Collective and decentralized management model in public hospitals: perspective of the nursing team

Bernardes, Andréa; Cecílio, Luiz Carlos de Oliveira; Évora, Yolanda Dóra Martinez; Gabriel, Carmen Silvia; Carvalho, Mariana Bernardes de

doi:10.1590/s0104-11692011000400020

Cited by 16 publications

(28 citation statements)

References 10 publications

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“…This study complements the only one published in this Journal in the last two years related to the Decentralized Management Model which focused mostly on the advances of this implementation (10) . The principals need to be decided on as a group, and then the teams need to identify how they will put into practice a particular value in the workplace.…”

Section: Limitations and Strengthsmentioning

confidence: 74%

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Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital

Bernardes

Cummings

Évora

et al. 2012

Rev. Latino-Am. Enfermagem

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Objective: This study aims to address difficulties reported by the nursing team during the process of changing the management model in a public hospital in Brazil. Methods: This qualitative study used thematic content analysis as proposed by Bardin, and data were analyzed using the theoretical framework of Bolman and Deal. Results: The vertical implementation of Participatory Management contradicted its underlying philosophy and thereby negatively influenced employee acceptance of the change. The decentralized structure of the Participatory Management Model was implemented but shared decision-making was only partially utilized. Despite facilitation of the communication process within the unit, more significant difficulties arose from lack of communication inter-unit. Values and principals need to be shared by teams, however, that will happens only if managers restructure accountabilities changing job descriptions of all team members. Conclusion: Innovative management models that depart from the premise of decentralized decision-making and increased communication encourage accountability, increased motivation and satisfaction, and contribute to improving the quality of care. The contribution of the study is that it describes the complexity of implementing an innovative management model, examines dissent and intentionally acknowledges the difficulties faced by employees in the organization. Enmarcando las dificultades de la aplicación del Modelo de Gestión Participativa en un hospital públicoObjetivo: El estudio tiene como objetivo tratar de las dificultades del equipo de enfermería durante el cambio del modelo de gestión en un hospital público en Brasil. Método: Este estudio cualitativo utilizó el análisis de contenido temático propuesto por Bardin; los datos fueron analizados utilizando el marco teórico de Bolman y Deal. Resultados: La aplicación vertical de la Gestión Participativa, en contradicción con su filosofía, incide negativamente en la aceptación del cambio por los empleados. La estructura descentralizada se llevó a cabo, pero la toma de decisiones compartida se utilizó sólo en parte. Aunque existe facilitación de la comunicación dentro de la unidad, dificultades surgieron de la falta de comunicación inter-unidades.Valores y principios deben ser compartidos por los equipos; esto sólo ocurre si los gerentes reestructurar las responsabilidades y describir las funciones de todos. Conclusión: Modelos innovadores de gestión que tienen como premisa la descentralización de las decisiones y una mayor comunicación fomentan la motivación, la responsabilidad, aumento de la satisfacción, y mejoran la calidad de la atención. La contribución de este estudio se centra en la complejidad de la implementación de una gestión innovadora, el análisis de disenso e intencionadamente en el reconocimiento de dificultades que enfrentan los empleados de la organización. in this context occasionally distance themselves from the care provided to patients. This can work against the nurses' role as professional practitioners who int...

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Section: Limitations and Strengthsmentioning

confidence: 74%

“…Although the need to change the management model from a centralized to a participatory and decentralized model is acknowledged in Brazil, overcoming barriers to implementation is not easy (9)(10) , particularly when the organization has invested in top-down communication, as well as the centralization of power and decision-making.…”

Section: Introductionmentioning

confidence: 99%

Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital

Bernardes

Cummings

Évora

et al. 2012

Rev. Latino-Am. Enfermagem

Self Cite

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“…In addition to planning the delivery of services to patients, health care professionals and policies makers should seek ways to improve communication within and across health care institutions and decide on the frequency of such communication [55]. With the increase in electronics these institutions can create tools to leverage the technology to improve the exchange of information more efficiently.…”

Section: Discussionmentioning

confidence: 99%

“…With the increase in electronics these institutions can create tools to leverage the technology to improve the exchange of information more efficiently. Kingston Public hospital is a national referral trauma centre, which is the case in other nations [55], and it for this reason why information is critical to effective health care management. This study, therefore, provides germane information from an empirical perspective on the matter of patient-sharing between Kingston Public and Spanish Town hospitals that can be used for policy and research framework.…”

Section: Discussionmentioning

confidence: 99%

Substitution and Complementary Effects of Hospitalizations in Jamaica: an Analysis of Spanish Town and Kingston Public Hospitals

Bourne¹

2016

J Healthc Commun

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Background and purpose: Despite significant medical and public health advances in Jamaica all too often health care planning lacks the flexibility to respond appropriately to the increased and varied demand of the population due to inadequate or inaccurate information. The accuracy of the information is pertinent to forward effective changes in the health care arena, which is instrumental in the coordination of care leading to cost reduction in health care management. This study sought to investigate: 1) Probabilities of hospitalization at two government hospitals in Jamaica; 2) Elasticities of hospitalization between two government hospitals in Jamaica; 3) Response-ability of patient-sharing between two government hospitals in Jamaica; and 4) The dual effect of patient-sharing in two government hospitals in Jamaica.

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“…and, also, that staff performance management is a tool to increase productivity and a quality service (10)(11) .…”

Section: Dimensioning From the Nursing Professionals' Point Of View Amentioning

confidence: 99%

Nursing care practices at an outpatient care center from an integrative perspective

Pinto

Marciliano²,

Zacharias³

et al. 2012

Rev. Latino-Am. Enfermagem

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Aim: to analyze nursing care practices at a Specialized Outpatient Care Center from the perspective of an integrative health care activity. Method: Interviews with 24 nursing professionals were undertaken. For data analysis, Thematic Content Analysis as proposed by Bardin was applied, resulting in the following themes: the team size and its commitment to health care; professional practices and activity of the nursing team. Results: The size of the nursing team was considered insufficient, which compromises the quality of care and results in work overload and dissatisfaction of the nursing professionals. On the other hand, they were satisfied with the tasks performed day-to-day and related integrality to individual care, considered it essential and usually practiced it daily. Conclusion: It is considered that the nursing team has the potential and commitment to develop their care practice combined with the integrative perspective, and therefore providing quality health care to the population. Las prácticas de enfermería en un ambulatorio en la perspectiva de la integralidadObjetivo: analizar las prácticas de Enfermería en un ambulatorio de especialidades, en la perspectiva de la integralidad de las acciones en salud. Método: Fueron realizadas entrevistas con 24 profesionales de enfermería. Para análisis de los datos se utilizó el análisis de contenido, llegando a los temas: el dimensionamiento y comprometimiento con el servicio de salud; actividades y las prácticas del equipo de enfermería. Resultados:Con relación a lo dimensionamiento, fue revelado que el equipo es insuficiente, comprometiendo la asistencia de calidad, resultando en sobrecarga y descontentamiento de los profesionales. Sin embargo, las personas se mostraran satisfechas con las tareas practicadas en el cotidiano, relacionando la integralidad al cuidado individual, percibido por los profesionales como esencial y, comúnmente, practicado en su cotidiano. Conclusión: se considera que el equipo de enfermería tiene potencialidad y comprometimiento para desarrollar su práctica articulada con el principio de la integralidad, atendiendo las necesidades de salud de la población con calidad de la asistencia. respectable, receptive and bonding. These meanings are similar to the idea of integrality used herewith: a plural term, ethical and democratic (1) .Integrality is the second essential guideline of the SUS (2) . The development and implementation of this guideline, as an attribute, will result in a change in the care model and may be the biggest challenge for the health sector in Brazil in present times (3) .It is known that a work team whose care is based on an integrative perspective must be capable of identifying the disease causing the pain, providing immediate response to the pain and recognizing the need for other interventions related to the promotion of good health and the prevention of diseases, that is, integrality is obviously distinguished by the care applied to the patients' needs (4) . Health care, when directed and organized by integrality...

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Collective and decentralized management model in public hospitals: perspective of the nursing team

Cited by 16 publications

References 10 publications

Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital

Framing the difficulties resulting from implementing a Participatory Management Model in a public hospital

Substitution and Complementary Effects of Hospitalizations in Jamaica: an Analysis of Spanish Town and Kingston Public Hospitals

Nursing care practices at an outpatient care center from an integrative perspective

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