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Crawford, H., and Jean Croce Hemphill. "Bridging the Gap in Care Transitions by Implementing an Electronic Homeless Resource Toolkit for Case Management Personnel: Hospital to Community." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7574.
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Silva, Wellington Coutinho da. "Fiscalização de obras públicas: gestão de segurança na Universidade Federal de Juiz de Fora." Universidade Federal de Juiz de Fora, 2015. https://repositorio.ufjf.br/jspui/handle/ufjf/1134.
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O setor da Indústria da Construção Civil tem um dos maiores índices de acidentes e fatalidades, refletindo o setor que apresenta as piores condições de segurança, em nível mundial. Uma das principais causas para o fato é de que a prevenção de riscos não é priorizada por diversas empresas, devido à falta de conscientização da real importância da Segurança e Saúde do Trabalho por parte dos responsáveis pelo gerenciamento dos empreendimentos. A questão da Segurança e Saúde ganha maior dimensão quando aplicada à obras maiores e mais complexas, como por exemplo, os hospitais. O objetivo deste trabalho é apresentar ferramentas de controle da Gestão de Segurança e Saúde do Trabalho utilizadas na obra de ampliação de um hospital universitário, na Universidade Federal de Juiz de Fora (UFJF) em Juiz de Fora – MG. É apresentada a forma como a empresa construtora, em conjunto com a fiscalização atuaram em relação à segurança do trabalho na execução de uma obra pública. A metodologia utilizada parte de uma revisão bibliográfica e segue com um estudo de caso exploratório. No período de pouco mais de um ano não foi constatado nenhum acidente grave com vítima fatal ou afastamento de colaboradores da produção. O estudo mostra que a existência de um processo de gestão criteriosamente estabelecido, seguido de um monitoramento constante são os fatores determinantes para que a segurança dos trabalhadores seja alcançada ao longo da execução da obra.
Construction is one of the highest rates of accidents and fatalities sector of Industry, showing an industrial sector that has the worst security conditions worldwide. One of the main causes is the fact that risk prevention is not priority of the companies, due to lack of awareness of the real importance of occupational health and safety by those responsible for managing the projects. The issue of health and safety grows in importance when applied to larger and more complex constructions, such as hospitals. The objective of this dissertation is to present control tools for Management of Occupational Health and Safety used in the expansion of a Teaching Hospital of Universidade Federal de Juiz de Fora (UFJF) in Juiz de Fora – MG, Brazil. This study displays how the construction company, along the UFJF inspection, works regarding workplace safety in the execution of a public facility. The methodology begins in a literature review and follows with an exploratory case. In one-year period it was not observed any serious accident with fatality or removal of employees in production. The research shows that the existence of a carefully established management process, followed by constant monitoring is critical for the safety of workers during the building activities.
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Feng, Feifei. "Hospital nurses' attitudes to work : a case study of a Chinese hospital." Thesis, University of Wolverhampton, 2018. http://hdl.handle.net/2436/622069.
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The aim of this study is to explore what the relevant factors of nurses' attitudes to and at work are. These include the separate but related hypotheses - the nature of the profession and changes in terms of management and training; the nature of the work situation including contracts and pay determination; and the nature of work relations as they impinge on nurse status including relations with co-workers and patients. All of which can be understood and compared with other workers in terms of both labour process and industrial relations as Goldthorpe (1968) did in the study of car workers. In the context of the contemporary Chinese social and political economy, the research also evaluates the roles of the government and how it affects nurses' attitudes to the profession. It is grounded in a case study of 330 nurses in a Chinese public sector hospital, using questionnaires, interviews, and documentary evidence on government policies and hospital practices. The findings suggest that nurses at the case study hospital are frequently put under pressure due to the high number of patients they are expected to care for. This was caused by insufficient government funding for public sector hospitals, and the pressure to improve overall efficiency within the health service. The use of different types of employment contracts for nurses has caused strong resentment among nurses because it fails to award 'equal pay for equal work'. In addition, the current system used in many Chinese hospitals for nurse education, recruitment, training and development, and pay have not helped establish realistic expectations of nursing or rewarded nurses for the work they do effectively.
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Stringer, Lisa, Kate E. Beatty, K. Wilson, and A. Ciecor. "From the Hospitals’ Perspective: Collaboration among Non-Profit Hospitals and Local Health Departments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6851.
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Beatty, Kate, Kirstin Wilson, Amanda Ciecior, and Lisa Stringer. "From the Hospitals’ Perspective: Collaboration among Non-Profit Hospitals and Local Health Departments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6856.
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Spatzer, Susan M. "The new age workplace and effective management within vs. traditional management." Instructions for remote access. Click here to access this electronic resource. Access available to Kutztown University faculty, staff, and students only, 1993. http://www.kutztown.edu/library/services/remote_access.asp.
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Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1993.Source: Masters Abstracts International, Volume: 45-06, page: 2888. Abstract precedes thesis title page as [1] preliminary leaf. Typescript. Includes bibliographical references (leaves 89-90).
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Beatty, Kate, Kristin D. Wilson, Amanda Ciecior, and Lisa Stringer. "Collaboration Among Missouri Nonprofit Hospitals and Local Health Departments: Content Analysis of Community Health Needs Assessments." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6827.
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Objectives. We identified the levels of joint action that led to collaboration between hospitals and local health departments (LHDs) using the hospital’s community health needs assessments (CHNAs).
Methods. In 2014, we conducted a content analysis of Missouri nonprofit hospitals (n = 34) CHNAs, and identified hospitals based on previously reported collaboration with LHDs. We coded the content according to the level of joint action. A comparison sample (n = 50) of Missouri nonprofit hospitals provided the basic comparative information on hospital characteristics.
Results. Among the hospitals identified by LHDs, 20.6% were “networking,” 20.6% were “coordinating,” 38.2% were “cooperating,” and 2.9% were “collaborating.” Almost 18% of study hospitals had no identifiable level of joint action with LHDs based on their CHNAs. In addition, comparison hospitals were more often part of a larger system (74%) compared with study hospitals (52.9%).
Conclusions. The results of our study helped develop a better understanding of levels of joint action from a hospital perspective. Our results might assist hospitals and LHDs in making more informed decisions about efficient deployment of resources for assessment processes and implementation plans.
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Hellwig, Sharon Donahue. "The relationship between climate and nurses work satisfaction in two types of hospitals /." Access Digital Full Text version, 1995. http://pocketknowledge.tc.columbia.edu/home.php/bybib/11790489.
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Thesis (Ed.D.)--Teachers College, Columbia University, 1995.Includes tables. Typescript; issued also on microfilm. Sponsor: Keville Frederickson. Dissertation Committee: Elizabeth Tucker. Includes bibliographical references (leaves 77-83).
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Lee, Cheuk-kiu Johnson. "A study of organizational effectiveness of medical social services under the new cluster management of the Hospital Authority." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B42577342.
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Preuss, Gil A. (Gil Amitai) 1964. "The restructuring of work in hospitals : an analysis of determinants and outcomes in information-based organization." Thesis, Massachusetts Institute of Technology, 1997. http://hdl.handle.net/1721.1/38187.
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D’Amour, Habagusenga Jean. "Job satisfaction of health professionals in Kigali University Teaching Hospital." Thesis, University of Western Cape, 2012. http://hdl.handle.net/11394/3370.
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Magister Public Health - MPHJob satisfaction is important for the delivery of quality health care and health worker retention. This study aimed to identify the extent of job satisfaction among University Teaching Hospital of Kigali (UTHK) health workers and to describe the variables related to job satisfaction. These included working conditions, remuneration, patient care, development opportunities, supervision, time pressure and staff relations. A cross- sectional survey of UTHK health workers was conducted using a standardized instrument to identify health worker job satisfaction with related key work factors. A self-administered questionnaire was used to collect data from 274 health workers selected using a proportional stratified random sampling method and which included 21 medical doctors, 159 nurses, 19 midwives, 37 paramedic and 37 administrative staff. Respondents provided written consent to participate in the study. Analysis consisted of both descriptive statistics of overall satisfaction and various satisfactionrelated factors. For determining whether there is a significant relationship between job satisfaction and its independent variables, data were categorized and Chi-square or Fisher Exact test performed. Results showed a moderate overall job satisfaction level with 79.1% of respondents rating their satisfaction between 6 and 8 (mean: 6.7) on a scale of 1-10. A majority of respondents (82.6%) reported being dissatisfied with work income and 85.6% believed that their pay was not comparable to the work done. Over four fifths of the respondents (83.3%) reported feeling overwhelmed by responsibilities at work while a big percentage (96.5%) reported their job to be demanding physically, emotionally as well as mentally. However, respondents reported strong satisfaction (between 80% and 95%) with respect to work meaning, professionalization, training and orientation variables. Factors significantly associated with job satisfaction were adequate training to fulfill responsibilities (p value<0.001), feeling unvalued by the hospital (p=0.037) and dissatisfaction with supervisor care for patients and employees (p=0.034). In conclusion, improvement of remuneration, working conditions and hospital management in Kigali University Teaching Hospital would be expected to increase the level of job satisfaction of hospital health workforce.
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Buffenbarger, Jennifer Sylvia. "Nurses' Experiences Transitioning from Staff Nurse to Management in a Community Hospital." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2346.
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This project study addressed the problem of frequent turnover of nurse managers at a Northeastern community hospital. The lack of retention of nurse managers has led to attenuated support for the nursing staff who continued to hold the front line in patient care. The purpose of this qualitative bounded case study was to explore nurse managers' experiences with turnover in order to identify strategies for enhancing retention. Work empowerment and servant leadership theories served as the frameworks for the study. Research questions focused on nurse managers' perceptions of empowerment and servant leadership characteristics that were important in decisions to assume and remain in a management/leadership role. Data collection included audio-recorded interviews with seven current or past full-time nurse managers, and observation of three of the participants at a leadership meeting. Interview transcripts were open coded and thematically analyzed. Observation data were categorized according to empowerment and servant leadership characteristics. Five themes were identified that related to research questions: struggling in management transition, seeking opportunity for transformation, being committed but powerless, embarking unprepared on an unplanned journey, and having the presence to lead others by serving. The findings of this study guided development of a 12-month program for new nurse managers that integrated characteristics of servant leadership to empower leaders and others. These contributions may promote positive social change by preparing new nurse managers for their role and developing their skills to become successful nurse managers.
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Tossell, Renee Fayhe. "The multiskilled health practitioner: Educational preparedness and effects of technology on organizational work practices in hospital settings." Diss., The University of Arizona, 2000. http://hdl.handle.net/10150/289198.
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This paper investigates the multiskilled health practitioner (i.e., imaging specialist) how they are trained for what they do and the way their traditional role as a generalist in radiologic technology has been impacted by advancing technologies. This dissertation consists of multiple case studies, which is primarily qualitative and exploratory in nature. It does not test a hypothesis in a strict sense and is grounded in analytical categories and theories derived from the literature on technology, work, occupations, and organizations. The data analysis section consists of four sections: perceptions of the MSHPs' work, the impact of technology (i.e., incentive structures, wages, issues of autonomy/authority, task difficulty/responsibility and patterns of interaction), the enskilling/deskilling findings for all MSHPs in general and each hospital subgroup, and the MSHPs perceptions about the effectiveness of their formal education programs. With regards to a cultural examination of the workplace, the most significant sociological perspective identified were in the patterns of interaction. Specifically, three primary stylistic differences are noted. In relation to the effects of technology, an institutionalized practice of the incentive structure and the homogeneity of three broad skills were noted among our cohort. Additionally, three contextual factors that condition social action and thereby affect a technology's tendency to enskill or deskill are revealed. In light of the attributes and deficiencies noted by the interviewees regarding their formal educational programs and skills required for their new roles, the researcher provides five recommendations for strengthening technology transfer programs in which to better prepare the MSHP.
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Sedumedi, Nolita Nancy. "Guidelines for implementation of a performance management system in a level 2 public hospital / Sedumedi N.N." Thesis, North-West University, 2012. http://hdl.handle.net/10394/7566.
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INTRODUCTION
The intention of this study was to formulate guidelines for the implementation of
Performance Management System (PMS) regarding line managers (LM) and employees
(E) in a level 2 public hospital in the North–West Province. From a preliminary
evaluation it was evident that the implementation of performance management as
outlined in the NWPG policy No. 13, was not effective. The results of the research was
to provide baseline data of the current policy implementation by the line managers and
employees; an indication of the ability of the PMS to reach its goal of improved
performance between line managers and employees in the long term; and the barriers
to the policy implementation discovered over the course of the study.
RESEARCH QUESTIONS
Based on the statement of the problem, the following research questions were asked:
* How is PMS implemented from the perspective of line managers in a level 2 public
hospital?
* How is PMS implemented from the perspective of employees in a level 2 public
hospital?
* What guidelines can be formulated for line managers and employees regarding
PMS?
AIM AND OBJECTIVES OF THE STUDY
The principal aim of this study was to formulate guidelines for implementation of PMS
by line managers and employees. The objectives below of the research which are
derived from the principal aim were:
* To describe the implementation of the PMS from the perspective of line managers in
a level 2 public hospital.
* To describe the implementation of the PMS from the perspective of employees in a
level 2 public hospital.
* To formulate guidelines for line managers and employees regarding PMS?
RESEARCH DESIGN
A quantitative, explorative, descriptive, and contextual design was used in this study to
reach the overarching aim and respective objectives.
RESEARCH METHOD
The researcher firstly conducted a literature review to understand implementation of
PMS and related constructs. Thereafter the researcher used two similar structured
questionnaires for both LM and E to collect data. The questionnaires were developed to
measure the perceptions of both LM and E in the implementation of PMS in a level 2
public hospital. The questionnaires were based on the six steps (performance planning,
developing performance criteria, performance monitoring, performance review and
assessment, annual performance assessment and performance assessment outcomes)
of the current PMS policy used in a level 2 public hospital. The study is based on
transformational leadership whereby the line managers (LM) as nurse leaders with
transformational characteristics are assumed to be empowering the employees (E) and
creating enthusiasm for nursing practice. Minor adaptations were made to the
questionnaires prior to administration to the nursing personnel in a level 2 public
hospital in North West Province. An all inclusive sample was taken, representative of a
larger population and this amounted to twenty four line managers (n=24) and fifty five
employees (n=55) that participated in the study.
RESULTS
There were problems identified from both the line managers (LM) and employees (E) in
performance planning, developing performance criteria, and monitoring performance, organizing and the process of performance review and assessment and lastly the
annual performance assessment. The main two main findings are:
* The effect size of all the questions indicates a practically visible and thus
significant difference with regard to LM and E perceptions of the implementation
of PMS.
* There is statistical evidence of improper implementation of PMS from both
groups regarding some of the performance implementation items.
Based on the empirical evidence and the problems identified from the results, guidelines
for the implementation of PMS were formulated. It is suggested that these be used and
implemented to streamline the PMS in level 2 public hospitals.
Keywords: Key result areas (KRAs), Generic assessment factors (GAFs), reward, work
plan, Performance Agreement (PA), Performance Management System (PMS).Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2012.
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Lee, Cheuk-kiu Johnson, and 李焯翹. "A study of organizational effectiveness of medical social services under the new cluster management of the Hospital Authority." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B42577342.
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Santos, Déborah Machado dos. "Adaptações e improvisações: repercussões para o processo de trabalho hospitalar da enfermagem." Universidade do Estado do Rio de Janeiro, 2012. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=9067.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorO estudo do fenômeno das adaptações e improvisações de materiais e equipamentos elaboradas no ambiente hospitalar é relativamente recente nas ciências da saúde. Pode-se inferir que esses artefatos decorrem predominantemente devido à adoção de políticas de recorte neoliberal, que gera carência qualitativa e quantitativa de recursos, material e humano, refletindo no gerenciamento administrativo e assistencial do cuidado. Objeto de estudo: as repercussões da prática de improvisar e de adaptar recursos materiais no processo de trabalho da enfermagem em ambiente hospitalar. Os objetivos foram: I) descrever as adaptações e improvisações de materiais e equipamentos no ambiente hospitalar; II) analisar as consequências das adaptações e improvisações de materiais e equipamentos para o processo de trabalho em enfermagem; III) discutir as concepções da prática das adaptações e improvisações para a qualidade do trabalho da enfermagem e para a saúde do cliente, na visão dos trabalhadores de enfermagem. Pesquisa qualitativa e descritiva, desenvolvida em um hospital geral situado no Rio de Janeiro. Os sujeitos foram vinte trabalhadores de enfermagem. A coleta de dados se deu por meio de entrevista semiestruturada e observação sistemática. O método de análise utilizado foi a análise de conteúdo. A partir da apropriação da técnica, emergiram três categorias empíricas: categoria 1: o contexto de criação das adaptações/improvisações no ambiente hospitalar; categoria 2: as adaptações e improvisações de recursos materiais presentes na organização e no processo de trabalho da enfermagem; categoria 3: A dialética da prática das adaptações e improvisações para a qualidade do trabalho da enfermagem e saúde do paciente. Os resultados consolidaram o entendimento de que as adaptações e improvisações surgem predominantemente devido a um contexto de precarização, que impelem os trabalhadores a elaborarem estas criações, a fim de assegurar que o processo de trabalho da enfermagem aconteça. Constatou-se que as adaptações e improvisações interferem no processo de trabalho, no sentido de aumentar o volume de trabalho, o modo operatório da enfermagem, o tempo gasto no processo de criação, os deslocamentos do profissional, a dificuldade do seguimento aos princípios científicos em situações emergenciais. No entanto, depreendeu-se que a enfermagem faz uma multiplicidade de adaptações e improvisações em prol da assistência, porém há concepções dialéticas, as quais simbolizam aspectos positivos e negativos para o trabalho de enfermagem e para a saúde do paciente. Conclui-se que o processo de trabalho na instituição não está em consonância com as necessidades práticas do trabalho da enfermagem, acarretando em sobrecargas, adaptações e improvisações, e em última instância, em transgressões do trabalho prescrito.
Investigation of the phenomenon of adaptation and improvisation practices in the use of materials and equipment in hospital environment is relatively recent in the heath sciences. It can be inferred that those artifacts result predominantly from neoliberal-natured policies, which generate qualitative and quantitative shortage of material and human resources, with effects on care management and assistance. Object: impact of improvisation and adaptation practices in the use of material resources in the nursing work process in hospital environment. Objectives: I) to describe adaptation and improvisation of material and equipment in hospital environment; II) to analyze the consequences of adaptation and improvisation in the nursing work process; III) to discuss adaptation and improvisation practice-related conceptions to the quality of nursing and to clients health in the view of nursing workers. Qualitative and descriptive research, developed in a general hospital in Rio de Janeiro, RJ, Brazil. Subjects comprised twenty nursing workers. Data collection was based on semi-structured interviews and systematic observation. Analysis methodology was content analysis. Three empirical categories emerged out of content analysis technique: category 1: context of adaptation/improvisation in hospital environment; category 2: adaptation and improvisation of material resources found in the organization as well as in the nursing work process; category 3: dialectics of adaptation and improvisation practice to the quality of nursing and clients health. Results have consolidated the understanding that adaptation and improvisation derive primarily from a context of growing precarization of working conditions, which urge workers to make up ways to ensure nursing care. Adaptation and improvisation were found to interfere in the work process, in the sense of increasing the workload, the nursing modus operandi, the time spent on the creative process, nursing professionals commuting, and difficulties abiding by scientific principles in emergencies. However, it was found that nursing relies on a wide spectrum of adaptation and improvisation in favor of assistance. However, dialectic conceptions can be identified, which symbolize both positive and negative aspects to nursing care as well as to clients health. Conclusions show that the work process at the hospital is not in accordance with the practical needs of nursing care delivery. It generates work overload, adaptation and improvisation, and ultimately, transgressions to the work prescribed.
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Scott, Gordon Livingstone Stanley. "An assessment of health and safety management in selected rural hospitals / Gordon Livingstone Stanley Scott." Thesis, North-West University, 2011. http://hdl.handle.net/10394/8437.
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Health and safety is of the utmost importance for any company or institution to be
successful. There is quite a negative perception regarding the health and safety
of rural hospitals and clinics.
Rural hospitals are most of the time overcrowded due the large amount of
patients that has no medical aid, thus increases the risk for health and safety
issues. Patients sit in long queues for hours to receive medical attention and their
medication and are therefore exposed to all kinds of diseases, which is a high
risk for these patients’s health.
The employees working in these rural areas are also exposed to life-threatening
diseases on a daily basis and have a good chance of being infected. Employees
leave the public sector because of these unsafe working conditions and find
themselves either working in the private sector or may even immigrate to foreign
countries for better and safer working conditions.
During this research done, there were a few shortcomings identified for the
management to improvement on and to ensure a safe working environment.
There are quite a lot of negativities surrounding the patients and employees in
these rural hospitals, because patients get raped by nurses, babies get stolen
from maternity wards, doctors are attacked by patients and much more horrific
incidents happening in these hospitals.
Cultural differences are also a main concern for management, because there are
a lot of different races working together in the same department and not
everyone has the same beliefs and ways in doing tasks. These cultural
differences may lead to clashes amongst employees and result in a negative
working environment. This quantitative research was done in selected rural hospitals, due to cost and
time consumption. Only 80 employees (doctors, nurses and pharmacists)
participated in the research done and the research was not an in-depth research,
but enough evidence was compiled to make the necessary assumptions that all
is not well in the public sector.
With the new National Health Insurance (NHI) to be implemented from 2012,
there may a lot of changes in the rural hospitals for the better. Hospitals all over
the country are being upgraded and the working conditions are being attended to
by the government which may attract more health professional to rural hospitals
and clinics.Thesis (MBA)--North-West University, Potchefstroom Campus, 2012
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Lin, Qinglian [Verfasser], Wolfgang [Akademischer Betreuer] Friesdorf, Marc [Akademischer Betreuer] Kraft, and Joachim [Akademischer Betreuer] Herrmann. "Analysis of resource management in complex work systems using the example of sterile goods management in hospitals : DERESIS - DEcision making model for REsource management of complex work System In Sterile goods management / Qinglian Lin. Gutachter: Marc Kraft ; Wolfgang Friesdorf ; Joachim Herrmann. Betreuer: Wolfgang Friesdorf." Berlin : Technische Universität Berlin, 2014. http://d-nb.info/1065665733/34.
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Lin, Qinglian [Verfasser], Wolfgang Akademischer Betreuer] Friesdorf, Marc [Akademischer Betreuer] [Kraft, and Joachim [Akademischer Betreuer] Herrmann. "Analysis of resource management in complex work systems using the example of sterile goods management in hospitals : DERESIS - DEcision making model for REsource management of complex work System In Sterile goods management / Qinglian Lin. Gutachter: Marc Kraft ; Wolfgang Friesdorf ; Joachim Herrmann. Betreuer: Wolfgang Friesdorf." Berlin : Technische Universität Berlin, 2014. http://nbn-resolving.de/urn:nbn:de:kobv:83-opus4-46155.
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Vaughan, Glenys. "Ethnic origin and the use of social services : the experience of a hospital social service department." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59620.
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The importance of ethnic origin as a factor in delivery of social services has been recognised internationally as relevant at different levels of organization. This study examined 500 dossiers, a random sample of clients referred in 1985 to one hospital social service department in Montreal. Age, gender, status of children, referring hospital service, problems experienced and involvement with community social service agencies were found to be related to ethnic origin, using the Kruskal-Wallis and Pearson chi-squared test. After accounting for differences between ethnic groups in age, type of problem and referring hospital service by the use of logit analysis, ethnic origin significantly affected the changes of involvement with Social Service Centres and Departments of Youth Protection. Among the implications of the results for social services in Montreal were the need for the following: recognition that some ethnic minorities have very different social service needs than the larger ethnic groups; development of skills in cross-cultural social service provision because of the clientele's varied ethnic background; consideration of the impact, desirability and viability of ethnic/socioculturally specific agencies and services. The urgent need for further research is emphasised.
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Miglioranza, Dalas Cristina. "A política de humanização no hospital universitário do oeste do paraná." Universidade Estadual do Oeste do Paraná, 2015. http://tede.unioeste.br/handle/tede/3232.
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Submitted by Edineia Teixeira (edineia.teixeira@unioeste.br) on 2017-12-01T18:22:55Z
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This study proposes to discuss how it has been the implementation of the National Policy of Humanization (PNH), in a general public school hospital called Hospital Universitário do Oeste do Paraná (HUOP). It aimed to understand which main elements present in this organization has influenced the implementation process of the PNH. The PNH proposes to engage and enhance workers, managers and users, in order to qualify and cause changes in management and health care process through concrete and objective elements and valuing the subjective aspects of the labor relations in health services. The research appears as a case study, and as a methodological resource, it was adopted the documental research and conducting semi-structured interviews, which enabled the analysis from thematic groups. The PNH begins to be thought in the HUOP from the contracting process for the achievement of goals and financial transfers. Therefore, it was necessary to create a Working Humanization Group (GTH), named as Humanization Commission (CH), and this has become the space responsible for humanizing actions in this service. It is noteworthy that some provisions of PNH have been deployed in HUOP as openness and flexibility of schedules of visits, the presence of a companion in most hospital wards and ambience projects. Other provisions of PNH that involves changing process of management and include the discussion of the work and its consequences for the health of workers have not been prioritized. Thus the main difficulties for implementation of the HNP in this context stands out the model of centralized and vertical management, the absence of direct participation of management and segments of users in CH. Therefore, the management model change becomes an essential element to institute legitimate participation processes that include the different segments, aiming to establish more democratic practices that promote the necessary strategies for the implementation of the PNH in hospitals
Neste estudo propõe-se discutir como tem ocorrido a implantação da Política Nacional de Humanização (PNH) em um hospital geral público de ensino denominado Hospital Universitário do Oeste do Paraná (HUOP). Tem como objetivo compreender quais os principais elementos presentes nessa organização que têm influenciado no processo de implementação da PNH. A PNH propõe envolver e valorizar trabalhadores, gestores e usuários de hospitais com vistas a qualificar e provocar mudanças nos processos de gestão e cuidado em Saúde, através de elementos concretos e objetivos e, também, valorizando os aspectos subjetivos presentes nas relações do trabalho nos serviços de Saúde. A pesquisa configura-se como um estudo de caso, tendo recorrido, como recurso metodológico, à pesquisa documental e à realização de entrevistas semiestruturadas, o que possibilitou a análise a partir de núcleos temáticos. A PNH começa a ser pensada no HUOP a partir do processo de contratualização para o cumprimento de metas e repasses financeiros. Assim, houve a necessidade de criar a um Grupo de Trabalho de Humanização (GTH), grupo denominado, neste serviço, como Comissão de Humanização (CH), sendo que tal comissão se tornou o espaço responsável pelas ações de humanização no hospital. Destaca-se que alguns dispositivos da PNH têm sido implantados no HUOP, como abertura e flexibilização dos horários de visitas, a presença de acompanhante na maioria das alas de internação e projetos de melhorias de ambientes. Outros dispositivos da PNH que envolvem os processos de mudanças no modelo de gestão que contemplam a discussão do trabalho e suas consequências para a saúde dos trabalhadores não têm sido priorizados. Assim, entre as principais dificuldades para a implementação da PNH, nesse contexto, destacam-se: o modelo de gestão centralizado e verticalizado, a ausência da participação direta da gestão e dos segmentos dos usuários na CH. Assim, portanto, a mudança do modelo de gestão torna-se elemento essencial para instituir processos de participação legítimos que contemplem os diferentes segmentos com vistas ao estabelecimento de práticas mais democráticas e que favoreçam as estratégias necessárias para a implantação da PNH no âmbito hospitalar.
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Tahhan, Burhan. "The impact of authentic leadership on the work environment and patient outcomes in hospital settings : A literature study." Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-21517.
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In Sweden, turnover among healthcare professionals is a significant problem in hospital settings. Efficient leadership of healthcare professionals is vital for enhancing the quality and integration of healthcare. Authentic leadership (AL) is a relational leadership style instigated from the field of positive organizational conduct and is asserted to advocate healthy work environments that impact healthcare professional’s efficiency and positive organizational outcomes. This master’s thesis aims to describe the impact of AL on the work environment and patient outcomes in hospital settings. The method is a literature study. Peer-reviewed English or Swedish articles that examined the impact of AL on the work environment and patient outcomes in hospital settings were selected from seven databases. Quality appraisal, data extraction, and analysis were accomplished on the included studies. A total of 26 articles (n=24 quantitative, n=1 qualitative and n=1 mixed method) satisfied the inclusion criteria. Results were evaluated according to the literature review content analysis. Findings support positive relationships between AL and increased optimism and trust among healthcare professionals, job satisfaction and turnover, patient care quality, structural empowerment, and work engagement. Findings were, therefore, consistent with AL theory. Future studies using more diversity in research themes, settings, study populations, organizations, job areas, geographic origins, and theory context are merited. People in positions of influence in healthcare settings and healthcare practitioners can use the findings of this study as a guide to increase awareness of the processes by which AL promotes positive outcomes in the workplace.
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McGeehan, Susan K. "Case management in integrated models of care." Connect to this document online, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=miami1121799835.
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Thesis (M. of Gerontological Studies)--Miami University, Dept. of Sociology and Gerontology, 2005.Title from first page of PDF document. Document formatted into pages; contains [1], v, 57 p. : ill. Includes bibliographical references (p. 49-51).
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Collinsworth, Brittney M. "Hospital to housing| A grant proposal for specialized discharge planning services for people who are homeless." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527688.
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The purpose of this project was to identify and create a program that would meet the needs of a target population, identify potential funding sources, and write a grant to fund a program at St. Mary's Hospital in Long Beach, California. An examination of the literature expanded knowledge about the challenges homeless individuals face. Homeless individuals commonly receive inadequate medical care and often access more costly acute care services due to limited resources, discrimination, and cost. Housing and case management services after discharge from a hospital setting can help improve health care outcomes and reduce costly services.
The program was designed to provide specialized discharge planning services to homeless individuals being discharged from St. Mary's Hospital. The California Wellness Foundation was chosen for this grant based on the program areas of the funder. The actual submission and/or funding of this proposal was not a requirement for completion of this project.
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Ganyaza, Thulisile Zioner. "Multi-disciplinary teamwork in an admission unit of a psychiatric institution." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51837.
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Al-Dakheel, Hiafa M. "The impact of TQM on a traditionally segregated work environment: An empirical study of the healthcare sector in the Kingdom of Saudi Arabia." Thesis, University of Bradford, 2002. http://hdl.handle.net/10454/5027.
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In the last decade, the rapid development in the Kingdom of Saudi Arabia (KSA) has forced its government to implement modern management styles such as Total Quality Management (TQM) to ensure continuous improvement in the provision of healthcare. There is a considerable body of literature that shows the benefits of implementing TQM in hospitals, but there are few empirical studies that show TQM implementation efforts in the healthcare sector. Furthermore, the healthcare literature did not explore the implementation of TQM in a context of gender segregated environment such as the case in KSA. This research project is an exploratory investigation assessing the impact of TQM in a gender segregated healthcare environment such as KSA. The research design used triangulation methods to investigate the problem at hand. A combination of quantitative and qualitative methodologies were used through field-work and external comparisons. The approach was based on the following: (1) Assessing the level of perception and understanding of TQM principles in several KSA hospitals, taking into account the differences and similarities between the different gender population, (2) Examining the approach to TQM implementation and its degree of effectiveness in four Saudi hospitals to highlight critical factors for effective implementations using the Baldrige assessment method; (3) Benchmarking the Saudi hospital experiences to UK and USA hospitals to highlight key facilitating and inhibiting factors; (4) Using key findings from the previous steps to identify the critical factors and propose a model for TQM implementations in a segregated healthcare environment such as the case in the KSA. The survey research findings show a weak appreciation, awareness and understanding of TQM in managing healthcare organisations by the respondents in the KSA. It clearly shows that many employees in the organisations do riot understand TQM. The degree of emphasis for each quality activity varied and thus more research needs to be done to investigate the importance of each quality activity to a TQM implementation process, as there are varying degrees of emphasis across the board. The KSA case studies show that in implementing organisations, TQM intentions and TQM policy frameworks are generally acceptable. However, the implementation process is generally weak and lacks coordination in the majority of these organisations. It is clear that the majority of the KSA cases have not succeeded in total commitment towards a total quality culture. When compared to the UK and USA hospitals, the majority of the KSA cases show deficiencies in most of the critical activities that form the foundation of a successful quality process. Furthermore, the study indicates three critical factors in KSA hospitals that either did not exist or were not given full attention. The importance of these factors were further validated in the literature. The factors were continuous top management commitment, continuous education and training, and culture awareness. These factors were then used to develop a model for TQM implementation for a segregated healthcare environment.King Saud University
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Torres, Rafael Augusto Tamasauskas. "Gestão do tempo no cotidiano de médicos residentes de clínica médica em um hospital público universitário de São Paulo, Brasil." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/6/6143/tde-28062018-124717/.
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Introdução: A formação médica é um processo complexo que envolve a aquisição de diversas competências. Este processo desenvolve-se durante a graduação e tende a consolidarse na residência médica. Embora seja uma forma reconhecida de capacitação profissional, críticas são feitas em relação à sobrecarga de trabalho, carga horária excessiva e privação de sono. Objetivo: Descrever e analisar estratégias de gestão do tempo no cotidiano de médicos residentes de Clínica Médica em um hospital universitário de São Paulo, Brasil. Métodos: Na 1° fase foram realizadas 8 entrevistas com médicos residentes abordando aspectos de vida pessoal, familiar, empregos, estudo teórico e atividades práticas. Realizada análise de conteúdo com auxílio do programa MaxQDA. Na 2° fase foram preenchidos protocolos de atividades diárias por 7 residentes, 5 no estágio de avaliação pré-operatória e 2 no estágio do pronto-socorro de clínica médica. Calculadas médias individuais e em grupo destes dados. Resultados: Após análise de conteúdo 5 categorias foram selecionadas: a) Organização do trabalho durante as atividades práticas da residência; b) Atividade para aprendizado ou atividade profissional?; c) Moradia, planejamento financeiro e atividades domésticas; d) Tempo para lazer e relacionamentos interpessoais; e) Planejamento familiar / filhos; f) Repouso / Sono. Há relatos de atividades remuneradas não vinculadas a residência, diminuindo o tempo previsto para repouso, estudo ou lazer. Nos períodos de plantões noturnos há uma piora do convívio social e familiar devido ao deslocamento do repouso para o período diurno. O grupo no estágio de avaliação pré-operatório, em dias de atividade na residência, apresentou mediana de tempo diário em atividade de 7,5h; em repouso noturno 6,7h; em estudo teórico 2,2h e no repouso diurno 0h. Para o grupo no estágio do prontosocorro de clínica médica, nos dias de atividades diurnas esses tempos foram 13,0h; 7,0h; 0h e 0h, respectivamente. Para os dias de atividades noturnas, foram 12,5h; 0h; 0h e 7,1h, respectivamente. Discussão: Há diferenças entre trabalho prescrito e real pois a duração da jornada é superior ao previsto em alguns estágios, devido a intercorrências e visitas em enfermarias. O aumento do período da residência permitiria diminuição da carga horária diária, mas impactaria no planejamento pessoal destes médicos. Há uma privação parcial de sono que piora em estágios com plantões, interferindo inclusive em relacionamentos sociais, principalmente fora do ambiente de trabalho. Durante plantões noturnos há um pior desempenho das atividades, incluindo incidentes como interpretação errônea de exames e erros de prescrição médica. Conclusões: Os residentes vivenciam um período de aprendizado intenso, mas que exige uma carga horária elevada e trabalho complexo, com períodos de plantões noturnos e em fins de semana. Optam por adiar o momento da maternidade /paternidade para centrar a atenção nos estudos, seja para a prova de título da especialidade, quanto para um novo concurso de residência. Há diversas estratégias adotadas para gestão do tempo: residir próximo ao hospital; auxílio das atividades domésticas por diaristas; realizar refeições nos restaurantes do hospital; adiamento da maternidade / paternidade; apoio social centrado no convívio com outros residentes e supervisores.Introduction: Medical education concerns in a complex process which involves acquisition of a wide range of skills. This process develops from undergraduate education to medical residency, when it consolidates. As long as it is a recognized way of training, criticisms are made due to work overload, excessive working hours, and sleep deprivation. Objective: To describe and analyze strategies of time management in the daily life of Internal Medicine residents in a university hospital in São Paulo, Brazil. Methods: In the first phase, 8 interviews were conducted with resident physicians addressing aspects of personal and family life, jobs, theoretical study and practical activities. Data analysis was carried out using the MaxQDA program. In the second phase, protocols of daily activities were filled by 7 residents, 5 in the preoperative evaluation internship and 2 in the adult emergency room internship. Individual and group averages of the time spent with residency activities, rest, leisure, study and other jobs were performed. Results: After data analysis, 5 categories were selected: a) Organization of work during the practical activities of the residence; b) Activity for learning or professional activity?; c) Housing, financial planning and domestic activities; d) Time for leisure and interpersonal relationships; e) Family planning / children; f) Rest / Sleep. Paid activities beside the residency program were reported and responsible for decreasing the rest, study and leisure time. During the night shifts was noticed a decrease of social and family ties due to the change of resting hours towards the daytime. For the group in the preoperative evaluation internship, were identified the median daily time in activity of 7,5h of working time, 6,7h of night rest, 2,2h of internal medicine theory study and 0h of daytime rest. For the adult emergency room internship group, the activities hours were 13,0h; 7,0h; 0h and 0h, respectively. Lastly, for night shifts routines, the activities hours were 12,5h; 0h; 0h and 7,1h respectively. Discussion: There are differences between described and factual work since the working shift length is higher than anticipated in some internships, due to intercurrences and medical visits in wards. Increasing the duration of residency programs would let a decrease of daily working hours, but would impact in the personal planning of resident doctors. Sleep deprivation gets worse in internships composed by shift hours, impacting in social relationships outside work. During working shifts is notable a worse performance, being reported incidents such as lab tests misreading and prescription mistakes. Conclusions: Resident physicians experience a period of intense learning that requires a high and complex workload with night and weekend shifts. For that, maternity/paternity is postponed to aim studies for board or fellowship exams. There are various strategies used to improve time management: housing around hospital, support of maid services at home, oncampus feeding and social support centered on other residents and medical staff.
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Dujardin, Pierre-Philippe. "La conduite de projets ordinaires pilotée par les cadres de santé." Thesis, Université Grenoble Alpes (ComUE), 2018. http://www.theses.fr/2018GREAS018.
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La littérature décrit l'organisation hospitalière comme complexe et cloisonnée. Elle identifie le cadre de santé (CdS) comme un pivot pour traduire et articuler les différentes logiques professionnelles. Sa fonction est habituellement décrite par son travail quotidien de coordination opérationnel au détriment d'un travail destiné à structurer et améliorer l'organisation.En s'intéressant à la gestion de projet, l'objectif de la thèse est d'identifier le travail de coordination organisationnelle porté par les CdS.Elle s'appuie sur un dispositif pédagogique qui met des étudiants cadres en position de tiers pour explorer un problème organisationnel délégué par un CdS. Suite à la restitution au CdS du travail produit par le tiers, la recherche intervention a suivi la mise en œuvre de 17 projets sur une année.La thèse est organisée autour de quatre articles publiés. Le premier qualifie les bénéfices et limites de l'intervention du tiers. Le second présente les deux manières d'utiliser la production du tiers, révélatrices de la relation entre le projet, le CdS et l'équipe. Le troisième article explore les conditions de la conduite du projet porté par le CdS dans trois dimensions relationnelles : en proximité avec l'équipe soignante, en transversal avec d'autres unités de soins et au niveau institutionnel avec les acteurs administratifs et hiérarchiques. Le quatrième définit, parmi 12 variables, les facteurs qui influencent le résultat du plan d'action mis en œuvre.Les résultats montrent que l'acteur-tiers a permis de reconfigurer les relations collectives dans l'unité de soins et a relancé le CdS dans son pouvoir d'agir. Le succès du projet a été plus fréquent quand il a été présenté à l'équipe et discuté en réunion, c'est-à-dire quand le CdS a été un régulateur des débats et un arbitre. A l'inverse, lorsque le CdS a attendu un soutien institutionnel, ou que la conduite de projet a été prescriptive, sans communication formelle avec les soignants, l'échec a été plus fréquent. Au final 71% des actions ont produit une amélioration opérationnelle.La recherche montre que les attributs de méthodes et sociaux, ne sont pas tous identifiés dans la conduite de projet portée par les CdS. Les résultats permettent de qualifier le travail de coordination produit par le CdS de « Projet ordinaire ».Des préconisations sont formulées. Au niveau institutionnel, il est proposé d'identifier une unité de soutien managérial. Il est souligné l'importance de donner de la visibilité au projet ordinaire et de développer des espaces de discussions. Des activités de formation initiale et continue sont identifiées pour accompagner les futurs CdS et les CdS dans leurs pratiques managérialesLiterature describes hospital organisation as complex and compartmentalised. It identifies the head nurse (HN) as a pivot to translate and articulate various professional logics. Her function is usually described by their daily operational work of coordination to the detriment of a job destined to structure and improve organisation.By focusing on project management, the aim of this thesis is to identify the work of organisational coordination carried by the HN.It leans on an educational device which puts student executives in the position of a third party to explore an organisational problem delegated by a HN. After the restitution to the HN produced by a third party, research intervention has followed the implantation of 17 projects over one year.The thesis is organised around four published articles: the first one prones the benefits and limits of the third party intervention. The second presents two methods to use the third party production, revealing the link between the project, the HN and the team. The third article explores the conditions of project management carried by the HN in three relational dimensions: in relation to the medical team, in cross section with other units of care, and at institutional level with the administrative and hierarchical actors. The fourth defines, among 12 variables, the factors which influence the result of the implemented action plan.The results show that the third party allowed to re-configure the collective relations in the unit of care and relaunched the HN in his power to act. The success of the project was more frequent when it was presented to the team and discussed in meetings, that is, when the HN helped regulate debates and be referee. On the contrary, when the HN waited for institutional support, or when the project management was prescriptive, without formal communication with the nursing staff, failure was more frequent. In summary, 71 % of the actions encountered resulted in an operational improvement.The research shows that the attributes of methods and social are not all identified in the project management carried by the HN. The results permit to consider the work of coordination produced by the HN as « ordinary Project ».Recommendations are formulated. At an institutional level, it is suggested to identify a unit managerial support. The proposals underline the importance of giving visibility to the ordinary project and necessity to develop spaces of discussion. Activities of initial and continuous training are identified to accompany the future HN and the HN in their managerial practices
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Terra, Inês Filipa da Silva. "Gestão de recursos humanos em época de emergência : o impacto nos colaboradores do Hospital da Horta, E.P.E.R." Master's thesis, Instituto Superior de Economia e Gestão, 2020. http://hdl.handle.net/10400.5/20648.
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Mestrado em Gestão de Recursos HumanosA crise de saúde pública, provocada pela Covid-19, levou à necessidade de uma rápida adaptação a esta nova realidade por parte das empresas. Como tal, a Gestão de Recursos Humanos teve que encontrar soluções para proteger os seus colaboradores e negócios. Devido a esta situação, tornou-se pertinente compreender o impacto da Covid-19 no funcionamento organizacional e na Gestão do Stress dos colaboradores do Hospital da Horta, E.P.E.R. (HH), nos Açores. De forma a alcançar os objetivos estipulados optou-se pela metodologia qualitativa. Assim sendo, foi realizado um estudo com 10 colaboradores de serviços distintos do HH, aos quais foram aplicadas entrevistas semidiretivas. Posteriormente, estas foram objeto de uma análise de conteúdo. Os resultados do estudo indicam que a pandemia teve um grande impacto no HH, nas rotinas dos colaboradores e na sua esfera pessoal. Os colaboradores que se mantiveram a prestar cuidados presencialmente no HH mencionaram uma sobrecarga de trabalho e horas de serviço, enquanto que os colaboradores em teletrabalho mencionaram o impacto do confinamento no seu bem-estar devido à dificuldade em dormir, ansiedade e medo de serem infetados, consequentemente, o equilíbrio trabalho-família também foi afetado. Os colaboradores não demonstraram um nível elevado de stress, como seria de esperar. Foram ainda identificadas algumas aprendizagens, a nível tecnológico, relacionadas com o trabalho à distância e no hospital. Esta pandemia obrigou a instituição a adotar mudanças nas suas políticas e estratégias de GRH, nomeadamente no recrutamento, formação e avaliação de desempenho. A investigação futura deverá debruçar-se sobre o teletrabalho em situações de crise.
The public health crisis, caused by Covid-19, led to the need for companies to quickly adapt to this new reality. As such, Human Resources Management (HRM) had to find solutions to protect its employees and business. Due to this situation, it became pertinent to understand the impact of Covid-19 on the organizational functioning and Stress Management (SG) of the employees of Hospital da Horta, E.P.E.R. (HH), in the Azores. In order to achieve the stipulated objectives, a qualitative methodology was chosen. Therefore, a study was conducted with 10 employees from different services of HH, to which semi-structured interviews were conducted. Subsequently, these were subject to a content analysis. The results of the study indicate that the pandemic has had a great impact on HH, more particularly on the routines of employees and on their personal sphere. Employees who continued to provide face-to-face care in HH mentioned an overload of work and hours of service, while teleworkers mentioned the impact of confinement on their well- being due to difficulty in sleeping, anxiety and fear of being infected, thus, the work- family balance was also affected. However, the employees did not show a high level of stress, as one would expect. Apprenticeship was also identified, at a technological level, related to distance and hospital work. This pandemic forced the institution to adopt changes in its HRM policies and strategies, namely in recruitment, training and performance evaluation. Future research should focus on telework in crisis situations.
info:eu-repo/semantics/publishedVersion
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Al-Dakheel, Hiafa Mansour. "The impact of TQM on a traditionally segregated work environment : an empirical study of the healthcare sector in the Kingdom of Saudi Arabia." Thesis, University of Bradford, 2002. http://hdl.handle.net/10454/5027.
Full textAbstract:
In the last decade, the rapid development in the Kingdom of Saudi Arabia (KSA) has forced its government to implement modern management styles such as Total Quality Management (TQM) to ensure continuous improvement in the provision of healthcare. There is a considerable body of literature that shows the benefits of implementing TQM in hospitals, but there are few empirical studies that show TQM implementation efforts in the healthcare sector. Furthermore, the healthcare literature did not explore the implementation of TQM in a context of gender segregated environment such as the case in KSA. This research project is an exploratory investigation assessing the impact of TQM in a gender segregated healthcare environment such as KSA. The research design used triangulation methods to investigate the problem at hand. A combination of quantitative and qualitative methodologies were used through field-work and external comparisons. The approach was based on the following: (1) Assessing the level of perception and understanding of TQM principles in several KSA hospitals, taking into account the differences and similarities between the different gender population, (2) Examining the approach to TQM implementation and its degree of effectiveness in four Saudi hospitals to highlight critical factors for effective implementations using the Baldrige assessment method; (3) Benchmarking the Saudi hospital experiences to UK and USA hospitals to highlight key facilitating and inhibiting factors; (4) Using key findings from the previous steps to identify the critical factors and propose a model for TQM implementations in a segregated healthcare environment such as the case in the KSA. The survey research findings show a weak appreciation, awareness and understanding of TQM in managing healthcare organisations by the respondents in the KSA. It clearly shows that many employees in the organisations do riot understand TQM. The degree of emphasis for each quality activity varied and thus more research needs to be done to investigate the importance of each quality activity to a TQM implementation process, as there are varying degrees of emphasis across the board. The KSA case studies show that in implementing organisations, TQM intentions and TQM policy frameworks are generally acceptable. However, the implementation process is generally weak and lacks coordination in the majority of these organisations. It is clear that the majority of the KSA cases have not succeeded in total commitment towards a total quality culture. When compared to the UK and USA hospitals, the majority of the KSA cases show deficiencies in most of the critical activities that form the foundation of a successful quality process. Furthermore, the study indicates three critical factors in KSA hospitals that either did not exist or were not given full attention. The importance of these factors were further validated in the literature. The factors were continuous top management commitment, continuous education and training, and culture awareness. These factors were then used to develop a model for TQM implementation for a segregated healthcare environment.
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Fontes, Katiene da Costa. "A Fundação Hospitalar de Saúde na SES de Sergipe e as estratégias de gestão do trabalho: examinando o caso do hospital de urgência de Sergipe." reponame:Repositório Institucional da FIOCRUZ, 2009. https://www.arca.fiocruz.br/handle/icict/2422.
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Previous issue date: 2009O presente estudo tem o propósito de analisar o processo de implantação do modelo gerencial de fundação estatal de direito privado adotado para a gestão da rede hospitalar do Estado de Sergipe, a partir da criação da Fundação Hospitalar de Saúde (FHS) e suas inovações no âmbito da gestão do trabalho. Elegeu-se como lócus da pesquisa o Hospital de Urgência de Sergipe Governador João Alves Filho. Em termos metodológicos, trata-se de um estudo de caso de abordagem qualitativa. Foram realizadas entrevistas com atores-chave que tiveram participação em diversos níveis na implantação da atual política de saúde no Estado e grupos focais com trabalhadores do HUSE. Adotando como pano de fundo a abordagem psicossociológica, e, como arcabouço da análise, o modelo contextualista, o estudo irá fazer uma breve descrição do contexto atual do SUS no Estado de Sergipe, e como se constituíram as propostas de mudança, em particular na assistência hospitalar, além de analisar o processo de implementação da Fundação Hospitalar de Saúde e o conteúdo da mudança a partir do olhar dos principais atores implicados no HUSE, sobretudo no que tange aos aspectos relativos à gestão do trabalho. Os resultados obtidos permitiram identificar um contexto favorável à criação de um novo modelo que fizesse enfrentamento aos problemas que se apresentavam, no âmbito da assistência, da gestão do trabalho e da capacidade operacional do estado. Na análise de conteúdo, inferiu-se que as propostas de inovações no âmbito da gestão do trabalho nos seus aspectos objetivos faz enfrentamento à questão da precariedade dos vínculos. Na análise do processo, o estudo permitiu visualizar o momento atual como de transição do modelo anterior para o novo modelo em implantação. Nos aspectos subjetivos e simbólicos, a pesquisa identificou que para o grupo gestor, expressa-se um imaginário de potência, de crença no projeto. Contudo,embora reconheçam a complexidade da implantação da mudança, não percebem os aspectos subjetivos e do imaginário presente na vida do hospital sobre o projeto, que ainda está distante de favorecer uma afiliação do coletivo de trabalhadores. Para o grupo trabalhador há um imaginário que expressa descrença, falta de idealização,impotência, frustração, dúvidas e expectativas negativas. Não reconhecem o projeto como seu e não se afiliam à proposta.
This study aims to examine the process of implementation of state management model foundation under private law adopted for the management of the hospital network of the State of Sergipe, with the creation of the Hospital Foundation of Health (FHS) and its innovations in work management. The selected research locus was Emergency Hospital Governor of Sergipe João Alves Filho. In methodological terms, this is a case study of qualitative approach. Interviews were conducted with key actors who have participated in various levels in the implementation of current health policy in the state and groups with workers from Huse. Adopting as its background the psychosocial approach and, as a framework of analysis, the contextual model, the study will give a brief description of the current context of SUS in the state of Sergipe, and constituted themselves as the proposals for change, particularly in assisting hospital, and analyze the implementation process of the Hospital Foundation of Health and the content of the change from the look of the main actors involved in Huse, especially regarding those aspects of the work management. The results identified a favorable environment for the creation of a new model that makes coping with the problems that presented themselves under the care, management of labor and operational capacity of the state. In content analysis, we inferred that the proposals innovations in the management of labor in its objective aspects is confronting the issue of insecurity linkages. In process analysis, the study allowed visualization of the current moment as a transition from the previous model for the new model in development. In the subjective and symbolic aspects, research has identified that the group manager, is expressed in an imaginary power, and belief in the Project. However, while acknowledging the complexity of the implementation of the change, do not realize the subjective and the imaginary life of this hospital on the project, which is still far from promoting an affiliate of the collective of workers. For this group there is an imaginary employee who expresses disbelief, lack of idealization, helplessness, frustration, oubts and negative expectations. Do not recognize the project as yours and is not affiliated with the proposal.
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Israelsen, Trevor L. ""Nothing remains stationary": Child Welfare and Health in Cincinnati's Episcopal Hospital for Children, 1884-1931." Miami University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=miami1467370529.
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Santos, Cidalia de Lourdes de Moura. "Proposta de um sistema de gestão de estresse para médicos em hospitais baseado na OHSAS." Universidade Federal da Paraíba, 2008. http://tede.biblioteca.ufpb.br:8080/handle/tede/5276.
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Previous issue date: 2008-11-28Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
This research aimed at developing a management model of stress for doctors in hospitals based on guidelines proposed by the OHSAS 18001:2007. With the advent of globalization and competitiveness, the work became more stressful and diseases resulting from stress were more present. Stress is a physiological reaction of the body, therefore, necessary for life. The stress on its balance brings benefits to the individual and is called eustress, on the contrary it is called distress. The medical work puts into context a number of stressors, such as: dealing with illness and death, extended days, night work, work overload, teams conflict, among others, and therefore are affected by various problems of stress at work. To change this scenario, a way to control the stress in the hospital and in the medical work is to create ways for its management, keeping it at a healthy level. Thus, with the guidelines of a model for management of the Health and Safety at Work, the OHSAS 18001:2007, a model to manage the stress in hospitals and for the medical profession was built. The research carried out was mainly exploratory and on literature, with elements of methodology and documentation. The development of the system was based on studies of the literature on stress, stress on doctors and a careful study in all the sections and subsections of the OHSAS18001. During the study, strong points of the instrument which are key points to the success of how to manage stress were observed. As for the hospital, its organizational culture must be turned to the stress experienced by doctors and it is the starting point so that the management can happen. As to the structure of OHSAS18001, the policy should be constructed in a well defined way with clear objectives; the involvement of the medical professionals should be done through participation, awareness and training; there must be cooperation among all sectors of the hospital related to the medical work; capable and responsible people should be in charge of the system implementation; the existence of controls must be effective; and the proposal for continuous improvement means that the system should be constantly reassessed, it gives credibility to the system and preventive character and attention to medical work. It follows therefore that it was possible to adapt the OSHAS 18001:2007 to the management of stress for doctors in hospitals. The validation was not performed, but it is expected that by proving its efficiency, this proposed system could be another instrument of prevention and quality of life at work.
Esta pesquisa teve por objetivo o desenvolvimento de um modelo de gestão de estresse para médicos em hospitais baseado nas diretrizes propostas pela OHSAS 18001:2007. Com o advento da globalização e da competitividade, o trabalho tornouse mais estressante e as doenças decorrentes do estresse se fizeram mais presentes. O estresse é uma reação fisiológica do corpo, portanto, necessária à vida. O estresse quando em equilíbrio traz benefícios para o indivíduo e é chamado de eustress, ao contrário fala-se de distress. O trabalho médico insere no seu contexto uma série de estressores, tais como: lidar com a doença e com a morte, jornadas prolongadas, trabalho noturno, sobrecarga de trabalho, conflitos em equipe, entre outros, e, por conseguinte, são acometidos de diversos problemas derivados do estresse no trabalho. Para mudar esse cenário, uma maneira se controlar o estresse no ambiente hospitalar e no trabalho médico, é criar caminhos para seu gerenciamento, mantendo-o num nível saudável. Desse modo, com as diretrizes de um modelo de gerenciamento da Saúde e Segurança no Trabalho, a OHSAS 18001:2007, foi construído um modelo para gerenciar o estresse em hospitais e para a classe médica. A pesquisa realizada foi essencialmente exploratória e bibliográfica, com elementos metodológicos e documentais. A elaboração do sistema foi realizada com base nos estudos da literatura sobre estresse, estresse em médicos e um estudo cuidadoso em todas as seções e subseções da OHSAS18001. Observou-se durante o estudo pontos fortes do instrumento base e que são peças chaves para o sucesso da forma de gerenciar o estresse. Quanto ao hospital, sua cultura organizacional deve estar voltada para o estresse vivenciado pelos médicos. Quanto à estrutura da OHSAS18001, a política deve ser construída de forma bem definida com objetivos claros; o envolvimento da classe médica deverá ser feito através da participação, conscientização, e treinamento; deve existir a colaboração de todos os setores do hospital; a implementação do sistema deve acontecer sob responsabilidade de pessoas capazes e responsáveis; a existência de controles deve ser eficaz; e a proposta de melhoria contínua faz com que o sistema seja reavaliado de forma constante. Tudo isso, dá ao sistema credibilidade e caráter preventivo e de atenção ao trabalho médico. A validação não foi realizada, porém espera-se que ao se comprovar a sua eficiência, esse sistema proposto possa ser mais um instrumento de prevenção e de qualidade de vida no trabalho.
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Fernandes, Marcia Simoni. "A produção e a gestão do cuidado: notas cartográficas dos atos cuidadores do enfermeiro no cotidiano hospitalar." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-30012007-180915/.
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Este é um estudo situado dentro da abordagem qualitativa, que teve como intuito partir para uma ?viagem? nos territórios da gestão e do cuidado. Questionamentos circundaram o momento de escrita acerca da formação e do trabalho do enfermeiro no contexto hospitalar, tendo como pano de fundo os princípios do Sistema Único de Saúde (SUS). Questiona-se: no contexto hospitalar, o atos cuidadores do enfermeiro estão centrados nas demandas dos usuários, como um elemento articulador de saberes e práticas, tendo em vista as propostas de integralidade e humanização? O objetivo delineado foi cartografar os atos cuidadores do enfermeiro no contexto hospitalar, analisando as linhas postas em ação e as superfícies predominantes, com suas potências e resistências, para a produção da vida. Buscou-se tônus teórico às inquietações postas, com a construção um mapa conceitual que abordasse o cuidado, a gestão do cuidado e as implicações do hospital com a temática, sendo possível, lançar mão de uma trama conceitual, com destaque aqui para alguns conceitos pertencentes à esquizoanálise, à saúde coletiva e outros referentes a área da enfermagem. No segundo momento da construção do mapa, realizou-se a desnaturalização das práticas de cuidado, fazendo uso da Genealogia Foucaultiana, culminando com a criação de quatro configurações das práticas de cuidado, objetivando desbloquear o tempo histórico para que, através de uma problematização de objetos tidos, como evidentes, se pudesse ressignificar o presente. As estratégias de produção do conhecimento constituíram-se de dois momentos: a utilização da Genealogia Foucaultiana, que possibilitou parte da construção do mapa conceitual. No segundo momento, realizou-se uma cartografia dos atos cuidadores do enfermeiro no contexto hospitalar. Selecionou-se uma unidade de internação de um hospital filantrópico, que presta atendimento a usuários do SUS. Efetuaram 62 horas de observações focadas no trabalho dos enfermeiros nos turnos da manhã e da tarde, que foram registradas em um Diário de Bordo. Fragmentos do Diário foram postos ao lado de escritos teóricos, poemas, lembranças, dialogando com o mapa conceitual, fazendo-se uma espécie de bricolagem. No território das práticas, visualizou-se a formação de dois micro-territórios: Máquina Paranóia e Máquina Desejo. A Maquina Paranóia caracterizou-se por modos instituídos, capturados pelo tempo, pelas regras, rotinas com tendências castradoras e antiprodutivas, pelo trabalho fragmentado, que fragmenta o paciente e pela paranóia do não-saber-poder. Os atos cuidadores dos enfermeiros revelaram a produção de cuidado, cortada por linhas de segmentaridade dura e circulares, configurando-se, muitas vezes, em um descuidado, esfriando os corpos cuidados, transformando os pacientes em uma ?carga?, não possibilitando a construção de sua autonomia. Detectou-se que a gestão estava focada no procedimento, não sendo o usuário um marcador do cuidado. A Maquina Desejo revelou potências nos atos cuidadores, permeada pela escuta/acolhimento e pelas tentativas de transversalizar a equipe de saúde, sendo a gestão uma estratégia para a produção do cuidado, cortado por linhas de fuga. Condiserou-se a necessidade de os enfermeiros e docentes (re)pensarem conceitos, buscando um diálogo mais efetivo com as práticas cotidianas hospitalares, em prol do fortalecimento do SUS. Dessa forma, uma das estratégias visualizadas é a possibilidade de criação de espaços coletivos de análise e reflexões acerca do processo de trabalho em saúde e do modelo de gestão hospitalar. O ensino, por sua vez, necessita ser refletido, no que se refere a utilização de conceitos/ferramentas que produzam impacto no trabalho cotidiano do enfermeiro ante as demandas dos usuários, no aspecto individual e coletivo, da equipe de saúde e do próprio serviço de saúde, libertando-se da amarras que reforçam a hegemonia e a subserviência.management. Questions about the nurse\'s learning and duty in the context of health care were also included, having as scenary the principles of the Sistema Único de Saúde (SUS) ? the Brazilian public health care service. It was inquired if the nurse\'s care giving practices were centered in the patients\' needs, if they were acting as articulators of both knowledge and practice, having in sight the integrality and humanization proposals. The design objective was: to cartografh the nurse\'s care giving practices, in the hospital context, analizing the lines put into practice and the prevailing surfaces, with their power and resistence to produce life. Theoretical sustenance to inquietude was searched, drawing a conceptual map, broaching care menagement as well as the hospital implications towards the theme, keeping hand in a conceptual plot ? esquizoanalysis concepts and collective health mainly. At the second moment of drawing the map, denaturalization of care giving was carried out by using the Foucaultian Genealogy, creating four care-giving-practice configurations, aiming to unblock historical time for the redefinition of present time through what was considered evidence. The strategies for knowledge production were obtained in two parts: first, the utilization of the Foucaultian Genealogy to construct part of the conceptual map; second, a cartography of the nurse\'s every day chores, in the hospital context, was outlined. A 62-hour observation was performed in a clinical surgical hospitalization unit which served beneficiaries of the SUS. The nurse\'s work process, observed during the morning and afternoon shifts, was recorded in a Log Book. Fragments of the Log Book were placed next to theoretical texts, poems, memories, turning into a dialogue between these writings and the conceptual map. A type of craftsmanship work was done. In the practice territory, two micro territories were uncovered: that of Paranoia Machine and that of Desire Machine. The Paranoia Machine is characterized by instituted methods that had been captured by time, rules, routines with castrating and antiproductive tendencies, by fragmented work, and by the non-knowledge-power paranoia. The nurse\'s care giving practices revealed a care production marked by hard and circular segmentarity lines, configured many times into careless acts, cooling the cared bodies, turning the patients into a ?burden?, not giving them chance, this way, to construct their autonomy. It was detected that the care management was focused on the procedure itself, with the beneficiary being not a care giving marker. The Desire Machine revealed a power for the care giving practices, permeated with listening and hospitality, managing as a strategy for care production traversed by escape lines. The nurse\'s needs were considered; lecturers rethought concepts, searching for a more effective dialogue with the hospital practices for the strenghtening of the SUS. One of the visualized strategies was the possibility of creating collective spaces for the analysis of the work process on health care, and of the hospital managing pattern. The teaching must rethink of the utilization of tool/concepts that are able to produce an impact on the nurse\'s work in face of the beneficiary\'s individual and/or collective needs, of the health staff, and of the health care service itself, becoming released from the bondaries that reinforce hegemony and subservience.
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Edholm, Angelique, and Linda Oxelgren. "District nurses as well as nurses work within palliative care at hospital wards or in-home care : A quantitative comparison study of how satisfied they are with their efforts." Thesis, Umeå universitet, Institutionen för omvårdnad, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-178000.
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Bakgrund: Palliativ vård utförs i hela världen och det är viktigt att utveckla och följa upp den typen av vård. Palliativ vård utgår från fyra hörnstenar och skall involvera mer än det fysiska i omvårdnaden. Det är viktigt att också lägga märke och ta hand om det psykiska, sociala och andliga. Ett stort mörkertal och brister har identifierats inom den palliativa vården som måste förbättras. Motiv: 2018 vårdades ca 19% av palliativa patienter i sitt eget hem. Många patienter som är hemma i livets slutskede skickas mellan sjukhus och hemmet för att tillslut dö på sjukhuset trots att deras vilja kanske var att dö hemma. Därför är det viktigt att se hur nöjd distriktssköterskan eller sjuksköterskan på vårdavdelningar samt i hemsjukvården är med sitt arbete och vad som kan förbättras. Syfte: var att kartlägga och jämföra hur nöjda distriktssköterskor och sjuksköterskor i hemsjukvård samt på vårdavdelning är angående sin insats i palliativ vård. Metod: En kvantitativ jämförelsestudie med stratifierat urval. En enkätundersökning skickades ut till åtta vårdavdelningar och till femton kommuners hemsjukvård. Deltagarna var distriktssköterskor och sjuksköterskor i norra Sverige, totalt deltog 83. Insamlad data analyserades i Jamovi och presenteras med Chi square test samt Fischer’s exact test. Resultat: En signifikant skillnad där distriktssköterskor alternativt sjuksköterskor i hemsjukvården är mer nöjd med symtomlindring vad gäller oro/ångest (p=0.038) samt smärta (p=0.021) upptäcktes. Vid jämförelse mellan hemsjukvård och vårdavdelning kring hur nöjd distriktssköterskan eller sjuksköterskan är med sin egna insats framkom en signifikant skillnad där de på vårdavdelningen var mindre nöjd. Konklusion: En påvisad skillnad kan ses mellan distriktssköterskor och sjuksköterskor i hemsjukvården eller på vårdavdelning vad gäller symtomlindring, vidareutbildning samt läkarkontakt. Fler studier behöver utföras för att få ett mer rättvist resultat.
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Formenton, Alessandro. "Avaliação da capacidade para trabalho e absenteísmo da equipe de enfermagem de unidade de terapia intensiva de um hospital de ensino." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/22/22132/tde-06022015-185918/.
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A gestão da força de trabalho em saúde representa um novo desafio aos gestores de diversos países que têm sido levados a se envolver com as questões de recursos humanos. Busca-se o equilíbrio entre o que está disponível em termos de trabalhadores e o que realmente é necessário para a realização das atividades. Este estudo de abordagem quantitativa, de corte transversal e descritivo, teve por objetivo avaliar o índice de capacidade para o trabalho e a taxa de absenteísmo de enfermeiros, técnicos e auxiliares de enfermagem dos Centros de Terapia Intensiva (CTI) de um hospital de grande porte do município de Ribeirão Preto, São Paulo. Os dados coletados foram referentes ao ano de 2013, e utilizaram-se três instrumentos: questionário de caracterização sociodemográfica e ocupacional, o índice de capacidade para o trabalho (ICT) e o formulário com dados das ausências da equipe. Os resultados evidenciaram uma população composta por 102 sujeitos, sendo 76,5% do sexo feminino, com média de idade de 37,58 anos (dp= 9,16), e 48% apresentaram nível superior de escolaridade. Em relação aos dados ocupacionais, 54,9% possuem menos de 10 anos de atuação na enfermagem, 59,8% desempenham a função atual por período inferior a 10 anos e 31 (30,4%), por período inferior a 5 anos. O tempo de trabalho no CTI em 51% dos sujeitos investigados é inferior a 5 anos. Com relação à jornada de trabalho, 73 (71,6%) participantes cumprem 30 horas semanais. A média do ICT foi de 39,62 pontos (dp= 6,11), com variação entre 11 pontos e 49. Em relação aos valores obtidos, 72,6% dos profissionais foram avaliados com boa e ótima capacidade para o trabalho; 25,5%, com moderada e 2%, com baixa. Entre os trabalhadores considerados com ICT ótimo e bom, 17 estavam entre os mais jovens e 23 entre aqueles que possuíam idade superior a 40 anos. Com relação à taxa de absenteísmo, obtiveram-se valores de 4,14 para os enfermeiros e 14,69 para o nível técnico, demonstrando ser inferior na comparação com outros estudos em realidades semelhantes e maior prevalência de ausências por doença. O monitoramento do índice de capacidade para o trabalho e da taxa de absenteísmo, além de fornecer subsídios para o processo de tomada de decisão em relação ao gerenciamento de recursos humanos de enfermagem, permite comparações com outras instituições hospitalares similares, favorecendo o estabelecimento de padrões aceitáveis e constitui-se em um instrumento gerencial de importância fundamental para os gestores em saúde, à medida que possibilita o conhecimento da realidade institucional quanto ao perfil dos trabalhadores de enfermagem que nela atuamThe health workforce management is a new challenge to manager of several countries, and for this reasons they have been taken to engage with the human resources issues. Manangers aim the balance between the real number of workers available and the real need to perform the activities. This quantitative and descriptive study aimed to evaluate the work ability and the absenteism índex of nurses, technicians and nursing assistants from the Intensive Care Unit of a large hospital in Ribeirão Preto, São Paulo. Data were collected for year 2013 by using three instruments: socio-demographic and occupational questionnnaire, Work Ability Index (WAI) questionnaire and staff absences data form. Results showed a population comprised 102 people, with 76.5% female, with mean age of 37.58 years (SD 9.16), and 48% presented a higher education. Regarding occupational data, 54.9% have less than 10 years of experience in nursing, 59.8% perform their actual function for less than 10 years and 31 (30.4%) less than 5 years. Working time in the ICU in 51% of population estudied is less than 5 years. Regarding working Journey, 73 (71.6%) participants work 30 hours per week. The mean WAI was 39.62 points (SD 6.11), ranging between 11 and 49 points. Regarding the values obtained, 72.6% were professionals with good reviews and great capacity for work; 25.5% as moderate and 2% low. Among workers considered with great and good WAI, 17 were among the younger and 23 among those who were older than 40 years. Regarding absenteeism rate, values were 4.14 for nurses and 14.69 for technical level, proving to be lower in comparison to other studies in similar situations, and higher prevalence of sickness absence. Monitoring Work Ability Capacity and absenteeism, provide support for decision making process regarding the management of nursing human resources and permit comparisons beteween similar hospitals as well, favoring the establishment of acceptable Standards, moreover, consists in a fundamental management tool for health managers because provide the knowledge of institutional reality as the profile of nursing staff working in it
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Johnstone, Patricia Lynne. "The process and organisational consequences of new artefact adoption in surgery." Thesis, Electronic version, 2001. http://hdl.handle.net/1959.14/3905.
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Thesis (PhD)--Macquarie University, Macquarie Graduate School of Management, 2001.Bibliography: leaves 288-310.
Introduction -- Introduction to research problem and methodology -- Study context -- Theoretical framework - Review of the literature -- Study design and methods -- Study sites, surgical procedures, and labour input to surgical production -- New intra-operative artefacts: goals, choices and consequences -- Conclusion.
Surgical technologies since the late 1980s have undergone substantial innovations that have involved ...the adoption of new machines, instruments, and related surgical materials... referred to throughtout this thesis as intra-operative artefacts... typically represents a commitment of substantial financial resources by the hospitals concerned. However, little is documented about the process whereby the decisions are made to adopt new intra-operative artefacts, and no previous research appears to have explored the work-related consequences of new intra-operative artefact adoption within operating theatre services. This thesis explores the reasons why new intra-operative artefacts are adopted, how the decisions are made, who are the participants in the decsion process and what are the expected and actual organisational consequences of new intra-operative artefact adoption.
Electronic reproduction.
xii, 347 leaves, bound :
Mode of access: World Wide Web.
Also available in print form
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Mascarenhas, Ely da Silva. "Gestão dos acidentes de trabalho com instrumentos perfurocortantes: estudo em um hospital público de emergência na cidade de salvador – Bahia." Universidade Federal da Bahia, 2008. http://www.adm.ufba.br/sites/default/files/publicacao/arquivo/ely_da_silva_mascarenhas.pdf.
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Acidente de trabalho é um importante problema de saúde pública no Brasil por representar custos sociais elevados e por apresentar conseqüências desastrosas sobre o processo saúde/doença dos trabalhadores. Dados do Centro de Testagem e Aconselhamento da Bahia apontam que no período de 2004 a 2006, o setor público e a cidade de Salvador apresentaram maior freqüência de acidentes com instrumentos perfurocortantes no Estado da Bahia. A carência de informações sobre os acidentes de trabalho no setor público, e as suas possíveis conseqüências, face às epidemias de hepatite B e C e HIV/AIDS, justificam esta pesquisa. Este trabalho apresenta como objetivos analisar as ferramentas adotadas no gerenciamento desses eventos, conhecer o fluxo estabelecido para o atendimento dos acidentes ocupacionais biológicos e elaborar o perfil dos acidentes com instrumentos perfurocortantes ocorridos em 2007 em um hospital público de emergência. Trata-se de um estudo de caso, qualiquantitativo. Como instrumentos de coleta de dados utilizaram-se a observação sistemática, as anotações no diário de campo, o roteiro de entrevista semi-estruturada e os formulários. O Hospital “A” possui um total de 2700 trabalhadores. A análise dos resultados, no que se refere às ferramentas de gestão, demonstrou que esses acidentes são notificados no Centro Estadual de Infecção Hospitalar. Existe um fluxo definido pela gestão do Hospital “A” para os acidentes com materiais biológicos; em 94% dos casos de acidente houve testagem do paciente fonte com o teste rápido para HIV e os trabalhadores acidentados são encaminhados para acompanhamento em unidades de saúde de referência em infectologia. Contudo, a percepção dos entrevistados sobre as causas dos acidentes com materiais perfurocortantes é de que os mesmos decorrem, principalmente, do descuido dos trabalhadores, evidenciando a necessidade de realizar uma análise ergonômica do trabalho para investigar e fazer emergir as causas reais desses eventos, evitando a culpabilização das vítimas. Foram observadas a existência de superlotação de pacientes na emergência, que o Hospital pesquisado não dispõe do Serviço de Saúde e Medicina do Trabalho e que não há uma política de prevenção definida para a saúde e segurança dos trabalhadores neste Hospital. No que se refere ao perfil dos acidentados, foram encontrados 106 acidentes com instrumentos perfurocortantes, correspondendo a 57,06% de todos os acidentes com materiais biológicos do ano de 2007 (N=185). As equipes médica e de enfermagem foram as que mais sofreram acidentes com materiais perfurocortantes, o que vai de encontro aos achados da literatura, que se referem à categoria de enfermagem como a mais atingida por este tipo de acidente. No grupo de acidentados, referiram já ter se acidentado mais de uma vez (27,5%) e o grupo de mulheres apresentou maior freqüência de acidentes perfurocortantes (66%). Estes resultados indicam a necessidade de adoção de uma política de saúde que priorize a saúde do trabalhador e a melhoria das condições de trabalho nas unidades de emergência, o que depende, principalmente, da reorganização da rede assistencial e de vigilância à saúde do Sistema Único de Saúde.
Salvador
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Borba, Daniela dos Santos Marona. "Liderança em enfermagem no sexto turno - finais de semana e feriados - em um hospital universitário." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2011. http://hdl.handle.net/10183/31974.
Full textAbstract:
Estudo qualitativo, do tipo exploratório descritivo, com o objetivo geral de analisar o processo de liderança em enfermagem no sexto turno de trabalho - turno fixo diurno de 12 horas, realizado em finais de semana e feriados, em um hospital de ensino de Porto Alegre, RS. Os objetivos específicos consistiram em: caracterizar o perfil de enfermeiros contratados e/ou remanejados para atuar em finais de semana e feriados; discutir acerca das implicações do trabalho nesse turno para o processo de liderança; e, por fim, elencar estratégias para o desenvolvimento da liderança, na equipe de enfermagem. A coleta de dados ocorreu em duas etapas. A primeira consistiu em análise documental, com base em consulta a queries de dados do sistema de informações gerenciais (IG) do campo investigado que viabilizaram traçar o perfil de enfermeiros contratados e/ou remanejados para o turno de finais de semana e feriados, no período entre janeiro de 2004 e janeiro de 2011. Os dados, analisados segundo estatística descritiva, com emprego do software SPSS 18.0, apontaram predomínio do sexo feminino (92,5%), idade média de 36 anos e tempo médio de permanência de 15,53 meses, no turno investigado. Outra etapa da pesquisa consistiu em grupos focais, realizado em setembro e outubro de 2009, com 9 enfermeiros, durante 4 encontros de duas horas, cujas informações foram submetidas à análise temática e agrupadas em 3 categorias: significado do processo de liderança, implicações do turno de trabalho no exercício da liderança e estratégias para a construção da liderança na equipe de trabalho. Os resultados dos debates apontaram que o significado do processo de liderança para os enfermeiros centra-se em certos atributos e práticas exercidas no cotidiano do trabalho, com ênfase a: credibilidade, confiança, coerência de idéias, discurso compatível com ações, lealdade e comprometimento. Além disso, foram mencionados o bom relacionamento com a equipe, a experiência profissional, e também o conhecimento sobre o trabalho e a cultura organizacional, representando os pilares que sustentam o desenvolvimento da liderança, no grupo. Nas discussões acerca de quais habilidades são necessárias, predominou o entendimento de que pendulam entre a perspectiva transacional e a transformacional, porém, com a ressalva de que ambas são importantes para o gerenciamento do trabalho. Quanto às implicações do turno de trabalho, os enfermeiros apontaram que a falta de contato diário provoca lacunas na comunicação, bem como, interfere na relação interpessoal do grupo, condições que dificultam o exercício de liderança. As estratégias elencadas nas discussões para o desenvolvimento da liderança concentraram-se nas reuniões de equipe como espaço dialógico que, por sua vez, alicerça a construção de propósitos coletivos. Outro realce conferido a estes espaços é que possibilitam o compartilhamento de idéias, estimulam o comprometimento, fortalecem a confiança entre os membros da equipe, e reforçam a idéia de pertencimento ao grupo de trabalho. Houve referência à fragilidade da dimensão relacional na equipe, apontando a comunicação como elo para a consolidação de vínculos construtivos no grupo. Nessa perspectiva, os processos interativos e a ambiência favorável tornam-se importantes condições para estimular práticas de liderança, considerando a necessária integração entre os membros da equipe para a consolidação do cuidado como resultado do trabalho da enfermagem.Qualitative study of an exploratory and descriptive nature, with the overall objective of analyzing the process of nursing leadership sixth shift. The study was held on weekends and holidays, in a teaching hospital in Porto Alegre, RS. The specific objectives were: to characterize the profile of nurses employed and / or relocated to work on weekends and holidays, to discuss the effects of work during this shift on the leadership process, and, finally, to set strategies for the development of leadership within the nursing staff. Data collection occurred in two stages. One of the stages consisted of document analysis based on general information system data (GIs) queries of the field being researched. These enabled the profiling of nurses employed and / or relocated to the weekends and holidays shifts between January 2004 and January 2011. The data was analyzed using descriptive statistics with the use of SPSS 18.0, and it showed a predominance of females (92.5%), with a mean age of 36 and mean duration of 15.53 months, in the shift in question. Another stage of the research consisted of focus groups with nine nurses, which included four meetings that lasted two hours. The data was subjected to thematic analysis and grouped into three categories: the meaning of the leadership process, implications of the shift in leadership, and strategies for leadership in building the team. The results of the discussions indicated that the significance of leadership for nurses focuses on certain attributes and practices in daily work, with emphasis on: credibility, confidence and coherence of ideas, actions compatible with the message, loyalty, and commitment. Other attributes and practices mentioned were: a good relationship with the team, work experience, and also knowledge about work and organizational culture, which represent the pillars that support the development of leadership in the group. In discussions about what skills are needed, the view prevailed that going back and forth between transactional and transformational perspectives is important, though both are vital to work management. As for the implications of the work shift, the nurses pointed out that lack of daily contact causes gaps in communication, as well as interferes with the interpersonal relationships of the group. These conditions hinder the exercise of leadership. The strategies listed in the discussions for the development of leadership focused on team meetings as a dialogic space that, in turn, underpins the construction of collective purposes. Another highlight is given to those spaces that enable the sharing of ideas, stimulate involvement, strengthen trust among team members, and reinforce the idea of belonging to the working group. There was reference to the fragility of the relational dimensions in the team, with communication pointed to as a way to create constructive ties in the group. From this perspective, the interactive processes and a favorable environment are important conditions to stimulate leadership practices; considering the necessary integration between team members for the consolidation of care as a result of the nursing profession.
Estudio cualitativo de forma exploratoria y descriptiva, con el objetivo general de analizar el proceso de liderazgo de la enfermería en el trabajo en un turno fijo diurno de 12 horas, que tuvo lugar los fines de semana y días festivos, en un hospital de enseñanza en Porto Alegre, RS. Los objetivos específicos fueron: caracterizar el perfil de las enfermeras empleadas y / o reubicadas para trabajar en fines de semana y días festivos; discutir sobre las implicaciones de este trabajo para activar el proceso de liderazgo, y, por último, establecer estrategias para el desarrollo del liderazgo, en el personal de enfermería. Los datos fueron recolectados entre en dos etapas. Un primer paso fue el análisis de documentos sobre la base de consultas al sistema de información de datos de gestión (IG) del campo investigado que permitió establecer los perfiles de los enfermeros empleados y / o reubicados en el turno de los fines de semana y días festivos, en el periodo entre enero de 2004 y enero de 2011. Los datos fueron analizados utilizando una estadística descriptiva con el uso del software SPSS 18.0, y mostraron un predominio del sexo femenino (92,5%), edad media 36 años y la duración media de 15,53 meses en el turno investigado. Otra etapa de la investigación consistió en grupos focales con nueve enfermeras, durante cuatro reuniones de dos horas, cuyas informaciones fueron sometidas al análisis temático y se agruparon en tres categorías: significado del proceso de liderazgo, implicaciones del turno en el liderazgo y estrategias para la construcción del liderazgo en el equipo de trabajo. Los resultados de los debates indican que la importancia del liderazgo para el personal de enfermería se centra en ciertos atributos y prácticas en el trabajo diario, haciendo hincapié en: la credibilidad, la confianza y la coherencia de las ideas, el lenguaje compatible con las acciones, la lealtad y el compromisso. Por otra parte, los encuestados también mencionaron la buena relación con el equipo de trabajo, la experiencia en el trabajo y también el conocimiento sobre el trabajo y la cultura organizacional, que representan los pilares que apoyan el desarrollo de liderazgo en el grupo. En las discusiones sobre qué habilidades son necesarias, prevaleció la opinión que oscilan entre las perspectivas transaccional y transformacional, sin embargo, con la salvedad de que ambos son importantes para la gestión de la obra. En cuanto a las implicaciones de la jornada de trabajo, las enfermeras señalaron que la falta de contacto diario crea lagunas en la comunicación, así como que interfiere en las relaciones interpersonales del grupo, condiciones que impiden el ejercicio del liderazgo. Las estrategias que figuran en las discusiones para el desarrollo de liderazgo, se centraron en las reuniones del equipo como un espacio de diálogo que, a su vez, sustenta la construcción de propósitos colectivos. Otro punto de destaque dado a aquellos espacios es que permiten el intercambio de ideas, estimulan el compromiso y la participación, fortalecen la confianza entre los miembros del equipo y refuerzan la idea de pertenencia al grupo de trabajo. Se hizo referencia a la fragilidad de la dimensión relacional en el equipo, apuntando a la comunicación como enlace que permite a la consolidación de lazos constructivos en el grupo. Desde esta perspectiva, los procesos interactivos y el ambiente favorable se convierten en importantes condiciones para estimular las prácticas de liderazgo considerando necesaria la integración entre los miembros del equipo para la consolidación del cuidado como resultado del trabajo de la enfermería.
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Vorster, Martine. "A comparative study on pharmacist job satisfaction in the private and public hospitals of the North–West Province / by Marine Vorster." Thesis, North-West University, 2010. http://hdl.handle.net/10394/4619.
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Pharmacists experience high levels of stress at work, especially from factors intrinsic
to their jobs and management roles. In South Africa, the public sector is confronted
with situational difficulties such as a shortage of staff and poor working conditions
Accordingly, a comparative survey was conducted using a self–constructed
questionnaire to obtain individual responses from the pharmacists in the public, as
well as the private sector. The focus population was the pharmacists in the public,
as well as the private hospitals in the North–West Province. The public sector
consists of 30 hospitals and the private sector of 20. By using the convenient
sampling method, 100 samples were taken. The questionnaire measured six factors
of job satisfaction, namely: job design, salary/remuneration satisfaction, performance
management, working arrangements, organisational climate, and professional
development. The questionnaire was distributed to 100 pharmacists in total, and a
response rate of 66% was obtained.
The only medium practical significance shown in the results was between the
averages of the private sector (2.89) in contrast with the public sector (3.38). This
indicates that the public sector demonstrates less satisfaction with their performance
management than the private sector. The data also indicated that the public sector
pharmacists are less satisfied with job design, performance of management,
professional development, and their working arrangements. The private sector
showed only a small difference in the means, when compared to the public sector. It
is clear that both sectors illustrate a moderate level of job satisfaction.
Recommendations, therefore, included the revisiting of the job design by increasing
job rotation and task identity. The need for self–actualization has to be
acknowledged and the opportunity for promotion needs to be provided. The link
between the actual activity and the bonus, with regards to performance
management, has to be re–established, and there has to be transparency
throughout. Decision–making control is extremely important and seeing that 82% of
the pharmacists were female, the employer can consider accommodating family
responsibilities, compressed working weeks, flexible working hours, job sharing, and
part–time work. Professional development is also very important within any company
and it is vital that the employer deposits time, money and skill into the staff.Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2011.
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Long, Shannon Rene. "PRESERVING, INTERPRETING, AND DISPLAYING MENTAL HEALTH HISTORY: ESTABLISHING THE PATTON STATE HOSPITAL MUSEUM AND ARCHIVE." CSUSB ScholarWorks, 2015. https://scholarworks.lib.csusb.edu/etd/209.
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There are few museums in the western half of the United States that provide an opportunity to educate the public about the history of mental health care. Recently, a mental health museum and archive of artifacts, photographs, and documents was established on the grounds of Patton State Hospital in Highland, California. The purpose of this paper is to reflect on the establishment of this museum and archive and to provide an account of the 125 year history of Patton State Hospital. Understanding the history of Patton provides an opportunity to understand the history of mental health care in the United States from the late 19th century to the present. The establishment of this museum and archive became a joint initiative between Patton and California State University, San Bernardino’s History Department in January 2014. The museum and archive are meant to provide an educational venue that will increase awareness of the plight of the mentally ill, decrease stigmatization of those afflicted with mental illness, and further efforts to improve the care of patients through preservation and display of the artifacts, photographs, and documents related to Patton’s history. The goal of this paper is to assist future public historians with the design and establishment of a museum and/or archive, be it related to mental health history or to projects with other themes, and to provide information to other mental health facilities that wish to establish their own museums.
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Kyrkander, Sara. "Traceability of Single-Use Medical Devices through the Hospital Supply Chain. Reflections and Recommendations for Implementation of Single-Use Medical Devices Traceability." Thesis, KTH, Medicinteknik och hälsosystem, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-279140.
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There is an increased need for complete medical device traceability in the healthcare industry. The two main reasons are the healthcare industry's global supply chain and decentralised adverse events reporting, where different laws apply for each country and where each country has their own database for incidents without international governance. The idea of improving traceability procedures in the surgical department at Karolinska University Hospital was formed in the light of a near miss event where guidelines regarding incident management of a Single-Use Medical Device (SUMD) were not followed properly. Hence, this thesis project will investigate the issue of finding an effective way to trace SUMDs at Karolinska University Hospital, in order to improve the incident management process and suggest improvements of patient safety at other Swedish hospitals as well. The collection of data consisted of different data sources; observations at the research site and interviews with relevant participants. By employing multiple sources to this study, a more holistic approach could be achieved. In addition to observing the current situation of device registration, it was of importance to ask individuals with competence and different perspectives on the issue of traceability of SUMDs. To answer the research questions, the acquired data was categorized into the different identified cornerstones of traceability of SUMDs. These were registration process, perioperative supply chain and incidents management. Each section was divided into an investigation of the current process, issues and suggested improvements, in order to clearly answer to the research questions. Furthermore, these acquired answers and insights, from observations and interviews, were translated and summarized to form a basis for the results. Based on the data acquisition and compilation from the different perspectives, key findings and themes are presented in the results. The thesis proposal include a visual representation that show the physical flow of a SUMD from the point of being delivered to the hospital by the distributor, through different entities where registration occur, until it is either discarded or saved for incidents reporting. In order to avoid many of the current issues and to realize the acquired suggestions from this thesis, interoperability between the systems within the healthcare organization as well as between the different entities throughout the entire supply chain is an essential part of the solution, which should be further studied.
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Barros, Juliana de Oliveira. "Interfaces entre produção de saúde e coordenação do cuidado: perspectiva da psicodinâmica do trabalho na compreensão do trabalhar de médicos inseridos em um hospital universitário - São Paulo, Brasil." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5170/tde-02052016-104008/.
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INTRODUÇÃO: Com base no referencial teórico da Psicodinâmica do Trabalho, compreende-se que a construção da subjetividade e, consequentemente, da identidade e da saúde mental dos sujeitos adultos têm no trabalho lugar central. OBJETIVO: Evidenciar componentes da organização do trabalho que possam favorecer a produção da saúde, a construção e o fortalecimento da identidade de sujeitos singulares e coletivos profissionais, a partir da compreensão de uma situação especifica de trabalho. METODOLOGIA: Trata-se de estudo de caso de caráter exploratório. Foi desenvolvido com um grupo de médicos inseridos no Hospital Universitário da Universidade de São Paulo, cujo trabalhar é atravessado pela coordenação de equipes e/ ou ações de cuidado. Realizou-se 14 entrevistas semi-estruturadas entre os meses de setembro de 2013 e abril de 2014, organizadas em duas fases. Da primeira, participaram sete médicos que ocupavam cargos de gestão. Puderam auxiliar na compreensão do organograma geral da instituição, do fluxo e da organização do trabalho médico. Da segunda fase, participaram sete médicos que, além de assistentes, atuavam como chefes de plantão. Pela importância das ações desenvolvidas por estes profissionais na dinâmica hospitalar e pela disponibilidade em participar do estudo, constituíram-se como a população alvo do mesmo. Adotou-se a postura fenomenológico hermenêutica para interpretação dos achados. Caracterizou-se o trabalhar e a identidade profissional desses sujeitos a partir de quatro eixos: conteúdo do trabalho; recursos disponíveis para realização das atividades previstas; trajetória para chegada nessa função e; experiências de sofrimento e prazer no trabalho. RESULTADOS: Semanalmente, por 12 horas consecutivas, os médicos chefes de plantão respondem por questões administrativas, representando a diretoria do hospital frente aos trabalhadores e usuários do serviço. Baseados em aspectos técnicos, nas regras institucionais e do trabalho tomam, simultaneamente, decisões clínicas no que se refere à possibilidade de acolhimento do conjunto de sujeitos que procura o hospital. Objetivam, ao máximo, manter a regularidade e a continuidade do funcionamento institucional e melhorar a resolutividade do atendimento prestado. Todos os recursos materiais e humanos da instituição são aliados quando das tomadas de decisão, mesmo se feitas de forma individual. Foram convidados pela diretoria do hospital a desempenharem essa função, a partir da identificação de certas características pessoais e profissionais. Dentre todas as atividades desenvolvidas, ocupar-se da gestão regulatória dos leitos hospitalares frequentemente os coloca diante de situações de impotência. DISCUSSÃO: Os chefes de plantão são profissionais que transitam entre o fazer clínico e a coordenação de situações e pessoas. Evidencia-se a importância do julgamento de utilidade técnica e social emitido, sobretudo, por aqueles que compõem a base da linha hierárquica organizacional, ao terem sua autoridade fundada nas competências profissionais e na qualidade das arbitragens que realizam. O reconhecimento, enquanto retribuição de natureza simbólica, parece impulsionar a construção de soluções criativas face às dificuldades encontradas no trabalho. Ressalta ainda o lugar do outro no movimento de conquista da própria identidade. Encontram-se diante de um cenário no qual, além de serem beneficiários, fomentam processos de cooperação a partir do modo como fazem a gestão. Os anos de trabalho compartilhado entre as mesmas equipes e a ética do cuidado em saúde, parecem sustentar esta dinâmica. CONCLUSÕES: Compreende-se que a cooperação e o reconhecimento são aspectos importantes quando se trata da produção da saúde mental e da prevenção de situações de adoecimento no trabalho. São ainda decisivos para a conquista da emancipação pela via do trabalho. Entender as condições que tornam possível a existência deles no seio das instituições é fundamental para aqueles que desejam aliar a produção de bens ou serviços à produção da saúde dos trabalhadoresINTRODUCTION: Based on the theoretical framework of work psychodynamics, it is understood that the construction of subjectivity and, hence, the identity and mental health of adult subjects have in the work its central point. PURPOSE: To highlight components of work organization which may support the health production, the building and strengthening of the identity of specific individuals and collective professionals based on an understanding of a specific work situation. METHODS: It is an exploratory case study. It was conducted with a group of doctors inserted in the University Hospital of University of São Paulo and whose work is crossed by coordination of teams and/or care actions. Fourteen semi-structured interviews taken between September 2013 and April 2014, which were organized into two phases. In the first one, seven manager doctors participated. They helped in the understanding of the general chart organizational of the institution, the flow and organization of medical work. In the second phase participated seven professionals who were doctors assistants and also duty chefs. Due to the importance of the actions developed by these professionals in the hospital and their availability to participate in the study, they were constituted as the target population of it. It was adopted the phenomenological-hermeneutic approach to the interpretation of the findings. The work and the professional identity of these subjects were characterized according to four areas: content of the work; resources available to carry out the planned activities; trajectory for arrival in this role and; experiences of suffering and pleasure at work. RESULTS: Weekly, for 12 consecutive hours, the doctors on duty chiefs are responsible for administrative matters and representing the board of the hospital face workers and service users. Based on the technical aspects, institutional and work rules, they make clinical decisions regarding the possibility of receiving and hosting subjects who seeks the hospital. They aim, as much as possible, to maintain the regularity and continuity of organizational efficiency and improve the resoluteness of care given. All the material and human resources of the institution are allied when the decisions have to be made, even if it is individually. They were invited by the hospital board to play this role, based in the identification of certain personal and professional characteristics. Among all the activities, to be in charge of the regulatory management of hospital beds often sets them against situations of powerlessness. DISCUSSION: The duty chefs are professionals who move between clinical work and coordination of situations and people. It highlights the importance of the judgment of technical and social utility, mainly by those who compose the organizational basis of organizational hierarchy, by having their authority founded on professional skills and quality of referrals that they do. The recognition as retribution in symbolic way, appears to boost the construction of creative solutions to face the difficulties encountered at work. We also emphasize the place of the other in the movement of achieve their own identity. They are in a scenario in which, besides being beneficiaries, also foster cooperation processes from the way they do the management. The years of work shared between the same teams and the ethics of health care, appear to sustain this dynamic. CONCLUSIONS: It is understood that cooperation and recognition are important aspects when it comes to mental health production and preventing disease situations at work. They are still decisive for the achievement of emancipation through work. Understanding the conditions that make possible their existence within the institutions is essential for those who wish to combine the production of goods or services to the production of health workers
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Lima, Maria da Conceição de Santana. "Os vínculos subjetivos com o trabalho em um hospital público no Estado de Sergipe: desafios para os processos e dispositivos de gestão." reponame:Repositório Institucional da FIOCRUZ, 2009. https://www.arca.fiocruz.br/handle/icict/2302.
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Previous issue date: 2009O presente trabalho teve por objetivo examinar os vínculos simbólicos e imaginários que os trabalhadores do maior hospital geral do Estado mantêm com a organização e com seu trabalho, discutindo, a partir desse conhecimento, possíveis dispositivos para o cotidiano da gestão que favoreçam a criatividade e a responsabilização desses trabalhadores para com seu trabalho e com a instituição. Ao apreender o imaginário organizacional e as representações psíquicas dos trabalhadores acerca da organização, tenta-se contribuir para a explicitação dos fatores que condicionam o estabelecimento dos vínculos à organização, interessando-nos mais especificamente a adesão, e identificar quais desafios os vínculos e o imaginário organizacional observado impõem para os processos e dispositivos de gestão. Elegeu-se como estudo de caso o setor de pediatria do hospital, tomando-se como referenciais teóricos para tal estudo a abordagem da Psicossociologia francesa sobre as organizações, e a Psicodinâmica do Trabalho. Na apresentação dos resultados desta investigação, discutem-se os sentidos do trabalho, a partir de uma aproximação do imaginário organizacional, das representações dos trabalhadores sobre o seu trabalho, da sua visão sobre a gestão, e a dinâmica prazer versus sofrimento no trabalho. Na análise dos vínculos que os trabalhadores estabelecem com o trabalho e com a instituição, emergem os desafios para o cotidiano de gestão do hospital. A tão esperada mudança nos nossos serviços de saúde parece não poder prescindir de uma reflexão crítica sobre o que temos hoje, e do reconhecimento quanto à importância da dimensão subjetiva, e intersubjetiva, como determinante dos modos de ser e de agir dos trabalhadores.
This study intends to analyze the imaginary and symbolic links that the workers from the largest hospital in the state remain with the organization and their work, based on this knowledge, a discussion will be made about the possible devices for the daily management to encourage creativity and the responsibility of these workers with their work and with the institution. From the worker’s organizational idea and the psychological representations of workers about the organization, a study about the factors that influence the establishment of links to the organization will be made, focused on the membership, and to identify the challenges that the organizational idea and the links observed are require to the processes and management arrangements. Was selected as a case study the pediatric section of the hospital, using as theoretical reference for this study the approach of the French Psychosociology on organizations, and the psychodynamics of work. In the results of this investigation, is discussed the meaning of the work, from an organizational approach, representation of the workers on their work, their vision on the management, and dynamic pleasure versus pain at work. In the analysis of the links that workers provide with work and with the institution, can be found challenges for the hospital daily management. The long-awaited change in our health services cannot be done without a critical reflection on what we have today, and the importance of the subjective and intersubjective, as a determinant of the ways that the employees are and behave.
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Francisco, Dolores Santos. "Gestão do trabalho e valorização profissional: a questão da sobrequalificação para o trabalhador técnico do SUS." EPSJV, 2015. https://www.arca.fiocruz.br/handle/icict/11194.
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Fundação Oswaldo Cruz. Escola Politécnica de Saúde Joaquim Venâncio. Programa de Pós-Graduação em Educação Profissional em Saúde.
Esta pesquisa tem como objetivo principal delinear o papel da Gestão do Trabalho em Saúde diante da sobrequalificação dos técnicos de enfermagem inseridos na emergência do Hospital Federal de Bonsucesso. A relevância do tema associa-se à centralidade de questões relativas ao processo de qualificação dos trabalhadores técnicos do SUS e suas repercussões no mundo do trabalho no âmbito da saúde. O trabalho de campo foi realizado a partir da abordagem qualitativa através de entrevistas com os trabalhadores selecionados no local de trabalho. A análise dos dados foi elaborada mediante a transcrição das entrevistas que foram classificadas a partir das percepções dos entrevistados sobre as categorias qualificação profissional, valorização do trabalhador e gestão do trabalho em saúde. Dessa forma foi possível constatar que a gestão do trabalho em saúde é um importante instrumento de valorização profissional para estes trabalhadores de enfermagem, porém sem uma participação efetiva diante dos processos de sobrequalificação que vem se configurando no mundo do trabalho em saúde.
This research aims to delineate the role of Labour Health Management before the overqualification of nursing technicians entered the emergence of the Federal Hospital Bonsucesso. The relevance of this issue is associated with the central issues concerning the qualification process of SUS technical workers and its impact on the world of work in health. Fieldwork was conducted from the qualitative approach through interviews with workers selected in the workplace. Data analysis was prepared by transcribing the interviews that were classified according to the perceptions of respondents about the professional qualification categories, worker exploitation and management of health work. Thus it was found that the health work management is an important professional development tool for these nursing workers, but without effective participation before overqualification processes that has emerged in the world of health work.
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Jerndahl, Fineide Mona. "Controlled by Knowledge : A Study of two Clinical pathways in Mental Healthcare." Doctoral thesis, Karlstads universitet, Fakulteten för ekonomi, kommunikation och IT, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-12937.
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Standardisation of professional work is a major policy concern to ensure quality and efficiency of services and a number of hospitals are now focusing on the use of clinical pathways as an important tool to standardise their work. This study sheds light on the processes set in motion when notions of standardisation meet local practice. In order to gain insight into what clinical pathways mean for professional work in mental health care, the focus of the study was to explore the contexts in which standardisation by “rule production” takes place. Two empirical cases from Norwegian mental health care show how dedicated professionals are in charge of carrying out the standardisation work, strongly influenced by a steering framework of defined governmental policies where employee involvement and responsibility ensured loyalty to the idea. Along with a “package” of ideas, new bodies and techniques, clinical pathways contribute to the institutionalisation of prima facie knowledge in demonstrating that evidence basing is linked to steering and control of employees. Thus, professional autonomy is threatened in an insidious way: through the institutionalisation of evidence-based knowledge as ‘prima facie’ knowledge in combination with professionals who standardise and control their own work. The thesis therefore concludes that the control of professional work has now become a complex and sophisticated process where professional work is “controlled by knowledge”.
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Derros, Ellie. "L'hôpital malade de l'absentéisme santé : évaluation socio-économique des congés "maladie" non ordinaires chez les personnels non médicaux dans trois établissements publics d'Auvergne." Thesis, Clermont-Ferrand 1, 2012. http://www.theses.fr/2012CLF10395/document.
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La présente étude s’attache à l’absentéisme long pour raison de santé chez les personnels hospitaliers non médicaux. Deux types de congé non ordinaire sont visés : les C.L.M. et C.L.D. Ceux-Ci constituent en effet un enjeu de gestion par les désorganisations et les coûts, principalement cachés, qu’ils suscitent. Ces derniers représentent également un enjeu de santé sociale (voire publique), en raison de la morbidité qu’ils expriment.Afin de les caractériser et de les mesurer, ce travail s’inspire de l’approche socioéconomique des organisations (I.S.E.O.R., Lyon). On s’efforce notamment de procéder à un diagnostic pluriel (social, organisationnel et financier). L’ambition est triple. Il s’agit 1) de faire prendre conscience de l’ampleur des préjudices (effet miroir pour la direction) ; 2) de contribuer au développement d’un référentiel théorique et pratique (évaluation élargie des absences) ; 3) d’encourager la promotion d’un présentéisme-Qualité (préconisations de type R.H.). Les diverses investigations se font sur trois hôpitaux régionaux publics (Auvergne) de taille volontairement différente (C.H.U., C.H. et H.L.). Les résultats laissent à chaque fois apparaître des profils, des fonctionnements, des dépenses et des vécus assez alarmants. Ils témoignent d’une défaillance au niveau des ressources humaines (organisationnelle et managériale). Ces retours négatifs attestent par ailleurs d’une possibilité d’extension de l’analyse de type socio-Économique (application aux interruptions prolongées en structures de soins). Ils autorisent enfin à dégager quelques pistes d’intervention, tantôt transversales(proximité dans les procédures), tantôt spécifiques (particularités de la structure)The present study focuses on the long absenteeism for health reason at non medicalhospital staff. Two types of non ordinary sick leave are aimed : the C.L.M. and C.L.D. (rulingson salary insurance). Those indeed constitute a challenge of management by thedisorganizations and the costs, mainly hidden, which they cause. They represent also a stakein social health, because of the morbidity they express.In order to characterize and measure them, this work takes as a starting point theorganizations socio-Economic approach (I.S.E.O.R., Lyon). We particularly try to carry out aplural diagnosis (social, organizational and financial). The ambition is threefold. It acts 1) tomake become aware of the scale of the damages (mirror effect for the direction); 2) tocontribute to the development of a theoretical and practical reference frame (widenedevaluation of the absences); 3) to contribute to the promotion of good and really presenteeim(human resources recommendations).The various investigations are done on three publicregional hospitals of voluntarily different size (C.H.U., C.H., H.L. – in the center of France).Each time the results let appear alarming profiles, operations, spending and lived. They giveevidence to a failure in organisational and managerial human resources. These negativereturns also attest an extension possibility of the socio-Economics’ analysis (to the extendedsickness absences in structures of care). They finally allows to identify some tracks ofintervention, sometimes transverse (proximity in the procedures), sometimes specific(peculiarities of the structure)
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Burellier, Franck. "Etre ou ne pas être mèdecin-gestionnaire ? : étude de la transition vers le rôle de responsable de pôle dans les hôpitaux publics français." Phd thesis, Université de Grenoble, 2011. http://tel.archives-ouvertes.fr/tel-00754966.
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Comment un médecin peut-il devenir médecin-gestionnaire ? Un médecin peut-il même simplement devenir médecin-gestionnaire ? Cette thèse a pour vocation de mieux comprendre le phénomène de transition vers un rôle de médecin-gestionnaire, phénomène jugé difficile autant en pratique qu'en théorie. Celui-ci tend à se développer avec l'introduction de la gestion de la performance dans les organisations publiques européennes. Cette recherche prend comme illustration le rôle de responsable de pôle, nouveau rôle mêlant responsabilités médicales et gestionnaires, instauré au sein des hôpitaux publics français. Cette thèse s'articule autour de trois études menées de manière progressive. Une première étude envisage la transition de manière globale, en s'attachant à l'analyse des ajustements entre le médecin et son nouveau rôle. Elle est menée à partir d'une étude de cas et d'entretiens auprès de deux établissements de santé (un Centre Hospitalier Universitaire et un Centre Hospitalier) et de leurs 22 responsables de pôle. Elle met en avant l'importance de la dimension individuelle dans la transition analysée. Une deuxième étude se focalise sur l'influence de l'identification au rôle de médecin-gestionnaire sur la transition. Elle est menée à partir d'une étude de cas et d'entretiens auprès de 4 responsables de pôle d'un CHU et de leurs principaux collègues. Elle soulève l'effet de customisation de la posture d'identification au rôle sur la tenue de ce dernier. Une troisième étude s'oriente finalement sur le travail identitaire des médecins dans la tenue de leur rôle de médecin-gestionnaire. Elle est également menée à partir d'une étude de cas auprès des 4 mêmes responsables de pôle, mais au travers d'observations directes de leur comportement en réunion. Elle fait émerger l'importance de l'utilisation de l'identité en action pour tenir un rôle de médecin-gestionnaire. La thèse que nous défendons est que la transition vers un rôle de médecin-gestionnaire peut s'effectuer à partir d'ajustements et avec des postures d'identification variées, du moment que l'identité du médecin est retravaillée dans l'action. Nous conseillons aux établissements de santé de privilégier des dispositifs d'accompagnement personnalisés sur le terrain afin d'aider les médecins à comprendre la logique de leur rôle.
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Montanheiro, Saulo Baldin. "Proposta de melhoria de processos de gestão de projetos numa empresa de construção." Master's thesis, 2019. http://hdl.handle.net/1822/64920.
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Dissertação de mestrado em Gestão de Projetos de EngenhariaEsta dissertação foi realizada no âmbito do mestrado em Gestão de Projetos de Engenharia da Universidade do Minho e na empresa DDN Gestão, Coordenação e Fiscalização de Obras. A estratégia de investigação utilizada foi o estudo de caso, portanto nesta dissertação será descrito o trabalho realizado no projeto de ampliação do hospital de Guimarães. Inicialmente é feita uma descrição da empresa DDN, mostrando o que a empresa faz e como faz. Em seguida é descrito o contexto do projeto e sobre como é o trabalho desempenhado pelo técnico fiscal. É mostrado todos os processos que são realizados diariamente. Estes processos e os documentos do projeto, ao longo dos oito meses de investigação, foram analisados de perto utilizando os métodos de investigação, nomeadamente observação participativa e análise documental. Através destes métodos, foi possível o investigador encontrar alguns problemas, que infelizmente ainda continuam a aparecer. São problemas variados, mas relacionados entre si. Desta forma, para facilitar a resolução foi criado uma categorização de quatro grupos principais. São problemas relacionados às plantas, ao mau planeamento, à burocracia documental e à dificuldade na tomada de decisão, e também sobre a falta de envolvimento das partes interessadas. É apresentado um diagnóstico a estes problemas e por fim, colocadas as soluções. Nomeadamente, a criação de uma comissão unicamente designada para analisar as plantas e os documentos escritos do projeto, correção do plano de trabalhos de obra (cronograma) de forma a utilizar datas e prazos mais realistas que devem estar em comum acordo entre as partes e para isto é proposto a utilização de técnicas de compressão de cronograma, a participação de pelo menos uma pessoa com poder de decisão nas reuniões de obra, e a utilização de uma matriz de avaliação do nível de envolvimento das partes interessadas. Estas soluções podem ser utilizadas não somente neste projeto de construção, mas também em outros projetos futuros da empresa. Este trabalho de investigação tem como objetivo o aumento de produtividade, melhorar o grau de satisfação das partes interessadas, aumentar a probabilidade de sucesso e consequentemente o lucro da organização.
This dissertation was conducted under the Master of Engineering Project Management at the University of Minho and at the company DDN Management, Coordination and Supervision of Works. The research strategy used was the case study, so this dissertation will describe the work done in the expansion project of the hospital of Guimarães. Initially a description of the DDN company is given, showing what the company does and how it does it. Next, there is a description of the project context and what is the work done by the technical inspector. All processes that are performed daily will be shown. These processes and contract documents, throughout the eight months of research, were closely analyzed using research methods, namely participatory observation and document analysis. Through these methods it was possible for the researcher to find some problems that unfortunately still continue to appear. These are varied problems, but with a certain relationship between them. In order to facilitate resolution four main groups were created. These are problems related to plants, poor planning, documentary bureaucracy, difficulty in decision making and also the lack of stakeholder commitment. A diagnosis is presented to these problems and finally, the solutions are be presented. The creation of a uniquely appointed committee to review the project plans and written documents, correct the work plan (schedule) to use more realistic dates and deadlines to be agreed upon by the parties are purposed. It has been also proposed to use schedule compression techniques, to involve at least one decision-maker in on-site meetings, and to use a stakeholder engagement level assessment matrix. These solutions can be used not only in this construction project, but also in other future company projects. This research work aims to increase productivity, improve stakeholder satisfaction, increase the likelihood of success and consequently the profitability of the organization.
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"Modeling Clinicians’ Cognitive and Collaborative Work in Post-Operative Hospital Care." Doctoral diss., 2017. http://hdl.handle.net/2286/R.I.44308.
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abstract: Clinicians confront formidable challenges with information management and coordination activities. When not properly integrated into clinical workflow, technologies can further burden clinicians’ cognitive resources, which is associated with medical errors and risks to patient safety. An understanding of workflow is necessary to redesign information technologies (IT) that better support clinical processes. This is particularly important in surgical care, which is among the most clinical and resource intensive settings in healthcare, and is associated with a high rate of adverse events. There are a growing number of tools to study workflow; however, few produce the kinds of in-depth analyses needed to understand health IT-mediated workflow. The goals of this research are to: (1) investigate and model workflow and communication processes across technologies and care team members in post-operative hospital care; (2) introduce a mixed-method framework, and (3) demonstrate the framework by examining two health IT-mediated tasks. This research draws on distributed cognition and cognitive engineering theories to develop a micro-analytic strategy in which workflow is broken down into constituent people, artifacts, information, and the interactions between them. It models the interactions that enable information flow across people and artifacts, and identifies dependencies between them. This research found that clinicians manage information in particular ways to facilitate planned and emergent decision-making and coordination processes. Barriers to information flow include frequent information transfers, clinical reasoning absent in documents, conflicting and redundant data across documents and applications, and that clinicians are burdened as information managers. This research also shows there is enormous variation in how clinicians interact with electronic health records (EHRs) to complete routine tasks. Variation is best evidenced by patterns that occur for only one patient case and patterns that contain repeated events. Variation is associated with the users’ experience (EHR and clinical), patient case complexity, and a lack of cognitive support provided by the system to help the user find and synthesize information. The methodology is used to assess how health IT can be improved to better support clinicians’ information management and coordination processes (e.g., context-sensitive design), and to inform how resources can best be allocated for clinician observation and training.Dissertation/Thesis
Doctoral Dissertation Biomedical Informatics 2017