Abstract
Kanban is a care management tool that values multi-professional work and intensive use of data and has been growingly used in Brazil to address overcrowding in hospital emergency services (HES). The researchers monitored the Kanban for ten months in multiple wards of a municipal HES, and their observations were recorded in field diaries and discussed in biweekly research team meetings. The empirical material was organized from two questions: Are there changes in "traditional attributions" of Kanban-operating nursing? Are Medicine-Nursing interprofessional relationships transformed? A strong nurse adherence to this tool was observed, coupled with greater specialization and fragmentation of their work: nurses working as diarists assume more traditional administrative functions, while those on-call develop more direct assistance to patients. Nurses consider that clinical decisions are still in the doctors' hands, although Kanban provides them with a stronger influence on such decisions. Nurses' role in the management of significant mass of clinical and operational data, central to Kanban's operationalization, strengthens their professional authority.
Highlights
Resumo O Kanban, uma tecnologia de gestão do cuidado caracterizada pela valorização do trabalho multiprofissional e o uso intensivo da informação, tem sido crescentemente utilizado para enfrentar a superlotação dos serviços de emergência hospitalar (SEH)
Kanban is a care management tool that values multi-professional work and intensive use of data and has been growingly used in Brazil to address overcrowding in hospital emergency services (HES)
The empirical material was organized from two questions: Are there changes in “traditional attributions” of Kanban-operating nursing? Are Medicine-Nursing interprofessional relationships transformed? A strong nurse adherence to this tool was observed, coupled with greater specialization and fragmentation of their work: nurses working as diarists assume more traditional administrative functions, while those on-call develop more direct assistance to patients
Summary
Enfermeiros na operacionalização do Kanban: novos sentidos para a prática profissional em contexto hospitalar?. Luiz Carlos de Oliveira Cecílio (https://orcid.org/0000-0002-9207-4781) 1 Ademar Arthur Chioro dos Reis (https://orcid.org/0000-0001-7184-2342) 1 Rosemarie Andreazza (https://orcid.org/0000-0002-3332-2183) 1 Sandra Maria Spedo (https://orcid.org/0000-0001-5951-5314) 1 Nelma Lourenço de Matos Cruz (https://orcid.org/0000-0003-0451-9822) 1 Luciana Soares de Barros (https://orcid.org/0000-0001-6320-4308) 1 Graça Carapinheiro (https://orcid.org/0000-0003-4374-5021) 3 Tiago Correia (https://orcid.org/0000-0001-6015-3314) 2,3 Mariana Cabral Schveitzer (https://orcid.org/0000-0001-9833-2932) 1
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