomes an unavoidable commitment of each health manager.5

In a study carried out by the authors with the objective of determining the level of knowledge of a group of health professionals to develop the necessary competencies in the organization of health systems applying the quality management approach, it was possible to demonstrate through interviews with graduates from different medical sciences professions in four municipalities of Villa Clara province, there are learning needs for these skills and, consequently, to increase efficiency and effectiveness in health organizations with a strategic approach; they did not answer correctly the questions related to the five foundations of a total quality process:

  • Understanding and satisfy customer requirements.
  • Understanding of the "zero defects" practice and orientating towards it.
  • Working more on prevention than on correction.
  • Assuming an absolute commitment on the part of the managerial as well as operative personnel of the organization.
  • Understanding and using the tool of continuous improvement.

As a result of the testimonies of the interviewees, it was found that 90,8 % considered the felt need for upgrading in this regard, taking into account their missions as health professionals.

The authors considered it appropriate to set up the postgraduate course: "Quality management in health institutions" with the aim of strengthening knowledge on this subject, which was carried out in the Faculty of Medicine of Villa Clara University of Medical Sciences. It was aimed at health professionals from all health care institutions in the province, to strengthen the quality and opportunity to improve the provision of services. Its impact, according to the criteria of its authors, was very positive because it was achieved that quality as a concept was a common thread in the motivation of the students, their expectations were fulfilled, which led to the implementation of a new edition.

In general, the course editions were evaluated applying the technique: positive, negative and interesting; it was determined as a pretension of the students the improvement of the contents and the development of skills on how to organize the health systems, managing their quality; its participants always maintained a high emotional state and a willingness to participate. Their experiences include the need to acquire knowledge for its application in the performance of their duties, and the conviction to do it in the most human and emotional possible way; therefore, the relevance of quality management in health institutions is considered an unavoidable subject for the postgraduate program.


Declaration of interests

The authors declare no conflict of interest.



1. Sánchez Jacas I. El diseño metodológico de las investigaciones evaluativas relacionadas con la calidad en salud. MEDISAN [Internet]. 2016 [citado 20 Mar 2018];20(4):[aprox. 18 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192016000400015&lng=es

2. López Abreu OL, García Muñoz JJ, Batte Monter I, Cobas Vilches ME. La mejora continua: objetivo determinante para alcanzar la excelencia en instituciones de educación superior. EDUMECENTRO [Internet]. 2015 [citado 20 Abr 2018];7(4):[aprox. 19 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2077-28742015000400014&lng=es

3. Alcántara Paisán FC. Experiencias adquiridas sobre formación vocacional y orientación profesional de las ciencias médicas en Villa Clara. EDUMECENTRO [Internet]. 2015 [citado 20 Abr 2018];7(2):[aprox. 15 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2077-28742015000200011&lng=es

4. Santos Peña M, de Pazos Carrazana J. La gestión de la calidad en las instituciones de salud. Medisur [Internet]. 2009 [citado 20 Mar 2018];7(5):[aprox. 1 p.]. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-897X2009000500001



Submitted: December 15 2017.
Accepted: May 17 2018.



Damarys Olivera Cuadra. Villa Clara University of Medical Sciences. Cuba. Email: damarysoc@infomed.sld.cu

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