Made available in DSpace on 2015-03-05T19:13:43Z (GMT). No. of bitstreams: 0 Previous issue date: 13 / Nenhuma / Esta dissertação tem o propósito de verificar a aplicabilidade do modelo referencial avançado de controle estratégico de custos (CEC) (Diehl, 2004) no contexto hospitalar universitário filantrópico. O primeiro capítulo faz uma contextualização do tema e da problemática do controle estratégico de custos neste ambiente. O segundo capítulo apresenta o cenário dos serviços hospitalares no Brasil, focando os hospitais universitários e filantrópicos. O terceiro capítulo apresenta o referencial teórico sobre a Estratégia e o quarto capítulo sobre Controle e Custos. O quinto capítulo apresenta o Modelo CEC, discutindo suas especificidades para o ambiente em questão. O sexto capítulo apresenta a metodologia de Estudo de Caso, aplicada no Hospital São Lucas da PUCRS. O sétimo capítulo apresenta o estudo de caso, discutindo a aplicabilidade do modelo ao novo contexto. O estudo conclui que o hospital, em um momento de afirmação das estratégias de liderança em custos e configuração organizacional de defensor, tem reforçad / This dissertation intends to verify the applicability of the referent advanced model of Strategical Control of Costs (SCC) (Diehl, 2004) in the context of a philanthropic university hospital. The first chapter contextualizes the theme and the strategical control of the cost problems in this environment. The second chapter presents the hospital service scene in Brazil focusing upon philanthropic university hospitals. The third chapter shows the theory about strategy and the fourth one includes control and costs. The fifth chapter specifies the SCC Model according to the mentioned environment. The sixth chapter presents the Study of Case methodology applied to PUCRS St. Lucas Hospital. In the seventh chapter the Study of Case sets up the discussion of the model applicability in relation to the new context. At last, the study concludes that the hospital is in an affirmation moment of the leadership strategies in relation to the costs and oranizational configuration as a defender the hospital has reinforced the c

Esta dissertação apresenta o uso de técnicas para o estudo de layout e avaliação de desempenho do setor de radiologia de um hospital universitário. A dissertação foi elaborada em formato de três artigos científicos, cujos temas e objetivos são: (i) aplicar a análise de conglomerados como etapa preliminar do planejamento sistemático de layout (Systematic Layout Planning – SLP) para planejar o layout do setor de radiologia de um hospital universitário; (ii) realizar uma revisão sistemática das técnicas e conceitos adotados para planejar layouts em ambientes hospitalares; e (iii) usar cartas de controle para avaliar o desempenho dos médicos do setor de radiologia de um hospital universitário. Os métodos desenvolvidos para os itens (i) e (iii) foram avaliados através da aplicação de estudos de caso, em exemplos com dados reais. Os métodos propostos para o item (i) foram adaptados especificamente para este caso. Para o item (ii) a metodologia proposta foi de pesquisa exploratória e descritiva, buscando referências na literatura para estudar e discorrer acerca do tema. Para o item (iii), o método foi implementado na prática em um ambiente onde existem apenas estudos de caráter conceitual. Os métodos apresentaram resultados satisfatórios em todos os casos. No primeiro artigo, chegou-se a um layout considerado ideal, separando zonas de ruído e de silêncio, e potencialmente melhorando a produtividade do setor de radiologia. Já no segundo artigo, conceitos, premissas e técnicas sobre o planejamento de layout em hospitais foram apresentados e difundidos, e lacunas e direcionamentos da pesquisa foram apontados. No terceiro artigo, foi possível avaliar o desempenho dos radiologistas através das cartas de controle e calcular a capacidade do processo usando os índices Cp e Cpk. / This study presents the use of techniques for the layout study and performance evaluation in a radiology sector of an university hospital. The study was performed in the form of three scientific articles, whose themes and objectives are: (i) to apply clustering analisys as the preliminary step of Systematic Layout Planning (SLP) to plan the layout of the radiology sector of a universitary hospital; (ii) to carry out a systematic review of the techniques and concepts adopted to plan layouts in hospital settings; and (iii) to use control charts to evaluate the performance of radiologists in a university hospital. The methods developed for items (i) and (iii) were evaluated through the application of case studies in examples with real data. The proposed methods for item (i) were adapted specifically for this case. For item (ii), the methodology proposed was exploratory and descriptive, seeking references in the literature to study and discuss the subject. For item (iii), the method was performed in a case study in an environment where there are only conceptual studies. The methods presented satisfactory results in all cases. In the first article, we reached an ideal layout, separating zones by noise and silence, and potentially improving the productivity of the radiology sector. In the second article, concepts, premises and techniques about layout planning in healthcare were presented and disseminated, gaps and directions of the research were pointed out. In the third article, it was possible to evaluate the performance of the radiologists through the control charts and to calculate the capacity of the process using the indexes Cp and Cpk.

Submitted by Alisson Mota (alisson.davidbeckam@gmail.com) on 2015-06-24T20:58:14Z No. of bitstreams: 1 Dissertacão - Mithell Lobo Souto Maior.pdf: 11901653 bytes, checksum: 7ff6f8e7eb56665dcc2803277a080798 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-06-26T15:22:51Z (GMT) No. of bitstreams: 1 Dissertacão - Mithell Lobo Souto Maior.pdf: 11901653 bytes, checksum: 7ff6f8e7eb56665dcc2803277a080798 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-06-26T15:34:24Z (GMT) No. of bitstreams: 1 Dissertacão - Mithell Lobo Souto Maior.pdf: 11901653 bytes, checksum: 7ff6f8e7eb56665dcc2803277a080798 (MD5) / Made available in DSpace on 2015-06-26T15:34:24Z (GMT). No. of bitstreams: 1 Dissertacão - Mithell Lobo Souto Maior.pdf: 11901653 bytes, checksum: 7ff6f8e7eb56665dcc2803277a080798 (MD5) Previous issue date: 2012-11-13 / At Getúlio Vargas University Hospital (GVUH), like other public hospitals, the food service little knows about the quality perceived by its customers, once there is not a model that allows to evaluate it and improve it systematically. Faced with this problem, this dissertation has the main objective to develop a model to evaluate the quality of the food service for the patients at Getúlio Vargas University Hospital (GVUH), in order to propose suggestions for improvements to the Hospital Management at Getúlio Vargas University Hospital(GVUH). However, literature researches were performed to identify evaluation models applied in the hospital environment then sought to develop and test a model, whose instrument of data collection was a questionnaire consisting of thirty questions, which was applied during the months of October and November 2011, with the 120 patients admitted to Getúlio Vargas University Hospital (GVUH). The data was analyzed and transformed in statistical graphics and was distributed in general form and also by each clinic in the hospital. After analyzing the data collected, the main conclusion of the research was that the model developed and tested can serve as an instrument for the managers of the hospital to obtain a better quality service while also improving the items identified as lower levels of satisfaction with the patients investigated. These items are: Taste the food, the menu variety, food texture, punctuality for lunch delivery, temperature of the food and friendliness of the waitress during the service. / No Hospital Universitário Getúlio Vargas (HUGV), a exemplo de outros hospitais públicos, o serviço de alimentação pouco conhece a qualidade percebida por seus clientes, uma vez que não há um modelo que permita avaliá-la e aperfeiçoá-la de forma sistemática. Diante deste problema, esta dissertação tem como objetivo principal desenvolver um modelo conceitual para avaliar a qualidade do serviço de alimentação para pacientes no HUGV, a fim de propor sugestões de melhorias para a Gestão Hospitalar do HUGV. Para tanto, pesquisas bibliográficas foram realizadas para identificar modelos de avaliação aplicados em ambiente hospitalar, em seguida, buscou-se elaborar e testar um modelo. O instrumento de coleta de dados foi um questionário composto de trinta questões, o qual foi aplicado nos meses de outubro e novembro de 2011, junto a 120 pacientes internados no HUGV. Os dados foram analisados e transformados em gráficos estatísticos distribuídos de forma geral e por clínica do hospital. Após a análise dos dados coletados, a principal conclusão da pesquisa foi que o modelo desenvolvido e testado pode servir como um instrumento para que os gestores do referido hospital obtenham um serviço de melhor qualidade melhorando também os itens identificados como índices de menor satisfação pelos pacientes investigados. Estes itens são: Sabor do alimento, Variedade do cardápio, Textura do alimento, Pontualidade na entrega do Almoço, Temperatura do alimento e Cordialidade da copeira durante o atendimento.

<p>Aim:The overall aim of this study was to obtain more knowledge on the implementation of health care marketing in Sweden, using Uppsala University Hospital (UUH) as a case study. Additionally, based on the results of this case study, the aim was also to give concrete suggestions on how to enable increased focus on the formulation and implementation of health care marketing management strategies. This gives the study a slightly normative approach and aim, since the line is not drawn at description and analysis but also advocate guidelines for the enabling of market orientation.</p><p>Method: The chosen methodology of the study was qualitative, as the study sought to explore, interpret and gain a deeper knowledge of the research area.  Three different strategies of primary data collection were used; (1) interviews with key hospital managers, (2) a survey sent to all heads of clinical departments (68 departments) and (3) the study of selected UUH internal documents and UUH internal material related to the subject. The massive data was consolidated, reported and analyzed as separate parts and as well as an overview analysis from a health care marketing management theoretical framework.</p><p>Results & Conclusions:The study showed that UUH, despite the fact that they produce an annual revenue from health care services sales of approx 1,5 billion SEK, lacks almost every aspect of the tools and abilities necessary to function on a competitive marketplace. This included a non-marketing based planning process, the absence of a marketing organizational unit, no marketing research abilities etc. There were also facts pointing at severe flaws in the accounting systems, uncertainties of the legality of the current marketing activities and no marketing-stimulating incentive-systems in place. Besides these hard facts, the conservative, non-market oriented, organizational culture was deemed to make an attempted marketing adaption very hard to implement. The interviews provided valuable data for the structure and analysis. The survey had a very low response-rate, which didn´t provide any valuable data per se, but was interpreted to support the analysis of the organizational flaws in regard to marketing orientation. The internal document study also resulted in support of this analysis and increased the validity. Based on the analysis, a suggestion for a “road map” to successfully market-adapt Swedish health care was presented.</p><p>Suggestions for future research:Health care marketing most likely constitute its own area of research which also is specific for Sweden, which gives infinite opportunities for further studies. The implementation of marketing strategies in health care is an area that really needs to be further studied, therefore a suggestion for future research is to try and find out just how to enable implementation of a marketing-orientation in an organization which never had one. Another suggestion for further research could be the study of how economic incentive systems and other means of co-worker stimulation influence the production of health care services.</p><p>Contribution of the thesis:We believe that this study will strengthen the marketing understanding for UUH personnel at both managerial as well as all other organizational levels that are interested in the subject. We also believe that politicians, both locally and nationally, will benefit from practical knowledge regarding health care marketing mechanisms currently in place. Though conducted as a case study at one hospital, we deem that the analysis and suggestions are applicable for many other health care providers acting on the Swedish health care services marketplace, possibly contributing to the development of Swedish health care.</p>

Aim:The overall aim of this study was to obtain more knowledge on the implementation of health care marketing in Sweden, using Uppsala University Hospital (UUH) as a case study. Additionally, based on the results of this case study, the aim was also to give concrete suggestions on how to enable increased focus on the formulation and implementation of health care marketing management strategies. This gives the study a slightly normative approach and aim, since the line is not drawn at description and analysis but also advocate guidelines for the enabling of market orientation. Method: The chosen methodology of the study was qualitative, as the study sought to explore, interpret and gain a deeper knowledge of the research area.  Three different strategies of primary data collection were used; (1) interviews with key hospital managers, (2) a survey sent to all heads of clinical departments (68 departments) and (3) the study of selected UUH internal documents and UUH internal material related to the subject. The massive data was consolidated, reported and analyzed as separate parts and as well as an overview analysis from a health care marketing management theoretical framework. Results &amp; Conclusions:The study showed that UUH, despite the fact that they produce an annual revenue from health care services sales of approx 1,5 billion SEK, lacks almost every aspect of the tools and abilities necessary to function on a competitive marketplace. This included a non-marketing based planning process, the absence of a marketing organizational unit, no marketing research abilities etc. There were also facts pointing at severe flaws in the accounting systems, uncertainties of the legality of the current marketing activities and no marketing-stimulating incentive-systems in place. Besides these hard facts, the conservative, non-market oriented, organizational culture was deemed to make an attempted marketing adaption very hard to implement. The interviews provided valuable data for the structure and analysis. The survey had a very low response-rate, which didn´t provide any valuable data per se, but was interpreted to support the analysis of the organizational flaws in regard to marketing orientation. The internal document study also resulted in support of this analysis and increased the validity. Based on the analysis, a suggestion for a “road map” to successfully market-adapt Swedish health care was presented. Suggestions for future research:Health care marketing most likely constitute its own area of research which also is specific for Sweden, which gives infinite opportunities for further studies. The implementation of marketing strategies in health care is an area that really needs to be further studied, therefore a suggestion for future research is to try and find out just how to enable implementation of a marketing-orientation in an organization which never had one. Another suggestion for further research could be the study of how economic incentive systems and other means of co-worker stimulation influence the production of health care services. Contribution of the thesis:We believe that this study will strengthen the marketing understanding for UUH personnel at both managerial as well as all other organizational levels that are interested in the subject. We also believe that politicians, both locally and nationally, will benefit from practical knowledge regarding health care marketing mechanisms currently in place. Though conducted as a case study at one hospital, we deem that the analysis and suggestions are applicable for many other health care providers acting on the Swedish health care services marketplace, possibly contributing to the development of Swedish health care.

Pagrindinis šio darbo tikslas yra išstudijuoti procesus, procedūras, priemonės ir problemas susijusias su klinikinių duomenų rinkimu, kaupimu, panaudojimu, informacijos judėjimu Kauno medicinos universiteto klinikose bei pasiūlyti idėjas, kaip patobulinti jau veikiančius duomenų rinkimo bei kaupimo metodus, pagerinti sukauptų duomenų analizavimą, statistikos rinkimą, apžvelgti integravimosi su kitomis egzistuojančiomis informacinėmis sistemomis, ir apibendrinant – pagerinti bei pagreitinti informacijos judėjimą gydymo įstaigoje sukuriant naują unifikuotą KMUK klinikinių duomenų informacinę sistemą. Šis tyrimas yra sutelktas ties informacijos rinkimu, apdorojimu bei apsikeitimu ne tik vietiniu mastu, t.y. tarp atskirų klinikų, bet ir visos Lietuvos mastu, t.y. su kitomis Lietuvos gydymo įstaigomis, bei kuriamu nacionalinės e. sveikatos sistemos projektu. Tyrimas parodė, jog duomenų rinkimas yra pakankamai sudėtingas. Yra naudojamos skirtingos priemonės, tokios kaip: pacientų kortelės, registrai, įvairios formos. Visos šios skirtingos duomenų rinkimo bei kaupimo priemonės rodo, jog yra didelis poreikis vieningos sistemos, kuri apimtų visus klinikose vykstančius procesus, realizuotų skirtingų profilinių klinikų darbo savitumus. Viso tyrimo metu diskutuojant tiek su gydymo įstaigų darbuotojais, tiek nagrinėjant jau esamas sistemas aš supratau, jog yra nemažai problemų susijusių su informacijos valdymu bei apdorojimu. Vienos iš jų – nepakankamas suvokimas poreikio kaupti... [toliau žr. visą tekstą] / The main aims and objectives of this study are, to explore the procedures, tools and problems related to primary health care data collection, storage, use and information flows in Kaunas university of medicine and to offer ideas and suggestions on how to improve the systems of routine data collection, storage, analysis and use of information and more generally to improve the flows of information and also to explore challenges related to realizing the potential for cooperative, integrated information systems in healthcare and more generally – to improve the flows of information by creating a new unified information system of clinical data. This study is based on data collection, processing and exchanging not only in the area of Kaunas university of medicine, but also, with the other institutions of health care and the „NESS“ project which is now being developed. The study showed that the process of data collection is rather complex. A number of data collection tools are used: patient cards, registers, various forms. All of this shows that a unified information system of clinical data is needed. It will involve all the processes inside clinics, deal with the individuality of every single clinic. Through a cross – case analysis and discussions with people who work in health care I found that there are several problems related to the use and management of information like lack of clear understanding of the purpose of data collection, poor knowledge of working with computer... [to full text]

Thesis (M.S.)--University of Michigan, 1975.

Thesis (M.S.)--University of Michigan, 1975.

Cette thèse s’intéresse aux évolutions de la médecine hospitalo-universitaire, sous l’angle des relations qui s’instaurent entre activités de soins et de recherche des enseignants-chercheurs praticiens hospitaliers (PUPH – MCUPH). Deux questions centrales organisent cette investigation sociologique. D’une part, en quoi l’autonomie historique (acquise au XIXème siècle) du savoir médical plus particulièrement anatomo-clinique et de ses agents est-elle, ou non, remise en cause sous l’effet des réformes bureaucratico-gestionnaires de l’espace dominant de la médecine (celui des CHU) de ces dernières années ? D’autre part, en prenant en compte l’existence d’un univers de la médecine historiquement différencié entre médecine clinique, médecine biologique et santé publique, peut-on dire que l’hégémonie clinique sur les autres sous-espaces de la médecine est atteinte dans ce contexte ? Ce travail revient sur la manière dont l’actualisation de la clinique dans le cadre des restructurations hospitalières constitue un enjeu pour l’élite médicale sur le terrain. Les luttes historiques constitutives du champ concernent en effet la définition même de la médecine clinique, ses frontières, les limites de son objet, ses objectifs, la nature de sa connaissance, ses modes d’interventions, ses conditions de pratiques et ses interactions avec les autres formes de connaissances, notamment scientifiques, essentielles à son essor. Face à l’ampleur que prend depuis les années 1970 les connaissances sociales, économiques et gestionnaires sur la médecine, nous faisons l’hypothèse qu’un processus de routinisation de la légitimité clinique au sein du champ médical tend à s’opérer par la voie de la réforme hospitalière : il s’agit de demander aux médecins de rendre compte de leur pratique et de rendre des comptes sur leur pratique. Autrement dit, de passer d’opérateur à témoin de ce qu’est la médecine, son champ d’intervention et les interrogations sociétales qu’elle porte. Ce sont ainsi les mécanismes de transformation possible de cet ordre des légitimités qu’il s’agit avant toute chose d’interroger, leur construction et leur mode d’intégration au champ. / This thesis is interested in developments in the university hospital medicine, in terms of the relationships that develop between care and research hospital practitioners teacher-researchers (PUPH - MCUPH). Two central questions are organizing this sociological investigation. First, how the historical autonomy (acquired in the nineteenth century) of particular anatomical clinical medical knowledge and its agents is it or not questioned as a result of bureaucratic-managerial reforms of space overlooking medicine (the CHU) in recent years? On the other hand, taking into account the existence of a universe of medicine historically differentiated between clinical medicine, biological medicine and public health, can we say that the clinical hegemony over other sub-areas of medicine reached in this context ? This work comes to how updating of the clinic in the context of hospital restructuring is a challenge for the medical elite field. The constituent historical struggles of the field concerned in fact the very definition of clinical medicine, its borders, the limits of its purpose, objectives, the nature of its knowledge, its modes of action, conditions of practice and its interactions with other forms of knowledge including science, essential to its growth. Given the scale that took since the 1970s social knowledge, economic and managers on medicine, we assume that routinization of clinical legitimacy process within the medical field tends to take place through Hospital Reform: it is asking doctors to report their practice and be accountable for their practice. In other words, to move from operator to witness what the medicine, its field of intervention and societal questions she wears. These are the possible transformation and mechanisms of this kind of legitimacy that it is above all to question, their construction and mode of integration in the field.

Esta dissertação apresenta o uso de técnicas para o estudo de layout e avaliação de desempenho do setor de radiologia de um hospital universitário. A dissertação foi elaborada em formato de três artigos científicos, cujos temas e objetivos são: (i) aplicar a análise de conglomerados como etapa preliminar do planejamento sistemático de layout (Systematic Layout Planning – SLP) para planejar o layout do setor de radiologia de um hospital universitário; (ii) realizar uma revisão sistemática das técnicas e conceitos adotados para planejar layouts em ambientes hospitalares; e (iii) usar cartas de controle para avaliar o desempenho dos médicos do setor de radiologia de um hospital universitário. Os métodos desenvolvidos para os itens (i) e (iii) foram avaliados através da aplicação de estudos de caso, em exemplos com dados reais. Os métodos propostos para o item (i) foram adaptados especificamente para este caso. Para o item (ii) a metodologia proposta foi de pesquisa exploratória e descritiva, buscando referências na literatura para estudar e discorrer acerca do tema. Para o item (iii), o método foi implementado na prática em um ambiente onde existem apenas estudos de caráter conceitual. Os métodos apresentaram resultados satisfatórios em todos os casos. No primeiro artigo, chegou-se a um layout considerado ideal, separando zonas de ruído e de silêncio, e potencialmente melhorando a produtividade do setor de radiologia. Já no segundo artigo, conceitos, premissas e técnicas sobre o planejamento de layout em hospitais foram apresentados e difundidos, e lacunas e direcionamentos da pesquisa foram apontados. No terceiro artigo, foi possível avaliar o desempenho dos radiologistas através das cartas de controle e calcular a capacidade do processo usando os índices Cp e Cpk. / This study presents the use of techniques for the layout study and performance evaluation in a radiology sector of an university hospital. The study was performed in the form of three scientific articles, whose themes and objectives are: (i) to apply clustering analisys as the preliminary step of Systematic Layout Planning (SLP) to plan the layout of the radiology sector of a universitary hospital; (ii) to carry out a systematic review of the techniques and concepts adopted to plan layouts in hospital settings; and (iii) to use control charts to evaluate the performance of radiologists in a university hospital. The methods developed for items (i) and (iii) were evaluated through the application of case studies in examples with real data. The proposed methods for item (i) were adapted specifically for this case. For item (ii), the methodology proposed was exploratory and descriptive, seeking references in the literature to study and discuss the subject. For item (iii), the method was performed in a case study in an environment where there are only conceptual studies. The methods presented satisfactory results in all cases. In the first article, we reached an ideal layout, separating zones by noise and silence, and potentially improving the productivity of the radiology sector. In the second article, concepts, premises and techniques about layout planning in healthcare were presented and disseminated, gaps and directions of the research were pointed out. In the third article, it was possible to evaluate the performance of the radiologists through the control charts and to calculate the capacity of the process using the indexes Cp and Cpk.