Modelo de gestão hospitalar: estudo de caso do Hospital Risoleta Tolentino Neves

Abstract

Introduction: building management models based on participation, where workers and users act as active subjects, remains a challenge, and it is essential to reveal the factors that impact the "misalignment" between the macroinstitutional definitions and the way to perform the management in the meso and micropolitical dimensions, focusing on what is defined and practiced in the institution. They are adopted as research questions: how is the management model of Risoleta Tolentino Neves Hospital (HRTN) configured? What are the intervening elements in the management model? General objective: to analyze the configuration of the management model of HRTN from the coordinators' perspective. Methodology: this is a qualitative research with the methodological design of a single holistic case study. The research participants were the coordinators of the care and administrative areas of the institution. The sources of evidence were document analysis and individual semi-structured interviews. Data were submitted to Critical Discourse Analysis allowing the discussion of four empirical categories: the prescribed on the HRTN management model: documental analysis; the real: HRTN management model in the participants' discourse; improvement of management tools and the implications for the HRTN management model and facilitators and hindrances of the HRTN management model. Results and discussion: the HRTN management model is described as participatory in institutional documents, however it was possible to find in the dichotomies interviews that made it difficult to advance the practices that promote the decentralization of management. The knowledge of alternative management models is concentrated in macropolitics and its assumptions are not widespread among other social actors. The use of the management tools pointed out by the participants, despite helping them in their daily practice, partially results in the improvement of the participative management model put forth by the institution in its documents. Analyzing the speeches of the interviewees, in general, the access that the coordinators have to the board of directors is a facilitator, while communication issues appear as a hindrance. Conclusion: the assumptions of this dissertation are confirmed from the detection of dissonances between what is defined as institutional principles and values and what happens in practice regarding the current management model in the HRTN.