ABSTRACT Objective To reduce surgical center idleness by analyzing the competitive structure of the surgical center in a hospital, and thereby generate value in operations and increase hospital revenue. Methods The study used qualitative and quantitative methods and an action research approach involving the surgical center leadership of a small private specialized hospital in southeastern Brazil. We used the Strengths, Weaknesses, Opportunities, and Threats or SWOT tool to analyze the competitive structure of the surgical center and then implemented interventions as proposed by the science of improvement method proposed by the Institute of Healthcare Improvement. Results By applying the SWOT tool, we identified a concentration of surgeries in the specialty of Otolaryngology and the need to establish a health management system to reduce the idleness of the operating rooms. Based on subsequent intervention, procedures from other specialties were inserted that increased surgical production by 2.62X, reduced idleness by 67.84%, and increased revenue by over US$ 276,609.87 in 2018 compared to the previous year 2017. Conclusion Investing in quality, surgical schedule management, and inducting new surgeons to the clinical staff resulted in decreased surgical idleness, increased production, better uniformity in scheduling, and increased revenue, while costs remained below the linear trend, allowing for increased profits.

Resumo Os estudos hidrológicos em bacias experimentais têm sido realizados devido à necessidade de compreensão dos processos que controlam o movimento da água e sedimentos e seus impactos na disponibilidade e qualidade das águas. Os modelos hidrológicos são ferramentas com alto potencial para a simulação de cenários hipotéticos em diferentes escalas. Assim, o objetivo desse trabalho foi avaliar a eficácia do modelo SWAT para representação do fluxo hidrossedimentológico em uma bacia hidrográfica catarinense a partir dos procedimentos usuais de calibração e validação. O estudo foi realizado na bacia do rio Camboriú com uma área de 195 km². Na análise do desempenho do modelo comparou-se os dados de vazão e sólidos transportados medidos e simulados na seção de controle. Os resultados obtidos atestaram a capacidade do SWAT para as simulações hidrossedimentológicas nessa bacia. Entretanto, foi preciso realizar a sua calibração para que as simulações atendessem os critérios de qualidade estabelecidos. Após a calibração, observou-se uma tendência de subestimativa das variáveis simuladas, porém, dentro de limites aceitáveis. Além disso, foi possível comprovar a eficiência do modelo para simulação das curvas de permanência das variáveis estudadas, caracterizando o SWAT como uma ferramenta importante na gestão de bacias hidrográficas como a do rio Camboriú.

Abstract Hydrological studies in experimental basins have been widely carried out in order to understand the processes that control the movement of water and sediment and their impact on the availability and quality of water. For this purpose, the hydrological models are used to simulate hypothetical scenarios at different spatial and temporal scales. The goal of this study was to evaluate the efficiency of the SWAT model to represent the hydrosedimentological flow in a Santa Catarina river basin by applying the usual procedures for calibration and validation. The study was conducted in the basin of the Camboriú River (BHRC), which has an area of 195 km². For model performance analysis purposes, the flow and solids transported to the control section studied and the simulated data were compared. The results obtained have proven the efficiency of SWAT hydrosedimentological simulations in the BHRC. However, it was necessary to calibrate the model so that the simulations would comply with the established quality criteria. Though it occurred within acceptable limits, there was a tendency of underestimation of the simulated variables after calibration. Additionally, it was possible to verify the efficiency of the model for simulating the retention curves of the analyzed variables, thus emphasizing the SWAT as an important tool for river basin management such as the basin of Camboriú River.