SESSÃO 6 E 7 - CRIANDO ORGANIZAÇÕES Uploaded by Ericcccbr Download as PDF or read online from Scribd. Flag for inappropriate. - Download as PDF File .pdf), Text File .txt) or read online. Criando Organizações Eficazes PDF - Google Search. Uploaded by. PDF | Two general orientations in the organizations strategic management are identified: the stockholders and stakeholders model. The article aims at.

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PDF | To some companies, adapting to new times is inevitable, a lífe or death decision. To otners, adaptation ls recommended as a precaution. Contemporary . Criando organizações eficazes: estruturas em cinco configurações. ://www.>. MINTZBERG, H. Criando organizações eficazes: estruturas em cinco organizações. São Paulo: Atlas, p. NADLER, D. A; GERSTEIN, M. S. Projetos de.

In short, it proposes the formulation of a "small explanatory theory" for each program Lipsey MW. Theory as method: small theories of treatments. In: Sechrest L, Scott A, editors. Understanding causes and generalizing about them. Additionally, Improvement Science explicitly acknowledges the importance of understanding behavioral and social phenomena pertaining to the promotion of changes for a healthcare quality improvement intervention Table 1.

Psychology Making psychological theory useful for implementing evidence based practice: a consensus approach. Validation of the theoretical domains framework for use in behaviour change and implementation research.

Using theory to synthesise evidence from behaviour change interventions: the example of audit and feedback. Explaining clinical behaviors using multiple theoretical models. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework.

Meanwhile, the social sciences expand the understanding of quality improvement as a social and political process, considering power relations and social interactions The heart of quality improvement processes lies at the intersection between the belief expressed in the action and the scientific evidence that sustains an intervention In the health field, at least partially, the evidence originates in clinical research.

The human sciences contribute to the understanding of how professionals absorb and apply this new knowledge, valuing the dynamic nature of the processes of change, as well as the inherent conflicts.

Valorization of the role of context The search for understanding the mechanisms of change and identifying obstacles and levers of the implementation and dissemination of interventions incur in the valorization of the context by Improvement Science How does context affect quality improvement.

Perspectives on context: a selection of essays considering the role of context in successful quality improvement. Bate P. Context is everything. Robert G, Fulop N. The role of context in successful improvement. Dixon-Woods M.

The problem of context in quality improvement. An interest in the role of the setting or context in organizations' performance first emerged in the organizational field with the system and contingency theories beginning in the s, when organizations came to be seen as open systems which, in order to achieve their objectives expressed in their products and services, need resources or elements found in their inner and outer setting.

Organizational performance depends on adequate interaction established between such elements, hence their importance. The concern lies less in defining setting or context and more in identifying and understanding the characteristics of these internal and external elements Daft RL.

Morgan G. Although the distinction between internal and external is not a consensus in the literature, some healthcare quality improvement authors highlight its usefulness for understanding the internal and external effects and constraints and especially for identifying which ones are modifiable or negotiable The influence of context on quality improvement success in health care: a systematic review of the literature.

External elements are defined as socio-political-economic, cultural, regulatory, professional, and technological aspects or conditions, including healthcare system characteristics and financing, among others. Meanwhile, internal elements include structural characteristics, the nature of the work processes, network and communication, and organizational culture and climate.

Also considered are the characteristics of individuals involved, i. Quality improvement thus results from organizational interventions that are contingent on the context in which they occur or, more specifically, contingent on the characteristics and interactions established among their internal elements and between the latter and external elements.

Although the distinction between intervention and context of intervention is somewhat arbitrary, the identification of internal and external factors or elements can shed light on the necessary conditions for being successful in the intervention implementation In short, healthcare quality improvement interventions do not happen in a sterile or laboratory setting Factors facilitate or hinder implementation of the intervention, influencing its effectiveness and financial and temporal sustainability.

In general, the limit between intervention and context is tenuous. Interactions among contextual factors themselves and between contextual factors and the implementation process are dynamic, modifying the process over time and frequently requiring adjustments to the intervention's components In order to understand the context in greater detail, some authors distinguish between the structural and psychological perspectives, related to the objective context structure or resources and subjective context actors' behavior, organizational climate, and assimilative capacity , or "hard" and "soft" contextual factors Little is known about which contextual elements are most important for success, whether they change in different improvement initiatives, or even whether their importance changes over time Recognition of their importance raises two concerns, the implementation strategy and the organizational change By valuing the role of context, healthcare improvement interventions are viewed less from the angle of normative or prescriptive decisions and more as a complex and multifaceted strategy for organizational change, contingent on the context An additional challenge is to deal with the socio-technical nature and complexity of tasks and work processes in health organizations.

Theoretical basis for the design, implementation, and evaluation of interventions Theories link interrelated concepts and proposals capable of explaining or predicting events based on the specification of relations between variables, inherent to which is the perspective of generalization or broad application and testability Glanz K, Bishop DB. The role of behavioral science theory in development and implementation of public health interventions.

Annu Rev Public Health ; But it is also useful the understanding,as "theoretical", of that which simply provides an assertive of a significant interaction between variables, or a coherent conceptual framework, in the shape of a map or model, of a phenomenon or complex interaction, describing how an independent variable changes the behavior of a dependent variable Davidoff et al.

The authors differentiate heuristically between grand theories, mid-range theories, and program theories small theories. In the first, they highlight the high level of abstraction and the capacity for generalization to different domains; in mid-range theories, the application to delimited areas and the intermediary position between minor working hypotheses and the all-inclusive speculations comprising a master conceptual scheme; and in small theories, the pragmatism and the specificity associated with each program or intervention The theory of the diffusion of innovations and normalization process theory are cited as examples of mid-range theories that provide frameworks for understanding the problem or guidelines for the development of interventions.

Meanwhile, in the development, implementation, and evaluation of healthcare quality improvement interventions, the small theories related to specific interventions describe the intervention's composition, expected results, mechanisms of change, and methods to assess the results.

In designing interventions, theories are thus expected to furnish the basis for defining the mechanisms of change to be considered, and, indirectly, for proposing components to be incorporated. Testing these interventions in a given context would thus function as a test of hypotheses concerning the predicted mechanisms of change under the observed conditions. As mentioned above, theories of change are defined a priori and updated a posteriori, with the capacity for generalization deriving from accumulation of experiences in different contexts Ideally, theories should also back the implementation and evaluation of interventions, providing elements for grasping plausible mechanisms of change and for explaining their success or failure.

The literature presents a set of studies identifying theories Institutionalization of evidence-informed practices in healthcare settings. Dearing JW. Applying diffusion of innovation theory to intervention development. Res Soc Work Pract ; Implementation Theory defines implementation as a social process of collective action whose central concepts derive from sociological theories of social fields and systems and cognitive theories of psychology. Based on these theories, a more comprehensive explanation of these elements constituing implementation process could be built The implementation process is explained as the interaction between "emerging expressions of agency" or what people do in order to make something happen, and how they deal with different components of a complex intervention and the context's dynamic elements the socio-structural and socio-cognitive resources people draw on to perform their actions of agency.

Agency expresses people's capacity and ability to achieve certain objectives based on their own actions in a complex context with constraints Table 1.

The implementation is begun deliberately by the agents that intend to introduce a new practice or modify institutionalized practices, developed by themselves or by other agents, which modifies the social system. The implementation will imply changes that can impact individual, organizational, and societal behavior.

Agents, individuals or groups engaged in the mobilization of material and cultural resources, seek to ensure the consent, cooperation, and knowledge of other agents that coexist in the context in which implementation of the practice takes place Intrinsic to this concept of implementation are two central concepts: social system and mechanisms. Social system is defined as the set of contingent, dynamic, and socially organized relations that shape the structure in which agents individuals or groups act, interacting among themselves, for the expression of agency.

Systems are emerging, continuously shaped in time and space by endogenous and exogenous factors, with a relatively unpredictable future. And within these emerging structural conditions, mechanisms operate, defined as the processes that promote or hinder a change in an actual system, unfolding over time and expressing contributions by the agency human intervention.

The focus on the mechanisms helps understand the means for promotion of changes projected in the interventions, the circumstances in which they act, and how they attempt to shape them In short, based on the above-mentioned theory, the effective implementation of a healthcare quality improvement intervention is conditioned by human behavior and the functioning of groups and organizations and their contexts, and can be explained from different points of view.

Considering the lack of convincing evidence that some theories are more explanatory than others, Grol et al. The first block includes cognitive, educational, and motivational theories that seek to explain how professionals make their choices and decisions. The second block includes theories that focus on the influence of the social context in the process of change social norms and values within a social network, leadership, peers, and the role of models , that interact with actions by individuals in the implementation processes.

They are the theories of communication, social learning, influence, social network, teamwork, professional development, and leadership. The third block focuses on the organizational context involving the theories of innovative organizations, quality management, reengineering, complexity, organizational learning, and organizational culture. Theories on the influence of economic factors focus on market regulations, competition, payment systems, and financial incentives, factors to be identified in the implementation of changes although they are largely beyond the control of the agents that promote them.

Improvement Science also adds theoretical frameworks for the implementation of healthcare quality improvement interventions, although it acknowledges their inherent limitations, due both to simplification and non-exhaustiveness, which impacts their applicability The model for understanding success in quality MUSIQ : building a theory of context in healthcare quality improvement.

Table 2: Theoretical frameworks for quality improvement interventions in healthcare.

Structural dimension: “A chameleon-like cluster” searching for major transformation

Enabling the implementation of evidence based practice: a conceptual framework. Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges.

A critical synthesis of literature on the promoting action on research implementation in health services PARIHS framework. CFIR McDonald KM. Considering context in quality improvement interventions and implementation: concepts, frameworks, and application. Acad Pediatr ; 13 6 Suppl :S Implementation is seen as a social process, where context is the set of unique circumstances or factors surrounding an effort at a given implementation.

The resposdentes 19 said they did not use formal mechanisms such as surveys or emails.

At this point, it is possible to identify the need for qualification in customer service. Based on information collected through the interviews, the canvas of gourmet bakery was assembled, showing more objectively the nuances of this business model, its epicenter - the Value Proposition - and the relationship between the blocks Osterwalder; Pigneur, Source: the authors. Through the intersection of data from qualitative research with quantitative data, you can see that the value proposition presented by the bakeries, in general, is perceived and valued by customers.

In traditional bakeries, as expected, the service is recognized as inferior to that offered by gourmet bakeries. The focus on costs and quality of the product, not service, is reflected in the perception of customers. In traditional bakeries surveyed, revealed a strong trend of continuity of the business model by maintaining the quality of products to meet customers old bakery, a public parochial and does not consume the product directly on the site provided by the bakery, but in their homes.


The customer of gourmet bakeries have more time to look at the ambiance, check and analyze customer service. In this sense, it is understandable that quality, for example, is no longer the main factor of perceived competitiveness. In contrast to customers of gourmet bakeries, customers of 21 traditional bakeries are not as concerned with extreme cleanup. Another important point relates to the similarity of opinion among customers of both types of bakeries, giving little importance to the organization of the ambiance, agility and service quality.

In traditional bakeries, the client's vision coincides with the opinion of the representatives of bakeries, since the customer has no interest in staying long in the store.

However, in the case of gourmet bakeries, there is a clear contrast of perceptions, since interviewees indicate speed and quality of care as essential. This contrast, nevertheless, is not observed when it comes to the diversity of the menu. In this case, both client and interviewees see diversity as relevant, in line with the idea of a diversified revenue stream, appointed by the representatives of gourmet bakeries. Finally, when analyzing the block central business models of both types of bakeries in contrast to the views of customers, one can identify a greater alignment in the case of traditional bakery.

The quality of the product is identified by customers as a relevant factor and that is precisely where these bakeries focus their attention.


The gourmet bakery, in turn, strongly invests in quality in assistance, while the customer perceives greater value on factors related to the ambiance. Conclusions, Managerial Implications and Future Researches The purpose of this paper is to show the main differences between the business model of traditional bakeries and gourmet bakeries concerning the delivery of value according to the Business Model Canvas Osterwalder and Pigneur, We also addressed the misperception between value proposition by bakeries and value perception by customers.

The research methodology used - mixed methods - contributed to the data analysis and was suitable to this project.

Qualitative research was strengthened by the evidence detailed in the quantitative phase, making it possible achieve the research goals. Given the evidence pointed at the results of the interviews, we found that the central focus of gourmet bakery is to deliver superior value in assistance, agility and 22 ambiance.

The trend of business model innovation in the bakery, in order to offer a value proposition more in line with customer demand, provide evidence to better understand the phenomenon taking place in the bakery industry in Sao Paulo, Brazil.

The results of this research indicate some differences between the Value Proposition of both types of bakeries and the perception of their client. Gourmet bakeries offer a Value Proposition focused on experience in the bakery, which corresponds to items identified as relevant to the client, such as Cleanliness.

However the low scores given to items such as the Organization of Ambiance, Quality Service and Agility in the Attendance suggest that the client does not consider them as relevant.

This conclusion, however, might be precipitated: eventually, the client does not assign value to these aspects because they consider them a minimum required for operation.

New research may seek to confirm these issues. This research exposed , through scientific methods, some important questions about the bakery industry and the perception of its customers in Sao Paulo.

Managerially, this study highlights evidence that can improve the performance of both models bakeries. On the one hand, gourmet bakeries require a more accurate understanding of its client, identifying exactly what are their wishes in order to offer a value proposition even more appropriate.

The managers of traditional bakeries, in turn, need to be aware of the profile change evidenced in the market. The idea of offering a single product for a more traditional public may compromise their survival in the medium and long term. Even though not offering an ambiance like gourmet bakery, the basket of products offered by traditional bakery needs to be reevaluated in order to keep their competitiveness. Future research could be conducted in other cities where the phenomenon occurs to verify and compare its characteristics.

Also, this kind of change may be occurring in another industry. The Business Model Canvas proved be a useful tool of analysis suitable for this type of project. Researchers could try to find out the drivers of change that reshapes the industry, so this information would be valuable to track changes in other industries. Lastly, in a more interpretative work, researches could try to understand how - and when - entrepreneurs decide to change an entire business model in order to follow a market trend - or just to follow competition.

Amit, Raphael; Zott, Christoph. Strategic Management Journal, vol. Chandler, A. California Publisher Sage. Universia Business Review, May. Flores, J. Barcelona, Editor: LCT, Ghoshal, Sumantra; Tanure, Betania.

Editora Campus. Hamel, G. H; Prahalad, C. Harvard Business Review. Harrison, J. Porto Alegre, Editora Bookman. Kotler, Philip; Armstrong, Gary. Lovelock, Christopher; Wirtz, Jochen. Megido, J. Tejon; Szulcsewski, Charles John. Editora Atlas.

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Porto Alegre: Bookman. Mintzberg, Henry. Osterwalder, Alexander; Pigneur, Yves. Porter, Michael. Prahalad, C. Harvard Business Review, May. Seloti Jr.

This fulfills the requirement of an approach based on structural, cognitive configurations , and relational and cognitive concrete system of actions and organizational social capital dimensions. The historical context provides the basis for analysis by signaling relevant events, turning points, links that become stronger or disappear, partnerships, types of records and event registration.

In principle, the matrices were not designed to present the categories, as we attempted to triangulate the sources of evidence and perform an argumentative integration of the theories presented using the matrices as the markers of integration in the theoretical apex , the baggage of the authors speculative apex and the field findings empirical apex.

Armand Collin; To ensure precise analyses we attempted to follow the decalog proposed by Minayo 31 Minayo MCS. Cien Saude Colet ; 17 3: Proposed analytical scheme inspired on the convergence of the assumptions of Mintzberg 14 Figure 1.

The Working Group has officially existed since 1 1. Cruz 3 3. Albuquerque TIP. Universidade Federal de Pernambuco; An approximation with Abrasco of which most were already members , and with the practices of the then- National School of Public Health NSPH and its project for Local Integrated and Sustainable Development in Manguinhos, strengthened the idea of creating a future WG at that association, which happened over the course of time, each time the group met.

A preliminary document with this intent was produced in , following the management report of that SPS 32 Conquering this space has enabled the development of a trust-based relationship between the Working Group and the members of government administration involved in promoting healthcare in Brazil.

These ties are essential for developing the proper social capital 27 Likewise, members of the MoH and Pan-American Health Organization are part of the Working Group, strengthening the ties that are essential for completing efforts involving shared values, principles and world visions 14 Rio de Janeiro, Ottawa: Akerman M, Mendes R, organizadores.

This seat on the PNPS management committee marked a turning point in the involvement of the Abrasco WG in the decision making spheres and those that define public policy. With a major concern in promoting fairness and equality, and in regionalizing, developing and implementing legal frameworks that are equivalent to those in the territorial bases, the WG representatives on the Policy Management Committee started to develop more robust relationships with all participating Institutions.

These relationships are based on competence and regular and influential participation. For the purposes of this article, and based on the authors cited, the MoH was classified with no specific in-depth analysis as a government entity coordinated by standardized results, whose starting point is its intermediate hierarchical line miscellaneous departments and coordinating bodies.

The Pan-American Health Organization is an organization of the professional bureaucracy that advises governments in Latin America. It is coordinated by standardized competences and qualifications, based on the assumptions of Mintzberg 14 Recognition of the level of professionalism and specialization of the members of an organization of this type make Abrasco an important ally in building a national public policy in any of the Theme Groups that make up the consultative and advisory structure, together with the Forums and Committees 36 Part of Abrasco, the PSDS WG, is at times an adhocracy not much formalization or organic structure, with a more horizontal and flexible structure , and sometimes a missionary organization actions taken around a shared ideology.

As mentioned above, since , many of the members of the three institutions have worked together towards a PNP and to map the reality of health promotion in this country, also trying to build the conceptual, theoretical and methodological frameworks for this area.

The emergence of the WG reinforces the concept of a hybrid missionary-adhocratic structure to implement actions, conduct studies and plan collective activities of an inter-regional character. In his book entitled Strategy Safari 37 This school favors adhocratic and missionary organization, as these seek transformation reformulation, revitalization, review.

The message this school aims to give is integrate and transform. The message to be received is aggregate and revolutionize, rather than adapt. Those who defend it agents of change, aggregators and integrators. It is based on history and does not negotiate to propose or develop strategies in the absence of a time line or a historical process. This discussion of the study leaves no question that the team leading the review actually created an adhocratic-missionary-professional configuration, where the professional component was not the prevailing one.

It was not the merit or qualifications that weighed in to continue the revision process. It was the combined strength around a shared vision of the world, and the desire to integrate and aggregate, more than the desire to adapt or hierarchize and classify that drove the process, and the configuration schools is based on this experience.

According to Serafim and Dias 38 This premise reinforces our findings and notes showing that not much use was made of specialized knowledge or hierarchical structures based on academic merit.

It was the values, principles and interests, more than knowledge of the discipline itself or, in this case several disciplines, that made a difference. Perhaps a certain level of homogeneity in terms of theme baggage, or the existence of a small group interested in Promoting Health with already strong ties , worked to dilute the cognitive factor, making it a supporting element in the review of the PNPS.

We should point out that this group was comprised of people very knowledgeable in the theme. Would it them be the obviously explicit expertise shared by most members the factor that made it appear invisible during the review? This dimension showed itself to be the most important for all steps of the PNPS review. Despite financial and thematic rules and limits, coercion was not the prevailing force. This is why the effort went far beyond the initial government proposal.

We thus found that the five regions in Brazil have different demands and priorities when it comes to Health Promotion 39 These are the following: We found to be present in almost all of the demands. Thus, it was the strong ties and relationships based on training, ideology and shared origin that initiated adjustments in the PNPS text to minimally meet the demands and expectations of the distal participants in the review.

The Feedback Seminar demonstrates the reach of this target. Further studies are required to confirm this analysis. Likewise, the existence of a specific Theme Group with an adhocratic and missionary structure — sharing values with other organizations responsible for coordinating, drafting and enforcing the working process seem to have acted as a facilitating and strategic factor to ensure and influence the inclusion of proposals originating in the citizens themselves.

This study shows the strength of actor interests and bets, their interactions 40 Bisset S, Potvin L. Expanding our conceptualization of program implementation: Health Educ Res ; 22 5: The intersubjectivity found and described worked, in this case, in favor of managing conflict 41 Granovetter M. The strength of weak ties: Sociological Theory ; 1: In the case of drafting and reviewing the PNPS, this type of configuration was positive.Yin R.

H; Prahalad, C. Disciplines like quality management, epidemiology, program evaluation, psychology, and social sciences are articulated to identify interventions capable of producing positive changes in healthcare quality, measurement of such changes, explanation of the mechanisms involved, and characterization of the contextual conditions for their functioning and sustainability.

Pereira RD. Would it them be the obviously explicit expertise shared by most members the factor that made it appear invisible during the review? When asked about what would be the most relevant items for success, 3 respondents mentioned the storefront and the location as an important channel of advertising and attracting customers.

Saponins causes reduction in the protozoal population which inhibits the inter species hydrogen transfer to the methanogenic bacteria attached to the protozoa, hence decreases the hydrogen availability to the methanogens. This fulfills the requirement of an approach based on structural, cognitive configurations , and relational and cognitive concrete system of actions and organizational social capital dimensions.

AJS ; 2 Yin R.