Liliane Bauer Feldman

História da evolução da qualidade hospitalar: dos padrões a acreditação

This work contemplates the literature revision of Quality Standardization and the evaluation process by means of Hospital Accreditation literature. A historic resume have been worked out, about the beginnings of quality evaluation within the health services, from the Hospital Standardization Program, elaborated by the American Surgeons College, in the middle of 1924, to the creation of ONA - National Accreditation Organization, who has as main goals the installation and implementation of a health assistance permanent improvement process, thus stimulating the services to reach higher quality standards. After a reflection exercise, it was considered that, in the evaluation of services, its necessary to seek a higher value of the assistentials results, as well as the elaboration of more equanimous patterns in the structure, processes and results of the assistential quality.This work contemplates the literature revision of Quality Standardization and the evaluation process by means of Hospital Accreditation literature. A historic resume have been worked out, about the beginnings of quality evaluation within the health services, from the Hospital Standardization Program, elaborated by the American Surgeons College, in the middle of 1924, to the creation of ONA National Accreditation Organization, who has as main goals the installation and implementation of a health assistance permanent improvement process, thus stimulating the services to reach higher quality standards. After a reflection exercise, it was considered that, in the evaluation of services, it’s necessary to seek a higher value of the assistentials results, as well as the elaboration of more equanimous patterns in the structure, processes and results of the assistential quality.

Identificação dos critérios de avaliação de resultados do serviço de enfermagem nos programas de acreditação hospitalar

The quality is already a part of daily reality in hospital organizations. Care is assessed through the organizational structures, work processes and obtained results. The goal was to identify the result evaluation criteria applied to the nursing service, used in accreditation programs, and to classify them in administrative, care and teaching/research activities. We carried out an exploratory, descriptive and quantitative study. Data were collected from 7 companies accredited by the National Accrediting Organization. These sent us 8 models, divided into groups A, B and C. Group A: models that use the manual; group B: models to which criteria were added; and group C: proper models. We identified 24 criteria: 13 administrative, 06 for care processes and 05 for teaching/research. Nursing services are evaluated with prominence to the administrative area, indicating that the other areas need to be reevaluated in terms of qualitative and quantitative aspects, in order to obtain more precise measurements.La calidad ya hace parte del cotidiano de las organizaciones hospitalarias. Para evaluar la atencion, severifican las estructuras organizacionales, los procesos de trabajo y los resultados obtenidos. La finalidad fueidentificar los criterios de evaluacion de resultado aplicados al servicio de enfermeria utilizados en los programasde acreditacion, y clasificarlos en las areas administrativa, asistencial y ensenanza/investigacion. Fue llevadoa cabo un estudio exploratorio, descriptivo y cuantitativo. Los datos fueron recolectados de 7 empresasacreditadas por la Organizacion Nacional de Acreditacion, que mandaron 8 modelos que fueron divididos en losgrupos A, B e C. Grupo A: modelos que usan el manual; grupo B: modelos a los cuales fueron anadidoscriterios; y grupo C: modelos propios. Identificamos a 24 criterios: 13 administrativos, 06 de procesosasistenciales, y 05 de ensenanza/investigacion. Se observo que el servicio de enfermeria es evaluado conenfasis en el area administrativa, indicando que las demas areas necesitan de una reevaluacion en los aspectoscuantitativos y cualitativos para obtener una medida mas precisa.DESCRIPTORES: evaluacion de procesos y resultados (atencion de salud); servicios de enfermeria; acreditacion;administracion hospitalaria

Criatividade e inovação: competências na gestão de enfermagem

This article presents the importance of the creativity and innovation on health services, distinguishing those concepts. Creative behavior is the improvement of an element or known actions: whereas innovation means finding new alternatives. Considering competences like knowledge, skill and attitude--KSA, it is understood that by stimulating creativity and innovation, the performance of the health professional will be optimized. Therefore, creativity and innovation are key elements for improvement and organization, and, more specifically, for Nursing to find alternatives for solving problems related to the occupation as a whole. In this way, this approach brings a strategic tool on the process of management and a differential for the nurse, which by innovating and creating will amaze herself with her potential.This article presents the importance of the creativity and innovation on health services, distinguishing those concepts. Creative behavior is the improvement of an element or known actions; whereas innovation means finding new alternatives. Considering competences like knowledge, skill and attitude - KSA, it is understood that by stimulating creativity and innovation, the performance of the health professional will be optimized. Therefore, creativity and innovation are key elements for improvement and organization, and, more specifically, for Nursing to find alternatives for solving problems related to the occupation as a whole. In this way, this approach brings a strategic tool on the process of management and a differential for the nurse, which by innovating and creating will amaze herself with her potential.

Avaliação dos serviços de enfermagem: identificação dos critérios de processo dos programas de acreditação hospitalar

Efforts to ensure quality in healthcare, to elaborate patterns and criteria have been a challenge in Brazil. This study aimed to identify the process of evaluation criteria applied to the nursing services adopted by Accreditation programs, and classify them in administrative, assistential and teaching research attributions. The study was exploratory, descriptive and quantitative. Collected data from 7 companies accredited by the National Accrediting Organization leaded into 8 models, which were divided into A, B and C groups. Seventy-nine criteria were identified; 32 from assistential, 32 administrative and 15 teaching-research processes. The nursing service was evaluated with focus in the C group. A small amount of assistential and learning research in A and B groups, showing that an increase in criteria would be necessary in order to obtain more accurate measuring.Esforcos para assegurar a qualidade da assistencia, elaborar padroes e criterios tem sido um desafio no Brasil.O objetivo foi identificar os criterios de avaliacao de processo aplicados aos servicos de enfermagem adotados nos programas de Acreditacao e classifica-los nas atribuicoes administrativas, assistenciais e ensino-pesquisa. Estudo foi exploratorio, descritivo e quantitativo.Os dados coletados de 7 empresas credenciadas pela Organizacao Nacional de Acreditacao nos enviaram 8 modelos, que foram divididos: grupos A, B e C. Identificou-se 79 criterios; 32 de processos assistenciais, 32 administrativos e 15 ensino-pesquisa.O servico de enfermagem foi avaliado com destaque no grupo C. Pouca quantidade de criterios assistenciais e ensino-pesquisa nos grupos A e B, indicando que acrescimo de criterios seja necessario para se obter mensuracoes mais precisas.

Identification of result evaluation criteria for nursing service in hospital accreditation programs

The quality is already a part of daily reality in hospital organizations. Care is assessed through the organizational structures, work processes and obtained results. The goal was to identify the result evaluation criteria applied to the nursing service, used in accreditation programs, and to classify them in administrative, care and teaching/research activities. We carried out an exploratory, descriptive and quantitative study. Data were collected from 7 companies accredited by the National Accrediting Organization. These sent us 8 models, divided into groups A, B and C. Group A: models that use the manual; group B: models to which criteria were added; and group C: proper models. We identified 24 criteria: 13 administrative, 06 for care processes and 05 for teaching/research. Nursing services are evaluated with prominence to the administrative area, indicating that the other areas need to be reevaluated in terms of qualitative and quantitative aspects, in order to obtain more precise measurements.La calidad ya hace parte del cotidiano de las organizaciones hospitalarias. Para evaluar la atencion, severifican las estructuras organizacionales, los procesos de trabajo y los resultados obtenidos. La finalidad fueidentificar los criterios de evaluacion de resultado aplicados al servicio de enfermeria utilizados en los programasde acreditacion, y clasificarlos en las areas administrativa, asistencial y ensenanza/investigacion. Fue llevadoa cabo un estudio exploratorio, descriptivo y cuantitativo. Los datos fueron recolectados de 7 empresasacreditadas por la Organizacion Nacional de Acreditacion, que mandaron 8 modelos que fueron divididos en losgrupos A, B e C. Grupo A: modelos que usan el manual; grupo B: modelos a los cuales fueron anadidoscriterios; y grupo C: modelos propios. Identificamos a 24 criterios: 13 administrativos, 06 de procesosasistenciales, y 05 de ensenanza/investigacion. Se observo que el servicio de enfermeria es evaluado conenfasis en el area administrativa, indicando que las demas areas necesitan de una reevaluacion en los aspectoscuantitativos y cualitativos para obtener una medida mas precisa.DESCRIPTORES: evaluacion de procesos y resultados (atencion de salud); servicios de enfermeria; acreditacion;administracion hospitalaria

Validation of the process criteria for assessment of a hospital nursing service

OBJETIVO: validar um instrumento com criterios de processo para avaliacao do servico de enfermagem, com base na Organizacao Nacional de Acreditacao. METODO: estudo descritivo, quantitativo, de abordagem metodologica, realizado em etapas, onde, apos elaboracao do instrumento com 69 criterios de processo, esse foi avaliado, conforme escala tipo Likert, por 49 enfermeiros de hospitais acreditados em 2009, e validado por 16 juizes, por meio do ciclo de Delphi, em 2010. RESULTADO: o instrumento inicial, analisado pelos enfermeiros com 69 criterios de processo, foi julgado pelo grau de importância, e passou para 39 criterios. No 1o ciclo Delphi, os 39 criterios atingiram o consenso entre os 19 juizes, com media de confiabilidade pelo alfa Cronbach. No 2o ciclo, foram validados 40 criterios convergentes, por 16 juizes, com alta confiabilidade. Os criterios abordam a gestao, custo, ensino, educacao, indicadores, protocolos, recursos humanos, comunicacao, entre outros. CONCLUSAO: os 40 criterios de processo validados formam um instrumento para avaliacao do servico de enfermagem hospitalar que, ao ser mensurado, pode melhor direcionar as intervencoes pelo enfermeiro para o alcance e fortalecimento dos resultados.OBJECTIVE to validate an instrument containing process criteria for assessment of a hospital nursing service based on the National Accreditation Organization program. METHOD a descriptive, quantitative methodological study performed in stages. An instrument constructed with 69 process criteria was assessed by 49 nurses from accredited hospitals in 2009, according to a Likert scale, and validated by 16 judges through Delphi rounds in 2010. RESULT the original instrument assessed by nurses with 69 process criteria was judged by the degree of importance, and changed to 39 criteria. In the first Delphi round, the 39 criteria reached consensus among the 19 judges, with a medium reliability by Cronbachs alpha. In the second round, 40 converging criteria were validated by 16 judges, with high reliability. The criteria addressed management, costs, teaching, education, indicators, protocols, human resources, communication, among others. CONCLUSION the 40 process criteria formed a validated instrument to assess the hospital nursing service which, when measured, can better direct interventions by nurses in reaching and strengthening outcomes.

Evaluating nursing practices beyond our borders.

www.nursingmanagement.com urse managers should routinely evaluate the services being rendered within their organizations. Evaluations provide near-instant feedback, which allows managers to immediately modify programs that require change. Evaluations also help determine future program, service, or care model redesign needs. To start, managers should identify improvement opportunities, but also highlight good care practices.1 The general objective of this study was to develop and validate an instrument containing outcome criteria for evaluating hospital nursing services in Brazil. Specifically, we sought to create an assessment instrument to measure hospital nursing services. This article reviews the outcome criteria used to develop the instrument.

Hospital quality evolution history: from patterns to accreditation

This work contemplates the literature revision of Quality Standardization and the evaluation process by means of Hospital Accreditation literature. A historic resume have been worked out, about the beginnings of quality evaluation within the health services, from the Hospital Standardization Program, elaborated by the American Surgeons College, in the middle of 1924, to the creation of ONA - National Accreditation Organization, who has as main goals the installation and implementation of a health assistance permanent improvement process, thus stimulating the services to reach higher quality standards. After a reflection exercise, it was considered that, in the evaluation of services, its necessary to seek a higher value of the assistentials results, as well as the elaboration of more equanimous patterns in the structure, processes and results of the assistential quality.This work contemplates the literature revision of Quality Standardization and the evaluation process by means of Hospital Accreditation literature. A historic resume have been worked out, about the beginnings of quality evaluation within the health services, from the Hospital Standardization Program, elaborated by the American Surgeons College, in the middle of 1924, to the creation of ONA National Accreditation Organization, who has as main goals the installation and implementation of a health assistance permanent improvement process, thus stimulating the services to reach higher quality standards. After a reflection exercise, it was considered that, in the evaluation of services, it’s necessary to seek a higher value of the assistentials results, as well as the elaboration of more equanimous patterns in the structure, processes and results of the assistential quality.

Validação dos critérios de processo para avaliação do serviço de enfermagem hospitalar

OBJETIVO: validar um instrumento com criterios de processo para avaliacao do servico de enfermagem, com base na Organizacao Nacional de Acreditacao. METODO: estudo descritivo, quantitativo, de abordagem metodologica, realizado em etapas, onde, apos elaboracao do instrumento com 69 criterios de processo, esse foi avaliado, conforme escala tipo Likert, por 49 enfermeiros de hospitais acreditados em 2009, e validado por 16 juizes, por meio do ciclo de Delphi, em 2010. RESULTADO: o instrumento inicial, analisado pelos enfermeiros com 69 criterios de processo, foi julgado pelo grau de importância, e passou para 39 criterios. No 1o ciclo Delphi, os 39 criterios atingiram o consenso entre os 19 juizes, com media de confiabilidade pelo alfa Cronbach. No 2o ciclo, foram validados 40 criterios convergentes, por 16 juizes, com alta confiabilidade. Os criterios abordam a gestao, custo, ensino, educacao, indicadores, protocolos, recursos humanos, comunicacao, entre outros. CONCLUSAO: os 40 criterios de processo validados formam um instrumento para avaliacao do servico de enfermagem hospitalar que, ao ser mensurado, pode melhor direcionar as intervencoes pelo enfermeiro para o alcance e fortalecimento dos resultados.OBJECTIVE to validate an instrument containing process criteria for assessment of a hospital nursing service based on the National Accreditation Organization program. METHOD a descriptive, quantitative methodological study performed in stages. An instrument constructed with 69 process criteria was assessed by 49 nurses from accredited hospitals in 2009, according to a Likert scale, and validated by 16 judges through Delphi rounds in 2010. RESULT the original instrument assessed by nurses with 69 process criteria was judged by the degree of importance, and changed to 39 criteria. In the first Delphi round, the 39 criteria reached consensus among the 19 judges, with a medium reliability by Cronbachs alpha. In the second round, 40 converging criteria were validated by 16 judges, with high reliability. The criteria addressed management, costs, teaching, education, indicators, protocols, human resources, communication, among others. CONCLUSION the 40 process criteria formed a validated instrument to assess the hospital nursing service which, when measured, can better direct interventions by nurses in reaching and strengthening outcomes.

CREATIVITY AND INNOVATION: COMPETENCES ON NURSING MANAGEMENT

This article presents the importance of the creativity and innovation on health services, distinguishing those concepts. Creative behavior is the improvement of an element or known actions: whereas innovation means finding new alternatives. Considering competences like knowledge, skill and attitude--KSA, it is understood that by stimulating creativity and innovation, the performance of the health professional will be optimized. Therefore, creativity and innovation are key elements for improvement and organization, and, more specifically, for Nursing to find alternatives for solving problems related to the occupation as a whole. In this way, this approach brings a strategic tool on the process of management and a differential for the nurse, which by innovating and creating will amaze herself with her potential.This article presents the importance of the creativity and innovation on health services, distinguishing those concepts. Creative behavior is the improvement of an element or known actions; whereas innovation means finding new alternatives. Considering competences like knowledge, skill and attitude - KSA, it is understood that by stimulating creativity and innovation, the performance of the health professional will be optimized. Therefore, creativity and innovation are key elements for improvement and organization, and, more specifically, for Nursing to find alternatives for solving problems related to the occupation as a whole. In this way, this approach brings a strategic tool on the process of management and a differential for the nurse, which by innovating and creating will amaze herself with her potential.