Use of management tools in the micropolitics of health work: an experience report

ABSTRACT Over the years, the Ministry of Health has been implementing incentive policies to qualify the management, reviewing work processes and structuring health care networks, for the improvement of primary care assistance. The aim of this study was to present the report of the students of the Improvement Course in Management of Basic Health Units, Clinic Management and Care about the use of management tools in the micropolitics of health work. This is an experience report of the first edition of the aforementioned course in the state of Goiás and in the Federal District. The grouping of the contents presented in the 25 reflective narratives was performed according to the themes of the Learning Units and the tools practiced (Circular Process, the Descriptor Flowchart, Management of Materials and themes of the Network, Line of Care, Singular Therapeutic Project, Regulation and Health Planning). It was identified in the narratives that the most worked tools and that demonstrated potent results for the management processes of the Basic Health Units were the Circular process, followed by the Singular Therapeutic Project, and the Descriptor Flowchart. It was concluded that all the tools offered by the course are able to be put into practice, contributing to the work process and to the qualification of care.

摘要 多年来，巴西卫生部为优化基层医疗服务，持续推行旨在规范管理、提升管理资质的激励性政策，梳理工作流程并搭建医疗服务网络体系。本研究旨在呈现《基层卫生单位（Basic Health Units）管理、诊所运营与服务提升研修班》学员针对卫生工作微观治理中管理工具应用情况的研修报告。本报告为戈亚斯州与巴西联邦区首期开设上述课程的实践总结。研究人员依据学习单元主题及实操工具类别，对25篇反思性叙事报告中的内容进行归类，所涉工具包括循环流程（Circular Process）、描述符流程图（Descriptor Flowchart）、物资管理、医疗网络主题、照护链路、个体化治疗方案（Singular Therapeutic Project）、协调规制（Regulation）与卫生规划（Health Planning）。经分析上述叙事报告发现，在基层卫生单位管理流程中应用频次最高且成效显著的管理工具依次为循环流程、个体化治疗方案及描述符流程图。研究结论表明，研修班所提供的全部管理工具均可落地实践，有助于优化工作流程并提升照护服务的资质认证水平。