Innovation in nursing health care practice: expansion of access in primary health care.

OBJECTIVE:: analyze the reorganization of the health care practice of nurses as an innovative strategy for expansion of access in primary care. METHOD:: qualitative and quantitative study, which interviewed 32 management and care nurses and collected documentary data from public reports of production of nursing consultations from 2010 to 2014, in a municipality in southern Brazil. Data processing for textual analysis was performed by IRAMUTEQ software; for simple descriptive statistical analysis, the program Excel 2013 was used. RESULTS:: in the innovative care practice  class, associated with awareness of change, related to implementation of the FHS, its challenges and advantages, the following subclasses were identified: reorganization of schedules, nursing consultation, physical restructuring of BHUs, and shared consultation. FINAL CONSIDERATIONS:: the need to expand access to and valorization of care practice encourages the development of innovative strategies. The protagonism of care needs to be discussed in the various spaces so that each professional carry out the respective role with competence and efficacy. OBJETIVO:: analisar a reorganização da prática assistencial do enfermeiro como estratégia inovadora para ampliação do acesso na atenção primária. MÉTODO:: estudo qualiquantitativo, tendo sido entrevistados 32 enfermeiros gerenciais e assistenciais e coletados dados documentais de relatórios públicos de produção de consultas dos enfermeiros de 2010 a 2014, num município sul-brasileiro. O processamento dos dados para análise textual foi realizado pelo software IRAMUTEQ; para análise estatística descritiva simples, o programa Excel 2013. RESULTADOS:: na classe prática assistencial inovadora, associada à sensibilização para a mudança, relacionada à implantação da ESF, seus desafios e fortalezas, foram identificadas as subclasses: reorganização das agendas, consulta do enfermeiro, reestruturação física das UBS e consulta compartilhada. CONSIDERAÇÕES FINAIS:: a necessidade de ampliar o acesso e valorização da prática assistencial incentiva o desenvolvimento de estratégias inovadoras. O protagonismo do cuidado precisa ser discutido nos diversos espaços a fim de que cada profissional desempenhe seu papel com competência e resolutividade.

[Specialized outpatient care in the Unified Health System: how to fill a void]. / Atenção especializada ambulatorial no Sistema Único de Saúde: para superar um vazio.

The structuring of specialized outpatient care is a bottleneck in the operation of the Unified Health System. Based on a brief discussion about this void in an organizational model, we propose the federal induction of a format of specialized services from the experiences of Centers of Support for Family Health (NASF). They adapted matrix operations and constitute an excellent prototype for the organization of specialized outpatient care. It allows for equal access and maximum proximity to the specialized care of the reality of primary care users, the personal relationship and the close relationship between the family health teams and medical and non-medical specialists, enabling mutual lifelong learning, negotiated regulation and increased efficacy of primary care. Municipal experiences of Florianopolis and Curitiba are synthesized as partial examples of the proposal. the structure of care in mental health of Florianópolis, all organized as a matrix support is briefly described; and we focus on the change in the action of the support teams of Curitiba, which gradually began to engage, involve and mediate the relationship between basic and specialized care. This format can be expanded to most medical specialties.

A medicina de família e comunidade revista / La Medicina Familiar y Comunitaria revisada / The Family and Community Medicine revised

Assumimos como editores da Revista Brasileira de Medicina de Família e Comunidade (RBMFC) há quase um ano. Nesse período tentamos implementar uma reforma na gestão para que a Revista ganhasse em eficiência. Ao mesmo tempo, modificamos alguns fluxos, fornecedores, secretaria e escopo.

We have assumed as editors of the Brazilian Journal of Family and Community Medicine (RBMFC) for almost a year. During this period we have tried to implement a management reform in order to gain efficiency. At the same time, we modified some flows, suppliers, office and scope.

Asumimos como editores de la Revista Brasileña de Medicina de Familia y Comunitaria (RBMFC) hace casi un año. Durante este período tratamos de poner en práctica una reforma de la gestión para el aumento de la eficiencia. Al mismo tiempo, hemos modificado algunos flujos, los proveedores, la oficina y el alcance.