Resumo Medir a inovação nas Instituições de Ensino Superior (IES) é desafiador devido à dependência dos rankings existentes em indicadores limitados a publicações e patentes. Este estudo propõe um modelo abrangente para avaliação da inovação nas IES e identifica quatro dimensões-chave: processos de gestão, programas acadêmicos, parcerias e marketing. Mais de 60 indicadores dentro dessas dimensões fornecem uma avaliação completa da capacidade de inovação das IES. Esse modelo possibilita a comparação com instituições similares, o acompanhamento do progresso da inovação ao longo do tempo e a tomada de decisões para aprimorar a inovação nas IES, além de oferecer uma abordagem mais precisa e útil para avaliar e fortalecer a inovação no Ensino Superior.

Abstract Measuring innovation in Higher Education Institutions (HEIs) is challenging due to the existing rankings’ reliance on limited indicators like publications and patents. This study proposes a comprehensive model for HEI innovation evaluation. It identifies four key dimensions: management processes, academic programs, partnerships, and marketing. Over 60 indicators within these dimensions provide a thorough assessment of the HEI innovation capacity. This model enables benchmarking against similar institutions, tracking innovation progress over time, and informing decision-making for enhancing innovation within HEIs. It offers a more accurate and useful approach for evaluating and strengthening innovation in Higher Education.

Resumen Medir la innovación en las instituciones de educación superior (IES) es un desafío debido a la dependencia de los rankings existentes en indicadores limitados a publicaciones y patentes. Este estudio propone un modelo integral para la evaluación de la innovación en las IES. Identifica cuatro dimensiones clave: Procesos de Gestión, Programas Académicos, Alianzas y Marketing. Más de 60 indicadores dentro de estas dimensiones proporcionan una evaluación exhaustiva de la capacidad de innovación de las IES. Este modelo permite la comparación con instituciones similares, el seguimiento del progreso de la innovación a lo largo del tiempo y la toma de decisiones para mejorar la innovación dentro de las IES. Ofrece un enfoque más preciso y útil para evaluar y fortalecer la innovación en la educación superior.

BACKGROUND. Monitoring quality indicators to improve breast cancer care is well established in high-income countries. This is the first evaluation of diagnostic and surgical quality indicators for initial benchmarking of breast cancer care in South Africa (SA). OBJECTIVE. To measure the adherence rates to quality indicators among women with breast cancer in SA. METHODS. Ten quality indicators were evaluated for 3 545 breast cancer patients across four SA surgical breast units using a shared electronic patient record system. Data quality and adherence rates with differences between units were determined. The effect of HIV status on adherence was assessed by multivariate Poisson regression analyses. RESULTS. Our electronic patient record reliably measured most quality indicators. Rates of positive margins (5.7%), overall axillary surgery (95.8%) and appropriate treatment sequencing in locally advanced breast cancer patients (98.4%) consistently reached minimum international standards. Rates of multidisciplinary team discussion (72.2%), radiotherapy (66.7%) and sentinel node biopsy (39.6%) showed wide cross-site variance. Histopathology reporting (62.0%), breast-conserving surgery (19.4%) and number of nodes excised with axillary dissection (47.3%) and sentinel node biopsy (82.7%) were consistently below minimum standards. Unit volumes were achieved consistently in Gauteng Province, but only for some years in KwaZulu-Natal Province; surgeon volumes were achieved across all units. HIV status did not affect adherence levels. Most quality indicators were well measurable, but data quality on reoperations and surgeon volumes was poor. CONCLUSION. We evaluated local quality indicators for an initial benchmark, and the most emergent gaps in care are the receipt of radiotherapy and underutilisation of sentinel node biopsy.

Abstract The purpose of this article is to show the evolution of international reporting standards for the public reporting of exploration results, mineral resources, and reserves, from the first initiatives to the current days. Particularities, similarities, and components, which ensure that the information provided complies to various worldwide instruments, are discussed. We also examined the recent changes in the national/regional Codes and guides, including the CRIRSCO Template published in late 2019. The systematization promotes understanding of company risks from the capital market and other financing mechanisms, making it possible to compare projects and do benchmarking analysis, allowing mining companies to comply in a more efficient, transparent, and less costly way to the jurisdictions under which they operate. Finally, presented is a chronology and evolution of the standardization and the localization of similar topics within the Codes of the CRIRSCO Family. The international reporting standards are a relevant and consistent instrument with reliable statements, clear language, and are recognized from one jurisdiction to another by financial institutions, which helps to improve and increase confidence in the mining industry. The objective of the CRIRSCO members is to provide and promote the understanding of the practices for mining investment decisions, being successful around the world.

ABSTRACT Purpose This study proposes to develop a consultancy model to evaluate the level of maturity of ESG practices. Design/Methodology/approach Business Model Canvas [BMC] as a framework for creating a business model focusing on Environmental, Social, and Governance [ESG] consultancy services. A five-level maturity scale was applied to the dimensions that characterize the diagnostic checklist model for ESG practices. The Delphi research method was used to evaluate the content of the diagnostic checklist for ESG practices. Findings As a result, a hypothetical consultancy called ENGES Consulting Ltda. was created, constituted through the creation of the social contract, the creation of the mission, vision, and values, in addition to the development of a business model based on the Business Model Canvas [BMC] strategic management tool. A checklist model was also created for diagnosing ESG practices and their respective maturity level. Originality/relevance The relevance and contribution of this study in the scientific aspect lie in the proposal of a consultancy model to assess the maturity level of ESG practices in disparate organizations. Practical implications The practical contribution lies in understanding Environmental, Social, and Governance [ESG] management practices based on the ESG practices diagnosis checklist model and the respective level of maturity, identifying strengths and points that demonstrate implementation or execution weaknesses, in addition to providing a way to compare results (benchmarking) obtained between organizations.

RESUMO Finalidade Este estudo propõe desenvolver um modelo de consultoria para avaliar o nível de maturidade das práticas ESG. Desenho / metodologia / abordagem Business Model Canvas [BMC] como uma estrutura para criação de um modelo de negócio com foco em serviços de consultoria Ambiental, Social e Governança [ESG]. Uma escala de maturidade de cinco níveis foi aplicada às dimensões que caracterizam o modelo de checklist de diagnóstico para práticas ESG. O método de pesquisa Delphi foi usado para avaliar o conteúdo do checklist de diagnóstico para práticas ESG. Constatações Como resultado, foi criada uma consultoria hipotética denominada ENGES Consultoria Ltda., constituída por meio da criação do contrato social, criação da missão, visão e valores, além do desenvolvimento de um modelo de negócio baseado na ferramenta de gestão estratégica Business Model Canvas [BMC]. Foi criado também um modelo de checklist para diagnóstico das práticas ESG e seu respectivo nível de maturidade. Originalidade/relevância A relevância e contribuição deste estudo no aspecto científico está na proposta de um modelo de consultoria para avaliar o nível de maturidade das práticas ESG em organizações distintas. Implicações práticas A contribuição prática está na compreensão das práticas de gestão Ambiental, Social e de Governança [ESG] com base no modelo de checklist de diagnóstico de práticas ESG e o respectivo nível de maturidade, identificando pontos fortes e pontos que demonstram fragilidades de implementação ou execução, além de proporcionar uma forma de comparação dos resultados (benchmarking) obtidos entre as organizações.

RESUMEN Introducción: La formación de posgrado en Salud Pública es un proceso fundamental para el desarrollo de los servicios de salud. Solo mediante la formación de profesionales con la calidad requerida será posible prevenir, atender y solucionar los problemas que afectan la salud de la población. Objetivo: Identificar buenas prácticas aplicables al Programa de la Maestría en Salud Pública de la Ensap. Métodos: Se realizó un estudio descriptivo de corte transversal en 2019-2021, mediante una referenciación competitiva a partir de 50 programas tomados como referencia. Se analizaron variables tales como la modalidad de estudio y dedicación, objetivos, perfil del egresado y las disciplinas que imparten, entre otras. Se consultó a egresados del programa para su valoración de las propuestas de mejoras. Resultados: En el 72 % de los programas estudiados se propone como principal objetivo la formación de investigadores en salud pública y en el 81,39 % de ellos en su perfil de egresado está presente lograr la capacidad de utilizar la investigación en salud pública. El 68,88 % de estos se imparte de manera presencial y en el 80,55 % su modalidad de dedicación es a tiempo parcial. Las disciplinas epidemiología, estadísticas, fundamentos de salud pública, políticas, planes y programas de salud, economía de la salud y metodología de la investigación se encuentran presentes en más del 50 % de los programas revisados. Conclusiones: Las buenas prácticas identificadas y consultadas con los egresados aportaron información de utilidad a tener en cuenta para su posible incorporación al actual programa de la Escuela Nacional de Salud Pública.

ABSTRACT Introduction: Postgraduate training in public health is paramount for the development of health services. Only by training professionals with the required quality will it be possible to prevent, address and solve the problems that affect the health of the population. Objective: To identify good practices applicable to the master's program in Public Health at Escuela Nacional de Salud Pública. Methods: A descriptive and cross-sectional study was conducted in 2019-2021, through benchmarking from 50 programs taken as reference. Variables such as study modality and dedication, objectives, graduate´s working profile and taught disciplines, among others, were analyzed. Graduates under that program were consulted for their assessment of the improvement proposals. Results: In 72 % of the studied programs, the training of public health researchers is proposed as the main objective; while, in 81.39 % of them, the graduate profile includes the ability to use research in public health. Of these, 68.88 % are taught on-site and 80.55% are part-time. The disciplines of Epidemiology, Statistics, Fundamentals of Public Health, Health Policies, Plans and Programs, Health Economics and Research Methodology are present in more than 50 % of the reviewed programs. Conclusions: The identified good practices, consulted with graduates, provided useful information to be taken into account for their possible incorporation into the current program of Escuela Nacional de Salud Pública.

RESUMEN Objetivo: Determinar acciones de comunicación de marketing para el posicionamiento de hoteles cubanos en las plataformas digitales. Materiales y métodos: Teóricos, empíricos y estadísticos; además, herramientas como: el benchmarking competitivo, el coeficiente de concordancia de Kendall, el test de bondad Chi cuadrado y el coeficiente de confiabilidad Alfa de Cronbach. Resultados: Para determinar las acciones, se diseñó un procedimiento sustentado en la teoría de la comunicación como elemento del marketing que cuenta con cinco etapas con sus herramientas; lo que posibilitó la determinación de cuatro acciones por las fuerzas competitivas de Porter, veinticinco por las plataformas digitales, dos por los atributos diferenciadores y uno por la definición del público objetivo, en ese orden de prioridad. Conclusiones: Se identificaron limitaciones metodológicas en cuanto al orden de realización de las etapas, su adecuación al contexto de hoteles cubanos, así como en relación al control de las acciones, entretanto se constató un alto porciento de coincidencias entre las etapas que se tomaron como referentes; el procedimiento, a través de cinco etapas dotadas de herramientas e indicaciones, establece un orden lógico a seguir, facilitando la determinación de acciones de comunicación de marketing para el posicionamiento de instalaciones hoteleras cubanas en plataformas digitales; además de la validez práctica del procedimiento con su implementación en un hotel cubano de ciudad que derivó en la propuesta de 32 acciones de comunicación de marketing debidamente estructuradas y ordenadas para el posicionamiento del hotel en plataformas digitales.

ABSTRACT Objective: Determine marketing communication actions for the positioning of Cuban hotels on digital platforms. Materials and methods: Theoretical, empirical and statistical; in addition, tools such as: competitive benchmarking, Kendall's coefficient of agreement, the Chi square goodness test and Cronbach's Alpha reliability coefficient. Results: To determine the actions, a procedure was designed based on the theory of communication as an element of marketing that has five stages with their tools; which made it possible to determine four actions for Porter's competitive forces, twenty-five for digital platforms, two for differentiating attributes and one for the definition of the target audience, in that order of priority. Conclusions: Methodological limitations were identified in terms of the order of carrying out the stages, their adaptation to the context of Cuban hotels, as well as in relation to the control of the actions, meanwhile a high percentage of coincidences was found between the stages that were taken as references; the procedure, through five stages equipped with tools and indications, establishes a logical order to follow, facilitating the determination of marketing communication actions for the positioning of Cuban hotel facilities on digital platforms; the practical validity of the procedure was confirmed with its implementation in a hotel in a Cuban city, which led to the proposal of 32 marketing communication actions duly structured and ordered for the positioning of the hotel on digital platforms.

Abstract: The objective of this research is to conduct a comparative evaluation of various averaging methods for estimating evoked potentials using realistic simulations. Simulated signals are commonly employed to assess pattern recognition algorithms for event-related potential estimation since obtaining gold standard records is challenging. The simulations used are considered realistic because they allow for variations in potential latency, component width, and amplitudes. Background noise is simulated using an 8th order Burg autoregressive model derived from the analysis of a real dataset of auditory evoked potentials. The simulations incorporate actual instrumentation and acquisition channel effects, as well as power line interference. Three averaging methods for estimating the evoked potential waveform are compared: classical consistent average, weighted average, and reported average. The comparisons are conducted in two scenarios: one without artifacts and the other with 20% contamination by artifacts. The results of the comparative evaluation indicate that the trimmed average offers the best trade-off between the estimated signal-to-noise ratio (SNR) value and bias.

BACKGROUND: Mentoring is recommended as a method to assist nurses in developing their leadership roles. Support and mentorship of nursing managers can yield positive results for their organisations because of the leadership quality. The lack of mentorship programmes for newly appointed facility managers has an impact on the management of the facilities. AIM: This study aims to explore and describe how facility managers experience mentorship at primary health care (PHC) facilities. SETTING: Participants were drawn from 11 different PHC facilities falling under the three sub-districts: Emfuleni, mid-Vaal and Lesedi. METHODS: A qualitative exploratory and descriptive research design was employed to achieve the study objectives. A non-probability purposive sampling method was used to select the facility managers from three sub-districts; a signed informed consent to participate in the study was obtained from each participant. A semi-structured interview guide was used to interview purposively selected facility managers. The interviews were audio recorded and subsequently transcribed verbatim. Data were analysed using the content analysis method. Rigour was ensured, and ethical principles measures were applied. RESULTS: Four themes emerged from the results: the experiences on mentorship, views on mentorship, barriers to mentorship and mentorship improvement strategies. CONCLUSION: The study found that there was a lack of formal mentoring in the district, and there is a need for benchmarking and the development of a formal mentorship programme. CONTRIBUTION: The results could be useful in identifying gaps, making recommendations to nursing management and future research. They could further broaden insight into the mentoring needs of facility managers.

South African school children tend to perform poorly in international mathematics and science benchmarking tests such as Trends in International Mathematics and Science Study (TIMSS). Various reasons underpin poor performance, but in this paper, we concern ourselves with curriculum challenges in science by analysing a science topic from a Grade 9 science textbook, the most significant tool for delivering curriculum outside of a teacher. Adopting the model designed by Morris et al. (2016), we analyse a single topic, force, from two science textbooks to ascertain if the abstraction of the topic is explicated and whether it is linked to any real-world application. Our findings indicate that the science concept of force in the textbooks that we analyse is presented in problematic ways that require teachers to elaborate on concepts outside of the text, which may not be possible when such content knowledge is unfamiliar.

Resumo: O artigo tem como objetivo analisar o desempenho da rede hospitalar do Sistema Único de Saúde (SUS) com base nos bancos de dados nacionais do Sistema de Informações Hospitalares (SIH) e do Cadastro Nacional de Estabelecimentos de Saúde (CNES). A pesquisa utilizou um conjunto de indicadores abrangendo a produção de internações, o perfil de atendimentos, a qualidade e o desempenho, associados ao porte dos hospitais e à natureza jurídica. Para análise de dados, empregou-se: a análise da variância com teste de Tukey-Kramer para evidenciar as diferenças entre hospitais públicos e privados; a análise de moderação para verificar o efeito do porte hospitalar; e o modelo Pabon Lasso para integrar os resultados. Estes demonstram que o aumento no número de leitos influencia o desempenho dos indicadores de maneira distinta para hospitais públicos e privados. Hospitais públicos apresentaram ganhos de eficiência de escala superiores com o aumento de leitos e os privados sem fins lucrativos, um desempenho superior no conjunto de indicadores e mais equilibrado nos diferentes portes. A aplicação do modelo Pabon Lasso demonstrou que hospitais pequenos, tanto públicos quanto privados, apresentam baixo desempenho, e evidenciou também que, a partir do médio porte, os hospitais públicos e privados apresentam um bom desempenho. No entanto, cada categoria exibe particularidades em seu perfil de performance, refletindo uma diversidade de práticas e resultados operacionais. Desse modo, o estudo confirma achados anteriores de que o desempenho hospitalar tende a melhorar com o aumento do número de leitos, mas revela também que ele varia significativamente em função da natureza jurídica dessas instituições.

Resumen: Este artículo tiene como objetivo analizar el desempeño de la red hospitalaria del Sistema Único de Salud brasileño (SUS, por sus siglas en portugués) a partir de las bases de datos nacionales del Sistema de Información Hospitalaria (SIH, por sus siglas en portugués) y del Registro Nacional de Establecimientos de Salud (CNES, por sus siglas en portugués). Para ello, se utilizó un conjunto de indicadores que cubren la producción de hospitalizaciones, el perfil de la atención, la calidad y el desempeño asociados con la capacidad de los hospitales y la naturaleza legal. El análisis de varianza con prueba de Tukey-Kramer se utilizó en el análisis de datos para identificar las diferencias entre los hospitales públicos y privados; el análisis de moderación para verificar el efecto de la capacidad del hospital; y el modelo Pabon Lasso para integrar los resultados. Los resultados mostraron que un aumento en la cantidad de camas influye en el desempeño de los indicadores de manera distinta tanto en los hospitales públicos como en los privados. Los hospitales públicos tuvieron mayor ganancia de eficiencia de escala con el aumento de camas, mientras que los hospitales privados sin fines de lucro mostraron un mejor desempeño en el conjunto de indicadores y más equilibrado en las diferentes capacidades. La aplicación del modelo Pabon Lasso demostró que los pequeños hospitales, tanto públicos como privados, tuvieron un bajo desempeño. También mostró que los hospitales públicos o privados de mediano tamaño tuvieron un buen desempeño. Sin embargo, cada categoría guarda particularidades en su perfil de desempeño, reflejando una diversidad de prácticas y resultados operativos. Por lo tanto, los resultados de este estudio confirman los hallazgos previos de que el desempeño hospitalario tiende a mejorar con el aumento del número de camas, pero también revela que hay una variación significativa dependiendo de la naturaleza legal de estas instituciones.

Abstract: This article aims to analyze the performance of the Brazilian Unified National Health System (SUS, acronym in Portuguese) hospital network based on the national databases of the Brazilian Hospital Information System (SIH, acronym in Portuguese) and the Brazilian National Registry of Health Establishments (CNES, acronym in Portuguese). The research used a set of indicators covering the production of admissions, the profile, quality and performance of care, associated with hospital size and legal nature. For data analysis, the Analysis of Variance with Tukey-Kramer test was used to highlight the differences between public and private hospitals, the moderation analysis to verify the effect of hospital size and the Pabon Lasso model to integrate the results. The results show that the increase in the number of beds influences the performance of the indicators differently for public and private hospitals. Public hospitals showed higher gains in scale efficiency with the increase in beds, whereas private non-profit hospitals showed a higher performance in the set of indicators and a more balanced performance in the different sizes. The application of the Pabon Lasso model showed that small hospitals, both public and private, perform poorly. It also showed that from medium-sized onwards, public and private hospitals perform well. However, each category displays particularities in its performance profile, reflecting a diversity of practices and operational results. This study thus confirms previous findings that hospital performance tends to improve as the number of beds increases, but also reveals that it varies significantly depending on the legal nature of these institutions.

RESUMO Objetivos Analisar a influência da pandemia de covid-19 na produtividade dos hospitais gerais de ensino do Brasil, por região e natureza jurídica, e propor parâmetros assistenciais. Métodos Estudo observacional por modelagem matemática com análise envoltória de dados e índice de Malmquist, utilizando dados de recursos e produção assistencial antes (2019) e durante (2021) a pandemia. Resultados Foram analisados 149 hospitais gerais de ensino, 32 dos quais foram considerados eficientes. Houve queda da produtividade em todas regiões e naturezas jurídicas. Para que todos os hospitais ineficientes atinjam a fronteira de eficiência gerada pela modelagem, há necessidade de aumento da produção em 2.205.856 (96,5%) internações e 872.264 (107,4%) cirurgias. Conclusão A queda na produtividade hospitalar decorreu do compromisso social dos hospitais durante a pandemia, com modificação do padrão de assistência. O modelo matemático utilizado permite gerar parâmetros para recuperação assistencial eficiente depois de finalizada emergência sanitária, podendo ser aplicado para planejamento hospitalar.

RESUMEN Objetivos Analizar la influencia de la pandemia de COVID-19 en la productividad de hospitales generales docentes de Brasil, por región y naturaleza jurídica, y proponer parámetros asistenciales. Métodos Estudio observacional mediante modelamiento matemático con análisis envolvente de datos e índice de Malmquist, utilizando datos de recursos y producción asistencial antes (2019) y durante (2021) la pandemia. Resultados Se analizaron 149 hospitales docentes, 32 se consideraron eficientes. Hubo una baja productividad en todas las regiones y naturalezas jurídicas. Para que todos los hospitales ineficientes alcancen la frontera de eficiencia generada por el modelamiento, es necesario aumentar la producción en 2.205.856 (96,5%) hospitalizaciones y 872.264 (107,4%) cirugías. Conclusión La caída de la productividad hospitalaria fue consecuencia del compromiso social de los hospitales durante la pandemia, con cambios en el estándar de atención. El modelo matemático utilizado permite generar parámetros para una recuperación eficiente de atención y puede aplicarse a planificación hospitalaria.

ABSTRACT Objectives To analyze the influence of the COVID-19 pandemic on the productivity of general teaching hospitals in Brazil, by region and legal entity, and to propose parameters of care. Methods This was an observational study by means of mathematical modeling with data envelopment analysis and Malmquist index, using data on inputs and healthcare output before (2019) and during (2021) the pandemic. Results A total of 149 general teaching hospitals were analyzed, 32 of which were considered efficient. There was a decrease in productivity across all regions and legal entity. To bring all inefficient hospitals to the efficiency frontier generated by the model, there is a need to increase output by 2,205,856 (96.5%) hospitalizations and 872,264 (107.4%) surgeries. Conclusion The decline in hospital productivity resulted from the social commitment of hospitals during the pandemic, with a change in the care delivery pattern. The mathematical model used allows for the generation of parameters to facilitate the efficient recovery of care services after the end of public health emergency, and can be applied to hospital planning.

Resumo O objetivo deste artigo é descrever e analisar a produção de procedimentos realizados pelas centrais de regulação e recursos móveis do SAMU 192 entre 2015 e 2019, segundo frequência, indicadores de base populacional e produtividade diária, estabelecendo um indicador de performance. Estudo censitário, observacional e descritivo, realizado com dados de produção, extraídos do Sistema de Informações Ambulatoriais, complementados com dados do Instituto Brasileiro de Geografia e Estatística e do Ministério da Saúde. Os 116,8 milhões de procedimentos analisados decorrem de 28,5% de aumento no período enquanto a população coberta e os recursos móveis cresceram 9,7% e 14,4% respectivamente. Cada mil habitantes cobertos geraram 109,8 chamadas, resultando em 24,0 envios de recursos móveis anuais. Diariamente, unidades de suporte básico realizaram 3,3 atendimentos e 0,5 transporte, enquanto o suporte avançado realizou 2,7 atendimentos e 0,9 transporte. A produção de procedimentos excedeu o crescimento de população coberta, com variações entre estados, alta produção em áreas populosas, forte presença do suporte básico e elevação dos transportes, todavia a produtividade nacional mostrou-se inferior a internacional.

Abstract The scope of this article is to describe and analyze the production of approved procedures carried out by regulation centers and mobile resources of SAMU 192 between 2015 and 2019, according to frequency, population-based indicators, and daily productivity, to establish a performance indicator. It consisted of an observational and descriptive census study, with production data drawn from the Outpatient Information System, and population data from the Brazilian Institute of Geography and Statistics and information from the Ministry of Health. The 116.8 million procedures analyzed resulted from a 28.5% increase in the period, while the population covered and mobile resources grew by 9.7% and 14.4%, respectively. Every 1,000 inhabitants covered generated 109.8 calls, resulting in 24.0 mobile resource dispatches per year. Basic support units performed 3.3 consultations, and 0.5 transfers daily, while advanced support performed 2.7 consultations and 0.9 transfers. The production of procedures exceeded the increase in the population covered, with variations between states, high incidence in populated areas, a strong presence of basic support and an increase in transfers, although national productivity was seen to be lower than international productivity.

RESUMEN Introducción: La búsqueda continua de la mejora de la atención de enfermería conlleva la aplicación de instrumentos contemporáneos. Objetivo: Identificar buenas prácticas para la mejora de procesos relacionados con la calidad de la atención de enfermería en el Instituto Cubano de Oftalmología “Ramón Pando Ferrer”. Métodos: Se realizó un proyecto de desarrollo tecnológico, descriptivo, que empleó las tecnologías gerenciales de referenciación competitiva y gestión por procesos entre el 2018-2021. La institución de referencia fue la Clínica Central “Cira García”. El grupo de estudio quedó conformado por personal vinculado a los procesos. Para la recolección de la información se diseñaron 10 instrumentos que se validaron con expertos por el método de Barraza. El estudio de los procesos de urgencias, esterilización y hospitalización se realizó en dos momentos: en el “Ramón Pando Ferrer” con el empleo de la metodología Lean y en la institución de referencia para conocer las buenas prácticas. Para el procesamiento de la información se utilizó la metodología planteada por Rodríguez y de Souza, para ello se tuvo en cuenta el referencial teórico del enfoque Lean y el de la referenciación competitiva. Resultados: Se identificaron mudas como espera, movimiento, sobreprocesamiento y defecto, se confeccionaron los diagramas de flujo y se identificaron indicadores de calidad. Conclusión: El procedimiento utilizado mostró resultados satisfactorios que evidencian la aplicabilidad de la integración de tecnologías en la identificación e incorporación de buenas prácticas.

ABSTRACT Introduction: The continuous search for the improvement of nursing care leads to the application of contemporary instruments. Objective: To identify good practices for the improvement of processes related to the quality of nursing care at Instituto Cubano de Oftalmología Ramón Pando Ferrer. Methods: A descriptive technological development project was carried out between 2018-2021, using the managerial technologies of competitive benchmarking and process management. The reference institution was Clínica Central Cira García. The study group was made up of personnel involved in the processes. For the collection of information, 10 instruments were designed and validated with experts by the Barraza method. The study of the emergency, sterilization and hospitalization processes was carried out in two stages: at the Ramón Pando Ferrer institution, with the use of the Lean methodology; and at the reference institution, to learn about good practices. The methodology proposed by Rodriguez and de Souza was used to process the information; also taking into account the theoretical referential of the Lean approach and that of competitive benchmarking. Results: Shortfalls were identified, such as waiting, movement, overprocessing and defect. Flow charts were drawn up and quality indicators were identified. Conclusion: The used procedure showed satisfactory results that demonstrate the applicability of integrating technologies in the identification and incorporation of good practices.

RESUMEN Introducción: Las acciones de enfermería en el consultorio médico de la familia son determinantes para el Programa de Detección Precoz del Cáncer Cervicouterino. Objetivo: Describir buenas prácticas incorporadas a las acciones de enfermería que se realizan en el consultorio 9 del policlínico “Felo Echezarreta Mulkay” a partir del estudio de un consultorio de referencia con buenos resultados. Métodos: Se realizó una investigación descriptiva de corte transversal en el período 2019-2020. Se utilizó la referenciación competitiva y el estudio de proceso en dos consultorios médicos, el 9 con reservas de mejora y el 13 (referencia). El grupo de estudio estuvo constituido por cuatro profesionales de salud, cuatro brigadistas sanitarias y 48 mujeres con citología positiva. Se aplicaron entrevistas y un cuestionario. Se realizó análisis cualitativo, temático y de contenido de la información y se identificaron categorías a priori a partir del referencial teórico. Resultados: Entre las buenas prácticas para la mejora del consultorio 9, se encuentran la vinculación con centros laborales de las mujeres, el uso de redes sociales como WhatsApp y Messenger, la vinculación de jubiladas en apoyo a las brigadistas sanitarias. Conclusiones: El estudio del consultorio de referencia aportó evidencia de prácticas aplicables en el consultorio 9 para la mejora de sus resultados, así como de la aplicabilidad de la integración de la referenciación competitiva y el estudio de procesos en la incorporación de buenas prácticas para la mejora de las acciones de enfermería vinculadas al Programa de Detección Precoz del Cáncer Cervicouterino.

ABSTRACT Introduction: Nursing actions in the family doctor's office are determinant for the Cervical Cancer Early Detection Program. Objective: To describe good practices incorporated into the nursing actions performed at the family doctor’s office number 9 of Policlínico Felo Echezarreta Mulkay, based on the study of a reference clinic with good results. Methods: A descriptive and cross-sectional research was conducted in the period 2019-2020. Competitive benchmarking and process study was used in two medical offices: the number 9, with improvement reservations; and the number 13, as a reference family medical office. The study group consisted of 4 health professionals, 4 health brigade members, and 48 women with positive Papanicolau test. Interviews and a questionnaire were applied. A qualitative, thematic and content analysis of the information was carried out, as well as a priori categories were identified from the theoretical referential. Results: Among the good practices for the improvement of the family medical office number 9 are the association of women with work centers, the use of social networks such as WhatsApp and Messenger, as well as the association of retired women in support of the health brigade members. Conclusions: The study of the reference family medical office provided evidence of practices applicable in the family medical office number 9 for improving its results, as well as evidence of the applicability of integrating competitive benchmarking and the study of processes in the incorporation of good practices for improving nursing actions linked to the Cervical Cancer Early Detection Program.

Apesar dos avanços significativos na terapia antirretroviral (TARV) para o HIV, a adesão continua sendo um desafio. Embora o Brasil tenha escalas validadas para a adesão ao tratamento, poucas avaliam as barreiras de adesão ao tratamento. Isso ressalta a necessidade de questionários validados sobre as barreiras de adesão para identificar os desafios específicos dos pacientes e aprimorar as estratégias de adesão à TARV. Este estudo teve como objetivo adaptar e validar o Adherence Barriers Questionnaire for HIV Patients on Antiretroviral Therapy (ABQ-HIV), um questionário de 17 itens que avalia as barreiras de adesão à TARV, para o contexto brasileiro e avaliar suas propriedades psicométricas em pacientes com HIV. Foi realizado um estudo metodológico sobre as propriedades psicométricas e a estrutura fatorial do ABQ-HIV. O estudo seguiu sete etapas: consentimento dos autores originais, duas traduções, síntese das traduções, comitê de especialistas, retrotradução, pré-teste e teste de confiabilidade. Um comitê de especialistas obteve um alto índice de validade de conteúdo (0,93). A amostra do estudo foi de 230 adultos com HIV, com idade média (IQR) de 37,0 (29,3-45,0) anos, e 52,2% eram homens. A análise fatorial exploratória com uma estrutura de três subescalas de 17 itens mostrou boa interpretabilidade (esfericidade de Bartlett (1167,2 [136]; p < 0,001) e Kaiser-Meyer-Olkin = 0,602) e consistência interna (α = 0,76; Ω = 0,76). Os indicadores de ajuste foram satisfatórios (χ2 = 89,931; df = 88; p > 0,005; RMSEA = 0,010; RMSR = 0,07; CFI = 0,996; GFI = 0,940; AGFI = 0,907; NNFI = 0,995). A versão brasileira do ABQ-HIV é um instrumento em potencial para identificar barreiras específicas à adesão à TARV em adultos vivendo com HIV no Brasil.

A pesar de los avances significativos de la terapia antirretroviral (TARV) para el VIH, la adherencia sigue siendo un desafío. Aunque Brasil ha validado las escalas de adherencia al tratamiento, pocas escalas evalúan las barreras de adherencia al tratamiento. Esto subraya la necesidad de cuestionarios validados sobre las barreras de adherencia para identificar los desafíos específicos de los pacientes y mejorar las estrategias de adherencia a la TARV. Este estudio tuvo como objetivo adaptar y validar el Adherence Barriers Questionnaire for HIV Patients on Antiretroviral Therapy (ABQ-VIH), un cuestionario de 17 ítems que evalúa las barreras para la adherencia a la TARV para el contexto brasileño, y evaluar sus propiedades psicométricas en pacientes con VIH. Se realizó un estudio metodológico sobre las propiedades psicométricas y la estructura factorial del ABQ-VIH. Este estudio consistió en siete etapas: consentimiento de los autores originales, dos traducciones, síntesis de traducciones, comité de expertos, retrotraducción, prueba previa y prueba de confiabilidad. Un comité de expertos obtuvo un alto índice de validez de contenido (0,93). La muestra del estudio estuvo conformada de 230 adultos con VIH, con una edad media (IQR) de 37,0 (29,3-45,0) años, y el 52,2% de ellos son del sexo masculino. El análisis factorial exploratorio con una estructura de tres subescalas de 17 ítems mostró una buena interpretabilidad (esfericidad de Bartlett (1167,2 [136]; p < 0,001) y Kaiser-Meyer-Olkin = 0,602) y consistencia interna (α = 0,76; Ω = 0,76). Los indicadores de ajuste fueron satisfactorios (χ2 = 89,931; df = 88; p > 0,005; RMSEA = 0,010; RMSR = 0,07; CFI = 0,996; GFI = 0,940; AGFI = 0,907; NNFI = 0,995). La versión brasileña de ABQ-VIH es una potencial herramienta para identificar barreras específicas en la adherencia a la TARV en adultos que viven con VIH en Brasil.

Despite significant advancements in antiretroviral therapy (ART) for HIV, adherence remains a challenge. While Brazil has validated scales for treatment adherence, few assess treatment adherence barriers. This underscores the necessity for validated questionnaires on adherence barriers to identify patient-specific challenges and enhance strategies for ART adherence. This study aimed to adapt and validate the Adherence Barriers Questionnaire for HIV Patients on Antiretroviral Therapy (ABQ-HIV), a 17-item questionnaire assessing the adherence barriers to ART, for the Brazilian context and to evaluate its psychometric properties in HIV patients. A methodological study on the psychometric properties and factorial structure of ABQ-HIV was conducted. The study followed seven steps: consent of the original authors, two translations, synthesis of the translations, expert committee, back-translation, pre-test, and reliability test. A high content validity index (0.93) was achieved with the expert committee. The study sample consisted of 230 adults with HIV, with 37.0 (29.3-45.0) years as the median age (IQR), and 52.2% were male. The exploratory factor analysis with a three subscales structure of 17 items showed good interpretability (Bartlett’s sphericity (1167.2 [136]; p < 0.001) and Kaiser-Meyer-Olkin = 0.602) and internal consistency (α = 0.76; Ω = 0.76). The fit indicators were satisfactory (χ2 = 89.931; df = 88; p > 0.005; RMSEA = 0.010; RMSR = 0.07; CFI = 0.996; GFI = 0.940; AGFI = 0.907; NNFI = 0.995). The Brazilian version of ABQ-HIV is a potential instrument for identifying specific barriers to adherence to ART in adults living with HIV in Brazil.