ABSTRACT
Hospitals stand out as a convergence center of several knowledge and practical health service
systems. As a complex institution, crossed by multiple interests, hospitals suffer permanent
and continuous discussion about the municipal manager, workers and users expectation
related to its role in integral care production with quality, efficiency and costs control. In this
context, the HOSPITAL DAS CLÍNICAS DA UNIVERSIDADE FEDERAL DE MINAS
GERAIS (HC-UFMG), a public university institution, has introduced, in 1999, a new
management proposal based on decentralization of administrative actions, creating the
Functional Units (UF). The new management model proposes to reorganize the logical of
hospital management, in order to obtain better results and better performance in health
services. But, in 2005, the HC-UFMG surgical center has organized itself as a Functional Unit
and also has started to be responsible for management of human, financial and material
resources, processes and results, the evaluation of assistance, the teaching and the research
developed in this sector. The surgical center unit is a great creator of costs to hospitals and,
because of that, the development of programs which guarantee quality is a necessity in terms
of efficiency and an obligation of ethical and moral point of view. In 2008 the results of a
performance evaluation has pointed inefficiency and low productivity, requiring adjustments.
This study has as objective to analyze the surgical center organization and functioning, in
order to understand its management process, the factors that help and those that difficult the
work process and the relationship between the different professionals who act in the unity. It
has been done a qualitative case study, in which the data were collected through semi-
structured interviews carried out with 19 professionals, of different areas, who act in the HC-
UFMG surgical center. The results were subjected to the analysis of content, using the
identification of thematic units, grouped into categories by affinity empirical. The analysis of
data shows that the surgical center is a sector which the work is stressful, there is a great time
for the completion of surgery, interpersonal relationships and between professions are
conflicting and there is predominance of medical power on the other professionals. The
management of the sector lacks the autonomy needed to put in place the necessary changes,
due to the strength of corporate professionals, especially medical doctors. The surgical center
did not incorporate, in its practice, the decentralized management model proposed to HC-
UFMG, keeping itself in a management format, parallel to the directives of the hospital,
crossed by multiples powers which exist inside the service. The relationship between the
different professionals who act in the unity and the new management model and the
organizational changes proposed happens formatted by the corporative logic of professions.
The data show that the planning, as an instrument of management, does not exist. It also
shows that the initiative of organization and efficiency suffers interference of the medical
power, because they requires from the directorship the same power of decision that they have
on surgical procedures, not recognizing the organizational standards. The difficulties for the
organization and operation of the surgical center are related to the shortage of managerial
strategies able to consider the various powers, seeking a team work in which the respect to the
various workers and the hospital rules predominate. Is important also to seek integration with
other sectors of the hospital as a way to organize the daily work, minimizing external
interference.
Key-words: health management, university hospitals, hospital surgical centers, hospital
administration.