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BACKGROUND: In Brazil, many public hospitals face constant problems related to high demand vis-à-vis an overall scarcity of resources, which hinders the operations of different sectors such as the surgical centre, as it is considered one of the most relevant pillars for the proper hospital functioning, due to its complexity, criticality as well as economic and social importance. Proper asset management based on well-founded decisions is, therefore, a sine-qua-non condition for addressing such demands. However, subjectivity and other difficulties present in decisions make the management of hospital resources a constant challenge. METHODS: Thus, the present work proposes the application of a hybrid approach, formed by the QFD tools, fuzzy logic and SERVQUAL as a decision support tool for the quality planning of the surgical centre of the Onofre Lopes Teaching Hospital (Hospital Universitário Onofre Lopes-HUOL). To accomplish such objective, it was necessary to discover and analyse the main needs of the medical team working in the operating room, through the application of the SERVQUAL questionnaire, associated with fuzzy logic. RESULTS: Then, the most relevant deficiencies were transformed into entries for the QFD-fuzzy, where they were translated into project requirements. Soon after, the analysis of the existing relationships between the inputs and these requirements was carried out, generating the ranking of actions with the greatest impact on the improvement of the surgical centre overall quality. CONCLUSIONS: As a result, it was found that the proposed methodology can optimize the decision process to which hospital managers are submitted, improving the surgical centre operation efficiency.

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BACKGROUND: Despite the proven value of multicriteria decision analysis in the health field, there is a lack of studies focused on prioritising victims in the Emergency Medical Service, EMS. With this, and knowing that the decision maker needs a direction on which choice may be the most appropriate, based on different and often conflicting criteria. The current work developed a new model for prioritizing victims of SAMU/192, based on the multicriteria decision methodology, taking into account the scarcity of resources. METHODS: An expert panel and a discussion group were formed, which defined the limits of the problem, and identified the evaluation criteria for choosing a victim, amongst four alternatives illustrated from hypothetical scenarios of emergency situations-clinical and traumatic diseases of absolute priority. For prioritization, an additive mathematical method was used that aggregates criteria in a flexible and interactive version, FITradeoff. RESULTS: The structuring of the problem led the researchers to identify twenty-five evaluation criteria, amongst which ten were essential to guide decisions. As a result, in the simulation of prioritization of four requesting victims in view of the availability of only one ambulance, the proposed model supported the decision by suggesting the prioritization of one of the victims. CONCLUSIONS: This work contributed to the prioritization of victims using multicriteria decision support methodology. Selecting and weighing the criteria in this study indicated that the protocols that guide regulatory physicians do not consider all the criteria for prioritizing victims in an environment of scarcity of resources. Finally, the proposed model can support crucial decision based on a rational and transparent decision-making process that can be applied in other EMS.

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BACKGROUND AND OBJECTIVE: The growth of the urban population exerts considerable pressure on municipalities' public managers to focus their attention on providing emergency medical care that meets the growing demand for emergency pre-hospital medical care. Currently, there are a significant number of traffic accidents and other serious occurrences, such as heart attacks, drownings, epidemics, fires and disasters (floods, landslides, earthquakes) that demand a prompt and seamless response from pre-hospital medical care. As a result of such scenario, the present article endeavours to apply a dual-coverage mathematical model (DSM-Double Standard Model) to define the optimal location of the Emergency Medical Service (SAMU) decentralized dispatch bases in Natal/RN and conduct a simulation study to evaluate the displacement of ambulances between such bases. METHODS: The methodological course that was followed by this research constitutes of 12 steps. The location of decentralized bases for sending emergency ambulances was established using the DSM model and the simulation model was performed using the FlexSim© software version 2018 evaluating base coverage in relation to the total number of calls by demand points for different scenarios. RESULTS: The results obtained throughout the research demonstrated the feasibility of redefining the decentralized bases of SAMU/Natal ambulances as a strategy to reduce response time and guarantee compliance with performance parameters established by international organizations (the World Health Organization, for instance, establishes the time of 8 minutes for emergency medical service calls response). The simulation study showed a significant reduction in response time, by up to 60% in some cases. CONCLUSION: The proposition of new locations for the decentralized dispatch bases of the SAMU/Natal can provide an overall significant reduction on the ambulance response time, so as to contribute to expedite the initiation of treatment of patients, if necessary, sent to hospitals.

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PURPOSE: The hospital is an organization that has its own characteristics that differentiate it from other institutions. It is characterized as a company providing services of social purpose, with a great operational complexity, due to the diversity of services provided. These organizations are dependent on technology to play the role of assisting society. Technology is onerous: it is up to the aforementioned institutions to adopt management tools to control these costs. The present study explains the process of implementing a shared service centre (CENTROMED) for the management of hospital medical equipment (HME) at the Hospital Universitário Onofre Lopes (HUOL) in the city of Natal, RN. PATIENTS AND METHODS: In order to achieve a successful implementation, four key steps were taken: process modelling; determination of key performance indicators, organization of physical arrangement; and adequate training and development of human resources. The work followed an action research approach focusing on three main methodological steps: identification of HUOL clinical engineering team's demands, definition of the process for providing the equipment service, and definition of the supply items that will be managed. RESULTS: The preliminary results of this research indicate that the centralization of the management of the HME contributed to the optimization of the processes, the reduction of the costs and the availability of the equipment, thus providing a powerful management tool to support the hospital operational management. CONCLUSION: The utilization of the shared service center for the management of hospital medical equipment is ultimately linked to the patient's well-being as it contributes to the agility in hospital procedures and provides support in maintaining the capacity of attendance of the assistance teams.

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BACKGROUND: Telework has been widely studied by public and private organizations; however, in ergonomics, studies that focused on this topic are still sporadic. OBJECTIVE: Thus, this article endeavours to systematize the qualified scientific research related to ergonomics and teleworking to determine the main benefits and disadvantages and to identify the main issues addressed by authors. METHODS: A thorough research was conducted in the Scopus/Embase and Web of Science databases for this review. The following descriptors were used for the cataloguing of articles: "teleworking", "telecommuting", "telecommuters", "home office", "ergonomics" and "human factors". 36 studies were selected. RESULTS: The study highlights four relevant questions in the scientific literature: a) where is the discussion of these themes consolidated; b) what are the main descriptors related to the discussion; c) which journals and conferences establish a scientific debate on the topic; and d) what are its main advantages and disadvantages. CONCLUSIONS: Results suggest that telecommuting can be a valuable tool for balancing professional and family life, which helps to improve the well-being of workers; however, several factors can influence the overall remote working experience which leads to the need for companies to adopt unique strategies reflecting their unique situation.

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BACKGROUND: Multiobjective decision-making processes present a high degree of complexity in their solution, and tools such as multicriteria decision analysis appear as a way to facilitate the decision-makers' solution and ensure that the decision is made cohesively and efficiently. In the public health sector, decisions are even more delicate because they work not only with the direct influence of human needs, but also with limited financial resources. An important point for the emergency care units is the triage system, which consists of a pre-evaluation of the patients, classifying them according to the degree of life risk. Through triage, the patient can be attended more quickly and efficiently, streamlining the whole process. Thus, the present research endeavored to determine the most appropriate triage protocol for emergency healthcare units in Natal-RN city in Brazil and may help others less advanced countries to determine the most appropriate triage protocol for emergency healthcare. METHODS: In this study, we used the multicriteria analysis method known as FITradeoff. In addition, interviews and structured questionnaires applied with nurses, specialists and directors. RESULTS: Based on the questionnaires and preferences presented by the decision-makers, the Spanish Triage System was the most suitable protocol for the emergency care units, which presented with high ease of use and implementation. CONCLUSIONS: This study reached its main objective, which was to determine the most appropriate triage protocol. In addition, it was observed the possibility of new research, such as the development of a specific protocol for this emergency care units and the creation of an application software for this new protocol.

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