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Uvod: Vodenje sprememb je danes postala ključna veščina vsake (zdravstvene) organizacije in nujnost njenega preživetja, saj je sprememba postala neizogibna. Stopnja neuspešnosti sprememb je kar do 70 odstotna, prav zato je pomembno poznati vzroke, zakaj spremembe uvajamo, ter načine, s katerimi bomo spremembe uspešno uvedli v vsakdanjo prakso. Upravljanje sprememb zajema premišljeno načrtovanje in implementiranje, uspešnost tega procesa pa je v veliki meri odvisna od pravilnega vodstvenega pristopa, saj stili vodenja neposredno vplivajo na uspešnost uvajanja sprememb, in sicer s preoblikovanjem stališč zaposlenih. Namen: Z magistrskim delom želimo preučiti in na osnovi izvedene raziskave pojasniti vpliv stilov vodenja na uvajanje sprememb ter oceniti zadovoljstvo in učinkovitost stilov vodenja, s ciljem vršnemu managementu zagotoviti informacije, ki jih potrebuje za optimalno in uspešno uvedbo spreminjanja v zdravstvenih organizacijah. Metode dela: Magistrsko delo je zasnovano kot kombinacija teoretičnega in empiričnega dela. Teoretični sklop našega raziskovanja predstavlja poglobljena analiza tuje in domače obstoječe uveljavljene literature, ki smo jo pridobili s pomočjo naslednjih uveljavljenih baz podatkov: COBISS Online, Google Učenjak, Web of Science, ScienceDirect in EBSCOhost. Ob predhodno predstavljenem raziskovalnem problemu smo problem vpliva vodstvenih pristopov na uvajanje sprememb v slovenskih zdravstvenih domovih proučevali z neeksperimentalno kvantitativno metodo empiričnega raziskovanja. Izvedli smo presečno študijo, za zbiranje podatkov smo uporabili anketni vprašalnik, ki smo ga oblikovali skladno z namenom empirične raziskave. Sodelovalo je 112 udeležencev, zaposlenih v štirih slovenskih zdravstvenih domovih. Obdelavo ter prikaz podatkov smo izvedli s programskim orodjem Microsoft Excel in programom za statistično obdelavo SPSS V 24. Rezultati: Vrnjenih smo prejeli 112 izpolnjenih anketnih vprašalnikov. Potrdili smo vseh pet predhodno formiranih hipotez. Dokazali smo, da je transformacijsko vodenje statistično (p < 0,05) pozitivno, povezano z zaznano uspešnostjo uvedenih sprememb v organizaciji. Prav tako se tudi transakcijsko vodenje pozitivno povezuje s samo uspešnostjo sprememb, vendar v manjši meri kot transformacijsko. Kot dodatno smo dokazali, da sta tako transformacijsko kot tudi transakcijsko vodenje z ocenjeno učinkovitostjo stilov vodenja povezana močno pozitivno, laissez-faire vodenje pa srednje močno negativno. Kot zadnje smo dokazali, da je moč povezave z zadovoljstvom zaposlenih največja pri transformacijskem vodenju. Razprava in sklep: Izsledki opravljene raziskave nam prikazujejo, da transformacijsko vodenje nastopa kot vodilni voditeljski slog v procesu uvajanja sprememb v zdravstvenih organizacijah. Rezultati naše raziskave so podobni zaključkom preostalih raziskav tega področja. Na osnovi opravljene kvantitativne raziskave lahko zapišemo, da se transformacijsko vedenje vodij pozitivno povezuje z uspešnostjo uvedene spremembe, višjo učinkovitostjo in višjim zadovoljstvom zaposlenih. V zadnjih desetletjih se je večji poudarek na spremembah izkazal kot ključni gonilnik organizacijskega uspeha. Primeren stil vodenja ima neposreden vpliv na uspešnost sprememb, nenazadnje pa tudi na delovno okolje, v katerem se spremembe uvajajo. Introduction: The management of change has become the key skill of every (health) organization and the necessity of its survival as change has become inevitable. The degree of unsuccessful change is as high as 70 percent, which is why it is important to know the reasons why we are introducing changes and how we can successfully implement changes in everyday practice. Change management involves thoughtful planning and implementation, and the success of this process largely depends on the correct management approach, since management styles have a direct impact on the success of introducing changes, by transforming employee attitudes. Purpose: We want to examine, based on the conducted research, and explain the influence of management styles on the introduction of changes, and to evaluate the satisfaction and effectiveness of leadership styles, with the goal of providing peer management with the information it needs to optimally and successfully introduce changes in health organizations. Methods: The master's thesis is designed as a combination of theoretical and empirical work. The theoretical part of our research represents an in-depth analysis of foreign and domestic existing established literature, which we acquired through the following established databases: COBISS Online, Google Scholar, Web of Science, ScienceDirect and EBSCOhost. Having previously presented the research problem, we examined the problem of the influence of managerial approaches on the introduction of changes in Slovene health centers by using an experimental quantitative method of empirical research. We carried out a cross-sectional study. We used a questionnaire for the collection of data, which we designed in accordance with the purpose of empirical research. 112 participants participated in four Slovenian health centers. The processing and display of data was carried out with the Microsoft Excel software and the SPSS V 24 statistical processing program. Results: We received 112 completed questionnaires. We confirmed all five previously formed hypotheses. We have shown that transformational guidance is statistically (p

Resumo: A pesquisa analisou o processo de expansão das Organizações Sociais da Saúde (OSS) no Brasil durante o período de 2009-2014. Para tanto, dimensionou as dez maiores OSS segundo recursos financeiros captados, explorou suas qualificações como entidades sem fins lucrativos, tomando em conta as evidências empíricas que apontam para sua expansão e consolidação no processo de gestão e prestação de serviços de saúde via estratégias próprias de organizações privadas lucrativas. O estudo é descritivo e exploratório, e foi realizado com base em fontes documentais de domínio público. No plano das relações com o Estado, as OSS têm se beneficiado das brechas e facilidades concedidas pela lei e apresentado uma notável expansão. Evidenciou-se um movimento recente das OSS pela busca concomitante da condição de entidades filantrópicas, assegurando múltiplas oportunidades de captação de recursos e de benefícios fiscais; a possibilidade de aplicação de excedentes financeiros no mercado de capitais; e a remuneração de seus corpos diretivos. Há uma concentração em serviços hospitalares com maior densidade tecnológica; nítida predominância de cláusulas respeitantes ao incremento de repasses financeiros em detrimento de outras cláusulas regulatórias; existência de modalidades especiais de contratos com serviços-meios absolutamente estratégicos para o funcionamento geral do Sistema Único de Saúde. Portanto, neste estudo as OSS se configuram como um dos componentes do Complexo Econômico Industrial da Saúde, nas vertentes da gestão, da prestação e da regulação de serviços, em um cenário de intensiva mercantilização da saúde e de transferência de fundo público para o setor privado. Abstract: The study analyzed the expansion of Social Healthcare Organizations (OSS in Portuguese) in Brazil from 2009 to 2014. The ten largest OSS were measured according to their budget funding and their qualifications as non-profit organizations were explored, considering evidence of their expansion and consolidation in the management and provision of health services via strategies proper to for-profit private enterprises. The study is descriptive and exploratory and was based on public-domain documents. In their relations with government, the OSS have benefited from legal loopholes and incentives and have expanded accordingly. There has been a recent trend for these organizations to simultaneously apply for status as charitable organizations, thereby ensuring multiple opportunities for fundraising and additional tax incentives, permission to invest financial surpluses in the capital market, and remunerate their boards of directors. These organizations tend to concentrate in technology-dense hospital services, with clauses concerning increasing financial transfers to the detriment of other regulatory clauses, and special contract modalities for enabling services that are absolutely strategic for the overall functioning of the Brazilian Unified National Health System. Thus, in this study, the OSS are one component of the Health Economic and Industrial Complex, acting in management, provision, and regulation of services in a scenario of intensive commodification of health and the transfer of public funds to the private sector. Resumen: La investigación analizó el proceso de expansión de las Organizaciones Sociales de Salud (OSS) en Brasil, durante el período de 2009-2014. Para ello, se dimensionaron las diez mayores OSS, según los recursos financieros captados, exploró sus características, como entidades sin ánimo de lucro, tomando en consideración las evidencias empíricas que apuntan a su expansión y consolidación en el proceso de gestión y prestación de servicios de salud, vía estrategias propias de organizaciones privadas con ánimo de lucro. El estudio es descriptivo y exploratorio, y fue realizado en base a fuentes documentales de dominio público. En el plano de las relaciones con el Estado, las OSS se han beneficiado de las brechas y facilidades concedidas por la ley y presentado una notable expansión. Se evidenció un movimiento reciente de esas organizaciones por la búsqueda concomitante de su condición como entidades filantrópicas, asegurando múltiples oportunidades de captación de recursos y de beneficios fiscales; la posibilidad de inversión de excedentes financieros en el mercado de capitales; y la remuneración de sus cuerpos directivos. Existe una concentración en servicios hospitalarios con una mayor densidad tecnológica; nítida predominancia de cláusulas, respecto al incremento de transferencias financieras, en detrimento de otras cláusulas regulatorias; existencia de modalidades especiales de contratos con servicios-medios absolutamente estratégicos para el funcionamiento general del Sistema Único de Salud. Por tanto, en este estudio las OSS se configuran como uno de los componentes del Complejo Económico Industrial de la Salud, en las vertientes de la gestión, de la prestación y de la regulación de servicios, en un escenario de intensiva mercantilización de la salud y de transferencia de fondos públicos hacia el sector privado.

Background: Change management has become a key instrument in every organization and is crucial for their survival since changes have become unavoidable. The manner in which changes are introduced in everyday practice is an important component of change management. Managing change involves thoughtful planning and implementation, as well as the involvement of employees. Success is based on an appropriate managerial approach since management styles have a direct impact on the introduction of change by transforming employee attitudes. The aim of the study was to examine the impact of different leadership styles onthe success of introducing changes. Methods: We used a quantitative methodology. The instrument used was a validated questionnaire with closed questions. Four Slovenian healthcare centers were included in the study. Results: The success of the introduced changes statistically positively correlates with the transformational leadership (p < 0.05), and negatively correlates with the Laissez-faire leadership (p < 0.05). The assessed effectiveness of leadership styles positively correlates with the transformational, transactional, and Laissez-faire leadership (p < 0.05). However, within the assessed effectiveness of leadership styles, and the satisfaction with the introduced changes the strong link was observed in transformational leadership. Conclusions: Over the past decades, the emphasis on change has proven to be a key feature of organizational success. Changes are introduced and based on a proper management style, which has a direct impact on the working environment., Uvod: Upravljanje promjenama postalo je ključni instrument u svakoj organizaciji i presudan je za njihov opstanak jer su promjene postale neizbježne. Način na koji se promjene uvode u svakodnevnu praksu važna je komponenta upravljanja promjenama. Upravljanje promjenama uključuje promišljeno planiranje i provedbu, kao i uključivanje zaposlenika. Uspjeh se temelji na odgovarajućem pristupu upravljanju, budući da stilovi vodstva izravno utječu na uvođenje promjena transformiranjem stavova zaposlenika. Cilj istraživanja bio je ispitati utjecaj različitih stilova vodstva na uspjeh uvođenja promjena. Metode: Primijenjena je kvantitativna metodologija. Instrument istraživanja bio je validirani upitnik s pitanjima zatvorenog tipa. Četiri slovenska doma zdravlja bila su uključena u istraživanje. Rezultati: Uspjeh uvedenih promjena statistički pozitivno korelira s transformacijskim stilom vodstva (p < 0,05), a negativno s laissez-faire stilom vodstva (p < 0,05). Procjena učinkovitosti stilova vodstva pozitivno korelira s transformacijskim, transakcijskim i laissez-faire stilom vodstva (p < 0,05). Međutim, jaka veza zabilježena je između transformacijskog stila vodstva i procijenjene učinkovitosti stilova vodstva i zadovoljstva uvedenim promjenama. Zaključak: Tijekom proteklih desetljeća naglasak na promjeni pokazao se kao ključna značajka organizacijskog uspjeha. Promjene se uvode i temelje se na odgovarajućem stilu upravljanja koji ima izravan utjecaj na radno okruženje.

Bu tezin temel amacı, küresel sağlık işbirliğini işlevsel bir bütünleşme alanı olarak ele almak ve Sağlık Diplomasisi'nin önemini vurgulamaktır. Çalışmada DSÖ'nün küresel sağlık alanında eşgüdümlü bir işleyişi mümkün kılmak için geliştirdiği yeni örgütsel çerçeveler, bu çerçevelerin devletlerin karar alma ve bu kararları uygulama esaslarını nasıl etkilemekte olduğu incelenmiştir. Bunun yanı sıra Sağlık Diplomasisi'nin DSÖ nezdinde nasıl algılanıp uygulamaya dönüştürüldüğü de analiz edilmiş, DSÖ'nün işlevsel faaliyetlerinin ulus devletlerin yerini alacağı bir sisteme doğru dünyaya yön verip vermediği de araştırılmaya çalışılmıştır. Ayrıca Sağlık Diplomasisi konusu, Küba ülke örneği ışığında bir dış politika aracı olarak ele alınmış, Küba'nın Sağlık Diplomasisi yürüterek elde ettiği kazanımlar araştırılmıştır. The main objective of this thesis is to consider global health cooperation as a domain of functional integration and to emphasize the importance of Health Diplomacy. The study examined the new organizational frameworks developed by WHO, in order to enable coordinated functioning in the global health arena, how those frameworks affect states' decision-making and the implementation of these decisions. In addition, WHO's perception and implementation of Health Diplomacy was analyzed and it was attempted to explore whether WHO's functional activities direct the world to a system in which international organizations will take the place of nation states. In addition, Health Diplomacy has been examined as a foreign policy tool in the Cuban country case and Cuba's achievements through Health Diplomacy have been researched. 181

El propósito de esta tesis es analizar la influencia de las organizaciones médicas en el desarrollo de reformas sanitarias en Colombia. Este trabajo de investigación recurre al método de estudio de caso para analizar de los sucesos ocurridos en el año 2013, cuando el gobierno de Juan Manuel Santos propuso una reforma al sistema de salud colombiano. Para lograr un adecuado análisis este estudio recurrió al uso de las fuentes teóricas de Pierre Bourdieu y John Kingdon que permitieran entender los sucesos ocurridos entre el año 2012 al 2014. Esta tesis prueba la hipótesis que explica el papel especial que juegan las organizaciones médicas en este momento histórico, enfatizando en las acciones sociales hechas por los profesionales médicos en la construcción de políticas públicas en salud. Finalmente, este trabajo está basado en un abordaje cualitativo soportado en los comunicados de prensa del Ministerio de Salud y Protección Social, revisión documental y entrevistas a los principales actores involucrados en esta particular reforma a la salud. The purpose of this thesis is to analyze the influence of medical organizations in the development of health reforms in Colombia. This research work includes case-study-methods to bring the analysis of the events that occurred in 2013, when the government of President Juan Manuel Santos proposed a reform of the Colombian health system. To achieve an adequate analysis approach, this study uses theoretical sources of Pierre Bourdieu (Year) and John Kingdon (Year), which were used to understand the events that occurred between 2012 and 2014. Moreover, this study tested the hypothesis that explains the special role of medical organizations in that historical moment, emphasizing on the social actions made by medical professionals in the construction of public health policies. Finally, this research work is based on a qualitative approach which is supported by press releases of the Ministry of Health, documentary review, and interviews to main actors involved into this particular health reform.

Objectives: The aim of this study is to identify the factors which affect innovation and toanalyze adaptation of doctors, nurses, pharmacists, administrative staff andother health care providers who work in health organizations such as publichospital and pharmacies in Tekirdağ-Şarköy to innovation and their attitudes towardsadaptation of innovation. Methods: Data was collected by questionnaire method. Within this perspectivedata gathered via the questionnaire were analyzed through statistical dataanalysis program (SPSS 20) and descriptive statistics (frequency, percentage,mean, standard deviation),chi square test, one-way ANOVA and correlation were conducted.Results: Accordingto results of the study it was revealed that innovation affected attitudes ofhealth care providers positively and there were no changes among health careproviders working different health organizations in terms of their attitudestowards innovation., Amaç: Buçalışmanın amacı, inovasyonu etkileyen faktörler belirlenerek, Tekirdağ –Şarköy ilçesindeki sağlık örgütleri olarak yer alan devlet hastanesi veeczanelerdeki doktorlar, hemşireler, eczacılar, idari kadrolar ve diğer sağlık çalışanlarınıninovasyon sürecine adaptasyonu, bu adaptasyona karşı tutumlarını analiz etmektir.Yöntem: Anket yöntemi ile veri toplanmıştır.Bu bağlamda anket aracılığıyla elde edilen veriler SPSS 20 veri analiz programıkullanılarak betimsel analiz (sayı, yüzde, ortalama ve standart sapma), ki-karetesti, One-Way ANOVA ve korelasyon testleri ile analiz edilmiştir.Bulgular: Çalışmasonucunda, inovasyonunsağlık örgütü çalışanların tutum ve davranışlarını olumlu yönde etkilediği vefarklı sağlık örgütlerinde çalışanlar arasında inovasyona ilişkin tutum vedavranışlarda farklılık olmadığı ortaya çıkmıştır.

The aim of this thesis is to explore how public relations contributes to organizational culture at Carilion Clinic, a large health organization based in Roanoke, Va. Using the excellence theory combined with organizational culture perspectives as a lens, the study interviewed Carilion Clinic communications employees to uncover the presence of excellence principles in their public relations. A second part of the study analyzed employee posts on the organization's internal website to identify the congruency of organizational value meaning and manifestation between the organization and its employees. Results from the study found presence of five of the seven excellence principles in Carilion's public relations and that three of the five organizational values are congruent between the organization and its employees. Results suggest that Carilion Clinic's public relations efforts are contributing to organizational culture. Efforts by Carilion's public relations successfully communicate organizational values and foster a participative culture. This case study shows that public relations is beneficial to fostering organizational culture and that excellence principles as developed by the excellence theory can serve as a guide for organizations when implementing and evaluating public relations practices. Master of Arts

International audience; Healthcare Systems (HCSs) throughout the world undergo important changes driven by aging populations and advances in biomedical technologies. At the same time, in the current economic climate, many Western countries are struggling to reduce public spending on all kinds of services, including healthcare. With this tension between tightening budgets and skyrocketing costs, many countries are seeking to identify ways of using Information Technology (IT) and Monitoring Technologies (MTs) to improve the efficiencies of HCSs while not reducing, or possibly even improving, the quality of healthcare and their delivery. Many experiments have been in progress since the 1990s. This paper has conducted a review evaluating such HCSs in terms of advantages and drawbacks. The objective of this review is to provide some illustrative publications and works and examples of Health Information Technology (HIT) systems to finally determine the place of biomedical MTs in the future HCS. We present the healthcare delivery system (HCDS) organization with roles of the different stakeholders, state initiatives in healthcare information delivery systems and the new relation between the hospital and the home though a new equilibrium. We mentioned the increasing role of telemedicine (TM), telecare (TLC) and telemonitoring (TLM) and expectations for monitoring the elderly. These expectations lead to preventive approaches based on monitoring technologies and pervasive healthcare (PH) which made healthcare improvements and cost reductions possible. Finally, we show the challenges and opportunities of the hospital versus home healthcare delivery.

Dans le cadre d’une réflexion sur les organisations de santé, nous présentons les résultats d’une revue de littérature portant sur les dynamiques organisationnelles et communicationnelles qui caractérisent ces organisations. Cette thématique de recherche, qui relève de ce que nous proposons de nommer la « communication organisationnelle et santé », est définie par des problématiques particulières, ainsi que par sa portée pratique, c’est-à-dire par la volonté de comprendre les enjeux auxquels font quotidiennement face les organisations de santé et proposer des démarches et interprétations pour les adresser. En réfléchissant aux orientations de la recherche dans ce domaine et en nous basant sur une approche constitutive de la communication organisationnelle, nous proposons d’élargir la définition d’organisation de santé aux processus organisants qui en seraient constitutifs, soit le « health organizing ». As part of an inquiry into healthcare organizations, we present the results of a literature review on organizational and communicational dynamics that characterize these organizations. This research theme, which we propose to call ‘organizational communication and health’, is defined by some specific issues, as well by its practical orientation, namely, the willingness to understand the day-to-day problems faced by health organizations and to suggest appropriate approaches and interpretations to address them. Reflecting on these research directions and drawing on a constitutive approach to organizational communication, we suggest to broaden the definition of health organizations to the organizing processes that constitute healthcare systems, that is ‘health organizing’.

RESUMO - O marketing interno (MI) surge como uma ferramenta de gestão que tem como principal objetivo desenvolver uma organização centrada no cliente, motivando e capacitando os seus colaboradores para alcançar os objetivos organizacionais. Esta investigação tem como principal objetivo verificar se a existência de práticas de MI influenciam a motivação dos colaboradores e ainda se estas práticas, bem como a motivação, divergem consoante a organização tenha um modelo de gestão pública ou um modelo inovador. Para tal, realizou-se um estudo descritivo onde participaram 234 enfermeiros que trabalham em hospitais EPE (modelo de gestão pública) e UCC (modelo de gestão inovador), com idades compreendidas entre os 23-58 anos de idade. Os resultados indicaram que as organizações de saúde estudadas recorrem a estratégias de MI, apesar de a sua perceção ser baixa, e que estas influenciam a motivação dos colaboradores. Verificou-se ainda que existem diferenças significativas nos procedimentos de MI e na motivação dos colaboradores entre hospitais EPE e UCC embora apenas em algumas dimensões. ABSTRACT - Internal Marketing (IM) was introduced as a management tool with the purpose of developing organizations focused on their costumers and on enabling their employees to achieve the organizational goals. The primary objective of this research was to verify if the existing methodologies of IM, influence employees’ motivation and if these practices, as well as the motivation factors, differ if and when the organization applies either a model of Public Management or an Innovative one. To this end, we performed a descriptive study, which included 234 nurses working in hospitals EPE (Public management model) and UCC (Innovative management model), aged between 23 and 58 years old. The results showed that the healthcare organizations studied use internal marketing strategies, despite the fact that they perceived it to be low, and that these influence the motivation of employees. It was also, verified that there are significant differences in the IM procedures and motivation of the employees between EPE hospitals and UCC although only in some dimensions. info:eu-repo/semantics/publishedVersion

ÖZETAmaç: 2003 yılından bu yana Tükiye sağlık sisteminin bütün paydaşlarını ilgilendiren köklü değişimler yaşanmış ve bu değişime `Sağlıkta Dönüşüm Programı` adı verilmiştir. Programın 8 bileşeninden birincisi Sağlık Bakanlığı'nın merkez ve taşra teşkilat yapısının değiştirilmesi ve devletin asli işlevleri olan kuralların düzenlenmesi ve sektör paydaşlarının rollerini kurallara göre yerine getirdiğinin denetlenmesidir. Üçüncü bileşen ise hizmetlerin sunuluşunda planlanan değişimlerdir. Ülkemizde Türkiye Halk Sağlığı Kurumu'nun ve illerde Halk Sağlığı Müdürlüklerinin kuruluşu bu iki bileşen ile ilişkilidir. Bu çalışma; ülke çapında bir planlama ve organizasyon konusu olan Türkiye Halk Sağlığı Kurumu'nun kuruluşu ve organizasyonu ile ilgili dinamiklerin incelenmesini, konuyla ilgili profesyonellerin ve akademisyenlerin görüşlerinin toplanıp değerlendirilmesini içermektedir. Çalışmanın amacı ülke çapında bir makro planlama ve organizasyon örneği olan Türkiye Halk Sağlığı Kurumu'nun oluşturulmasında görüş ve deneyimlerin hem günümüzde hem de gelecekte faaliyet gösterecek Sağlık Yöneticilerine aktarılmasına katkıda bulunmaktır.Sonuçlar: Yapılan kalitatif ve kantitatif araştırmaların sonucunda, Türkiye Halk Sağlığı Kurumunun organizasyon işlevi çerçevesinde birçok yönüyle başarılı olduğunu, birinci basamak sağlık hizmetlerine, çevreye, bulaşıcı hastalıkların önlenmesine, halkın bilinçlendirilmesinde önemli katkılarının olduğu, ancak organizasyon bazında halen geliştirilmesi gerektiği sonucuna ulaşılmıştır.Anahtar Sözcükler: Türkiye Halk Sağlığı Kurumu, Örgütlenme, Halk Sağlığı SUMMARYObjective: Since 2003 big changes related to all partners of health system in Turkey have been realized and this reform endeavour is called Health Transformation Program. The first one of the eight components of the program is changing the central and peripherial structure of the Ministry of Health and reorganization of Ministry roles as regulating all sides of the sector properly. The third component is about the provision of healthcare services. Turkish Public Health Institution and Provincial Public Health Directorates are related to this component. This study is about Turkish Public Health Institution which is a country-wide planning and organization subject. Method of the study is examination of the organization dynamics, collection, analysis and evaluation of views of the related academics and professionals. The aim of the study is to contribute to the transfer of know-how about the big organizational change for today's and tomorrow's health managers. Results: Considering the qualitative and quantitative findings of the study, Turkis Public Health Institution is successful from different perspectives of management, however there is still need to progress on first level curative services, environmental health studies, prevention of communicable diseases and increase of health literacy.Key Words: Turkish Public Health Institution, Organization, Public Health 152

Hastane organizasyon şeması üzerine yapılan literatür taramaları ve incelemelerde bu konu üzerinde bir çalışma bulunmadığı ve Türkiye'de organizasyon şemaları açısından kamuda ve özel sektörde bir standart olmadığı görülmüştür. Bu araştırma hastane organizasyon şemaları üstüne yapılan ilk çalışma niteliği taşımaktadır. Çalışmanın amacı, hastane örgütlenmesinde hastanelerin organizasyon şemalarının öneminin açıklanması ve kullanım yollarının bilimsel olarak ifade edilmesidir. Araştırma kesitsel tanımlayıcı bir araştırmadır. Beş (5) uzman öğretim üyesiyle yüz yüze görüşmeler yapılmış ve görüşleri doğrultusunda bir Hastane Organizasyon Şemalarını Değerlendirme Formu geliştirilmiştir. Form kapsamında Marmara Bölgesi'ndeki özel sektöre ait hastane organizasyon şemaları değerlendirilmiş ve hastanelerin kurumsal web sayfalarındaki içerik özellikleri incelenerek sonuca gidilmiştir.Araştırmada hastane organizasyon şemalarının örgütsel önemi üzerinde durulmuş ve doğru, etkili çizim yolları açıklanmaya çalışılmıştır. Bu bağlamda hastaneler için organizasyon şeması model önerisi geliştirilmiştir. Araştırmanın bundan sonra bu konuda yapılacak olan çalışmalara bir kaynak teşkil edebileceği düşünülmektedir. Literature reviews and studies on the hospital organization chart show that there is no study on this subject and that there is no standard in the public and private sector in terms of organizational schemes in Turkey This research is the first study of hospital organization charts. The aim of the study is to explain the principles of organizational charts of hospitals in hospital organization and to scientifically express ways of using them.The study is a cross-sectional descriptive study. Face-to-face interviews were conducted with five (5) specialist faculty members and a Hospital Organization Charts Evaluation Form was developed in line with their views. The hospitals which are belong to the private sector in Marmara Region are evaluated in the scope of the form and the content features of the hospitals institutional web pages are examined for the result.In the research, organizational importance of hospital organization chart is emphasized and accurate and effective ways of drawing are explained. In this context, the organizational chart model for hospitals was developed. It is thought that the research can then be used as a resource for this work. 200

İnsan ve toplum hayatının vazgeçilmez bir öğesi olarak sağlık faaliyetleri, Amerikan misyonerlerinin en önemli aracı haline gelmiştir. Azınlıklara hizmet etmeyi amaçlayan misyonerler, dispanserler ve hastaneler açarak bu hizmeti daha geniş bir alana yaymayı hedeflemişlerdir. Bu çalışmada misyonerlerin İzmir'de tıbbi misyona ne tür işlevler yüklediklerine odaklanılmıştır. As an essential and irreplaceable component of human and community life, medical missions had become the most important element to the religious aims of the American missionaries. They established dispensaries and hospitals to serve the minorities. As a result of this attempt, they aimed to spread evangelical work through medical missions. This study examines the variety of ways and functions ABCFM created using the medical missions in Izmir. 127

Bu çalışmanın amacı, Antalya ilindeki devlet hastaneleri ile özel hastanelerde yatarak tedavi gören hastaların hasta mahremiyetine yönelik bilgi düzeylerinin tespiti ve hastanelerde hasta mahremiyetine gösterilen özenin hastaların bakış açısıyla değerlendirilmesidir. Araştırma tanımlayıcı türde bir çalışma olup, yüz yüze anket tekniği kullanılarak gerçekleştirilmiştir. Araştırmanın evrenini Antalya il merkezinde faaliyet gösteren Devlet ve Özel hastanelerde yatarak tedavi gören (N=385.396) hastalar oluşturmaktadır. Bu evrenden basit rastgele örneklem yöntemi kullanılarak 503 kişilik bir örneklem grubu oluşturulmuştur. Araştırmada verilerin toplanması amacıyla araştırmacı tarafından geliştirilen "Hasta Mahremiyeti Envanteri" kullanılmıştır. Envanterde yer alacak soruların belirlenmesinde ilgili literatür, hasta mahremiyeti ile ilgili mevzuat, Sağlıkta Kalite Standartları (SKS), Hasta Hakları Yönetmeliği (HHY) ve uzman görüşlerinden faydalanılmıştır. Envanterde hastaların demografik bilgilerine yönelik olarak 11 soru, hastaların hasta mahremiyeti hakkında bilgilerinin ölçülmesi için 13 soru, kliniklerde sağlık çalışanlarının hasta mahremiyetine uyup uymadıklarının tespiti için ise 39 soru sorulmuştur. Araştırma verileri SPSS 16.0 programında değerlendirilmiştir. Veriler üzerinde öncelikle tanımlayıcı istatistikler uygulanmıştır. sosyo-demografik değişkenler ve kurumlar açısından hasta mahremiyeti uygulamalarının farklılık gösterip göstermediğini değerlendirmek amacıyla Ki-kare testi uygulanmıştır. Araştırmanın sonucunda; araştırmaya katılan hastaların mahremiyetlerine gösterilen özenin özel hastanelerde devlet hastanelerine göre daha iyi durumda olduğunu gözlemledikleri, özel hastanelerde yatan hastaların mahremiyet bilgi düzeylerinin devlet hastanelerindeki hastalardan daha yüksek olduğu ayrıca fiziki ortam açısından değerlendirildiğinde de özel hastanelerin fiziki mekanlarının hastaların mahremiyetlerini korumak açısından daha uygun fiziki şartları taşıdığı tespit edilmiştir., The aim of this study is to identify the level of their knowledge about the inpatients in the State and Private hospitals in Antalya province and to evaluate the level of their knowledge about the patient privacy and the care shown to the patient privacy in the mentioned hospitals in their point of view. This research is a descrpitive study and has been carried out using a face to face survey technique. The research has focused on the ınpatients ((N=385.396) in the state and private hospitals in Antalya city centre. From these mentioned hospitals a sample group consisting of 503 patients has been formed by using a random sample technique. In the research a " Patient's Privacy Inventory" which was developed by the researcher has been used with the aim of collecting datas. It has been benefited from the dealing literature, patient's privacy legistlation, the quality Standarts in Health (SKS) Regulations on Patient's Rights and from the views of experts in the determining of the questions that will take place in the inventory. In the inventory, there are 11 questionts about the demographic conditionts of the patients, 13 questions to measure their knowledge about patient's privacy, and 39 questions to detect whether the parademics working in the clinics and hospitals obey the patient's privacy rules or not. The datas of reserach have been evaluated in the program of SPSS 16.0. Over the datas primarily descriptive statistics have been applied, Chi square test has been applied to be able to detect if the patient's privacy applications have shown any differences in the respect of socio-demographic variables and institutions. In the result of the survey it has been detected that the patient's privacy care shown to the inpatients joining the survey in the private hospitals is better than in the state hospitals, the knowledge level of the inpatients in the private hospitals about patient's privacy is higher than those in the state hospitals and when it is evaluated in the respect of environment private hospitals have got better physical conditions to protect their privacy.

Bu tez çalışması, kamu yönetimi alanında devletin dönüşümü olgusunu diyalektik bir yaklaşımla sağlık örgütlenme mantığının değişimi ekseninde analiz etmeyi amaçlamaktadır. Türkiye bağlamında tarihsel süreçte kapitalizm ve sermaye birikimi açısından sağlık hizmetlerinin gördüğü çeşitli işlevlere göre örgütlenme yapısındaki dönüşüm araştırmanın temel inceleme nesnesini oluşturmaktadır. Çalışmanın temel tezi, sağlığın eskiden meta üretiminin bir tamamlayıcısı iken günümüzde meta üretiminin öznesi konumuna gelmesinin izdüşümü olarak Türkiye'de sağlık hizmetlerinin örgütlenmesinin, Erken Cumhuriyet döneminden itibaren sermaye birikiminin önkoşullarını sağlamaya yönelik iken, 1980 sonrası sermaye birikiminin nesnesi haline geldiğidir. Sağlık Bakanlığının kuruluşundan itibaren devlet, temel sağlık hizmetlerinin gelişimi (halk sağlığı, bulaşıcı ve salgın hastalıklara karşı koruma, ana çocuk sağlığı, sağlık eğitimi gibi) ile sermaye birikiminin maddi koşullarını yerine getirmeye çalışarak altyapı boşluğunu doldurmaya yönelik örgütlenirken, kapitalizm açısından emeğin yeniden üretimi asli işlev niteliğine sahipti. 1980 sonrası neoliberal politikaların etkisiyle sağlıkta piyasalaşma ve işletmecilik esaslı yönetim anlayışı yerleşmeye başlamıştır. Bu doğrultuda 1990'lı yıllarda Dünya Bankası proje kredileri ile yönlendirilen reform girişimleri iktisadi krizler, sınıfsal çelişkiler, siyasi bunalımlar gibi faktörlerin de etkisiyle kısmen sekteye uğramıştır. 2003 yılında ise Sağlıkta Dönüşüm Programı ile sağlık hizmetlerinin metalaştırılması yoluyla ciddi bir yatırım alanına dönüşen sağlık alanında devlet, 663 sayılı KHK ile stewardshiplik fonksiyonuna uygun olarak ilaç ve tıbbi cihaz, tıp eğitimi, hastane hizmetleri, Ar-Ge, biyoteknoloji gibi üretici politikalar ile sağlık turizmi, KÖO modeli ile inşa edilen sağlık kampüsleri gibi araçlarla doğrudan sermaye birikimine katkı sağlayan bir işlev yerine getirmeye başlamıştır. Bu bağlamda da sağlık politikalarının odağı ve dolayısıyla sağlık hizmetlerinin örgütlenmesi sağlık hizmetlerinden sağlık endüstrilerine doğru bir değişim göstermektedir.Anahtar Kelimeler: Sağlık Hizmetleri, Devlet, Kapitalizm, Sermaye Birikimi, Emeğin Yeniden Üretimi. This thesis study aims to analyze the way in which the role of the state in Turkey was transformed in the field of public administration, on the axis of the changes the rationale behind the organization of health with the dialectical approach. The main subject examined in this study is the transformation which the organizational structure of healthcare in Turkey have experienced over time, depending on the different functions they fulfilled, and also with respect to capitalism and the accumulation of capital. The main argument of the study is that the organization of healthcare in Turkey, when health was a complement to the production of commodity in the past, as the projection of commodity production as the subject of the present day, from the early republican period principally focused on ensuring the infrastructural prerequisites for the accumulation of capital, they have, in the period after 1980, actually become the object of the accumulation of capital.Since the establishment of the Ministry of Health, the state's activities were organized to ensure the development of basic healthcare (such as public health, protection against infectious and epidemic diseases, maternal child health, health education) and to meet the physical requirements for the accumulation of capital, with the underlying intention to remedy the existing deficiencies in terms of infrastructure. In this context, the state had, from the standpoint of capitalism, assumed a principal role in the reproduction of labor. In the period after 1980, the influence of neoliberal policies led to the growing prevalence of a new administration mind that emphasized marketization and management in healthcare. In this direction, reform initiatives driven by World Bank project loans in the 1990s, were partly interrupted due to factors such as economic crises, class contradictions and political crises.In 2003, the state transformed the health sector into a serious investment area thanks to the commodification of health services through the Health Transformation Program. Pursuant to the Decree Law No. 663, in accordance with the stewardship function, it has begun to fulfill a function that contributes directly to capital accumulation through productive policies – covering areas such as R&D, biotechnology, medical education, hospital services, pharmaceuticals and medical devices and such instruments health tourism, health campuses built with the P3 model. In this context, the focus of health policies and therefore the organization of healthcare has shifted from healthcare to the health industries.Key Words: Healthcare, Capitalism, State, Capital Accumulation,Reproduction of Labor Power. 442

Resumen En este artículo de investigación se analizó el proceso de adquisición tecnológica en las instituciones prestadoras de servicios de salud (IPS) en Colombia. Para este propósito se aplicó una metodología de diagnóstico empresarial denominada benchmarking en seis IPS del departamento de Antioquia (tanto del sector público como del sector privado), lo que permitió identificar las principales formas de adquirir tecnología biomédica, la priorización de las necesidades tecnológicas, los métodos empleados por las instituciones hospitalarias para la evaluación del equipamiento médico, las fuentes de identificación de necesidades, los requisitos legales y técnicos exigidos en el momento de la compra, así como la proporción de búsqueda de alertas nacionales e internacionales en bases de datos relacionadas con los dispositivos. De esta manera, se desarrolló un ejercicio de referenciación comparativa y competitiva como herramienta de gestión que promueve la caracterización e incorporación de las posibles mejores prácticas ejercidas por las clínicas y hospitales del país. Abstract We analyzed in this research article the process of technology acquisition in Colombian health service provider institutions (IPS). For this purpose we applied a business assessment methodology called benchmarking in six different IPS of the Antioquia department (both in the public and private sectors). This allowed us to identify the main ways to acquire biomedical technology; the prioritization of technological needs; the methods used by hospitals to assess medical equipment; the sources for the identification of needs; the legal and technical requirements requested at the moment of purchase; and also the amount of searches performed regarding national and international alerts in databases related to the devices. In this way, we developed a comparative and competitive referencing work as a management tool promoting characterization and the inclusion of the possible practical improvements carried out by clinics and hospitals across the country. Resumo Neste artigo de pesquisa foi analisado o processo de aquisição de tecnologia nas instituições que prestam serviços de saúde (IPS, pelas suas siglas em espanhol) na Colômbia. Para o efeito, foi aplicada uma metodologia de diagnóstico empresarial chamada de benchmarking em seis IPS do departamento de Antioquia (tanto do sector público como do privado), o que permitiu identificar as principais maneiras de adquirir tecnologia biomédica, a priorização das necessidades de tecnologia, métodos empregados pelos hospitais para avaliação de equipamentos médicos, fontes de identificação das necessidades, requerimentos legais e técnicos necessários no momento da compra, assim como a proporção de procura de alarmes nacionais e internacionais em bases de dados relacionadas com dispositivos. Assim, um exercício de avaliação comparativa e competitiva foi desenvolvido como ferramenta de gestão que promove a caracterização e incorporação da possível melhor prática exercida por clínicas e hospitais do pais.

Resumo: Este artigo analisa o Serviço Social brasileiro na entrada do século XXI, refletindo a respeito das mudanças do capitalismo contemporâneo e de suas implicações para o trabalho profissional. Objetiva discutir como os assistentes sociais têm se posicionado no plano teórico-prático/interventivo e ético-político/organizativo, na tentativa de enfrentar essa realidade, defender seus valores e responder, enquanto trabalhadores assalariados dotados de estatuto intelectual, às exigências impostas pela sociedade capitalista e às necessidades sociais dos sujeitos sociais. Abstract: This article analyzes the Brazilian Social Service at the entrance of the century, reflecting on the changes of contemporary capitalism and its implications for employment. It aims to discuss how social workers has positioned itself in the theoretical and practical plan / interventional and ethical-political / organizational in an attempt to address the current reality, to defend its values and respond as salaried workers with intellectual status, the requirements imposed by capitalist society and social needs of social subjects.

Background: The role of emotional intelligence is one of the main issues in modern management. Contemporary terms withsemiotic meaning that target emotions, such as ‘leading with the heart’, ‘the art of influence’, ‘team mind’ and ‘teamintelligence quotient’, are now quite frequent in Greek and International literature.The objective of this study was the investigation of the level of emotional intelligence in three professional groups ofemployees in a district hospital.Methods: The population of the study consisted of 132 employees of a General Regional Hospital (doctors, nurses,administrative employees). The “Emotional Competence Inventory (ECI)”, which was developed in 1999 by Goleman,Boyatzis and Rhee and is applied in organizational environments after relevant permission, was used for data collection.Chi-square test and Takey test (ANOVA / POST –HOC) were used in the statistical analysis of the data, which wasperformed with SPSS and Microsoft Office Excel.Results: Chi-square test was used to investigate the relationship between the answers of every professional group, therelationship between males and females of the population of the study, as well as the relationship between the educationlevel of the study’s population. Important differences were found. The values of the answers were summed up (Likert-scale– additive model) and were converted to z-scores. According to the study’s model, nurses of the hospital in question are firstin self-awareness, social awareness and cognitive thought; whereas self-management was found in doctors and relationshipmanagement was found in administrative employees.Conclusions: The analysis of the results indicates differences between the professional groups and distinctively points outthe qualitative characteristic elements of each profession which relate with the subfactors that investigate emotionalintelligence. The difference between professionals in how they manage their tasks with emotional intelligence affects thequalitative characteristics of the services that they produce and offer.

Este artigo apresenta a perspectiva teórica com a qual abordamos a gestão em saúde e, particularmente, o trabalho gerencial e o trabalho em saúde. Para fazer face à complexidade dos problemas relacionados à gestão dos serviços públicos de saúde e à qualidade do cuidado - importantes desafios da reforma sanitária brasileira - as autoras têm estudado a característica grupal/intersubjetiva e inconsciente dos processos organizacionais, que apresenta um impacto importante na dinâmica dos serviços de saúde e em sua qualidade. Para este propósito, procura-se articular três eixos de pensamento: (1) a abordagem da psicossociologia francesa sobre as organizações e a sociedade contemporânea; (2) a abordagem psicanalítica sobre os processos intersubjetivos e grupais; e (3) a psicodinâmica do trabalho, que focaliza as relações entre prazer e sofrimento no trabalho. Neste caminho de investigação, temos explorado as mediações entre as realidades psíquicas, intersubjetivas, grupais e sociais, nas organizações de saúde, no trabalho gerencial e no trabalho em saúde, identificando os limites e possibilidades que elas estabelecem para o exercício da liderança, para a cooperação e construção de projetos coletivos e para a qualidade do cuidado em saúde. This paper presents our theoretical perspective over health management, particularly on managerial and health work. To face the complex problems related to public health services management and health care quality - important challenges of Brazilian Sanitary Reform - we study the group/inter-subjective and unconscious characteristic of organizational processes, which has important effects over health services dynamics and their quality. For this purpose, we attempt to articulate three theoretical perspectives:(1) the French Psycho sociology approach on organizations and contemporary society; (2) the psychoanalytical theory on inter-subjective and group processes; and (3) the Work Psychodynamics, which focuses the relations between pleasure and suffering in work processes. Through this research process, we explore links and mediations among psychic, inter-subjective, group and social realities that are present in health organizations, managerial work and health work. Also, limits and possibilities these mediations set to leadership, cooperation, collective projects and health care quality are identified.

Este artigo apresenta a perspectiva teórica com a qual abordamos a gestão em saúde e, particularmente, o trabalho gerencial e o trabalho em saúde. Para fazer face à complexidade dos problemas relacionados à gestão dos serviços públicos de saúde e à qualidade do cuidado - importantes desafios da reforma sanitária brasileira - as autoras têm estudado a característica grupal/intersubjetiva e inconsciente dos processos organizacionais, que apresenta um impacto importante na dinâmica dos serviços de saúde e em sua qualidade. Para este propósito, procura-se articular três eixos de pensamento: (1) a abordagem da psicossociologia francesa sobre as organizações e a sociedade contemporânea; (2) a abordagem psicanalítica sobre os processos intersubjetivos e grupais; e (3) a psicodinâmica do trabalho, que focaliza as relações entre prazer e sofrimento no trabalho. Neste caminho de investigação, temos explorado as mediações entre as realidades psíquicas, intersubjetivas, grupais e sociais, nas organizações de saúde, no trabalho gerencial e no trabalho em saúde, identificando os limites e possibilidades que elas estabelecem para o exercício da liderança, para a cooperação e construção de projetos coletivos e para a qualidade do cuidado em saúde.This paper presents our theoretical perspective over health management, particularly on managerial and health work. To face the complex problems related to public health services management and health care quality - important challenges of Brazilian Sanitary Reform - we study the group/inter-subjective and unconscious characteristic of organizational processes, which has important effects over health services dynamics and their quality. For this purpose, we attempt to articulate three theoretical perspectives:(1) the French Psycho sociology approach on organizations and contemporary society; (2) the psychoanalytical theory on inter-subjective and group processes; and (3) the Work Psychodynamics, which focuses the relations between pleasure and suffering in work processes. Through this research process, we explore links and mediations among psychic, inter-subjective, group and social realities that are present in health organizations, managerial work and health work. Also, limits and possibilities these mediations set to leadership, cooperation, collective projects and health care quality are identified.

OBJETIVOS: Divulgar experiência multidisciplinar de parceria entre gestores da rede pública de saúde e organizações não-governamentais voltadas à atenção à gestante HIV positivo; e caracterizar as situações de exposição ao HIV por gestantes atendidas pelo Projeto Transmissão Vertical Zero do Município de Sorocaba - SP. MÉTODOS: Estudo retrospectivo com emprego de fontes documentais, e com levantamento de dados para caracterização sócio-demográfica e situações de exposição ao risco de infecção pelo HIV de 120 gestantes atendidas pelo Projeto, entre 1998 e 2004. RESULTADOS: O compartilhamento de ações entre o público e o terceiro setor constituiu-se em eficiente alternativa de assistência à mulher soropositiva para o HIV, ainda que 56,7% das gestantes desconhecessem a sorologia do parceiro e 73,3% nunca terem usado preservativo. CONCLUSÃO: A parceria contribuiu para a redução da transmissão vertical do HIV em Sorocaba - SP.OBJETIVOS: Divulgar la experiencia multidisciplinaria de sociedad entre gestores de la red pública de salud y organizaciones no gubernamentales dirigidas a la atención de la gestante VIH positivo; y caracterizar las situaciones de exposición al VIH por gestantes atendidas por el Proyecto Transmisión Vertical Zero del Municipio de Sorocaba - SP. MÉTODOS: Se trata de un estudio retrospectivo realizado con el empleo de fuentes documentales, y con el levantamiento de datos para caracterización socio-demográfica y situaciones de exposición al riesgo de infección por el VIH de 120 gestantes atendidas por el Proyecto, entre 1998 y 2004. RESULTADOS: El compartir acciones entre el público y el tercer sector se constituye en una eficiente alternativa de asistencia a la mujer seropositiva para el VIH, aunque el 56,7% de las gestantes desconociese la serología de la pareja y el 73,3% nunca haya usado preservativo. CONCLUSIÓN: La sociedad contribuyó a la reducción de la transmisión vertical del VIH en Sorocaba - SP.OBJECTIVES: To describe a multidisciplinary partnership experience between public and private agencies that provide care for HIV positive pregnant women, and to characterize the risk factors for HIV among pregnant women who were participating in the project "zero vertical HIV transmission" in the district of Sorocaba. METHODS: A retrospective study was conducted using records of 120 pregnant women who participated in the project between 1998 and 2004. A form was used to gather demographics and risk factors for HIV. RESULTS: Partnership between the public and private agencies was an efficient alternative to provide better care for HIV positive pregnant women. However, the majority of women (56.7%) was not aware of their partner HIV status and almost three fourths of them (73.3%) had never used contraceptive devices. CONCLUSION: The partnership between the public and private agencies contributed to the reduction of HIV Vertical Transmission in Sorocaba, SP.

Bu tezde iş sağlığı ve güvenliği örgütlenmesi ele alınmıştır. Bu kapsamda resmi ve işyeri örgütlenmeleri incelenmiştir. Resmi örgütlenme kamu kurumlarından oluşur. İşyeri örgütlenmesi iş güvenliği uzmanı, işyeri hekimi, diğer sağlık personeli ve iş sağlığı ve güvenliği kurulu ve biriminden oluşmaktadır. 6331 sayılı İş Sağlığı ve Güvenliği Kanunu'na göre işverenler iş sağlığı ve güvenliği önlemlerini almakla yükümlüdür. Bu kapsamda işverenler iş sağlığı ve güvenliği örgütü oluşturmakla yükümlüdür. Occupational health and safety organization in this thesis are discussed. In this context, official and workplace organization have been examined. Official organizations are public institutions. Occupational safety and health workplace organization consist of occupational physician, occupational safety specialist, technician, occupational nurse, worker's representative and occupational health and safety committee and unit. According to the Occupational Health and Safety Act No. 6331, the employer shall have a duty to ensure the safety and health of workers in every aspect related to the work. In this context, employers are obliged to create occupational health and safety organization. 307

International audience; Fundraising by health organizations is a very long-standing practice. In France, with the exception of some health organizations that have implemented a strategy to raise funds for many years, few have yet developed a professional approach. Conversely, the fundraising is practiced in many hospitals in the United States, Québec. In addition, research is scarce. The objective of this article is consequently exploratory. It aims at highlighting the levers, specificities and characteristics of hospital fundraising. These questions will be dealt with regarding this scarce literature review and exploratory interviews.; Las donaciones son una práctica habitual desde hace muchos años. En Francia, salvo contados centros hospitalarios que tienen ya, desde hace años, una estrategia de captación de fondos, resulta extraño encontrar centros donde se haya realizado una implementación profesional de este tipo de estrategia de captación de fondos. En zonas como EE UU o Quebec, el fundraising es una práctica habitual. No hay demasiados trabajos empíricos sobre este tema. El carácter de este artículo es exploratorio, sobre las características y especificidades del fundraising practicado por los centros hospitalarios descrito en los estudios existentes, además de en la realización de entrevistas exploratorias.; La collecte de fonds (ou fundraising) de la part des établissements de santé est une pratique très ancienne. Mais, en France, peu ont déployé une démarche professionnelle. A l’inverse, le fundraising est pratiqué dans un grand nombre de structures de santé aux Etats-Unis, au Québec. Par ailleurs, les travaux des chercheurs sur le sujet restent peu nombreux. L’objectif de cet article est donc exploratoire. Il vise à mettre en lumière les leviers, spécificités et caractéristiques du fundraising des établissements de santé en nous basant sur cette littérature parcellaire et des entretiens exploratoires menés auprès de 18 hôpitaux français et québécois.

The current study attempts to construct a valid and applicable job satisfaction scale for measuring the contentment level of hospital staff in Taiwan. The job description inventory (JDI) and Job Satisfaction Index (JSI) were adopted as the foundation of the job satisfaction measure for hospital staff in a selected hospital. To verify and validate the scale, data collected in 2012 and 2013, were analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. Subsequently, Pearson correlations analysis was used to examine the strength and direction of the relationships between job satisfaction dimensions. Overall, the job satisfaction scale developed in this research illustrated valid and accurate measure for assessing hospital staffs' satisfaction. Both EFA and CFA results demonstrated that items consistently emerged six dimensions i.e. work environment, work achievement, compensation and benefits, education and training, promotion and evaluation, and management system. The findings also highlight that management support, work achievement, and promotion and evaluation are three critical factors that significantly contribute to high levels of job satisfaction for hospital staff.

Introducción: Las relaciones interpersonales generan discrepancias y conflictos. Las organizaciones de salud no están exentas de ellos por el aumento de la exigencia de los usuarios para obtener respuestas rápidas y adecuadas a su situación de vulnerabilidad y por la reducción de recursos humanos y materiales consecuentes al momento actual de crisis económica que comportan cambios organizacionales para adaptarse a ella, entre otras múltiples causas. Se hace necesario que los profesionales, mediante la formación continuada, posean competencias mediadoras que les permita prevenirlos y gestionarlos adecuadamente. En este sentido, la comprensión del proceso de transferencia y mantenimiento de las competencias adquiridas deviene imprescindible. Proceso que debe contemplar la satisfacción de los participantes, la percepción de posibilidad o dificultad para la implementación de las competencias y la comprensión de los condicionantes profesionales y organizacionales que influyen en su implementación. Objetivo general: Comprender el significado que los profesionales de la salud otorgan al proceso de transferencia y mantenimiento de las competencias adquiridas en la formación en habilidades mediadoras. Metodología: Investigación cualitativa, basada en el paradigma constructivista y la teoría fundamentada. Para la recogida de datos se utilizan las entrevistas por correo electrónico, el grupo de discusión y las entrevistas en profundidad cara a cara. La muestra se configura con el total de participantes inscritos en un programa formativo en habilidades mediadoras. El grupo de discusión, constituido por 4 informantes, se establece para recoger nuevos datos y alcanzar la saturación teórica de los mismos. Las entrevistas cara a cara se han utilizado para verificar el mantenimiento y vigencia en el tiempo de los datos obtenidos. El análisis de los datos se realiza mediante el método de las comparaciones constantes. Resultados y discusión: Se han identificado 4 dominios que configuran el dominio central. El dominio central, “a pesar de”, desarrolla el sentido del programa formativo en relación a la transferencia y sostenibilidad, y emerge como un hilo conductor que forja un conocimiento nuevo, propio de estas informantes en esta situación concreta, es decir genera teoría sustantiva. El primer dominio, hace referencia a la adquisición y satisfacción de competencias vinculadas a la formación, en tanto que a medio y largo plazo, se refuerza la autocapacitación. El segundo dominio, se refiere al convencimiento que las HHMM mejoran las relaciones interpersonales por lo que se favorece la salud de los profesionales, equipos, usuarios y organizaciones que conlleva una asistencia y cuidados de calidad. El tercer dominio, referido a la importancia de los cambios consecuentes a la implementación que generan una experiencia positiva en el proceso de crecimiento en todas las esferas de la persona. El cuarto dominio, constata la importancia del camino iniciado en cuanto a las relaciones interprofesionales que repercuten en la calidad de los cuidados. Se evidencia que resulta útil e imprescindible que se adquieran competencias que permitan, en los puestos de trabajo, desarrollar estrategias y técnicas para la detección de posibles situaciones interpersonales problemáticas en la prevención y gestión de conflictos. Ante cualquier cambio organizacional que se plantee, debe disponerse de recursos y del apoyo de los gestores. Durante el proceso de transferir y mantener los cambios, se produce una importante crisis económica que conlleva que los programas centrados en la gestión de conflictos se reduzcan o desparezcan. En este punto, de los datos emerge la certidumbre de la utilidad de la habilidades mediadoras y el empeño por seguir manteniendo las competencias adquiridas a pesar de la reducción del apoyo de sus organizaciones. Este convencimiento perdura con el paso del tiempo y el crecimiento económico. Conclusiones: El proceso de transferibilidad y sostenibilidad de las competencias obtenidas durante la formación en habilidades mediadoras, adquiere sentido en cuanto a que hace referencia a la necesidad vivida de prevenir y transformar las situaciones problemáticas, evitando así su evolución hacia conflictos de difícil abordaje. Esta necesidad de desarrollo de competencias, se asume como una necesidad personal y profesional que se mantiene a pesar de las dificultades organizacionales., Introduction: Relationships generate disagreements and conflicts. Health organizations are not exempt from them due to the increase of users’ demands to get fast and appropriate answers, adapted to vulnerable reality. As a consequence of the ongoing economic crisis, conflicts also arise from the shortage of human and material resources requiring organizational changes, to adapt to it. It is necessary that professionals have mediation skills and strategies (HHMM) to allow them to prevent and manage conflicts properly. In this sense, continuous training becomes an imperative for professionals to acquire these skills. In this sense, understanding of the transfer process and maintenance of acquired skills becomes essential. The process should include the satisfaction of participants, the perception of possibility or difficulty implementing the skills and understanding of professional and organizational conditions that influence its implementation. Objective: To understand the meaning given by health professionals participating in a HHMM training program regarding the transferability and sustainability of the skills acquired in their workplace context. Methodology: Qualitative research, based on the Constructivist Paradigm and the Grounded Theory. For data collection, interviews by e-mail, focus group and face to face interviews were used. The sample was conformed by 21 participants who enrolled in a HHMM training program. The focus group, consisting of 4 informants, was set to collect new data enough to reach the theoretical data saturation. Face to face interviews were used to check the maintenance and duration in time of the data obtained. The analysis of the data was guided by the constant comparisons method. Results and discussion: Four domains raised from data. The central domain, “a pesar de”, gives sense to the training program in relation to the transferibility and sustainability, and emerges as a common thread that forges new knowledge; this is typical of these informants in this particular situation, therefore substantive theory is generated. The first domain, refers to the acquisition and satisfaction of skills related to training, while the medium and long term self-empowerment is reinforced. The second domain refers to the belief that HHMM improve interpersonal relationships, therefore improving professionals ‘health, equipment’s, people and organizations thus meaning better quality of care. The third domain refers to the importance of consistent changes related to implementation that generate a positive experience in all areas of the growing process. The fourth domain, notes the importance of the road initiated regarding interprofessional-relationships that affect the quality of care. It is evidenced that it is useful and essential that skills are acquired, allowing participants to develop strategies and techniques for detecting and preventing problematic interpersonal situations in the workplace. For any organizational change that may arise, the support from managers should be always available. During the transfer and maintenance process a major economic crisis occurred; this meant an important reduction or disappearing of those programmes focusing on conflict management. At this point, data indicates the conviction of the usefulness of HHMM training programme and the personals efforts to continue to maintain the skills acquired despite the reduces support of the organizations. This belief persists over time and economic growth. Conclusions: The meaning attributed to the transferability and sustainability of skills acquired during mediation skills training, refers to the vividly need to prevent and transform problematic situations, thus avoiding its evolution towards difficult approach conflicts. This need for personal and professional development of competencies is experienced as a personal and professional necessity that is maintained despite organizational difficulties.

Background: Public sector organizations worldwide are engaging with social media as part of a growing e-government agenda. These include government departments of health, public health agencies, and state-funded health care and research organizations. Although examples of social media in health have been described in the literature, little is known about their overall scope or how they are achieving the objectives of e-government. A systematic literature review is underway to capture and synthesize existing evidence on the adoption, use, and impacts of social media in the public health sector. A series of parallel scoping exercises has taken place to examine (1) relevant existing systematic reviews, to assess their focus, breadth, and fit with our review topic, (2) existing concepts related to e-government, public health, and the public health sector, to assess how semantic complexity might influence the review process, and (3) the results of pilot searches, to examine the fit of social media within the e-government and health literatures. The methods and observations of the scoping exercises are reported in this protocol, alongside the methods and interim results for the systematic review itself.Objective: The systematic review has three main objectives: To capture the corpus of published studies on the uses of social media by public health organizations; to classify the objectives for which social media have been deployed in these contexts and the methods used; and to analyze and synthesize evidence of the uptake, use, and impacts of social media on various outcomes.Methods: A set of scoping exercises were undertaken, to inform the search strategy and analytic framework. Searches have been carried out in MEDLINE, the Cochrane Library, Web of Science, and the Scopus international electronic databases, and appropriate gray literature sources. Articles published between January 1, 2004, and July 12, 2015, were included. There was no restriction by language. One reviewer (AT) has independently screened citations generated by the search terms and is extracting data from the selected articles. A second author (CP) is cross-checking the outputs to ensure the fit of selected articles with the inclusion criteria and appropriate data extraction. A PRISMA flow diagram will be created, to track the study selection process and ensure transparency and replicability of the review.Results: Scoping work revealed that the literature on social media for e-government in the public health sector is complicated by heterogeneous terminologies and concepts, although studies at the intersection of these three topics exist. Not all types of e-government are evident in the health care literature. Interim results suggest that most relevant articles focus on usage alone.Conclusions: Public health organizations may be taking it for granted that social media deliver benefits, rather than attempting to evaluate their adoption or impacts. Published taxonomies of e-government hold promise for organizing and interpreting the review results. The systematic review is underway and completion is expected in the beginning of 2016.Trial Registration: PROSPERO International Prospective Register of Systematic Reviews: CRD42015024731; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015024731 (Archived by WebCite at http://www.webcitation.org/6dV1Cin91).

Introducción: transferir conocimiento para la salud pública es un asunto posible, según los diferentes espacios contextúales y culturales existentes en una sociedad de conocimiento. Metodología: este estudio presenta lecciones aprendidas de tres casos de gestión del conocimiento con base en la experiencia, las condiciones comunes y los procesos de liderazgo social autogestionado promovidos en espacios locales, concertado con actores y agentes locales de organizaciones en Antioquia, Colombia, mediante análisis comparativo y técnicas de exploración documental. Resultados: la gestión social del conocimiento como mecanismo local de promoción de las evidencias informadas en salud pública puede y debe ser intercambiada a través de espacios observados, como las redes de conocimiento, los observatorios y los tanques de pensamiento. Conclusión: las lecciones aprendidas confluyen en promover procesos de participación social para la construcción colectiva de conocimiento y abordar debates sobre la igualdad de oportunidades regionales en Colombia. Introduction: According to a different contextual and cultural knowledge society, knowledge transfer on public health is a possible issue nowadays. Methods: This implementation health research based on lessons learnt shows three cases of knowledge management supported by experience, common conditions and self-management social leadership processes developed in local spaces with stakeholders in Antioquia, Colombia through comparative analysis and documented scoping review. Results: Social Knowledge Management as a local mechanism on promotion the informed evidence on public health can be interchanged by observed spaces like knowledges networks, observatories, think tanks. Conclusion: Lessons learnt conduct in promote social participation processes for the collective building knowledge and concrete debates about equity for regional chances in Colombia. Introdução: transferir conhecimento para a saúde pública é um assunto possível, segundo os diferentes espaços contextuais e culturais existentes em uma sociedade de conhecimento. Metodologia: este estudo apresenta lições aprendidas em três casos de gerenciamento do conhecimento com base na experiência, as condições comuns e os processos de liderança social auto gerenciado, promovidos em espaços locais, marcados com atores e agentes de organizações em Antioquia, Colômbia, mediante análise comparativa e técnicas de exploração documentária. Resultados: o gerenciamento social do conhecimento como mecanismo local de promoção das evidências informadas em saúde pública pode e deve ser trocado através de espaços observados, como as redes de conhecimento, os observatórios e os tanques de pensamento. Conclusão: as lições aprendidas levam a promover processos de participação social para a construção coletiva de conhecimento e abordar debates sobre a igualdade de oportunidades regionais na Colômbia.

Bu tez, Türkiye'de kamusal ve özel sağlık sektöründe yaşanan değişimler üzerinde durur. Birinci bölüm tezin kuram ve metodolojisini içerir. Kuram kısmında McDonaldlaştırma ve boyutları, kuramın düşünsel kökleri, McDonaldlaştırmanın olumsuzlukları ve sağlık açısından bu kuramın ne şekilde gözlemlenebileceği yer alır. Metodoloji kısmında da yöntem olarak belirlenen tarihsel karşılaştırmalı araştırma tekniği ele alınır.İkinci bölümde dünyada ve Türkiye'de sağlık sosyolojisinin tarihsel gelişimi ve sosyoloji literatüründe sağlığı ele alan kuramsal yaklaşımlar sıralanır. Ayrıca sağlık, sağlık statüsü, sağlık hizmetleri ve finansmanı gibi başlıklar altında tezin kavramsal çerçevesi açıklanır. Üçüncü bölüm ise Türkiye'de sağlık hizmetlerinin tarihsel dönemlere ayrılarak incelenmesini içerir. Özellikle 2003 yılından günümüze kadar devam eden AKP iktidarının uygulamalarından biri olarak Sağlıkta Dönüşüm Programı kapsamında gerçekleştirilen düzenlemeler, incelemelerin odağını oluşturur. Sonuç olarak ileri sürüldüğü gibi Türkiye'de sağlık sektörünün McDonaldlaştırmanın boyutları çerçevesinde dönüştüğü görülür. This thesis focus on the experienced changes in public and private healthcare system in Turkey. Chapter One includes the theory and methodology of the thesis. In the theory part, McDonaldization and its dimensions, philosophical origins of the theory, irrationalities of McDonaldization and in what ways this theory can be observed in terms of health contains. In the methodology part, also, historical-comparative research determined as a method is mentioned.In Chapter Two, the historical development of the medical sociology in Turkey and World, and theorical approaches related to the health concept in the sociology literature is ranked. Also the conceptual framework of the thesis is mentioned under the titles of health, health status, healthcare services and health financing.In Chapter Three, also, includes the separation and examination of the historical period of healthcare services. Especially, regulations made within Health Transformation Program as one of the applications of AKP goverment that has been in power since 2003 is the center of analysis. Consequently, as put forward it is seen that the healthcare sector in Turkey has been transformed within framework of the dimension of McDonaldization. 171

Sendika; üyelerinin ekonomik, sosyal hak ve menfaatlerini koruyan, haksızlığa ve adaletsizliğe uğradığı durumlarda üyelerin başvurabileceği sivil toplum kuruluşlarıdır. Memur sendikacılığının gelişimi gerek dünyada gerek ülkemizde çeşitli aşamalardan geçmiştir. Memur sendikaları Ülkemizde 2001 yılında 4688 sayılı Kamu Görevlileri Kanunu ile yasal zemine kavuşmuştur. Bu gün üye sayısı ele alındığında ülkemizde üç büyük sendikanın olduğu, bunun yanı sıra az sayıda üyesi olan sendikaların da mevcut olduğu görülmektedir. Türkiye'de memur sendikalarında üyelik oranına bakıldığında kısmen siyasi duruma göre şekillendiği de bir gerçektir. Memur Sendikacılığı ve Sağlık İş kolunda ki bazı sendikaların çalışanlara karşı etik olmayan üye yapma yöntemleri ve sendikaların görevleri olmayan başka işlerle uğraşmaları, memur sendikacılığının gelişmesine zarar vermektedir. Üye yapma esnasındaki olumsuzluklar sağlık çalışanlarının sendikalardan uzak durmasını sonucunu meydana getirmektedir.Ülkemizde, kuruluş amacı doğrultusunda Devletine ve Milletine sahip çıkan sağlıklı sivil toplum kuruluşlarının oluşmasında büyük yarar bulunmaktadır. Bu kapsamda sivil toplum kuruluşu olarak memur sendikalarının asli görevleri, iş kolundaki memurların hak ve menfaatlerinin korunması çerçevesinde olmalıdır.Anahtar Kelimeler : Sendika, Memur Sendikaları, Sağlık ĠĢ Kolu Unions are the organizations to which members can apply to protect their social rights and interests when they face situations of injustice and disrespect. The improvements of public servants' unions have been through several stages in our country as well as in the whole World. The public servants' unions have reached the legal grounds in 2001 with the Law of Public Servants number 4688. Considering the number of members we can see three big unions; however, there are some other unions with few numbers of members. Considering the rate of increase in public servants' unions members, it can be seen that it is shaped partly by political conjuncture. Departments of officer Trade Unionism and Health Business of certain trade unions are harming the development of officer trade by unethically making their employees members and dealing with other jobs that are not their duty. The problems with the process of membership are causing health workers to stay away from unions.It is highly essential that non-governmental organizations are present in our country. The actual duties of the public unions are to be in the frame of the protection of the rights and interests of the officers, which would enable them to function efficiently.Key Words : Union, Collor Union, Health Work Art 145

The mportance of Implementing Managerial Skills in Hospital Administration The goal of the present study was to emphasize the importance of managerial skills in hospitals and health services administration. In order to achieve the above goal, health care organizations were analyzed from efficiency and effectiveness point of view. The importance of managerial skills in governing such organizations have been discussed in this paper. The content of the present paper leads the reader to the conclusion that involvement of specialized managers in hospital administration, and upgrading their professional skills are vital to the survival of health care organizations. 1- * .( Correspondmg Author) 2- Instruc 'Jr, M.S in Health Services Administration, Faculty of Research, Islamic Azad Uneverslty, 1ehran. Management And Medical Information

A experiência de um novo modelo de gestão dos serviços públicos de saúde implantada no Estado de São Paulo é analisada neste artigo, a partir da caracterização da especificidade da lei que regulamenta a criação das Organizações Sociais de Saúde, tendo como referencial a gestão estadual do Sistema Único de Saúde, seus antecedentes e a situação atual. Os dados apresentados foram coletados a partir de relatórios produzidos pela equipe técnica responsável pelo convênio entre a Secretaria e a Faculdade de Saúde Pública -- USP, para acompanhamento do projeto. Os resultados encontrados demonstraram o cumprimento satisfatório por parte das OSS/SUS, a partir das metas estabelecidas no contrato de gestão pela Secretaria, para o primeiro ano de atividade. O trabalho aborda, ainda, as perspectivas do novo modelo e da atual política. Os autores alertam para o fato de que a regulação, através de um novo contrato de gestão, deve considerar o desempenho das OSS, enfatizando processos, resultados e inserção sistêmica, referenciada pela demanda de saúde regional.The experience with a new model of public health services management, introduced in the São Paulo State is analyzed in this paper based on the characterization of the specificity of the law that referring to the creation of Social Organizations of Health. It has still as a referential the state management of the Single Health System given by the antecedents and actual situation. The data showed were collected from reports produced by the technical team responsible by the agreement between the Health Secretary of State and the Public Health Faculty -- São Paulo University. The results achieved showed from the fixed aim in the management agreement, by the Secretary, for the first year of activity a satisfactory performance by the Social Organizations of Health. The paper discuss the perspectives of a new model and the actual politics, taking in care the threatens and opportunities. The authors distinguish aspects related to a new regulation linked to process, results and systems since health regional demand.

Kalite Kavramı, son otuz yılda Türkiye'de sanayi ve bilimin bir arada yürütülmesi, mühendislik ve ekonominin bir arada düşünülmesi ile birlikte gelişme göstermiş bir doğru, etkin, verimli ve güvenilir iş yapma yöntemi olarak ortaya çıkmaktadır. Kalite ve yönetsel sistem bir arada değerlendirildiğinde ise toplam kalite yönetimi şeklini almaktadır. Sağlık hizmetleri boyutuyla birlikte düşünüldüğünde kalite uygulamaları oldukça somut ve ölçülebilir nitelikte görünmektedir. Ancak bireylerin algısı anlamında düşünüldüğünde kaliteyi ölçmek bir o kadar zor bir hal almaktadır. Bu zorluğu aşmak için konu, birinci basamak örgütlenmeleri ve bu örgütlenmelerdeki personel ile kurumsal yapı ilişkisi çerçevesinde düşünülmüştür. Çalışma kapsamında sağlık hizmetlerinde kalite algısı, nicel ve nitel araştırma yöntemleri kullanılarak ortaya konulmuştur. Çalışanların kurumlarıyla ilişkileri, yapılandırılmış sorulara verilen sözlü yanıtların deşifresi ve analizi şeklinde yapılmıştır. Quality Concept, a combination of science, industry and the execution of the last thirty years in Turkey, consider a combination of engineering and economy developed along with a proper, effective, efficient, and appears to be a reliable method of doing business. Were assessed by a combination of quality and management system takes the form of total quality management. Considering the quality of Health care services with the size of applications seems quite tangible, and measurable. However, considering the quality in terms of the perception of individuals is becoming a difficult one to measure. To overcome this difficulty issue, primary care Organizations and is considered within the framework of the relationship between institutional structure in organization's' staff. In the study the perception of quality in healthcare, qualitative research methods were asked to be introduced. Employee relations agencies, statistical data and analysis of deciphering are not structured in the form of answers to the questions were verbally. 102

En las organizaciones del sector salud en Colombia, se realizan procedimientos que a pesar de ser homólogos entre ellos, no se discriminan ocasionando que no siempre se escoja el que genere mejores resultados, no solo desde el punto de vista médico sino también de la dirección que se ejerce en las organizaciones la cual debe estar en función de optimizar cualquiera de los procesos propios de la actividad, en este caso, en busca de generación de valor usando como vía la apropiada GC, éste documento está orientado a demostrar que la GC aporta herramientas que permiten desarrollar la aproximación a un modelo metodológico que procura facilitar la elección de procedimientos en salud si se toman los costos asociados como criterios relevantes del análisis, se seleccionaron como instrumento de demostración a los procesos denominados Traqueostomía Quirúrgica y Traqueostomía Percutánea la intensión de desarrollar una aproximación a un modelo metodológico orientado a los procesos de gestión de conocimiento generadores de valor en organizaciones del sector salud en Colombia. In the organizations from the healthy sector in Colombia different procedures are carried out. Although these procedures can be similar, they are not well differentiated, what has caused that it is usually chosen the one that doesn't generate the best results not only from a medical point of view but also from the management persepective. It is precisely this last perspective the one that is called to optimize any process in any enterprise; but in this specific context it aims to generate value through the appropiate GC. That's the reason why this study intents to demonstrate that the GC provides tools that allow the choice of healthy procedures in an easier way if the associated costs as well as the analysis criteria are taken into account. To develop this study, the demonstration instruments used were the processes known as the surgical tracheotomy and the percutaneous tracheotomy. CENTRO DE ESTUDIOS EMPRESARIALES PARA LA PERDURABILIDAD

A B S T R A C T - The present research seeks to describe and understand how strategy influences leader-ship and how this in turn interacts in the process of innovation and change in healthorganizations.This is an exploratory and descriptive study that involved five health organizations: fourPortuguese and one Spanish. We used a mixed approach of research (qualitative and quan-titative), which enabled us to understand, through case study, how strategy and leadershipwere articulated with innovation in these five health organizations.Despite their complexity and specificity, both the model of Miles & Snow (organizationalstrategy) and the model of the Competing Values Framework of Quinn (organizational cul-ture and leadership), suitably adapted, have proven heuristic power and are able to beapplied to healthcare organizations.Public and private healthcare organizations, as well as public–private partnerships, can betracked and monitored in their processes of innovation and change in order to understandits kind of culture, leadership or organizational strategy adopted.Health organizations coexist in a continuum, where the environment (internal and external)and time are key factors which determine the strategy to be adopted. Here too dependingon the dynamic and complex reality where the organization moves, there are no pure types.There is indeed a great organizational plasticity and flexibility.Leaders usually carry the formal authority by circular normative. They are not pairs (orprimi inter pares). Instead they are, sometimes, in a position of superiority, when the bestthing is partnership, collaboration, cooperation, building consensus and cooperation withall stakeholders, in order that they are the real protagonists and facilitators of change andinnovation. R E S U M O - A presente investigação procura descrever e compreender como a estratégia influencia a liderança e como esta, por sua vez, interage nos processos de inovação e mudança em organizações de saúde. Trata-se de um estudo exploratório e descritivo que envolveu cinco organizações de saúde, quatro portuguesas e uma espanhola. Utilizou-se uma abordagem mista de investigação (qualitativa e quantitativa), que permitiu compreender, através do estudo de caso, como se articulam a estratégia, a liderança e a inovação nessas cinco organizações de saúde. Tanto o modelo de Miles & Snow (estratégia organizacional) como o modelo dos val- ores contrastantes de Quinn (cultura organizacional e lideranç a), devidamente adaptados, mostram-se heurísticos e provam poder aplicar-se às organizações de saúde, apesar a sua complexidade e especificidade. As organizações do setor público como do setor privado e organizações públicas concessionadas (parcerias-público privadas) podem ser acompanhadas e monitorizadas nos seus processos de inovação e mudança, associados aos tipos de cultura, liderança ou estratégia organizacionais adotados. As organizações de saúde coabitam num continuum, onde o ambiente (quer interno quer externo) e o tempo são fatores decisivos que condicionam a estratégia a adotar. Também aqui, em função da realidade dinâmica e complexa onde a organização se move, não há tipologias puras. Há, sim, uma grande plasticidade e flexibilidade organizacionais. Quanto aos líderes exercem, habitualmente, a autoridade formal pela via da circular normativa. Não são pares (nem primi inter pares). Colocam-se por vezes numa posição de superioridade, quando o mais adequado seria a relação de parceria, cooperação e procura de consensos, com todos os colaboradores, a fim de serem eles os verdadeiros protagonistas e facilitadores da mudança e das inovações. info:eu-repo/semantics/publishedVersion

The present research seeks to describe and understand how strategy influences leader-ship and how this in turn interacts in the process of innovation and change in health organizations. This is an exploratory and descriptive study that involved five health organizations: four Portuguese and one Spanish. We used a mixed approach of research (qualitative and quantitative), which enabled us to understand, through case study, how strategy and leadership were articulated with innovation in these five health organizations. Despite their complexity and specificity, both the model of Miles & Snow (organizational strategy) and the model of the Competing Values Framework of Quinn (organizational culture and leadership), suitably adapted, have proven heuristic power and are able to be applied to healthcare organizations. Public and private healthcare organizations, as well as public–private partnerships, can be tracked and monitored in their processes of innovation and change in order to understand its kind of culture, leadership or organizational strategy adopted. Health organizations coexist in a continuum, where the environment (internal and external) and time are key factors which determine the strategy to be adopted. Here too depending on the dynamic and complex reality where the organization moves, there are no pure types. There is indeed a great organizational plasticity and flexibility. Leaders usually carry the formal authority by circular normative. They are not pairs (or primi inter pares). Instead they are, sometimes, in a position of superiority, when the best thing is partnership, collaboration, cooperation, building consensus and cooperation with all stakeholders, in order that they are the real protagonists and facilitators of change and innovation. RESUMO - A presente investigação procura descrever e compreender como a estratégia influencia a liderança e como esta, por sua vez, interage nos processos de inovação e mudança em organizações de saúde. Trata-se de um estudo exploratório e descritivo que envolveu cinco organizações de saúde, quatro portuguesas e uma espanhola. Utilizou-se uma abordagem mista de investigação (qualitativa e quantitativa), que permitiu compreender, através do estudo de caso, como se articulam a estratégia, a liderança e a inovação nessas cinco organizações de saúde. Tanto o modelo de Miles & Snow (estratégia organizacional) como o modelo dos valores contrastantes de Quinn (cultura organizacional e liderança), devidamente adaptados, mostram-se heurísticos e provam poder aplicar-se às organizações de saúde, apesar a sua complexidade e especificidade. As organizações do setor público como do setor privado e organizações públicas concessionadas (parcerias-público privadas) podem ser acompanhadas e monitorizadas nos seus processos de inovação e mudança, associados aos tipos de cultura, liderança ou estratégia organizacionais adotados. As organizações de saúde coabitam num continuum, onde o ambiente (quer interno quer externo) e o tempo são fatores decisivos que condicionam a estratégia a adotar. Também aqui, em função da realidade dinâmica e complexa onde a organização se move, não há tipologias puras. Há, sim, uma grande plasticidade e flexibilidade organizacionais. Quanto aos líderes exercem, habitualmente, a autoridade formal pela via da circular normativa. Não são pares (nem primi inter pares). Colocam-se por vezes numa posição de superioridade, quando o mais adequado seria a relação de parceria, cooperação e procura de consensos, com todos os colaboradores, a fim de serem eles os verdadeiros protagonistas e facilitadores da mudança e das inovações. info:eu-repo/semantics/publishedVersion

The article presents a reflection on the construction of public health from different aspects, concluding the ethical, economic, cultural and ecological necessity implies the existence of citizens and not consumers health, rethought organizational systems and mechanisms of participation and user involvement in the health sector. Capital, empowerment, self-care and self-management, more territorial dimension and local development, with governance, ethics of care and networks are topics in which eclectically takes this reflection. Develop networks for healthcare involves building synergies through coordination instruments without hierarchy (heterarchy) between nodes of the network, guided by the demands arising from the territory. Territorial claims surveyed require combining economic, cultural and environmental aspects, making joint economic policies with social policies. The notion of network proposes a re-interpretation of the relationship between state and society, because demand self-organization and self-regulation in the institutions and regional organizations, with exchanges of resources linked to the experience of the actors, and political resources, related to the position actors in the political system. El artículo presenta una reflexión respecto de la construcción de ciudadanía en salud desde distintos aspectos, para concluir la necesidad ética, económica, cultural y ecológica que implica la existencia de ciudadanos y no de consumidores de salud, repensado los sistemas organizativos y mecanismos de participación e involucramiento de usuarios del sector salud. Capital social, empoderamiento, autocuidado y autogestión, más dimensión territorial y desarrollo local, junto a gobernanza, ética del cuidado y redes, son temáticas en las que transcurre eclécticamente esta reflexión. Desarrollar redes para la asistencia sanitaria implica construir sinergias a través de coordinación instrumental y sin jerarquía (heterarquía) entre los nodos de la red, orientadas por las demandas surgidas desde el territorio. Las demandas territoriales relevadas obligan a conjugar aspectos económicos, culturales y ambientales, lo que hace articular políticas económicas con políticas sociales. La noción de red propone una re-interpretación de la relación Estado-Sociedad, porque demanda autoorganización y autorregulación en las instituciones y organizaciones territoriales, junto a intercambios de recursos vinculados a la experiencia de los actores, y de recursos políticos, relacionados con la posición de los actores en el sistema político. O artigo apresenta uma reflexão sobre a construção da saúde pública a partir de diferentes aspectos, concluindo a necessidade ética, econômica, cultural e ecológica implica a existência de cidadãos e não os consumidores de saúde, repensado sistemas e mecanismos de participação e organização a participação do usuário no sector da saúde. Capital, empoderamento, auto-cuidado e auto-gestão, dimensão mais territorial e desenvolvimento local, com a governação, ética do cuidado e redes são temas em que toma eclectically esta reflexão. Desenvolver redes de cuidados de saúde envolve sinergias através de instrumentos de coordenação sem hierarquia (heterarquia) entre os nós da rede, guiado pelas exigências decorrentes do território. Reivindicações territoriais pesquisadas exigir combinando aspectos econômicos, culturais e ambientais, tornando as políticas econômicas conjuntas com as políticas sociais. A noção de rede propõe uma re-interpretação da relação entre Estado e sociedade, porque a demanda auto-organização e auto-regulação nas instituições e organizações regionais, com o intercâmbio de recursos vinculados à experiência dos atores e recursos políticos, relacionada com a posição atores do sistema político.

S to magistrsko nalogo želimo pojasniti pojem vrednot in z njimi povezanih pojmov. V teoretičnem delu so s pomočjo strokovne literature predstavljene vrednote z vsemi svojimi lastnostmi in delovanjem, predstavljeni so tudi drugi deli strateškega plana. Opisali smo teorijo zadovoljstva zaposlenih in predstavili neprofitne zdravstvene organizacije. V empiričnem delu je uporabljena kvantitativna metoda dela raziskovanja, ki smo jo izvedli s pomočjo anketnega vprašalnika med zaposlenimi v zdravstvu na Koroškem (v Zdravstvenem domu Ravne na Koroškem, Splošni bolnišnici Slovenj Gradec, Centru za usposabljanje, delo in varstvo Črna na Koroškem in Domu starejših Na Fari Prevalje). Ugotavljali smo usklajenost vrednot zaposlenih v zdravstvu z vrednotami njihovih organizacij, kot jih zaznajo zaposleni. Zanimal nas je tudi vpliv te usklajenosti vrednot na zadovoljstvo zaposlenih pri delu. Ugotavljali pa smo tudi razvijanje in uveljavljenje vrednot najvišjega managementa v teh organizacijah. Rezultati raziskave in razprava so predstavljeni s pomočjo tabel, grafov in statističnih metod. Odgovorili smo na zastavljena raziskovalna vprašanja in prišli do zaključka, da vrednote zaposlenih v zdravstvu na Koroškem niso usklajene z vrednotami njihovih organizacij, kar delno vpliva tudi na zadovoljstvo zaposlenih pri delu, najvišji management teh organizacij pa ne dela sistematično na tem, da bi skupaj z zaposlenimi razvil in zapisal skupne vrednote. Zapisani so še predlogi sprememb in skupne vrednote, ki smo jih dobili s to raziskavo. This dissertation explains the concept of values and with values related terms. The theoretical part clarifies values with all its characteristics explained on professional literature. There are also presented non-profit health organizations. In the empirical part the quantitative method of research is used, which was conducted through a questionnaire among employees in different health organization in Koroska. We assessed the consistency of employees’ values with the values of their organizations as perceived by employees. We were interested in the impact of coherence values in employees’ satisfaction at work. We also determined the development and effectuation of values in the highest management of these organizations. The discussion and research results are presented using tables, graphs and statistic methods. We answered the research questions and came to the conclusion that the values of the employees in health organizations in Koroska are not consistent with the values of their organizations, what partly affects the employees’ satisfaction at work. The highest management of these organizations is not working systematically with their employees in developing and writing down their common values. In the end are included suggestions of changes and common values that we obtained with this research.

n Colombia, just the same as in the whole World, globalization of the market led to a large increase in importating of diverse devices. In case of devices for aesthetic use, importing a large number of different device types without adequate control of products, increases the risk of appearance of adverse events for their users. On the other hand, there are very few studies of adverse events caused by their use, or risk assessment studies. This paper presents the role of academy in defining the conditions for safety of aesthetic devices and evaluation of medical devices 'Class 1', for use in aesthetics. With support of the Colombian government, the Pan American Health Organization PAHO, and the regulating entity INVIMA, we proposed a model of control and regulation of use of devices for aesthetics in order to achieve ease of classification and ensure adequate use of devices for aesthetics, and to minimize the risk for users of the technology. As a result of this model, a tool was developed to facilitate to the regulatory entity the classification and evaluation of devices for aesthetic use 'Class 1', which will be implemented by the Colombian government with the support of biomedical engineers having the required knowledge and skills. © 2013 IEEE.

O conhecimento tem sido utilizado como recurso no planejamento de ações inteligentes e eficazes nas organizações. O interesse em investigar processos de gestão do conhecimento vem se intensificando nas diversas áreas. Esta revisão sistemática da literatura foi norteada pela questão: quais as contribuições das publicações em periódicos nacionais e internacionais sobre gestão do conhecimento na saúde? A amostra totalizou 32 itens que se enquadraram nos critérios de inclusão deste estudo. Os resultados mostraram que 78% dos periódicos que publicaram sobre o assunto são internacionais, 77% dos pesquisadores atuam em ensino superior e 65% possuem título de doutor. Os textos originaram cinco categorias temáticas, sendo as principais: desenvolvimento de sistemas de gestão do conhecimento em saúde (37,5%), discussões sobre a aplicação da gestão do conhecimento em saúde (28,1%) e função do enfermeiro na gestão do conhecimento (18,7%). El conocimiento ha sido utilizado como recurso en la planificación de acciones inteligentes y eficaces en las organizaciones. El interés en investigar procesos de gestión de conocimiento se ha intensificado en diversas áreas. Fue desarrollada una revisión sistemática de la literatura, basada en la cuestión: ¿Cuáles son las contribuciones de las publicaciones en revistas brasileñas e internacionales sobre gestión de conocimiento en salud? La muestra abarcó a 32 ítems que cumplieron con los criterios de inclusión. Los resultados mostraron que el 78% de las revistas que publicaron sobre el tema son internacionales, 77% de los investigadores actúan en la educación superior y 65% tiene título de doctor. Los textos originaron a cinco categorías temáticas, siendo las principales: desarrollo de sistemas de gestión del conocimiento en salud (37,5%), discusiones sobre la aplicación de la gestión del conocimiento en salud (28,1%) y función del enfermero en la gestión del conocimiento (18,7%). Knowledge has been used as a resource for intelligent and effective action planning in organizations. Interest in research on knowledge management processes has intensified in different areas. A systematic literature review was accomplished, based on the question: what are the contributions of Brazilian and international journal publications on knowledge management in health? The sample totaled 32 items that complied with the inclusion criteria. The results showed that 78% of journals that published on the theme are international, 77% of researchers work in higher education and 65% have a Ph.D. The texts gave rise to five thematic categories, mainly: development of knowledge management systems in health (37.5%), discussion of knowledge management application in health (28.1%) and nurses' function in knowledge management (18.7%).

Todo o processo que envolve a comunicação é de extrema relevância, sendo tanto ou mais importante, quanto mais útil for a comunicação para a satisfação das necessidades básicas de sobrevivência do homem. Este trabalho pretendeu demonstrar que o stresse parece contribuir largamente para as dificuldades de comunicação entre médico/utente e que nesta ligação é importante um terceiro elemento, o psicólogo. O enquadramento nas organizações de saúde é de extrema importância, principalmente, nas instituições públicas, porque muitas das vezes, o processo de comunicação é gerador de stresse e acaba por promover no utente um grande sofrimento. Any process which involves communication is of extremely relevance, yet it becomes more important when communication is used to satisfy a person’s basic need of survival. This paper seeks to demonstrate that stress contributes significantly to the difficulties in communication between doctor/patient and that in this process a third element also important, the psychologist. The environment in health organizations is extremely important, especially in public institutions, because often the communication process generates stress and it turns out to cause great suffering to users.

En la actualidad, la percepción de las empresas como meras creadoras de beneficio económico empieza ya a estar superada. Una nueva concepción de las organizaciones se está extendiendo y la Responsabilidad Social es quizás la más evidente de sus manifestaciones. En este panorama el estilo de liderazgo que ejercen los directivos de las organizaciones juegan un papel fundamental, puesto que ellos son quienes marcan las estrategias y las líneas a seguir para alcanzar sus objetivos. El presente artículo pretende hacer una reflexión acerca de la situación económica-social que azota a España y plantea la necesidad de asentar el nuevo modelo post-crisis sobre criterios éticos de Responsabilidad Social, cuyo desarrollo e implantación requiere de estilos de liderazgos comprometidos con la excelencia empresarial, la globalización y el cambio., Currently, the perception of companies as merely creating economic benefit is already beginning to be overcome. A new concept of organization is expanding and Social Responsibility is perhaps the most obvious manifestations. In this scenario the style of leadership exercised by managers of organizations play a fundamental role, since they are the ones who make the strategies and guidelines to follow to achieve their goals. This article aims to reflect on the social-economic situation plaguing Spain and a need to establish the new post-crisis model of ethical social responsibility, the development and implementation requires leadership styles committed to excellence business, globalization and change.