The purpose of this study was to determine if shared governance systems result in an increased perception of autonomy for staff nurses. The population for this study included all registered nurses providing inpatient care at two mid-sized community hospitals in the Midwest, who were not identified as supervisors, managers or executives. The convenience sample was obtained from those completing and returning a distributed survey. The sample was 146 staff nurses from each organization. Only responses from nurses with more than one year experience at the current facility were included in the study. , One hospital had a shared governance system in place. The other hospital had a traditional organizational system.The theoretical framework for the study was the Neuman Systems Model (1989). Staff nurse autonomy was measured by the Nursing Activity Scale (Schutzenhofer, 1987). Management characteristics were measured by the Profile of Organizational Characteristics (Liken, 1978). Also administered was a brief demographic data questionnaire (Schutzenhofer & Musser, 1994).Each hospital provided the researcher with access to participant mailboxes of those registered nurses providing inpatient care and not in management or executive roles Surveys were placed in each mailbox, and drop boxes were made available in unit classrooms in one hospital, and in nursing administration in the other hospital. A reminder notice was placed in each participant mailbox one week after initial survey distribution. Drop boxes were retrieved by the researcher one week following the reminder notice distribution. Study participants were informed about the study by cover letter and invited to participate. Participation was strictly voluntary. Data was available only to the investigator and only group data were reported without reference to individual participants. Participant responses were completely anonymous. Questionnaires were printed on two different colors of paper in order to distinguish between hospitals. No code numbers or other identifying marks were placed on any of the questionnaires. The study provided information on which to base management decisions regarding nursing governance arrangements. / School of Nursing

This thesis applied the decision support mechanism, Q-Methodology, to an integrated model of issues management and strategic planning. This approach was applied at Riverview Hospital in Noblesville, Indiana in order to respond to the health care reform issue.The research approach involved the three primary stakeholder groups of the hospital: Board of Directors, physicians and managers. The three groups, representing 56 people, attended a planning retreat and identified Riverview's planning options in the form of 77 statements representing future program or service options. These 77 statements were then ranked using Q-methodology.The findings of the study included a QMETHOD computer and researcher analysis of the statements from the perspective of the total group and also the three factors.The final result was a list of statements that comprised Riverview's response to the reform issue in the form of corporate goals and objectives. The conclusions of the study show that:--The integrated approach did provide focus to the strategic planning process. The final list of objectives were all related to the health reform proposal.--Q-Methodology was an appropriate decision support mechanism. It not only provided the final list of corporate objectives but clearly identified potential support and resistance.--A viable set of corporate objectives was developed to respond to the health reform proposal.--All of the stakeholder groups unanimously approved the final list of statements (objectives) in a formal voting process. / Department of Journalism

Made available in DSpace on 2014-06-11T19:24:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-02-28Bitstream added on 2014-06-13T20:32:08Z : No. of bitstreams: 1 cyrino_cms_me_botfm.pdf: 4258514 bytes, checksum: f97f3700b71fe2636b3e5ebb6ddbdfa2 (MD5) / A adequação quanti/qualitativa do quadro de profissionais de enfermagem por meio do Sistema de Classificação de Pacientes tornou-se essencial na prática gerencial e assistencial. Este estudo analisou a implantação de Sítios Assistenciais na Unidade de Terapia Intensiva Adulto de um Hospital Escola como forma de organização e classificação de pacientes, bem como avaliou suas implicações na qualidade do cuidado de acordo com taxas de Infecção Hospitalar, alocação dos funcionários por mediação do Nursing Activities Score (NAS) e satisfação da equipe de enfermagem perante o processo proposto. Trata-se de estudo quantitativo, prospectivo, descritivo e transversal. A unidade envolvida foi configurada por três Sítios Assistenciais: isolamento (pacientes em isolamento por gotículas e/ou aerossóis ou com necessidade de hemodiálise); pós-operatório (principalmente pacientes em pré e/ou pós-operatório); e o de longa permanência (pacientes crônicos). A coleta foi realizada de julho a outubro de 2010 com auxílio de cinco instrumentos. Foram registrados sexo, idade, tempo de internação, comorbidade, especialidade, desfecho e mudança entre os Sítios Assistenciais de 214 pacientes. A satisfação da equipe foi avaliada por entrevista aos técnicos de enfermagem (n=31) e enfermeiras (n=7) da unidade. O estudo teve parecer favorável do Comitê de Ética e Pesquisa da instituição (OF.257/2010). Foi constatado que o mês de setembro teve maior número de internações e o sítio pós-operatório apresentou maior rotatividade de pacientes. A amostra foi constituída principalmente por pacientes masculinos, neurocirúrgicos e com idade média de 57 anos. O tempo de internação médio foi de 9,3 dias e o principal desfecho foi alta (67%). Apenas 20% dos pacientes não apresentavam comorbidades. A taxa de mudanças... / The quantitative and qualitative suitability of framework of nurse team by the Patient Classification System became essential for management and care practices. This study analyzed the implementation of Assistances Sites in a intensive care unit of adults of a universitary hospital as a form of organization and classification of patients, also was assessed the impact of this process on the quality of care by the hospital infection rates, staff allocation by the Nursing Activities Score (NAS) and the team satisfaction about this system. It is a quantitative, prospective, descriptive and transversal research. The unit was divided in three Assistance Sites: isolation (patients with precaution of droplets or aerosols and those with hemodialysis requirement); post operative (patients in pre or post operative); and long stay (chronic patients). Data collection was conducted from July to October 2010 with utilization of five specific instruments. Sex, age, length of stay, comorbidity, diagnostic expertise, outcome and transfers between the sites were registered for 214 patients. Team satisfaction was evaluated by an interview with thirty-one nursing technician and seven nurses of the unit. This study had an approval by the local ethic committee (OF.257/2010). As results It was possible to observe that the month of September had more admissions and post-operative site showed higher turnover of patients. Overall casuistic was constitude mainly of male patients, neurosurgical with mean age 57 years. Mean of unit length of stay was of 9.3 days and the main outcome was discharge (67%). Only 20% of patients presented comorbidities. Transfers between sites occurred with a rate of 18% especially for patients with length of stay higher than six days. Mean for NAS was 71.72% (48.2% - 109.1%). Concerning infection... (Complete abstract click electronic access below)

Este estudo teve por objetivo comparar o Grupo Apollo de Hospitais, considerado referência mundial em turismo de saúde, com os empreendimentos Sul brasileiros: Hotel e Spa Recanto das Águas e Itá Thermas Resort e Spa, por possuírem um departamento específico destinado à qualidade de vida e bem-estar. A pesquisa foi comparativa, de caráter exploratório-descritivo, de corte qualitativo. Para tanto, elegeu-se unidades de significado para a definição de categorias de análise que permitiram determinar quanto essas variáveis se afastam ou se aproximam do modelo indiano, considerado ideal, levando em consideração o fato de Índia e Brasil estarem em esferas político, social, econômica e cultural diferentes. São elas: a) excelência da área médica; c) hotelaria hospitalar; e c) entorno. No estudo, empregou-se a pesquisa bibliográfica e documental, entrevistas e observações in loco. Os documentos analisados foram materiais bibliográficos pertinentes, documentos e matérias publicadas em sites oficiais do governo indiano e documentos acerca da realidade do Apollo Hospitals em seu site na internet, bem como arquivos solicitados para apreciação. As entrevistas foram realizadas com os gestores dos empreendimentos brasileiros, objetos deste estudo. As observações in loco se deram no Hotel e Spa Recanto das Águas e no Itá Thermas Resort e Spa. Os resultados evidenciaram que o Brasil já possui recursos físicos e humanos suficientes para que seja implantado o turismo de saúde, de acordo com os moldes indianos, desde que, se respeite as especificidades sociais, culturais, políticas e econômicas desse país. / Submitted by Ana Guimarães Pereira (agpereir@ucs.br) on 2016-05-18T12:51:30Z No. of bitstreams: 1 Dissertacao Paula Cristina Nora.pdf: 51502217 bytes, checksum: ca901a06ff62fb04664e1aa22e48df3c (MD5) / Made available in DSpace on 2016-05-18T12:51:30Z (GMT). No. of bitstreams: 1 Dissertacao Paula Cristina Nora.pdf: 51502217 bytes, checksum: ca901a06ff62fb04664e1aa22e48df3c (MD5) Previous issue date: 2016-05-18 / Universidade de Caxias do Sul, UCS. / The objective of this study was to compare the Apollo Group of Hospitals, which is considered a worldwide reference for medical tourism, to the Brazilian south's enterprises Hotel and Spa Recanto das Águas and Itá Thermas Resort and Spa, for they have an especific department dedicated to life quality and well being. The research was comparative, of exploratory and descriptive nature, with a qualitative edge. Therefore units of meaning for definition of categories of analisys were elected, which allowed it to determine how much these variables grow farther or closer from the Indian model, considered ideal, taking under consideration the fact that India and Brazil are in different cultural, economic, social and politic levels. They are: a) excellency in the medical areas, b) hospitalar hotels, c) surroundings. In this study the bibliographic and documental researches were engaged, and intervews and observations made in person. The analyzed documents were bibliographic and relevant, contents published in oficial governamental Indian sites and themes around the reality of the Apollo Hospitals on its own site on the net, as well as archives required for appreciation. The interviews were made with the managers of Brazilian enterprises, objects of this study. The observations in person happened in the Hotel and Spa Recanto das Águas and in the Itá Thermas Resort and Spa. The results prove that Brazil already has enough built range, geographic and human resourses for the medical tourism to be enrooted according to the Indian models, as long as the social, cultural, political and economic factors of this country are respected.

Orientador: Magda Cristina Queiroz Dell'Acqua / Banca: Kátia Grillo Padilha / Banca: Carmem C. M. C. Juliane / Resumo: A adequação quanti/qualitativa do quadro de profissionais de enfermagem por meio do Sistema de Classificação de Pacientes tornou-se essencial na prática gerencial e assistencial. Este estudo analisou a implantação de Sítios Assistenciais na Unidade de Terapia Intensiva Adulto de um Hospital Escola como forma de organização e classificação de pacientes, bem como avaliou suas implicações na qualidade do cuidado de acordo com taxas de Infecção Hospitalar, alocação dos funcionários por mediação do Nursing Activities Score (NAS) e satisfação da equipe de enfermagem perante o processo proposto. Trata-se de estudo quantitativo, prospectivo, descritivo e transversal. A unidade envolvida foi configurada por três Sítios Assistenciais: isolamento (pacientes em isolamento por gotículas e/ou aerossóis ou com necessidade de hemodiálise); pós-operatório (principalmente pacientes em pré e/ou pós-operatório); e o de longa permanência (pacientes crônicos). A coleta foi realizada de julho a outubro de 2010 com auxílio de cinco instrumentos. Foram registrados sexo, idade, tempo de internação, comorbidade, especialidade, desfecho e mudança entre os Sítios Assistenciais de 214 pacientes. A satisfação da equipe foi avaliada por entrevista aos técnicos de enfermagem (n=31) e enfermeiras (n=7) da unidade. O estudo teve parecer favorável do Comitê de Ética e Pesquisa da instituição (OF.257/2010). Foi constatado que o mês de setembro teve maior número de internações e o sítio pós-operatório apresentou maior rotatividade de pacientes. A amostra foi constituída principalmente por pacientes masculinos, neurocirúrgicos e com idade média de 57 anos. O tempo de internação médio foi de 9,3 dias e o principal desfecho foi alta (67%). Apenas 20% dos pacientes não apresentavam comorbidades. A taxa de mudanças... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The quantitative and qualitative suitability of framework of nurse team by the Patient Classification System became essential for management and care practices. This study analyzed the implementation of Assistances Sites in a intensive care unit of adults of a universitary hospital as a form of organization and classification of patients, also was assessed the impact of this process on the quality of care by the hospital infection rates, staff allocation by the Nursing Activities Score (NAS) and the team satisfaction about this system. It is a quantitative, prospective, descriptive and transversal research. The unit was divided in three Assistance Sites: isolation (patients with precaution of droplets or aerosols and those with hemodialysis requirement); post operative (patients in pre or post operative); and long stay (chronic patients). Data collection was conducted from July to October 2010 with utilization of five specific instruments. Sex, age, length of stay, comorbidity, diagnostic expertise, outcome and transfers between the sites were registered for 214 patients. Team satisfaction was evaluated by an interview with thirty-one nursing technician and seven nurses of the unit. This study had an approval by the local ethic committee (OF.257/2010). As results It was possible to observe that the month of September had more admissions and post-operative site showed higher turnover of patients. Overall casuistic was constitude mainly of male patients, neurosurgical with mean age 57 years. Mean of unit length of stay was of 9.3 days and the main outcome was discharge (67%). Only 20% of patients presented comorbidities. Transfers between sites occurred with a rate of 18% especially for patients with length of stay higher than six days. Mean for NAS was 71.72% (48.2% - 109.1%). Concerning infection... (Complete abstract click electronic access below) / Mestre

Thesis (MTech (Information Technology))--Peninsula Technikon, Cape Town, 2005 / The overall objective of this study is to identify the importance of culture in the implementation of Information systems and how output influences the success of a system. • The first objective is to assess the organizational culture in each hospital in terms of one of the dimensions of culture on Hofstede's checklist, namely power distance. • The second objective is to determine whether the speed with which a HIS was implemented was a success at the two academic hospitals in the Western Cape using the reduction of the level of backlog (paper based patient registration records) as a measure of implementation progress.

Thesis (MTech (Information Technology))--Peninsula Technikon, 2005. / This study was initiated to investigate whether power distance facilitates the successful implementation of a hospital information system. A comparative study was done to evaluate the effect of culture on the same information system (CLINICOM), implemented at the same time, but at different locations. The overall objective of this study was to identify the importance of culture in the implementation of In formation systems and how output influences the success of a system. • The first objective was to assess the organizational culture in each hospital in terms of one of the dimensions of culture on Hofstede's check Iist, namely power distance. • The second objective was to determine whether the speed with which a HIS was implemented was a success at the two academic hospitals in the Western Cape using the reduction of the level of backlog (paper based patient registration records) as a measure of implementation progress. The literature was reviewed on what determines the success of an information system. The effects of culture were studied and in particular power distance on the implementation of an information system and how this factor affected the backlog of information entries. Questionnaires were administered to the clerical staff at the hospitals, as they were the high users of the information system. The study showed that both institutions had a high power distance score, but the one institution had a Power distance Index (POI) that was considerable higher than the other. PDr relates to the concentration of authority. This finding suggests that the managers were more autocratic at the one hospital than at the other. The study found that the higher the PDI, the faster the backlog was reduced at implementation. Thus the higher the por the greater the concentration of authority;

A busca premente nas empresas contemporâneas pela geração do conhecimento como fator de diferenciação cria a necessidade cada vez maior de mecanismos eficazes de cooperação com as instituições de ensino. Essas em seu papel de geradoras de conhecimento também se beneficiam da interação com as empresas, já que a proximidade com a realidade de mercado estimula o desenvolvimento do corpo docente e discente e promove tanto a inovação quanto a visibilidade da academia na comunidade. Dentro deste contexto, o presente estudo visou projetar e implantar um sistema de capacitação executiva em gestão hospitalar para o Hospital Paranaense de Otorrinolaringologia (IPO) em parceria com a FAE Centro Universitário. Além disso foram analisados os processos atuais de Gestão de Parcerias da Universidade que teve seus procedimentos comparados com as premissas do framework para transferência de tecnologia na interação Universidade-Empresa, ferramenta que mostrou-se útil principalmente para apontar melhorias no processo. No que se refere ao produto final da cooperação, foi projetado e implementado o curso de MBA em Gestão Hospitalar e Sistemas de Saúde, de caráter lato sensu, o que veio ao encontro da demanda por capacitação provinda do Hospital e que se apresenta como uma solução de ensino-aprendizagem que se tornou viável a partir da cooperação, troca de conhecimentos e alinhamento de interesses entre os parceiros. O modelo descrito neste estudo pode servir de referência a parcerias futuras da universidade com outras empresas. / The urgent search in contemporary companies for the generation of knowledge as a factor of differentiation creates a growing need for effective mechanisms of cooperation with educational institutions. These institutions, in their role as generators of knowledge also benefit from the interaction with the companies, since their proximity to the reality of the market stimulates the development of both the teaching staff and the students, and promotes innovation as much as visibility of the academy in the community. Within this context, this study aimed to design and implement a training system in hospital management for the Hospital of Otolaryngology of Parana (IPO) in partnership with FAE University Center. Therefore, the present partnership management process of the university were analyzed and compared with the principles of the framework for technology transfer and Company University interaction, the tool proved to be useful mainly to point improvements to the process. Regarding the final product of the cooperation, the MBA in Health Management course, latu sensu, was designed and implemented. This came to meet the demand for training from the hospital. It was also a teaching-learning process solution that became feasible through the cooperation, knowledge exchange, and alignment of interests between partners. We believe that the model described in this study may serve as reference for future partnerships between the university and other companies. / 5000

Este trabalho teve como objetivo desenvolver um modelo para mensuração do desempenho na gestão hospitalar por meio de indicadores chaves, desdobrados em boas práticas, elencados nas perspectivas do Balanced Scorecard visando delinear o enfoque estratégico organizacional. Após a delimitação das boas práticas, projetou-se a valoração da performance ideal esperada e diagnosticou-se a realizada, oportunizando a elaboração de um índice de desenvolvimento que foi submetido ao método de apoio a decisão multicritério ELECTRE II, resultando na ordenação para detecção e priorização das alternativas fragilizadas. Por meio de pesquisa bibliográfica, possibilitou-se evidenciar que uma quantidade relevante de trabalhos converge ao indicar como eficiente a utilização do BSC aliado aos métodos de apoio a decisão multicritério, sendo verificados 43 indicadores chaves de desempenho comumente utilizados. Destes, 15 foram escolhidos e desdobrados em 57 boas práticas, tidas por sub-indicadores, para aplicação do método de mensuração do desempenho hospitalar. Os resultados do método proposto demonstraram-se satisfatórios pelo fato de direcionarem os pontos críticos que necessitam serem melhores desenvolvidos na organização, além de apoiarem os processos de tomadas de decisão e estarem de acordo com a missão, visão e valores da organização estudada. / This study aimed to develop a model for performance measurement in hospital management through key indicators, unfold into good practices listed in the Balanced Scorecard perspectives aiming to outline the organizational strategic focus. After the definition of best practices, designed to valuation of ideal performance expected and diagnosed to held, providing opportunities for the development of a development index which was subjected to the method of supporting multi-criteria decision ELECTRE II, resulting in order to detect and prioritization of vulnerable alternatives. Through literature, if allowed to evidence that a significant amount of work converges to indicate how effective the use of BSC ally methods of supporting multi-criteria decision being checked 43 key performance indicators commonly used. Of these, 15 were chosen and deployed in 57 good practices taken by sub-indicators for the application of hospital performance measurement method. The results of the proposed method proved to be satisfactory because steering plenty of critical points that need to be better developed in the organization, and support decision-making processes and be in accordance with the mission, vision and values of the organization studied.

A busca premente nas empresas contemporâneas pela geração do conhecimento como fator de diferenciação cria a necessidade cada vez maior de mecanismos eficazes de cooperação com as instituições de ensino. Essas em seu papel de geradoras de conhecimento também se beneficiam da interação com as empresas, já que a proximidade com a realidade de mercado estimula o desenvolvimento do corpo docente e discente e promove tanto a inovação quanto a visibilidade da academia na comunidade. Dentro deste contexto, o presente estudo visou projetar e implantar um sistema de capacitação executiva em gestão hospitalar para o Hospital Paranaense de Otorrinolaringologia (IPO) em parceria com a FAE Centro Universitário. Além disso foram analisados os processos atuais de Gestão de Parcerias da Universidade que teve seus procedimentos comparados com as premissas do framework para transferência de tecnologia na interação Universidade-Empresa, ferramenta que mostrou-se útil principalmente para apontar melhorias no processo. No que se refere ao produto final da cooperação, foi projetado e implementado o curso de MBA em Gestão Hospitalar e Sistemas de Saúde, de caráter lato sensu, o que veio ao encontro da demanda por capacitação provinda do Hospital e que se apresenta como uma solução de ensino-aprendizagem que se tornou viável a partir da cooperação, troca de conhecimentos e alinhamento de interesses entre os parceiros. O modelo descrito neste estudo pode servir de referência a parcerias futuras da universidade com outras empresas. / The urgent search in contemporary companies for the generation of knowledge as a factor of differentiation creates a growing need for effective mechanisms of cooperation with educational institutions. These institutions, in their role as generators of knowledge also benefit from the interaction with the companies, since their proximity to the reality of the market stimulates the development of both the teaching staff and the students, and promotes innovation as much as visibility of the academy in the community. Within this context, this study aimed to design and implement a training system in hospital management for the Hospital of Otolaryngology of Parana (IPO) in partnership with FAE University Center. Therefore, the present partnership management process of the university were analyzed and compared with the principles of the framework for technology transfer and Company University interaction, the tool proved to be useful mainly to point improvements to the process. Regarding the final product of the cooperation, the MBA in Health Management course, latu sensu, was designed and implemented. This came to meet the demand for training from the hospital. It was also a teaching-learning process solution that became feasible through the cooperation, knowledge exchange, and alignment of interests between partners. We believe that the model described in this study may serve as reference for future partnerships between the university and other companies. / 5000