Os ruídos encontrados na construção de um modelo democrático e participativo de gestão hospitalar

Abstract

Os ruídos encontrados na construção de um modelo democrático e participativo de gestão hospitalarObstacles found in the construction of a democratic and participatory hospital management model

Decision-making of the nursing team after the revitalization of a decentralized management model

“…We believe that to achieve the ideal of this managerial model, each member of the collective needs to have a desire to participate, abdicating the individual role to become a "team member", that is, enable accountability. For that, however, these individuals need to manifest interest in the change and, more importantly, need to absorb the assumptions that guide this model, 3,6,23 a fact that did not occur after revitalization in the institution under study.…”

“…2 In the current context, the complexity of the hospital itself and the hospital routine, marked by conflicting interests, has indicated a need for a theoretical framework to aid thinking on hospital micro politics, such as experimenting news management strategies. 3 Certain organizational structures imply certain management models, and consequently, new distribution of power, authority, communication and decision-making. Contemporary management models have indicated a need to intensify communication and to make both the decision-making process and the distribution of power more flexible.…”

Representações sociais do processo de escolha de chefias na perspectiva da equipe de enfermagem

“…The adop on of management models directed towards a par cipatory, shared or collegiate culture, points to a transforma on in our environment, where there are s ll many obstacles to be overcome to eff ec vely democra ze the power rela onships that exist in the healthcare organiza ons. This is par cularly relevant to the hospital, which s ll reproduces a management model anchored in the tradi onal assump ons of administra on with power and decision making concentrated among the nurses (6) .…”

“…At present, the hospital s ll occupies and cul vates its hegemony over the healthcare ac ons and reproduces an undemocra c management model, which reiterates crystallized labor prac ces that do not favor the emergence of the subjects that can transform the method of managing and performing healthcare (6)(7) . The constant advances and transforma ons in the produc on scenarios of healthcare prac ces, especially in the hospital environment, have an impact on the ways in which the teams organize themselves to provide healthcare and led the professionals to rethink their ac ons and ways of caring, not forge ng that Nursing occupies a central posi on in the healthcare systems and in the care process to the user, this condi on being a prerequisite for the transforma on of reali es (8) .…”

Colegiados de gestão em serviços de saúde: um estudo empírico

“…Em trabalhos anteriores 3,4,5,6 , e com base em estudos empíricos, já havia sido apontado um conjunto de problemas ligados à concepção, organização e funcionamento de colegiados gestores em ambiente hospitalar. Nesses estudos, discutia-se o quanto, na prática, existia uma grande distância entre as formulações originais a respeito dos propósitos e das expectativas postas nos colegiados gestores e o que acontecia quando eles eram operacionalizados, de fato, por exemplo, nos hospitais.…”