{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:34:58Z","timestamp":1762868098957,"version":"3.41.2"},"reference-count":44,"publisher":"FapUNIFESP (SciELO)","issue":"3","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"abstract":"<jats:p>Resumo: O Kanban \u00e9 um arranjo tecnol\u00f3gico de organiza\u00e7\u00e3o do cuidado hospitalar orientado para a gest\u00e3o de leitos e da cl\u00ednica, que visa \u00e0 qualidade e integralidade da assist\u00eancia, maior rotatividade dos leitos, com consequente redu\u00e7\u00e3o do tempo de interna\u00e7\u00e3o e custos hospitalares. O constante e atualizado acompanhamento do paciente, compartilhado pela equipe profissional em reuni\u00f5es sistem\u00e1ticas \u00e9 seu elemento mais marcante e inovador. O objetivo foi caracterizar os prov\u00e1veis impactos da ado\u00e7\u00e3o de tal arranjo no poder profissional (autonomia e autoridade) dos m\u00e9dicos. Estudo qualitativo em hospital de urg\u00eancia-emerg\u00eancia municipal com uso das seguintes t\u00e9cnicas de produ\u00e7\u00e3o de dados: etnografia do cotidiano do hospital, com observa\u00e7\u00e3o e registro em di\u00e1rios de campo, e realiza\u00e7\u00e3o de semin\u00e1rios compartilhados entre pesquisadores e equipes. Os m\u00e9dicos valorizam o trabalho multiprofissional como um qualificador de sua pr\u00e1tica, em uma linha auxiliar e complementar. Acresce que o Kanban tende a ser controlado por \u201ch\u00edbridos\u201d (m\u00e9dicos que acumulam fun\u00e7\u00f5es gerenciais e cl\u00ednicas) que traduzem sinergias entre \u201cgest\u00e3o cl\u00ednica\u201d e \u201cgest\u00e3o de leitos\u201d. Assim, interfer\u00eancias no trabalho dos m\u00e9dicos n\u00e3o s\u00e3o exercidas de fora, e as suas decis\u00f5es cl\u00ednicas continuam a condicionar o trabalho dos demais grupos profissionais. Os m\u00e9dicos n\u00e3o percebem sua autoridade e autonomia amea\u00e7adas pelo Kanban, dada a articula\u00e7\u00e3o entre a autoridade administrativa e a autoridade profissional. Contudo, aspectos relacionados \u00e0 hibridiza\u00e7\u00e3o e estratifica\u00e7\u00e3o interna da profiss\u00e3o m\u00e9dica precisam ser mais convocados para o debate do poder profissional em sa\u00fade.<\/jats:p>","DOI":"10.1590\/0102-31100242918","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T16:50:28Z","timestamp":1584982228000},"source":"Crossref","is-referenced-by-count":4,"title":["Os m\u00e9dicos e a gest\u00e3o do cuidado em servi\u00e7os hospitalares de emerg\u00eancia: poder profissional amea\u00e7ado?"],"prefix":"10.1590","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9207-4781","authenticated-orcid":false,"given":"Luiz Carlos de Oliveira","family":"Cecilio","sequence":"first","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6015-3314","authenticated-orcid":false,"given":"Tiago","family":"Correia","sequence":"additional","affiliation":[{"name":"Universidade Nova de Lisboa,  Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3332-2183","authenticated-orcid":false,"given":"Rosemarie","family":"Andreazza","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7184-2342","authenticated-orcid":false,"given":"Arthur","family":"Chioro","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4374-5021","authenticated-orcid":false,"given":"Gra\u00e7a","family":"Carapinheiro","sequence":"additional","affiliation":[{"name":"Instituto Universit\u00e1rio de Lisboa,  Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0451-9822","authenticated-orcid":false,"given":"Nelma Louren\u00e7o de Matos","family":"Cruz","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6320-4308","authenticated-orcid":false,"given":"Luciana Soares de","family":"Barros","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo,  Brazil"}]}],"member":"530","published-online":{"date-parts":[[2020]]},"reference":[{"year":"2002","series-title":"Fr\u00e1geis deuses: profissionais de emerg\u00eancia entre os danos da viol\u00eancia e a recria\u00e7\u00e3o da vida","author":"Deslandes SF","key":"ref1"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.annemergmed.2004.07.449","article-title":"The quality gap searching for the consequences of emergency department crowding","volume":"44","author":"Magid DJ","year":"2004","journal-title":"Ann Emerg Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1111\/j.1553-2712.2004.tb01369.x","article-title":"Estimating the degree of emergency department overcrowding in academic medical centers results of the National ED Overcrowding Study (NEDOCS)","volume":"11","author":"Weiss SJ","year":"2004","journal-title":"Acad Emerg Med"},{"year":"2005","series-title":"Urg\u00eancias e emerg\u00eancias em sa\u00fade: perspectivas de profissionais e usu\u00e1rios","author":"Giglio-Jacquemot A","key":"ref4"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"1439","DOI":"10.1590\/S0102-311X2009000700002","article-title":"Interven\u00e7\u00f5es para solucionar a superlota\u00e7\u00e3o nos servi\u00e7os de emerg\u00eancia hospitalar uma revis\u00e3o sistem\u00e1tica","volume":"25","author":"Bittencourt RJ","year":"2009","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref6","first-page":"S331","article-title":"Integralidade da aten\u00e7\u00e3o e integra\u00e7\u00e3o de servi\u00e7os de sa\u00fade desafios para avaliar a implanta\u00e7\u00e3o de um \"sistema sem muros\". 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