Gerenciamento de Leitos: do Planejamento à Implementação em um Serviço Hospitalar / Hospital bed management: from planning to implementation in a hospital service

Objetivo: A falta de leitos hospitalares no Brasil é queixa comum entre usuários do Sistema Único de Saúde. Objetivo: Relatar a experiência da construção de um Serviço de Gerenciamento de leitos e apresentar a atuação do enfermeiro como gestor, em prol da visibilidade e fortalecimento da classe de enfermagem. Método: Relato de experiência da implementação da gestão de leitos de um hospital público estadual de médio porte, em um município do interior do estado de São Paulo. Resultado: A partir da implantação houve mudanças no perfil dos indicadores dos setores assistencias, com a utilização dos leitos aproveitados em sua capacidade máxima. Observou-se a diminuição da fila de espera para internação em consequência do acesso oportuno e ordenado à vaga. Conclusão: Pode-se inferir que o gerenciamento de leitos é efetivo e eficiente na gestão hospitalar com resultados operacionais e financeiros satisfatórios e um fator preponderante para a segurança e satisfação dos clientes.(AU)

Objective: The lack of hospital beds in Brazil is a common complaint among users of the Unified Health System. Objective: To report the experience of the construction of a Bed Management Service and to present the nurse's role as manager, for the visibility and strengthening of the nursing class. Method: Experience report of the implementation of bed management in a public hospital of medium size, in a city in the interior of the state of São Paulo. Result: From the implementation there were changes in the profile of the indicators of the care sectors, with the use of beds used to their maximum capacity. A reduction in the waiting list for hospitalization was observed as a result of the timely and orderly access to vacancies. Conclusion: It can be inferred that the management of beds is effective and efficient in hospital management with satisfactory operational and financial results and a preponderant factor for the customers' safety and satisfaction.(AU)

Objetivo: La falta de camas hospitalarias en Brasil es una queja común entre los usuarios del Sistema Único de Salud. Objetivo: Relatar la experiencia de la construcción de un Servicio de Gestión de camas y presentar la actuación de la enfermera como gestora, para la visibilidad y fortalecimiento de la clase de enfermería. Método: Relato de experiência da implementação da gestão de lechos de um hospital público estadual de médio porte, em um município do interior do estado de São Paulo. Resultado: A partir da implementação houve mudanças no perfil dos indicadores dos setores assistência, com o uso de camas utilizadas ao seu máximo de capacidade. Observou-se a diminuição da fila de espera para internação em consequência do acesso oportuno e ordenado à vaga. Conclusão: É possível inferir que a gestão de camas é eficaz e eficiente na gestão hospitalar com resultados operacionais e financeiros satisfatórios e um factor preponderante para a segurança e satisfação dos clientes.(AU)

Cuidado humanizado: Reto para el profesional de enfermería / Humanized Care: A Challenge for the Nursing Professional

Objetivo: El objetivo general de la investigación fue analizar el cuidado humanizado: Reto para el profesional de enfermería. Método: Se desarrolló desde un enfoque cuantitativo con una metodología descriptiva con diseño no experimental, la cual se apoya en el análisis documental­bibliográfico. Se organizó un proceso investigativo en donde la población de estudio, se basó primordialmente en documentos escritos como tesis, revistas arbitradas y artículos científicos. Resultados: Se planteó la idea de desconstruir el significado de humanizar y reconstruir el concepto de cuidad desde la humanización. En conclusión: Sin duda alguna el profesional de enfermería se enfrenta a grandes retos en la gestión de cuidado humanizado, en un mundo globalizado y en donde se están desarrollando tecnologías que buscan desplazar la acción del ser humano, sin embargo, la calidez y acompañamiento que ofrece este profesional a los pacientes y familiares no podrán ser sustituidos.

Objective: The general objective of the research was to analyze humanized care: Challenge for the nursing professional. Method: It was developed from a quantitative approach with a descriptive methodology with non-experimental design, which is supported by documentary-bibliographic analysis. A research process was organized in which the study population was based primarily on written documents such as theses, peer-reviewed journals and scientific articles. Results: The idea of deconstructing the meaning of humanizing and reconstructing the concept of care from humanization was proposed. In conclusion: Undoubtedly, the nursing professional faces great challenges in the management of humanized care, in a globalized world where technologies are being developed that seek to displace the action of the human being, however, the warmth and accompaniment offered by this professional to patients and family members cannot be replaced.

National Survey of Pharmacy and Therapeutic Committee in Saudi Arabia: Meetings, Organization, and Management

Objective: Pharmacy and Therapeutic Committee (PTC) is required for the effective running of a hospital. In the beginning, there was no such concept of drug committee, but with the advent of time, the need for an effective PTC started increasing. In the PTC, the pharmacist, physicians and nurses play an important role, in addition to the presence of an administrative. This study aims to explore the importance of having effective meetings organization and management of PTC at Ministry of Health (MOH) hospitals in Saudi Arabia. The purpose of this study was to explore the meetings organization and management of PTC at MOH hospitals in Saudi Arabia. Methods: This is a 4-month cross-sectional national survey of PTC at MOH hospitals in Saudi Arabia. The survey consisted of two parts: the first part collected demographic information and the second part consisted of 93 questions divided into four domains: Domain 1: the scope, structure and responsibilities; domain 2: the formulary management system; domain 3: evaluation of drug formulary and decision-making; and domain 4: organization and management of committee meetings. This questionnaire was prepared in an electronic format and was distributed all drug information centers at MOH hospitals. It analyzed organization and management of committee meetings through Survey Monkey system. Results: A total of 50 drug information centers responded to the questionnaire (100% response rate). The person leads the discussion in PTC was a Chairman of the Committee (29 (58%)), Chief of Pharmacy (13 (26%)) and Director of Drug Information (3 (6%)). The number of scheduled meetings per year (1–4) was 18 (36%) per hospital with a duration (1-2 hrs) at 48 (96%). Most of discussions were related to medications of infectious diseases (26 (52%)) and cardiovascular diseases (21 (42%)). Most of the challenging recommendations that needed implementation was a lack of resources (37 (74%)), lack of hospital administrator support (23 (46%)) and lack of pharmacist role (18 (36%)). Conclusion: The PTC is a demanding scientific resource and administrative support. Total quality management system, workload analysis, positive outcomes of PTC were lacking. Special education and training needs to be provided to all the healthcare providers with hospital administrator’s support.

Adaptación argentina de la guía de indicadores de calidad de vida para organizaciones que apoyan a personas con trastornos del espectro autista / Argentine adaptation of the Quality of Life Indicators guide for organizations that support people with autistic spectrum disorders

Este artículo describe el proceso de adaptación en Argentina de la guía de indicadores de calidad de vida para organizaciones que prestan apoyo a personas con trastornos del espectro autista (Cuesta, J. L., 2009), a través de la técnica Delphi, en la que han participado un grupo de expertos representativos de diferentes ámbitos e instituciones del país, relacionados con el autismo. El resultado es un instrumento, basado en el modelo de calidad de vida, adaptado al contexto argentino, que ayuda a planificar y evaluar centros y programas para personas con trastornos del espectro autista y da respuesta al creciente número de servicios específicos que responden a las necesidades de este colectivo.

This article describes the adaptation process of the Quality of Life Indicators guide for organizations that support people with autistic spectrum disorders which has taken place in Argentina (Cuesta, J. L., 2009) using the Delphi method, and with the participation of a group of autism-related experts from different fields and domestic institutions. The result is an instrument based on a quality-of-life model which is adjusted to the Argentine setting, helps planning and assessing centers and programs for people with autistic spectrum disorders, and responds to the increasing number of specific services which cover the needs of this population.

Sanitation and antiepidemic practice in Chinese Ebola Treatment Unit in Liberia / 第二军医大学学报

Objective To summarize the design and implementation of standard work flow of sanitation and epidemic prevention work in the anti-Ebola mission in Liberia, so as to provide reference for treating infectious diseases in the future. Methods The working practice for sanitation and epidemic prevention in Chinese Ebola Treatment Unit in Liberia, including the organizational operation mode, work flow, quality control, and the improvement of the performance were reviewed. Then the importance of sanitation and epidemic prevention was analyzed and the experience and lessons were summarized. Results Deployed in Liberia for the mission of treating Ebola virus disease, the Medical Team of the Chinese People's Liberation Army (PLA) successfully achieved the goal of "win the war, zero infection", in which the sanitary and epidemic prevention work had played an important role. Conclusion The sound organization and management, excellent material preparation, reasonable arrangement of work flow, strict quality control and the continuous improvement of problems were the keys for successful sanitary and epidemic prevention work in the Chinese Ebola Treatment Unit in Liberia.

Analysis on the Current Status of Private Hospitals of Traditional Chinese Medicine / 中国中医药信息杂志

Objective To grasp the development of private hospitals of traditional Chinese medicine (TCM) from a macro level;To provide reference for stakeholders by analyzing the underlying database of TCM private hospitals. Methods By analyzing the TCM database of hospital health agency annual statement from“National Health Statistical Investigation System”, current status of TCM private hospitals were analyzed from the aspects of organization, personnel, beds, number of service, and patient burden. The developing level of TCM was reflected by comparison with public hospitals. Results By the end of 2013, there were 938 TCM private hospitals, accounting for about 26.13% of TCM hospitals. Average annual growth rate of beds, health technicians, outpatient visits, and discharged patients exceeded 10%, while the hospital degree, bed utilization ratio, physician burden, and average length of stay for discharge patients were only 70%of TCM public hospitals. Conclusion TCM private hospitals have achieved rapid development in the number of these indicators, but the service efficiency, scale and level are still far behind TCM public hospitals.

Calidad de higiene en salas de cirugía por luminometría de adenosín trifosfato / Quality of Cleaning on Surgery Room by Adenosin Triphosfate Luminometry / Qualidade de higiene em salas de cirurgia por luminometria de adenosina trifosfato

Objetivo: evaluar la calidad del proceso de desinfección, medido en unidades relativas de luz (URL) en superficies ambientales de salas de cirugía, instrumentos reutilizables y de reuso mediante el equipo luminómetro 3M Clean Trace. Materiales: con un punto de corte en 250 URL, para definir adecuada calidad de la desinfección, se evaluó una muestra por conveniencia de 39 elementos: seis críticos de reuso, seis superficies ambientales y veintisiete de reutilización de difícil limpieza. Resultados: se encontró mala calidad en la mayoría de elementos evaluados. El gancho monopolar (reuso), la cánula de Frazzier (reutilización) y la mesa de medicamentos (superficie ambiental) fueron los elementos con niveles más elevados en cada grupo. Conclusiones: es necesario mejorar la calidad de limpieza y desinfección en salas de cirugía; el lu-minómetro demostró ser un instrumento útil en el control de calidad de este proceso; se requieren estudios adicionales para proponer puntos de corte más apropiados.

Objective: To assess the quality of the disinfection process, measured in relative light units (URL) on environmental surfaces in operating rooms, reusable and disposable instruments through the luminometer equipment 3M Clean Trace. Materials: With a cut-off point on 250 URL to define the adequate quality of disinfection, we evaluated a convenience sample of 39 elements, six disposable instruments of critical importance, six environmental surfaces and twenty-seven reusable that are difficult to clean. Results: Bad quality was found on most of the evaluated elements. The monopolar hook (disposable), the Frazzier cannula (reusable) and the medicine counter (environmental surface) were the elements with the highest levels in each group. Conclusions: It is necessary to improve the quality of cleaning and disinfection in operating rooms. The luminometer proved to be a useful instrument in the quality control of this process. Additional studies are required to propose more appropriate cut-off points.

Objetivo: avaliar a qualidade do processo de desinfecáo, medido em unidades relativas de luz (URL), em superficies ambientais de salas de cirurgia, instrumentos reutilizáveis e de reuso mediante a equipe luminómetro 3M Clean Trace. Materiais: com um ponto de corte em 250 URL, para definir adequada qualidade da desinfecáo, foi avaliada amostra por conveniencia de 39 elementos: seis críticos de reuso, sies superficies ambientais e vinte e sete de reutilizacáo de difícil limpeza. Resultados: Encontrou-se má qualidade na maioria de elementos avaliados. O gancho monopolar (reuso), a cánula de Frazzier (reutilizacao) e a mesa de medicamentos (superficie ambiental) foram os elementos com níveis mais elevados em cada grupo. Conclusoes: é preciso melhorar a qualidade de limpa e desinfeção em salas de cirurgia; o luminómetro demonstrou ser instrumento útil no controle de qualidade deste processo; requerem-se estudos adicionais para propor pontos de corte mais apropriados.

Organization and management of pre-deployment training for PLA peacekeeping medical units / 第二军医大学学报

Objective To analyze the organization and management of pre-deployment training of peacekeeping medical units of PLA, so as to put forward suggestions for improvement. Methods Literature review, seminar(four sessions), and questionnaire survey were used in this study. A total of 260 questionnaires were sent out and 231 effective ones were collected, with an effective rate of 88.85%. The management mode, management regulation, training period, training site and standardization of training were investigated and analyzed. Results The PLA peacekeeping medical units needed a more standard organization and management system, a unified training period (now it ranging from 30 to 90 days), a better training condition, and standardized operation for pre-deployment training. Conclusion A more specific organization and management system is needed for pre-deployment training of PLA peacekeeping medical units. We should establish a training base for PLA peacekeeping troop and unified health service training should be practiced.

La especialidad en Organización y Administración de Salud Pública y la Escuela Cubana de Salud Pública / The public health organization and management specialty and the National School of Public Health

Se realiza un recorrido histórico que abarca el desarrollo de la Escuela Cubana de Salud Pública, pasando por la etapa de la Escuela de Higienistas Cubanos con el Dr. Carlos J. Finlay al frente, hasta llegar al momento actual. Se destaca la negativa repercusión de la extinción de la especialidad de Organización y Administración de Salud Pública dentro de los estudios de posgrado en Cuba desde hace más de 20 años. Se hace hincapié en que hoy más que nunca en el Sistema Nacional de Salud de Cuba resulta imposible ignorar la necesidad de la existencia de la especialidad, surgida en la práctica y desarrollada desde hace más de 200 años, que si bien se ha llamado de diversos modos en el mundo, ha sido y es el diario quehacer de un sin número de profesionales que intentan dirigir sobre bases científicas las tareas propias de los sistemas de salud. Disponer de profesionales de la salud pública competentes es una prioridad absoluta para el buen desempeño y perfeccionamiento constante del Sistema Nacional de Salud y que en la consecución de este noble propósito, la especialidad de Organización y Administración de Salud Pública, una vez que surja de nuevo con este nombre o con otro, se consolide en el tiempo y cumpla su encargo social coherentemente, podrá ser de suma utilidad

A historical review covering the development of the Cuban School of Public Health, the stage of the Cuban School of Hygienists led by Dr. Carlos J. Finlay, and the present time was made. Emphasis was made on the negative impact of the elimination of the public health organization and management specialty from the graduate studies in Cuba for more than 20 years. It is stressed that today more than ever, it is not longer possible to ignore the need for this over 200 years-old specialty to be rescued; even though it has been called differently worldwide, it has been and it is the daily work of a number of professionals who attempt to lead the tasks inherent to the health systems on a scientific basis. The availability of competent professionals in public health is a priority for good performance and constant improvement of the national health systems, and to accomplish this, the public health organization and management specialty could be very useful, once it re-emerges under the same or a new name, becomes stronger and coherently fulfils its social task

Direção ou coordenação? Repensando a representatividade institucional da enfermagem / Direction or coordination? Rethinking the institutional representativeness of nursing / ¿Dirección o coordinación? Repensando la representatividad institucional de la enfermería

Trata-se de pesquisa descritiva, de abordagem qualitativa, do tipo documental, que teve como local o Hospital das Clínicas da Universidade Federal do Paraná (HC-UFPR), na cidade de Curitiba-PR. O objetivo foi analisar comparativamente a descrição de dois cargos que representam o Serviço de Enfermagem, adotados em modelos gerenciais distintos. A análise de conteúdo dos documentos referentes aos cargos nos respectivos modelos de gerência evidenciou diferenças significativas. Os resultados apontaram várias alterações na descrição dos cargos e, dentre elas, do termo Direção de Enfermagem para Coordenação de Enfermagem, com a supressão da autonomia e poder de decisão sobre assuntos inerentes à profissão. Conhecimento e competência no exercício profissional são condições para que o enfermeiro mantenha sua autonomia e representatividade na estrutura organizacional.

This is a documentary-type descriptive research, using a qualitative approach and, which was carried out at the Hospital of the Federal University of Paraná (HC-UFPR), in the city of Curitiba-PR. It aimed to comparatively analyze the description of two job positions that represent the nursing service, which were adopted in different managerial models. The content analysis of the documents related to the job positions in the respective management models showed significant differences. The results pointed out several changes in the description of the job positions, i.e. the term Nursing Direction was changed into Nursing Coordination, involving the suppression of autonomy and decision-making power over matters intrinsic to this profession. Knowledge and competence in the professional practice are required by the nurse practitioners in order to keep their representativeness in the organizational structure.

Se trata de una investigación descriptiva, de abordaje cualitativa, de tipo documental, que tuvo como local el Hospital de Clínicas de la Universidad Federal de Paraná (HC-UFPR), en la ciudad de Curitiba-PR. El objetivo fue analizar comparativamente la descripción de dos cargos que representan al servicio de Enfermería, adoptados en modelos gerenciales diferentes. El análisis del contenido de los documentos referentes a los cargos en los respectivos modelos de gerencia puso en evidencia diferencias significativas. Los resultados apuntaron varias alteraciones en la descripción de los cargos, entre ellas el término Dirección de Enfermería por Coordinación de Enfermería, con la supresión de la autonomía y poder de decisión sobre asuntos inherentes a la profesión. Conocimiento y competencia en el ejercicio profesional son condiciones para que el enfermero mantenga su autonomía y representatividad en la estructura organizacional.

Study of the follow-up management strategies after installation of improved stoves to prevent coal-burning type endemic fluorosis in Guizhou province / 中国地方病学杂志

Objective To study the follow-up management strategies after improving stoves for controlling coal-burning type endemic fluorosis in Guizhou and to provide a scientific basis for exploring the follow-up management measures.Methods In 2006 - 2009,three counties of Puding,Bijie and Liuzhi with improved stoves in 2005 and implemented follow-up management measures for subsequent three years were chosen,3 towns were chosen randomly in each chosen county,2 villages were selected randomly in each chosen town,10 households were investigated randomly in each chosen village,and 20 students were investigated of the knowledge of fluorosis control.The investigation included also the usage of the stoves,dehydration methods of grain and related conditions.Results ①The head of the family and student awareness of fluorosis control were 82.6％(743/900)and 91.7％ (1650/1800),respectively,and 35.0％ ( 385/1100 ) and 61.0％ (6605/10 835 ),respectively,before the test,and the difference was statistically significant( x2 =33.04,1189.12,all P ＜ 0.01 ).②The rates of chimney out of the house were 88.5％(69/78) and 100.0％(102/102),respectively,compared with those before the trial[74.4％(2125/2856) and 2.1％(104/4984),respectively],the difference was statistically significant(x2 =720.56,4295.38,all P ＜ 0.01).The iron stove and the table stove's airtight utilization rates were 85.9％(67/78) and 100.0％(102/102),respectively.③The corn and the hot pepper's correct drying rates were 100.0％(180/180).Compared with those[27.2％(49/180) and 32.2％(58/180),respectively]before the trial,the difference was statistically significant(x2 =26.68,37.38,all P ＜ 0.01 ).The corn and the hot pepper's washing rates before eating were 95.0％(57/60) and 98.3％(177/180),respectively.Compared with those[85.0％(153/180) and 77.8％(140/180)]before the trial,the difference was statistically significant(x2 =135.00,490.82,all P ＜ 0.01 ).Conclusions The target population's awareness and knowledge of fluorosis prevention and related behavior are significantly elevated and enhanced after implementation of the three years post-management,which has reached the desired goal.The strategies of the follow-up management suits Guizhou province and widespread application is suggested.

Atendimento de urgência: o transporte sanitário como observatório de saúde de Belo Horizonte / Emergency care: health transport in the city of Belo Horizonte / Atención de urgencia: el transporte sanitario como observatorio de salud de Belo Horizonte

O objetivo com este estudo é descrever a estrutura e o funcionamento do serviço de transporte sanitário público de Belo Horizonte como experiência pioneira em um grande centro urbano do país e sua importância para o acesso da população aos serviços. Trata-se de um estudo de caso cujos dados foram coletados em protocolos, relatórios e estatísticas de atendimento, sendo a última organizada em gráficos e analisada de acordo com a legislação sobre urgências. Nos resultados, aponta-se uma experiência que viabiliza o transporte de usuários entre os serviços de saúde de acordo com suas necessidades, facilita o acesso, organiza a integração entre os serviços e racionaliza custos.É importante observatório de saúde do município ao possibilitar a identificação de novas morbidades, visão da rede,oferecendo subsídios para propostas e gestão municipal da saúde.

This study aims to describe the structure and functioning of the public health transport in the city of Belo Horizonte. It is a pioneering experience in a large urban center and it is extremely important to ensure the citizen’s access to health services. This is a case study and all data were collected using protocols, reports and hospital assistance statistics which were organized in a graphic format and analyzed according to emergency medicine legislation. The results show that this experience facilitates access, organization and integration of health services, as well as reduces overall costs. In summary, health transport is an important issue as it allows the identification of new morbidities, offers a network vision and provides subsidies for proposals regarding health management.

El objetivo del presente estudio ha sido de describir la estructura y funcionamiento del servicio de Transporte Sanitario Público de Belo Horizonte como experiencia pionera en un gran centro urbano del país y su importancia para el acceso de la población a los servicios. Se trata de un estudio de caso cuyos datos fueron recogidos en protocolos, informes yestadística de atención organizada en gráficos y analizada de acuerdo con la legislación sobre urgencias. Los resultados señalan una experiencia que hace viable el transporte de usuarios entre los servicios de salud en conformidad con sus necesidades, facilita el acceso, organiza la integración entre los servicios y racionaliza costos. En síntesis, el Transporte Sanitario es un importante observatorio de salud del municipio porque permite identificar nuevas morbidades y tener una visión de la red y, además, ofrece subsidios para propuestas de la gestión municipal de la salud.

Organization and management in hospital's humanistic services / 中华医院管理杂志

The service behavior of medical staff is influenced by the organizational environment and management mode of the hospital. That is to say, the organization and management determine the standardization and sustainability of a hospital's humanistic services, and organizational driving force is also an important factor for the staff to innovate their services. Organization and management of a hospital' s humanistic services is composed of three factors: service operation management, service elements management and service performance management. These factors ensure a hospital's humanistic services to achieve whole-staff-participation, sustainability and standardization.

A prática do ensinar e aprender administração em enfermagem com base na metodologia freireana / The practice of teaching and learning about nursing management based on Freire's methodology / La práctica de enseñar y aprender administración en enfermería en base de la metodología freireana

Educational practices have been increasingly facing new ethical challenges and dilemmas that originate in the biotechnological process. The article relates a collective-constructive experience based on Freire’s method, of a methodological and theoretical model about the nurse’s management with a group of student enrolled in a Nursing Management course, during its practical phase. The results pointed to the importance of team work in the health area, the importance of the nurse’s role as a mediator and team leader, and also to the user/patient viewed within a relationship of equality and interactivity with all of the professionals that are part of the health team.

Las prácticas educativas si están parecidos, cada vez más, con nuevos desafíos y dilemas éticos derivados del proceso biotechnological. En base del método freireano, el artículo ten por lo objetivo relatar una experiencia de la construcción colectiva de un modelo teórico-metodológico sobre la administración del enfermero, con un grupo de académico de la disciplina de la administración de la enfermería durante la fase práctica. Los resultados señalan para la importancia del trabajo del equipo en salud, la importancia del papel de la enfermera enquanto mediadora y líder del equipo y, finalmente, para el usuario/paciente visibilizado a partir de una relación de la igualdad e interatividade con todos los profesionales que integran a equipo de la salud.

As práticas educativas se deparam, crescentemente, com novos desafios e dilemas éticos oriundos do processo biotecnológico. Com base no método freireano, o artigo tem por objetivo relatar uma experiência construtivo-coletiva de um modelo teórico-metodológico sobre a administração do enfermeiro, com um grupo de acadêmicos da disciplina de Administração em Enfermagem durante a fase prática. Os resultados sinalizam para a importância do trabalho de equipe em saúde, a importância do papel do enfermeiro enquanto mediador e líder da equipe e, por fim, para o usuário/paciente visibilizado a partir de uma relação de igualdade e interatividade com todos os profissionais que integram a equipe de saúde.

Avaliação de um modelo empírico de gestão implantado em Unidades de Internação de um hospital privado / Assessment of an empirical mannagement model introduced in-patient Unites in a private hospital

Este estudo objetivou: apresentar e avaliar, segundo a percepção de enfermeiras, um modelo empírico de gestão de enfermagem implantado em Unidades de Internação geral de um hospital privado do município de São Paulo e, propor um novo modelo de gestão. O modelo empírico teve como finalidade a melhoria da qualidade do trabalho de enfermagem. Foi pautado em pressupostos empíricos subsidiados pela crença da construção de processos de trabalho com base na realidade; no atendimento dos anseios dos clientes, profissionais e política institucional; e no oferecimento de oportunidades de participação aos profissionais, potencializando suas competências. A implantação do modelo empírico aconteceu pela identificação de focos de atenção que foram: o papel da enfermeira centrado em ações à distância do paciente; as dificuldades na especialização e individualização da assistência; as dificuldades em manter o clima motivacional; e as dificuldades em manter a dinâmica de produção e resultados. Em resposta à problemática identificada foram propostos focos de correção que foram direcionados à revisão das atividades assistenciais, administrativas e educativas das enfermeiras; à especialização e atualização do conhecimento dos profissionais; à viabilização da autonomia nas decisões; e à a viabilização das idéias dos profissionais. As ações empregadas, nessa correção, constituíram os focos de ação e foram: reestruturação organizacional do Serviço de Enfermagem, revisão dos processos de trabalho, capacitação técnico-científica dos profissionais, formação de grupos de estudo, divisão das Unidades por especialidades médicas, revisão da divisão do trabalho, revisão dos treinamentos admissionais, utilização de grupos focais para avaliação do trabalho e construção de planos estratégicos por Unidade. Na avaliação do modelo empírico, utilizou-se a metodologia do Estudo de Caso, adotando-se um questionário que foi aplicado às enfermeiras ) com mais de um ano de trabalho, cujas respostas foram analisadas, segundo as técnicas da Análise de Conteúdo, para a construção de categorias. Em seguida, estas foram discutidas e validadas por um Grupo Focal constituído de enfermeiras com mais de seis anos na área, que vivenciaram a implantação do modelo empírico. A discussão das categorias apontou possíveis ajustes no modelo empírico. Assim, a inclusão de programas de capacitação em gerenciamento e em informação, a revisão do papel da enfermeira encarregada, a melhoria da política de incentivos e o reconhecimento do desempenho foram considerados e o novo modelo foi redesenhado, em formato de diagrama, e denominado FACA-(Focos de atenção, correção e ação). O novo modelo alinha-se aos conceitos atuais do Gerenciamento da Qualidade

The subject of this study was: to present and to evaluate, according to the assessment considerations nurses, an empirical management model implemented in a general in-patients Unites at a private hospital in the city of São Paulo and also purpose a new management model. The purpose of this model was to improve the quality of nursing work. It was based on empirical presupposes and believing the work process building focused in the reality; in the needs of the clients, professionals and the organization's politic; and offering the opportunities for professionals to participate and improve their competencies. The implementation of the empirical model occurred by the identification of the attention focus which were: the nurse role environment based in actions carried in a distance of the patient; the difficulties in specialization and individualization assistance; the difficulties in keeping a motivational environment; the difficulties in carrying on the production dynamism and results. In order to answer for the problems identified it was purposed correction focus which were aimed to: review the nurse's activities of care, management and educational; the skill and upgrade knowledge of the professionals; offer the own decision and feasibility to use their ideas. The actions used in this corrections constituted the action focus and they were: re-structure the Nursing Department organization; review the work process; professionals technique and scientifically capability, create groups of studies; share the units according to the medicals specialties; review the work division; review the qualification program using the nurse staff to evaluate the work and create strategic plans by each Units. In the empirical model evaluation it was used the Case Study methodology, adopting a questionnaire, which was applied to nurses with one year up working, which answers were analyzed according to the Content Analyze technique to create categories. After that, these were discussed and validated by a Focal Group of nurses with six years up working which experienced fully. The discussion of the categories showed possible arrangements in the empirical model. Consequently, the inclusion of a capacity programs in management and inform; the revision of the nurse role environment; the improvement of the politic incentives and performance recognition at work were considered and the new model was re-designed, like a diagram, and nominated FACA- (Attention, Correction and Action Focus). The new model approaches the actual concepts about Quality Management

Discussing the organization and management of the extracurricular scientific and technological activities in the medical undergraduates / 中华医学教育探索杂志

After much investigative work,it has been found that the extracurricular scientific and technological activities in the medical undergraduates today has one phenomenon that its organizational forms and its contents haven't fully met the needs of the students. The main factors are as follows:leaders attaching little importance to it,imperfect management system,shortage of the necessary condition,etc. The author puts forward such four measures about improving its organization and management as improving the organizational and managerial rules,establishing the satisfactory organizational structure,building the medical undergraduates'groups for scientific research and raising scientific research funds in many ways.

Experience in conducting mass QC group activities / 中华医院管理杂志

The paper sums up the experience of Tianjin in conducting mass QC group activities for the past 12 years. The major steps taken include:(1)enhancing the awareness of the importance of and willingness to conduct QC group activities; (2)stepping up personnel training, improving their general quality and giving them correct guidance; (3)taking pains to organize and manage QC group activities; and (4)working hard to assess and release the results of QC groups. Persistent conduction of mass QC group activities has led to a higher QC level of the hospital and better delivered services to patients.