Práticas institucionalizadas na gestão hospitalar pública: um olhar para os hospitais universitários.

Abstract

Federal university hospitals are strategic components of the health system and as such have faced constant challenges to maintain the provision of quality health services. From this perspective, we sought to identify the practices and organization present in the structure of university hospitals in light of the neo-institutional theory regarding the daily situations of the public health system. In order to do so, the methodology used was constructed according to the parameters established for an exploratory research, with a low focus on aspects relevant to the theme, mainly the evaluation of the divergence observed between normative and institutionalized professional practices in public hospitals. At the same time, it was tried to demonstrate that there were significant changes in the management of university hospitals with the arrival of EBSERH, but there is still much to do, since it is still noticeable the need to work together with other levels of health care, especially when related to the performance of the primary care teams. It was also sought to show the need for contracting and reviewing the employment relationships of the professionals working in hospitals, since this is an old problem and that directly affects the quality of the services offered in the hospital units. In addition, it has also been shown that the existing conflicts between management and professional service providers present as obstacles the implementation and full performance of the new management activities presented by EBSERH to the hospitals. The results show that, in the implementation of the EBSERH management model, the workforce recomposition, the adequacy of the old professionals, the rupture of the status quo, and the dimensioning of the demands were presented as important problems to be solved.