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1.
Recurso educacional aberto em Espanhol | CVSP - Argentina | ID: oer-1101

RESUMO

Se pretende definir indicadores apropiados para la gestión de los distintos servicios de una organización que presta servicios integrales de salud pública a una población y territorio definidos. Métodos: Análisis de la actividad y discusión con los responsables de los diversos servicios para buscar indicadores de obtención viable que recojan de la mejor forma tres aspectos: su actividad, su cobertura, calidad o efectividad, y su coste.


Assuntos
Indicadores de Serviços , Indicadores de Gestão , Custos e Análise de Custo , Avaliação em Saúde , Avaliação de Programas e Projetos de Saúde , Organização e Administração , Administração em Saúde Pública
2.
J Pediatr Orthop ; 32(4): 327-33, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22584830

RESUMO

BACKGROUND: Major natural disasters may provoke a mass casualty situation, and children tend to represent an important proportion of the victims. The purpose of this study was to prospectively record medical conditions presented by pediatric survivors of a major natural disaster to determine the type of medical specialists most needed during the acute phase of relief response. METHODS: After the 2010 Haiti earthquake, age, sex, date of presentation, diagnosis, and treatment provided were prospectively recorded for all patients less than 18 years old treated by a medical relief team. Patients were then allocated to 1 of the 2 groups: surgical (traumatism or surgical disorder) and medical (medical disorder). Medical activity lasted for 43 days. RESULTS: Four hundred seventy-one of the 796 treated patients were less than 18 years old. Two hundred forty-four (52%) were assigned to the surgical group and 227 (48%) to the medical group. As there was a substantial decrease in the number of new surgical patients registered on day 11 of activity, we arbitrarily defined an early period (until day 10 of activity) and a late period (beginning on day 11 of activity). Data obtained from the 147 new patients registered during the early period revealed 134 (91%) surgical patients and 13 (9%) medical patients. Eighty-eight percent of patients needed specialized care for traumatic orthopaedic lesions, and procedures under anesthesia or sedation were mainly (98%) performed for traumatic conditions. Data obtained for the 324 new patients registered during the late period revealed 110 (34%) surgical patients and 214 (66%) medical patients. There was a switch from high surgical needs to more routine medical and surgical care, with less procedures (88%) for the treatment of traumatic lesions. CONCLUSIONS: Pediatric orthopaedic surgeons have a major role to play in the acute phase of relief response to potentially minimize long-term physical and psychosocial disability associated with these complex injuries in growing patients. LEVEL OF EVIDENCE: Economic or decision analyses, level II.


Assuntos
Terremotos , Serviços Médicos de Emergência/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Sobreviventes , Adolescente , Anestesia/métodos , Criança , Pré-Escolar , Feminino , Haiti , Humanos , Lactente , Masculino , Incidentes com Feridos em Massa/estatística & dados numéricos , Procedimentos Ortopédicos/estatística & dados numéricos , Estudos Prospectivos , Especialização/estatística & dados numéricos
3.
J Agric Food Chem ; 59(18): 10013-22, 2011 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-21797247

RESUMO

Inorganic arsenic (iAs) is considered to be a human carcinogen. In this paper, total (As) and iAs contents of 215 food products and drinks (i.e., seafood, fruits and vegetables, meat products, oils and fats, rice and rice products, seasonings, and alcoholic drinks) marketed in Catalonia (Spain) were quantified by inductively coupled plasma-mass spectrometry. The analytical method described was used for different food products, obtaining feasible results without the need to couple LC-ICP-MS for iAs. Daily As and iAs intakes for the average adult Catalan consumer were estimated at 354 and 6.1 µg/day/person, respectively, using consumption data from the Catalan Nutrition Survey (ENCAT). The highest As content was found in seafood, contributing 96% of dietary As intake, whereas rice presented the highest iAs values, corresponding to 67% of dietary iAs intake. As cooking process may affect iAs content, boiled rice was evaluated, showing an iAs reduction (up to 86%) when using higher water volumes (30:1 water/rice ratio) than those used in previous studies. This iAs exposure was slightly below the exposure risk range stated by the European Food Safety Authority (0.3-8 µg/kg of body weight/day), although the possibility of a risk to the population with high rice consumption cannot be excluded.


Assuntos
Arsênico/análise , Contaminação de Alimentos/análise , Carcinógenos/análise , Dieta , Inocuidade dos Alimentos , Humanos , Oryza/química , Fatores de Risco , Alimentos Marinhos/análise , Espanha
4.
J Pediatr Orthop ; 31(1): e1-5, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21150721

RESUMO

BACKGROUND: MacFarland fracture is a joint fracture of the ankle in children involving the medial malleolus (Salter-Harris type III or IV). These fractures are acknowledged to have poor prognosis because of the risk of misalignment due to the development of an epiphysiodesis bridge. Current recommended treatment for a displacement of ≥ 2 mm is open reduction through an arthrotomy with screw fixation. This study aimed to evaluate functional and radiologic results of a less-invasive surgical technique consisting of closed reduction, arthrographic control of fracture reposition, and percutaneous screw fixation. METHODS: Retrospective analysis of 12 cases of children with MacFarland fractures who underwent percutaneous screw fixation with intraoperative arthrography. Data collected for each child included age, sex, radiologic Salter-Harris classification of medial and lateral malleolus fractures, fracture gap before and after treatment, intraoperative and postoperative complications, and length of follow up. Results were evaluated according to the 3 outcome categories according to the classification by Gleizes and based on clinical and radiologic criteria. RESULTS: There were 7 boys and 5 girls with an age range of 10 to 15 years (average, 12 y 6 mo). Average follow-up was 18 months (range: 9 to 57 mo). Medial malleolus fracture was Salter-Harris type III in 7 patients and type IV in 5. There were 9 Salter-Harris type I fractures and 1 type II at the level of the distal fibular physis. The mean preoperative gap was 2.8 mm (1.9 to 4 mm). Fracture fixation was performed with 2 screws in 9 patients and 1 screw in 3 patients. Mean surgical time was 58 minutes (45 to 75 min). The mean postoperative articular gap was 0 mm in 8 patients, inferior to 1 mm in 3 patients, and 2 mm in 1 patient. At the time of last follow-up, the outcome was considered good in all but 1 patient. CONCLUSIONS: Closed reduction combined with ankle arthrography followed by percutaneous osteosynthesis is an interesting and less invasive safe surgical alternative to classic open reduction and internal fixation of displaced MacFarland fractures. LEVEL OF EVIDENCE: Therapeutic study, level IV.


Assuntos
Traumatismos do Tornozelo/cirurgia , Artrografia/métodos , Fixação Interna de Fraturas/métodos , Fraturas Ósseas/cirurgia , Adolescente , Traumatismos do Tornozelo/patologia , Parafusos Ósseos , Criança , Feminino , Seguimentos , Fixação Interna de Fraturas/efeitos adversos , Humanos , Masculino , Monitorização Intraoperatória , Complicações Pós-Operatórias , Prognóstico , Estudos Retrospectivos
5.
Gac. sanit. (Barc., Ed. impr.) ; 24(5): 378-384, sept.-oct. 2010. tab
Artigo em Espanhol | IBECS | ID: ibc-95622

RESUMO

Objetivos Se pretende definir indicadores apropiados para la gestión de los distintos servicios de una organización que presta servicios integrales de salud pública a una población y territorio definidos.Métodos Análisis de la actividad y discusión con los responsables de los diversos servicios para buscar indicadores de obtención viable que recojan de la mejor forma tres aspectos: su actividad, su cobertura, calidad o efectividad, y su coste.Resultados Se obtienen indicadores cuantitativos para todos los servicios productivos de salud pública relacionados en el catálogo de servicios, pero en algunas líneas de trabajo no parece factible cubrir los tres ámbitos. Además, para las actividades de coordinación y enlace los indicadores son a menudo menos cuantitativos y poco sensibles a cambios. Se ha podido cuantificar el coste para las grandes líneas de trabajo productivo y los 47 servicios o productos, y los costes indirectos se han estimado en un 14%.Conclusiones Es factible desarrollar un sistema de información de gestión para los servicios de salud pública que permita comparaciones a lo largo del tiempo o entre territorios, con indicadores de actividad para todas las líneas de trabajo productivo. Los indicadores que reflejan la cobertura, calidad o impacto de los servicios plantean las mayores dificultades. Para algunas líneas de trabajo se pueden obtener indicadores de coste por unidad de producto con sentido, y para otras es más difícil. En todos los casos, el coste por habitante y año es un buen indicador sintético del coste de los servicios de salud pública (AU)


Objectives To define a set of indicators for the management of the various services of an agency responsible for comprehensive public health in a defined area and population. Methods We analyzed the agency’s activity and held discussions with those responsible for the distinct services to define indicators whose estimation is viable and which optimally describe three aspects: the services’ activity, coverage, quality or effectiveness, and cost. Results Quantitative indicators were defined for all the productive public health services inventoried in the agency’s services portfolio, but not all three aspects could be covered in all areas. In addition, for coordination and liaison services, the indicators were often less quantitative and less sensitive to change. Costs were estimated for the main areas of productive activity and for the 47 services or products, with indirect costs being estimated as 14% of expenditure.Conclusions We defined a system of indicators for management control, allowing comparisons over time and with other geographical areas, and with activity indicators covering all production areas. Defining indicators reflecting coverage, quality or impact for all services is more difficult. Cost can be estimated by unit of production for some services, but less successfully for others. The yearly cost by population is always a good synthetic indicator of the cost of public health services (AU)


Assuntos
Humanos , Administração de Consultório/tendências , Administração de Serviços de Saúde/tendências , Gestão da Qualidade , Indicadores de Qualidade em Assistência à Saúde , Avaliação de Processos e Resultados em Cuidados de Saúde/estatística & dados numéricos , /tendências , Financiamento da Assistência à Saúde
6.
Inj Prev ; 16(6): 408-10, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20805621

RESUMO

OBJECTIVE: To analyse population-based data on hospitalisation caused by dog bite injuries after changes in legal regulations on dog ownership, including breed-specific regulations. DESIGN: Descriptive study. SETTING: Hospitals in Catalonia (Spain), 1997-2008. SUBJECTS: Persons hospitalised with injuries caused by dog bites. RESULTS: There has been a significant decline in hospitalisation caused by injuries from dog bites from 1.80/100,000 in 1997-9 to 1.11/100,000 in 2006-8, after the enactment of stricter regulations on dog ownership in 1999 and 2002. The magnitude of this change is significant (-38%), and has been greatest in less urban settings. CONCLUSIONS: Government regulations were associated with a sizable decrease in injuries caused by dog bites in Catalonia. More evaluative studies in this field may provide criteria to focus future regulations and other preventive interventions.


Assuntos
Mordeduras e Picadas/epidemiologia , Cães , Hospitalização/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Animais , Animais Domésticos , Mordeduras e Picadas/classificação , Serviço Hospitalar de Emergência , Feminino , Regulamentação Governamental , Humanos , Masculino , Saúde Pública , Espanha/epidemiologia , Ferimentos e Lesões/classificação
7.
Gac Sanit ; 24(5): 378-84, 2010.
Artigo em Espanhol | MEDLINE | ID: mdl-20554080

RESUMO

OBJECTIVES: To define a set of indicators for the management of the various services of an agency responsible for comprehensive public health in a defined area and population. METHODS: We analyzed the agency's activity and held discussions with those responsible for the distinct services to define indicators whose estimation is viable and which optimally describe three aspects: the services' activity, coverage, quality or effectiveness, and cost. RESULTS: Quantitative indicators were defined for all the productive public health services inventoried in the agency's services portfolio, but not all three aspects could be covered in all areas. In addition, for coordination and liaison services, the indicators were often less quantitative and less sensitive to change. Costs were estimated for the main areas of productive activity and for the 47 services or products, with indirect costs being estimated as 14% of expenditure. CONCLUSIONS: We defined a system of indicators for management control, allowing comparisons over time and with other geographical areas, and with activity indicators covering all production areas. Defining indicators reflecting coverage, quality or impact for all services is more difficult. Cost can be estimated by unit of production for some services, but less successfully for others. The yearly cost by population is always a good synthetic indicator of the cost of public health services.


Assuntos
Assistência à Saúde/organização & administração , Administração em Saúde Pública , Humanos , Espanha
10.
Gac. sanit. (Barc., Ed. impr.) ; 23(5): 440-443, sept.-oct. 2009. tab
Artigo em Espanhol | IBECS | ID: ibc-85442

RESUMO

ObjetivoHay un creciente interés por incorporar criterios de calidad a la gestión de los servicios públicos. Este trabajo propone un esquema integral de evaluación de la calidad del servicio del Centro de Acogida de Animales de Compañía gestionado por los servicios de salud pública de Barcelona.MétodosSe realizó una evaluación con tres componentes: la información recogida por los indicadores de actividad del centro (2000–2006), la conformidad con las normas legales e internas de los resultados de una auditoría interna (2006), y la satisfacción de los usuarios/clientes mediante una encuesta de satisfacción basada en el modelo SERVPERF (2006).Resultados Durante este periodo los animales sacrificados se redujeron casi un 70% y aumentaron las adopciones. La auditoría detectó 10 disconformidades (3,2% de los items valorados), sin que ninguna estuviera relacionada con el servicio al cliente. Las dimensiones de calidad del modelo obtuvieron puntuaciones elevadas en la encuesta de satisfacción; la seguridad (94,2%) y la empatía del personal (81,8%) fueron las mejor valoradas. La aparición tras la adopción de problemas de comportamiento (p=0,039) o de salud del animal (p=0,068) se asocia con una menor percepción de calidad.ConclusionesUn esquema de evaluación integral de un servicio de este tipo se revela factible. Se demuestra el cumplimiento con los procedimientos de trabajo establecidos y con la normativa legal vigente. Los resultados de la encuesta muestran un elevado grado de satisfacción de los usuarios(AU)


ObjectiveThere is growing interest in integrating quality approaches to the management of public services. The aim of the present study was to develop a comprehensive evaluation of service quality in the animal shelter managed by the public health services of the city of Barcelona (Catalonia, Spain).ResultsThe number of animals put to sleep was reduced by almost 70% and the number of adoptions increased. The audit detected 10 non-conformities (3.2% of items), none of which was related to customer service. In the satisfaction survey, the quality dimensions with the highest scores were safety (94.2%) and empathy (81.8%). The emergence of behavioral problems (p=0.039) or health problems (p=0.068) in the adopted animals had a negative influence on quality perception among adopters.ConclusionsA comprehensive scheme for the evaluation of this service is feasible. There is compliance with established protocols and regulations. The results of the survey show a high degree of user satisfaction(AU)


Assuntos
Animais , Gatos , Cães , Avaliação de Resultados em Cuidados de Saúde , Indicadores de Qualidade em Assistência à Saúde , Saúde Pública , Comportamento do Consumidor , Espanha
11.
Gac Sanit ; 23(5): 440-3, 2009.
Artigo em Espanhol | MEDLINE | ID: mdl-19467741

RESUMO

OBJECTIVE: There is growing interest in integrating quality approaches to the management of public services. The aim of the present study was to develop a comprehensive evaluation of service quality in the animal shelter managed by the public health services of the city of Barcelona (Catalonia, Spain). METHODS: An evaluation study with three components was performed. Trends in the shelter's activity indicators (2000-2006) were analyzed, compliance with current regulations and protocols was assessed with an internal audit (2006), and user-customer satisfaction was measured with a survey based on the SERVPERF model (2006). RESULTS: The number of animals put to sleep was reduced by almost 70% and the number of adoptions increased. The audit detected 10 non-conformities (3.2% of items), none of which was related to customer service. In the satisfaction survey, the quality dimensions with the highest scores were safety (94.2%) and empathy (81.8%). The emergence of behavioral problems (p=0.039) or health problems (p=0.068) in the adopted animals had a negative influence on quality perception among adopters. CONCLUSIONS: A comprehensive scheme for the evaluation of this service is feasible. There is compliance with established protocols and regulations. The results of the survey show a high degree of user satisfaction.


Assuntos
Gatos , Cães , Avaliação de Resultados em Cuidados de Saúde , Saúde Pública , Indicadores de Qualidade em Assistência à Saúde , Animais , Comportamento do Consumidor , Espanha
12.
Gac Sanit ; 22(1): 76-8, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-18261448

RESUMO

Changes in the Barcelona animal shelter from 2002 to 2005 are presented. In 2003, routine euthanasia of unclaimed stray animals was discontinued, due to a political decision of the city council. Changes were also made in the management of the shelter: from January 2003 to July 2004 the shelter was operated by an animal protection organization, and then directly again by the city public health agency. Management of the shelter by the animal welfare organization was associated with an increase in the proportion of dogs rescued and adopted. The suspension of routine euthanasia was associated with a marked increase in the number of stray dogs. Canine distemper became endemic in the shelter until late 2004, due to a certain unwillingness to use euthanasia to control infection transmission. Direct operation by public health services in a context of transparency and high social expectations has led to the development and adoption of standardized work protocols in the shelter, improving quality.


Assuntos
Bem-Estar do Animal/tendências , Cães , Abrigo para Animais , Saúde Pública , Bem-Estar do Animal/normas , Animais , Animais Domésticos , Cinomose/epidemiologia , Cinomose/prevenção & controle , Eutanásia Animal , Espanha
13.
Gac. sanit. (Barc., Ed. impr.) ; 22(1): 76-78, ene.-feb. 2008. tab
Artigo em Espanhol | IBECS | ID: ibc-63374

RESUMO

Se presenta la evolución del centro de acogida de animales de compañía de la ciudad de Barcelona de 2002 a 2005. Por mandato municipal se suspenden de forma general los sacrificios desde 2003. Se producen cambios de gestión, asumida durante los meses que van de enero de 2003 a julio de 2004 por una entidad protectora, y luego directamente por los servicios de salud pública. La gestión de una protectora conllevó notables incrementos en el número de animales rescatados y adoptados. La suspensión del sacrificio se acompañó de un extraordinario incremento de la tasa de abandonos. La reticencia en eutanasiar a animales aquejados de enfermedades infecciosas generó una endemia de moquillo, que se controló a finales de 2004. La recuperación de la gestión directa por los servicios de salud pública en un contexto de transparencia y exigencia social ha llevado al desarrollo y la adopción de protocolos de trabajo sistematizados, que mejoran la calidad


Changes in the Barcelona animal shelter from 2002 to 2005 are presented. In 2003, routine euthanasia of unclaimed stray animals was discontinued, due to a political decision of the city council. Changes were also made in the management of the shelter: from January 2003 to July 2004 the shelter was operated by an animal protection organization, and then directly again by the city public health agency. Management of the shelter by the animal welfare organization was associated with an increase in the proportion of dogs rescued and adopted. The suspension of routine euthanasia was associated with a marked increase in the number of stray dogs. Canine distemper became endemic in the shelter until late 2004, due to a certain unwillingness to use euthanasia to control infection transmission. Direct operation by public health services in a context of transparency and high social expectations has led to the development and adoption of standardized work protocols in the shelter, improving quality


Assuntos
Animais , Animais Domésticos , Bem-Estar do Animal/organização & administração , Abrigo para Animais/normas , Criação de Animais Domésticos/organização & administração , Cães , Gatos
14.
Gac Sanit ; 21(2): 172-5, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-17419935

RESUMO

Implementing health authority is a basic public health service. Part of the responsibility of public health managers is to ensure compliance with regulations. These are developed when certain risks are considered inadmissible. Mostly, the exercise of health authority deals with the routine application of detailed norms, although there is always some uncertainty, as shown by the frequent use of cautionary measures by health officers during inspections. However, epidemiologic surveillance periodically involves situations in which human health is damaged and there is no reference regulation; in these situations, health authorities must act according to their own criteria, weighing the risks of intervention against those of nonintervention. In this article, we present 3 such scenarios: using coercion in the treatment of patients with smear-positive tuberculosis, regulation of activities with soy beans posing asthma risks, and setting limits to the professional activity of an HIV-positive physician.


Assuntos
Programas Obrigatórios , Saúde Pública/legislação & jurisprudência , Espanha
15.
Gac. sanit. (Barc., Ed. impr.) ; 21(2): 172-175, mar.-abr. 2007. tab
Artigo em Espanhol | IBECS | ID: ibc-054922

RESUMO

El ejercicio de la autoridad sanitaria es un servicio básico de la salud pública. Parte de la responsabilidad de los gestores de la salud pública es hacer cumplir normas. Éstas se desarrollan cuando se dan circunstancias que llevan a considerar inadmisibles ciertos riesgos. El grueso del ejercicio de la autoridad sanitaria se basa en la aplicación relativamente sistemática de normativas detalladas de referencia, aunque siempre hay cierta incertidumbre, ejemplificada en la frecuente adopción de medidas cautelares por un inspector sanitario aplicando el principio de precaución. Pero la vigilancia epidemiológica plantea de forma intermitente situaciones de afectación de la salud humana sin normas de referencia, en las que la autoridad sanitaria debe actuar según su criterio, contrapesando los riesgos de intervenir con los de no actuar. En este manuscrito presentamos 3 casos de este tipo: la coerción en el tratamiento de enfermos con tuberculosis bacilífera; la regulación de actividades con haba de soja que plantean riesgos de asma; y la limitación del ejercicio profesional de un médico infectado por el virus de la inmunodeficiencia humana


Implementing health authority is a basic public health service. Part of the responsibility of public health managers is to ensure compliance with regulations. These are developed when certain risks are considered inadmissible. Mostly, the exercise of health authority deals with the routine application of detailed norms, although there is always some uncertainty, as shown by the frequent use of cautionary measures by health officers during inspections. However, epidemiologic surveillance periodically involves situations in which human health is damaged and there is no reference regulation; in these situations, health authorities must act according to their own criteria, weighing the risks of intervention against those of nonintervention. In this article, we present 3 such scenarios: using coercion in the treatment of patients with smear-positive tuberculosis, regulation of activities with soy beans posing asthma risks, and setting limits to the professional activity of an HIV-positive physician


Assuntos
Humanos , Vigilância Sanitária/métodos , Planejamento Sanitário , Administração Sanitária , Tuberculose/tratamento farmacológico , Asma/etiologia , Infecções por HIV/transmissão , Reconhecimento Automatizado de Padrão
16.
Gac Sanit ; 21(1): 60-5, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-17306188

RESUMO

OBJECTIVE: The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. METHODS: Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. CONCLUSION: The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board.


Assuntos
Auditoria Administrativa/métodos , Sistemas de Informação Administrativa , Administração em Saúde Pública/métodos , Controle de Formulários e Registros , Humanos , Equipes de Administração Institucional , Modelos Teóricos , Técnicas de Planejamento , Avaliação de Programas e Projetos de Saúde , Espanha
17.
Gac. sanit. (Barc., Ed. impr.) ; 21(1): 60-65, ene. 2007. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-053935

RESUMO

Objetivos: El Cuadro de Mando Integral (CMI, o Balanced Scorecard) es un instrumento para la planificación estratégica de las empresas. Adoptamos su uso en una organización de salud pública para alinear la práctica cotidiana de la dirección con los objetivos más estratégicos. Métodos: Nuestro equipo directivo requirió de discusiones con apoyo externo para clarificar los conceptos subyacentes en el CMI, adaptarlos a una organización sanitaria pública distinta del medio empresarial para el que se diseñó inicialmente y adoptarlo como instrumento de dirección. Esto llevó a la construcción de un CMI por el Comité de Dirección en el año 2002, a la posterior evaluación y a su reformulación periódica. Además, se han formulado CMI de segundo nivel para diversas direcciones y servicios de la organización. La adopción del CMI por el equipo directivo comportó un esfuerzo previo de clarificación sobre quiénes son los accionistas y los clientes de una organización pública como la nuestra. También llevó a realizar un análisis de la actividad realizada y de su producción, así como un modelo de procesos. Aunque es difícil atribuir determinados cambios a una causa concreta, creemos que diversas mejoras de gestión introducidas se pueden relacionar, al menos parcialmente, con su uso. Conclusión: El uso sistemático del CMI ha permitido cohesionar mejor el equipo de dirección y el conjunto de la organización, e impregnar la gestión cotidiana con los objetivos más estratégicos. La organización ha integrado mejor los elementos relacionados con sus clientes, ha iniciado acciones para mejorar los procesos internos transversales más complejos, y ha desarrollado de manera más sistemática y general los elementos orientados al crecimiento y desarrollo de sus cuadros y de todo el personal. Al mismo tiempo, los directivos han pasado a tener más presentes las necesidades de las administraciones titulares de la agencia que conforman sus órganos de gobierno


Objective: The Balanced Scorecard is a tool for strategic planning in business. We present our experience after introducing this instrument in a public health agency to align daily management practice with strategic objectives. Methods: Our management team required deep discussions with external support to clarify the concepts behind the Balanced Scorecard, adapt them to a public organization in the health field distinct from the business sector in which the Balanced Scorecard was designed, and adopt this instrument as a management tool. This process led to definition of the Balanced Scorecard by our Management Committee in 2002, the subsequent evaluation of the degree to which its objectives had been reached, and its periodic redefinition. In addition, second-level Balanced Scorecards were defined for different divisions and services within the agency. The adoption of the Balanced Scorecard by the management team required prior effort to clarify who are the stockholders and who are the clients of a public health organization. The agency's activity and production were also analyzed and a key processes model was defined. Although it is hard to attribute specific changes to a single cause, we believe several improvements in management can be ascribed, at least in part, to the use of the Balanced Scorecard. Conclusion: The systematic use of the Balanced Scorecard produced greater cohesion in the management team and the entire organization and brought the strategic objectives closer to daily management operations. The organization is more attentive to its clients, has taken steps to improve its most complex cross-sectional processes, and has developed further actions for the development and growth of its officers and its entire personnel. At the same time, its management team is more in tune with the needs of the agency's administrative bodies that compose its governing board


Assuntos
Humanos , Auditoria Administrativa/métodos , Sistemas de Informação Administrativa , Administração em Saúde Pública/métodos , Controle de Formulários e Registros , Equipes de Administração Institucional , Modelos Teóricos , Técnicas de Planejamento , Espanha , Avaliação de Programas e Projetos de Saúde
18.
Gac Sanit ; 18(6): 479-82, 2004.
Artigo em Espanhol | MEDLINE | ID: mdl-15625047

RESUMO

Public services must satisfy a variety of agents: users of these services, the citizens who pay the taxes that finance them, politicians, and those that work in them. To obtain public services that give priority to the citizen-user, knowledge of clients, their expectations, preferences, complaints and degree of satisfaction is essential. This article presents the process of internal discussion in our agency about its clients, who differ from those of an industrial or commercial organization. A proposal for the classification of clients, as well as the process that has led to a client portfolio, are presented and steps to improve services from the perspective of the client are suggested.


Assuntos
Comportamento do Consumidor , Assistência à Saúde/normas , Saúde Pública , Órgãos Governamentais/normas , Humanos , Espanha
19.
Rev. invest. UNSAC ; 1: 33-38, dic. 2001. ilus
Artigo em Espanhol | Peru nacional | ID: pnc-10766

RESUMO

Eurysacca melanocapta Meyrick, conocida como polilla de la quinua es la plaga más importante de este cereal andino y se encuentra en todas las áreas de siembra; principalmente en los departamentos de Cusco y Puno a una altura aproximada de 3 200 a 4 500 msnm. El estado dañino es el larval, pudiendo convertirse en mimador de hoja o comedor de granos siendo este último el de mayor importancia económica ya que puede destruir completamente la panoja. Los adultos no producen daños, son mariposas pequeñas de color grisáceo, tienen comportamiento nocturno y depositan sus huevos sobre las hojas y/o panojas, las larvas recién eclosionadas se alimentan de los granos de quinua en formación. Cuando el daño es muy intenso se observa un polvillo blanco, en el suelo al fondo del surco, producto de la alimentación de las larvas. Estas maduran en el suelo y algunas veces en el interior de la panoja, incrementando las pérdidas en el cultivo. (Yábar, 1993). Esta plaga es conocida con el nombre vulgar de “Kona Kona” o “Yawa” en Puno, “Ppislu” en la provincia de Quispicanchis, en Anta se le conoce como gorgojo de la quinua. Conociendo la necesidad de investigar acerca de la utilización de biocidas en el control de plagas que sustituyan a los agroquímicos nos motivó la realización del presente proyecto de investigación teniendo como base resultados obtenidos bajo condiciones de cautiverio (Ardiles, et, al, 1998), se utilizó mediante aspersión “propolis” comercial como bioinsecticida en dos concentraciones: al 0,5 y 1,0 por ciento (p/v). La población inicial que se tuvo ue como sigue: A= Propolis 0,50 por ciento: 120 larvas. B= Propolis 0,10 por ciento: 180 larvas. C=Testigo: 240 larvas. D= Químico : 179 larvas. ... (AU)


Assuntos
Própole/uso terapêutico , Larva , Chenopodium album , Controle Biológico de Vetores , Peru , Epidemiologia Experimental
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