Ações para redução de falhas na gestão da coprodução em tratamentos oncológicos com terapia antineoplásica oral

Abstract

Coproduction in Health Services and related processes are still under-researched topics. In health services, the patient becomes an integral part of the productive process by performing the role of coproducer, performing the management of his treatment autonomously. In this perspective, it is necessary to understand how the services and the health professionals manage the use of drugs in the specific context of long-term treatments, as in the case of Oral Antineoplastic Therapy (TAO), used in the treatment of cancer. This work proposed a set of actions with the objective of reducing failures in the process of coproduction management in TAO treatments in the hospital setting. In order to meet this objective, a conceptual framework was developed, based on a bibliographical survey that investigated the concepts of Co-production in Services, Failures in Coproduction, Health Services and TAO, and a systematic literature review on the concepts of Co-production in Services of Health. From this conceptual framework, the categories of analysis were defined, used as basis for the elaboration of the instrument of data collection. A semistructured questionnaire with open questions was the collection tool used in this research, based on a qualitative approach, adopting the case study as a method. The case study was carried out with an Oncology Service, located in a large hospital, located in the state of Rio Grande do Sul. The interviews were analyzed through a content analysis technique, whose purpose is to interpret the characteristics and the standards behind the content of messages and documents. To support the analysis of the content, the software for qualitative data analysis Atlas.ti - version 8.0 was used. With the consolidation of data, the research findings were compared through triangulation, involving results, perspectives or theories, researchers or methods, as a response to reliability and the validity of the study with the theoretical findings. The results indicate that the work processes are still not ordered in order to produce the best result in the delivery of the service to the patients in the context of the TAO treatments. Thus, the proposed set of actions suggests the adoption of procedures to reduce failures in coproduction management with respect to the integral approach of the patient, adequacy to the routine of drug distribution, education for coproduction, demand management, coproduction management, and optimization of the flow of medication request and authorization.