RESUMO
In the current socio-economic scenario characterized by a growing shortage of resources and progressive budget constraints, the need to better coordinate processes in health institutions appears as a relevant aspect to ensure the future sustainability of system. In this sense, Relational Coordination (RC) provides a valuable opportunity for the reconfiguration of clinical guidelines concerning isolated single-level considerations. In this research the RC model has been applied to explain best results in the process of diagnosing and offering clinical treatments for lung cancer. Lung cancer presents the higher rates of tumor's mortality worldwide. Through unstructured and informal interviews with clinicians at both levels (Primary/Specialist Care), a diagnosis of the situation in relation to joint management of lung cancer is provided. Solutions of continuity in terms of coordination are explained due to the observation of lack of effective knowledge transfer between the two levels. It is this disconnection which justifies the introduction of a modified model of RC for the study and implementation of transfer relations between the knowledge holders, in order to structure consolidated and cooperative evidence-based models that lead to a substantial shortening in the response times with a marked outcomes improvement. To our knowledge, the application of this model to a Public Health problem bringing together both levels of care, hasn't been made till now.
RESUMO
Clinical practice guidelines in nursing (CPG-N) are tools that allow the necessary knowledge that frequently remains specialist-internalised to be made explicit. These tools are a complement to risk adjustment systems (RAS), reinforcing their effectiveness and permitting a rationalisation of healthcare costs. This theoretical study defends the importance of building and using CPG-Ns as instruments to support the figure of the nursing supervisor in order to optimise the implementation of R&D and hospital quality strategies, enabling clinical excellence in nursing processes and cost-efficient reallocation of economic resources through their linear integration with SARs.
Assuntos
Enfermeiras Administradoras , Enfermagem/organização & administração , Enfermagem/normas , Guias de Prática Clínica como AssuntoRESUMO
Clinical practice guidelines in nursing (CPG-N) are tools that allow the necessary knowledge that frequently remains specialist-internalised to be made explicit. These tools are a complement to risk adjustment systems (RAS), reinforcing their effectiveness and permitting a rationalisation of healthcare costs. This theoretical study defends the importance of building and using CPG-Ns as instruments to support the figure of the nursing supervisor in order to optimise the implementation of R&D and hospital quality strategies, enabling clinical excellence in nursing processes and cost-efficient reallocation of economic resources through their linear integration with SARs.
As diretrizes de prática clínica em enfermagem (GPC-E) constituem ferramentas que permitem explicitar o conhecimento necessário que com frequência permanece interiorizado nos especialistas. Essas ferramentas são um complemento dos sistemas de ajuste de risco (SAR), que reforçam a eficácia e permitem a racionalização dos custos de cuidados de saúde. Neste estudo teórico, defende-se a importância da elaboração e do uso das GPC-E como instrumentos de apoio para a função da supervisão de enfermagem e o aperfeiçoamento das estratégias de implementação da investigação e desenvolvimento (I+D) e da qualidade hospitalar, tornando possível a excelência clínica em processos de enfermagem e a realocação eficaz em termos de custo-efetividade de recursos econômicos por meio de sua integração alinhada com os SAR.
Las guías de práctica clínica en enfermería (GPC-E) constituyen herramientas que permiten la explicitación del conocimiento necesario que con frecuencia permanece interiorizado en los especialistas. Estas herramientas son un complemento de los sistemas de ajuste de riesgo (SAR), los cuales refuerzan su eficacia y permiten una racionalización de los costos de cuidados de salud. En este estudio teórico, se defiende la importancia de la elaboración y de la utilización de las GPC-E como instrumentos de apoyo para la función de la supervisión de enfermería y así, optimizar las estrategias de aplicación de la investigación y desarrollo (I+D) y de calidad hospitalaria, haciendo posible la excelencia clínica en los procesos de enfermería y la reasignación eficaz en términos de costo-efectividad de los recursos económicos mediante su integración alineada con los SAR.
