Submitted by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2015-05-26T12:53:02Z No. of bitstreams: 1 arquivototal.pdf: 2980634 bytes, checksum: 4c7ccb2e54be16c1b0bcb01cfa7a50f5 (MD5) / Made available in DSpace on 2015-05-26T12:53:02Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2980634 bytes, checksum: 4c7ccb2e54be16c1b0bcb01cfa7a50f5 (MD5) Previous issue date: 2015-02-27 / The Patient Safety has been, in the last decades a thematic evidenced in the Brazilian and world scenario. There are cases that refer to bad prescription, errors in medication administration , stress and professional disillusion. Attached to concerns regarding the quality of medical records, Patient Safety becomes a study of high importance for Risk Reduction, both for patients as for professionals and health services. Therefore, this study concerned to better understand the reality of management of records of Alcides Carneiro University Hospital (ACUH) a federal public institution in the city of Campina Grande, Paraíba. The aspirations for improvements in service hospital records, along with initial actions of ACUH Management Risk and Patient Safety Center, were the main indicators for this study to have its start up. The focus of this work was to understand the situation seen as problematic by the institution Hospital Records Division and, through observations and systemic reviews, identify opportunities for improvement. The methodology used was the Soft Systems Methodology (SSM), recognized worldwide in the management of public health services, especially in studies carried out in National Health Service (NHS) in Britain. The application of SSM had allowed greater understanding of how the records management is conducted in ACUH, and the main obstacles for attendance to Brazilian national guidelines Risk Management and Patient Safety. In addition to organizational learning, this study led to the construction of a project named the Medical Records Management Improvement Program (MRMIP), which may be applied by the administration of ACUH. / A Segurança do Paciente tem sido, nas últimas décadas, uma temática evidenciada no cenário nacional brasileiro e mundial. São casos que se referem à má prescrição, à administração de medicamentos de forma equivocada, ao estresse e à desilusão profissional. Atrelada à preocupação referente à qualidade dos registros médicos, a Segurança do Paciente é um estudo de suma importância para a Redução de Riscos, tanto para os pacientes quanto para os profissionais e serviços de saúde. Este estudo teve a preocupação de compreender melhor a realidade da gestão de prontuários do Hospital Universitário Alcides Carneiro (HUAC), instituição pública federal da cidade de Campina Grande, na Paraíba. Os anseios por melhorias no serviço de registros hospitalares, aliados às ações iniciais da Gerência de Risco e Núcleo de Segurança do Paciente do HUAC, foram os principais indicadores para que este estudo tivesse início. O foco foi compreender a situação tida como problemática pela Divisão de Registro Hospitalar da instituição e, por meio de observações e avaliações sistêmicas, identificar oportunidades de melhoria. A metodologia utilizada foi a Soft Systems Methodology (SSM), reconhecida mundialmente no âmbito da gestão em serviços de saúde pública, principalmente em estudos realizados pelo National Health Service (NHS), o serviço de saúde pública do Reino Unido. A aplicação da SSM ampliou o entendimento sobre a gestão de prontuários no HUAC, bem como apresentou os principais obstáculos para que sejam atendidas as diretrizes nacionais brasileiras de Gestão de Riscos e Segurança do Paciente. Além do aprendizado organizacional, este estudo propiciou a construção do Programa de Melhorias da Gestão de Prontuários (PMGP), que poderá ser aplicado pela administração do HUAC.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-04-18T12:25:54Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO - MPA - JOSÉ ORLANDO.pdf: 1683147 bytes, checksum: dceefacc13fbb80c75b08210bf27154d (MD5) / Made available in DSpace on 2017-04-18T12:25:54Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO - MPA - JOSÉ ORLANDO.pdf: 1683147 bytes, checksum: dceefacc13fbb80c75b08210bf27154d (MD5) Previous issue date: 2016-07-27 / As organizações hospitalares compreendem uma das mais complexas unidades gerenciais, exigindo do gestor hospitalar da cadeia logística de medicamentos que, neste trabalho, são os antirretrovirais, uma proficiência no seu gerenciamento. Pois uma falha na sua distribuição, a percepção, quanto à qualidade do serviço oferecido, é imediatamente comprometida. Esta pesquisa foi realizada no Hospital das Clínicas da UFPE e objetivou avaliar a percepção da qualidade em relação à prestação de serviços logísticos no programa de medicamentos antirretrovirais. Este é um estudo exploratório-descritivo de natureza qualitativa, realizado por meio de entrevista semiestruturada, junto aos farmacêuticos e técnicos em farmácia do hospital em estudo e coordenadores logísticos do programa HIV/AIDS da Secretaria Estadual de Saúde. Um pilar, para o entendimento da qualidade em relação à prestação de serviços logísticos, é a visão sistêmica do funcionamento da cadeia de distribuição através da Soft Systems Methodology (SSM), a qual permitiu compreender seu funcionamento a partir das diferentes percepções. Desta situação adveio à importância também em avaliá-la, com base nas dimensões da qualidade percebida em serviços logísticos, quais sejam: confiabilidade no prazo de entrega; confiabilidade da quantidade e do produto correto; flexibilidade no serviço prestado; disponibilidade; apoio pós-entrega; armazenamento etc.; no sentido de realizar um monitoramento mais apurado dos processos ou propor ações que previnam problemas futuros no atendimento às necessidades dos profissionais do programa e usuários convivendo com o HIV/AIDS. Os resultados obtidos possibilitaram uma avaliação detalhada do funcionamento da cadeia logística dos medicamentos antirretrovirais, a importância de uma gestão eficiente do estoque, do fluxo de informações e do planejamento real da demanda. Entende-se, então, a necessidade de repensar a estrutura física atual no sentido de possibilitar um atendimento humanizado aos usuários e familiares, e rever, junto à coordenação logística estadual, as cláusulas contratuais firmadas. Por fim, ficou evidente que algumas dimensões avaliadas demandam mudanças operacionais, tendo em vista o alto valor monetário agregado; e que o acesso contínuo a terapia traz consigo, não só a satisfação dos profissionais e usuários, a credibilidade dos serviços e a construção de uma imagem positiva, mas principalmente, o aumento da sobrevida desses usuários. / Hospital organizations have one of the most complex unit managements, demanding from drugs supply chain hospital manager, which in this paper is antiretroviral, a proficiency in management. As a distribution failure occurs, the perception about the service quality offered is immediately compromised. This research was conducted at the Hospital das Clínicas, UFPE and aimed to evaluate the perception of quality related to logistic services provision in the antiretroviral drug program. This is an exploratory-descriptive qualitative study, conducted through semi-structured interviews with the study hospital’s pharmacists and pharmacy technicians and logistical coordinators of the HIV/AIDS program from the State Department of Health. A foundation to understand the quality associated to logistic services provision is a systemic view about the supply chain operation through Soft Systems Methodology (SSM), which allows the operation understanding from different perceptions. This situation also originated the importance to evaluate it based on dimensions of perceived quality in any logistic services: reliability in prompt delivery, amount and correct product reliability, service flexibility, availability, post-delivery support, etc., in order to achieve a more accurate monitoring process or propose actions to prevent future problems to program’s professionals and users living with HIV/AIDS. The results enabled a detailed assessment of the supply chain functioning from antiretroviral drugs, the importance of an efficient stock management, the information flow and the real demand planning. It made to understand the need to rethink the current physical structure in order to allow a humanized care to patients and families, and review along with the state logistic coordination the contract terms signed. Finally, it was clear that some dimensions evaluated require operational changes, considering the high monetary value; and the continued access to therapy brings not only the professionals and users’ satisfaction, the credibility of services and building a positive image, but mainly increasing these users survival.

This diploma thesis aims to analyse virtual gaming community and it's problems in case of community belonging to EU server of the game called World of Tanks. To solve these problems, Soft System Methodology by P. Checkland, is used. The thesis includes analysis of significance of gaming communities for the gaming industry as a whole. Gaming community is then defined as a soft system. There are 3 problems analysed in the practical part of the thesis using newer version of SSM. One iteration of learning cycle of this methodology is used to solve every single one of the presented problems. Problems are chosen by players using questionnaire. At the end, application of the SSM is evaluated for the domain of gaming communities in general and problems with its application are presented.

Driven by the highly cyclical nature of their increasingly commoditised product offerings, many capital goods manufacturers are seeing the benefits of delivering services integrated with their core product offerings. Whilst existing research is almost unanimous in advocating the value of a servitization strategy, understanding how these product-service systems (PSSs) can be developed and delivered remains a significant challenge. The closely related PSS field, which has its heritage in the environmental and social science disciplines, is more mature in this area and a number of models have been proposed. The research reported within this thesis contributes to knowledge by investigating whether the approaches to PSS development, reported within the PSS literature, reflects the PSS development practice of servitized manufacturers. More specifically, soft systems methodology was used to explore the delivery of PSSs within the UK railway industry in order to gain an understanding of the implications for developing new PSSs. With this understanding, the existing approaches to PSS development were evaluated with respect to one servitized manufacturer through an in-depth single case study. The findings highlighted a number of significant differences between the practice of the servitized manufacturer and the literature. A survey was used to investigate whether the differences were generalisable to a larger sample of servitized manufacturers. The findings point towards the simplification of the reported phases within PSS development and the inclusion of a number of previously unreported processes and activities. Based on these results a new model of PSS development is proposed to better reflect the practice of servitized manufacturers. The model, consisting of four phases and seventeen processes, was operationalised in the form of a workbook and tested through application. Applying the workbook resulted in the successful creation of a number of new PSS concepts.

This thesis seeks to review Urban Sustainability in cities of the Developing South within the broader spectrum of Sustainable Development. Notably, the Developing South has for many years struggled to embrace Sustainability in its general terms: in part, because of the fragile institutions that cannot be counted on to uphold sustainability in the truest sense of the word; and in part because of the numerous challenges that often distract any attempt to prioritize Sustainable Development. Sustainability then becomes an option in the midst of other options, rather than an option that should affect all other options. Narrowing it down further to matters urban makes it even stranger in a host of cities across the Developing South. It is against this backdrop that this study seeks to examine in depth the contextual challenges that have invariably stood in the way of Sustainable Development across the Developing South. While it may not be practically possible in a four-month study to offer outright solutions or recommendations that could address these challenges in entirety, this study nevertheless has endeavoured to stay true to the realities that are often ignored whenever challenges of Sustainable Development are mentioned on global platforms. Among these realities is the reality of slum presence in most cities of the Developing South that existentially complicates any equation for urban sustainability ever formulated to provide a way out or forward for these cities. State governments understand this too well, and so do Civil Society Organizations (CSOs) and international organizations alike involved in the crusade for improved living conditions for city resident, and in particular slum residents. Yet the State governments have never been as resolute in their quest for slum free cities. The question then remains: exactly what are the sustainable approaches for this noble cause? While the State governments have over the years insisted on enforcing conventional approaches (that include forced evictions, relocations and/ or redevelopment); one international network, however, thinks and responds differently to slum situations. The network is Shack/Slum Dwellers International (SDI). It is considerably this network of slum dwellers and their undeniably innovative approach to urban sustainability and inclusivity that largely frames the direction and general content of this study. Specifically, the methodology adopted in the study is one of a Case study - which in this case is SDI; and two separate Cases, namely Railway Relocation Action Plan (RAP) in Nairobi, Kenya and slum Re-blocking project in Joe Slovo, Cape Town, South Africa, respectively - as typical cases that captures in large part the enormous contribution that SDI is making towards inclusive and sustainable cities in the Developing South. In the discussion part, however, the study introduces Soft Systems Methodology (SSM) as a comparative methodology to SDI’s approach. SSM particularly benefits from LUMAS model and Social Learning – both key components that potentially reserve a dynamic capacity to enriching SDI’s approach as a future reference methodology for urban sustainability and inclusivity.

After the introduction of the term,  sustainable development, a variety of  academicians from different disciplines tried to conceptualize it in their own way, drawing on these views, many different degrees but with similar titles have been established in many universities all around the world. Masters  program in  Sustainable Development  (MSD) at Uppsala University and the Swedish University of Agricultural Sciences (SLU) is one the most recent ones. Before starting this study, it was investigated that the expectations of the different actors in this program are not fulfilled completely. Presence of many different ideas and perspectives in addition to the high number of actors involved in the situation made the situation too complex to be fixed easily. Therefore, the Soft Systems Methodology (SSM), as an appropriate approach for improving complex problematic situations,  is  used to reform the organization of  the  MSD in coming years. The process of identifying the  challenges of this program and then  improving some of them in  practice  are described in this thesis. Alongside the  action phase, the applications of Systems Approach in transformation of Education for Sustainable Development (ESD) are explored.  It is investigated that three levels of learning, i.e. basic, meta-  and epistemic learning, and accordingly three levels of organizational change, i.e. the first, second and third order, need to be recognized, if an ESD program is to be different from the unsustainable trends of education.

A publicação do livro “The machine that changed the world” de Womack et al. (1990) tornou popular no mundo ocidental o termo Lean, que segundo os autores seria a forma generalizada do sistema Toyota de produção. Desde então, a academia tem se dedicado a estudar diversos aspectos envolvidos com o Lean. Apesar do conhecimento teórico gerado, poucas empresas têm conseguindo aplicar esta estratégia de manufatura apropriadamente e experimentar os supostos benefícios. Este é o caso, por exemplo, da siderúrgica AGR (nome fictício). Em 2004, a empresa iniciou um programa formal para transformação Lean e poucos anos depois os esforços foram descontinuados. Recentemente, novos direcionamentos na empresa conduziram à retomada destes esforços. Neste contexto específico, um questionamento foi realizado: como os esforços Lean podem ser retomados e organizados na AGR? Cabe ressaltar que implicitamente este questionamento desdobrou em uma revisão da literatura que identificou diferentes pontos de vista teóricos sobre o fenômeno Lean. Neste sentido, Fujimoto (1999), como pensador mais proeminente da escola de pensamento evolucionária – utilizando uma abordagem interpretativista – argumenta que a Toyota apresenta uma capacidade de aprendizagem evolucionária que permite a emergência de um novo sistema de manufatura ao longo do tempo. A provável ausência desta capacidade de aprendizagem em empresas que buscam se tornar Lean indicaria uma das razões pelas quais se tem dificuldade em alcançar e sustentar este sistema. Observando a descrição desta capacidade na Toyota, verifica-se que a mesma ocorre via construção social da realidade. Desta forma, uma aprendizagem similar poderia ser gerada ao operacionalizar-se a Soft Systems Methodology no processo de estruturação da transformação Lean. Uma pesquisa-ação foi conduzida para avaliar esta possibilidade na prática e ao mesmo tempo auxiliar a AGR com a situação problemática na retomada dos esforços Lean. / The term lean became popular in the Western world after publication of "The machine that changed the world" (Womack et al., 1990) which argues it is the generalized form of the Toyota Production System. Since then, the academy has been investigating several aspects about it. Despite theoretical knowledge contribution, few companies have been able to implement this manufacturing strategy properly and, therefore, have experienced the supposed benefits. This is the case of AGR (fictitious name) steelmaking facility. The company started a lean transformation program in 2004 and few years later the efforts were discontinued. Recently new directions led other attempt at lean efforts. In this particular context, an inquiry was made: how the lean efforts can be organized and reinitiate in AGR? It is noteworthy that this implicitly unfolded a literature review that identified different theoretical views on the lean phenomenon. Fujimoto (1999) as the most prominent thinker of evolutionary school of thought – using an interpretivist approach – argues that Toyota has an evolutionary learning capability that enables the emergence of a new manufacturing system over time. The absence of a similar learning capability in companies seeking lean practices indicates one possible reason why they are difficult to achieve and sustain. Fujimoto (1999) describes it operating at Toyota through social construction of reality. Thus, a similar learning could be generated applying the Soft Systems Methodology as the structuration process for lean transformation. An action research was conducted to evaluate this proposition in practice and at the same time to help AGR in the attempt at lean efforts.

A publicação do livro “The machine that changed the world” de Womack et al. (1990) tornou popular no mundo ocidental o termo Lean, que segundo os autores seria a forma generalizada do sistema Toyota de produção. Desde então, a academia tem se dedicado a estudar diversos aspectos envolvidos com o Lean. Apesar do conhecimento teórico gerado, poucas empresas têm conseguindo aplicar esta estratégia de manufatura apropriadamente e experimentar os supostos benefícios. Este é o caso, por exemplo, da siderúrgica AGR (nome fictício). Em 2004, a empresa iniciou um programa formal para transformação Lean e poucos anos depois os esforços foram descontinuados. Recentemente, novos direcionamentos na empresa conduziram à retomada destes esforços. Neste contexto específico, um questionamento foi realizado: como os esforços Lean podem ser retomados e organizados na AGR? Cabe ressaltar que implicitamente este questionamento desdobrou em uma revisão da literatura que identificou diferentes pontos de vista teóricos sobre o fenômeno Lean. Neste sentido, Fujimoto (1999), como pensador mais proeminente da escola de pensamento evolucionária – utilizando uma abordagem interpretativista – argumenta que a Toyota apresenta uma capacidade de aprendizagem evolucionária que permite a emergência de um novo sistema de manufatura ao longo do tempo. A provável ausência desta capacidade de aprendizagem em empresas que buscam se tornar Lean indicaria uma das razões pelas quais se tem dificuldade em alcançar e sustentar este sistema. Observando a descrição desta capacidade na Toyota, verifica-se que a mesma ocorre via construção social da realidade. Desta forma, uma aprendizagem similar poderia ser gerada ao operacionalizar-se a Soft Systems Methodology no processo de estruturação da transformação Lean. Uma pesquisa-ação foi conduzida para avaliar esta possibilidade na prática e ao mesmo tempo auxiliar a AGR com a situação problemática na retomada dos esforços Lean. / The term lean became popular in the Western world after publication of "The machine that changed the world" (Womack et al., 1990) which argues it is the generalized form of the Toyota Production System. Since then, the academy has been investigating several aspects about it. Despite theoretical knowledge contribution, few companies have been able to implement this manufacturing strategy properly and, therefore, have experienced the supposed benefits. This is the case of AGR (fictitious name) steelmaking facility. The company started a lean transformation program in 2004 and few years later the efforts were discontinued. Recently new directions led other attempt at lean efforts. In this particular context, an inquiry was made: how the lean efforts can be organized and reinitiate in AGR? It is noteworthy that this implicitly unfolded a literature review that identified different theoretical views on the lean phenomenon. Fujimoto (1999) as the most prominent thinker of evolutionary school of thought – using an interpretivist approach – argues that Toyota has an evolutionary learning capability that enables the emergence of a new manufacturing system over time. The absence of a similar learning capability in companies seeking lean practices indicates one possible reason why they are difficult to achieve and sustain. Fujimoto (1999) describes it operating at Toyota through social construction of reality. Thus, a similar learning could be generated applying the Soft Systems Methodology as the structuration process for lean transformation. An action research was conducted to evaluate this proposition in practice and at the same time to help AGR in the attempt at lean efforts.

A publicação do livro “The machine that changed the world” de Womack et al. (1990) tornou popular no mundo ocidental o termo Lean, que segundo os autores seria a forma generalizada do sistema Toyota de produção. Desde então, a academia tem se dedicado a estudar diversos aspectos envolvidos com o Lean. Apesar do conhecimento teórico gerado, poucas empresas têm conseguindo aplicar esta estratégia de manufatura apropriadamente e experimentar os supostos benefícios. Este é o caso, por exemplo, da siderúrgica AGR (nome fictício). Em 2004, a empresa iniciou um programa formal para transformação Lean e poucos anos depois os esforços foram descontinuados. Recentemente, novos direcionamentos na empresa conduziram à retomada destes esforços. Neste contexto específico, um questionamento foi realizado: como os esforços Lean podem ser retomados e organizados na AGR? Cabe ressaltar que implicitamente este questionamento desdobrou em uma revisão da literatura que identificou diferentes pontos de vista teóricos sobre o fenômeno Lean. Neste sentido, Fujimoto (1999), como pensador mais proeminente da escola de pensamento evolucionária – utilizando uma abordagem interpretativista – argumenta que a Toyota apresenta uma capacidade de aprendizagem evolucionária que permite a emergência de um novo sistema de manufatura ao longo do tempo. A provável ausência desta capacidade de aprendizagem em empresas que buscam se tornar Lean indicaria uma das razões pelas quais se tem dificuldade em alcançar e sustentar este sistema. Observando a descrição desta capacidade na Toyota, verifica-se que a mesma ocorre via construção social da realidade. Desta forma, uma aprendizagem similar poderia ser gerada ao operacionalizar-se a Soft Systems Methodology no processo de estruturação da transformação Lean. Uma pesquisa-ação foi conduzida para avaliar esta possibilidade na prática e ao mesmo tempo auxiliar a AGR com a situação problemática na retomada dos esforços Lean. / The term lean became popular in the Western world after publication of "The machine that changed the world" (Womack et al., 1990) which argues it is the generalized form of the Toyota Production System. Since then, the academy has been investigating several aspects about it. Despite theoretical knowledge contribution, few companies have been able to implement this manufacturing strategy properly and, therefore, have experienced the supposed benefits. This is the case of AGR (fictitious name) steelmaking facility. The company started a lean transformation program in 2004 and few years later the efforts were discontinued. Recently new directions led other attempt at lean efforts. In this particular context, an inquiry was made: how the lean efforts can be organized and reinitiate in AGR? It is noteworthy that this implicitly unfolded a literature review that identified different theoretical views on the lean phenomenon. Fujimoto (1999) as the most prominent thinker of evolutionary school of thought – using an interpretivist approach – argues that Toyota has an evolutionary learning capability that enables the emergence of a new manufacturing system over time. The absence of a similar learning capability in companies seeking lean practices indicates one possible reason why they are difficult to achieve and sustain. Fujimoto (1999) describes it operating at Toyota through social construction of reality. Thus, a similar learning could be generated applying the Soft Systems Methodology as the structuration process for lean transformation. An action research was conducted to evaluate this proposition in practice and at the same time to help AGR in the attempt at lean efforts.

Learning Management Systems (LMSs), in a blended learning educational environment, support face to face education and enable enhanced communication and interaction among instructors and students as well as among students. However, Technology-Enhanced Learning (TEL), which improves the learning process, does not come without challenges. The aim of this research is double fold. Firstly, it aims to explore users’ –instructors and students- perceptions on how the LMS Open eClass, in TEI of Athens Greece, supports and facilitates their communication and interaction. Secondly, based on users’ needs and desires, the study aims to formulate suggestions for improving communication and interaction through the platform. The study adopts an interpretivist stance and is built upon an inductive qualitative approach. Firstly, users’ perceptions are solicited through semi-structured interviews and the collected data are analyzed through the thematic analysis method. Subsequently, the study adopts Soft Systems Methodology (SSM) to capture the complexity of the situation, derived from the different worldviews of instructors and students in their association with Open eClass and emerge suggestions for improvements. The results indicate that Open eClass is used to facilitate instructors convey material and information to students, while neither meaningful communication and interaction nor collaboration is performed adequately through the platform. However, the users have expressed a positive disposition towards utilizing these capabilities of the platform, as they recognize their fundamental importance to learning, especially during an economic crisis which constraints the physical presence of many students in classes. Therefore, the study proposes three, accommodating to all, systemically desirable and culturally feasible changes that could improve the situation, mainly based on pedagogy. Overall, this research contributes to existing knowledge about the usage of LMS regarding interaction and communication in a blended learning environment by providing a holistic view on users’ perceptions and identifying changes capable to bring about improvements.