Criação de valor público no processo de institucionalização da acreditação internacional em hospital público : um estudo de caso

Abstract

Public value can be understood as the benefits granted to citizens resulting from the result of specific government policies by area of interest. As our area of interest, health was studied, which has a great budgetary and social impact for the country. The thesis proposes that for the public value created with the institutionalized international accreditation strategy to be effectively legitimized, there is a need to create, measure and disseminate the indicators of elements of public value to the internal and external society. Thus, the objective was to analyze how measurement and dissemination of the creation of public value occurs in the process of institutionalizing international hospital accreditation in public hospital. The research strategy chosen in this research was a single case study, with an descriptive purpose and an inductive approach, through direct observations, document analysis and interviews. In the analysis of the results, in relation to the determining factors for the search for the international hospital accreditation strategy in the investigated public hospital, it was found that the search was fundamentally to acquire more quality and more safety for patients. In the research discussions, it was pointed out that the institutional changes, resulting from the search for international ospital accreditation in the investigated public hospital, were influenced by mimetic and normative isomorphic pressures. In addition, it was found that the institutionalization process of international hospital accreditation went through the three stages of habitualization, objectification and sedimentation suggested by Tolbert and Zucker (1999). With regard to public value, 42 (forty-two) elements of public value were identified in the investigated institution that were created with the international hospital accreditation process. Regarding the measurement and dissemination of public value, it was found that tangible elements of public value created by the institutionalization process of international hospital accreditation are measured and evidenced to the internal society through hospital indicators, but intangible elements of value are still only perceived by managers and other employees of the investigated institution. Finally, for the external society, it was found that in management reports, the elements of public value created with the international accreditation strategy in the investigated public hospital have not yet been disclosed, neither for the government nor for the interested parties, thus, the international accreditation process has not yet been effectively legitimized, and the disclosure of public value possibly benefits accountability and public transparency. These, our findings corroborate the thesis defended.