Lisbon’s Assistance Network before All Saints Hospital

All Saints Royal Hospital: Lisbon and Public Health, 2021

Marques-Vieira, C.; Sousa, L. & Baixinho, C.L. Cuidados de enfermagem à pessoa com doença aguda (pp. 963-876)., 2021

Os desafios atuais aos sistemas de saúde e à organização dos cuidados, tornando-os mais seguros, tem imposto alterações ao processo de continuidade de cuidados entre o hospital e a comunidade. A diminuição da demora média de internamento numa população com pluripatologia e polimedicada é um claro desafio a repensar os modos de fazer para evitar a desfragmentação dos cuidados. Os autores são unânimes ao advogar que as dificuldades na comunicação e articulação entre os cuidados de saúde primários e diferenciados são um obstáculo para responder de uma forma integrada às necessidades da população com problemas complexos de saúde-doença. Na realidade não garantimos a continuidade de cuidados quando não se justifica o internamento hospitalar embora as pessoas ainda não estejam nas melhores condições para regressar a casa (Gonçalves, 2010; Duarte, 2014). Um estudo recente concluiu mesmo que a partilha de informação entre os serviços de saúde em Portugal é inexistente ou escassa (Mendes et al., 2017), com implicações claras na qualidade dos serviços prestados à população. Esta questão ...

"Abstract Proposal for Paper at 40 Years Society for the Social History of Medicine – Annual Conference 2010 Knowledge, Ethics and Representations of Medicine and Health: Historical Perspectives 8-11 July 2010, Durham and Newcastle, UK Organised by the Northern Centre for the History of Medicine Sponsored by the Wellcome Trust, London, and the Society for the Social History of Medicine The Civil Hospitals of Lisbon: the launch of the first urban health coordinating body in Portugal (1913-1927) To define the origins of the social politics concerning the health in Portugal, the Civil Hospitals of Lisbon (Hospitais Civis de Lisboa) acquired a real importance in the first reforms taken among the health in the country. Starting to implement several measures after the political change which came with the declaration of the Republic in 1910, the governments interfered with the regulation and organization of the health units of the country’s capital. With this, the State defined for the first time a coordinating body which, as a matter of fact, continued some of the structure that pre-existed in the Monarchy with the direction of the São José Royal Hospital and Outbuildings (Hospital Real de São José e Anexos) assured by the hospital matron (enfermeiro-mor) with a informal connexion with the directors of its several units. The structure maintained this scheme for almost three years – with the loss of the title Royal for obvious reasons – when the government decided to create an autonomous management for the medical assistance, administration and accountancy in the new Civil Hospitals of Lisbon, giving the responsibility of the direction in terms of medical, hygiene and pharmacy procedures to a Medical Commission (September 9, 1913), soon changed into a Directive Commission (November 27, 1914) with the directors of the health units. Its major competences were the definition of the internal regulations conserving its autonomy, the transfer of the amounts of the State budget and the vote of the annual budgets and the approval of annual amounts for the Hospitals` management. It was the first major health directive body in Portugal which was a privileged spot of the definitions of the health politics in that period."

RECOVERING THE PORTUGUESE NATIONAL HEALTH SERVICE AND THE HEALTH OF THE PORTUGUESE POPULATION (Atena Editora), 2023

The Portuguese National Health Service (PNHS) was created in 1979 and is financed by the state, in order to provide access to quality, universal and generally free healthcare. The SNS is made up of a network of public hospitals, health centers and other health units that from January 2024 onward will be reconfigured into Local Health Units. Clinical governance is an indispensable practice to achieve the highest standards of excellence in the healthcare provided and to generate value, reducing waste and increasing the quality of processes. It is urgent to use the PNHS scarce resources appropriately and maximize the value of human capital, in order to guarantee access to users of the best possible healthcare, integrating emerging changes.

All Saints Royal Hospital: the City and Public Health, Lisboa, Câmara Municipal de Lisboa, 297-301, 2021

Founded long ago in the late 15th century, All Saints Hospital and the Misericórdia [House of Mercy] of Lisbon were united on June 27, 1564, after the confraternity accepted the invitation from the kingdom’s regent, Cardinal Infante D. Henrique, to govern his esprital de todos os sanctos da dita cidade como convem ao serviço de nosso Senhor e ao meu [All Saints Hospital in said city as befits the service of our Lord and mine] (Pereira, 1998, p. 252). Two centuries later, on January 31, 1775, secretary of state of the kingdom Sebastião José de Carvalho e Melo, the future Count of Oeiras and Marquis of Pombal, proclaimed the restauração e nova fundação da Santa Casa da Misericórdia de Lisboa e dos hospitais dos enfermos e inocentes expostos [restoration and new foundation of the Lisbon Misericórdia and of the hospitals for the sick and foundlings] (ANTT, Ministério do Reino, Livro 376, f. 16), imprinting his mark of reform upon the two institutions that continued to dominate relief work in the country, by then symbolically installed in the buildings of the Society of Jesus: the church and house of São Roque and the College of Santo Antão-o-Novo. The new stage in the life of the hospital and Misericórdia had been set to coincide with the beginning of the year according to the secretary of state’s wishes, beginning with the transfer of the sick from All Saints to Santo Antão, but it was postponed until April due to delays in the works (ANTT, Ministério do Reino, Livro 376, fs. 79-79v.; Hospital de São José, Livro 944, n.º 5). However, it was not in fact a reunification, as suggested by Victor Ribeiro (Ribeiro, 1998, p. 124), because the confraternity had not been dispossessed of the hospital. Rather, it was a decisive moment in a transformation underway since the 1755 earthquake, a project completed the following November, with the abolition of the Misericórdia of Lisbon’s 1618 constitution. In this article, we intend to reflect on the evolving relationship between All Saints Hospital and the Misericórdia of Lisbon during the government of Sebastião José de Carvalho e Melo as secretary of state of the kingdom. At a time characterized by state control, we intend to outline the secretary of state’s policies regarding these two institutions and evaluate their effectiveness. To this end, we use some information from previous studies (Abreu, 2013, pp. 28-43) on the financial organization of the new relief structure that dictated the end of All Saints and, in light of the documentation produced by the hospital,reanalyse the Breve Memorial [Brief Memoir] by the chief nurse, Jorge Francisco Machado de Mendonça Eça Castro Vasconcelos and Magalhães (Mendonça, 1761).

2013

Changes in the morbidity and mortality profile from chronic non-communicable diseases affect the urgency/emergency care services. We aimed to characterize the profile of emergency clinical care, according to demographic and epidemiological variables and length of stay in a teaching hospital in the interior of São Paulo, 2007. This is a descriptive, exploratory and documentary research that used official data, analyzed by descriptive statistics, discussed based on the theoretical framework of reorganization of urgency and emergency clinical care. In this period there were 5,285 clinical assistances, most were male (54.1%), with elementary education (73.9%), aged from 18 to 59 years (62.8%). Diseases of the circulatory system were the most frequent and the average length of stay in the unit was less than 6 hours (39.8%). The characterization of clinical care in the urgency/emergency service enables the work organization in the study unit and in the hospital. Descriptors: Emergency Med...

Cogitare Enfermagem, 2018

Objective: Analyze the structure of the social network of mothers/caregivers during the hospitalization of their child. Method: Qualitative study in a pediatric hospital in Rio de Janeiro. Ten mothers/caregivers were interviewed from February to December 2015. A theoretical-methodological framework and social network analysis by Lia Sanicola were used. Results: The primary networks were medium-sized, with strong bonds, particularly the networks for children being hospitalized for the first time. They were more numerous than those for children who had been previously hospitalized. The following secondary networks were mentioned: formal, third sector and market. No mixed and informal networks were mentioned. Conclusion: Extended and frequent hospital stays of children affect the dynamics of social networks. Over the course of hospital stays, they become smaller, but the bonds within them are strengthened. The primary healthcare network was not mentioned, due to the fact that the children had been diagnosed with chronic diseases since birth.

Ciência & Saúde Coletiva, 2007

Brazil's hospital system: status and challenges The care provided by the hospital system is an important aspect of Brazil's National Health System (SUS) and its Supplementary Health System. Absorbing a large proportion of its financial, material and human resources, it responds to the healthcare needs of society, in parallel to more specific demands with high political and social visibility. Brazilian citizens perceive shortfalls in hospital care more clearly than the flaws of other types of social welfare, as they are the repositories of people's hopes and desires in times of trouble. In parallel to the expansion of basic, medium and highly complex outpatient care, a steady stream of quantitative and qualitative alterations to diagnostic procedures and treatments, with shifts in the demographic, epidemiological, social, economic and cultural profiles of the population, are important aspects of the changes taking place in the financial and technical care models for hospitals. These changes have triggered crises and instability in hospital and nonhospital services, as well as healthcare systems in general and public opinion. It is becoming increasingly important and urgent to develop an in-depth understanding of the complex nature of these crises and the proposed alternatives for dealing with today's challenges. The issue of hospital care is open to multiple approaches. The concept guiding this special edition is the presentation of papers written by practitioners, most of whom are (or have been) engaged in hospital management at differing levels and in various sectors. By presenting their views of the specific characteristics of public and private management, university services, public-private partnerships, government financing and the production of hospital information, this enterprise attempts to supplement the output on topics in the Collective Health field. This is not a matter of claiming greater importance for hospital care, to the detriment of primary or outpatient facilities, but rather strives for closer integration / interaction among the many different layers and players of Brazil's healthcare systems. Fine-tuning their respective competencies, it attempts to build up a system that is steadily more able to respond effectively and accurately to the needs of the Brazilian people and society as a whole. These discussion papers exhaustively chart the current (2007) issues affecting the hospital system in Brazil, supplemented by the discussants. Deliberate efforts have been made to include papers with widely differing approaches, views and topics, offering in-depth analyses of relevant, controversial or little-known aspects. We thank the editors of Ciência & Saúde Coletiva for the opportunity to bring this enterprise to fruition, also expressing our gratitude to all the authors for their valuable contributions. We hope that this special issue will appeal to the widely varied universe of the readers of this journal, fostering the appearance of new prospects and innovative proposals for the hospital system in Brazil.

Health systems in transition, 2011

Acta Médica Portuguesa