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Complex systems design based on actual system functioning: Coping with variability in a national water ambulances service.
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- Author(s): Bellas, Hugo Cesar; Arcuri, Rodrigo; Ferreira, Denise de Souza; Bulhões, Bárbara; Masson, Letícia; Vidal, Mario Cesar Rodríguez; de Carvalho, Paulo Victor Rodrigues; Jatobá, Alessandro
- Source:
Work; 2022 Supplement, Vol. 73, pS265-S277, 13p, 1 Color Photograph, 1 Black and White Photograph, 3 Charts, 2 Graphs- Subject Terms:
WORK environment; UNIFORMS; RESEARCH; GLOBAL Positioning System; ORGANIZATIONAL structure; AMBULANCES; RESEARCH methodology; LOCAL government; CROSS-sectional method; SYSTEMS design; WATER; INTERVIEWING; EXECUTIVES; ETHNOLOGY research; FIELDWORK (Educational method); EMERGENCY medical services; DECISION making; COMMUNICATION; HEALTH care teams; RESEARCH funding; MANAGEMENT; PSYCHOLOGICAL adaptation; CONTENT analysis; PERSONAL protective equipment; STATISTICAL sampling; PSYCHOLOGICAL resilience; PERSONNEL management - Source:
- Additional Information
- Subject Terms:
- Abstract: BACKGROUND: In Brazil, the Mobile Emergency Medical Service (SAMU) is a model of mobile assistance and care for emergencies standardized throughout the country. The water ambulance service within the SAMU operates in riverside and coastal areas, and faces challenges and peculiarities that increase the complexity of providing a high-quality and safe emergency care service. OBJECTIVE: To develop organizational design guidelines aiming to improve resilient performance of complex systems, with an application to riverine and coastal mobile emergency care in Brazil. METHODS: Data collection followed an ethnographic approach. Fieldwork was carried in a participatory way, based on worksite technical description, semi-structured interviews with managers and emergency care teams' professionals, and work observation whenever possible. Five regional SAMU coordinations were visited. Data coding employed content analysis and grouped data excerpts according to concepts of capacity and demand. Interfaces were identified between demand and capacity elements and adaptations led by system agents, orienting the proposal of guidelines for organizational design as solutions to face the verified gaps. RESULTS: Design guidelines produced spanned composition and training of both intervention teams and dispatch central teams, uniforms and personal protective equipment (PPE), decentralized water bases, means of communication, intervention protocols, biosafety and inter-sector actions. CONCLUSION: The approach enabled framing and assessment of specific design elements according to resilience engineering concepts, which in turn showed paths for improving the service and reconciling work-as-imagined and actual system functioning. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Work is the property of IOS Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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