Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital

Objective: This study aims to address difficulties reported by the nursing team during the process of changing the management model in a public hospital in Brazil. Methods: This qualitative study used thematic content analysis as proposed by Bardin, and data were analyzed using the theoretical framework of Bolman and Deal. Results: The vertical implementation of Participatory Management contradicted its underlying philosophy and thereby negatively influenced employee acceptance of the change. The decentralized structure of the Participatory Management Model was implemented but shared decision-making was only partially utilized. Despite facilitation of the communication process within the unit, more significant difficulties arose from lack of communication inter-unit. Values and principals need to be shared by teams, however, that will happens only if managers restructure accountabilities changing job descriptions of all team members. Conclusion: Innovative management models that depart from the premise of decentralized decision-making and increased communication encourage accountability, increased motivation and satisfaction, and contribute to improving the quality of care. The contribution of the study is that it describes the complexity of implementing an innovative management model, examines dissent and intentionally acknowledges the difficulties faced by employees in the organization.

Impact of thermal bridging on the performance of buildings using Light Steel Framing in Brazil

The Light Steel Framing building technology was introduced in Brazil in the late 1990s for the construction of residential houses. Because the design system was imported from the United States and is optimised to work well in that temperate climate, some modi fi cations must be made to adapt it for the Brazilian climate. The objective of this paper was to assess the impact of thermal bridging across enclosure elements on the thermal performance of buildings designed with Light Steel Framing in Brazil. The numerical simulation program EnergyPlus and a speci fi c method that considered the effects of metallic structures in the hourly simulations were used for the analysis. Two air-conditioned commercial buildings were used as case studies. The peak thermal load increased approximately 10% when an interior metal frame was included in the numerical simulations compared to non-metallic structures. Even when a metal frame panel was used only for vertical elements in the facade of a building with a conventional concrete structure, the simulations showed a 5% increase in annual energy use.