Perspectivas da qualidade no atendimento em um serviço público de urgência sob a ótica dos trabalhadores

Abstract

A qualitative research, case study type, which aimed to capture the employees' perceptions of a Public Emergency Service in relation to the quality of Structure, Process and Result of the attendance. The study was conducted with ten employees who were part of the multidisciplinary team and had at least five months of experience in the service. Data collection occurred in April 2010, through individual interviews using the guiding phrase: "Tell us about your perception in relation to the care quality in the emergency room service". The data were treated using the Content Analysis technique proposed by Bardin, which allowed the identification of three categories: 1) A Look at the Emergency Department Structure; 2) Dealing with Process Service Interfaces in the Emergency Room; 3) Exploring the Care Result and its Relation to Quality. In the first category, the respondents considered that the attendance Structure was satisfactory due to the availability of material resources; reforms and adjustments made; qualification and professional training; transfer of financial resources according to institutional goals; direction of services by means of protocols; monitoring of information through quality indicators. However, there were reports about the weaknesses in Structure, highlighting the high temperature of the environment and human resources shortage. The second category was divided into two dimensions entitled Technical and Relational. In the first dimension, respondents identified the quality in the care process, evidencing the integration between emergency and extrahospital services; the necessity of quality to be present at all levels of health care system; the expectation and direction of the leaderships in relation to service quality; the management of adverse events focused on the work process; the promotion of quality from the Reception with Risk Classification and the attendance of referred cases. Regarding to the second dimension, respondents emphasized the occurrence of humanized practices through compliance towards the needs and preferences of users and the friendly relationship among the workers. It is noteworthy, however, that some respondents expressed dissatisfaction relating to teamwork. The third category showed care and quality relation result, noting that the respondents value the evaluation of care process in order to achieve positive results; that they are engaged to the solving of problems presented by users; who are willing to confront the new challenges related to quality certification. More over, it was found that the participants assume that it is not enough to achieve institutional goals, it is also necessary to act with humanity and in partnership with the user. One aspect that needs to be improved, in the respondents' point of view, is the effective user participation during the service. It is concluded that in general, the service investigated, Structure, Process and Results are in line with the precepts of Quality Management.