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1.
Acta Paul. Enferm. (Online) ; 34: eAPE002095, 2021. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1349837

ABSTRACT

Resumo Objetivo Identificar, avaliar e sumarizar as evidências científicas sobre os modelos de gestão em enfermagem nos serviços hospitalares entre os anos de 2013 e 2019. Métodos Trata-se de uma revisão integrativa da literatura realizada nas bases de dados Web of Science, Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde - BIREME/ BVS, National Library of Medicine (PubMed/MEDLINE), Education Resources Information Center (Eric) e na biblioteca Scientific Electronic Library Online (SciElo), entre os anos de 2013 e 2019. Resultados Dos 100 estudos encontrados nas bases, 16 foram selecionados para análise, após aplicação dos critérios de inclusão e exclusão. Destes, 14 (87,5%) produções eram internacionais e duas (12,5%) nacionais. Seis publicações (37,5%) eram originárias dos Estados Unidos da América, dois (12,5%) artigos brasileiros e outros dois (12,5%) provenientes da Itália. África, Portugal, Inglaterra, Alemanha, China e Canadá tiveram um artigo (6,2%) cada. As evidências relacionadas aos modelos de gestão adotados por enfermeiros no ambiente hospitalar foram sistematizadas em três categorias: Gestão com foco na melhoria do cuidado; Gestão com ênfase na eficiência dos serviços; e Gestão voltada aos custos hospitalares. Essas categorias evidenciam uma diversidade de modelos adotados na gestão hospitalar sob liderança de enfermeiros. Conclusão O estudo indica a existência de modelos de gestão na perspectiva da melhoria continuada dos processos assistenciais e de fortalecer a prática profissional do enfermeiro na produção de cuidados, a fim de garantir uma assistência livre de danos e, sobretudo, a satisfação de clientes e trabalhadores. Sinaliza-se a diversidade de Modelos de Gestão.


Resumen Objetivo Identificar, analizar y resumir las evidencias científicas sobre los modelos de gestión en enfermería en servicios hospitalarios entre los años 2013 y 2019. Métodos Se trata de una revisión integradora de la literatura realizada en las bases de datos Web of Science, Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud - BIREME/ BVS, National Library of Medicine (PubMed/MEDLINE), Education Resources Information Center (Eric) y en la biblioteca Scientific Electronic Library Online (SciElo), entre los años 2013 y 2019. Resultados De los 100 estudios encontrados en las bases, 16 fueron seleccionados para el análisis, luego de aplicar los criterios de inclusión y exclusión. Entre estas producciones, 14 (87,5 %) eran internacionales y dos (12,5 %) nacionales. Seis publicaciones (37,5 %) eran originarias de los Estados Unidos de América, dos (12,5 %) artículos brasileños y otros dos (12,5 %) provenientes de Italia. África, Portugal, Inglaterra, Alemania, China y Canadá tuvieron un artículo (6,2 %) cada uno. Las evidencias relacionadas con los modelos de gestión adoptados por enfermeros en el ambiente hospitalario fueron sistematizadas en tres categorías: Gestión con foco en la mejora del cuidado, Gestión con énfasis en la eficiencia de los servicios y Gestión orientada a los costos hospitalarios. Estas categorías demuestran una diversidad de modelos adoptados en la gestión hospitalaria bajo liderazgo de enfermeros. Conclusión El estudio indica la existencia de modelos de gestión en la perspectiva de la mejora continua de los procesos asistenciales y de fortalecer la práctica profesional del enfermero en la producción de cuidados, a fin de garantizar una atención libre de daños y, sobre todo, la satisfacción de clientes y trabajadores. Se observa una diversidad de modelos de gestión.


Abstract Objective To identify, assess, and summarize the scientific evidence on nursing management models in hospital services between 2013 and 2019. Methods This is an integrative literature review carried out in the Web of Science, Latin American and Caribbean Center for Health Sciences Information, BIREME/VHL, National Library of Medicine (PubMed/MEDLINE), Education Resources Information Center (Eric), and Scientific Electronic Library Online (SciElo) databases between 2013 and 2019. Results Of the 100 studies found in the databases, 16 were selected for analysis after applying the inclusion and exclusion criteria. Of these, 14 (87.5%) productions were international and two (12.5%) were national. Six publications (37.5%) were from the United States of America, two (12.5%) were Brazilian articles and two (12.5%) were from Italy. Africa, Portugal, England, Germany, China and Canada had one article (6.2%) each. The evidence related to the management models adopted by nurses in the hospital environment was systematized into three categories: Management focused on improving care; Management focused on service efficiency; Management focused on hospital costs. These categories show a diversity of models adopted in hospital management under the leadership of nurses. Conclusion The study indicates the existence of management models in the perspective of continuous improvement of care processes and to strengthen the professional practice of nurses in production of care, in order to guarantee harm-free care and, above all, customer and worker satisfaction. The diversity of management models is highlighted.


Subject(s)
Hospital Services , Nursing/organization & administration , Models, Organizational , Quality Management , Patient-Centered Care
2.
Rev. medica electron ; 42(5): 2449-2464, sept.-oct. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1150029

ABSTRACT

RESUMEN muy poco se conoce y apenas existe documentación sobre lo que la Federación Estudiantil Universitaria ha realizado en la provincia y en la Universidad de Ciencias Médicas de Matanzas. Por ser tan importante esta temática como parte del rescate de la memoria histórica de la organización estudiantil, constituye un reto investigar y escribirla. Describir algunos apuntes históricos del inicio y desarrollo de la Federación Estudiantil Universitaria en la hoy Universidad de Ciencias Médicas de Matanzas, durante una primera etapa. Se describen algunos de los principales hechos vinculados al trabajo de los miembros de la Federación de Estudiantes Universitarios de las carreras de ciencias médicas de Matanzas, se recopiló información sobre sus dirigentes estudiantiles, eventos académicos, científicos, culturales, juegos deportivos, entre otros, desde los años iniciales de la educación médica superior en la provincia hasta el comienzo de la década del 90. La historia de la Federación de Estudiantes Universitarios, en la hoy Universidad de Ciencias Médicas de Matanzas, refleja el papel desempeñado por la organización, sus miembros y dirigentes, lo que la hace rejuvenecer cada año, con las nuevas generaciones que la integran (AU).


SUMMARY Very little is known and there is hardly any documentation on what the University Students Federation (FEU by its Spanish initialism) has done in the province and at Matanzas University of Medical Sciences. Because this theme is so important as part of the rescue of the historical memory of the student's organization, it is a challenge to investigate and write it. To provide some historical notes on the beginning and development of the University Student Federation in the current University of Medical Sciences of Matanzas, during a first stage. The authors described some of the main facts related to the work of the members of the University Students Federation of the medical sciences degree courses of Matanzas; they collected information about its student leaders, academic, scientific, cultural events, sports games, among others, from the initial years of higher medical education in the province until the beginning of the 90s.The history of the University Students Federation at Matanzas University of Medical Sciences mirrors the role played by the organization, its members and leaders, rejuvenating it every year, with the new generations joining it in (AU).


Subject(s)
Humans , Male , Female , Organizations/history , Students, Public Health/history , Universities/history , Models, Organizational , Education/history , Education/methods
3.
Ciênc. Saúde Colet ; 25(2): 553-565, Feb. 2020. tab
Article in Portuguese | LILACS | ID: biblio-1055833

ABSTRACT

Resumo Cuidados colaborativos entre saúde mental e atenção primária são efetivos em melhorar desfechos de saúde. O apoio matricial tem semelhanças com cuidados colaborativos pouco exploradas na literatura. Este artigo compara os dois modelos e analisa o apoio matricial a partir de evidências sobre cuidados colaborativos. Revisão narrativa. Componentes de cada modelo (atividades e dimensões) foram identificados e comparados. Evidências sobre cuidados colaborativos informaram análise de componentes semelhantes do apoio matricial. Foram identificadas dimensões do apoio matricial - suporte educacional, cuidado especializado, regulação, cogestão - e dos cuidados colaborativos - cuidado multiprofissional, comunicação sistemática, cuidado estruturado, suporte organizacional. A principal semelhança entre os modelos está nas atividades colaborativas diretas em torno de problemas clínicos, relacionadas a efetividade em estudos sobre cuidados colaborativos. Atividades colaborativas diretas são ponto positivo do apoio matricial. Cuidado estruturado e suporte em nível organizacional devem ser encorajados. Futuros estudos devem refinar as categorias propostas e explorar seu uso para desenvolvimento do apoio matricial.


Abstract Collaborative care between mental health and primary care is effective in improving health outcomes. The matrix support has similarities with collaborative care little explored in the literature. This article compares the two models and analyzes the matrix support from evidence on collaborative care. Narrative review. Components of each model (activities and dimensions) were identified and compared. Evidence on collaborative care informed analysis of similar components of matrix support. The dimensions of the matrix support - educational support, specialized care, regulation, co-management - and collaborative care - multiprofessional care, systematic communication, structured care, organizational support - were identified. The main similarity between the models lies in the direct collaborative activities around clinical problems which is related to effectiveness in collaborative care studies. Direct collaborative activities are a positive aspect of matrix support. Structured care and support at the organizational level should be encouraged. Future studies should refine the proposed categories and explore their use for the development of matrix support.


Subject(s)
Humans , Primary Health Care/organization & administration , Models, Organizational , Mental Health Services/organization & administration , Mental Health , Cooperative Behavior
4.
Ciênc. Saúde Colet ; 24(6): 2147-2154, jun. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1011817

ABSTRACT

Resumo A saúde pública em Brasília sofreu diversas melhorias desde sua implementação devido à mudança do perfil econômico, social e de escolaridade da população. Foi realizada uma reforma na Atenção Hospitalar por gestão baseada em evidências, através de um conjunto normativo que estabeleceu o ordenamento dos Serviços Hospitalares de Emergência, Atenção Ambulatorial Secundária, Regulação de Serviços de Saúde e modelagem organizacional da Secretária de Saúde do Distrito Federal. Tais mudanças permitiram que os profissionais nos seus diferentes níveis de atenção estejam interligados. Ou seja, os profissionais passam a prestar um serviço de saúde de forma contínua para a população, proporcionando um cuidado de saúde integral ao paciente. Essa abordagem garante ganho de eficiência no tratamento do paciente, pois os profissionais multifocais e focais trabalham de maneira integrada. Com a implementação da gestão da organização por processos de trabalho e o planejamento adequado, foi possível redesenhar o modelo assistencial utilizado nos dias atuais, permitindo através da gestão do conhecimento a ampliação do acesso e da interatividade, proporcionado ao cidadão através do modelo de gestão em saúde que agregue valor.


Abstract Since its creation in 1988, major changes have been made to Brazil's public health system in response to the epidemiological transition and the country's changing economic context and demographics. This article describes the recent healthcare reform implemented in the federal district's public hospital system. Guided by evidence-based management and a series of regulatory instruments, the reform organized hospital emergency services and secondary outpatient care, regulated health services, and remodeled the organizational structure of the Department of Health. These changes were aimed at promoting integration between health professionals across different levels of care and ensuring the provision of continuing comprehensive care. This approach guarantees efficiency gains in patient treatment, since multifocal and focal professionals work in an integrated manner. By reorganizing work processes and ensuring adequate planning, it was possible to redesign the care model to promote knowledge management and improve access to information and interactivity, thus helping to ensure the provision of quality, value-added care.


Subject(s)
Humans , Public Health , Health Care Reform , Delivery of Health Care/organization & administration , Hospitals, Public/organization & administration , Personnel, Hospital/standards , Brazil , Models, Organizational , Evidence-Based Medicine , Emergency Service, Hospital/organization & administration , National Health Programs/organization & administration
5.
Ciênc. Saúde Colet ; 24(6): 2095-2103, jun. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1011794

ABSTRACT

Resumo A recente mudança de modelo da atenção primária à saúde para estratégia de Saúde da Família, com foco centrado no usuário e na territorialização foi o momento ideal para implantação do Projeto AcolheSUS em uma Unidade Básica de Saúde (UBS) da Região Central de Brasília, Distrito Federal. A equipe de servidores da UBS realizou o diagnóstico situacional da unidade e o planejamento estratégico situacional, com o objetivo de reorganizar o serviço a partir da problematização e com foco nos processos de trabalho. Com o AcolheSUS houve aumento do número de cadastros individuais realizados pelas equipes de 135 para 3.525, o número de atendimentos de enfermagem aumentou em 193,7% e o número de procedimentos realizados por enfermeiros teve um acréscimo 121,2%. O percentual de residentes da área adstrita que procuravam a unidade básica de saúde durante o processo de mudança de modelo de atenção era 71% do total e alcançou 90,5% após o AcolheSUS. A média mensal de usuários acolhidos e classificados foi de 1.099,8. A construção conjunta de protocolos sólidos e o ajuste de processos de trabalho contribuíram para a melhoria na oferta de serviços e propiciaram maior acesso do usuário à unidade de saúde.


Abstract The recent change in model of primary health care introduced for the Family Health Strategy, to one centred on the user and territorialisation, provided the ideal opportunity to implement the AcolheSUS Project in a Basic Health Unit (UBS) of the Central Region of Brasília, in Brazil's Federal District. The UBS team conducted a situational diagnosis of the unit and situational strategic planning with a view to reorganising the service to address the problems identified, focusing on the work processes. With introduction of AcolheSUS, the number of individual user registrations performed by the teams increased from 135 to 3525, the number of nursing visits increased by 193.7% and the number of procedures performed by nurses increased by 121.2%. During changeover to the new care model, 71% of residents in the catchment area attended the basic health unit; after introduction of AcolheSUS, the percentage reached 90.5%. The monthly average of users received and classified was 1099.8. The joint construction of solid protocols and adjustments to work processes contributed to improving service delivery and afforded users greater access to the health care unit.


Subject(s)
Humans , Primary Health Care/organization & administration , Family Health , Delivery of Health Care/organization & administration , National Health Programs/organization & administration , Strategic Planning , Brazil , Models, Organizational , Health Services Accessibility
6.
Ciênc. Saúde Colet ; 24(6): 2031-2041, jun. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1011792

ABSTRACT

Resumo O Sistema Único de Saúde tem passado por constante evolução e ampliação desde a publicação da Constituição Federal de 1988. O Distrito Federal apresentou contribuições no campo da Política de Atenção Primária à Saúde, sobretudo entre os anos 2016 e 2018, ao definir a Estratégia Saúde da Família como forma definitiva de organização dos serviços na APS e estabelecer um conjunto de ações orientadas para a conversão ao modelo. Esse artigo descreve e analisa os principais processos dessa mudança. Utilizou-se o método de análise documental de portarias, resoluções, relatórios e outros documentos, bem como dados disponíveis nas bases oficiais. Destacam-se a elaboração de um arcabouço normativo que inclui a implantação das equipes, os processos de trabalho dos profissionais, mudanças nas especialidades médicas e reordenamento dos profissionais de saúde que já atuavam na APS. A experiência demonstra a viabilidade de mudanças incrementais nas políticas de saúde em prol da ampliação de acesso da população aos serviços de saúde, por meio da definição de prioridades, melhor gestão da força de trabalho, capacitação e planejamento descentralizado, repercutindo na elevação da cobertura populacional de Saúde da Família dos iniciais 28% para 69%, alcançados em um período de dois anos.


Abstract Conclusion The Unified Health System has undergone constant evolution and expansion since the publication of Brazil's 1988 Federal Constitution. The Federal District has provided contributions to the field of Primary Health Care Policy, especially between 2016 and 2018, by defining the Family Health Strategy as the definitive way of organizing Primary Health Care (PHC) services and by establishing a set of actions aimed at conversion of existing PHC services to this model. This article describes and analyzes the key processes of this change. The method used was analysis of ordinances, resolutions, reports and other documents, as well as assessment of data from official databases. We emphasize the development of a normative structure that includes the teams' implementation, the professionals' work processes, changes in medical specialties and reorganization of the health professionals who already worked in PHC. with an effect of increasing the population's Family Health Strategy coverage (in a population of approximately 3 million inhabitants) from 28% to 69% during a two-year period, the experience demonstrates the feasibility of incremental changes in health policies such as defining priorities, better management of the workforce, training and decentralized planning to increase access to health services.


Subject(s)
Humans , Primary Health Care/organization & administration , Health Care Reform , Delivery of Health Care/organization & administration , National Health Programs/organization & administration , Patient Care Team/organization & administration , Brazil , Family Health , Health Personnel/organization & administration , Models, Organizational , Health Policy , Health Services Accessibility
7.
Ciênc. Saúde Colet ; 24(6): 2053-2064, jun. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1011789

ABSTRACT

Resumo A rede de saúde pública do Distrito Federal, como de resto todo o Sistema Único de Saúde, padece de ineficiências relacionadas à dificuldade de contratação e gestão de profissionais, bem como de realização de contratos para abastecimento e manutenção. Em Brasília, implantou-se em 2018 um novo modelo de gestão em seu maior hospital. Com a criação do serviço social autônomo Instituto Hospital de Base, unidade de saúde em funcionamento desde 1960, abriu-se a possibilidade de conferir agilidade a essas contratações, além de se instalar uma gestão baseada em metas e indicadores de resultado, com expressivos ganhos de eficiência. Este artigo relata os passos para a implantação desse modelo descentralizado de gestão hospitalar, as alternativas cogitadas, as dificuldades enfrentadas e alguns dos primeiros resultados desse novo modelo. Já se pode verificar e afirmar o sucesso do modelo jurídico-administrativo do Instituto Hospital de Base, que pode servir de paradigma para outras unidades de saúde do Distrito Federal e do Brasil.


Abstract The public health network of the Federal District, as in the rest of the Brazilian Unified Health System, suffers from inefficiencies related to the difficulty in hiring and managing professionals, as well as the implementation of supply and maintenance contracts. In Brasilia, a new management model was implemented in 2018 in its largest hospital. With the creation of the autonomous social service "Instituto Hospital de Base", a health unit in operation since 1960, the possibility of providing agility to these contracts was opened, in addition to establishing a management based on goals and outcome indicators, with expressive efficiency gains. This article reports the steps for the implementation of this decentralized model of hospital management, the alternatives considered, the difficulties faced and some of the first results of this new model. One can already verify and affirm the success of the legal-administrative model of "Instituto Hospital de Base", which can serve as a paradigm for other health units in the Federal District and in Brazil.


Subject(s)
Humans , Public Health , Models, Organizational , Hospitals, Public/organization & administration , National Health Programs/organization & administration , Social Work/organization & administration , Brazil , Quality Indicators, Health Care
8.
Ciênc. Saúde Colet ; 24(3): 817-826, mar. 2019.
Article in French | LILACS | ID: biblio-989618

ABSTRACT

Résumé La sécurité des patients est devenue une priorité des politiques de santé publique. En 30 ans, les systèmes de santé se sont approprié les outils de gestion des risques conçus pour les industries. L'objectif de cette revue de littérature est de décrire les modèles et les démarches de sécurité actuellement déployés dans les systèmes de santé et d'explorer les nouvelles perspectives. La recherche bibliographique a été réalisée à partir de trois bases de données, en français et en anglais. L'analyse thématique du matériel retenu (48 références) a guidé la construction de l'article et l'identification d'une typologie de démarches de prévention. Après une présentation des démarches « classiques ¼, nous exposons les limites de ces démarches dans le contexte spécifique des soins. Puis nous présenterons les perspectives scientifiques actuellement envisagées pour construire de nouvelles approches de prévention en santé. Ces perspectives interrogent, en conclusion, la nécessité d'un changement de paradigme, comme le propose le courant de l'« ingénierie de la résilience ¼.


Abstract Patient security has become a priority in public health policies. In 30 years, health systems have adopted the risk management tools designed for industries. The purpose of this review of the literature is to describe the current security models and approaches deployed in health systems and to explore new perspectives. The bibliographic search was conducted from three databases, in French and in English. The thematic analysis of the selected material (48 references) guided the construction of the article and the identification of a typology of prevention approaches. After a presentation of the «classical¼ approaches, the limits of these approaches in the specific context of care are exposed. The scientific perspectives currently envisaged to build new approaches to prevention in health are then presented. By way of conclusion, these perspectives question the need for a paradigm shift, as proposed by the current of «resilience engineering¼.


Subject(s)
Humans , Risk Management/methods , Delivery of Health Care/standards , Patient Safety/standards , Models, Organizational , Health Policy
9.
Rev. saúde pública (Online) ; 53: 85, jan. 2019. tab
Article in English | LILACS | ID: biblio-1043321

ABSTRACT

ABSTRACT Group prenatal care is an alternative model of care during pregnancy, replacing standard individual prenatal care. The model has shown maternal benefits and has been implemented in different contexts. We conducted a narrative review of the literature in relation to its effectiveness, using databases such as PubMed, EBSCO, Science Direct, Wiley Online and Springer for the period 2002 to 2018. In addition, we discussed the challenges and solutions of its implementation based on our experience in Mexico. Group prenatal care may improve prenatal knowledge and use of family planning services in the postpartum period. The model has been implemented in more than 22 countries and there are challenges to its implementation related to both supply and demand. Supply-side challenges include staff, material resources and organizational issues; demand-side challenges include recruitment and retention of participants, adaptation of material, and perceived privacy. We highlight specific solutions that can be applied in diverse health systems.


RESUMEN La atención prenatal en grupo es un modelo alternativo de atención durante el embarazo, que sustituye la atención prenatal individual estándar. El modelo ha mostrado beneficios maternos y se ha implementado en diferentes contextos. Llevamos a cabo una revisión narrativa de la literatura en relación a su efectividad, utilizando bases de datos como PubMed, EBSCO, Science Direct, Wiley Online y la editorial Springer, para el periodo 2002 a 2018. Adicionalmente, discutimos los retos y soluciones de su implementación desde nuestra experiencia en México. La atención prenatal en grupo puede mejorar el conocimiento prenatal y el uso de servicios de planificación familiar en el postparto. El modelo se ha implementado en más de 22 países y existen retos de su implementación desde la oferta y la demanda. Los retos desde la oferta incluyen al personal, recursos materiales y cuestiones organizacionales; desde la demanda, el reclutamiento y retención de participantes, adaptación del material y privacidad percibida. Resaltamos soluciones concretas que pueden aplicar a diversos sistemas de salud.


Subject(s)
Humans , Female , Pregnancy , Prenatal Care/methods , Group Structure , Prenatal Care/standards , Reproducibility of Results , Models, Organizational , Mexico
10.
Salud colect ; 14(3): 545-562, jul.-sep. 2018. graf
Article in Spanish | LILACS | ID: biblio-979097

ABSTRACT

RESUMEN En este artículo presentamos una modelización que tiene como meta la construcción de una respuesta integral y comunitaria frente a problemáticas de salud adolescente. Desde un abordaje integral, que incluye acciones de prevención y promoción, asistencia y protección, y que involucra a diferentes sectores y áreas del Estado y de la comunidad, describimos las bases conceptuales del modelo, los ejes y los principios que recuperamos de los debates de la promoción de la salud, la salud colectiva y de las experiencias de trabajo del equipo de investigación en distintas comunidades a lo largo de los últimos 15 años en Argentina. Posteriormente, damos cuenta de los pasos desarrollados para facilitar la realización de intervenciones y retomamos algunos nudos teóricos, políticos y prácticos que se encuentran en su gestación, en una apuesta por vincular la reflexión crítica con el desarrollo de tecnologías sociales. Este modelo da cuenta de la reflexión sobre cómo llevar adelante acciones de promoción de la salud que busquen transformar las realidades particulares, respetando sus singularidades y recuperando lo que las conecta con otras.


ABSTRACT This article presents a model for building a comprehensive community response to adolescent health problems. The approach is comprehensive in that it includes prevention and promotion, assistance and protection, and involves different sectors and areas of the State and the community. We describe the conceptual framework and principles of the model, developed based on debates regarding health promotion and collective health as well as the work experiences of the research team in different communities in Argentina over the last 15 years. We then present the steps developed to help facilitate interventions and analyze certain theoretical, political and practical issues underlying the management of such a model, in an attempt to link critical reflection with the development of social technologies. This model takes into account reflections regarding how to carry out health promotion actions that seek to transform particular realities, respecting their singularities but at the same time acknowledging their connections to others.


Subject(s)
Humans , Adolescent , Adolescent Health Services/organization & administration , Models, Organizational , Community Health Services/organization & administration , Adolescent Health , Community-Based Participatory Research , Health Promotion/organization & administration , Patient Participation , Argentina , Power, Psychological , Personal Autonomy , Health Promotion/methods
11.
Rev. cub. inf. cienc. salud ; 29(3): 1-12, jul.-set. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-978364

ABSTRACT

Objetivos: reflejar los principales elementos de una auditoría de conocimiento que combine los procesos principales con los indicadores de desarrollo profesional que podrían identificar aquellos componentes del capital humano que deberían ser favorecidos. Métodos: se analizaron los principales elementos sobre una auditoría de conocimiento que combina los procesos principales con los indicadores de desarrollo profesional. Se propone un enfoque que permite la identificación de los componentes del capital humano que deben ser potenciados. No se ha identificado ninguna otra metodología con esta orientación. Resultados: la imagen de las fortalezas y debilidades de las organizaciones, así como el conocimiento necesario en cada proceso, proporcionan la base para la regulación de los procesos organizacionales y los componentes humanos y tecnológicos necesarios. Contribuye a la identificación de vacíos de conocimiento así como de los elementos culturales que deben ser tratados. Es una orientación sólida para programar acciones de desarrollo profesional que podrían solidificar el diseño futuro de estos procesos y contribuir a las competencias profesionales de los miembros de estas comunidades de práctica. Conclusiones: esta es una guía sólida para la práctica de desarrollo profesional, orientada hacia el desarrollo futuro de procesos organizacionales y contribuye al crecimiento de las competencias profesionales de estas comunidades de práctica. La plataforma estratégica de la organización se ha enriquecido con la identificación de las fortalezas y debilidades de sus procesos desde diferentes puntos de vista. Este enfoque metodológico se aplicará en diferentes casos a posibles ajustes analizados en su diseño(AU)


Objectives: to reflect the principal elements of a knowledge audit that combines principal processes with professional development indicators that could identify those human capital components that should be favored. Methods: the main elements about a knowledge audit that combines principal processes with professional development indicators were analyzed. This approach allows the identification of those components of human capital that should be raised. No other methodology with this orientation has been identified. Results: the image of strengths and weaknesses of the organizations, as well as knowledge needed in each process gives the base for the regulation of organizational processes and necessary human and technological components. It contributes to the identification of knowledge gaps as well as cultural elements that should be treated. This is a solid orientation for programming professional development actions that could solidify the future design of these processes and contribute to professional competences of the members of these communities of practice. Conclusions: this is a solid guidance for executing professional development practice, oriented towards the future development of organizational processes and contribute to the growth of professional competences of these communities of practice. The strategic platform of the organization has been enriched with the identification of strengths and weaknesses of its processes from different views. This methodological approach will be applied in different cases to analyze possible adjustments in its design(AU)


Subject(s)
Humans , Professional Competence/standards , Models, Organizational , Knowledge Management/standards
12.
Rev. medica electron ; 40(4): 1011-1022, jul.-ago. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-961276

ABSTRACT

Introducción: el clima organizacional es un fenómeno complejo y multifactorial, que involucra a factores relacionados con los estilos de dirección, la estructura y los comportamientos dentro de la organización, y tienen como sustento los conocimientos, actitudes y prácticas. Objetivo: evaluar el clima organizacional en la Clínica Docente Estomatológica "27 de Noviembre". Colón. Materiales y métodos: se realizó una investigación descriptiva de corte transversal, en el periodo de enero a mayo del 2017. El universo y muestra estuvo constituido por los 120 trabajadores que fueron organizados por estratos. Se estudiaron tres dimensiones básicas: comportamiento organizacional, estructura organizacional y estilo de dirección. Resultados: las dimensiones comportamiento organizacional; estructura organizacional y estilo de dirección, fueron percibidas como clima organizacional adecuado. Conclusiones: el clima organizacional en la Clínica Docente Estomatológica "27 de Noviembre" fue evaluado de adecuado para todas las dimensiones objeto del estudio. Todas las categorías investigadas fueron evaluadas de aceptable, excepto las condiciones de trabajo que fueron evaluadas en riesgo (AU).


Introduction: the organizational climate is a multifactorial, complex phenomenon involving factors related with managing styles, structure and behavior inside the organization, and have as a support knowledge, attitudes and practice. Objective: to assess the organizational climate in the Teaching Dental Clinic ¨27 de noviembre¨ of Colón. Materials and methods: a descriptive, cross-sectional research was carried out in the period from January to May of 2017. The universe and sample was formed by 120 workers who work in the institution organized by strata. Three basic dimensions were studied: organizational behavior, organizational structure and managing style. Results: the dimensions organizational behavior; organizational structure and managing style were perceived as adequate organizational climate. Conclusions: the organizational climate in the Teaching Dental Clinic ¨27 de noviembre¨ was assessed as adequate for all the dimensions that were object of study. All the investigated categories were evaluated as satisfactory, except for occupational conditions that were evaluated as at risk (AU).


Subject(s)
Humans , Male , Female , Models, Organizational , Dental Clinics/organization & administration , Professional Practice/organization & administration , Dental Health Services/organization & administration , Work Performance/organization & administration , Governance/organization & administration
13.
Ciênc. Saúde Colet ; 23(7): 2085-2094, jul. 2018.
Article in English | LILACS | ID: biblio-952686

ABSTRACT

Abstract This article provides an overview of the profound changes in the more advanced welfare states in Europe and Latin America over the past 35 years. Deindustrialization, informalization, and the rise of unstable employment, combined with aging populations rendered traditional employment-based models of social protection less effective and at the same time increased demands on the welfare state. The two main responses to these challenges were efforts at cost containment and inclusion in non-contributory social protection schemes and health services of those in marginal labor market positions. The mix of these two responses and the depth of the changes were shaped by the intensity of the economic and demographic pressures, policy legacies, the partisan preferences of governing parties and coalitional constraints, the strength of groups in civil society, the presence of veto points in the political system, and in Latin America the process of democratization, along with the international context. A broad comparison between Latin America and Europe highlights the importance of the international context in the form of a relentless pursuit of neoliberal models by the International Financial Institutions in Latin America in contrast to the model of Social Europe promoted by the European Union.


Resumo O artigo apresenta um panorama das profundas mudanças nos Estados de Bem-Estar Social mais avançados da Europa e da América Latina nos últimos 35 anos. Desindustrialização, informalização e o aumento dos empregos instáveis, associados ao envelhecimento populacional, tornaram os modelos de proteção social baseados no emprego menos efetivos e, ao mesmo tempo, aumentaram as pressões sobre os Estados de Bem-Estar Social. As principais respostas para esses desafios foram esforços de contenção de custos e de inclusão em esquemas de proteção social e de saúde não contributivos das pessoas em posições precárias nos mercados de trabalho. A combinação dessas respostas e a profundidade das mudanças foram moldadas pela intensidade das pressões econômicas e demográficas, legados das políticas, preferências dos partidos no governo e constrangimentos pelas coalizões de poder, força dos grupos da sociedade civil, presença de pontos de veto no sistema político e, na América Latina, o processo de democratização e o contexto internacional. A comparação entre América Latina e Europa destaca a importância do contexto internacional expressa em pressões das instituições financeiras internacionais pela adoção de modelos neoliberais na América Latina, em contraste com o modelo de Europa Social promovido pela União Europeia.


Subject(s)
Humans , Politics , Public Policy/trends , Delivery of Health Care/trends , Social Welfare/trends , Models, Organizational , Europe , Latin America
14.
Ciênc. Saúde Colet ; 23(6): 1791-1798, jun. 2018.
Article in Portuguese | LILACS | ID: biblio-952652

ABSTRACT

Resumo O artigo teve como objetivo refletir sobre os desafios da construção das Regiões e Redes de Saúde no Brasil. São elencados como desafios centrais para a constituição das Regiões e Redes de Saúde: o Modelo de Atenção, a Atenção Primária à Saúde, o Cuidado aos Usuários com Doenças Crônicas e a Assistência Hospitalar. Para a consolidação das Regiões e Redes é necessária a incorporação de um sentido ético da organização: a centralidade nas necessidades sociais, populacionais e individuais, derivadas da integralidade, dos direitos humanos e sociais, em amplas interações multiescalares e intersetoriais; com a constituição de uma inovação sistêmica regionalizada. É central a capacidade de divisar quais são os princípios gerais responsáveis por manter a unidade (o modo de atenção), buscando balizar a coerência dos diferentes modelos de provisão que o sistema pode desenvolver segundo as necessidades sociais em contextos regionais. Sem isso, os usuários continuarão a buscar e a criar maneiras de acessar os serviços de saúde que desafiam a racionalidade dos próprios serviços. É também necessária uma reforma hospitalar que integre e reoriente as redes. Essas ponderações são importantes para que o SUS mantenha seu projeto de solidariedade, expresso na tríade da universalidade-integralidade-equidade.


Abstract The aim of this article was to reflect on the challenges faced in building the Health Regions and Networks in Brazil. These reflections result from studies conducted in several health regions. The central challenges for the constitution of the Health Regions and Networks are as follows: the Care Model, Primary Health Care, Care for Users with Chronic Diseases, and Hospital Care. In order to consolidate the regions and networks the organization needs to incorporate an ethical sense: focusing on social, public and individual needs, derived from comprehensive care, human and social rights, in broad, multi-scale and inter-sectorial interactions, with the constitution of a systemic, regionalized innovation. Of prime importance is the capacity to devise which general principles are responsible for maintaining the unity(mode of care), seeking to outline the coherence of the different provision models that the system might develop according to the social needs in regional settings. Without that, users will continue to seek and create ways of accessing health services that challenge the rationale of those very services. Hospital reform is also required to integrate and reorient the hospital networks. These reflections are important for the SUS to uphold its solidarity project, expressed in the trinity of universality-comprehensiveness-equality.


Subject(s)
Humans , Primary Health Care/organization & administration , Delivery of Health Care/organization & administration , Health Services Accessibility , National Health Programs/organization & administration , Brazil , Models, Organizational , Health Care Reform , Hospital Administration
15.
Rev. bras. ter. intensiva ; 30(1): 57-63, jan.-mar. 2018. tab, graf
Article in Portuguese | LILACS | ID: biblio-899558

ABSTRACT

RESUMO Objetivo: Descrever os diferentes modelos de prestação de cuidados de reabilitação em prática nas unidades de cuidados intensivos de adultos portuguesas. Métodos: Estudo observacional simples (transversal), realizado por meio de inquérito on-line enviado aos enfermeiros-chefes ou responsáveis das 58 unidades de cuidados intensivos de adultos que integram a base de dados da Sociedade Portuguesa de Cuidados Intensivos. Resultados: Foram identificados três modelos de organização dos cuidados de reabilitação: cuidados prestados pela equipe da unidade de cuidados intensivos (22,9%), cuidados prestados por equipes externas especializadas (25,0%), um misto dos modelos anteriores, conjugando as duas situações (52,1%). No primeiro modelo, os cuidados eram prestados essencialmente por enfermeiros com especialização em reabilitação e, no segundo, por fisioterapeutas. Não foram encontradas diferenças significativas entre os modelos no que diz respeito à disponibilidade de cuidados, em horas/dia ou dias/semana (p = 0,268 e 0,994 respetivamente), ou a resultados como tempo de internamento em cuidados intensivos, tempo de ventilação ou taxa de mortalidade na unidade (p = 0,418, 0.923 e 0,240 respetivamente). Conclusão: A organização dos cuidados de reabilitação nas unidades de cuidados intensivos portuguesas é singular e heterogênea. Apesar dos diferentes modelos de organização de cuidados, a disponibilidade de horas de cuidados é semelhante, bem como os resultados gerais observados nos doentes.


ABSTRACT Objective: To describe the different rehabilitation care models in practice in Portuguese adult intensive care units. Methods: A simple observational (cross-sectional) study was conducted through an online survey sent to the head nurses or individuals responsible for the 58 adult intensive care units that are part of the database of the Sociedade Portuguesa de Cuidados Intensivos. Results: We identified three models of organization of rehabilitation care: care provided by the staff of the intensive care unit (22.9%), care provided by specialized external teams (25.0%), and a mixture of the previous models, combining the two situations (52.1%). In the first model, the care was provided mainly by nurses with specialization in rehabilitation and, in the second model, the care was provided by physiotherapists. No significant differences were found between the models regarding the availability of care, in hours/day or days/week (p = 0.268 and 0.994, respectively), or results such as length of hospital stay in intensive care, ventilation time, or mortality rate in the unit (p = 0.418, 0.923, and 0.240, respectively). Conclusion: The organization of rehabilitation care in Portuguese intensive care units is unique and heterogeneous. Despite different care organization models, the availability of hours of care is similar, as are the overall results observed in patients.


Subject(s)
Humans , Adult , Rehabilitation/organization & administration , Models, Organizational , Critical Care/organization & administration , Intensive Care Units/organization & administration , Patient Care Team/organization & administration , Portugal , Rehabilitation/methods , Respiration, Artificial/statistics & numerical data , Cross-Sectional Studies , Hospital Mortality , Health Care Surveys , Critical Care/methods , Length of Stay
16.
Singapore medical journal ; : 642-646, 2018.
Article in English | WPRIM | ID: wpr-773453

ABSTRACT

INTRODUCTION@#Postgraduate medical education in Singapore underwent a major transition recently, from a British-style system and accreditation to a competency-based residency programme modelled after the American system. We aimed to identify the relative importance of factors influencing the choice of sponsoring institution (SI) for residency among medical students during this transition period.@*METHODS@#A questionnaire-based cross-sectional study of Singapore undergraduate medical students across all years of study was performed in 2011. Participants rated the degree of importance of 45 factors (including research, academia and education, marketing, reputation of faculty, working conditions, posting experience and influence by peers/seniors) to their choice of SIs on a five-point Likert scale. Differences in gender and seniority were compared.@*RESULTS@#705 out of 1,274 students completed the survey (response rate 55.3%). The top five influencing factors were guidance by mentor (4.48 ± 0.74), reputation for good teaching (4.46 ± 0.76), personal overall experience in SI (4.41 ± 0.88), quality of mentorship and supervision (4.41 ± 0.75), and quality and quantity of teaching (4.37 ± 0.78). The five lowest-rated factors were social networking (2.91 ± 1.00), SI security (3.01 ± 1.07), open house impact (3.15 ± 0.96), advertising paraphernalia (3.17 ± 0.95) and research publications (3.21 ± 1.00). Female students attributed more importance to security and a positive working environment. Preclinical students rated research and marketing aspects more highly, while clinical students valued a positive working environment more.@*CONCLUSION@#Quality of education, mentorship, experiences during clerkship and a positive working environment were the most important factors influencing the choice of SI.


Subject(s)
Accreditation , Cross-Sectional Studies , Curriculum , Education, Medical, Graduate , Economics , Education, Medical, Undergraduate , Economics , Female , Humans , Internship and Residency , Male , Mentors , Models, Organizational , Schools, Medical , Singapore , Students, Medical , Surveys and Questionnaires , United States , Universities
17.
Ciênc. Saúde Colet ; 23(10): 3123-3132, Out. 2018.
Article in Portuguese | LILACS | ID: biblio-974678

ABSTRACT

Resumo Este artigo trata dos desafios em saúde enfrentados pelas sociedades contemporâneas, na qual atores com interesses diversos e às vezes antagônicos se enfrentam para a constituição de uma agenda pública de cuidados da população. Neste campo, o moderno Estado de Bem-estar social joga um papel importante, não somente enquanto executor da agenda pública, mas igualmente garantidor na provisão de serviços. Neste ensaio trabalharemos com o conceito de governança, que busca refletir sobre as novas práticas de governo na modernidade tardia, incorporando a complexa relação entre atores, em um arranjo onde ingredientes como participação popular e controle social dos negócios públicos são colocados em destaque. A temática redes é introduzida enquanto instrumento para a compreensão do fenômeno da governança. o conceito de governança em saúde é construído para dar conta de fenômenos recentes dos arranjos organizacionais da gestão pública, principalmente do fato de que entram em cena novos atores. Não é mais possível ter um retrato próximo da realidade se utilizarmos os modelos de análise organizacional tradicionais. Temos que incorporar outros instrumentos teórico-metodológicos, e cremos que a análise de redes sociais é um importante aliado para a compreensão desta complexa realidade.


Abstract This paper addresses the health challenges of contemporary societies, where stakeholders with diverse, and sometimes antagonistic interests, are faced with the establishment of a public agenda for the health care of the population. In this field, the modern welfare state plays an important role, not only as an implementing agent of the public agenda but also as a guarantor in the provision of services. In this essay, we will explore the concept of governance, which seeks to analyze the new governance practices in late modernity, incorporating the complicated relationship among stakeholders, in a scheme where ingredients such as popular participation and social control of public affairs are put to the fore. The theme of networks is introduced as an instrument for understanding the phenomenon of governance. The concept of health governance is constructed to explain the phenomena of new organizational schemes of public management, especially from the fact that new actors enter the stage. It is no longer possible to have a close picture of reality by using traditional organizational analysis models. It is essential to incorporate other theoretical-methodological instruments, and we believe that the analysis of social networks is an essential tool for understanding this complex reality.


Subject(s)
Humans , Models, Organizational , Delivery of Health Care/organization & administration , Social Networking , Social Control, Formal , Government Regulation
18.
Rev. chil. pediatr ; 88(6): 723-729, dic. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-900043

ABSTRACT

Resumen Introducción: Los pacientes pediátricos con recomendaciones especiales de vacunación son una po blación creciente. El Ministerio de Salud de Chile posee un programa de vacunación especial para estos casos, al cual nuestro hospital gestiona solicitudes de vacunas a través de un flujograma esta blecido. Objetivo: Describir los resultados del modelo de gestión de vacunas especiales, marzo de 2015 a septiembre de 2016, y caracterizar a la población beneficiada por este programa. Pacientes y Método: Estudio observacional, descriptivo. Incluye a la población de pacientes crónicos atendidos en el Hospital Dr. Exequiel González Cortés (HEGC) con vacunas solicitadas al programa ministerial de vacunas especiales, período marzo 2015 a septiembre 2016. La información se obtuvo de las bases de datos de los registros de solicitudes y monitorización de los esquemas especiales de vacunas del Programa Nacional de Inmunizaciones (PNI). Los pacientes se clasificaron en crónicos ambulato rios, ambulatorios y hospitalizados. Para la caracterización clínica y demográfica se describieron las variables de edad, sexo, previsión de salud, especialidad médica que solicitó la vacuna, cronicidad y vacunas administradas. Para medir los resultados del modelo de gestión de vacunas especiales se utilizaron indicadores: Autorización de esquema de vacunación por el PNI, Esquemas de vacunación completados, Tiempo de repuesta del PNI y Oportunidad de vacunación. Resultados: Se gestionaron un total de 367 esquemas de vacunas a 215 pacientes, administrándose en el período un total de 405 vacunas. Las especialidades que más solicitaron fueron infectología (39,1%), inmuno-reumatología (24,2%) y broncopulmonar (20%). El Programa Nacional de Inmunizaciones autorizó el 97,8% de los esquemas solicitados (n = 359), el tiempo de respuesta desde la solicitud hasta la respuesta del Programa Nacional de Inmunizaciones tuvo una mediana de 15 días (rango 0-174 días), la oportu nidad de vacunación tuvo una mediana de 41 días (rango 0-287 días) y el total de esquemas com pletados al momento de tabular los resultados fue de 52,8%. Conclusiones: Las vacunas son una de las principales políticas de equidad en salud pública y en Chile existe un flujograma para solicitud de vacunas especiales, que requiere de un trabajo multidisciplinario para otorgarle cobertura a esta población infantil vulnerable.


Abstract Introduction: Special vaccines recommendation patients are a growing population. The Ministry of Health has developed a special vaccination program for these cases, through which our hospital manages vaccine forms by an established flowchart. Objective: To describe the special vaccines model of management results in the period between March 2015 and September 2016, and the clinical and demographics characterization of the pediatric population benefited with this program in Dr. Exe-quiel González Cortés Children's Hospital. Patients and Methods: We performed a descriptive ob servational study, which covers the chronically ill patient's population who received special vaccines during the period between March 2015 to September 2016. Results: A total of 367 vaccine schemes were administered to 215 patients, with a total of 405 vaccines administered during the period. The medical specialties that most requested vaccines were infectology (39.1%), immune-rheumatology (24.2%) and bronchopulmonary specialists (20%). The National Immunization Program authorized 97.8% of the requested schemes (n = 359), the response time had a median of 15 days (range 0-174 days), the vaccination opportunity had a median of 41 days (range 0-287 days) and the total of sche mes completed at the time of tabulating the results was 52.8%. Conclusions: Vaccines are one of the main public health equity policies and Chile has special vaccines request flowchart a flow chart, which requires a multidisciplinary work to provide coverage to this vulnerable child population.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Vaccines , Immunization Programs/organization & administration , Program Evaluation , Chile , Chronic Disease , Models, Organizational , Immunization Programs/statistics & numerical data , Hospitals, Pediatric/organization & administration , Hospitals, Pediatric/statistics & numerical data
19.
Ciênc. Saúde Colet ; 22(8): 2487-2499, Ago. 2017. tab
Article in Portuguese | LILACS | ID: biblio-890410

ABSTRACT

Resumo Este artigo apresenta a aplicação de um protocolo de indicadores para a avaliação da capacidade de gestão do Componente Especializado da Assistência Farmacêutica (CEAF) em um estado do Sul do Brasil. A escolha do referencial teórico de capacidade de governo de Carlos Matus, refletido no conceito de capacidade de gestão e de gestão da assistência farmacêutica, tem por base a necessidade de superar a fragmentação e a redução tecnicista imposta à área. A aplicação do protocolo envolveu a coleta de dados em 74 unidades (municipais ou estaduais). Os resultados das análises indicam que a capacidade de gestão necessita de avanços nas três dimensões avaliadas, principalmente em relação aos aspectos que visam à sustentabilidade da gestão. O modelo e o protocolo utilizados trazem avanços para a gestão da assistência farmacêutica ao propor uma mudança do foco técnico-logístico, para as ações de natureza estratégica e política, ou que fomentem maior participação e autonomia. De posse dos resultados poder-se-á desenvolver estratégias para a qualificação do acesso a medicamentos no SUS, no sentido de que o CEAF se torne capaz de garantir a integralidade dos tratamentos medicamentosos.


Abstract This paper presents application of an indicator protocol to assessment of current levels of governance capacity of the Specialized Component of Pharmaceutical Services (CEAF) in a state of the South of Brazil. We chose the theoretical referential of 'governance capacity' proposed by Carlos Matus, which reflects in the concepts of management capacity and pharmaceutical service management, due to the perception of a need to overcome the fragmentation and technicist reductionism that we believe has been imposed on the area of pharmaceutical services. Data was collected using the protocol in 74 municipal or state units. The results of the analysis indicate that the currently existing governance capacity needs improvement in all three dimensions that were evaluated, principally in relation to the aspects that seek sustainability of the governance. The model and the protocol used indicate a way forward for governance of pharmaceutical service by proposing a change from the technicist-logistical focus to an emphasis on strategic and political actions, or ones which foster greater participation and autonomy. With these results in hand, it will be possible to develop strategies for improvement of access to medicines in the SUS, in the sense that the CEAF becomes able to guarantee integrality of medicines treatments.


Subject(s)
Humans , Pharmaceutical Services/organization & administration , Capacity Building , National Health Programs/organization & administration , Politics , Brazil , Cross-Sectional Studies , Models, Organizational , Health Services Accessibility
20.
Cienc. Trab ; 19(59): 95-104, ago. 2017. tab, graf
Article in Spanish | LILACS | ID: biblio-890077

ABSTRACT

RESUMEN Ante los desafíos que plantea hacer a las empresas sustentables con responsabilidad social, es necesario desarrollar procesos de mejora basados en una gestión integral con impactos medibles en los resul tados de calidad, productividad, salud y seguridad en el trabajo, el cuidado del medio ambiente y la cultura de protección civil. Para estas materias existen lineamientos internacionales y marcos jurí dicos nacionales que cumplir, los cuales establecen la metodología para reconocer, evaluar y controlar los factores de riesgo de todo tipo en el lugar de trabajo y para la comunidad. Este documento presenta un modelo de gestión integral para la sustentabilidad de las organizaciones desde la perspectiva de la salud y la seguridad en el trabajo sin limitarse a ellas: se denomina SSeTGIS; es holísti-co, multidisciplinar, centrado en las personas, preferentemente participativo, el cual se desarrolla como un proceso de ciclos de mejora continua en tres niveles de actuación: individual, lugar de trabajo y organizacional. Se exponen los argumentos, los propósi tos, los componentes, el proceso y la metodología, así como algunas notas de su aplicación.


ABSTRACT Faced with the challenges of making sustainable companies with social responsibility, it is necessary to develop improved processes based on comprehensive management with measurable impacts on the results of quality, productivity, health and safety at work, envi ronmental care and culture of civil protection. These subjects for which international guidelines and national legal frameworks exist for their fulfillment, establish the methodology for recognizing, evaluating and controlling all kinds of risk factors in the workplace and for the community. This document presents a model of integral management for the sustainability of organizations from the per spective of health and safety at work without limiting to them, referred to as SSeTGIS. It is holistic, multidisciplinary, people-cen tered, and preferably participatory. It is developed as a process of cycles of continuous improvement in three levels of performance: individual, workplace and organizational. The arguments, the pur poses, the components, the process and the methodology are pre sented as well as some notes of their application.


Subject(s)
Humans , Organizations/organization & administration , Occupational Health , Safety Management , Models, Organizational , Efficiency
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