Organização e gestão do Centro Cirúrgico de um Hospital Universitário de Belo Horizonte - Minas Gerais

AUTOR(ES)

Maria do Carmo de Souza Mota Avelar Gomes

DATA DE PUBLICAÇÃO

2009

RESUMO

Hospitals stand out as a convergence center of several knowledge and practical health service systems. As a complex institution, crossed by multiple interests, hospitals suffer permanent and continuous discussion about the municipal manager, workers and users expectation related to its role in integral care production with quality, efficiency and costs control. In this context, the HOSPITAL DAS CLÍNICAS DA UNIVERSIDADE FEDERAL DE MINAS GERAIS (HC-UFMG), a public university institution, has introduced, in 1999, a new management proposal based on decentralization of administrative actions, creating the Functional Units (UF). The new management model proposes to reorganize the logical of hospital management, in order to obtain better results and better performance in health services. But, in 2005, the HC-UFMG surgical center has organized itself as a Functional Unit and also has started to be responsible for management of human, financial and material resources, processes and results, the evaluation of assistance, the teaching and the research developed in this sector. The surgical center unit is a great creator of costs to hospitals and, because of that, the development of programs which guarantee quality is a necessity in terms of efficiency and an obligation of ethical and moral point of view. In 2008 the results of a performance evaluation has pointed inefficiency and low productivity, requiring adjustments. This study has as objective to analyze the surgical center organization and functioning, in order to understand its management process, the factors that help and those that difficult the work process and the relationship between the different professionals who act in the unity. It has been done a qualitative case study, in which the data were collected through semistructured interviews carried out with 19 professionals, of different areas, who act in the HCUFMG surgical center. The results were subjected to the analysis of content, using the identification of thematic units, grouped into categories by affinity empirical. The analysis of data shows that the surgical center is a sector which the work is stressful, there is a great time for the completion of surgery, interpersonal relationships and between professions are conflicting and there is predominance of medical power on the other professionals. The management of the sector lacks the autonomy needed to put in place the necessary changes, due to the strength of corporate professionals, especially medical doctors. The surgical center did not incorporate, in its practice, the decentralized management model proposed to HCUFMG, keeping itself in a management format, parallel to the directives of the hospital, crossed by multiples powers which exist inside the service. The relationship between the different professionals who act in the unity and the new management model and the organizational changes proposed happens formatted by the corporative logic of professions. The data show that the planning, as an instrument of management, does not exist. It also shows that the initiative of organization and efficiency suffers interference of the medical power, because they requires from the directorship the same power of decision that they have on surgical procedures, not recognizing the organizational standards. The difficulties for the organization and operation of the surgical center are related to the shortage of managerial strategies able to consider the various powers, seeking a team work in which the respect to the various workers and the hospital rules predominate. Is important also to seek integration with other sectors of the hospital as a way to organize the daily work, minimizing external interference.

ASSUNTO(S)

hospitais univertários/ organização &administração decs enfermagem teses administração hospitalar decs humanos decs dissertações acadêmicas como assunto decs centro cirúrgico hospitalar/organização &administração decs enfermagem decs gestão em saúde decs

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