Vanessa Gomes Maziero

Decision-making of the nursing team after the revitalization of a decentralized management model

This studys objective was to identify changes in decision-making arising from the revitalization of the participatory management model and how these changes impacted the daily work of the nursing staff, as well as to identify potential difficulties. This qualitative case study was conducted in a public hospital in the State of Sao Paulo, Brazil. Participant observation and semi- structured interviews were conducted with 23 nursing workers and the Health Technical Assistant. We used thematic content analysis for data analysis. The revitalization of the management model was not comprehensive because many professionals were oblivious to the process. Shared actions did not occur and adherence to the model was hampered because the workers were not fully informed of the assumptions concerning this management model. For the implementation of this model to be effective, teamwork and the inclusionObjetivou-se identificar alteracoes ocorridas na tomada de decisao decorrentes da revitalizacao do modelo de gestao compartilhada e a interferencia delas no cotidiano de trabalho da enfermagem, bem como identificar as dificuldades encontradas. Trata-se de estudo de caso com abordagem qualitativa, desenvolvido em hospital publico do estado de Sao Paulo. Observacao participante e entrevistas semiestruturadas foram realizadas com 23 trabalhadores da enfermagem e a Assistente Tecnica de Saude. Para a analise dos dados optou-se pela analise tematica de conteudo. A revitalizacao do modelo de gestao nao ocorreu de forma expressiva, pois muitos profissionais desconheciam esse processo. O agir compartilhado nao se efetivou e a adesao ao modelo foi prejudicada, pois foi incipiente a estrategia de orientacao acerca dos pressupostos do modelo gerencial. Para que seja possivel a efetivacao deste modelo, deve ser revisto o trabalho em equipe e a insercao de todos os envolvidos buscando um trabalho mais articulado e qualificado.

A tomada de decisão da equipe de enfermagem após revitalização do modelo compartilhado de gestão

This studys objective was to identify changes in decision-making arising from the revitalization of the participatory management model and how these changes impacted the daily work of the nursing staff, as well as to identify potential difficulties. This qualitative case study was conducted in a public hospital in the State of Sao Paulo, Brazil. Participant observation and semi- structured interviews were conducted with 23 nursing workers and the Health Technical Assistant. We used thematic content analysis for data analysis. The revitalization of the management model was not comprehensive because many professionals were oblivious to the process. Shared actions did not occur and adherence to the model was hampered because the workers were not fully informed of the assumptions concerning this management model. For the implementation of this model to be effective, teamwork and the inclusionObjetivou-se identificar alteracoes ocorridas na tomada de decisao decorrentes da revitalizacao do modelo de gestao compartilhada e a interferencia delas no cotidiano de trabalho da enfermagem, bem como identificar as dificuldades encontradas. Trata-se de estudo de caso com abordagem qualitativa, desenvolvido em hospital publico do estado de Sao Paulo. Observacao participante e entrevistas semiestruturadas foram realizadas com 23 trabalhadores da enfermagem e a Assistente Tecnica de Saude. Para a analise dos dados optou-se pela analise tematica de conteudo. A revitalizacao do modelo de gestao nao ocorreu de forma expressiva, pois muitos profissionais desconheciam esse processo. O agir compartilhado nao se efetivou e a adesao ao modelo foi prejudicada, pois foi incipiente a estrategia de orientacao acerca dos pressupostos do modelo gerencial. Para que seja possivel a efetivacao deste modelo, deve ser revisto o trabalho em equipe e a insercao de todos os envolvidos buscando um trabalho mais articulado e qualificado.

Implementation of a participatory management model: analysis from a political perspective.

AIM To analyse experiences of managers and nursing staff in the implementation of participatory management, specifically processes of decision-making, communication and power in a Canadian hospital. BACKGROUND Implementing a Participatory Management Model involves change because it is focused on the needs of patients and encourages decentralisation of power and shared decisions. METHODS The study design is qualitative using observational sessions and content analysis for data analysis. We used Bolman and Deals four-frame theoretical framework to interpret our findings. RESULTS Participatory management led to advances in care, because it allowed for more dialogue and shared decision making. However, the biggest challenge has been that all major changes are still being decided centrally by the provincial executive board. CONCLUSIONS Managers and directors are facing difficulties related to this change process, such as the resistance to change by some employees and limited input to decision-making affecting their areas of responsibility; however, they and their teams are working to utilise the values and principles underlying participatory management in their daily work practices. IMPLICATIONS FOR NURSING MANAGEMENT Innovative management models encourage accountability, increased motivation and satisfaction of nursing staff, and improve the quality of care.

La toma de decisiones del equipo de enfermería después de la revitalización del modelo de gestión descentralizada

This studys objective was to identify changes in decision-making arising from the revitalization of the participatory management model and how these changes impacted the daily work of the nursing staff, as well as to identify potential difficulties. This qualitative case study was conducted in a public hospital in the State of Sao Paulo, Brazil. Participant observation and semi- structured interviews were conducted with 23 nursing workers and the Health Technical Assistant. We used thematic content analysis for data analysis. The revitalization of the management model was not comprehensive because many professionals were oblivious to the process. Shared actions did not occur and adherence to the model was hampered because the workers were not fully informed of the assumptions concerning this management model. For the implementation of this model to be effective, teamwork and the inclusionObjetivou-se identificar alteracoes ocorridas na tomada de decisao decorrentes da revitalizacao do modelo de gestao compartilhada e a interferencia delas no cotidiano de trabalho da enfermagem, bem como identificar as dificuldades encontradas. Trata-se de estudo de caso com abordagem qualitativa, desenvolvido em hospital publico do estado de Sao Paulo. Observacao participante e entrevistas semiestruturadas foram realizadas com 23 trabalhadores da enfermagem e a Assistente Tecnica de Saude. Para a analise dos dados optou-se pela analise tematica de conteudo. A revitalizacao do modelo de gestao nao ocorreu de forma expressiva, pois muitos profissionais desconheciam esse processo. O agir compartilhado nao se efetivou e a adesao ao modelo foi prejudicada, pois foi incipiente a estrategia de orientacao acerca dos pressupostos do modelo gerencial. Para que seja possivel a efetivacao deste modelo, deve ser revisto o trabalho em equipe e a insercao de todos os envolvidos buscando um trabalho mais articulado e qualificado.