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[Between protocols and subject: quality of hospital care in a hematology service].
- Source :
-
Cadernos de saude publica [Cad Saude Publica] 2018 Jun 25; Vol. 34 (6), pp. e00043817. Date of Electronic Publication: 2018 Jun 25. - Publication Year :
- 2018
-
Abstract
- The article presents partial results of a study at Hospital Edgar Santos, Universidade Federal da Bahia (HUPES), Brazil, analyzing the service's experience with improvement in quality of care within a context of hospital accreditation. The article focuses on the hematology service and specifically its quality of care and intersubjective processes. The study adopted a qualitative approach, using interviews and observation. From the theoretical point of view, the work of Campos, Cecílio, and Merhy acknowledge healthcare's complex nature and micropolitical and intersubjective dimension and the capacity of health professionals to produce meanings and practice creativity. To understand the health professionals' processes of psychosocial linkage and subjective mobilization, we drew on concepts from the French school of psychosociology (Enriquez) and Dejours' psychodynamics of work. The analysis was organized along three lines: psychosocial linkage and the imaginary of self-management; bonding and affect: singularity of the subject's care and clinical case; real work and the healthcare team. One of the main conclusions is the building of a self-management imaginary, expressed in shared projects, expectations, and some forms of interpreting and operating reality, based on affectively invested representations of autonomy and unity. Alongside technical elements such as protocols, the article highlights professional judgment, proper to the intersubjective dimension, fostering the singularity of care. In our view, the real work in the patient care scene is traversed by adjustments that demonstrate team cooperation.
- Subjects :
- Accreditation organization & administration
Accreditation standards
Brazil
Humans
Patient Care Management standards
Personnel Administration, Hospital methods
Quality of Health Care standards
Workflow
Clinical Protocols standards
Hematology organization & administration
Hospital Administration methods
Patient Care Management organization & administration
Quality of Health Care organization & administration
Subjects
Details
- Language :
- Portuguese
- ISSN :
- 1678-4464
- Volume :
- 34
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Cadernos de saude publica
- Publication Type :
- Academic Journal
- Accession number :
- 29952396
- Full Text :
- https://doi.org/10.1590/0102-331X00043817