Binsfeld Luciane, Rivera Francisco Javier Uribe, Artmann Elizabeth
Instituto Nacional de Saúde da Mulher, Criança e Adolescente Fernandes Figueira, Fiocruz. Av. Rui Barbosa 716, Flamengo. 22250-020 Rio de Janeiro RJ Brasil.
Escola Nacional de Saúde Pública Sergio Arouca, Fiocruz. Rio de Janeiro RJ Brasil.
Cien Saude Colet. 2017 Jan;22(1):209-220. doi: 10.1590/1413-81232017221.12822015.
This article analyzes the process of shaping the care profile of federal hospitals in the city of Rio de Janeiro. This is a qualitative, descriptive study that draws on semi-structured interviews with hospital administrators. Data analysis used the Collective Subject Discourse approach. Managers believe this process is the result of a set of emerging strategies, proposals and need for change, which result in adaptive reactions that hospitals develop with no coordination between them to resolve problems identified by professionals and managers. The process is analyzed much more from a political point of view than from a rational and systemic one. Some of the experience with the hospital mission, such as the focus on a strategic approach, already signals a more collegiate approach to defining the profile of care, where the hospital is one component of an integrated network of services, with a decision process that is less incremental and more integrating.
本文分析了里约热内卢市联邦医院护理概况的形成过程。这是一项定性描述性研究，采用了对医院管理人员的半结构化访谈。数据分析采用了集体主体话语方法。管理人员认为，这一过程是一系列新兴战略、提议和变革需求的结果，这些导致了医院在没有相互协调的情况下产生的适应性反应，以解决专业人员和管理人员发现的问题。对这一过程的分析更多地是从政治角度而非理性和系统角度进行的。医院使命的一些经验，比如对战略方法的关注，已经预示着在定义护理概况方面将采取更具合议性的方法，即医院是综合服务网络的一个组成部分，其决策过程的渐进性降低且整合性增强。
