Governança pública: avaliação das práticas de governança em uma unidade hospitalar

Abstract

The literature points out that given the dynamics and complexity in the global scenario, aggravated by the pandemic moment that the world is going through, health governance constitutes a necessary prerogative to provide organizations with transformative management models. This research is a case study whose general objective is to evaluate the adherence of the results/action of governance in health at Fundação Santa Casa de Misericórdia (FSCMPA) by measuring good governance practices. It is a methodological procedure of case study of an applied, exploratory and descriptive nature, with a quantitative and qualitative approach. For data collection, a management tool was developed (google forms questionnaire) applied and tested in the organization from October/2021 to November/2021 to evaluate the mechanisms of leadership, strategy and control from the self-assessment of 68 employees. For the elaboration of the questionnaire, the methodology of the governance and management guide prepared by the Federal Audit Court (TCU) was used as a reference, applicable to health secretariats and councils, which was duly adapted to be applied in hospital units. For data processing, descriptive statistical analysis was used, and for the Categorization of Answers - Numerical limits of the stages of capacity -, an adaptation of the TCU Secretariat for External Control of State Administration (Secex Administration). The survey resulted in an improved governance maturity level for the leadership and strategy mechanisms that reached a stage of 71.46% and 82.26%, respectively. The control mechanism indicated an intermediate maturity level of 67.90%, demonstrating weaknesses in good governance practices. It is concluded that despite the Santa Casa de Misericórdia do Pará Foundation (FSCMPA) having reached an improved institutional maturity index of 73.87%, the adherence of its actions to good governance practices needs to be better worked. The research leaves as a product a governance model for hospital organizations, accompanied by an assessment instrument capable of promoting continuous improvement in governance practices, as well as recommendations to encourage behavioral changes in public administration.