Increase in the cost of medical care services has become an important issue in many countries that have implemented national health insurance, including Taiwan. On July of 2002, the National Health Insurance of Taiwan implemented a global budgeting system for all hospital payments. It was hoped that such a system would control the increase of medical expenses within a certain expected range. However, in the absence of reasonable payment bases and effective utilization management and control mechanism, the outcome of implementing this new payment system has been difficult to measure. Therefore, the National Health Insurance (NHI) studied the possibility of implementing DRGs (diagnosis related groups) for all in-patient payments. To evaluate the impact of the new payment system, the medicinal datas collected 1 year before and after implementation of TW-DRGs were analyzed. The tested target is an orthopaedic department in a Public Medical Center. The tested items including average of days in hospital, medical costs, application of National insurance, and sub-item total knee replacement (TKR) and total hip replacement (THR). For overall investigation of the tested orthopaedic department, our findings revealed that implementation of TW-DRGs significantly diminished the average of days in hospital and the average of medical costs. However, implementation of TW-DRGs showed slight influence on the National Health Insurance Application. As to investigate common surgeries, TKR and THR, only the average of days in hospital of TKR was significantly decreased by implementation of TW-DRGs. In addition, other specific TW-DRGs numbered items were also examined to determine the alteration of the factors described above. Our results showed that implementation of TW-DRGs significantly diminished the days in hospital, the medical cost, and the National Health Insurance Application for the selected TW-DRGs numbered items. However, the quality in health care didn¡¦t have significant change after implementation of TW-DRGs. More complete data pools are needed for the more precise analysis to evaluate the influence of TW-DRGs system on the management of hospital and other medical factors in Taiwan.

Stroke is a preventable disease. Minor stroke and transient ischaemic attack (TIA) are important warning signs of the possibility of a major stroke. Worldwide, stroke is the third most common killer and the largest cause of disability. The incidence of stroke is predicted to increase with the predominance of unhealthy lifestyles and the aging population. The adoption of a healthy lifestyle can reduce many of the risk factors. This descriptive study was designed to explore patients’ understanding of modifiable risk factors of cerebrovascular disease. It investigated lifestyle changes actually made, as well as the factors affecting patients’ decisions about whether to make lifestyle changes. The two major factors considered were patients’ sources and level of knowledge and their attitudes and beliefs around making changes. A convenience sample of patients who had suffered a minor stroke or TIA was recruited through a major metropolitan hospital. Thirty-five subjects responded to a postal questionnaire. The mean age was 68 years and 37% of the subjects had sustained some disability as a result of the TIA or minor stroke. The results demonstrated that many subjects had a poor understanding of risk factors of stroke. While smoking was well recognised as a risk factor, subjects showed less awareness of other risk factors, such as excessive alcohol consumption and obesity. Subjects also reported significant confusion regarding diet. Sixty-six percent of subjects depended on doctors as their main source of health information. This may be problematic as the current shortages of General Practitioners has put pressure on doctors to keep appointment times short and reduce the time available for health education. The main barriers to lifestyle change, were lack of motivation, and inadequate, knowledge, guidance, and support and the inability to access good information. Although 83% of subjects suffered from hypertension, medication was the accepted method of control, few subjects realised the significance of lifestyle factors. Nine percent of subjects were only diagnosed with hypertension after their stroke or TIA and few monitor their own blood pressure, despite the wide availability of home monitoring devices. From the findings of this study it is concluded that health promotion and education are very important strategies in the prevention of stroke and it is recommended that this kind of education begins in childhood with tailored, age-specific programs delivered to the public over the lifespan. The role of health screening cannot be underestimated in the detection of risk factors such as hypertension and obesity. Early detection makes effective treatment possible and helps prevent the occurrence of strokes, thus reducing the cost to the community. Long-term health strategies such as improving health resource distribution and enhancing health education are needed where patients and their families participate together in comprehensive education programs. It is hoped that this may lead to a shared understanding, which may translate to patients being more supported, and therefore more able, to make the necessary lifestyle changes. Dysphagia is a common complication following stroke, which can result in significant morbidity and mortality. Multidisciplinary collaboration facilitates management strategies, decision-making and the efficiency of rehabilitation. Nurses are responsible for coordination of management and in particular for continuous monitoring, assessment of swallowing and nutritional state, maintaining safety and preventing complications. An understanding of the issues and strategies relating to management may provide valuable information to enhance the safety, cost-effectiveness and quality of care. A retrospective review of patients’ medical records was used to collect data. A sample of ninety-five adults who were admitted to an Australian public hospital between January 2003 and April 2006, with a diagnosis of dysphagic stroke were recruited. Statistical Package for Social Sciences (SPSS) was used to analyse the quantitative data, while content analysis was used to analyse the qualitative data. All subjects were assessed by a speech pathologist, the mean age was 75 years and 50.5% were male. Except for critically ill subjects, almost all were assessed within three days. Ninety-six percent of subjects had communication problems and 81% had upper limb motor impairment. During hospitalisation almost 60% of subjects had an improvement in their oral intake including 8% resuming their premorbid diet. Eighteen percent were on enteral tube feeding upon discharge, 4% deteriorated and 16% died. It appears that oral intake of most subjects was unsatisfactory. When recorded the mean body weight lost was 2.3kg. At least 22% had malnutrition or dehydration. Forty-five percent aspirated and 22% had respiratory infection. Almost half of the subjects (48%) were discharged to aged care facilities. Eighty percent had no documented follow-up scheduled for management of their dysphagia. Early identification of dysphagia, prudent supervising of appropriate oral intake and mouth care may help to maintain safe swallowing, preventing aspiration and chest infection. Regular checks of body weight, serum albumin level, oral intake and early enteral feeding are essential to guide nutritional support, minimise malnutrition and problematic medication administration. Encouraging oral intake and providing families with support could promote recovery of swallowing skills and help patients to regain the ability to eat independently. Providing helpful information on the care options available may allay patient and family anxiety. A qualified nurse practitioner could assess patients and ensure that a tailored care plan was designed to meet patients’ needs and this may improve the outcomes considerably. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1320650 / Thesis (D.Nurs.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

Thesis (M.H.A.)--University of Michigan, 1973.

Thesis (M.H.A.)--University of Michigan, 1973.

175 p. / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-01-07T18:21:52Z No. of bitstreams: 1 44.pdf: 976609 bytes, checksum: aac68f9049fb667613434e3bff35007d (MD5) / Made available in DSpace on 2013-01-07T18:21:52Z (GMT). No. of bitstreams: 1 44.pdf: 976609 bytes, checksum: aac68f9049fb667613434e3bff35007d (MD5) Previous issue date: 2009 / Esta dissertação tem como objetivo compreender os efeitos dos conhecimentos gerados pelos estudos da gestão da informação na promoção de melhorias na gestão do Hospital Jorge Valente, de atuação geral, privado e de médio porte. O trabalho está fundamentado por um quadro teórico baseado na gestão da informação e no contexto organizacional relacionado ao conceito de hospital como um dos elementos integrantes do sistema de saúde e articulado com uma pesquisa de campo aplicada, onde o problema foi abordado como um estudo de caso, exploratório e de cunho qualitativo com análise de conteúdo. O instrumento de pesquisa utilizado baseia-se em Rezende (2002), que propõe quatro construtos: sistemas de informações, tecnologia da informação, recursos humanos e contexto organizacional. Foram conduzidas entrevistas seguindo o enquadre desses construtos e as respostas foram categorizadas seguindo a temática de Bardin (1977). À guisa de conclusão, o presente estudo indica a necessidade de uma gestão da informação e traz contribuições às discussões que já vêm sendo realizadas no campo teórico, tendo em perspectiva o ambiente hospitalar. Demonstra ainda que a utilização de estratégias qualitativas de pesquisa pode contribuir para os avanços que vêm sendo realizados na área da gestão hospitalar. Além disto, oferece um panorama de dados devidamente categorizados que possibilitam uma compreensão dos efeitos dos conhecimentos gerados pelos estudos da gestão da informação na promoção de melhorias na gestão hospitalar. Vários trabalhos futuros são sugeridos visando maior aprofundamento e melhor investigação sobre a gestão da informação hospitalar. / Salvador

Made available in DSpace on 2015-12-06T23:46:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2013 / Este trabalho possui o objetivo de avaliar a usabilidade das interfaces graficas de dois sistemas de Gestão hospitalar. Os sitemas escolhidos foram o PEP/Unifesp e Tasy, por serem produzidos no Brasil e possuir origens distintas. O primeiro e um sistema nao comercializado, pertence e e utilizado na universidade de São Paulo. O segundo e um sistema comercializado pela empresa Philips, onde varias instituicoes de Saúde o utilizam inclusive o Hospital do Rim o qual doi o foco da pesquisa. A avaliacao da usabilidade foi realizada atraves de duas tecnicas documentadas na literatura. A primeira etapa consistiu na avaliacao do tipo diagnostica ou preditiva, onde nao e necessaria a utilizacao de usuarios finais dos sistemas. Essa fase foi realizada pelo autor junto de duas pessoas voluntarias, onde responderam o checklist denominado Ergolist. A segunda avaliacao, do tipo prospectivo, foi realizada com o usuario sendo o proprio avaliador das interfaces. Eles responderam a um questionario. Para as duas tecnicas, foram utilizados criterios ergonomicos desenvolvidos pelos pesquisadores franceses Bastien e Scapin, sao 18 criterios e subcriterios que as interfaces devem possuir para obter boa usabilidade. A amostra foi compostas por 20 medicos, escolhidos de acordo com a disponibilidade dos medicos, ou seja foi uma amostra de conveniencia. Os resultados mostraram que os ambientes apresentaram problemas de adaptabilidade, pois nao possuem flexibilidade em suas interfaces e nao levam em consideracao a experiencia do usuario. Por sua vez, os criterios coerencia e legibilidade obtiveram os melhores resultados para os dois sistemas, confirmando assim que as informacoes presentes na interface sao de facil acesso e que as paginas seguem padroes bem definidos. Alguns criterios utilizados na pesquisa obtiveram resultados diferentes nas avaliacoes. Dessa forma, podemos salientar a necessidade de utilizar varias tecnicas em conjunto para a avaliacao de usabilidade / The main objective of this project is to evaluate the usefulness of the graphicinterfaces of two systems of hospital management. The chosen systems were o PEP/Unifesp e Tasy; because they were developed in Brazil and they have different origins. The first one is a noncommercial system, it belongs and it’s used by the University of São Paulo. The second system is a commercialized system by Philips; many institutions are using it, especially the Hospital do Rim (São Paulo) which is the focus of the research. The evaluation of the usefulness was applied thought two technics documented in literature. The first step was diagnostic or predictive evaluation, which is not necessary the use of the final system users. This step was performed by the author and two volunteers; they answered the checklist named “Ergolist”. The second evaluation, a prospective, was performed by the user as the evaluator of the interfaces. They answered a questionnaire. Both technics, ergonomics criterion were developed by French researchers Bastien and Scapin. There are 18 criteria and sub-criteria that interfaces should have in order to get a good usability. The sample was composed by 20 doctors, randomly chosen by the author. The results showed that the environments presented adaptability issues, due to the inflexibility of the interfaces; it was not taken into consideration the user experience. Therefore the criteria coherence and readability achieved the best results systems, thus confirming that the information in the interface are easy to access and that the pages follow well-defined patterns. Some criteria used in the survey scored differently in evaluations. Thus, it is important to highlight the need to use several techniques together for usability evaluation. / BV UNIFESP: Teses e dissertações

This research is a qualitative approach investigation that has the aim of studying the conflict in nurse s management practice in hospital context. Its objective is to analyze the conception nurses have of conflict, to infer the strategies used to solve it and to interpret the phenomenon from the variables it assumes in management ambit. The theoretical references are based on the concepts of habitus and Bourdieu s field and on the disciplines of Nursing and Management. For the data collection, a semistructured interview was used, according to Resolution 196/96. Thirteen nurses, hospital managers of hospitals with more then fifty beds, were the informants of this research. In order to interpret the results, one made use of the technique of content analysis (Minayo, 2007), from which emerged five categories: 1) the manager nurses and their practice; 2) the manager nurses perception and the conflict; 3) manager nurses and their sentences; 4) in presence of conflict, to combat it strictly is needed; 5) the conflict in every day fighting camp. Among the evidences, one highlight: 11 from the 13 nurses are in management function most of 80% of their time as graduated and express they have no Idea about the role of a manager before assuming this function. The whole of them understands that conflicts are inherent to organization and the nurse has to acquaint and interact with it. They reveal that inside conflicts are the most impacting to the managers. One concludes that: it is necessary to understand the origin of conflicts; factors which favor their installation and to recognize the importance to approach them in an interdisciplinary way. / Trata-se de uma dissertação com abordagem qualitativa tendo como objeto de estudo o conflito no exercício gerencial do enfermeiro no contexto hospitalar. Objetiva analisar a concepção que os enfermeiros têm do conflito, inferir estratégias utilizadas na resolução dos mesmos e interpretar o fenômeno a partir das nuances que ele assume no âmbito da gerência. O referencial teórico tem como base os conceitos de habitus e campo de Bourdieu e das disciplinas de Administração e Enfermagem. Para a coleta dos dados foi utilizada a entrevista semi-estruturada, os procedimentos de pesquisa seguiram a Resolução 196/96. Participaram do estudo 13 enfermeiras gerentes de hospitais com mais de cinqüenta leitos. Para a interpretação dos resultados utilizou-se a técnica de análise de conteúdo (Minayo, 2007) emergindo cinco categorias: 1) as enfermeiras gerentes e sua prática; 2) percepção das enfermeiras gerentes e o conflito; 3) enfermeiras gerentes e suas sentenças; 4) na presença do conflito combater com altivez é preciso; 5) o conflito no campo de luta de todos os dias. Entre as evidências destaca-se: 11 das 13 enfermeiras estão na função de gerente mais de 80% do período de graduadas e expressam que não tinham idéia sobre o papel do gerente antes de assumir a função. A totalidade compreende que os conflitos são imanentes à organização tendo o enfermeiro que conviver e interagir diante dele. Revelam que conflitos internos são os mais marcantes para as gerentes. É preciso compreender a origem dos conflitos; fatores que favorecem sua instalação e reconhecer a importância de abordá-lo interdisciplinarmente.

As temáticas da qualidade, avaliação e gestão hospitalar, na atualidade, têm pautado as transições demográficas e epidemiológicas como elementos fundamentais de análise organizacional tendo em vista reorientar a gestão da qualidade hospitalar. Tal perspectiva é importante para os gestores que devem buscar desenvolver uma visão que inclua em suas análises administrativas as características da clientela atendida, uma vez que trazem implicações para a gestão do espaço físico, dos recursos materiais, equipamentos médicos, dos recursos humanos, entre outros. Desse modo, nosso estudo tem como objetivo caracterizar o perfil demográfico e epidemiológico das internações e identificar os eventos adversos relativos a infecção hospitalar segundo as topografias do trato urinário, do aparelho respiratório e da corrente sangüínea, na especialidade de clínica médica de um hospital de urgência e emergência de alta complexidade. Trata-se de estudo exploratório, retrospectivo com foco em análise de dados secundários, do tipo individual, o que possibilitou realizar associações das características das internações estudadas. A população de estudo constituiu-se de todas as internações de pacientes adultos, na especialidade de clínica médica no período de 1999 a 2005. As variáveis de interesse para o estudo foram as variáveis demográficas, as epidemiológicas e as relativas a eventos adversos de infecção hospitalar. Os dados foram coletados do Sistema de Informação Gerencial Hospitalar - SIGH e dos arquivos da Comissão de Controle de Infecção Hospitalar - CCIH. Os resultados revelaram que com a implantação da Central Única de Regulação Médica houve uma reorganização do atendimento no hospital de estudo, priorizando-se o acesso a pacientes que demandam atenção de nível terciário, assim ocorreu diminuição de 32,6% das internações do ano de 1999 para 2000. Os dados demográficos revelaram que as internações de 60 anos ou mais, nos anos de 1999-2003, obtiveram percentual superior a 40%. Em relação ao estado civil o maior percentual por ano foi da categoria casados com variação no período de 33,2% a 46,8%, houve predomínio da raça branca com média de 76,5% e o grau de instrução preponderante foi o 1º grau com média de 76,4%. Quanto aos dados epidemiológicos, as doenças do aparelho circulatório participaram do quantitativo de internações com o maior percentual, com uma média de 26,1%, seguida das doenças do aparelho respiratório com média de 12,2% e doenças infecciosas e parasitárias com 11,9%. Nota-se no decorrer dos anos aumento no percentual de pacientes com diagnósticos de neoplasias, doenças do sangue, dos órgãos hematopoéticos e transtornos imunitários e, dos casos de lesões, envenenamento e outras causas externas. Cabe destacar que a maioria, média de 77,6% das internações no período retratam co-morbidades com associação de 2 a 7 diagnósticos médicos. Em relação ao evento adverso infecção hospitalar a pneumonia mantêm padrão em elevação atingindo 57,1% em 2002, sendo a ocorrência mais freqüente das infecções ao longo do período. As infecções da corrente sangüínea nos dois últimos anos apresentam elevação significativa de 8,3% em 2003 para 36,4 em 2005 e as infecções urinárias demonstram uma trajetória de alternância de ocorrências, atingindo o patamar máximo de 41,6% em 2003 declinando para 18,2% em 2005. Acreditamos que o estudo do perfil demográfico de uma clientela internada, também contribui para o delineamento de planos de ações de saúde e de enfermagem, cabendo destacar que as co-morbidades, a faixa etária de 60 anos ou mais, o rebaixamento do grau de instrução implicam em um maior número de fatores de risco à saúde exigindo direcionalidade na atuação dos gestores e profissionais de saúde. A análise dos resultados conforma o contexto de atuação do enfermeiro no que refere a gerência de cuidados à pacientes de alta complexidade, cabendo destacar o foco prioritário da gerência clínica, inicialmente no que concerne à dimensão biológica uma vez que as situações de urgência colocam em risco a vida do paciente, para então, ir ampliando a fim de acolher as necessidades integrais da pessoa hospitalizada. / Hospital quality, assessment, and management are themes that have currently affirmed demographic and epidemiologic transitions as fundamental elements for organizational analyses, with a view to redirect hospital quality management. This perspective is important for administrators who should search to develop a view that includes clients\' characteristics in the administrative analyses, since they bring implications when administrating the physical area, material resources, medical equipment, human resources, and others. Hence, the purpose of this study is to characterize demographic and epidemiological profiles of hospitalizations and identify the adverse events regarding hospital infection according to topographies of the urinary tract, respiratory system, and bloodstream, in the internal medicine ward of a highcomplexity emergency hospital. This is an exploratory, retrospective study, focused on individual secondary data analysis, which permitted to make associations between the studied hospitalization characteristics. The study population consisted of all adult patient hospitalizations in the internal medicine ward, from 1999 to 2005. The variables of interest in this study were the demographic variables, as well as epidemiological variables and those regarding adverse hospital infection events. Data were collected from the Hospital Management Information System (HMIS) and from the Commission for Hospital Infection Control (CCIH) files. Results showed that, by implementing the Single Medical Regulation Central, a reorganization of the studied hospital care took place, giving priority to patients who required tertiary care. Hence, there was a 32.6% reduction in hospitalizations from 1999 to 2000. Demographic data revealed that hospitalizations of patients aged 60 years or more from 1999 to 2003 was above 40%. Regarding marital status, the highest percentage was for married patients, with a rate ranging from 33.2% to 46.8% in the studied period. As to ethnicity, most patients were white, with an average of 76.5%. Regarding education, primary level prevailed, with an average of 76.4%. As to epidemiological data, circulatory system diseases were the most frequent among hospitalizations, with an average of 26.1%, followed by respiratory system diseases with an average of 12.2%, and infectious and parasitic diseases with 11.9%. It is observed that, over the years, there was an increase in the percentage of patients with diagnosis for neoplasms, blood diseases, hematopoietic organ diseases, and immunity disorders, as well as cases of injuries, poisoning, and other external causes. It is worth highlighting that most hospitalizations (77.6% in average) in the studied period represent co-morbidities with associations between 2 to 7 medical diagnoses. Regarding the adverse hospital infection event, pneumonia maintains a growing standard, reaching 57.1% in 2002. Moreover, pneumonia is the most frequent infection occurrence throughout the period. Bloodstream infections presented a significant increase over the two last years, from 8.3% in 2003 to 36.4 in 2005. Urinary infections demonstrated a path of occurrence exchange, reaching a maximum level of 41.6% in 2003 and dropping to 18.2% in 2005. The authors believe that studies about the demographic profile of a hospitalized population also contribute to outlining health and nursing action plans. It is worth emphasizing that co-morbidities, the age group of 60 years or more, and low education levels imply a greater amount of health risk factors, and, thus, demand directionality from administrators and health professionals. The result analysis confirms the context in which nurses work regarding managing highcomplexity patient care, and it is worth emphasizing the primary focus of clinical management, initially concerning the biological dimension since emergency situations put patients\' lives at risk, to then broaden the focus with a view to approach the hospitalized individual\'s integral needs.

Submitted by Rafael Santana (rafael.silvasantana@ufpe.br) on 2017-05-05T16:38:22Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Larissa-versão final_31 agosto 2016.pdf: 1155415 bytes, checksum: 2f839b2f4b7c3e8f05871ad4ea324e73 (MD5) / Made available in DSpace on 2017-05-05T16:38:22Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Larissa-versão final_31 agosto 2016.pdf: 1155415 bytes, checksum: 2f839b2f4b7c3e8f05871ad4ea324e73 (MD5) Previous issue date: 2016-07-21 / As possibilidades de significado de espiritualidade vêm ganhando expressão no ambiente de trabalho em resposta às inquietações dos funcionários que buscam equilíbrio e bem-estar no espaço laboral, essencialmente no ambiente hospitalar, de modo a atender as necessidades dos usuários, dos colaboradores, das comunidades, e, estrategicamente pode ser uma nova abordagem na estrutura organizacional, com o avanço na fronteira do conhecimento nesta área. A ênfase desta dissertação incide sobre a percepção dos gestores sobre a espiritualidade no ambiente de trabalho do Real Hospital Português de Beneficência em Pernambuco (RHP). Os aspectos que motivaram a escolha do tema estão diretamente relacionados à carência de estudos no que se refere à Espiritualidade no Ambiente de Trabalho (EAT) e por possibilitar novos olhares dos gestores que poderão visualizar um rosto mais humano em suas funções. Assim, os construtos tomados como base desta dissertação foram a Gestão em Hospitais, a Espiritualidade no Ambiente de Trabalho, a Humanização no Ambiente Hospitalar e a Liderança Servidora. A pesquisa caracteriza-se por ser qualitativa, utilizando como estratégia o estudo de caso, do tipo exploratória. A coleta de dados foi realizada sob a forma de entrevista individual semiestruturada e os dados analisados de acordo com a Análise da Pragmática da Linguagem proposta por Mattos (2005). As observações foram efetivadas no ambiente do hospital e as entrevistas realizadas com 11 gestores do RHP. Os resultados mostraram que a maioria dos gestores percebe a espiritualidade no ambiente de trabalho, tal como foi proposta e, por estar vinculada ao contexto hospitalar, existe uma forte correlação com a prática da humanização na saúde. / The possibilities of spirituality definitions are gaining expression in the work field as a result of employees seeking balance and welfare in the workspace, primarily in the hospital environment in order to meet the needs of users, employees, communities, and it can strategically be a new approach to the organizational structure, with the advance of the knowledge frontiers in this area. The emphasis of this dissertation stands on the perception of managers about spirituality at Real Hospital Português' work place in Pernambuco (RHP). The aspects that motivated the choice of this theme are directly related to the lack of studies regarding the Spirituality in the Workplace and allow managers to have a new perspective, being able to have a more human look towards their tasks. Thus, the constructs used as the basis of this work were the Management in Hospitals, Spirituality in the Workplace, Humanization in the hospital environment and Servant Leadership. The research is characterized as qualitative, using as strategy an exploratory-type case study. Data collection was carried out in the form of semi-structured individual interviews and analyzed according to the Pragmatic Analysis of the Language proposed by Mattos (2005). The observations took place in the hospital environment and the interviews were made with 11 managers from RHP. The results showed that most managers perceive spirituality in the workplace, just like proposed, and for being linked to the hospital context, there is a strong correlation to the practice of humanization in healthcare.

Para a efetiva consolidação do Sistema Único de Saúde (SUS) é preciso revisão e aperfeiçoamento de processos assistenciais e de gestão da clínica. A viabilização de sistemas de informação em saúde, como ferramentas de gestão, é uma medida estratégica e constitui-se na base para a qualificação na tomada de decisão na área da saúde. Nas últimas décadas, a informatização dos processos assistenciais e de gestão dos atendimentos ambulatoriais tem sido progressivamente incorporada à rotina dos profissionais de saúde do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRP-USP). Entretanto existem poucas informações sobre o significado destes novos recursos. Recentemente, foi desenvolvido e implantado no Hospital o sistema de Atendimento Eletrônico do Paciente (AEP), cujo objetivo é avaliar a percepção dos usuários do AEP e a potencialidade dos indicadores gerados pelo sistema, na gestão dos ambulatórios. Este estudo tem dois componentes, sendo um descritivo e outro exploratório sobre a fase inicial de sua implantação. Caracteriza-se como um estudo do tipo pesquisa - ação, já que os resultados obtidos nas fases iniciais (descritiva/exploratória) podem influenciar nas etapas subsequentes de implementação plena do Sistema na Instituição. As informações obtidas neste estudo serviram de base para a implementação integral do AEP em todas as especialidades médicas do HCFMRP-USP. Dentre os resultados do estudo apresentamos uma descrição detalhada do AEP e as diferenças observadas em relação ao sistema de agendamentos existente até então. São apresentadas as informações/indicadores que podem ser obtidos em tempo real, tais como: o número de pacientes atendidos, número de consultórios utilizados por especialidade, profissional de saúde que está atendendo, tempo de atendimento e tempo de espera do paciente, entre tantos outros, além da percepção dos usuários em relação ao AEP. O novo sistema possibilita à equipe médica e aos gestores acesso rápido aos dados e sua utilização na tomada decisão em termos assistenciais e de ensino, visando um atendimento mais eficaz e humanizado ao paciente do hospital. A implantação do AEP possibilitou aos coordenadores, médicos e ao gestor dos ambulatórios, acesso rápido aos dados e sua utilização como ferramenta para gestão da clínica e tomada de decisão em termos assistenciais e de ensino, visando à melhoria da qualidade no atendimento ao paciente / For the effective consolidation of the Unified Health System (SUS) is necessary to review and improvement of healthcare process and the clinical management. The implementation of Health Informatics systems is a strategic action and constitutes the basis to qualify decision-making in health care. In recent decades, there is an increase use in technology associated with healthcare and also in the management of outpatient-clinic processes has been progressively incorporated into the routine of the University Clinics Hospital of Ribeirão Preto. However there is a lack of information about the significance of these new developments in the clinical and management practice. Recently, the hospital implemented the Electronic Scheduling System (ESS) for the Patient, and the aim of this study is to evaluate the users\' perception of ESS and the potential of the indicators generated by the system in the management of the outpatient-clinic healthcare. This study has two components, a descriptive and another exploratory on the initial phase of ESS implementation. This is \"action-research\" study, since the results obtained in the early stages (descriptive/exploratory) may influence the subsequent steps of full implementation of the system in the institution. The information from this study was the basis for the institutional full implementation of ESS, in all medical specialties. This study was approved by the Hospital IRB. The results are a detailed description of the ESS, compared with existing scheduling system so far. The information/indicators that can be obtained in real time are presented, such as: the number of patients seen; number of offices used by each specialty; how long take the consultation?; how many each resident see?. In addition we got the users perception about the ESS. The new system enables the medical staff and managers to have quick access to data and to use it in the decision-makingaiming for amore effective and humanized care to hospital patients. The implementation of the ESS enabled, medical coordinators and clinical managers, a fast access to data and its use as a clinical tool for the management in health care and in terms of health professions education