{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T10:32:42Z","timestamp":1762079562034},"reference-count":12,"publisher":"FapUNIFESP (SciELO)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:p>Summary The kidney transplant program at Hospital do Rim (hrim) is a unique healthcare model that applies the same principles of repetition of processes used in industrial production. This model, devised by Frederick Taylor, is founded on principles of scientific management that involve planning, rational execution of work, and distribution of responsibilities. The expected result is increased efficiency, improvement of results and optimization of resources. This model, almost completely subsidized by the Unified Health System (SUS, in the Portuguese acronym), has been used at the hrim in more than 11,000 transplants over the last 18 years. The hrim model consists of eight interconnected modules: organ procurement organization, preparation for the transplant, admission for transplant, surgical procedure, post-operative period, outpatient clinic, support units, and coordination and quality control. The flow of medical activities enables organized and systematic care of all patients. The improvement of the activities in each module is constant, with full monitoring of various administrative, health care, and performance indicators. The continuous improvement in clinical results confirms the efficiency of the program. Between 1998 and 2015, an increase was noted in graft survival (77.4 vs. 90.4%, p&lt;0.001) and patient survival (90.5 vs. 95.1%, p=0.001). The high productivity, efficiency, and progressive improvement of the results obtained with this model suggest that it could be applied to other therapeutic areas that require large-scale care, preserving the humanistic characteristic of providing health care activity.<\/jats:p>","DOI":"10.1590\/1806-9282.62.07.664","type":"journal-article","created":{"date-parts":[[2016,11,30]],"date-time":"2016-11-30T21:32:11Z","timestamp":1480541531000},"page":"664-671","source":"Crossref","is-referenced-by-count":12,"title":["A pioneering healthcare model applying large-scale production concepts: Principles and performance after more than 11,000 transplants at Hospital do Rim"],"prefix":"10.1590","volume":"62","author":[{"given":"Jos\u00e9 Medina","family":"Pestana","sequence":"first","affiliation":[{"name":"Hospital do Rim,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","series-title":"Constitui\u00e7\u00e3o da Rep\u00fablica Federativa do Brasil","year":"1988"},{"issue":"4","key":"ref2","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.transproceed.2004.03.061","article-title":"Organ transplantation in Brazil in the year 2002","volume":"36","author":"Medina-Pestana JO","year":"2004","journal-title":"Transplantation Proc"},{"key":"ref3","series-title":"Dimensionamento dos transplantes no Brasil e em cada estado (2008- 2015)","volume-title":"RBT Registro Brasileiro de Transplante. Ve\u00edculo oficial da Associa\u00e7\u00e3o Brasileira de Transplante de \u00d3rg\u00e3os","year":"2015"},{"issue":"11","key":"ref4","first-page":"1510","article-title":"Organization of a high-volume kidney transplant program - The \"Assembly line\" approach","volume":"81","author":"Medina-Pestana JO","year":"2006","journal-title":"Transplantation"},{"key":"ref5","first-page":"107","article-title":"More than 1,000 kidney transplants in a single year by the \"Hospital do Rim\" Group in Sao Paulo - Brazil","author":"Medina-Pestana JO","year":"2010","journal-title":"Clin Transpl"},{"issue":"4","key":"ref6","first-page":"472","article-title":"Kidney transplantation in Brazil and its geographic disparity","volume":"33","author":"Medina-Pestana JO","year":"2011","journal-title":"J Bras Nefrol"},{"issue":"1","key":"ref7","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/TP.0000000000001041","article-title":"Jose Medina Pestana, MD, PhD, FRCS: Head of Transplant Division","volume":"100","author":"Pestana JM","year":"2016","journal-title":"Transplantation"},{"issue":"2","key":"ref8","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.transproceed.2007.01.030","article-title":"Deceased organ donation in Brazil: how can we improve?","volume":"39","author":"Medina-Pestana JO","year":"2007","journal-title":"Transplant Proc"},{"issue":"2","key":"ref9","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/S0041-1345(02)02592-7","article-title":"Outcome of 605 consecutive living donor nephrectomies through an anterior subcostal retroperitoneal approach","volume":"34","author":"Baptista-Silva JC","year":"2002","journal-title":"Transplant Proc"},{"issue":"7","key":"ref10","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1111\/j.1600-6143.2011.03564.x","article-title":"The emerging role of Brazil in clinical trial conduct for transplantation","volume":"11","author":"Silva Jr HT","year":"2011","journal-title":"Am J Transplant"},{"issue":"7","key":"ref11","first-page":"A665","article-title":"Budget impact analysis: would the Brazilian public health system increase, by means of transplants, the cost of treatment of chronic terminal kidney disease?","volume":"16","author":"Alvares J","year":"2013","journal-title":"Value in Health"},{"issue":"8","key":"ref12","doi-asserted-by":"crossref","first-page":"1663","DOI":"10.1007\/s11255-014-0695-0","article-title":"Expanding the use of expanded criteria donors in kidney transplantation","volume":"46","author":"Assis-Borba L","year":"2014","journal-title":"Int Urol Nephrol"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/ramb\/v62n7\/0104-4230-ramb-62-07-0664.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,5,24]],"date-time":"2017-05-24T01:54:45Z","timestamp":1495590885000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302016000700664&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10]]},"references-count":12,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["S0104-42302016000700664"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.62.07.664","relation":{},"ISSN":["0104-4230"],"issn-type":[{"value":"0104-4230","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10]]}}}