The perception of workers about the work process in a Federal University Hospital under the management of a state-owned private law firm

ABSTRACT Research with a qualitative methodology which, based on semi-structured interviews, studied a university hospital as a case of a service that changed their model of management to a state-owned private law firm since 2014. The perception of workers was recorded and analyzed, focusing on the organization of and participation in the work process, in a Federal University Hospital (HUF) under that new model of management. The speeches brought: lack of materials, necessary to daily work, as a chronic problem; increased control over staff and lack of flexibility on work shifts; existence of many work flows; complexity of the organization chart; several hierarchical levels; difficulties in the interaction between workers with different forms of contracts; non-existence of a policy of participation of workers in the decision-making processes. Thus, only the change of the management model was not enough, in the view of the workers, to solve many of the Hospital’s problems. Several elements of the business-managerial paradigm have been identified, which is being put into practice in practically all HUF in Brazil and, rather than solving old problems, ends up creating new ones.

摘要 本研究采用质性研究方法，以半结构化访谈为研究工具，选取某大学附属医院作为案例，探讨其自2014年起将管理模式转型为国有私法法人运营模式的实践。研究记录并分析了员工的认知与看法，聚焦于采用该新管理模式的联邦大学附属医院（Federal University Hospital，HUF）的工作流程组织与员工参与情况。访谈反馈显示，员工普遍提及以下问题：日常工作所需物资匮乏这一长期顽疾；对员工的管控力度加大、排班灵活性缺失；工作流程冗余繁杂；组织结构复杂、层级架构繁多；不同用工形式员工间的互动存在障碍；未建立员工参与决策制定的相关机制。据此，在员工看来，仅依靠管理模式转型不足以解决该院诸多现存问题。研究团队已识别出商业管理范式的多项核心要素，这类范式目前已在巴西几乎所有联邦大学附属医院中推行，其非但未能解决既往顽疾，反而催生了一系列新的问题。