Francisco José Kliemann Neto

Rede social no sistema de saúde: um estudo das relações interorganizacionais em unidades de serviços de HIV/AIDS

The coordination of health services, obtained by integration and cooperation between units of a local system, is achieved by understanding interorganizational relationships, identifying central units and dynamics flow, such as patients, information and knowledge. This paper demonstrates the contributions of social network analysis to the health system, identifying patterns and structures in the network of services, through a case study of the HIV/AIDS healthcare units in the city of Porto Alegre - Brazil. Through interviews with those responsible for the care and data from the council, five types of relationships were studied: forwarding and receiving patients, coordination of cases, joint programs and consultancies. The results indicate a weak dynamic in this network, particularly in relationships that do not involve an exchange of patients, suggesting that if there are established instruments such as scheduled appointments, there is greater dynamic in the network, if not, the personal or local initiatives result in little or no action in terms of coordination between services. The social network measures also identify the role of units and the formation of subgroups, and this information could support the local health authority in the formulation of policies and programs for the improvement of local governance.

Gestão Hospitalar: identificação das práticas de aprendizagem existentes em hospitais

A profissionalizacao da gestao em hospitais, a partir de diferentes praticas da administracao, tem sido amplamente discutida, a luz de conceitos como gestao baseada em evidencia, gestao do conhecimento e aprendizagem organizacional. Entretanto, sao poucos os artigos identificando e discutindo essas praticas nas organizacoes de saude. Este e o objetivo do presente artigo. Buscou-se realizar uma analise historica da gestao em saude no Brasil, considerando uma mudanca a partir do processo de descentralizacao. Foi realizado o mapeamento das praticas de gestao enfatizando-se as metodologias de aprendizagem existentes no setor, a partir de pesquisas documentais. Pode-se perceber uma mudanca de modelo mental na area, passando de um enfoque linear para um enfoque sistemico. Da mesma forma, identificou-se o processo de construcao do conhecimento nessas organizacoes, especialmente a partir da pratica medica. Constatou-se ainda que o processo de aprendizagem enfatiza a aprendizagem individual e nao a aprendizagem organizacional.

Development and application of a bioeconomic efficiency index for beef cattle production in Rio Grande do Sul, Brazil

An index was developed to estimate the bioeconomic efficiency of production systems, identifying alternative scenarios that could improve their efficiency, and building isoefficiency relations in beef cattle production systems in Rio Grande do Sul. The concept of return on investment was used to develop the indicator. Scenarios regarded as efficient showed values higher than 3. The bioeconomic efficiency index for beef cattle production in the theoretical reference scenario was considered inefficient. At least four modifications in the variables method made it a bioeconomically efficient activity. These circumstances were studied using sensitivity analyses, with theoretical changes in the scenarios by changing variables two by two, while the others were kept constant. In Rio Grande do Sul, alternatives that make the activity efficient were identified by changing productivity, production cost, land price and product price. Isoefficiency relationships were identified in other scenarios. The application of this indicator in other agricultural activities, as well as the design of bioefficiency studies including both environmental and social welfare characteristics are recommended.

O impacto da incorporação da inflação na análise de projetos de investimentos

Investment analyses performed in a satisfactory way are essential for companies to apply capital resources in appropriate projects. To this end, the correct quantification of cash flow components, as well as the quantification of the depreciation, inflation and tributary impact of the income tax in economical-financial analysis is fundamental. Hence, the purpose of this study was to evaluate different forms of including inflation in investment analyses and discuss the depreciation role and its impacts. The article indicates two methods of analysis: homogeneous, where every component in the cash flow is updated by the same inflation index; and, heterogeneous, where each component is updated by a different inflation index. Results showed the impact of these two different concepts on the analysis, indicating the necessity of managers to focus on the issue of inflation during the assessment of their projects.

Tools for evaluating environmental performance at Brazilian public ports: Analysis and proposal

The port sector critically needs improved management techniques to evaluate its environmental performance. In the present study, we conducted an exploratory research to understand the metrics used in the Brazilian public ports to assess their environmental performance. We considered two state agencies and two port authorities of southern Brazil. As preliminary results, we found that economic factors are excluded in the tools for measuring environmental performance. A system of indicators to address this shortcoming was then proposed, but it could not be applied because of data deficiencies. Thus, the system was divided into two parts: a simplified system with 7 indicators (measuring costs related to criteria were measured only technically) and an advanced system with 5 indicators (approaching costs were currently difficult to measure). Thus, the proposed indicators can be applied by port authorities to facilitate decision-making related to environmental management. As suggestions for further work, we propose research that includes more ports, both public and private, to provide an overview at the national level.

Métodos colaborativos na gestão de cadeias de suprimentos: desafios de implementação

The collaborative management issue has been discussed as a mean to generate competitive advantage. Collaborative initiatives in supply chains (SC) enabled the emergence of methods and practices that support the idea that competitiveness does not occur between isolated companies any longer, but between chains. In literature, in addition to collaborative methods for supply chain management (SCM), it is possible to find initiatives for project, configuration, and optimization, among others. However, there is little adhesion of collaborative methods for SCM, as well as implementation difficulties. The purpose of the article is to investigate the collaborative methods concerning the coordination of SC and analyze their characteristics and implementation difficulties. A systematic review indicated the Collaborative Planning, Forecasting and Replenishment (CPFR) as the most discussed collaborative approach and, subsequently, a case study identified difficulties in the implementation that complemented what was researched in the literature.The collaborative management issue has been discussed as a mean to generate competitive advantage. Collaborative initiatives in supply chains (SC) enabled the emergence of methods and practices that support the idea that competitiveness does not occur between isolated companies any longer, but between chains. In literature, in addition to collaborative methods for supply chain management (SCM), it is possible to find initiatives for project, configuration, and optimization, among others. However, there is little adhesion of collaborative methods for SCM, as well as implementation difficulties. The purpose of the article is to investigate the collaborative methods concerning the coordination of SC and analyze their characteristics and implementation difficulties. A systematic review indicated the Collaborative Planning, Forecasting and Replenishment (CPFR) as the most discussed collaborative approach and, subsequently, a case study identified difficulties in the implementation that complemented what was researched in the literature.

Produção Conjunta no Processo de Beneficiamento de Carvão Mineral: Custos Conjuntos

Um processo produtivo em que a mesma materia-prima gera mais de um produto, e que cada um nao possa ser produzido sem que os demais ocorram conjuntamente na mesma operacao, denomina-se de producao conjunta. No beneficiamento de carvao mineral existe a producao conjunta cada vez que a rocha combustivel, em seu estado bruto, da origem a produtos (carvao com maior poder calorifico) e subprodutos (rejeito), separados apenas em determinada etapa do processamento (ponto de separacao). Por essa peculiaridade, a operacao conjunta acarreta custos conjuntos durante o processo de concentracao da materia carbonosa, repartindo originalmente, no ponto de separacao, o referido custo conjunto igualmente entre produtos e subprodutos, distorcendo desse modo o valor agregado individualmente, na medida em que tambem atribui custos aos subprodutos sem faturamento aparente. Atraves de criterios, mesmo que arbitrarios, busca-se distribuir no presente estudo os custos conjuntos individualmente por produto, segundo sua maior capacidade em absorver os custos dos subprodutos com receitas inexistentes ou despreziveis. Pelo metodo de alocacao adotado nos cenarios apresentados, pretende-se entender a sistematica de individualizacao dos custos, inicialmente conjuntos, e a analise da rentabilidade marginal quando um novo produto, obtido a partir do reprocessamento do rejeito, e introduzido na matriz de custeio, redistribuindo os custos individualizados e impactando no resultado global.

ERM for Health Care Organizations: An Economic Enterprise Risk Management Innovation Program (E2RMhealth care)

BACKGROUND In recent years, health care organizations have looked to enterprise risk management (ERM) for novel systems to obtain more accurate data on which to base risk strategies. OBJECTIVE This study proposes a conceptual ERM framework specifically designed for health care organizations. METHODS We explore how hospitals in the United States and Brazil are structuring and implementing ERM processes within their management structure. This study incorporates interviews with 15 chief risk officers (8 from the United States and 7 from Brazil) with qualitative data analysis using NVivo (QSR International software). RESULTS The interviews confirm that adopting ERM for health care organizations has gained momentum and become a priority, and that the demand for risk economic assessment orientation is common among health care risk managers. CONCLUSION We propose an ERM model for health care (Economic Enterprise Risk Management in Health Care) divided into four maturity levels and complemented by an implementation timeline. The model is accompanied by guidelines to orient the gradual implementation of ERM, including orientation to perform risk economic assessment.

A proposed enterprise risk management model for health organizations

Abstract Health care organizations are environments with high management complexity and subject to a constant exposure to risks. Enterprise risk management (ERM) has been studied and applied in different economic environments with the aim of improving organizational performance. However, the health sector still suffers from a lack of attention in this context, in particular with regard to the need for a high degree of financial transparency and for the establishment of process-orientated management, and this provides the motivation for the study described in this paper. An ERM model for health organizations is proposed, based on a systematic literature review and on seven case studies in Brazilian hospitals. An approach to economic risk assessment using indicators such as the cash flow at risk and the variability of costs and receipts from the proposed model is suggested. The health organizations involved in the case studies all interpret ERM as a source of information contributing to corporate governance, and the indicators listed provide constructive data for improvement-driven decision-making. Given the interest expressed by the organizations involved, further application and validation of the proposed model in subsequent studies is suggested.

Manufacturing feature-based cost management system: a case study in Brazil

Feature costing is a topic of recent discussion related to cost management systems (CMSs) aimed at understanding how product features influence production process costs. It raises as a key issue in mass customisation environments where a single product model can present hundreds of menu options. In this study, we explore the concept of feature costing beyond the use of activity-based costing (ABC). We propose a CMS based on features and common elements as costing objects instead of products. In our model, we use the unit of production effort method to organise the direct manufacturing costs, ABC method to address the indirect cost and the standard methods to compute raw materials costs. We illustrate the method in the production of bus seats in a Brazilian manufacturing company. This study gives different perspectives to the international academic community on the use of a different CMS used by many Brazilian companies.