As múltiplas faces da gestão a prática gerencial nos serviços de saúde de Piraí

Abstract

The discussion of management is recent in Brazil, particularly in the context of public administration. The guidelines of SUS are important instruments inducing modernization and changes in management, including aspects relating to the organization of care, as its humanization and also the search for higher levels of performance and institutional responsibility for the results achieved. Several authors have studied the issue management, but which the management model that could combine an active role in leadership and coordination for managers with autonomy? The present work aims to analyze management practice in health services Piraí, trying to understand the social dimensions of such practices and intersubjective, and the narrative as the main source of their managers. The city has a peculiar political context, with a continuing policy since 1993, adopts a policy of participatory management in health with various formal and a practical investment in health above the level recommended by the Federal Constitution which allows for investment in structuring and provision of services public. From the methodological point of view, the study adopted the approach of life narratives, focusing on management as a social world and an expression of processes in organizations and across the interviewees. We interviewed four managers of health facilities in Piraí. The analysis of the empirical material was one of its bases to study the career paths of managers, especially the processes that led to the managerial function. The contingency marks these trajectories that unfold in a context where there is no requirement as to management education. Another aspect discussed is the management practices where they examined the meanings that the exercise of managerial function has for the subject, as well as their strategies work. The examination of management practices guided by the analysis of the possibilities and limits to trigger processes of change. The statements show the characteristics of those in management, seeking to build conditions for processes of change, either through previous experience of these managers or strategies of work and seeking to develop a management system. The design professionals interviewed three of the four will clearly define the scope of management: see themselves, not as professional training of its original area (nurse, doctor), but above all as managers, fueled by the recognition of their capabilities mobilization and development of changes on other achievements in the field of management.