Controle de gestão em organizações hospitalares
TL;DR: In this article, the authors present a discussion about two models for evaluating the management control function in hospitals: Hospital Certification and Reinforcement and Improvement Program for Quality in Hospitals (Pro-Hosp).
About: This article is published in REGE - Revista de Gestão.The article was published on 2009-09-01 and is currently open access. It has received 33 citations till now.
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TL;DR: This article aims to systematically review the implementation of Lean tools and techniques applied to hospital organizational areas in a 5-year period, between 2014 to 2018, complementing some of the most relevant reviews already published.
Abstract: Even though the implementation of lean in health care environments is relatively recent, it has been receiving a lot of attention in recent years. Partly because of the fact that it is a recent field of practise and research and partly because the number of works developed in this field has grown rapidly, it is important to frequently update the perspectives on this field of investigation. Thus, this study aims to review the implementation of lean tools and techniques applied to hospital organizational areas in a five-year period, between 2014 and 2018, complementing some of the most relevant reviews already published. The most important criteria such as tools, methods and principles, hospital areas intervened, improvements and difficulties were assessed and quantified.,As starting point for this systematic literature review (SLR), a set of selected pre-existing review publications was used to support the current study and as the ground base for the expansion of the studies about lean health care. The current study contemplated 114 articles from a five-year period between 2014 and 2018. A subset of 58 of these articles was critically assessed to understand the application of lean tools and methods in different hospital areas.,The thorough analysis of selected articles show a lack of works in continuous improvement approaches when compared to the application of production organization methods, visual management and diagnosing and problem-solving tools. The reported improvement results demonstrate alignment with the principles and foundations of lean philosophy, but such results are presented in isolated initiatives and without robust evidence of long-term maintenance. Moreover, this study shows an evolution in the number of articles referring to lean implementation in hospital areas, but in its great majority, such articles report isolated implementations in different areas, not spreading those for the global organization. Thus, some of the main recommendations are the need to implement studies on complete flows of patients, drugs and materials, instead of isolated initiatives and strive to promote the cultural change of hospitals through structural changes, following new visions and strategic objectives, supported by real models of continuous structural and sustained improvement.,The current study develops a new perspective of the articles published under the thematic of lean health care, published in a recent period of five years, which are not completely covered by other works. Additionally, it explicitly applied, in an innovative way, an approach that used a set of previous reviews as the starting point for this SLR. In this way, it integrates approaches and categories from different SLRs, creating a framework of analysis that can be used by future researchers. Finally, it shows the most recent implementations of lean health care, exposing the current trends, improvements and also the main gaps.
24 citations
TL;DR: The results show a greater interest on the part of researchers in looking for a more vertically and horizontally dialogical administration, better definition of work processes, innovative technological tools to support the management process and finally the possibility of applying project management methodologies in collaboration with hospital management.
Abstract: Hospitals are complex organizations which, in addition to the technical assistance expected in the context of treatment and prevention of health hazards, also require good management practices aimed at improving their efficiency in their core business. However, in administrative terms, recurrent conflicts arise involving technical and managerial areas. Thus, this article sets out to conducta review of the scientific literature pertaining to the themes of hospital management and projects that have been applied in the hospital context. In terms of methodology, the study adopts the webiblioming method of collection and systematic analysis of knowledge in indexed journal databases. The results show a greater interest on the part of researchers in looking for a more vertically and horizontally dialogical administration, better definition of work processes, innovative technological tools to support the management process and finally the possibility of applying project management methodologies in collaboration with hospital management.
21 citations
Cites background from "Controle de gestão em organizações ..."
...C ên ia & aú de C oltiva, 22(6)95-1904, 2017 Um setor com essas características, além dos benefícios óbvios à gestão dos recursos financeiros, associa-se às práticas mais dialógicas defendidas pela gestão participativa, a medida que aproxima a gestão de topo e os setores do hospital....
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...C ên ia & aú de C oltiva, 22(6)95-1904, 2017 O presente levantamento bibliométrico foi realizado entre outubro de 2015 e janeiro de 2016....
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...C ên ia & aú de C oltiva, 22(6)95-1904, 2017...
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...C ên ia & aú de C oltiva, 22(6)95-1904, 2017 Quadro 2....
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TL;DR: In this paper, five Portuguese hospitals were contacted for analysis of performance and maintenance service contracts, and the initial results of the analysis of 38 proposals from two hospitals, point to the need for significant improvements in the details of the specification of such contracts.
11 citations
21 Dec 2010
TL;DR: Moreno et al. as discussed by the authors present a modelo-padrao, which compreende tanto financeiros quanto operacionais for calculo da eficiencia dos hospitais da amostra.
Abstract: Apesar de apresentarem predominante importância no sistema de saude no Brasil, poucos estudos nacionais dissertam sobre a avaliacao de hospitais, principalmente sobre a analise financeira de indicadores que possam orientar os formuladores de politicas publicas no pais. Alem disso, poucos estudos internacionais tem como foco analisar organizacoes prestadoras de servicos de saude (LA FORGIA; COUTTOLENC, 2009). De forma geral, alem das dificuldades inerentes as especificidades dessas organizacoes, os estudos tem demonstrado que a ausencia de informacoes confiaveis sobre qualidade, eficiencia e custos da atencao hospitalar e um dos principais problemas dos hospitais e dificulta os esforcos para melhorar a eficacia na prestacao de servicos. Dado esse contexto, o presente estudo tem como foco a gestao financeira de hospitais, o qual pode ser traduzido em duas perguntas de pesquisa, a saber: (i) que fatores determinam a eficiencia de hospitais? (ii) como os indices de eficiencia variam entre hospitais de tipos e tamanhos diferentes? Para tanto, o objetivo do presente estudo foi analisar a eficiencia de hospitais a partir de indicadores financeiros e nao financeiros, a fim de evidenciar a (in) eficiencia da gestao financeira das organizacoes hospitalares publicas e privadas (com e sem fins lucrativos). Dentre os resultados apresentados, destaca-se a proposta de uma estrutura de avaliacao de eficiencia da gestao financeira de hospitais. Composta de treze Modelos que utilizam o metodo da Analise Envoltoria de Dados (Data Envelopment Analysis DEA), a proposta compreende tanto indicadores financeiros quanto operacionais para calculo da eficiencia dos hospitais da amostra. Por meio dos indicadores selecionados a partir dos ultimos seis desses Modelos, propoe-se um Modelo-padrao, composto pelas variaveis de maior peso e que, portanto, podem determinar a eficiencia dos hospitais analisados. Salienta-se que de um total de 72 hospitais prestadores de servicos conveniados ao Sistema Unico de Saude (SUS), foram selecionadas 26 organizacoes para analise, devido principalmente a disponibilidade de acesso as demonstracoes financeiras que deveriam ser publicamente divulgadas e, em especial, via Internet e aos dados do Sistema de Informacoes Hospitalares do SUS (SIH-SUS) e do Sistema de Informacoes Ambulatoriais do SUS (SIA-SUS). Os indicadores considerados nas formulacoes dos Modelos foram (i) financeiros PCT, LC, PMP, GA, MO, ROA e End; (ii) operacionais TO, TMP, LO, FTE/LO. As relacoes estabelecidas entre esses indicadores basearam-se nos autores: (i) Schuhmann (2008) e McCue e Nayar (2009); (ii) Barnum e Kutzin (1993); (iii) Younis, Younies e Okojie (2006); (iv) Marinho, Moreno e Cavalini (2001); (v) Ersoy et al. (1997). A partir dos resultados, pode-se observar que os indicadores financeiros considerados no estudo PCT, LC, PMP, End de forma geral, apresentaram, para os Modelos com resultados referentes a esses inputs, relevância para a determinacao da eficiencia dos hospitais. A excecao foi para o input PMP, que nao apresentou peso medio relevante nos Modelos calculados. Para os indicadores operacionais TMP, TO, LO e FTE/LO, obtiveram-se resultados relevantes para o indicadores TMP, TO e FTE/LO em alguns dos Modelos que consideraram esses indicadores como inputs. De forma geral, concluiu-se que o presente trabalho pode contribuir para a analise do desempenho da gestao financeira de hospitais. Em primeiro lugar, porque se apresenta a relacao de indicadores financeiros e operacionais que podem ser utilizados para analise da eficiencia dessas organizacoes. Em segundo, porque se apresentam valores desses indicadores que podem ser utilizados como padrao para analise das organizacoes do setor de saude.
8 citations
TL;DR: A pesquisa bibliometrica, baseada nas Leis de Lotka, Zipf e Bradford, com abordagem quantitativa, foi realizada por meio de analise documental, buscando no texto completo as palavras hospital and healthcare nos dez periodicos de maior impacto da area de administracao, conforme o Journal Citacion Report (JCR) as mentioned in this paper.
Abstract: O estudo objetiva descrever caracteristicas bibliometricas dos artigos sobre gestao hospitalar publicados em periodicos de alto impacto da area de administracao, com um recorte longitudinal de 2000 a 2011. Pesquisa bibliometrica, baseada nas Leis de Lotka, Zipf e Bradford, com abordagem quantitativa, foi realizada por meio de analise documental, buscando no texto completo as palavras hospital e healthcare nos dez periodicos de maior impacto da area de administracao, conforme o Journal Citacion Report (JCR). Os resultados evidenciam que as pesquisadoras Margaret Abernethy e Leslie G. Eldenburg se destacam quanto ao volume de artigos publicados e de citacoes por outros pesquisadores. Na aplicacao das leis bibliometricas, observa-se concentracao de producao em poucos autores e na sua distribuicao em periodicos. Os resultados empiricos se aproximam do estabelecido nas Leis de Lotka e Bradford. No entanto, contrariando as expectativas em relacao a selecao dos periodicos objeto de estudo, para o tema em analise, conclui-se que os periodicos de maior impacto pelo JCR nao constituem-se naqueles que concentram um terco dos artigos publicados sobre gestao hospitalar, como preve a Lei de Bradford. Justificam-se assim novas pesquisas bibliometricas, ampliando o periodo de analise e de periodicos para possiveis explicacoes sobre os achados deste estudo.
6 citations
References
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Book•
01 Jan 2005
TL;DR: Yin et al. as mentioned in this paper present a nova edicao do best-seller Estudo de Caso foi cuidadosamente revisada, atualizada, and ampliada, mantending todos as qualidades e a abrangencia da segunda edition.
Abstract: Esta nova edicao do best-seller Estudo de Caso foi cuidadosamente revisada, atualizada e ampliada, mantendo todos as qualidades e a abrangencia da segunda edicao. Com um texto muito claro, o autor trata de todos os aspectos do estudo de caso, da definicao do problema, do projeto, da coleta e analise de dados a elaboracao do relatorio. Yin tambem demonstra os usos e a importância de estudos de caso em uma grande variedade de campos, incluindo sociologia, psicologia, historia, administracao, planejamento, servico social e educacao...(AU)
5,383 citations
Journal Article•
TL;DR: The application of knowledge management principles will be limited to the context of hospitals, hospital systems or associations, or other groupings of hospitals based on a common interest or focus.
Abstract: It is a long-term, sustainable commitment to changing the culture of health care to become more collaborative, more transparent, and more proactive. Knowledge management, implemented well, will transform the health care delivery system over the next few decades, into a more cost-effective, erroraverse, and accountable public resource. For the sake of simplicity, this article will limit the application of knowledge management principles to the context of hospitals, hospital systems or associations, or other groupings of hospitals based on a common interest or focus. The field of knowledge management has tremendous application and value to the health care industry, particularly for hospitals and hospital systems. For many who have invested in a knowledge management infrastructure, it has become the
114 citations
TL;DR: The layered approach for system evolution did provide an environment in which a flexible and participatory software development process could be established and will play an increasingly important role to establish responsive IT-infrastructures where the application developer can concentrate on business process alignment instead of coding and debugging.
111 citations
TL;DR: Reforcar tais especificidades e perspectivas de aproximacao, buscou-se nao somente registrar a amplitude e complexidade dos dispositivos e acoes propostos no âmbito do HumanizaSUS, como tambem fazer uma breve revisao of conceitos e componentes englobados na area of monitoramento e avaliacao.
Abstract: The purpose of this paper is to prompt discussions of the perspectives of the Evaluation of Brazil's National Health Humanization Policy being implemented by the Ministry of Health (PNH/HumanizaSUS). It strives to systemize some Health Evaluation benchmarks, distinguishing two key aspects of this evaluation: one examines methodologies for the definition of Humanization actions monitoring indicators; the other analyzes evaluatory surveys measuring the impacts of these actions. Both aspects were scored, highlighting specific characteristics that must be recognized in the approach and use of evaluation methodologies under the aegis of this Policy. In order to strengthen such specific characteristics and approach perspectives, it explores the extent and complexity of the tools and actions proposed in the field covered by this Policy, while also offering an brief review of the concepts and components encompassed by the Monitoring and Evaluation area.
90 citations
TL;DR: This work contemplates the literature revision of Quality Standardization and the evaluation process by means of Hospital Accreditation literature to seek a higher value of the assistentials results, as well as the elaboration of more equanimous patterns in the structure, processes and results of the helpential quality.
Abstract: This work contemplates the literature revision of Quality Standardization and the evaluation process by means of Hospital Accreditation literature. A historic resume have been worked out, about the beginnings of quality evaluation within the health services, from the Hospital Standardization Program, elaborated by the American Surgeons College, in the middle of 1924, to the creation of ONA - National Accreditation Organization, who has as main goals the installation and implementation of a health assistance permanent improvement process, thus stimulating the services to reach higher quality standards. After a reflection exercise, it was considered that, in the evaluation of services, it's necessary to seek a higher value of the assistentials results, as well as the elaboration of more equanimous patterns in the structure, processes and results of the assistential quality.
90 citations