Avaliação de desempenho multicritério construtivista na gestão administrativa de hospital

Abstract

One of the challenges for hospital administrative managers consisting of promoting balance between human, technological and financial resources in order to achieve efficient management and quality services. In this sense, the present research had as general objective to construct a model of evaluation of performance of support to the an management administrative of a hospital localized in the Southwest region of the Paraná state, considering the particularities of the context. It is a case study, characterized as exploratory and descriptive. It follows a qualitative-quantitative approach, with primary and secondary data. Initially, was used the Knowledge Development Process – Constructivist (Proknow – C) for the process of search and systemic analysis of the literature on performance evaluation in hospitals. Then, was used the Multicriteria Decision Support Methodology – Constructivist (MCDA – C) for construct the proposed model at objective general. The systematic analysis of the bibliographic portfolio (PB) revealed that the authors did not use a constructive methodology for the construction of the model, and per hospitals to be environments with large diversity, the utilization of standard indicador may fail to translate the result real for a especific environment. Ultimately, was identified the necessity construction of model of performance evaluation on hospitals in the constructivist view, considering the particularities of the organization, the perceptions and values of the decision maker, that attend to the theory of measurement and that perform an integration, generating an performance global assessment, and improvement actions, contributing to the construction of knowledge about the contexto, in order to support decision-making. From the construction of the performance evaluation model for the hospital under study, The principal results were: the construction of 121 indicators for the assessment of performance of administration management, separated into two major areas of concern, Management and Human Resources. In the global evaluation of the current situation, the performance was 61 points. It was verified 19 indicators with compromising performance, being suggested improvement actions, which if implemented would leverage performance to 81 points. It was noticed that only 18 indicators found in the literature present similarities with those constructed in the model of this research, making it clear that the model is unique and valid only for the context for which it was developed. It can be concluded that the present research presents theoretical implications for the literature, because the MCDA-C methodology, which has in its process the structuring of problems, was efficient in making the decision maker identify and judge the necessary and sufficient criteria to evaluate its contexto, being this one of the difficulties of the management of hospitals pointed out in the literature. The research also fills gaps found in the hospital performance evaluation literature and contributes to the área, since in the systemic analysis the scarcity of works that approach the constructivist paradigm was identified. For the problem-structuring study área, the research contributes to highlight the potential of Soft methodologies in the construction of a performance evaluation model. Besides, the construction of the model resulted in a decision support methodology in the administrative management of the hospital, because it contributes to the hospital's managerial control, with decreasing waste and improving the application of resources, as well as the verification of investment strategies that best suit the objectives of the organization.