Rationalization and sensemaking in care management: an experience of change in a hospital of the SUS (Unified Health System)

Ciencia e Saude Coletiva

Sá, Marilene de Castilho¹  Miranda, Lilian¹  Grabois, Victor¹  Azevedo, Creuza da Silva¹  Cunha, Marcela¹  Matta, Gustavo Correa¹ 

[1] Fiocruz, Rio de Janeiro, Brasil

关键词: Hospital management;    Care organization;    Health work;    Healh care quality;    Subjectivity and management;   

DOI  :  10.1590/1413-81232017226.13312016

学科分类：社会科学、人文和艺术（综合）

来源: Associacao Brasileira de Pos - Graduacao em Saude Coletiva

【 摘 要 】

This study aimed to analyze organizational processes of change in the hospital care management by using qualitative evaluation developed in the case study. The study was developed at the Hospital Fornecedores de Cana de Piracicaba, in São Paulo State, Brazil, in September and October of 2012. There were 25 interviews with members of the senior board of directors of the hospital, managers and health professionals linked to healthcare of adults, in addition to the analysis of managerial documents and observations of some activities. In this article it is analyzed part of the results, dividing the organizational change in three axes: the planning process developed in the healthcare sectors; The protocol/creation of assisted routines in order to obtain better efficiency and safety for the patient; and the work of hospitalist physicians. The study highlights the complexity of the processes of change in the care management sphere in hospitals and the dynamism between a given management concept and its rational tools and the subjects and groups that seek, in the micropolitic and intersubjective processes, meanings to their practices.

【 授权许可】

CC BY