Work analysis of drug-dispensing process in a hospital emergency pharmacy

The work organization performs a crucial role in activities that involves problem resolution and decision making. A hospital emergency pharmacy consists in an example where the work environment has several kinds of demands that might be inconsistent and influenced by overcrowding – common situation in Brazilian hospitals – causing harm to work organization and suitability of workload. The objective of this study is to evaluate labor conditions of professionals that work in the emergency pharmacy of a university public hospital, seeking opportunities of improvement. A transversal study was developed with a descriptive character to analyze the work conditions. An ergonomic work analysis was conducted and, for the fulfillment of its steps, observations in loco were performed and methods Deparis, RULA and ABC analysis were used, pursuing to analyze data collected and rearranging the work situation. The findings allowed propositions of improvement, related mainly to the process of drug dispensation, organization and arrangement of the work environment. The ABC analysis presented itself as a valuable method for improving drugs organization in the pharmacy and might be useful in other work situations where accessibility of items is necessary, but many items must be positioned

Melhorias de processos : integrando princípios da produção enxuta e dos sistemas complexos em um hospital

A crescente demanda por serviços de saúde, juntamente com a necessidade de proporcionar um cuidado com qualidade e com segurança, trazem desafios para as instituições que trabalham nessa área. Buscando-se soluções para esse problema, hospitais vêm aderindo a filosofia Lean Healthcare (LH), contudo é necessário ressaltar a dificuldade que essas aplicações podem ter, em longo prazo, por ser uma abordagem distinta da gestão tradicional e não levar em consideração a natureza complexa da saúde. Esse estudo buscou em desenvolver um Framework para análise e intervenção em Sistemas Complexos (SC), por meio da integração entre princípios de gestão de sistemas enxutos e princípios da ciência da complexidade. Para isso, lançou-se mão de métodos, como mapeamento de fluxo de valor, mapeamento de processos e Functional Resonance Analysis Method (FRAM). O Framework proposto estruturou-se em 6 etapas, sendo construído por meio da Design Science Research. O estudo aplicado ocorreu em um hospital universitário na análise do fluxo do paciente grave do Serviço de Emergência para a Unidade de Terapia Intensiva. Como resultado dessa aplicação, foi possível identificar 16 problemas nesse fluxo, propondo-se um plano de ação para um dos problemas e simulando os potenciais impactos por meio da utilização do FRAM. Concluiu-se que é possível unificar as visões de LH e de SC, gerandose uma visão aprofundada dos problemas enfrentados no cotidiano dos serviços da saúde, criando meios para intervenções mais seguras e que proporcionem maior qualidade no cuidado prestado ao paciente.The increasing demand for healthcare, altogether with the necessity to provide quality and secure care, bring challenges for institutions in this domain. Pursuing solutions for this problem, hospitals are implementing Lean Healthcare (LH) philosophy, although, it is important to consider difficulties that this application might have in a long term. This is due to the fact LH differs from a tradition approach and does not take in consideration the complex nature of healthcare systems. This study sought to develop a Framework for analysis and intervention in Complex Systems (CS) through integration of principals from Lean Production Management and Complex Science. In this way, methods such as Value Stream Mapping, Process Mapping, and Functional Resonance Analysis Method (FRAM) were used. The proposed Framework had six stages, been based in Design Science Research. The Framework application took place in an university hospital, focusing in the critically ill patients flow from the emergency service to the intensive therapy unit. As a result, it was possible to identify 16 problems in the flow and an action plan was proposed for one problem using FRAM for potential impacts simulation. In conclusion, the integration of LH and CS was possible, generating a deeper understanding of day-by-day problems in healthcare, creating means for secure interventions and allowing more quality in patient care

Melhorias de processos : integrando princípios da produção enxuta e dos sistemas complexos em um hospital

A crescente demanda por serviços de saúde, juntamente com a necessidade de proporcionar um cuidado com qualidade e com segurança, trazem desafios para as instituições que trabalham nessa área. Buscando-se soluções para esse problema, hospitais vêm aderindo a filosofia Lean Healthcare (LH), contudo é necessário ressaltar a dificuldade que essas aplicações podem ter, em longo prazo, por ser uma abordagem distinta da gestão tradicional e não levar em consideração a natureza complexa da saúde. Esse estudo buscou em desenvolver um Framework para análise e intervenção em Sistemas Complexos (SC), por meio da integração entre princípios de gestão de sistemas enxutos e princípios da ciência da complexidade. Para isso, lançou-se mão de métodos, como mapeamento de fluxo de valor, mapeamento de processos e Functional Resonance Analysis Method (FRAM). O Framework proposto estruturou-se em 6 etapas, sendo construído por meio da Design Science Research. O estudo aplicado ocorreu em um hospital universitário na análise do fluxo do paciente grave do Serviço de Emergência para a Unidade de Terapia Intensiva. Como resultado dessa aplicação, foi possível identificar 16 problemas nesse fluxo, propondo-se um plano de ação para um dos problemas e simulando os potenciais impactos por meio da utilização do FRAM. Concluiu-se que é possível unificar as visões de LH e de SC, gerandose uma visão aprofundada dos problemas enfrentados no cotidiano dos serviços da saúde, criando meios para intervenções mais seguras e que proporcionem maior qualidade no cuidado prestado ao paciente.The increasing demand for healthcare, altogether with the necessity to provide quality and secure care, bring challenges for institutions in this domain. Pursuing solutions for this problem, hospitals are implementing Lean Healthcare (LH) philosophy, although, it is important to consider difficulties that this application might have in a long term. This is due to the fact LH differs from a tradition approach and does not take in consideration the complex nature of healthcare systems. This study sought to develop a Framework for analysis and intervention in Complex Systems (CS) through integration of principals from Lean Production Management and Complex Science. In this way, methods such as Value Stream Mapping, Process Mapping, and Functional Resonance Analysis Method (FRAM) were used. The proposed Framework had six stages, been based in Design Science Research. The Framework application took place in an university hospital, focusing in the critically ill patients flow from the emergency service to the intensive therapy unit. As a result, it was possible to identify 16 problems in the flow and an action plan was proposed for one problem using FRAM for potential impacts simulation. In conclusion, the integration of LH and CS was possible, generating a deeper understanding of day-by-day problems in healthcare, creating means for secure interventions and allowing more quality in patient care

Análise dos modelos de negócios de provedores de serviços de hemodiálise

O objetivo deste estudo foi avaliar o modelo de negócio das clínicas de hemodiálise na cidade de Porto Alegre. Foram realizadas três entrevistas semiestruturadas com os gestores dessas empresas, objetivando compreender a lógica de criação, de entrega e de captura de valor. Como resultado desse levantamento, foi possível observar um modelo de negócio predominante utilizado pelas clínicas, devendo-se essa situação, principalmente, a regulamentação rígida, obrigando as empresas que atuam nesse setor a funcionarem de uma forma similar. Em relação a inovações do modelo de negócio, foi apresentado algumas possibilidades de como as clínicas poderiam modificar o valor entregue ao paciente, como o exemplo da empresa norte-americana NxStage.The aim of this study was to evaluate the business model of hemodialysis clinics in the city of Porto Alegre. Three semi-structured interviews with the managers of these companies were made to understand the logic of creation, delivery and value capture. As a result of this survey, it was possible to observe a predominant business model used by clinics and must be the situation, especially the strict regulations force companies that operate in this sector to operate in a similar way. Regarding innovation of the business model was presented possibilities of how they could modify the clinical value delivered to the patient, as the example of the U.S. company NxStage

Análise dos modelos de negócios de provedores de serviços de hemodiálise

O objetivo deste estudo foi avaliar o modelo de negócio das clínicas de hemodiálise na cidade de Porto Alegre. Foram realizadas três entrevistas semiestruturadas com os gestores dessas empresas, objetivando compreender a lógica de criação, de entrega e de captura de valor. Como resultado desse levantamento, foi possível observar um modelo de negócio predominante utilizado pelas clínicas, devendo-se essa situação, principalmente, a regulamentação rígida, obrigando as empresas que atuam nesse setor a funcionarem de uma forma similar. Em relação a inovações do modelo de negócio, foi apresentado algumas possibilidades de como as clínicas poderiam modificar o valor entregue ao paciente, como o exemplo da empresa norte-americana NxStage.The aim of this study was to evaluate the business model of hemodialysis clinics in the city of Porto Alegre. Three semi-structured interviews with the managers of these companies were made to understand the logic of creation, delivery and value capture. As a result of this survey, it was possible to observe a predominant business model used by clinics and must be the situation, especially the strict regulations force companies that operate in this sector to operate in a similar way. Regarding innovation of the business model was presented possibilities of how they could modify the clinical value delivered to the patient, as the example of the U.S. company NxStage

Independent Journal of Management & Production WORK ANALYSIS OF DRUG-DISPENSING PROCESS IN A HOSPITAL EMERGENCY PHARMACY

ABSTRACT The work organization performs a crucial role in activities that 135 INDEPENDENT JOURNAL OF MANAGEMENT & PRODUCTION (IJM&P) http://www. ijmp.jor.br v. 7, n. 1, January -March 2016 ISSN: 2236 The ABC analysis presented itself as a valuable method for improving drug organization in the pharmacy and might be useful in other work situations where accessibility of items is necessary, but many items must be positioned

WORK ANALYSIS OF DRUG-DISPENSING PROCESS IN A HOSPITAL EMERGENCY PHARMACY

The work organization performs a crucial role in activities that involves problem resolution and decision making. A hospital emergency pharmacy consists in an example where the work environment has several kinds of demands that might be inconsistent and influenced by overcrowding – common situation in Brazilian hospitals – causing harm to work organization and suitability of workload. The objective of this study is to evaluate labor conditions of professionals that work in the emergency pharmacy of a university public hospital, seeking opportunities of improvement. A transversal study was developed with a descriptive character to analyze the work conditions. An ergonomic work analysis was conducted and, for the fulfillment of its steps, observations in loco were performed and methods Deparis, RULA and ABC analysis were used, pursuing to analyze data collected and rearranging the work situation. The findings allowed propositions of improvement, related mainly to the process of drug dispensation, organization and arrangement of the work environment. The ABC analysis presented itself as a valuable method for improving drugs organization in the pharmacy and might be useful in other work situations where accessibility of items is necessary, but many items must be positioned