Analise das melhores práticas em business process management: estudo de casos em organizações hospitalares de Natal/RN

O gerenciamento dos processos organizacionais vem sendo estudado pela ciência administrativa como forma de romper com o paradigma da estrutura organizacional funcional através da Gestão por Processos. O Business Process Management ( BPM alinhado às estratégias organizacionais e suportado cada vez mais pela Tecnologia da Informação (TI), proporciona clareza nas diversas pontas do processo colaborando para sua melhoria contínua com o objetivo de gerar valor agregado ao cliente. As organizações de saúde estão entre as empresas prestadoras de serviço pouco estudadas em relação ao gerenciamento por processos. Assim, este estudo analisou por meio de um estudo empírico de natureza qualitativa, como estão sendo conduzidos os processos organizacionais hospitalares à luz das melhores práticas em BPM. A pesquisa foi realizada através do estudo de casos múltiplos realizados em duas organizações hospitalares na cidade de Natal/RN. A literatura de referência apresentou diversos fatores para um desempenho otimizado em BPM, tratados nesta pesquisa como as melhores práticas em BPM. A partir da revisão da literatura foi elaborada uma síntese das melhores práticas de BPM que serviu de base para elaboração do modelo da pesquisa utilizado para coleta e análise dos dados. Este modelo indicou onze categorias que foram utilizadas para elaboração do roteiro de estrevistas semi-estruturadas, através da técnica de análise de conteúdo, com categorização de grade fechada. As categorias foram agrupadas em duas dimensões: Elementos relacionados à gestão ( governança ; liderança , alinhamento estratégico , cultura e conhecimento ) e elementos relacionados aos processos ( desenho , responsável , executores , tecnologia da informação e indicadores ), e ainda foi identificada uma terceira categoria: escritório de processos . Para seleção dos sujeitos desta pesquisa foi adotada a estratégia em cadeia ou bola de neve . Foi possível identificar que todas as categorias apontadas no modelo de pesquisa emergem entre os fatores buscados pelas organizações hospitalares para o gerenciamento por processos com destaque para categorias: cultura ; conhecimento ; desenho ; tecnologia da informação e indicadores . Em complemento às categorias de análise, foram identificadas dificuldades relacionadas à comunicação e integração dos diversos elos do processo. Além disso, constatou-se que nos hospitais investigados há um desvio do conceito de BPM no que diz respeito a seu objetivo final: agregar valor ao cliente. A pesquisa concluiu que o gerenciamento por processos nas organizações hospitalares investigadas encontra-se em fase inicial ou em desenvolvimento, sendo necessário superar as barreiras da comunicação e edificar uma cultura organizacional orientada às necessidades dos clientes para aplicação das melhores práticas de BPM, desta forma pesquisas futuras sobre este tema em outras organizações hospitalares, podem facilitar um estudo comparativo e ampliar o conhecimento no assunto

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

Clima organizacional e satisfação laboral: um estudo sobre os núcleos hospitalares de epidemiologia de Natal/RN

The Hospital Epidemiology Nucleus (NHE) is a structure that has a specific organizational climate, which influence the level of job satisfaction among professionals working in it. This is a descriptive study with a quantitative approach, aimed to identify the relationship between organizational climate in the NHE regulated in the city of Natal / RN and the job satisfaction among its professionals from the perspective of theoretical issues about Organizational Development. The research was carried out in 13 hospitals with different kinds of sponsorship, 9 public, 3 philanthropic and 1 private. Data were collected using the instrument "organization in hospitals: issues relating to climate and job satisfaction , with 33 professionals appointed and active on NHE. This study obtained an appropriate consent of the Research Ethics Committee of the Hospital of Pediatrics Professor Heriberto Ferreira Bezerra, from the Riograndense Northern League Against Cancer and the Federal University of Rio Grande do Norte. Data collected were organized and treated with simple descriptive statistics. It was observed that from 33 of surveyed people, 93% was female, had an average of 40 years old age, with activity duration between 1 and 2 years (84.9%). Furthermore, 45.5% of industry professionals were nurses. It was identified that professionals working in NHE perceive and experience its work environment as an Organization Structure in construction. It was found that with the exception of the aspects "working life", "socio-cultural" and "organizational culture , the other internal and external factors to the NHE does not have strong expression in the forming of an organizational climate conducive to the development of the sector. It was found that 70% of interviewed perceive the organizational climate as favorable for the industry's progress. Regarding the job level of satisfaction, respondents feel fairly satisfied with the organizational structure. Therefore, the results of this study are suggestive that there is some factor that is greatly contributing to a healthy organizational climate that encourages the industry team members of the NHE present behaviors that identify them as actors committed and satisfied with the work, even face of all obstacles to implementation of epidemiological surveillance. Thus, it is suggested for futures studies to seek to determine how the organizational culture, while significant internal factor, influencing the organizational climate establishment of NHE and therefore the level of job satisfaction and well-being of each members of the team

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

Condição microbiológica dos leitos hospitalares antes e depois de sua limpeza

INTRODUÇÃO: O meio ambiente hospitalar guarda uma íntima relação com as infecções hospitalares, podendo proporcionar focos de contato e de transmissão. Como a higiene representa uma das formas de controlar a contaminação ambiental, realizou-se estudo para avaliar as condições microbiológicas dos colchões hospitalares antes e depois de sua limpeza. MÉTODOS: Utilizaram-se, para a colheita dos espécimes, placas de contato -- Rodac-plate ¾ preparadas com meio de cultura ágar-sangue. Selecionaram-se os leitos de acordo com critérios previamente estabelecidos, e os locais de colheita sob o colchão foram escolhidos por sorteio aleatório. Aplicou-se o teste estatístico de Goodman para o estudo das alterações numéricas quanto a positividade das placas. RESULTADOS: Foram investigados 52 colchões, totalizando 520 placas, das quais 514 (98,8%) resultaram em culturas positivas, sendo que 259 corresponderam ao período anterior à limpeza e 255 ao período posterior ao procedimento. Houve redução de culturas positivas em apenas 4 placas. CONCLUSÕES: Os resultados obtidos sugerem que a limpeza, da forma como vem sendo conduzida, provoca o deslocamento da carga microbiana para outros pontos do colchão em vez de diminuí-la, resultando na manutenção da quantidade de microorganismos que existia anteriormente à limpeza.

Atividade comparada da cefepima, cefpiroma e amicacina em amostras bacterianas hospitalares

The objective of this study was to evaluate the in vitro activity of cefepime, cefpirome and amikacin against the most prevalent nosocomial bacteria. Initially a prospective study was designed to compare the bacterial susceptibility to the three drugs using 1,022 pathogenic strains. The strains were isolated from hospitalized patients of the Hospital das Clinicas - Faculdade de Medicina de Botucatu, SP, from March to December of 1996, by using the Bauer-Kirby susceptibility diffusion controlled method. The activity of cefepime by the Kirby-Bauer method was significantly higher (χ2, p ≤ 0.05) than cefpirome and amikacin for the following bacteria: P. aeruginosa (72% x 56% x 64%, respectively), Enterobacter cloacae (98% x 88% x 80%) and total strains (79.5% x 74.3% x 76.8%). Cefpirome exhibited higher activity than cefepime only to Enterococcus faecalis (42% x 23%). In the 12 other bacterial groups studied the sensibility of the three drugs was similar (χ2, p ≥ 0.05). The minimal inhibitory concentration (MIC) for 127 bacterial strains - Enterobacter cloacae (12), Citrobacter sp (15), Pseudomonas aeruginosa (50), Acinetobacter baumannii (12), BGNF others (22) and Enterococcus faecalis (16)-from the same origin previously described and isolated during 1997, was determined by E-test. Ranges of MIC intervals, MIC(50%), MIC(90%) and the proportion of the sensitive bacterial strains were determined and permitted the following analysis: the activity of cefepime against Gram-negative bacteria was 2 or more times higher than that of cefpirome and amikacin, specially when CIM(90%) was considered; the activity of cefpirome was higher only against E. faecalis. This information must be considered in the rational use of antibiotic, specially in patients with nosocomial infections.

Ocorrência e determinação do perfil de sensibilidade às drogas das cepas de Staphylococcus aureus isoladas de fossas nasais e orofaringe dos servidores hospitalares

Staphylococcus aureus is a very important hospital and community pathogen. This species is related to supurative disease, systemic and widespread metastatic lesions. The ability of S. aureus to develop resistance to antibiotics, more recently to methicillin, associates this bacteria with epidemic outbreaks of severe nosocomial infection. The source of staphylococcal infection is a patient with a staphylococcal lesion or a career member of the hospital staff. We aimed to detect the frequency of S. aureus isolated from anterior nares and oral cavities among the hospital staff in Bauru - SP, and to determine the antibiotic susceptibility of the isolates. Within 213 of the staff members analyzed. S. aureus was found in 94 (44.13%) of careers, with 47 (50%) of nasal carriers, 23 (24.4%) of oral carriers and 24 (25.5%) of both carriers. The biochemical characteristics analyzed for the species identification were similar to S. aureus ATCC 29213. All strains identified as S. aureus showed varied sensibility to the antimicrobial agents tested. No vancomicin resistant strains and only 8 (8.5%) strains with oxacilin resistance were found.

Análise da acessibilidade e usabilidade de equipamentos médico-hospitalares para pacientes obesos da cidade de Bauru (SP)

Pós-graduação em Design - FAAC

Fatores críticos de sucesso da gestão ambiental com foco em eco-eficiência energética: estudo de múltiplos casos em unidades prestadoras de serivços hospitalares

Pós-graduação em Engenharia de Produção - FEB