Avaliação qualitativa da implantação do modelo de linhas de cuidado em hospital público de Belo Horizonte

Abstract

The aim of this study was to evaluate the implementation of the model lines Care of a public hospital in Belo Horizonte, Minas Gerais, considering the involvement of managers, health professionals and users in the proposal. The study was motivated by the need to evaluate, from the point of view of the people involved, as the model was being careful lines deployed in the research institution. The theoretical and methodological proposal is a qualitative evaluative, based on institutional analysis to understand the modes of action of individuals within institutions and between institutions in social change processes, such as the implementation of model lines Care in a general hospital in the Unified Health System of Brazil. The information was collected throughgroup interview, focus group of professional service and individual interviews with managers and users, and analyzed based on the Structural Analysis of Narrative. We interviewed ten users of the service, seven managers and conducted five focus groups with aid workers from the hospital study. The interpretation of the data revealed three core categories: The Work Process; Institutional Management; Teaching Hospital. Work Process category five subcategories emerged: The look of managers and workers about the care model; institutional multidisciplinary teams; Continuity of care and differences in care stations; Teamwork: multidisciplinary or interdisciplinary?; Hospital andhealth network; User in hospital. Institutional Management category, threesubcategories emerged: Hospital Planning and Management, Human Resource Management, Commissions and Colleges. Observed, some misunderstanding with respect to the proposed model. The overcrowding of the ER and work overload were placed as limiting for the implementation of Care Lines. The continuity and comprehensiveness of care in the institution are still incipient and teams, mostly characterized by grouping people. However, institutions Stroke Unit, Palliative Care, EMTN, Multidisciplinary Residency and Training Students are breaking the traditional model and serve as models, driving the other scenarios for the proposed logic. User satisfaction was perceived mainly related to the good service provided. Listening to this user is still incipient, this beingplaced further treatment margins, thereby not providing the same autonomy. Few spaces collegiate management to co-responsibility of the actors. It is understood that the care model lines Care is being implemented in the institution with strong forces instituting various institutions present.