Impact of the COVID-19 pandemic on the mental health of frontline healthcare workers in a highly affected region in Brazil.

BACKGROUND: The COVID-19 pandemic had a major impact on the mental health of healthcare workers (HCWs), especially in low and middle-income countries, which had to face additional political, social, and economic challenges. We thus aimed to assess the prevalence of mental health outcomes and the associated factors in HCWs treating COVID-19 patients in one of the most affected regions in Brazil. METHODS: We used the Respondent-Driven Sampling method to assess the risks of COVID-19 infection and symptoms of mental disorders in nurses, nursing technicians, and physicians who worked on the frontline in the metropolitan region of Recife. 865 healthcare workers completed a survey regarding sociodemographic data, work-related risks, and symptoms of mental disorders - SRQ-20 for common mental disorders (CMD); AUDIT-C for problematic alcohol use; GAD-7 for anxiety; PHQ-9 for depression; PCL-5 for post-traumatic stress disorder (PTSD). Gile's successive sampling estimator was used to produce the weighted estimates by professional category. A Poisson regression model with robust variance was used to analyze factors associated with a positive screening for CMD. We will present the results of a cross-sectional analysis of the mental health outcomes after the first peak of COVID-19 - from August 2020 to February 2021. RESULTS: The prevalence ratios for a positive screening for CMD were 34.9% (95% CI: 27.8-41.9) in nurses, 28.6% (95% CI: 21.3-36.0) in physicians, and 26.6% (95% CI: 16.8-36.5) in nursing technicians. Nurses presented a higher prevalence of depressive symptoms (23%). Positive screening for problematic alcohol use (10.5 to14.0%), anxiety (10.4 to 13.3%), and PTSD (3.3 to 4.4%) were similar between the professional categories. The main factors associated with CMD in nurses and physicians were related to an intrinsic susceptibility to mental illness, such as previous or family history of psychiatric disorder, and female sex. Among nurse technicians, work-related factors, such as accidents with biological material, presented the strongest association with CMD. CONCLUSION: The mental health of HCWs fighting COVID-19 in Recife was severely affected. It is crucial that healthcare services provide adequate working conditions and psychological support, investing in programs to promote and protect HCWs mental health.

Mental health outcomes in frontline healthcare workers in Brazil during the COVID-19 epidemic: Results of an online survey in four regions using respondent-driven sampling (RDS).

BACKGROUND: The COVID-19 pandemic overwhelmed health facilities and presented healthcare workers (HCWs) with a new infectious disease threat. In addition to a sanitary crisis, Brazil still had to face major political, economic, and social challenges. This study aimed to investigate mental health outcomes in frontline HCWs in different regions of the country and at different epidemic times. We also sought to identify the main risk factors associated with these outcomes. METHODS: A cross-sectional online survey using respondent-driven sampling was conducted to recruit physicians (n = 584), nurses (n = 997), and nurse technicians (n = 524) in 4 regions of Brazil (North, Northeast, Southeast, and South) from August 2020 to July 2021. We used standardized instruments to screen for common mental disorders (CMD)(SRQ-20), alcohol misuse (AUDIT-C), depression (PHQ-9), anxiety (GAD-7), and post-traumatic stress disorder (PTSD)(PCL-5). Gile's successive sampling estimator was used to produce weighted estimates. We created a three-cluster data set for each HCW category and developed a hierarchical regression model with three levels: individual characteristics; workplace-related aspects; COVID-19 personal experience. The impact of the epidemic moment on the outcomes was also studied. RESULTS: The prevalence of probable CMD was 26.8-36.9%, alcohol misuse 8.7-13.6%, depression 16.4-21.2%, anxiety 10.8-14.2%, and PTSD 5.9-8.0%. We found a stronger association between mental health outcomes and the following factors: history of psychiatric disorders, female gender, and clinical comorbidities (level 1); work overload and family isolation (level 2); sick leave (level 3). Epidemic variables, such as the number of deaths and trend of deaths by COVID-19, had almost no impact on the outcomes. CONCLUSION: An alarmingly high prevalence of depression and anxiety was found in Brazilian frontline HCWs. Individual factors were the most strongly associated with mental health outcomes. These findings indicate the need to develop programs that provide emotional support, identify professionals at risk and refer them to specialized treatment when necessary.

Reports from the frontline: health workers describe COVID-19 risks and fears in five cities in Brazil.

BACKGROUND: Health providers are under unprecedented pressures to perform in the COVID-19 health crisis and under unprecedented risks. We initiated a large mixed-method survey of health professionals in five large metropolitan areas in Brazil to document the risks and needs of health professionals. To initiate the study, we conducted formative research. METHODS: We conducted 77 open-ended semi-structured interviews online in a convenience sample of physicians, nurses, nurse technicians, and physiotherapists in Belem, Fortaleza, Porto Alegre, Recife, and São Paulo, Brazil. Design, data collection, and analysis were informed by Rapid Ethnographic Analysis (REA). RESULTS: Responses are organized into three themes that emerged in the interviews: the lack of preparation - both locally and nationally-for the pandemic and its effects on staffing and training; the overlap of personal, family, and professional risk and consequences; and inadequately addressed anxiety and suffering among health staff. CONCLUSIONS: Our respondents were unprepared for the epidemic, especially the institutional sequelae and psychological cost. These consequences were exacerbated by both lack of leadership and sweeping changes undercutting the Brazilian health system noted by almost all participants.

Real-world effectiveness of original BNT162b2 mRNA COVID-19 against symptomatic Omicron infection among children 5-11 years of age in Brazil: A prospective test-negative design study.

OBJECTIVE: To estimate original wild-type BNT162b2 effectiveness against symptomatic Omicron infection among children 5-11 years of age. METHODS: This prospective test-negative, case-control study was conducted in Toledo, southern Brazil, from June 2022 to July 2023. Patients were included if they were aged 5-11 years, sought care for acute respiratory symptoms in the public health system, and were tested for SARS-CoV-2 using reverse transcription polymerase chain reaction. In the primary analysis, we determined the effectiveness of two doses of original wild-type BNT162b2 against symptomatic COVID-19. The reference exposure group was the unvaccinated. RESULTS: A total of 757 children were enrolled; of these, 461 (25 cases; 436 controls) were included in the primary analysis. Mean age was 7.4 years, 49.7 % were female, 34.6 % were obese, and 14.1 % had chronic pulmonary disease. Omicron accounted for 100 % of all identified SARS-CoV-2 variants with BA.5, BQ.1, and XBB.1 accounting for 35.7 %, 21.4 % and 21.4 %, respectively. The adjusted estimate of two-dose vaccine effectiveness against symptomatic Omicron was 3.1 % (95 % CI, -133.7 % to 61.8 %) after a median time between the second dose and the beginning of COVID-19 symptoms of 192.5 days (interquartile range, 99 to 242 days). CONCLUSION: In this study with children 5-11 years of age, a two dose-schedule of original wild-type BNT162b2 was not associated with a significant protection against symptomatic Omicron infection after a median time between the second dose and the beginning of COVID-19 symptoms of 192 days, although the study may have been underpowered to detect a clinically important difference. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov number, NCT05403307 (https://classic. CLINICALTRIALS: gov/ct2/show/NCT05403307).

BNT162b2 mRNA COVID-19 against symptomatic Omicron infection following a mass vaccination campaign in southern Brazil: A prospective test-negative design study.

BACKGROUND: Evidence regarding effectiveness of BNT162b2 mRNA COVID-19 vaccine against Omicron in Latin America is limited. We estimated BNT162b2 effectiveness against symptomatic COVID-19 in Brazil when Omicron was predominant. METHODS: This prospective test-negative, case-control study was conducted in Toledo, Brazil, following a mass COVID-19 vaccination with BNT162b2. Patients were included if they were aged ≥12 years, sought care for acute respiratory symptoms in the public health system between November 3, 2021 and June 20, 2022, and were tested for SARS-CoV-2 using RT-PCR. In the primary analysis, we determined the effectiveness of two doses of BNT162b2 against symptomatic COVID-19. RESULTS: A total of 4,574 were enrolled; of these, 1,758 patients (586 cases and 1,172 controls) were included in the primary analysis. Mean age was 27.7 years, 53.8 % were women, and 90.1 % had a Charlson comorbidity index of zero. Omicron accounted for >97 % of all identified SARS-CoV-2 variants, with BA.1 and BA.2 accounting for 84.3 % and 12.6 %, respectively. Overall adjusted estimate of two-dose vaccine effectiveness against symptomatic COVID-19 was 46.7 % (95 %CI, 19.9 %-64.6 %) after a median time between the second dose and the beginning of COVID-19 symptoms of 94 days (IQR, 60-139 days). Effectiveness waned from 77.7 % at 7-29 days after receipt of a second dose to <30 % (non-significant) after ≥120 days. CONCLUSION: In a relatively young and healthy Brazilian population, two doses of BNT162b2 provided protection against symptomatic Omicron infection. However, this protection waned significantly over time, underscoring the need for boosting with variant-adapted vaccines in this population prior to waves of disease activity. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov number, NCT05052307 (https://clinicaltrials.gov/ct2/show/NCT05052307).

Quality of life of family primary caregivers of individuals with bipolar disorder and schizophrenia in south of Brazil.

BACKGROUND: The process of deinstitutionalization of individuals with mental disorders (MD) brought greater family responsibility in terms of patient care. AIMS: Evaluate the Quality of Life (QoL) and its associated factors of primary caregivers of bipolar and schizophrenic subjects. METHODS: A cross-sectional survey was conducted from 2012 to 2015 with 125 caregivers at an outpatient service of a teaching hospital in the South of Brazil. QoL instruments (WHOQOL-Bref, SF-36), questionnaires regarding socio-demographic, clinical data and depressive symptoms (BDI) were applied. RESULTS: Caregivers of schizophrenic individuals presented lower QoL scores than caregivers of bipolar individuals, with moderate effect in physical, and social domains of WHOQOL-Bref, and in physical functioning, role-physical, and role-emotional domains of SF-36. QoL scores of caregivers were lower when compared with the normative data of the Brazilian population. The factors associated with lower QoL scores were: patient diagnosis of schizophrenia, female gender, presence of clinical disease and presence of depressive symptoms in the caregiver. CONCLUSIONS: Caregivers of patients with schizophrenia or bipolar disorder present a significant impairment in their QoL when compared with the general population, highlighting the relevance of developing support programs in the mental health services that include these caregivers.

BNT162b2 against COVID-19 in Brazil using a test-negative design: Study protocol and statistical analysis plan.

INTRODUCTION: Real-world data on COVID-19 vaccine effectiveness are needed to validate evidence from randomized clinical trials. Accordingly, this study aims to evaluate, in a real-world setting in Brazil, the effectiveness of Pfizer-BioNTech BNT162b2 against symptomatic COVID-19 and COVID-19-related complications across diverse populations. MATERIALS AND METHODS: A test-negative case-control study with follow-up of cases is currently being conducted in Toledo, a city in southern Brazil, following a mass COVID-19 vaccination campaign with BNT162b2. The study is being conducted among patients aged 12 years or older seeking care in the public health system with acute respiratory symptoms and tested for SARS-CoV-2 on reverse transcription polymerase chain reaction (RT-PCR). Cases are RT-PCR positive and controls RT-PCR negative. Test-positive cases are prospectively followed through structured telephone interviews performed at 15 days post-enrollment, and at 1, 3, 6, 9 and 12 months. Baseline demographic, clinical, and vaccination data are being collected by means of structured interviews and medical registry records reviews at the time of enrollment. All RT-PCR-positive samples are screened for mutations to identify SARS-CoV-2 variants. ETHICS AND DISSEMINATION: The study protocol has been approved by the research ethics committee of all participant sites. Study findings will be disseminated through peer-reviewed publications and conference presentations. TRAIL REGISTRATION: Clinicatrials.gov: NCT05052307.

Bipolar Disorder Mixed Episodes: A Pragmatic Trial of a Public Health Treatment Effectiveness.

OBJECTIVES: To evaluate the effectiveness of an algorithm for the treatment of mixed episodes in bipolar disorder (BD) using the medications available under the Unified Health System (Sistema Único de Saúde) in Brazil. METHODS: The study included 107 individuals with BD in a current mixed episode, assessed biweekly for the outcomes of response and remission. The subjects were randomly assigned to start treatment with lithium, valproic acid, or carbamazepine, following a clinical protocol at a public outpatient clinic. Eligibility screening instruments, semistructured interview, and clinical psychiatric evaluation were used for diagnosis. To measure response and remission, the Hamilton Rating Scale for Depression and the Young Mania Rating Scale were used. A parameter of 50% or less in the symptom scales was used to define responses, as assessed by Kaplan-Meier time-event analysis. RESULTS: For the main outcome, response to treatment, all interventions proposed were proven to be effective, with no difference in response time for any of them. There was a lack of placebo control and blinding for intervention or outcomes. Individuals with mixed episodes in BD often face contradictory symptoms, and these inherent difficulties are the main obstacles to stabilize such a condition. CONCLUSIONS: The findings presented in this study show that the treatments available under the Unified Health System are able to reduce the overall burden of disease in terms of symptom reduction.

Effectiveness evaluation of mood disorder treatment algorithms in Brazilian public healthcare patients.

OBJECTIVE: To assess the effectiveness of three mood disorder treatment algorithms in a sample of patients seeking care in the Brazilian public healthcare system. METHODS: A randomized pragmatic trial was conducted with an algorithm developed for treating episodes of major depressive disorder (MDD), bipolar depressive episodes and mixed episodes of bipolar disorder (BD). RESULTS: The sample consisted of 259 subjects diagnosed with BD or MDD (DSM-IV-TR). After the onset of symptoms, the first treatment occurred ∼6 years and the use of mood stabilizers began ∼12 years. All proposed algorithms were effective, with response rates around 80%. The majority of the subjects took 20 weeks to obtain a therapeutic response. CONCLUSIONS: The algorithms were effective with the medications available through the Brazilian Unified Health System. Because therapeutic response was achieved in most subjects by 20 weeks, a follow-up period longer than 12 weeks may be required to confirm adequate response to treatment. Remission of symptoms is still the main desired outcome. Subjects who achieved remission recovered more rapidly and remained more stable over time. CLINICAL TRIAL REGISTRATION: NCT02901249, NCT02870283, NCT02918097.

Gestão por processos, alinhamento estratégico e agenda 2030 / Process management, strategic aligment and 2030 agenda

Artigo de pesquisa intervencionista, avalia a implantação da Gestão por Processos na Fundação Oswaldo Cruz (Fiocruz), orientada pela expectativa de promover a agenda pública, em meio aos gaps1 estruturais que desafiam a excelência operacional. Adota referencial BPM - Business Process Management2: processos são analisados para qualificação ou reestruturação em rede, de modo a atender compromissos com as partes interessadas e direcionadores estratégicos da Estratégia Fiocruz para a Agenda 2030. Resulta na incorporação dos ODSs, por adesão a requisitos de excelência operacional e responsabilidade pública e socioambiental.

Effectiveness evaluation of mood disorder treatment algorithms in Brazilian public healthcare patients

Objective: To assess the effectiveness of three mood disorder treatment algorithms in a sample of patients seeking care in the Brazilian public healthcare system. Methods: A randomized pragmatic trial was conducted with an algorithm developed for treating episodes of major depressive disorder (MDD), bipolar depressive episodes and mixed episodes of bipolar disorder (BD). Results: The sample consisted of 259 subjects diagnosed with BD or MDD (DSM-IV-TR). After the onset of symptoms, the first treatment occurred ∼6 years and the use of mood stabilizers began ∼12 years. All proposed algorithms were effective, with response rates around 80%. The majority of the subjects took 20 weeks to obtain a therapeutic response. Conclusions: The algorithms were effective with the medications available through the Brazilian Unified Health System. Because therapeutic response was achieved in most subjects by 20 weeks, a follow-up period longer than 12 weeks may be required to confirm adequate response to treatment. Remission of symptoms is still the main desired outcome. Subjects who achieved remission recovered more rapidly and remained more stable over time. Clinical trial registration: NCT02901249, NCT02870283, NCT02918097

[Cue exposure treatment and coping skills training as adjuvant therapies in the management of craving in a crack cocaine addict]. / Tratamento de exposição a estímulos e treinamento de habilidades como coadjuvantes no manejo do craving em um dependente de crack.

OBJECTIVE: An increased prevalence of crack cocaine users has been observed in clinical samples over the past years, underscoring the need for conducting research and developing treatment strategies aimed at this population. The objective of this study was to describe the case of a crack cocaine addict (inpatient) submitted to cue exposure treatment (CET) and coping skills training (CS) as adjuvant approaches to the conventional addiction treatment. CASE DESCRIPTION: A male patient, 29 years old, single, with complete high school, was dependent on crack cocaine and marijuana and also had a diagnosis of harmful alcohol use. The patient had been hospitalized for 2 weeks and had undertaken a protocol comprising four motivational interview and relapse prevention sessions. Six sessions of CET and CS were carried out over 2 weeks, including both in vivo and imaginal exposure to stimuli evoking craving for crack cocaine, such as a crack pipe, a lighter, and simulated crack cocaine rocks (in vivo exposure), or remembering places and friends associated with drug use (imaginal exposure). The patient was also trained to use strategies for the management of craving. Three months after hospital discharge, toxicological screening was performed to assess abstinence. CET and CS were considered by the patient to be important techniques for the maintenance of abstinence and of a low level of craving 3 months after discharge. COMMENTS: These findings suggest that the two techniques may be useful as adjuvant therapies in the treatment of crack cocaine dependents. CET and CS should be assessed in clinical trials in order to demonstrate their real benefits.

A rede técnico-científica na gestão da vigilância sanitária

Este artigo objetiva verificar os relacionamentos em rede na produção científica no tocante à área de vigilância sanitária, identificando elementos que possam propiciar uma política pública de incremento à interação entre cientistas e formuladores de política nesta área. As variáveis para avaliação do uso do conhecimento científico propostas por Souza & Contandriopoulos (2004) e a análise de redes sociais foram aplicadas como método para visualizar o contexto de interação científica entre pesquisadores que tiveram artigos publicados em revistas classificadas como Qualis A, no campo da saúde pública em vigilância sanitária e teses de doutorados defendidas na mesma área, ambos no período de 1999 até 2009, disponibilizados, respectivamente, no Banco de Periódicos e Banco de Teses da CAPES. Foram mapeados elos de autoria, coautoria, orientação, citação, vínculo institucional e temática da produção científica, identificando-se comunidades de pesquisadores. Os principais aglutinadores destas comunidades são pesquisas em temáticas definidas e vinculadas, principalmente, a instituições selecionadas como centros colaboradores pela ANVISA. O estudo evidencia o ambiente, no qual a disponibilidade, acessibilidade e relativa autonomia são fatores propícios para maior interação entre cientistas e gestores.

Tratamento de exposição a estímulos e treinamento de habilidades como coadjuvantes no manejo do craving em um dependente de crack / Cue exposure treatment and coping skills training as adjuvant therapies in the management of craving in a crack cocaine addict

OBJETIVO: Tem-se observado um aumento da prevalência de dependentes de crack em amostras clínicas, o que torna necessária a realização de pesquisas quanto a estratégias de tratamento direcionadas a essa clientela. O objetivo deste estudo foi descrever o caso de um dependente de crack internado no qual foram utilizados o tratamento de exposição a estímulos (TEE) e o treinamento de habilidades (TH) como coadjuvantes ao tratamento tradicional. DESCRIÇÃO DO CASO: O paciente é do sexo masculino, 29 anos de idade, solteiro, ensino médio completo. Era dependente de crack e de maconha e fazia uso nocivo de álcool. O paciente já estava internado havia 2 semanas e tinha passado por um protocolo de quatro sessões com entrevista motivacional e prevenção à recaída. Foram feitas seis sessões, ao longo de 2 semanas, de TEE e TH, nas quais o paciente foi exposto in vivo e pela imaginação a estímulos evocadores de fissura, como cachimbo de crack, isqueiro, pedras simuladas, lembranças de locais e amigos associados ao uso da droga. Ele também foi treinado para utilizar estratégias de manejo da fissura. Após 3 meses da alta hospitalar, foi realizado screening toxicológico para avaliar a manutenção de abstinência. O paciente avaliou o uso das técnicas como importante para a manutenção da abstinência após 3 meses da alta e para sua baixa média de fissura pelo crack. COMENTÁRIOS: Talvez o TEE e o TH para manejo da fissura possam ser úteis como coadjuvantes no tratamento de dependentes de crack. Tal uso deve ser avaliado em ensaios clínicos para demonstrar seu real benefício (AU)

OBJECTIVE: An increased prevalence of crack cocaine users has been observed in clinical samples over the past years, underscoring the need for conducting research and developing treatment strategies aimed at this population. The objective of this study was to describe the case of a crack cocaine addict (inpatient) submitted to cue exposure treatment (CET) and coping skills training (CS) as adjuvant approaches to the conventional addiction treatment. CASE DESCRIPTION: A male patient, 29 years old, single, with complete high school, was dependent on crack cocaine and marijuana and also had a diagnosis of harmful alcohol use. The patient had been hospitalized for 2 weeks and had undertaken a protocol comprising four motivational interview and relapse prevention sessions. Six sessions of CET and CS were carried out over 2 weeks, including both in vivo and imaginal exposure to stimuli evoking craving for crack cocaine, such as a crack pipe, a lighter, and simulated crack cocaine rocks (in vivo exposure), or remembering places and friends associated with drug use (imaginal exposure). The patient was also trained to use strategies for the management of craving. Three months after hospital discharge, toxicological screening was performed to assess abstinence. CET and CS were considered by the patient to be important techniques for the maintenance of abstinence and of a low level of craving 3 months after discharge. COMMENTS: These findings suggest that the two techniques may be useful as adjuvant therapies in the treatment of crack cocaine dependents. CET and CS should be assessed in clinical trials in order to demonstrate their real benefits (AU)

Dilemas do processo de gestão descentralizada da vigilância sanitária no Estado do Rio de Janeiro / Dilemmas of the process of decentralized management of health surveillance in Rio de Janeiro State

Com a criação do Sistema Único de Saúde, em 1990, o Ministério da Saúde tomou as primeiras medidas para descentralizar as ações de vigilância sanitária, o que significou decisiva inovação na tradicional institucionalidade dessa área e grande desafio para os gestores nos três níveis da Federação. Os efeitos dessa determinação somente foram sentidos após criação da Agência Nacional de Vigilância Sanitária, em fins de 1999, quando foi possível estruturar o atual Sistema Nacional de Vigilância Sanitária numa concepção que incentiva o papel diretor, coordenador e executor das ações de maior complexidade das Secretarias Estaduais de Saúde. Este estudo analisa a descentralização da gestão da VISA empreendida pela Secretaria de Estado de Saúde do Rio de Janeiro no período 2002-2006 e as condições das Secretarias Municipais no exercício das respectivas funções, através de pesquisa baseada em análise dos relatórios de avaliação da descentralização elaborados pelo Centro de Vigilância Sanitária. Entre as conclusões, destaca a fragilidade da própria Secretaria de Saúde do estado para assumir os encargos a ela atribuídos e questões subjacentes ao exercício municipal. Tais constatações refletem as muitas dificuldades enfrentadas nas relações intergovernamentais diante do imperativo de as partes agirem solidariamente numa área fundamental para a saúde individual e coletiva e para o bem-estar da população. O estudo informa requisitos básicos do processo de estruturação de um órgão de VISA e constitui importante contribuição para melhor compreender os entraves políticos, institucionais, técnicos, materiais e humanos que desafiam os gestores, para implementar as inovações ensejadas com a descentralização neste complexo campo.

With the creation of the Unified Health System in 1990, the Ministry of Health has taken the first steps to decentralize health surveillance actions, which meant a decisive innovation in the traditional institutional framework in this area and challenge for managers at all three levels of the Federation. The effects of this determination were felt only after the creation of the National Sanitary Surveillance Agency, in late 1999, when it was possible to structure the current National System of Sanitary Surveillance in a design that encourages the role director, coordinator and executor of the more complex actions of the State Health Secretariats. This study analyzes the decentralization of management of VISA undertaken by the State Secretariat of Health of Rio de Janeiro between 2002-2006 and the conditions of the municipal acting in their duties by providing research-based analysis of reports evaluation of decentralization developed by the Center for Health Surveillance. Among the findings, it highlights the fragility of the State Health Secretariat to shoulder the burden assigned to it and issues underlying the performance hall. These findings reflect the many difficulties in intergovernmental relations on the need for parties to act jointly in a key area for the individual and collective health and welfare of the population. The study states the basic requirements of the process of structuring a body of VISA and makes an important contribution to better understand the political barriers, institutional, technical, material and human challenge to managers, to implement the innovations occasioned by decentralization in this complex field.

Relatório Regularizar Acesso ao PG e CTA - SisGen INI/Fiocruz: Modelagem de Processos

Este Relatório apresenta a Modelagem de processo "Regular Acesso ao PG e CTA" realizada pela Assessoria de Inovação Tecnológica do INI/FIOCRUZ para padronização interna do seu Núcleo de Inovação Tecnológica e orientação dos demais trabalhadores do INI/FIOCRUZ, sendo constituído como Instrutivo. A finalidade é estimular a regularização, segundo a Lei 13.123 de 2015, servindo de base ao estudo e consulta eventual na realização dos cadastros no SisGen e Envio e Remessa de Material Biológico. Ao aplicar o Gerenciamento de Processos de Negócio (BPM), notação BPMN, foi utilizada a versão gratuita do software Bizagi. O intuito é padronizar as ações, apoiando os trabalhadores da unidade envolvidos no processo e garantido a adesão exigida à regularização de acesso ao Patrimônio genético (PG) e Conhecimento Tradicional Associado (CTA). Em síntese, o propósito é orientar nos procedimentos de Regularização do Acesso ao PG e CTA no SisGen, os profissionais do INI, tanto os em função de Pesquisa como os envolvidos em processos de Regulação, Desenvolvimento Tecnológico e Inovação.

Relatório Realizar Assistência Farmacêutica Especializada CHC/INI/Fiocruz: Modelagem de Processos

Este Relatório apresenta a Modelagem de Processo realizada na implantação do Centro Hospitalar Covid-19 do Instituto Nacional de Infectologia Evandro Chagas da Fundação Oswaldo Cruz (CHC/INI/Fiocruz), inaugurado inicialmente para o enfrentamento a Pandemia. Todo o trabalho foi possível pela decisão e envolvimento da Alta Direção em sua realização e compromisso e dedicação dos gestores e demais profissionais do INI/Fiocruz. Ao aplicar o Gerenciamento de Processos de Negócio (BPM), notação BPMN, foi utilizada a versão gratuita do software Bizagi, com o propósito de realizar a modelagem ponta a ponta dos processos críticos. O intuito foi facilitar a harmonização das ações, orientando os procedimentos realizados por diversos profissionais de saúde reunidos pela primeira vez em um hospital de grande porte para atuar no combate a uma doença ainda em estudo, sem tratamento cientificamente validado, de elevada transmissibilidade e letalidade. A necessidade de rapidez na implantação das atividades no recém inaugurado CHC/INI/Fiocruz, na formalização dos fluxos e a inexistência de procedimentos prévios fizeram com que a metodologia de modelagem implementada fosse focada na segurança do paciente, na agilidade e simplicidade da representação da dinâmica de funcionamento do CHC/INI/Fiocruz, vis a vis as diretrizes institucionais, requisitos normativos, estado da arte na Atenção à saúde e Boas Práticas Clínicas. O objetivo deste documento é orientar a realização dos serviços e servir de base para consulta e estabelecimento de debates de alto nível entre os diversos profissionais do CHC/INI/Fiocruz, Gestores e demais partes interessadas para melhoria contínua dos processos, produtos e serviços, com foco nos usuários, nas pessoas e no desenvolvimento institucional. Como documento vivo que busca o design da dinâmica da prestação dos serviços de saúde no CHC/INI/Fiocruz em tempo real, este Relatório é o retrato do momento inicial da Modelagem do processo que segue sendo refinado continuamente por todos aqueles que participam da Cadeia de Valor da Atenção à Saúde Hospitalar no INI/Fiocruz. Configura-se assim em um registro histórico do processo de implantação do hospital de referência do INI/Fiocruz.

Relatório Acolher Pacientes e Responsáveis CHC/INI/Fiocruz: Modelagem de Processos

Este Relatório apresenta a Modelagem de Processo realizada na implantação do Centro Hospitalar Covid-19 do Instituto Nacional de Infectologia Evandro Chagas da Fundação Oswaldo Cruz (CHC/INI/Fiocruz), inaugurado inicialmente para o enfrentamento a Pandemia. Todo o trabalho foi possível pela decisão e envolvimento da Alta Direção em sua realização e compromisso e dedicação dos gestores e demais profissionais do INI/Fiocruz. Ao aplicar o Gerenciamento de Processos de Negócio (BPM), notação BPMN, foi utilizada a versão gratuita do software Bizagi, com o propósito de realizar a modelagem ponta a ponta dos processos críticos. O intuito foi facilitar a harmonização das ações, orientando os procedimentos realizados por diversos profissionais de saúde reunidos pela primeira vez em um hospital de grande porte para atuar no combate a uma doença ainda em estudo, sem tratamento cientificamente validado, de elevada transmissibilidade e letalidade. A necessidade de rapidez na implantação das atividades no recém-inaugurado CHC/INI/Fiocruz, na formalização dos fluxos e a inexistência de procedimentos prévios fizeram com que a metodologia de modelagem implementada fosse focada na segurança do paciente, na agilidade e simplicidade da representação da dinâmica de funcionamento do CHC/INI/Fiocruz, vis a vis as diretrizes institucionais, requisitos normativos, estado da arte na Atenção à saúde e Boas Práticas Clínicas. O objetivo deste documento é orientar a realização dos serviços e servir de base para consulta e estabelecimento de debates de alto nível entre os diversos profissionais do CHC/INI/Fiocruz, Gestores e demais partes interessadas para melhoria contínua dos processos, produtos e serviços, com foco nos usuários, nas pessoas e no desenvolvimento institucional. Como documento vivo que busca o design da dinâmica da prestação dos serviços de saúde no CHC/INI/Fiocruz em tempo real, este Relatório é o retrato do momento inicial da Modelagem do processo que segue sendo refinado continuamente por todos aqueles que participam da Cadeia de Valor da Atenção à Saúde Hospitalar no INI/Fiocruz. Configura-se assim em um registro histórico do processo de implantação do hospital de referência do INI/Fiocruz.

Relatório Realizar Governança Hospitalar INI/Fiocruz: Modelagem de Processos

Este Relatório apresenta a Modelagem de Processo realizada na implantação do Centro Hospitalar Covid-19 do Instituto Nacional de Infectologia Evandro Chagas da Fundação Oswaldo Cruz (CHC/INI/Fiocruz), inaugurado inicialmente para o enfrentamento a Pandemia. Todo o trabalho foi possível pela decisão e envolvimento da Alta Direção em sua realização e compromisso e dedicação dos gestores e demais profissionais do INI/Fiocruz. Ao aplicar o Gerenciamento de Processos de Negócio (BPM), notação BPMN, foi utilizada a versão gratuita do software Bizagi, com o propósito de realizar a modelagem ponta a ponta dos processos críticos. O intuito foi facilitar a harmonização das ações, orientando os procedimentos realizados por diversos profissionais de saúde reunidos pela primeira vez em um hospital de grande porte para atuar no combate a uma doença ainda em estudo, sem tratamento cientificamente validado, de elevada transmissibilidade e letalidade. A necessidade de rapidez na implantação das atividades no recém-inaugurado CHC/INI/Fiocruz, na formalização dos fluxos e a inexistência de procedimentos prévios fizeram com que a metodologia de modelagem implementada fosse focada na segurança do paciente, na agilidade e simplicidade da representação da dinâmica de funcionamento do CHC/INI/Fiocruz, vis a vis as diretrizes institucionais, requisitos normativos, estado da arte na Atenção à saúde e Boas Práticas Clínicas. O objetivo deste documento é orientar a realização dos serviços e servir de base para consulta e estabelecimento de debates de alto nível entre os diversos profissionais do CHC/INI/Fiocruz, Gestores e demais partes interessadas para melhoria contínua dos processos, produtos e serviços, com foco nos usuários, nas pessoas e no desenvolvimento institucional. Como documento vivo que busca o design da dinâmica da prestação dos serviços de saúde no CHC/INI/Fiocruz em tempo real, este Relatório é o retrato do momento inicial da Modelagem do processo que segue sendo refinado continuamente por todos aqueles que participam da Cadeia de Valor da Atenção à Saúde Hospitalar no INI/Fiocruz. Configura-se assim em um registro histórico do processo de implantação do hospital de referência do INI/Fiocruz.