Gestão estratégica de pessoas e inovação: estudos de caso no contexto hospitalar

Neste trabalho, procurou-se analisar as relações entre variáveis do contexto organizacional e de gestão de pessoas e as inovações. Os principais objetivos foram analisar e comparar os aspectos organizacionais e de gestão de pessoas que têm contribuído para a implementação de inovações. Foram conduzidos três estudos de caso em instituições hospitalares, duas localizadas no Brasil e uma nos Estados Unidos. Os resultados da pesquisa indicaram que a adoção de determinadas variáveis do contexto organizacional e de gestão de pessoas poderá estimular a inovação. Além disso, foi possível concluir que essas mesmas variáveis, quando alinhadas aos objetivos organizacionais de inovação, poderão facilitar a superação de obstáculos inerentes ao setor da saúde e que impedem a implementação bem-sucedida de inovações.

Atendimento Pré-hospitalar Móvel. Mapeando Riscos e Prevenindo Erros

The attention with safety of the patients is important in the quality of the nursing and health care. In the pre-hospital care, such care is essential on site with the purpose of avoiding possible consequences to the individual, ensuring a fast and appropriate care, with improvement of the morbidity and reduction of the mortality. This medical attention is equally associated with the significant risks of adverse events and serious mistakes, which can be reduced with the awareness of the professionals, organization and quality management. It is a descriptive, transversal research, of quantitative approach, with the objective of identifying the risks for the safety of the patient during the mobile pre-hospital care under the view of the nurses, in a city of the Brazilian Northeast. The sample was formed by 23 nurses. The inclusion criteria: to have at least two years of experience and accept to participate on the research. The data collection was done in two steps, first photo collection, through the adapted method of photographic analysis, and the second with the application of questionnaire, divide in two parts: socio-professional data and digital photo punctuation instrument of the patient s safety. The majority of the nurses had an average working time in the mobile pre-hospital care of six years and six months, in the age group of 38 to 53 years old (69,56%) and with Lato sensu specialization (73,91%), being (29,41%) emergency and (29,41%) in intensive care. The (74%) have the Advance Cardiac Life Support (ACLS) and (100%) have the Pre-Hospital Trauma Life Support (PHTLS); (91, 30%) know the thematic safety of the patient. On the pictures it was observed a bigger variability of the categories (risks) where 44% of variance emerged on the first picture of the research. The pictures 4 and 9 with the average below 5 were classified as very insecure, while pictures 7 and 3 with an average above 7, very secure. On the results of risks observed for the patient s safety in the mobile pre-hospital care five categories emerged: organization and packaging of the equipment and materials, routines and specificities in the mobile pre-hospital care, risks on the management of medications, for traumas and infections. Starting from the analysis of these risks, it was proposed ten steps for the safety in the mobile pre-hospital care: 1- Identify the patient; 2- Safety related to prevention of infection; 3- Safety in the management of medications; 4- Safety and standardization of the packaging of equipment and materials; 5- Attention to the specificities of the mobile pre-hospital care; 6- Incentive and value the participation of the patient and family; 7- Promote the communication with the central of regulation; 8- Prevention of traumas and falls; 9- Protect the skin from additional injuries; 10- Understand the benefit of all the equipment in the ambulance. The multiple risks and their emerged combinations on the research indicate a variety of actions to be developed and stimulated, like the use of steps for the patient s safety in the mobile pre-hospital care which contributes with the aid and management of risks, reduction of mistakes, disabilities and death

Trauma em idosos atendidos pelo serviço pré-hospitalar móvel

O The aim of this study was to characterize the occurrence of trauma in the elderly population served by the mobile pre-hospital service, in Natal, Rio Grande do Norte. This is a descriptive, transversal and quantitative approach and whose population consisted of 2,080 trauma victims. The sample, of systematic random type, consisted of 400 elderly people, aged from 60 years old, assisted by the Office of Mobile Emergency in Natal / RN, between January 2011 and December 2012. Data collection began after consent and assent of the institution of a Research Ethics Committee under No. 309 505. It was proceeded to documentary retrospective analysis of records of this service through a form of self-development, validated by expert judges considered reliable (α> 0.75) and valid (CVI = 0.97) in their clarity and relevance. Data were tabulated by the Statistical Package for Social Sciences, version 20.0. The results show that older victims have an average age of 74.19 years old, with a prevalence of female involvement by chronic diseases, especially hypertension, average usage of 2.2 routine medications with vital signs within normal limits. The trauma prevailed during the daytime, in the residence of the victims, north of the city and on weekends. Among the mechanisms of trauma were falls, traffic accidents and physical aggression, whose most common type was brain-cerebral trauma and the main consequences were suture wounds and closed fractures. Basic Support Units were as more driven to pre-hospital care (87.8%) and the main destination place consisted of a referral hospital for emergency of the state (57.5%). Among the most commonly performed procedures by nursing staff immobilization with rigid board and neck collar and the peripheral venipuncture, and the main component used for volume replacement to saline were highlighted. There was a significant relationship between the deaths and the mechanism of injury, mechanism of injury and procedures, except medication administration procedures carried out, except immobilization and unit for service. It is highlighted the prevalence of trauma in the elderly, poor follow-up Pre-Hospital Trauma Life Support protocol and the paucity of records and nursing procedures performed. There is need for a protocol of care specific to elderly trauma victims and education strategies for the prevention of such events

Gestão de estoques: uma proposta de reposição contínua para material médico hospitalar e medicamentos em um hospital universitário federal do estado do Rio Grande do Norte

The inventory management in hospitals is of paramount importance, since the supply materials and drugs interruption can cause irreparable damage to human lives while excess inventories involves immobilization of capital. Hospitals should use techniques of inventory management to perform replenishment in shorter and shorter intervals, in order to reduce inventories and fixed assets and meet citizens requirements properly. The inventory management can be an even bigger problem for public hospitals, which have restrictions on the use of resources and decisionmaking structure more bureaucratized. Currently the University Hospital Onofre Lopes (HUOL) uses a periodic replacement policy for hospital medical supplies and medicines, which involves one moment surplus stock replenishment, the next out of stock items. This study aims to propose a system for continuous replenishment through order point for inventory of medical supplies and medicines to the hospital HUOL. Therefore, a literature review of Federal University Hospitals Management, Logistics, Inventory Management and Replenishment System in Hospitals was performed, emphasizing the demand forecast, classification or ABC curve and order point system. And also, policies of inventory management and the current proposal were described, dealing with profile of the mentioned institution, the current policy of inventory management and simulation for continuous replenishment order point. For the simulation, the sample consisted of 102 and 44 items of medical and hospital drugs, respectively, selected using the ABC classification of inventory, prioritizing items of Class A, which contains the most relevant items in added value, representing 80 % of the financial value in 2012 fiscal year. Considering that it is a public organization, subject to the laws, we performed two simulations: the first, following the signs for inventory management of Instruction No. 205 (IN 205 ), from Secretary of Public Administration of the Presidency ( SEDAP / PR ), and the second, based on the literature specializing in inventory management hospital. The results of two simulations were compared to the current policy of replenishment system. Among these results are: an indication that the system for continuous replenishment reorder point based on IN 205 provides lower levels of safety stock and maximum stock, enables a 17% reduction in the amount spent for the full replenishment of inventories, in other words, decreasing capital assets, as well as reduction in stock quantity, also the simulation made from the literature has indicated parameters that prevent the application of this technique to all items of the sample. Hence, a change in inventory management of HUOL, with the application of the continuous replenishment according to IN 205, provides a significant reduction in acquisition costs of medical and hospital medicine

A regulação no contexto hospitalar enquanto ferramenta gerencial: a compreensão dos profissionais envolvidos

Pós-graduação em Saúde Coletiva - FMB

Incidentes relacionados a medicamentos em uma instituição hospitalar: subsídios para a gestão

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Sitios Assistenciais em Unidade de Terapia Intensiva e Relação do Nursing Activities Score com a Infecção Hospitalar

The Patient Classification System has become essential concerning to the practice in management and care from a nurse. This study analyzed the implementation of Assistance Sites in an intensive care unit for adults as a way of organization and classification of patients, as well as the impact of this process on the quality of care according to the Nursing Activities Score and the relation with the Hospital Infection. This is a quantitative, prospective, descriptive and transversal study. The data collection was realized from July until October 2010. The sample was consisted of 214 patients, mostly male, neurosurgical and with a mid age of 57 years. The NAS was on the average of 71.72%. Regarding the Hospital Infection before and after implantation, there was a reduction in the rates of pneumonia. However, the nursing workload remained the same. Moreover, It was evident the importance of using the Nursing Activities Score and the implementation of new ways for classification of patients to improve the organization of the care.

Sistemas de acreditação e certificação hospitalar em Portugal Continetal

Dissertação apresentada à Escola Superior Agrária do Instituto Politécnico de Castelo Branco para obtenção do grau de Mestre em Inovação e Qualidade na Produção Alimentar.

Sistemas de custeio na gestão hospitalar

The cost management in any organization provides a number of benefits such as security in the good management of resources, but it is little used in the public hospital sector which is shaped like a paradox, facing the complexity of hospital organization and the underfunding situation of Cheers. The purpose of this book was to develop and submit an application method of a costing system in public hospitals. This proposal was developed in partnership with the Secretariat of the State of Paraná Health, with financial support from PPSUS and Araucaria Foundation. The study was conducted as an action research in two public hospitals in Paraná, but it can be replicated in any hospital from the premises of the developed method. For this, We developed the concepts of administration and public governance, the right to health in Brazil, the costs in the public sector and the detailed presentation of the proposed costing system model. The results constitute an important management tool for hospitals and Ministry of Health, enabling greater security leaders in the face of difficulties and challenges in this segment. Thus, it is expected that the book will contribute to governments for better management of public funds allocated to health; with academia, as a still incipient theme in literature; and society, so that more hospitals were professionalize its cost management and thereby provide a more efficient and effective service.

Paradigma da formação em contexto hospitalar: Análise da realidade percepcionada pelos enfermeiros de cuidados gerais

A presente investigação empírica, desenvolvida na área da formação contínua, procura compreender como se processa a formação continua em contexto de trabalho dos enfermeiros de uma organização hospitalar, centrando-se na percepção e representações dos enfermeiros de cuidados gerais sobre a qualidade, autopercepção do impacte e importância da formação no desenvolvimento de competências e motivação para a participação na formação contínua, como forma de promover o desenvolvimento de competências. Considerando-se que a problemática do paradigma da formação, subsiste na falta de articulação entre os processos comunicacionais, motivadores, procedimentais e dos recursos à disposição dos usuários e gestores da formação, a nível micro dos serviços da organização e macro da tutela o que contribui para a inexistência de resultados quantificáveis, em termos de eficácia e eficiência da formação no desenvolvimento de competências dos colaboradores e crescimento da organização. Apesar da formação contínua, nas organizações, objectivar o desenvolvimento de competências, implicar a construção de um quadro de referência a partir de uma abordagem multidisciplinar, de forma a incluir a complexidade dos fenómenos, a investigação dos factores determinantes que concorrem para a performance dos enfermeiros, parece ser uma abordagem imprescindível para compreender e analisar a problemática na sua dimensão. O estudo empírico consistiu numa investigação exploratória/descritiva, partindo de uma amostragem não probabilística, optando-se por uma metodologia quantitativa, através da aplicação de questionários a 208 enfermeiros da prestação de cuidados, de uma organização hospitalar pública EPE, da Administração Regional de Saúde de Lisboa e Vale do Tejo. Esta investigação permitiu verificar que no geral, os enfermeiros têm uma percepção positiva sobre a qualidade da formação contínua desenvolvida no serviço onde desempenham funções. Maioritariamente consideram importante a formação contínua como factor de desenvolvimento de competências, sentem-se motivados e participam activamente na formação. No entanto, não se conseguiu efectuar qualquer tipo de inferências ou correlações entre as variáveis de estudo constatando-se que os enfermeiros responderam frequentemente e Sempre, na grande maioria das questões, havendo heterogenia nas respostas a questões semelhantes. O estudo demonstrou que apesar da percepção positiva dos enfermeiros sobre a formação contínua desenvolvida no serviço, não se consegue ter a verdadeira percepção de como é conduzida a formação em serviço qual o seu impacte na melhoria do desempenho dos enfermeiros e se a organização evidencia uma cultura de formação voltada para uma estratégia de melhoria continua das qualificações dos enfermeiros. À luz dos resultados, foi desenvolvido um projecto de intervenção sócio-organizacional na área da gestão da formação, numa perspectiva de estratégia de desenvolvimento organizacional, melhoria das competências individuais e proposto um portfólio de descrição de funções do enfermeiro responsável pela formação. ABSTRACT: This study, based on the issues of continuous professional training in the hospital setting, as a factor to develop nurses competencies, intends to understand how the training program in the hospital milieu is conducted, focusing on perceptions and concepts of quality, impact, importance and motivation to participate in ongoing professional training, according to general care registered nurses point of view. The study main goal is to identify how is developed professional training in a medical institution from Sub-Região de Saúde de Lisboa and Vale do Tejo, and evaluate the impact of the training program. Considering that a problematic exists in the articulation between the communication processes, motivational drives, procedures and resources at the disposition of the participants and managers of the professional development program, at a micro level of services in the organization and at a macro level of the government policies and organizational strategies leaders; which contributed to the absence of quantifiable results and little evidence, in terms of efficiency of the professional development program to enhance the professional competencies of those participating in the study. The investigation of the factorial determinants related to nurse’s efficient performance enhanced by participating in continuous professional training, seems to be an imperative approach to understand and analyze the problematic in its own dimension. The empirical study consisted in an exploratory/descriptive investigation, departing from a random sample, by means of a quantitative methodology approach; through the use of questionnaires being administered to 208 nurses in general care, from a public medical organization. This study, allowed to verify that nurses have a positive perception of the professional development programs established in their workplace, and the competencies of those nurses in charge of delivering the program. The majority, considered the maintenance of a continuous professional development program, imperative to maintain good professional skills; they feel motivated and actively participate in professional development programs. However, it was not possible to make any correlations between the variables of the study, noticing that the nurses answered frequently and always, to the majority of the questions. The study demonstrated that even though nurses have a positive perception of professional development in terms of their workplace, it was inconclusive to ascertain the training quality programs delivered at medical facilities. ln conclusion, a plan of intervention centered on a socio-organizational model, was developed to create a uniform, procedural approach to developing high standards competencies for the registered nurses, by a professional training program, that include monitoring the process and assessing the results of the program. Management competencies according to a balanced scorecard it's another proposal of this study.

Reformas na gestão hospitalar:análise dos efeitos da empresarialização

Tese de Doutoramento em Ciências Sociais na Especialidade de Administração da Saúde

A profissionalização dos servidores do legislativo e o curso superior e administração legislativa da Unisul

Desde 1995, o Brasil apresenta uma nova onda de profissionalização do serviço público. No campo do Legislativo, esse movimento levou à criação de escolas do legislativo e à preocupação com a adoção de modernas técnicas de gestão pública. Há que se indagar, entretanto, qual o perfil desejado para o profissional do Legislativo. O curso de graduação tecnológica em Administração Legislativa, oferecido pela Unisul como uma oportunidade de formação específica dos servidores do Legislativo, traz uma definição desse profissional que é analisada criticamente neste estudo.

Elaboração de proposição dispondo sobre a alienação de bens imóveis da União, sob a administração da Câmara dos Deputados

Consultoria Legislativa - Área VIII - Área de Direito Administrativo e de Administração Pública.

Estudo pormenorizado da situação dos secretários parlamentares contratados pelo regime da CLT com pelo menos cinco anos de tempo de serviço à data da promulgação da Constituição Federal de 1988, visando subsidiar decisão da administração superior da Casa sobre reivindicações de vínculo pelo RJU

Consultoria Legislativa - Área VIII - Administração Pública.