Professional interaction in management of the triad: Permanent Education in Health, patient safety and quality.

Cintia Koerich,Alacoque Lorenzini Erdmann,Gabriela Marcellino De Melo Lanzoni

doi:10.1590/1518-8345.4154.3379

Cintia Koerich, Alacoque Lorenzini Erdmann + Show 1 more

Open Access

https://doi.org/10.1590/1518-8345.4154.3379

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Abstract

Objective:to understand how professional interaction takes place in the hospital organizational structure for the management of Permanent Education in Health, to guarantee patient safety and the quality of nursing care.Method:this is a qualitative study, which used the structuralist aspect of the Grounded Theory as a methodological framework. 27 interviewers participated in the study, who made up four sample groups.Results:six categories and 13 subcategories were presented, representing the studied phenomenon and highlighting particularities of the public health system and the influence of the manager’s support and management priority, the disposition of the organizational structure, the institutional culture, the external encouragement to institution, and the nurses’ initiative and leadership in the professional interaction for the management of the Permanent Education in Health, patient safety, and quality of care triad, revealing the need for cultural change through interdisciplinarity.Conclusion:the professional interaction in the hospital organizational structure requires the creation of new management models with an emphasis on more participative management, in order to improve the care processes in hospital institutions.

Highlights

The Health Care Network (Rede de Atenção à Saúde, RAS) in Brazil proposes an integration among services and aims to contemplate the doctrinal and organizational principles of the Unified Health System (Sistema Único de Saúde, SUS)
The results show the central category of Understanding the multiprofessional interaction supported by the Permanent Education in Health (PEH), patient safety, and quality triad, which lists seven categories and 13 subcategories that were organized by using the components of the paradigm composing the substantive theory
PEH management was not revealed in isolation, since PEH, patient safety, and quality of care showed a movement of interdependence

Summary

Introduction

The Health Care Network (Rede de Atenção à Saúde, RAS) in Brazil proposes an integration among services and aims to contemplate the doctrinal and organizational principles of the Unified Health System (Sistema Único de Saúde, SUS). The organizational structure of Brazilian public hospitals usually follows the guidelines established by the classic organization charts of the administration, in which hierarchy, authoritarianism, and decision-making centrality stand out, which results in little cooperation, difficulty in working in teams and developing interdisciplinarity[2] In this sense, considering the history of fragmentation of hospital institutions, with regard to the arrangement of the organizational structure, as well as the performance of health professionals, it is relevant to investigate how these aspects affect the management of Permanent Education in Health (PEH) for patient safety and quality, since education is an essential practice in building safer and quality patient care[3,4]. This study defends the need to place these three axes in the same level of importance and relevance in order to achieve the articulation indispensable to the necessary paradigmatic change

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