Indicadores claves de desempeño y su aplicación en la gerencia estratégica de las empresas de salud / Key performance indicators and their application in the strategic management of healthcare companies

Introducción: La gerencia empresarial, a lo largo de la historia, se ha preocupado por alcanzar objetivos y metas mediante la utilización de estrategias con el fin de tratar de garantizar los réditos que le permitan seguir trabajando en el tiempo. El interés de lograr alcanzar la eficiencia empresarial ha sido clave para que los investigadores modernos hayan realizado importantes aportes a la epistemología de las ciencias administrativas. Surge entonces la pregunta en la mente de los administradores: ¿Es de importancia la aplicación de indicadores claves de desempeño en la gerencia estratégica de las empresas de salud? Los indicadores claves de desempeño, o KPIs por sus siglas en inglés, forman parte del conjunto de métricos que la administración moderna utiliza para saber si el negocio está logrando los objetivos y metas planteadas por la gerencia. El tablero de mando integral de Kaplan y Norton, desde su aparición en el año de 1992, ha sido también de gran valor para la gerencia estratégica empresarial. Objetivo: Presentar la importancia que tiene la utilización de los indicadores claves de desempeño al ser aplicados en la gerencia estratégica de las empresas de salud. Metodología: Basada en el paradigma cualitativo-descriptivo de investigación acción, el cual se sustentó en literatura científica publicada entre los años 2017 y 2021 apoyado en las plataformas Google Scholar y SciELO. Los criterios de inclusión fueron artículos y textos que abordaran los temas de: indicadores claves de desempeño, inteligencia de negocios, gerencia estratégica y tablero de mando integral. Resultado y Conclusiones: El continuo monitoreo del ambiente competitivo en el que la empresa está inmerso, permite la adaptación de los métricos de acuerdo con los cambios del entorno. En la medida en que los métricos permitan a la empresa volverse líquida, es decir, facilitar que se amolde a los cambios en el medioambiente económico, se facilitará la toma de decisiones de negocios eficaces y oportunas.

Introduction: Business management throughout history has been concerned with achieving objectives and goals, through the use of strategies in order to try to guarantee the revenues that allow it to continue operating over time. The interest in achieving business efficiency has been key for modern researchers to have made important contributions to the epistemology of administrative sciences. The question then arises in the minds of administrators: Is it important to apply key performance indicators in the strategic management of health companies? Key performance indicators, or KPIs for its acronym in English, are part of the set of metrics that modern management uses to know if the business is achieving the objectives and goals set by senior management. Kaplan and Norton's Balanced Scorecard, since its appearance in 1992, has also been of great value for strategic business management. Objective: To present the importance of the use of key performance indicators when applied in the strategic management of health companies Methodology: Based on the qualitative-descriptive and hermeneutical paradigm in the which was based on studies between 2017 and 2021 supported by the Google Scholar and SciELO platforms. The inclusion criteria were articles and texts that addressed the topics of: key performance indicators, business intelligence, strategic management and balanced scorecard. Results and Conclusions: The continuous monitoring of the competitive environment in which the company is immersed, allows the adaptation of the metrics according to changes in the environment. To the extent that the metrics allow the company to become liquid, that is, make it easier to adapt to changes in the economic environment, effective and timely business decision-making will be facilitated.

El balanced scorecard en la gestión de salud / The balanced scorecard in health management

El propósito de este estudio consistió en revisar el modelo del Balanced Scorecard y analizar su aplicabilidad como instrumento de gestión en los centros de salud. El tipo de investigación fue de tipo documental, con un diseño no experimental. Para alcanzar el objetivo, se revisaron los postulados teóricos de Kaplan y Norton, así como algunas implementaciones prácticas centradas en este paradigma que fueron desarrolladas en Norteamérica, Europa y Sur América. Los resultados demuestran el alto valor agregado que ofrece el Balanced Scorecard como instrumento de gestión en centros de salud.

The purpose of this study was to review the Balanced Scorecard model and analyze its applicability as a management instrument in health centers. The type of research was documentary, with a non-experimental design. To achieve the objective, the theoretical postulates of Kaplan and Norton were reviewed, as well as some practical implementations focused on this paradigm that were developed in North America, Europe and South America. The results demonstrate the high added value that the Balanced Scorecard offers as a management instrument in health centers.

Modelo del sistema de enfrentamiento a la COVID-19 soportado en un Cuadro de Mando Integral / Effectiveness of the system to face COVID-19 pandemic supported on a Balanced Scorecard

RESUMEN Introducción: El enfrentamiento a la COVID-19 impone importantes retos a los profesionales de la salud relacionados con la prevención y control de infecciones en la comunidad y en las instituciones de salud. Uno de los mayores retos a los que se enfrenta los hospitales es gestionar de una forma más eficiente sus recursos sin que ello suponga un deterioro de la calidad percibida por el paciente y personal sanitario. Objetivo: Modelar la efectividad del sistema de enfrentamiento a la COVID-19 basado en su eficacia y eficiencia. Método: Confección de un Cuadro de Mando Integral basado en indicadores de eficiencia y eficacia. Resultados: Se diseñó el Cuadro de Mando Integral para el sistema de enfrentamiento a la pandemia. Cuenta con cinco perspectivas: Financiera, Aprendizaje y Crecimiento, Procesos internos, Cliente y Vida, esta última relacionada con el indicador de letalidad del virus. Se tiene los indicadores globales de eficacia y eficiencia y el EFECOVID, que permite determinar la efectividad del sistema ante esta pandemia. Conclusiones: Se diseña el indicador EFECOVID para diagnosticar la efectividad del sistema de enfrentamiento a la COVID-19. Tiene como soporte un Cuadro de Mando Integral diferente al tradicional por estar dirigido a disminuir los efectos de la pandemia, además, detener como perspectiva adicional de desempeño a "Vida" que manifiesta que el fin es quebrantar la pandemia.

ABSTRACT Introduction: Facing COVID-19 adds important challenges for healthcare professionals in charge of the facilities, and the control and prevention of infections in the community. One of the biggest challenges faced by hospitals is to manage their resources with more efficiency without lowering the quality of the service. Objective: To shape the efficacy of COVID-19 management system, based on its effectiveness and efficiency. Method: A balanced scorecard was made based on indicators of efficiency and effectiveness. Results: The balanced scorecard was designed to support the pandemic management system, with 5 indicators of performance: Financial, Learning and Growth, Internal Processes, Client and Life (the last one related to virus lethality indicator). The global indicators of efficiency-effectiveness and EFECOVID serve as references to determine the usefulness of the system to face the pandemic. Conclusions: The EFECOVID indicator was designed to diagnose the efficacy of COVID-19 management system. It is supported by a balanced scorecard, different from the traditional one in order to stop the pandemic, contrary to ¨Vida¨ program, that was focused on dealing with the pandemic.

Modelo del sistema de enfrentamiento a la COVID-19 soportado en un Cuadro de Mando Integral / Effectiveness of the system to face COVID-19 pandemic supported on a Balanced Scorecard

Introducción: El enfrentamiento a la COVID-19 impone importantes retos a los profesionales de la salud relacionados con la prevención y control de infecciones en la comunidad y en las instituciones de salud. Uno de los mayores retos a los que se enfrenta los hospitales es gestionar de una forma más eficiente sus recursos sin que ello suponga un deterioro de la calidad percibida por el paciente y personal sanitario. Objetivo: Modelar la efectividad del sistema de enfrentamiento a la COVID-19 basado en su eficacia y eficiencia. Método: Confección de un Cuadro de Mando Integral basado en indicadores de eficiencia y eficacia. Resultados: Se diseñó el Cuadro de Mando Integral para el sistema de enfrentamiento a la pandemia. Cuenta con cinco perspectivas: Financiera, Aprendizaje y Crecimiento, Procesos internos, Cliente y Vida, esta última relacionada con el indicador de letalidad del virus. Se tiene los indicadores globales de eficacia y eficiencia y el EFECOVID, que permite determinar la efectividad del sistema ante esta pandemia. Conclusiones: Se diseña el indicador EFECOVID para diagnosticar la efectividad del sistema de enfrentamiento a la COVID-19. Tiene como soporte un Cuadro de Mando Integral diferente al tradicional por estar dirigido a disminuir los efectos de la pandemia, además, detener como perspectiva adicional de desempeño a "Vida" que manifiesta que el fin es quebrantar la pandemia(AU)

Introduction: Facing COVID-19 adds important challenges for healthcare professionals in charge of the facilities, and the control and prevention of infections in the community. One of the biggest challenges faced by hospitals is to manage their resources with more efficiency without lowering the quality of the service. Objective: To shape the efficacy of COVID-19 management system, based on its effectiveness and efficiency. Method: A balanced scorecard was made based on indicators of efficiency and effectiveness. Results: The balanced scorecard was designed to support the pandemic management system, with 5 indicators of performance: Financial, Learning and Growth, Internal Processes, Client and Life (the last one related to virus lethality indicator). The global indicators of efficiency-effectiveness and EFECOVID serve as references to determine the usefulness of the system to face the pandemic. Conclusions: The EFECOVID indicator was designed to diagnose the efficacy of COVID-19 management system. It is supported by a balanced scorecard, different from the traditional one in order to stop the pandemic, contrary to ¨Vida¨ program, that was focused on dealing with the pandemic(AU)

Avaliação de indicadores de desempenho da área de engenharia clínica: uma proposta para um hospital público universitário / Evaluation of clinical engineering performance indicators: a proposal for a university public hospita

RESUMO Objetivo: Propor um conjunto de indicadores de desempenho para o Departamento de Engenharia Clínica (EC) de um hospital público universitário. Metodologia: Após pesquisa bibliográfica dos indicadores da área de engenharia clínica citados na literatura, foi elaborado um questionário aplicado a gestores de hospitais de alta complexidade, docentes e especialistas para avaliar a pertinência, credibilidade do resultado, esforço de apuração, simplicidade de interpretação e de algoritmo de cálculo dos indicadores. Resultados:Foram propostos 14 indicadores para o departamento de EC: percentual de conclusão do programa de manutenção preventiva, tempo médio de atendimento, tempo médio de paralisação de máquina, número de reparos repetidos, percentual do total de ordens de serviço concluídas, número de ordens de serviço por área, percentual de reparos realizados externamente, percentual de reparos realizados por erro do usuário, custo de manutenção versus custo de aquisição, custo total de manutenção, satisfação do funcionário, treinamento da equipe técnica, satisfação do cliente e treinamento de usuários. Conclusões: Numa instituição pública de grande porte e nível terciário, a escolha dos indicadores para compor um painel para a gestão do Departamento de EC, bem como a apuração dos resultados deve ser ponderada, tendo em vista que, instituições governamentais sofrem impactos diretos quanto à disponibilidade de verba e entraves burocráticos que, muitas vezes, geram impasses difíceis de serem solucionados. É importante que exista um trabalho de conscientização dos funcionários quanto ao seu papel nos resultados dos indicadores e na busca das metas estabelecidas pela organização, pois, somente esse conjunto vai permitir uma gestão de sucesso (AU)

Objective: To propose a set of performance indicators for the Clinical Engineering Department (CE) of a public university hospital. Methodology: After a bibliographic search of clinical engineering indicators cited in the literature, a questionnaire was applied to hospital managers of high complexity, professors and specialists to evaluate the relevance, credibility of the result, calculation effort, sim-plicity of interpretation and calculation algorithm of indicators. Results: 14 indicators were proposed to the CE Department: percentage of completion of the preventive maintenance program, average service time, average machine downtime, number of repeated repairs, percentage of total work or-ders completed, number of service orders by area, percentage of repairs performed externally, per-centage of repairs performed by user error, maintenance cost versus cost of acquisition, total cost of maintenance, employee satisfaction, technical team training, customer satisfaction and user training. Conclusions: In a large public institution and tertiary level, the choice of the indicators to compose a panel of indicators for the management of the CE Department, as well as the calculation of the results, should be considered, since State institutions suffer direct impacts on the availability of funds and bu-reaucratic obstacles that often generate impasses that are difficult to solve. It is important that there is a work of awareness of the employees about their role in the results of the indicators and the search of the goals established by the organization since only this set will allow successful management (AU)

Practice and effect of nursing post management performance appraisal / 中华医院管理杂志

Objective To establish a post management performance appraisal method for orthopedic nurses, and explore its practical effects. Methods The balanced scorecard performance tool was used in combination with two rounds of expert consultation to establish the appraisal index system. It comprises assessment indexes of four dimensions, dimension weight and index score value. Monthly performance appraisal value was calculated based on the nurses′post coefficient, and the health factor was used to reduce nurses′dissatisfaction in performance appraisal. Four orthopedics departments were selected for a one-year trial, with the results evaluated in the end. Results A comparison made before and after this appraisal found an increase of the nurses′ job satisfaction (9 out of 13 survey items, P <0.05), higher inpatient satisfaction (P<0.05), and higher nursing quality ( number of adverse nursing events Ⅳ, P <0.05). Other indicators include more nurses participate in learning and theoretical researches ( number of papers published, number of lecture hosts and the number of participants in nursing competition ( P <0.05 ). Conclusions The performance appraisal system of orthopedic nurses can improve nursing quality and patient satisfaction, effectively mobilize the initiative and creativity of nurses, and meet the characteristics of nurse post management, proving a success in use.

Study on the evaluation system of hospital scientific research performance based on balanced scorecard / 中华医学科研管理杂志

Objective To change the deficiencies of the traditional performance evaluation model based on financial performance,give full play to the potential of hospital scientific research in the exploration of medical resources in hospital,improve the long-term development ability of hospital,and explore a new performance evaluation system of hospital scientific research.Methods By means of literature review combined with practice analysis,the paper conducted a comparative study on the advantages and characteristics of the research performance evaluation system and the traditional hospital performance evaluation system.Results The performance evaluation system of hospital scientific research based on balanced scorecard theory matches the dynamic process dimension of hospital scientific research.Conclusions The balanced scorecard-based performance evaluation system of hospital is able to change the previous rigid performance evaluation of scientific research,realized a dynamic and whole-process management mode which better mobilize the enthusiasm of medical staff for scientific research.

Scorecard for early recognition of patients at high risk of delirium in emergency department

OBJECTIVE: This study was conducted to evaluate scorecards for early recognition of high-risk patients of delirium in the emergency department (ED). METHODS: Data from 399 consecutive patients aged 65 years or older between January 1, 2015 and December 31, 2015 were retrospectively analyzed. Delirium was identified by reviewing medical records and was confirmed by a psychiatrist. The study population was divided into a training and validation group. Predisposing factors were evaluated and validated by multivariate logistic regression analysis and a calibration plot, after which a scorecard was constructed using these factors and applying points to double odds to each regression coefficient. RESULTS: Dementia, transfer from a long-term care facility, acute acid-base imbalance, moderate pain, and stroke were independent predisposing factors for delirium in ED, with assigned scores in the scorecard of 3, 2, 2, 2, and 2, respectively. The total score of the scorecard for delirious patients was significantly higher than that for non-delirious patients in both the training and validation groups. The coefficient of determination (R²) of the calibration plot was 0.74 and 0.68 in the training and validation group, respectively. In the receiver operation characteristic curve, the cut-off point of the scorecard for delirium was 2.5 and the sensitivity, specificity, and accuracy were 75.0%, 87.8%, and 86.7% in training group, while they were 76.9%, 85.1%, and 84.2% in the validation group, respectively. CONCLUSION: The scorecard was a useful screening tool for early recognition of patients with a high-risk of developing delirium in the ED.

Developing the High-Risk Drinking Scorecard Model in Korea

OBJECTIVES: This study aimed to develop a high-risk drinking scorecard using cross-sectional data from the 2014 Korea Community Health Survey. METHODS: Data were collected from records for 149,592 subjects who had participated in the Korea Community Health Survey conducted from 2014. The scorecard model was developed using data mining, a scorecard and points to double the odds approach for weighted multiple logistic regression. RESULTS: This study found that there were many major influencing factors for high-risk drinkers which included gender, age, educational level, occupation, whether they received health check-ups, depressive symptoms, over-moderate physical activity, mental stress, smoking status, obese status, and regular breakfast. Men in their thirties to fifties had a high risk of being a drinker and the risks in office workers and sales workers were high. Those individuals who were current smokers had a higher risk of drinking. In the scorecard results, the highest score range was observed for gender, age, educational level, and smoking status, suggesting that these were the most important risk factors. CONCLUSION: A credit risk scorecard system can be applied to quantify the scoring method, not only to help the medical service provider to understand the meaning, but also to help the general public to understand the danger of high-risk drinking more easily.

La irrupción de la gerencia en las organizaciones sanitarias del sector público / Irruption of management into the public health organizations

Durante los últimos veinte años, la administración pública y, en particular sus organizaciones sanitarias han puesto de relieve numerosas debilidades en el manejo eficiente de los recursos que no necesariamente aparecían como tales en sus boletines estadísticos. Fallas importantes como la sostenibilidad de buenos sistemas de salud, notable presencia de eventos adversos o una variabilidad no justificada de la práctica clínica, hicieron evidente el hecho de que lo importante no era cuánto dinero se tenía, sino que se hacía con este. Como respuesta, empezaron a asimilar tecnologías que habían resultado exitosas en otros sectores y que podían incorporarse creativamente en este contexto. Un enfoque de gestión es uno diferente a uno de recortes, no se trata de suspender servicios, limitar el acceso o introducir el copago, sino eliminar todo aquello que no crea valor para el paciente, pero consume tiempo y recursos. Desde finales del siglo xx y lo que va del actual, la gerencia en salud ha permitido a las organizaciones sanitarias públicas que la han incorporado, crecer en calidad y en oportunidad de hacer más y mejor salud con menos recursos. Como en todas las cosas, las sombras acompañan a las luces y a veces prevalece la oscuridad, por lo cual es importante conocerlas y saberlas enfrentar(AU)

During the last twenty years, a number of failures in the efficient management of resources have been brought to light in the public administration and particularly its healthcare organizations, but these ones were not generally shown in the statistical bulletins. Significant failures such as problems in sustainability of good health systems, many adverse events as a sign of poor quality care, or unjustified variation in medical practice made it clear that the main problem was not the amount of money you have, rather; what you do with that money. As a benchmarking approach, many successful management technologies from other sectors began to be tailored for using them in the public health care organizations. A management approach is something different from budgets cuts; it has nothing to do with eliminating services, restricting access or introducing co-payment; it deals with everything that does not create values for the patient and consume time and resources. Since the end of the 20th century up to now, health management has allowed those public health organizations which have it in place to raise quality and to create opportunities to doing more in health improvement with fewer resources. As it usually happens, the darkness and the light coexist and, sometimes, darkness prevails. That is why it is so important to identify it and to learn how to face it(AU)

Application of the Balanced Scorecard in the research performance management of the universities / 中华医学科研管理杂志

The Balanced Scorecard,as a new strategic management tool,has been widely used in the performance evaluation of Chinese enterprise.This review discussed the application and potential problems of the Balanced Scorecard in the research performance management of the research universities.

"EXCELÊNCIA E PRODUTIVIDADE": NOVOS IMPERATIVOS DE GESTÃO NO SERVIÇO PÚBLICO / "EXCELENCIA Y PRODUCTIVIDAD": NUEVOS IMPERATIVOS DE GESTIÓN EN SERVICIO PÚBLICO / "EXCELLENCE AND PRODUCTIVITY": NEW MANAGEMENT IMPERATIVES IN PUBLIC SERVICE

Este artigo tem como objetivo discutir os efeitos desestabilizadores da subjetividade no trabalho de servidores federais após a implantação de uma nova ferramenta de gestão, baseada na excelência, na produtividade e na avaliação do desempenho de uma instituição pública da Amazônia. O estudo, de caráter qualitativo, baseou-se no referencial teórico da Psicodinâmica do Trabalho aplicada ao campo da Saúde Mental Relacionada ao Trabalho (SMRT). Foram entrevistados 14 servidores afastados do trabalho por motivo de transtornos mentais e comportamentais, de acordo com a Classificação Internacional de Doenças - CID-10. As entrevistas, agrupadas em categorias, foram interpretadas com base na análise temática de Bardin. Observou-se que as mudanças organizacionais na instituição resultaram em avanço tecnológico e introduziram metas de qualidade total, no entanto, tiveram impacto na subjetividade e no próprio corpo do trabalhador, limitando a autonomia e o reconhecimento no trabalho e tornando-se fonte de mal-estar, sofrimento psíquico e adoecimento...

Este artículo tiene como objetivo discutir los efectos desestabilizadores de la salud mental en el trabajo de los funcionarios públicos después de la implementación de una nueva herramienta de gestión, basado en la excelencia y la productividad y en la evaluación del desempeño de una institución pública La Amazônia. El estudio, cualitativo, se basó en la psicodinámica del marco teórico de Trabajo aplica al campo de la salud mental relacionados con el trabajo (SMRT). fueron entrevistados 14 servidores fuera del trabajo debido a los trastornos mentales y del comportamiento, de acuerdo con la Clasificación Internacional de Enfermedades - CID-10. Las entrevistas se interpretan con base en el análisis temático de Bardin. Se observó que los cambios en la organización como resultado el avance tecnológico y la introdujeron objetivos de calidad total, sin embargo, tuvo un impacto en la subjetividad y el cuerpo del trabajador, lo que limita la autonomía y el reconocimiento en el trabajo y convertirse en una fuente de incomodidad, malestar psicológico y enfermedad...

This article aims to discuss the destabilizing effects in the subjectivities of federal employees after implementation of a new management tool based on excellence, productivity and performance evaluation in a public institution in Amazon's state. The qualitative study was based on the theoretical framework of labour psychodynamics in the field of Mental Health at Work. 14 employees absent from work for reasons of mental and behavioral disorders were interviewed, according to the International Classification of Diseases - ICD- 10. The interviews were grouped into categories and interpreted based on Bardin's thematic analysis (2011). We observed that the institution organizational changes resulted in technological advancement and introduced total quality goals. However, this improvement had an impact in the worker's subjectivity and body, limiting the autonomy and recognition at work, as well as becoming a source of discomfort, psychological distress and illness...

Design of performance evaluation indexs of scientific research management based on the Balanced Scorecard in military medical universities / 中华医学科研管理杂志

The scientific outputs are usually used as the main measure basis of the traditional performance evaluation of scientific research in military medical universities.In this research,we design the performance evaluation indexs of scientific research management based on the Balanced Scorecard from four levels including finance,customers,internal processes and learning and growth,which can provide a new perspective and theoretical basis for improving performance evaluation system of scientific research management in military medical universities.

The balanced scorecard and behavioral medicine discipline development in general hospitals / 中华行为医学与脑科学杂志

This study run through the process of developing behavioral medicine discipline in a general hospital with action research method,based on the balanced scorecard (BSC) framework.The four perspectives of the behavioral medicine BSC covered the main areas in hospital discipline development,including patients and community,healthy financial disciplines,clinical service process and efficiency,and research,innovation and growth.By the implementation of the discipline BSC,this hospital clarified its discipline development strategy,provided a communication platform,determined the objective and monitored the discipline effectively,and provided a mode which can integrate the discipline development and providing clinical services.The hospital set up the first neurology behavioral medicine clinic in Jinan Region though the exploration of the path and methods for developing behavioral medicine discipline,which had practical guiding significance for behavioral medicine development and services.

Innovative strategies in the public administration: report of the experience at the School of Dentistry (Institute of Science and Technology) - Universidade Estadual Paulista “Julio de MesquitaFillho” – UNESP, Campus of São José dos Campos / Estratégias inovadoras na administração pública: relato de experiência da faculdade de odontologia da Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP Campus de São José dos Campos

This ARTICLE aims to show an organization changing process, which is being performed in a public university, School of Dentistry of São José dos Campos – UNESP. A Strategic Planning was developed to promote such change, first using the usual model of this tool. Then the strategies were aligned with the expectations of a Balanced Scorecard engaged with the targets of a public organization (student success on the market, learning and growth, structure to work and leadership). To work the strategic review and the creation of renewal strategies a method from Matrix of Four Actions was used, aiming to identify values to add to the institution by diagnoses previewed on this tool, which makes easier the study of the fact that will be raised, eliminated, reduced and created. All this process was established along with the leadership development through trainings, individual and group coaching and the tracking of critical points of the strategic areas of this University Teaching Institute

O artigo tem por objetivo apresentar o processo de mudança organizacional que está em fase de implantação na instituição pública do ensino superior, Faculdade de Odontologia de São José dos Campos – UNESP, Campus de São José dos Campos. Para promover esta mudança foi desenvolvido o Planejamento Estratégico, inicialmente utilizando se o modelo tradicional desta ferramenta. Posteriormente as estratégias foram alinhadas às perspectivas de um Balanced Scorecard adaptado às necessidades dos objetivos estratégicos desta organização pública (sucesso do aluno no mercado, aprendizado e crescimento, infraestrutura de trabalho e governança institucional). Para promover a revisão estratégica e a criação de estratégias de inovação foi utilizada a metodologia da Matriz das Quatro Ações, visando identificar valores a agregar à instituição por meio do diagnóstico previsto nesta ferramenta, que facilita o levantamento dos fatores a serem elevados, eliminados, reduzidos e criados. Todo esse processo foi estabelecido conjuntamente com o desenvolvimento das lideranças de cada setor da instituição, por meio de treinamentos, sessões coaching individual e coletivo e mapeamento dos processos críticos das áreas estratégicas desta IES (Instituição de Ensino Superior).

Predomínio da gestão e violência simbólica / Management predominance and symbolic violence

Após duas décadas de forte ascensão do neoliberalismo, a degradação das condições de trabalho foi denunciada por numerosos observadores: alguns falam de "violência no trabalho", acentuando as dimensões socioeconômicas que estruturam os universos profissionais. Este artigo se inscreve nesta perspectiva e considera particularmente o papel que a dinâmica de gestionarização desempenha no exercício da violência no trabalho. O artigo se apoia sobre duas situações emblemáticas: o trabalho nas centrais de teleatendimento e a implementação de um dispositivo de gestão "total", o Balanced Scorecard, em uma multinacional. Mostra que as violências ligadas ao fato gestionário manifestam-se em três níveis articulados. No primeiro nível, esta violência resulta das transformações macropolíticas que tornam incontornáveis a introdução e a renovação dos dispositivos de gestão. No segundo nível, a violência se exerce em torno da implementção de dispositivos de gestão. Enfim, no terceiro nível, violência simbólica, que dá suporte às práticas de diferentes categorias de ator, manifesta-se. A imbricação entre estes níveis leva uma maioria de atores a adotar uma atitude de resignação diante da impossibilidade de se emancipar da gestão. Esta constatação pemite focar melhor o lugar e o modo de ação para enfrentar a violência no trabalho.

After two decades of dramatic ascension of neoliberalism, several observers have denounced the degradation of work conditions: some of them mention "violence at work", highlighting the social-economic dimensions that shape professional universes. This article is included in this perspective and particularly considers the role of "managerialism dynamics" in the use of violence at work. It stands on two emblematic situations: work in call centers, and the implementation of a "total" management device called Balanced Scorecard, in a multinational company. The paper shows that violences linked to a "managerial fact" are revealed in three different articulated levels. In the first one, violence results from macro-political transformations that make introduction and renewing of the management devices implausible. In the second level, violence takes place as a result of the implementation of management devices. Finally in the third level, symbolic violence, which supports practices of different categories of actors, is revealed. The overlapping between these levels makes most actors adopt an attitude of resignation due to their impossibility to get free from management. This evidence leads to a better focusing on the place and on the way of acting to face violence at work.

HRP- and BSC-based system for evaluating performance of military hospitals / 第二军医大学学报

Objective To set up an evaluation system for hospital performance, so as to meet the requirement of health system reform, to properly allocate health resources, to effectively standardize the administration of military hospitals, and to upgrade their overall performance. Methods According to the current situation, an evaluation system for performance of military hospitals, which including four domains-finance, patients, internal flow, and learning and progression, was established based on the balanced scorecard (BSC) ideology using the hospital resources planning (HRP) system, analytic hierarchy process (AHP) and Delphi method. Results We established an evaluation system for the performance of military hospitals, which including four first level parameters, 13 second level parameters, and 55 third level parameters. Conclusion HRP combined with BSC for evaluating hospital performance can help the proper allocation of health resources in military hospitals, contributing to the sound, cost-saving and highly efficient administration of hospitals. Adjustment should be made in actual application, and attention should be given to the time effectiveness and scientific nature of the parameters.

Study on performance assessment mode of clinical departments in modern hospital / 中华医学科研管理杂志

Objective Construct the reasonably effective performance assessment mode of clinical departments,which is suitable for the continuous development of modern hospital.Method Use of balanced scorecard (BSC) principle,using the analytic hierarchy process (AHP) and Rank sum ratio method (RSR)to establish a performance assessment system. Results Constructed the performance assessment mode of clinical departments,which can be dynamically adjusted based on management objectives strategy.The mode takes the BSC as the baseline,the strategy of hospital development as the guide,performance assessment index system as the key element. Conclusion The performance assessment mode of clinical departments,base on BSC,achieve the strategic performance management,and is conducive to the hospital for continuous improvement of medical care quality,in line with the long-term strategic needs of the hospital.

Impacts of Diagnosis Related Groups and Balanced Score-card on inpatient medical services / 中华医院管理杂志

Objective To improve overall value of healthcare industry through setting up critical inpatient medical services strategic plan.Methods Identify major objectives which the local government expects to achieve through strategic map; Standardize inpatient output and assign weight to each group through diagonosis related groups; Translate the objectives of strategic map and result of diagnosis related group to Balanced Score-card; Finally build up strategic map and according action plans.ResultsPreliminarily established 16 objectives、23 measures and 13 tasks in four perspectives including customer,internal work flow,learning and growing and finance.ConclusionThe strategy map and the balanced score-card can help implement full strategic plan of regional inpatient medical services; DRGs is a core management tool of patient-centred service output management; Balanced Score-card is able to realize continuous improvement of Beijing inpatient medical services from macro to micro persoetive.

Development of a performance evaluation indexing system in for-profit hospitals / 中华医院管理杂志

This paper demonstrates the necessity for developing for-profit hospitals according to property right theories;It analyzed the inherent unity of social benefits and economic benefits in such hospitals,and clarified their business objectives.It put forward a process to build a performance evaluation indexing system in for-profit hospitals in view of the characteristics of such hospitals.Calling into play the performance management method of the balance scorecard,it identified the business objectives of such hospitals as measured by such performance indexes as finance,patients,process,and learning,and the logic relationship existing among the indexes as well.In addition,it vertically extends such a system to the departments and employees of the hospital to make a complete performance evaluation indexing system.