Puesta en marcha del primer Centro Especializado Ambulatorio en Cuba

introduction putting into operation a health institution is a complex task requiring good planning. objectives to identify the main problems for the putting into operation the first specialized outpatient service center in cuba and to determine their order of priority. methods for the problem identification, a brainstorming activity was performed in which members of the managing board and selected heads of services were involved. several weighing methods to reduce the listing of problems and to select a certain number of them were used. the ranking method served to prioritize problems followed by the causal diagnosis, based on the ishikawa or "fishbone" technique, which allowed defining both the internal and the external causes. results four fundamental problems were detected following the order of priority: need for putting engineering services into operation, calculation of the required medical and non-medical inputs, incorporation of the human resources and departments, and finally, the incorporation of the various medical services in line with the agreed social object of the institution. conclusions the planning and the used methods assured the fulfilment of the objectives and the putting into operation of "heroes de playa girón" specialized outpatient service center, attached to "dr. gustavo aldereguía lima" general university hospital in cienfuegos.