Geschäftsprozesse gelten als kritischer Erfolgsfaktor für die Unternehmensgestaltung und im Kontext der digitalen Transformation als essentielles Werkzeug für die Entwicklung von Informationssystemen. Zur Modellierung von Geschäftsprozessen werden sogenannte Prozessmodellierungssprachen verwendet. Die Ereignisgesteuerte Prozesskette (EPK) ist eine der verbreitetsten Modellierungssprachen und nutzt u.a. Ereignisse, Funktionen und Verbindungselemente, um einen betrieblichen Ablauf als semi-formales Modell abzubilden. Obwohl die Bedeutung und der positive Einfluss vorliegender Geschäftsprozessmodelle auf die Unternehmensgestaltung und den Unternehmenserfolg in Wissenschaft und Praxis dokumentiert sind, steht die Geschäftsprozessmodellierung mit der EPK vor vielfältigen Herausforderungen: Da die EPK bislang kein systematisches Spezifikationsverfahren durchlaufen hat, werden die Modellierungstätigkeiten und der Modellaustausch erschwert wird, wodurch als Konsequenz zunehmend auf andere Modellierungssprachen zurückgegriffen wird. Gleichzeitig leidet die Geschäftsprozessmodellierung an generellen Akzeptanzproblemen: Modellierungssprachen werden immer komplexer, sodass Anwender verstärkt auf rein visuelle, kaum formalisierte Modellierungsformen und grafische Standardsoftware zu Modellierungszwecken zurückgreifen. Auch das Ausbleiben von Innovationssprüngen der Modellierung führt dazu, dass die Akzeptanz und der wahrgenommene Nutzen der Prozessmodellierung in den Hintergrund rücken. Noch immer werden primär statische Desktop-Computer und umfangreiche Software-Systeme zur Prozessmodellierung verwendet, was dem mehr und mehr durch Mobilität und Agilität geprägten Arbeitsalltag der Anwender nicht mehr gerecht wird. Vor dem Hintergrund dieser Herausforderungen ist die Zielsetzung der vorliegenden Forschungsarbeit die Konstruktion und Spezifikation von Modellierungssprachen, die nicht nur für klassischen Arbeitsumgebungen wie Desktop-Computer geeignet sind, sondern auch auf neuartigen, mobilen Endgeräte wie Tablets oder Smart Glasses zur Prozessmodellierung zum Einsatz kommen können. Um die Anwendbarkeit und Zweckmäßigkeit der entwickelten Sprache zu erhöhen, sind dabei insbesondere Anwendungsfall- als auch Technologie-spezifische Anforderungen der Endgeräte berücksichtigen. Eingebettet in einen gestaltungsorientierten Forschungsrahmen werden innerhalb von sechs Einzelbeiträgen in dieser kumulativen Dissertation geeignete Forschungsmethoden der Wirtschaftsinformatik angewandt und sinnvoll verknüpft, um die skizzierte Zielsetzung sukzessive zu adressieren. Die Forschungsarbeit demonstriert die (Weiter-)Entwicklung einer Prozessmodellierungssprache auf Basis der EPK, die insbesondere eine Anwendung innerhalb des mobilen Endgeräts „Smart Glasses“ in den Mittelpunkt rückt. Gleichzeitig wird die Anwendbarkeit der entwickelten Sprachvariante durch die Implementierung innerhalb einer Smart-Glasses-basierten Prozessmodellierungsumgebung unterstrichen.

Context: Process mining is an approach that exploits event logs to discover real processes executed in organizations, enabling them to (re)design and improve process models. Goal modelling, on the other hand, is a requirements engineering (RE) approach mainly used to analyze what-if situations and support decision making. Problem: Common problems with process mining include the complexity of discovered “spaghetti” processes and a lack of goal-process alignment. Current process mining practices mainly focus on activities and do not benefit from considering stakeholder goals and requirements to manage complexity and alignment. The critical artifact that process mining practices rely on is the event log. However, using a raw version of real-life event logs will typically result in process models being too complex, unstructured, difficult to understand and, above all, not aligned with stakeholders’ goals. Method: Involving goal-related factors can augment the precision and interpretability of mined models and help discover better opportunities to satisfy stakeholders. This thesis proposes three algorithms for goal-oriented process enhancement and discovery (GoPED) that show synergetic effects achievable by combining process mining and goal-oriented modelling. With GoPED, good historical experiences will be found within the event log to be used as a basis for inferring good process models, and bad experiences will be found to discover models to avoid. The goodness is defined in terms of alignment with regards to three categories of goal-related criteria: • Case perspective: satisfaction of individual cases (e.g., patient, costumer) in terms of some goals; • Goal perspective: overall satisfaction of some goals (e.g., to decrease waiting time) rather than individual cases; and • Organization perspective: a comprehensive satisfaction level for all goals over all cases. GoPED first adds goal-related attributes to conventional event characteristics (case identifier, activities, and timestamps), selects a subset of cases concerning goal-related criteria, and finally discovers a process model from that subset. For each criterion, an algorithm is developed to enable selecting the best subset of cases where the criterion holds. The resulting process models are expected to reproduce the desired level of satisfaction. The three GoPED algorithms were implemented in a Python tool. In addition, three other tools were implemented to complete a line of actions whose input is a raw event log and output is a subset of the event log selected with respect to the goal-related criteria. GoPED was used on real healthcare event logs (an illustrative example and a case study) to discover processes, and the performance of the tools was also assessed. Results: The performance of the GoPED toolset for various sizes and configurations of event logs was assessed through extensive experiments. The results show that the three GoPED algorithms are practical and scalable for application to event logs with realistic sizes and types of configurations. The GoPED method was also applied to the discovery of processes from the raw event log of the trajectories of patients with sepsis in a Dutch hospital, from their registration in the emergency room until their discharge. Although the raw data does not explicitly include goal-related information, some reasonable goals were derived from the data and a related research paper in consultation with a healthcare expert. The method was applied, and the resulting models were i) substantially simpler than the model dis-covered from the whole event log, ii) free from the drawbacks that using the whole event log causes, and iii) aligned with the predefined goals. Conclusion: GoPED demonstrates the benefits of exploiting goal modelling capabilities to enhance event logs and select a subset of events to discover goal-aligned and simplified process models. The resulting process model can also be compared to a model discovered from the original event log to reveal new insights about the ability of different forms of process models to satisfy the stakeholders’ goals. Learning from good behaviours that satisfy goals and detecting bad behaviours that hurt them is an opportunity to redesign models, so they are simpler, better aligned with goals, and free from drawbacks that using the whole event log may cause.

This thesis describes the research carried out to identify mechanisms as potential causes of action that can lead to improved learning outcomes. Identifying mechanisms requires an exploratory approach because mechanisms are not always directly perceivable. The potential mechanisms in this study were identified by analysing the reflections of students who participated in experiential learning projects during business process management education. The research was necessary due to a persistent need to minimise the gap between learning and practice. The research is unique because it takes a student-dominant approach to review students' reflective practices using a novel pragmatic-critical realist paradigm. Although reflection is central to experiential learning, there is limited understanding of how students reflect and what they consider to influence their learning outcomes. This limitation was explored using action research with mixed methods analysis which combined thematic analysis and partial least squares based structural equation modelling. During four action research cycles, student reflections on business process projects as part of higher education enterprise systems and business process management courses in a South African higher education institution were observed and analysed. Each action research cycle changed one aspect of the students' projects. The first intervention required students to reflect on action, the second required students to reflect in action, and the third required reflection for action. In the fourth cycle, the teaching staff changed. The findings showed that reflection is complex and must be linked to action to improve learning. Reflections were observed to positively influence learning outcomes when students apply effort to assigned tasks. On the basis of the observations, two models were proposed. The first model is a learning influence model embedded in the second disruptive learning model. The models show that reflective practices can improve learning outcomes by recognising that students learn at different levels but are predominantly absolutist. Students need to be inspired to apply effort in completing tasks and overcoming satisficing.

No description available.

In recent years, the scope of Machine Learning algorithms and its techniques are taking up a notch in every industry (for example, recommendation systems, user behavior analytics, financial applications and many more). In practice, they play an important role in utilizing the power of the vast data we currently generate on a daily basis in our digital world.In this study, we present a comprehensive comparison of different supervised Machine Learning algorithms and feature selection techniques to build a best predictive model as an output. Thus, this predictive model helps companies predict unwanted behavior in their business processes. In addition, we have researched for the automation of all the steps involved (from understanding data to implementing models) in the complete Machine Learning Pipeline, also known as AutoML, and provide a comprehensive survey of the various frameworks introduced in this domain. These frameworks were introduced to solve the problem of CASH (combined algorithm selection and Hyper- parameter optimization), which is basically automation of various pipelines involved in the process of building a Machine Learning predictive model. / Under de senaste åren har omfattningen av maskininlärnings algoritmer och tekniker tagit ett steg i alla branscher (till exempel rekommendationssystem, beteendeanalyser av användare, finansiella applikationer och många fler). I praktiken spelar de en viktig roll för att utnyttja kraften av den enorma mängd data vi för närvarande genererar dagligen i vår digitala värld.I den här studien presenterar vi en omfattande jämförelse av olika övervakade maskininlärnings algoritmer och funktionsvalstekniker för att bygga en bästa förutsägbar modell som en utgång. Således hjälper denna förutsägbara modell företag att förutsäga oönskat beteende i sina affärsprocesser. Dessutom har vi undersökt automatiseringen av alla inblandade steg (från att förstå data till implementeringsmodeller) i den fullständiga maskininlärning rörledningen, även känd som AutoML, och tillhandahåller en omfattande undersökning av de olika ramarna som introducerats i denna domän. Dessa ramar introducerades för att lösa problemet med CASH (kombinerat algoritmval och optimering av Hyper-parameter), vilket i grunden är automatisering av olika rörledningar som är inblandade i processen att bygga en förutsägbar modell för maskininlärning.

La visión de la "Internet de las Cosas", hace énfasis en la integración entre elementos del mundo real y los Sistemas de Información. Gracias a tecnologías de Identificación Automática (Auto-ID) cómo RFID, los sistemas pueden percibir objetos del mundo físico. Cuando éstos participan de manera activa en los procesos de negocio, se evita el uso de los seres humanos como transportadores de información. Por tanto, el número de errores se reduce y la eficiencia de los procesos aumenta. Aunque actualmente ya es posible el desarrollo de estos sistemas, la heterogeneidad tecnológica en Auto-ID y los requisitos cambiantes de los procesos de negocio dificultan su construcción, mantenimiento y evolución. Por lo tanto, es necesaria la definición de soluciones que afronten la construcción de estos sistemas mediante métodos sólidos de desarrollo para garantizar la calidad final del producto. Partiendo de las bases de la Ingeniería Dirigida por Modelos (MDE), esta tesis presenta un proceso de desarrollo para la construcción de este tipo de sistemas. Este proceso cubre desde la especificación del sistema hasta su implementación, centrándose en los requisitos particulares del enlace entre los mundos físico y virtual. Para la especificación de los sistemas se ha definido un Lenguaje de modelado adaptado a los requisitos de la "Internet de las Cosas". A partir de esta especificación se puede obtener una solución software de manera sistemática. Como validación de la propuesta, ésta se ha aplicado en la práctica con usuarios finales. Pese a que el proceso de desarrollo no ofrece una automatización completa, las guías ofrecidas y la formalización de los conceptos implicados ha demostrado ser útil a la hora de elevar el nivel de abstracción en el desarrollo, evitando el esfuerzo de enfrentarse a detalles tecnológicos. / Giner Blasco, P. (2010). Automating the development of Physical Mobile Workflows. A Model Driven Engineering approach [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/8272

A regulação assistencial é um importante instrumento de gestão pública que tem como objetivo viabilizar o acesso dos usuários aos serviços de saúde. No entanto, há estudos que apontam que não há um equilíbrio entre a oferta e a demanda por serviços da atenção secundária no SUS. Na presente pesquisa questiona-se como está efetivamente estruturado o acesso a esse nível de atenção e quais os principais entraves para a efetividade do acesso. O objetivo consistiu em analisar o processo de acesso à atenção secundária da saúde buscando identificar oportunidades de melhoria. O foco desse estudo foi o acesso à especialidade médica de gastrocirurgia dos dois hospitais secundários integrantes do complexo do Hospital das Clínicas de Ribeirão Preto. Foram realizadas entrevistas com gestores, médicos e demais profissionais envolvidos no processo. A partir das informações coletadas foi construído um mapa dos processos utilizando o software Bizagi e a notação de modelagem de processos de negócios (BPMN). A partir da descrição e análise, foi verificado como os processos descritos poderiam ser otimizados. Foi possível identificar que os dois processos estudados, apesar de terem o mesmo objetivo: prover acesso a atenção secundária de saúde, possuem diferenças marcantes. As vagas são distribuídas aos municípios na forma de cotas no processo de acesso ao HEAB enquanto que no acesso ao HERP há uma regulação compartilhada entre o DRSXIII e o próprio hospital. Os principais problemas identificados foram: absenteísmo dos usuários nas consultas; guias de referência incompletas ou ilegíveis; dificuldades de relacionamento entre os profissionais e organizações de saúde; demora para agendar consulta, entre outros. Concluiu-se que existem pontos no processo que não estão coerentes com as normas que o regulam e que há dados que podem ser utilizados para medir o desempenho do processo, como a proporção de casos novos e de pedidos de interconsulta; distribuição de vagas por município e situação após primeira consulta. Concluiu-se ainda que os problemas identificados podem ser solucionados a partir da implantação de melhorias sugeridas como: melhorar a comunicação e a triagem nos municípios, realizar treinamento dos funcionários e divulgar protocolos aos envolvidos. / The assistance regulation is an important public management tool that aims to facilitate users\' access to health services. However, studies show that there is not a balance between supply and demand for services in secondary care in the Unified Health System (SUS). In the present study it casts doubt on how the access is effectively structured to this level of care and what the main obstacles to the effectiveness of access are. The aim was analyze the process of access to secondary health care seeking to identify opportunities for improvement. The focus of this study was the access to medical specialty Gastrosurgery of the two hospitals that are members of the complex of the General Hospital of Ribeirão Preto Medical School (University of São Paulo). Interviews were conducted with managers, doctors and other stakeholders. From the information collected, a map of the processes using the Bizagi software and the notation for business process modeling (BPMN) was constructed. From the description and analysis, it was verified how the described processes could be optimized. It was possible to identify that the two processes studied have the same goal: provide access to secondary health care, have marked differences, such as how the distribution of vacancies. The vacancies are distributed to municipalities for quotas in the process of access to HEAB while access to HERP there is a shared regulation between the DRSXIII and the hospital. The main problems identified were outpatient non-attendance (absenteeism), incomplete or illegible reference guides, relationship difficulties between professionals and health organizations, long wait for schedule consultation, among others. It was concluded that there are points in the process that are not consistent with the rules that regulate, there is data that can be used to measure the performance process, as the proportion of new cases and requests for referral; distribution of vacancies for municipality and situation after first appointment. It was possible concluded also that the problems found can be solved through the implementation of suggested improvements; such as how improve communication and sorting in the municipalities, conduct employee training and disseminate the protocols involved.

Submitted by JOSIANE SANTOS DE OLIVEIRA (josianeso) on 2017-06-06T13:04:42Z No. of bitstreams: 1 Rafael Tiburi Bettiol_.pdf: 3696012 bytes, checksum: 981a8a497c8c80c028d42c364106eda3 (MD5) / Made available in DSpace on 2017-06-06T13:04:42Z (GMT). No. of bitstreams: 1 Rafael Tiburi Bettiol_.pdf: 3696012 bytes, checksum: 981a8a497c8c80c028d42c364106eda3 (MD5) Previous issue date: 2016-06-27 / Nenhuma / A Gestão de Processos de Negócio (BPM) vem sendo adotada pelas organizações a fim de solucionar problemas latentes nas interações das atividades organizacionais, proporcionando assim, maior eficiência operacional e melhores níveis de serviço, os quais satisfarão e melhorarão a experiência dos clientes para com os produtos e serviços. Para essa adoção, os processos de negócio passam por projetos de BPM, os quais tem o objetivo de entender como uma determinada etapa da organização atua, eliminando desperdícios, e redesenhar o processo aderindo à melhores práticas e à novos conceitos. Após essas fases de projeto, são estabelecidas ações que irão transformar o processo de negócio do estado atual ao futuro. É neste contexto de pós projeto que este estudo de casos busca analisar o “por que” e o “como” os processos de negócio efetivamente transformaram. O “por que” está na análise das variáveis que influenciam a efetiva transformação, sendo que as variáveis estão baseadas em conceitos de Rotinização, Infusão e Mudança Cultural. E o “como” está baseado nos projetos de BPM, suas técnicas, métodos, ferramentas e entregáveis, estabelecendo padrões de condução. Na execução desta pesquisa, foram efetuadas pesquisas bibliográficas para estabelecer os principais conceitos, possibilitando definições claras das variáveis envolvidas. A pesquisa foi baseada em um estudo de múltiplos casos através das técnicas de coleta de dados entrevista e dados secundários. Foram efetuadas validações dos conceitos, das variáveis, das perguntas e do roteiro de entrevista junto a especialistas empregando Focus Group. Após a validação do instrumento de pesquisa, as entrevistas foram realizadas com organizações que haviam executado projetos de BPM e os respectivos processos estivessem em operação no instante da pesquisa. A coleta de dados, junto com os dados secundários, obteve informações suficientes para a segmentação, codificação e análise. Na análise, para medir a efetiva transformação, foram estabelecidos níveis de influência, negativo, neutro e positivo, para cada variável. Sendo assim, a efetiva transformação dos processos de negócio pôde ser analisada através da composição das influências das variáveis, uso prolongado, uso na integração, orçamento, equipe, capacitação, governança corporativa, fornecimento e manutenção, atitudes individuais para com a mudança e compartilhamento de conhecimento. O resultado do estudo demonstra que a variável uso prolongado foi a que mais influenciou negativamente a efetiva transformação dos casos analisados e, por outro lado, a variável governança corporativa foi a que mais influenciou positivamente. Na análise dos padrões de condução através das técnicas, métodos, ferramentas e entregáveis utilizados nos respectivos projetos de BPM, foi utilizada uma análise chamada de Densidade de Código. A partir dessa 5 densidade pôde-se verificar que Brainstorming, BPMN e Entrevistas são as mais utilizadas dentre as técnicas, métodos, ferramentas e entregáveis dos casos analisados. Portanto, essas análises geraram conteúdo para discussões que se estenderam desde os facilitadores e barreiras para a efetiva transformação, passando por um paralelo entre a efetiva transformação conceitual e a observada, até as técnicas, métodos, ferramentas e entregáveis que mais foram utilizadas. / The Business Process Management (BPM) has been adopted by organizations to solve potential problems in the interactions of organizational activities, thus providing greater operational efficiency and improved service levels, which meet and improve the customer experience toward products and services. For this adoption, business processes undergo BPM projects, which aims to understand how a certain stage of organization operates, eliminating waste, and redesigning the process adhering to best practices and new concepts. After these project phases, actions are established that will transform the business process from the current state to the future. It is in this context of post project that this study of cases aims to analyze the "why" and "how" business processes effectively transformed. The "why" is the analysis of the variables that influence the effective transformation, and the variables are based on concepts of Routinization, Infusion and Cultural Change. And the "how" is based on BPM projects, their techniques, methods, tools and deliverables, setting leading standards. In the execution of this research, literature searches were performed to establish the main concepts, enabling clear definitions of the variables involved. The research was based on a multiple case study through interview data collection techniques and secondary data. The concepts, variables, questions and interview guide were validated with experts using Focus Group. After validation of the research instrument, interviews were conducted with organizations that had implemented BPM projects and their processes were in operation at the instant of the research. The data collection, along with the secondary data, obtained enough information for segmentation, coding and analysis. In the analysis, to measure the effective transformation, were established levels of influence, negative, neutral and positive, for each variable. Thus, the effective transformation of business processes could be analyzed through the composition of the influences of variables, extended use, use in integration, budget, staff, training, corporate governance, supply and maintenance, individual attitudes towards change and sharing knowledge. The result of the study shows that extended use variable was the most negatively influenced the effective transformation of the cases and, on the other hand, the variable corporate governance was the most influenced positively. In the analysis of leading patterns through the techniques, methods, tools and deliverables used in their BPM projects, a analysis called code density was used. From this density could be seen that Brainstorming, BPMN and Interviews are the most used among the techniques, methods, tools and deliverables of the cases. Therefore, these analyzes generated content for discussions that extended from the facilitators and barriers to effective transformation, through a parallel 7 between the conceptual and observed effective transformation until the techniques, methods, tools and deliverables that more were used.

Made available in DSpace on 2016-03-04T13:55:09Z (GMT). No. of bitstreams: 2 8.pdf: 9480685 bytes, checksum: 65cbb930cc2b75597dfdd60ac4a1838c (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2015 / Fundação Oswaldo Cruz. Instituto de Tecnologia em Fármacos/Farmanguinhos. Rio de Janeiro, RJ, Brasil. / O setor farmacêutico sofre rígida regulamentação e fiscalização para atender às exigências domercado consumidor de forma a garantir a segurança, qualidade e eficácia dos medicamentos.Por fazer parte de um negócio altamente dinâmico como o setor farmacêutico, Farmanguinhostem que lidar com a velocidade das transformações e seus impactos nos processos decomercialização. Desta forma, é crucial que a administração tenha capacidade de resposta àmudança do ambiente, percebendo os desafios impostos, diagnosticando os impactos,decidindo o que fazer e pondo em prática suas decisões. A implantação de um sistemaintegrado de gestão alinhando o planejamento à estratégia e aos processos da organização temsido tratado e exposto em vários estudos. O gerenciamento de processos de negócios (BPM)permite as organizações uma melhor visibilidade de suas atividades o que favorece ações demelhoria na qualidade de seus produtos e serviços além de proporcionar o alinhamento comas estratégias organizacionais. Esse estudo contribui para o aperfeiçoamento da gestão públicacom a adoção de práticas de BPM, buscando a integração dos processos institucionais àestratégia. A partir desta proposta, Farmanguinhos passa a adotar uma ferramenta que poderáestabelecer a sistematização do planejamento com o alinhamento da estratégia aos processos,devendo estar claramente definidos e difundidos em toda a organização. / The pharmaceutical industry undergoes strict regulations and supervision to meet the requirements of the consumer market in order to ensure the safety, quality and efficacy of medicines. To be part of a highly dynamic business like the pharmaceutical industry, Farmanguinhos have to deal with the speed of change and its impact on marketing processes. Thus, it is crucial that the administration be responsive to environmental change, realizing the challenges, diagnosing the impacts, deciding what to do and putting into practice their decisions. The implementation of an integrated management system aligning planning the strategy and the organization's processes have been treated and exposed in several studies. The business process management (BPM) enables organizations better visibility of its activities which favors actions to improve the quality of its products and services in addition to providing alignment with the organizational strategies. This study contribute to the improvement of public management with the adoption of BPM practices, seeking from integration of institutional processes to strategy. Based on this proposal, Farmanguinhos will adopt a tool that can establish systematic planning with the alignment of strategy to proceedings and should be clearly defined and disseminated throughout the organization.

A regulação assistencial é um importante instrumento de gestão pública que tem como objetivo viabilizar o acesso dos usuários aos serviços de saúde. No entanto, há estudos que apontam que não há um equilíbrio entre a oferta e a demanda por serviços da atenção secundária no SUS. Na presente pesquisa questiona-se como está efetivamente estruturado o acesso a esse nível de atenção e quais os principais entraves para a efetividade do acesso. O objetivo consistiu em analisar o processo de acesso à atenção secundária da saúde buscando identificar oportunidades de melhoria. O foco desse estudo foi o acesso à especialidade médica de gastrocirurgia dos dois hospitais secundários integrantes do complexo do Hospital das Clínicas de Ribeirão Preto. Foram realizadas entrevistas com gestores, médicos e demais profissionais envolvidos no processo. A partir das informações coletadas foi construído um mapa dos processos utilizando o software Bizagi e a notação de modelagem de processos de negócios (BPMN). A partir da descrição e análise, foi verificado como os processos descritos poderiam ser otimizados. Foi possível identificar que os dois processos estudados, apesar de terem o mesmo objetivo: prover acesso a atenção secundária de saúde, possuem diferenças marcantes. As vagas são distribuídas aos municípios na forma de cotas no processo de acesso ao HEAB enquanto que no acesso ao HERP há uma regulação compartilhada entre o DRSXIII e o próprio hospital. Os principais problemas identificados foram: absenteísmo dos usuários nas consultas; guias de referência incompletas ou ilegíveis; dificuldades de relacionamento entre os profissionais e organizações de saúde; demora para agendar consulta, entre outros. Concluiu-se que existem pontos no processo que não estão coerentes com as normas que o regulam e que há dados que podem ser utilizados para medir o desempenho do processo, como a proporção de casos novos e de pedidos de interconsulta; distribuição de vagas por município e situação após primeira consulta. Concluiu-se ainda que os problemas identificados podem ser solucionados a partir da implantação de melhorias sugeridas como: melhorar a comunicação e a triagem nos municípios, realizar treinamento dos funcionários e divulgar protocolos aos envolvidos. / The assistance regulation is an important public management tool that aims to facilitate users\' access to health services. However, studies show that there is not a balance between supply and demand for services in secondary care in the Unified Health System (SUS). In the present study it casts doubt on how the access is effectively structured to this level of care and what the main obstacles to the effectiveness of access are. The aim was analyze the process of access to secondary health care seeking to identify opportunities for improvement. The focus of this study was the access to medical specialty Gastrosurgery of the two hospitals that are members of the complex of the General Hospital of Ribeirão Preto Medical School (University of São Paulo). Interviews were conducted with managers, doctors and other stakeholders. From the information collected, a map of the processes using the Bizagi software and the notation for business process modeling (BPMN) was constructed. From the description and analysis, it was verified how the described processes could be optimized. It was possible to identify that the two processes studied have the same goal: provide access to secondary health care, have marked differences, such as how the distribution of vacancies. The vacancies are distributed to municipalities for quotas in the process of access to HEAB while access to HERP there is a shared regulation between the DRSXIII and the hospital. The main problems identified were outpatient non-attendance (absenteeism), incomplete or illegible reference guides, relationship difficulties between professionals and health organizations, long wait for schedule consultation, among others. It was concluded that there are points in the process that are not consistent with the rules that regulate, there is data that can be used to measure the performance process, as the proportion of new cases and requests for referral; distribution of vacancies for municipality and situation after first appointment. It was possible concluded also that the problems found can be solved through the implementation of suggested improvements; such as how improve communication and sorting in the municipalities, conduct employee training and disseminate the protocols involved.