0080/2016 - Tomada de decisão e alta administração: a implantação de projetos de mudanças de gestão da clínica em hospitais do SUS Decision-making and senior management: the implementation of clinical management of change projects in SUS hospitals
O presente artigo analisa a tomada de decisão da alta administração de hospitais públicos do Sistema Único de Saúde (SUS) em relação a projetos que foram elaborados com a intencionalidade de mudar a gestão da clínica. O desenho metodológico é de natureza qualitativa, baseado na perspectiva hermenêutica-dialética. Em termos de resultados, destaca-se que os diretores dos hospitais perceberam que os projetos de gestão da clínica mudaram a realidade hospitalar, aprimorando sua organização, mobilizando seus servidores no sentido de ordenar e sistematizar as ações e os recursos disponíveis. A racionalidade técnica foi a principal fundamentação presente nas tomadas de decisão dos gestores, apesar de, por vezes, os contextos organizacionais fragmentados impedirem a utilização de outros aspectos relacionados com a racionalidade, como a análise econômico-financeira. O modelo incremental e o político também se manifestaram nos discursos. Conclui-se que a tomada de decisão é prática de enorme dimensão que contempla aspectos racionais, como uso de técnicas de gestão e da capacidade de análise, interpretação e síntese, e aspectos subjetivos, como seleção de valores e vivências pessoais, visto que os problemas gerenciais são mais amplos, ambíguos, complexos e menos estruturados na prática.
Palavras-chave:
Tomada de decisões
Diretores de hospitais
Gestão da clínica
Gestão hospitalar
Abstract:
This article analyzes the decision making of top managers of public hospitals of the Unified Health System (SUS) with respect to projects that were developed with the intention to change the clinical governance. The methodological design is qualitative in nature, based on the hermeneutic-dialectic perspective. The results show that, in view of the hospitals directors studied, the clinical governance projects turned the hospital reality, improving its organization, mobilizing their servers in order to organize and systematize the actions and the resources available, besides having occurred an advance in administrative efficiency. The technical rationality was the main rationale in decision-making by these managers, although sometimes fragmented organizational settings prevent the use of other aspects of rationality, such as economic and financial analysis. The incremental model as well the political were expressed in the speeches. The conclusion is that decision-making is a huge sized practice that includes rational aspects such as use of management techniques and analysis skills, interpretation and synthesis, and subjective aspects, such as selection of values and personal experiences, as the problems management are broader, ambiguous, complex and less structured in practice.
Decision-making and senior management: the implementation of clinical management of change projects in SUS hospitals
Resumo (abstract):
This article analyzes the decision making of top managers of public hospitals of the Unified Health System (SUS) with respect to projects that were developed with the intention to change the clinical governance. The methodological design is qualitative in nature, based on the hermeneutic-dialectic perspective. The results show that, in view of the hospitals directors studied, the clinical governance projects turned the hospital reality, improving its organization, mobilizing their servers in order to organize and systematize the actions and the resources available, besides having occurred an advance in administrative efficiency. The technical rationality was the main rationale in decision-making by these managers, although sometimes fragmented organizational settings prevent the use of other aspects of rationality, such as economic and financial analysis. The incremental model as well the political were expressed in the speeches. The conclusion is that decision-making is a huge sized practice that includes rational aspects such as use of management techniques and analysis skills, interpretation and synthesis, and subjective aspects, such as selection of values and personal experiences, as the problems management are broader, ambiguous, complex and less structured in practice.
Pacheco, José Márcio da Cunha, Gomes, R. Tomada de decisão e alta administração: a implantação de projetos de mudanças de gestão da clínica em hospitais do SUS. Cien Saude Colet [periódico na internet] (2016/fev). [Citado em 23/12/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/tomada-de-decisao-e-alta-administracao-a-implantacao-de-projetos-de-mudancas-de-gestao-da-clinica-em-hospitais-do-sus/15502?id=15502
