A gender approach to work ability and its relationship to professional and domestic work hours among nursing personnel

The association between working hours and work ability was examined in a cross-sectional study of male (N = 156) and female (N = 1092) nurses in three public hospitals. Working hours were considered in terms of their professional and domestic hours per week and their combined impact; total work load. Logistic regression analysis showed a significant association between total work load and inadequate work ability index (WAI) for females only. Females reported a higher proportion of inadequate WAI, fewer professional work hours but longer domestic work hours. There were no significant differences in total work load by gender. The combination of professional and domestic work hours in females seemed to best explain their lower work ability. The findings suggest that investigations into female well-being need to consider their total work load. Our male sample may have lacked sufficient power to detect a relationship between working hours and work ability. (c) 2008 Elsevier Ltd. All rights reserved.

Uso de indicadores de saúde na gestão de hospitais públicos da região metropolitana de São Paulo

O objetivo geral do presente estudo é conhecer os indicadores disponíveis bem como a utilização dos mesmos nas atividades de planejamento e gerenciamento dos hospitais públicos estaduais da Região Metropolitana da Grande São Paulo RMGSP. A partir de revisão bibliográfica e consulta a documentos técnicos sobre experiências no uso de indicadores para a gestão hospitalar, foram identificados os indicadores mais adequados às atividades da administração superior de Hospitais. Por meio de levantamento dos dados existentes na Secretaria de Estado da Saúde de São Paulo e de entrevistas semi-estruturadas com os gestores dos hospitais e com profissionais que atuam na área de informações, foram identificados os indicadores hospitalares disponíveis, e analisado o uso dos mesmos para a tomada de decisão, em nível gerencial. Os resultados do estudo demonstraram que os hospitais públicos estaduais produzem um considerável volume de informações, embora com lacunas importantes, e que muitos gestores desconhecem a existência de tais informações ou não as utilizem adequadamente para a formulação das diretrizes e a gestão dos hospitais.

Atentado à formação de um Espirit de Corps: pelas tentativas da administração gerencial por um discurso da eficiência e pelas tentações dos "Espíritos de Porco"

This dissertation discuss the course of formation of EPPGG" (Specialists on Public Politics and Administration). We did a brief historical research on the origins of this career, stressing the problems of its implementation. We describe the process of selection and formation of "EPPGG" classes, focusing our attention on the first and fifth classes, the latter being the main object of our study. We avoided the standard approaches to this suject and based our investigation on the daily social interaction developed during the course, trying to unveil conflicts that show internal problems of the career and of "ENAP" (Scholl of Public Administration).

Questões contemporâneas referentes à educação e ao ensino à luz de pesquisas recentes em dissertações de mestrado em administração e gestão educacional

Este trabalho tem como principal objetivo de estudo as questões contemporâneas sobre educação e ensino à luz das dissertações de mestrado apresentadas à Escola Brasileira de Administração Pública. O tema educação vem sendo, ultimamente, uma das principais estratégias de formuladores de políticas públicas, visto o "gargalo educacional" em que se encontra o Brasil para seu crescimento. Constatada a relevância do tema na atualidade, iniciamos o trabalho situando as questões da educação em contexto histórico no qual diferentes forças políticas se confrontam, configurando um duelo de diretrizes educacionais. A partir deste contexto histórico, apresentamos as questões contemporâneas sobre educação. Finalmente, na última parte deste trabalho, analisamos as propostas apresentadas sobre educação, verificando a eficácia de implementação e o tipo de abordagem realizada pelos autores.

The Profile of a Manager in Higher Education Institution in Latin America: The Case of the EBAPE

The aim of this study is to analyze the profile of today’s manager, according to the classical management literature, working on internationalized higher education institute. This paper draws together knowledge about the manager’s profile in a corporate environment and how it can be appreciated in a higher education institute all of this taking into consideration the environment that nowadays exists in these institutions. Data were collected through semi-structured interviews, with professors of the Fundacao Getulio Vargas, more specific on their Public and Business Administration School (EBAPE), which had active roles on its development, internationalization and during some point in time their management. The findings obtained where analyzed under the perspective brought by the theoretical reference framework, and, based on this approach is represented the manager whom could have a better perspective to administrate a higher education institute.

A influência das especificidades das organizações públicas na implementação da gestão de processos

Este estudo objetivou identificar de que forma as especificidades das organizações públicas influenciam a implementação da Gestão de Processos em seu âmbito. Para isso foi realizada uma análise de referenciais teóricos com a finalidade de delinear, principalmente, questões relevantes para entender as diferenças entre a administração pública e a privada e que impactam na implementação da Gestão de Processos naquelas organizações, e de subsidiar a elaboração de um roteiro de entrevistas estruturado. A partir dessa etapa, foi efetuada uma pesquisa de campo constituída por oito entrevistas com especialistas brasileiros de destaque no mundo acadêmico nos quadros de empresas ou instituições que atuam com Gestão por Processos, em consultorias nessa área e/ou profissionais com certificação internacional em processos, bem como com experiência na implantação da Gestão de Processos em organizações da Administração Pública Direta Federal. O resultado dessas entrevistas foi analisado, consolidado e examinado à luz da posição dos autores do referencial teórico. Na percepção dos especialistas consultados nesta pesquisa, a menor maturidade apresentada pelas organizações públicas, relacionada à medição de resultados e ao acompanhamento do desempenho, prejudica a tangilibilização dos resultados decorrentes da adoção da Gestão de Processos. Em consequência, as pessoas envolvidas têm dificuldade em perceber os ganhos que podem dela obter, situação que complica sobremaneira a possibilidade de movimentos de mobilização e o próprio comprometimento para a implementação da Gestão de Processos. Além disso, os entrevistados consideram que a postura e o perfil dos servidores públicos, aliados a outras especificidades das organizações públicas - tais como estabilidade na carreira; falta de mecanismos de reconhecimento e recompensa e de avaliação de desempenho criteriosa; cultura de documentação e controle excessivos e as disfunções da burocracia; e a descontinuidade na gestão devido a influências políticas - também podem prejudicar o engajamento, a motivação das pessoas para essa gestão e a identificação e implementação de melhorias contínuas nos processos organizacionais, atividades intrínsecas da Gestão de Processos.

Política habitacional em zonas urbanas: o caso do conjunto habitacional Vila da Barca, em Belém

o presente estudo é o resultado da pesquisa feita durante o Mestrado em Gestão Empresarial da Escola de Administração Pública e de Empresas, da Fundação Getúlio Vargas. Este trabalho buscou compreender a produção espacial da cidade de Belém, precisamente sobre a Vila da Barca, situada às margens da Baia do Guajará, região que teve alguns de seus moradores remanejados para o Projeto de Habitação e Urbanização do local como parte da política pública habitacional da área, realizada pelo Governo Municipal em parceria com o Governo Federal. Este projeto habitacional é gerenciado pela Secretaria Municipal de Habitação - SEHAB. O objetivo principal deste estudo voltou-se para a avaliação do Projeto de Habitação da Vila da Barca no sentido de identificar como se efetivou o processo de concepção, remanejamento e reinstalação das famílias do setor analisado. Além disso, buscou-se conhecer o que foi feito em relação ao desenvolvimento desse espaço urbano. A metodologia se desenvolveu em duas fases: aplicação de questionários aos moradores e, de entrevistas aos técnicos envolvidos (Gerente de Desenvolvimento Urbano (GIDUR); Técnico Social e Engenheiro, funcionários da Caixa Econômica Federal em Belém). A pesquisa procurou demonstrar a opinião dos envolvidos no processo de efetivação dessa política pública, compreender a produção desse espaço urbano em suas diferentes dimensões e perceber os aspectos positivos e negativos do projeto, verificando alguns elementos de construção desse espaço. Como conclusão, percebe-se que é preciso construir formas atuais eficazes de exercer por parte da sociedade o controle social sobre o poder do Estado e sobre os mecanismos que controlam o mercado. Esse é o desafio maior da contemporaneidade

Existe trade-off entre eficiência e qualidade nas organizações hospitalares?

A mudança do perfil demográfico e epidemiológico das populações, com progressivo envelhecimento populacional e aumento de portadores de doenças crônicas não transmissíveis, somado a necessidade da ampliação da oferta de serviços de saúde e crescentes custos em saúde, impõe enormes desafios aos sistemas e serviços de saúde. A eficiência organizacional dos serviços de saúde tem papel importante tanto na racionalização dos custos quanto na melhoria da qualidade e segurança assistencial. Tendo papel central nos sistemas de saúde como centros difusores de conhecimento, capacitação profissional, incorporação de tecnologias, prestação de serviços de maior complexidade aos pacientes e, consequentemente, elevados custos destes serviços, aos hospitais é fundamental a busca por essa eficiência. Este estudo buscou analisar se existe trade-off entre eficiência e qualidade em organizações hospitalares e identificar quais determinantes poderiam estar associados com maiores ou menores escores de eficiência. Utilizou-se dois modelos de análise de envelopamento de dados (data envelopment analysis, DEA), sem e com variáveis de qualidade, com retornos variáveis de escala e orientados para resultado. Foram estudados 47 hospitais gerais públicos do estado de São Paulo. No modelo sem variáveis de qualidade 14 deles foram considerados eficientes, enquanto que 33 no modelo com estas variáveis. O coeficiente de correlação de Spearman entre os dois modelos foi de 0,470 (correlação moderada). Não há evidências de que haja trade-off entre eficiência e qualidade nestas organizações hospitalares. Hospitais eficientes no modelo sem variáveis de qualidade, também o foram com variáveis de qualidade, assim como houve hospitais ineficientes no modelo sem variáveis de qualidade que foram eficientes com estas variáveis. Não foram encontradas associações estatisticamente significantes (p<0,05) entre eficiência e as características dos hospitais estudados, como acreditação, modelos de gestão, porte hospitalar e atividades de ensino, apesar de alguns achados de maior ou menor escore de eficiência para alguns determinantes. Desta maneira, concluiu-se que a utilização de variáveis de qualidade é um fator fundamental na determinação da eficiência de organizações de saúde, e não podem estar dissociadas. Gestões eficientes também estão relacionadas à obtenção de melhores resultados assistenciais sem a necessidade que se tenha de optar em alcançar melhores resultados econômico-financeiros ou melhores resultados assistenciais.

Windows of opportunities and knowledge networks: implications for the catch-up in developing countries

This document represents a doctoral thesis held under the Brazilian School of Public and Business Administration of Getulio Vargas Foundation (EBAPE/FGV), developed through the elaboration of three articles. The research that resulted in the articles is within the scope of the project entitled “Windows of opportunities and knowledge networks: implications for catch-up in developing countries”, funded by Support Programme for Research and Academic Production of Faculty (ProPesquisa) of Brazilian School of Public and Business Administration (EBAPE) of Getulio Vargas Foundation.

Fatores de longevidade do programa Central do Cidadão no Rio Grande do Norte

The public management reform in Brazil, since 1995, provoked new experiences in public administration. Among the new models of public service the one-stop shopping has distinguished and was adopted at Rio Grande do Norte with the Citizens Center Program. The one-stop shopping assembles in the same place many public services with appropriate structure, enabled human resources and citizens focus processes. The goal of this research was understand how citizens focus processes help to explain Citizens Center Program s longevity. It was made a case study and the research tools were applied with Citizen Center Programs workers and citizen-users at South Unit of Citizen Center Program placed at Via Direta Mall, Natal. The major contributions for Citizen Center Program s longevity were imputed to Basic Operation Processes. The most spoken features in Citizen Center Program mentioned were quality, efficiency, celerity e personal appearance, what demonstrate concern and care with citizen-users. Worker s personal appearance, accommodation, celerity, politeness and attending capacity planning were high evaluated by citizen-users revealing the wisely choice of use a large quality concept and citizenship concept in public administration. Citizen-users also pointed the necessity of refine and enlarge the communication ways that form an essential mechanism to public citizen focus administration. Not ignoring the policy aspect citizen focus processes were noticed like especial management actions that make easier citizen s activities and public service access, what generate satisfaction to citizen-users. It s possible to conclude that the high level approving evaluation of Citizen Center Program consolidates it an especial public policy that serves citizen s necessities e create appropriate legitimacy conditions of the public policy making harder the choice of ending the policy even in more fragile moments strongly contributing for its longevity

Qualidade de vida no trabalho: o caso de enfermeiros dos Hospitais Públicos Walfredo Gurgel e Santa Catarina

The theoretical foundation of this study addresses the construct Quality of Worklife involving pro-active reading organizations in face to social developments of the working class, which is a challenge to the people s management. In this sense, as a contribution to the studies of quality of worklife (QOWL), this study addresses the quality of lifework of nurses at Walfredo Gurgel and Santa Catarina public hospitals. The goal is to make a diagnosis about the quality of lifework of these employees taking as a basis dimensions and performance indicators shown in the model by Fernandes (1996). The research is characterized by field, in a descriptive way. This survey comprised 75 nurses, with 49 by Walfredo Gurgel hospital and 26 by Santa Catarina one. The data collection was carried out through structured questionnaire. The questions were processed in the software Statistic 6.0, with factor analysis and multiple regressions, after the systematization of data. As a result, the most nurses in hospitals are dissatisfied with the quality of lifework, with the highest incidence in Santa Catarina hospital. The variable occupational health assessment was more negative in the hospital Santa Catarina one, whereas in Walfredo Gurgel, was family assistance. The variable guarantee of employment was more positive assessment in two hospitals without, though, implying in high importance on QOWL of nurses. The factor structure and decision showed greater sensitivity to explain the QOWL of nurses, joining 17 variables from 40 of the model. The factor working conditions, joining 6 variables, showed the second highest sensitivity. The compensation factor, gathering 5 variables, showed the third highest sensitivity while image and health factors showed minor importance

A saúde psíquica de quem faz saúde: uma análise crítica sobre a humanização direcionada ao profissional de saúde

It is noticeable that pressure, tension and overwork are frequent in health professionals routine. The work related to the ward area demands deep attention and surveillance. Because of that, it is essential to have a specific look at the humanization directed at health professionals, considering that taking care of other human beings is the essence of their job. This study has analyzed the psychic health levels, as well as the stress health professionals are submitted to, providing a debate about the humanization in 06 public hospitals (03 of them awarded by actions of humanization, and 03 not awarded) in Rio Grande do Norte state, Brazil. A study with 126 active health professionals (doctors, nurses, psychologists, nutritionists and social workers) in ward areas in their respective institutions was carried out. The thesis presented, with multi-disciplinary characteristic, counted on the support of statisticians (to calculate samples and data analysis), psychologists, social workers and administrators (linked to the human resources sector in each hospital). A cross-sectional study was performed, taking into consideration both quantitative and qualitative factors. The tools used for that were a semistructured questionnaire with socio-demographic characteristics, work and humanization; Lipp's Stress Symptoms Inventory for Adults (ISSL), and the Goldberg s General Health Questionnaire (QSG). The workers are predominantly women (84,9%), married (54,8%), between 46 and 55 years old (40,5%), working in the same institution for more than 20 years (22,2%), and between 16 and 20 years (20,6%), respectively. They work 40 hours a week (71,4%) and have multiple jobs (61,9%). Although most of these individuals global psychic health is in a good level, there are a significant number of people that is gradually getting worse concerning psychic stress (F1) showed by QSG (54,7%), and stress showed by ISSL(42,1%). Observing the categories, nurses (41,5%). Nutritionists (20,8%), doctors and social workers (18,9%), were among the most affected. About general health (F6), 63% of the awarded hospitals and 70% of the not awarded ones, presented good health levels (ranging from 5 to 50%). It was also noticed that, in the groups mentioned above, 25 and 20% respectively, were inserted in scores between 55 to 90%, what means that they are in worsening phase. The fact that the hospital is awarded or well recognized doesn t interfere in health professionals stress level and in their psychic health. Through what was heard from these individuals, it was possible to verify that they know little about humanization, once few of them identify or know that the service they offer is in an adoption process by Ministerial Policies. It was also detected the necessity of developing actions aimed at worker s health. Such results showed the importance of have more investments in programs that are directed to workers well-being, because they deal with other people s health and it is known that it is difficult for them to offer high-quality assistance if there are not suitable physical, psychological and material conditions to help them develop their jobs. As a warning, it is fair to say that investments in actions that provide humanized care to health professionals, mainly concerning preventive care for their health and life quality in their work

As repercussões dos serviços hospitalares em diferentes contextos: uma análise de profissionais de saúde

This study has as general object: to verify as the health professionals that work in different hospitals evaluate the hospital services; and specific objectives: identify how health professionals evaluate the work conditions in different hospitals and verify the central nucleus and the peripheral elements of the social representations elaborated by these professionals about these institution. This is a descriptive study realized in Natal, capital of Rio Grande do Norte. Were collected 213 questionnaires. Concerning the evaluation of the health services, high averages had been verified in the philanthropic hospital, for example, quality of the customer service. At the state hospital was observed lowest ones: respect to the privacy of the patients. Similar results were found about work conditions. It was observed as central nucleus the categories Overcrowded and Humanized care, in the state and philanthropic hospital respectively, and as peripheral elements Low wages and Overcrowded. Being thus the conflicts in this scene are inevitable because of the poor structure of some public hospitals, however, these problems can be foresee and solvable if the hospital has a free expression channel accessible to all agents. The evaluation has to become integrant part of the culture of the organization, a time that this will guide the steps in direction to the best quality in the hospital assistance

A intenção e o gesto :ações gerenciais de enfermeiros em espaços hospitalares

The present study analyses the supervisory practice of the nurse in the hospital environment. It has, as its main objective identify the use of planning, supervision and evaluation, as managerial instruments in the daily nursing practice. It tries also to identify the importance given to these instruments in their supervisory actions and the difficulties encountered in their use. It deals with an exploratory and analytical investigation with a qualitative approach having as its main point of analysis the principles of strategic planning. In order for it to be done 10 nurses were interviewed, distributed in three public hospitals in the city of Natal/RN. The results show that, although the nurses recognize the importance of the managerial instruments, they do not put them into practice in an effective and systematic way. They justify it because of the existence of personal, professional and institutional difficulties. On the other hand we could conclude from what they say that there is the desire to overcome the eminently burocratic vision of the management. Thus, they express a feeling for change and point in the direction of looking for ways that will contribute to innovate this practice

CAD e engenharia reversa como ferramentas de auxílio na fabricação de cartuchos para próteses ortopédicas

The manufacturing of above and below-knee prosthesis starts by taking surfac measurements of the patient s residual limb. This demands the making of a cartridg with appropriate fitting and customized to the profile of each patient. The traditiona process in public hospitals in Brazil begins with the completion of a record file (according to law nº388, of July 28, 1999 by the ministry of the health) for obtaining o the prosthesis, where it is identified the amputation level, equipment type, fitting type material, measures etc. Nowadays, that work is covered by the Brazilian Nationa Health Service (SUS) and is accomplished in a manual way being used commo measuring tapes characterizing a quite rudimentary, handmade work and without an accuracy.In this dissertation it is presented the development of a computer integrate tool that it include CAD theory, for visualization of both above and below-knee prosthesis in 3D (i.e. OrtoCAD), as well as, the design and the construction a low cos electro-mechanic 3D scanner (EMS). This apparatus is capable to automatically obtain geometric information of the stump or of the healthy leg while ensuring smalle uncertainty degree for all measurements. The methodology is based on reverse engineering concepts so that the EMS output is fed into the above mentioned academi CAD software in charge of the 3D computer graphics reconstruction of the residualimb s negative plaster cast or even the healthy leg s mirror image. The obtained results demonstrate that the proposed model is valid, because it allows the structura analysis to be performed based on the requested loads, boundary conditions, material chosen and wall thickness. Furthermore it allows the manufacturing of a prosthesis cartridge meeting high accuracy engineering patterns with consequent improvement in the quality of the overall production process