title: [Under the aegis of urgency: management practices by public hospital directors in Rio de Janeiro, Brazil].
abstract: This article discusses management practices in public hospitals (general hospitals with emergency services) in the city of Rio de Janeiro, Brazil, based on a psychosociological approach to organizational analysis. Of the 12 existing hospitals, 8 were included in the current study, conducted from July 2003 to April 2004. The research, drawing on hospital directors' narratives, identified three management models. The first focuses on processes of change, highlighting symbolic and imaginative elements for building a vision of the future for the hospitals. The second concentrates on specific projects, which absorbs all the management efforts. A third pattern (predominant in the study) is marked by the struggle to keep the hospital working, with the image of urgency as the driving force. The imposition of continuous action leaves no room for reflection. The crisis in Rio de Janeiro's public hospitals has led to a "wartime" environment and thus the dissemination of the urgency-based model.
authors: Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. creuza@ensp.fiocruz.br
authors: Creuza da Silva
authors: Cda S
authors: Azevedo
authors: Maria Inês Assumpção
authors: MI
authors: Fernandes
authors: Tereza Cristina
authors: TC
authors: Carreteiro
mesh_terms: D001938:Brazil; D016542:Chief Executive Officers, Hospital / Q000458:organization & administration* / Q000523:psychology; D004632:Emergency Medical Services / Q000458:organization & administration*; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic