0291/2019 - Enfermeiros na operacionalização do Kanban: Novos sentidos para a prática profissional em contexto hospitalar? Nurses in the Kanban: Are there news meanings of professional practice in innovative tools for hospital care management?
O Kanban, uma tecnologia de gestão do cuidado caracterizada pela valorização do trabalho multiprofissional e o uso intensivo da informação, tem sido crescentemente utilizado para enfrentar a superlotação dos serviços de emergência hospitalar (SEH). Pesquisadores acompanharam durante dez meses o Kanban em vários setores de um SEH municipal. Suas observações, registradas em diários de campo, foram discutidos em reuniões quinzenais por um coletivo de pesquisadores. O material empírico foi organizado a partir de duas questões: Há mudanças nas “atribuições tradicionais” da enfermagem atuando no Kanban? Há transformações nas relações interprofissionais entre Medicina e Enfermagem na operacionalização do Kanban? Observou-se forte adesão dos enfermeiros ao arranjo, pari passu com uma maior especialização e fragmentação do seu trabalho. Os diaristas assumem funções administrativas tradicionais da enfermagem, enquanto os plantonistas desenvolvem assistência direta aos pacientes. Os enfermeiros consideram que a decisão clínica ainda é do médico, embora o Kanban propicie sua maior influência na decisão. A gestão de grande massa de dados clínico-operacionais pelos enfermeiros, central na operacionalização do Kanban, reforça sua autoridade profissional.
Palavras-chave:
Enfermagem. Serviços médicos de emergência. Assistência Centrada no Paciente. Kanban. Relações Médico-Enfermeiro.
Abstract:
The Kanban is a tool for care management that values multi-professional work and intensive use of data, and it has been growingly used in Brazil to address overcrowding in hospital emergency services (HES). The researchers monitored the Kanban for ten months in multiple wards of a municipal HES. Their observations, registered in field diaries, were discussed in biweekly meetings in team. The empirical material was organized based on two questions concerning the Kanban’s operationalization: are there changes in nursing “traditional attributions”? And, are there transformations in interprofessional relations between medicine and nursing? Nurses’ strong adhesion to this tool was observed, simultaneous to greater specialization and fragmentation of their work: diarist nurses take more traditional administrative functions, while those on duty develop more direct assistance to patients. Overall, nurses consider that the clinical decision is still in the doctors’ hands, although they also recognize that the Kanban provides them higher influence on such decisions. Their role in the management of great mass of clinic-operational data, which is one of the Kanban’s core aspect, is key to strengthen their professional authority in hospital settings.
Keywords:
Nursing. Emergency medical services. Patient assistance based care. Kanban. Medicine-Nursing relationships.
Nurses in the Kanban: Are there news meanings of professional practice in innovative tools for hospital care management?
Resumo (abstract):
The Kanban is a tool for care management that values multi-professional work and intensive use of data, and it has been growingly used in Brazil to address overcrowding in hospital emergency services (HES). The researchers monitored the Kanban for ten months in multiple wards of a municipal HES. Their observations, registered in field diaries, were discussed in biweekly meetings in team. The empirical material was organized based on two questions concerning the Kanban’s operationalization: are there changes in nursing “traditional attributions”? And, are there transformations in interprofessional relations between medicine and nursing? Nurses’ strong adhesion to this tool was observed, simultaneous to greater specialization and fragmentation of their work: diarist nurses take more traditional administrative functions, while those on duty develop more direct assistance to patients. Overall, nurses consider that the clinical decision is still in the doctors’ hands, although they also recognize that the Kanban provides them higher influence on such decisions. Their role in the management of great mass of clinic-operational data, which is one of the Kanban’s core aspect, is key to strengthen their professional authority in hospital settings.
Palavras-chave (keywords):
Nursing. Emergency medical services. Patient assistance based care. Kanban. Medicine-Nursing relationships.
Cecílio, L.C.O, Chioro, A., Andreazza, R., Spedo, S.M., Cruz, N.L.M, Barros, L.S, Carapinheiro, G., Correia, T.. Enfermeiros na operacionalização do Kanban: Novos sentidos para a prática profissional em contexto hospitalar?. Cien Saude Colet [periódico na internet] (2019/out). [Citado em 31/05/2025].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/enfermeiros-na-operacionalizacao-do-kanban-novos-sentidos-para-a-pratica-profissional-em-contexto-hospitalar/17365?id=17365
