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Advisor(s)
Abstract(s)
Considerando-se os Centros de Responsabilidade como um novo modelo de gestão e organização, estes devem ser avaliados segundo um percurso histórico enquadrado no contexto da evolução do Sistema Nacional de Saúde.
Os Centros de Responsabilidade surgem na sequência das reformas do Sistema Nacional de Saúde. Constituem um nível intermédio de gestão com o objetivo de aproximar os órgãos hierárquicos superiores ao centro operacional, funcionando como um micro hospital dentro do macro hospital. Perante a reconfiguração dos serviços em Centros de Responsabilidade que representam uma reestruturação ao nível da gestão, toda a organização institucional será desafiada a uma mudança de cultura e esta deve fazer com que os profissionais participem e se envolvam na missão da instituição e na mudança, de forma a atingir os objetivos propostos.
Neste contexto e verificando-se a escassez de informação sobre os Centros de Responsabilidade, pretende-se analisar o conhecimento científico disponível sobre este modelo de gestão e através de uma Revisão Sistemática da Literatura sem metanálise, responder à questão de investigação deste estudo: Quais as estratégias identificadas pelos profissionais de saúde para a implementação efetiva dos Centros de Responsabilidade? Desta análise emergiram os objetivos de investigação:
- Identificar os fatores que contribuem para a implementação efetiva dos Centros de Responsabilidade;
- Identificar possíveis limitações na implementação efetiva dos Centros de Responsabilidade;
- Elaborar um modelo de referência que agrupe um conjunto de orientações para a criação e implementação de um Centro de Responsabilidade.
A partir do método PI[C]O: Participantes; Intervenções; [Comparações]; Outcomes, foi definido as palavras-chave, selecionados os critérios de inclusão e exclusão e assim, realizada uma pesquisa de artigos científicos em base de dados eletrónica no período entre 1997 e 2012, dos quais obtiveram-se 6 estudos.
Após reflexão da informação científica recolhida para este estudo, pode concluir-se que os Centros de Responsabilidade representam um modelo de gestão efetivo, quando são implementados através de um plano estratégico, com uma equipa responsável pela mudança e tendo em conta que o tipo de comunicação e a participação dos profissionais constitui um fator determinante para o sucesso de uma mudança. Em todos os estudos descrevem-se algumas orientações comuns à criação dos Centros de Responsabilidade, o que conduziu à elaboração de um modelo de referência que agrupa um conjunto de indicações para a formação de futuros Centros de Responsabilidade, visando-se o sucesso e a eficiência da mudança.
The Responsibility Centers being considered as a new model of management and organization should be evaluated taking into account a historical set in the context of the evolution of the National Health System. The Responsibility Centers are the result of the National Health System reforms. They constitute an intermediate level of management with the goal of bringing the higher hierarchical bodies to the operational centre, working as a micro hospital within a macro one. With the reconfiguration of services in Responsibility Centers that represent a restructuring at the management level, the entire institutional organization will be challenged to a culture change and this should cause professionals to participate and engage in the mission of the institution and in the change in order to achieve the proposed objectives. In this context and verifying the lack of information about the Responsibility Centers, it is intended through a Systematic Review of the Literature without meta-analysis, analyze the available scientific knowledge on this management model in order to answer the research question of this study: What strategies are identified by health professionals for the effective emplementation of the Responsibility Centers. This analysis revealed the following research goals: - Identify the factors that contribute to the effective implementation of Responsibility Centers; - Identify pontential limitations on the effective implementation of Responsibility Centers; - Develop a reference model that groups a set of guidelines for the creation and implementation of a Responsibility Center. From the PI[C]O method: Participants, Interventions, [Comparisons]; Outcomes, keywords were defined, the criteria for inclusion and exclusion were selected and thus a survey of scientific papers on the basis of electronic data collected between 1997 and 2012 was conducted giving origin to six studies. After consideration of scientific information collected for this study, it can be concluded that the Responsibility Centers are an effective management model, when implemented through a structural process with a team responsible for the change and taking into account that the type of communication and the participation of professionals are a key factor for the success of a change. In all studies are described some common orientations for the creation of Responsibility Centers, which led to the development of a reference model that brings together some guidelines for the formation of future Responsibility Centers leading at the success and efficiency of change.
The Responsibility Centers being considered as a new model of management and organization should be evaluated taking into account a historical set in the context of the evolution of the National Health System. The Responsibility Centers are the result of the National Health System reforms. They constitute an intermediate level of management with the goal of bringing the higher hierarchical bodies to the operational centre, working as a micro hospital within a macro one. With the reconfiguration of services in Responsibility Centers that represent a restructuring at the management level, the entire institutional organization will be challenged to a culture change and this should cause professionals to participate and engage in the mission of the institution and in the change in order to achieve the proposed objectives. In this context and verifying the lack of information about the Responsibility Centers, it is intended through a Systematic Review of the Literature without meta-analysis, analyze the available scientific knowledge on this management model in order to answer the research question of this study: What strategies are identified by health professionals for the effective emplementation of the Responsibility Centers. This analysis revealed the following research goals: - Identify the factors that contribute to the effective implementation of Responsibility Centers; - Identify pontential limitations on the effective implementation of Responsibility Centers; - Develop a reference model that groups a set of guidelines for the creation and implementation of a Responsibility Center. From the PI[C]O method: Participants, Interventions, [Comparisons]; Outcomes, keywords were defined, the criteria for inclusion and exclusion were selected and thus a survey of scientific papers on the basis of electronic data collected between 1997 and 2012 was conducted giving origin to six studies. After consideration of scientific information collected for this study, it can be concluded that the Responsibility Centers are an effective management model, when implemented through a structural process with a team responsible for the change and taking into account that the type of communication and the participation of professionals are a key factor for the success of a change. In all studies are described some common orientations for the creation of Responsibility Centers, which led to the development of a reference model that brings together some guidelines for the formation of future Responsibility Centers leading at the success and efficiency of change.
Description
Keywords
Centros de responsabilidade Hospital Profissionais de saúde Mudança organizacional Responsibility centers Health professionals Organizational change