Gestao Hospitalar

861

Obstacles found in the construction of a democratic and participatory hospital management model

Andrea Bernardes 1
Luis Carlos de Oliveira Cecílio 2
Janete R. S. Nakao 3
Yolanda D. Martinez Évora 3

1

Departamento de
Enfermagem, Centro
Universitário Barão de
Mauá. Rua Ramos de
Azevedo 423. 14090-180
Ribeirão Preto SP. [e-mail] 2
Universidade Federal de
São Paulo.
3
Escola de Enfermagem de
Ribeirão Preto,
Universidade de São Paulo.

Abstract A path leading to management modernization is based on an approach stressing dialog and discussions of the construction of a healthcare enhancement project whose main characteristic is its emphasis on joint management concepts at all levels. This paper assesses almost ten years of management by committee in a public hospital in Rio de Janeiro State, Brazil, seeking impacts on its micro-policies. The intention is to identify and analyze how the nursing staff experienced the implantation of this management model in the hospital. Empirical matters were analyzed at two levels: initially the comments of the players were grouped into themes, followed by cross-theme readings that analyzed the concept of “noise”.
The remarks made by the respondents indicated that this “noise” functions within the organization, demonstrating that the selected management process and the manner in which it was conducted are not sufficient to penetrate and intervene in institutional micro-policies, leaving gaps between the proposals set forth by this management model and the real situation of the workers.
Key words Joint management, Democratic and participatory management, Management by committee

Resumo Um caminho para a modernização gerencial tem se pautado na perspectiva mais dialógica em torno da construção de um projeto de qualificação da assistência que tem como característica importante a ênfase na gestão colegiada em todos os níveis, a partir do conceito de co-gestão. O estudo visa