1. Focus on health needs and comprehensive care |
Health needs - historically constructed - understood as complex phenomena that encompass biological, psychosocial and cultural dimensions. Comprehensive care as an articulated response from professionals, services and different logics to meet individual and collective health needs. Egalitarian assistance regardless of age, sex, religion, sexual option, political option or socioeconomic and cultural insertion. Professionals and managers who agree on common objectives and share responsibilities, aiming to provide comprehensive care for people and populations. |
10.00 |
0.00 |
2. Focus on outcomes that add value to health and life |
Employment of standards to improve clinical efficiency, efficacy and effectiveness, aiming to reduce the use of unnecessary resources and considering the value added to users’ quality of life and health. Use of outcome indicators targeted at the promotion of healthy lifestyles and risk, vulnerability and damage reduction. |
8.14 |
1.57 |
3. Focus on and responsibility for collective interests |
Decision-making oriented by the guidelines of health systems, through the utilization of different perspectives. Accounting in the services/institutions involved in the healthcare network. Guarantee of formal spaces for distinct groups of interest and spaces where they can speak and be heard. Transparency in communication with and provision of information for people, populations, the media and society. Promotion of social control by means of representative colleges. |
8.14 |
2.41 |
4. Obtention of the maximum benefit, without causing damages, in healthcare. |
Reduction in the risk inherent in the care process and increase in the safety of professionals and users of health services. Reduction in damage to the lowest possible level. Variability reduction in clinical decisions and optimization of outcomes based on the best evidences available. |
9.57 |
0.79 |
5. Articulation of management and clinical-epidemiological rationalities |
Incorporation of the clinical-epidemiological and management perspectives into care production. Implementation of processes to monitor clinical decisions with the participation of the individuals involved, promoting professionals’ and teams’ autonomy and accountability. Health professionals’ competence profiles including management capacities as a strategy to provide better responses for people’s and societies’ health needs. |
8.43 |
1.13 |
6. Articulation and legitimation of different health practices and types of knowledge to face the complexity of health problems |
Recognition of the values of patients, users and family, aiming at greater effectiveness. Development of therapeutic plans guided by health needs. Teaching-service partnership to act in the education and qualification of health professionals, articulating the different views of the individuals involved. Multiprofessional teamwork with an interdisciplinary approach. Dialog with popular knowledge in healthcare. Articulation with integrative and complementary practices. |
8.00 |
3.65 |
7. Power sharing and co-accountability between services and professionals that act jointly in care management |
Responsibility for care shared by professionals, patients, users, families, community and managers. Decision-making process of care networks with participation of the services/professionals involved and managerial mechanisms that promote co-accountability and articulation among different environments and levels of care. Accessible, opportune and effective information and communication systems for professionals and services aiming at the qualification of care. Consensual definition of the responsibility of each point of the healthcare network in the promotion of comprehensive care targeted at collective interests. Establishment of articulated cooperation processes among actors (including users) and institutions involved in the healthcare network. Incentive to participation and stimulation of professionals’ autonomy and creativity in the collective construction of care plans. Teamwork, respecting different types of knowledge and potentialities. |
7.86 |
3.67 |
8. Recognition of the other as a legitimate subject in shared decision-making |
Patient/user as subject in care management, with legitimate opinions and desires. Decisions about care shared in the team. Educational actions grounded on respect for and acceptance of people as legitimate subjects in the decision-making about their own health and way of dealing with life. |
7.57 |
3.82 |
9. Adoption of reflectiveness, in which thought and action co-exist and influence one another in the reproduction and transformation of practices |
Reflective dialog between clinical management actions and information about the reality where these actions are inserted. Understanding clinical management activities as activities that can be reviewed in light of new information. Permanent assessment and reformulation of clinical management practices in light of new information. |
8.00 |
3.70 |
10. Recognition of people’s and organizations’ capacity to learn how to learn in view of the incompleteness of knowledge |
Recognition of the importance of innovation and improvement in care processes. Recognition of the effort to overcome difficulties or limitations in health work. Promotion of patients’, family’s and teams’ autonomy in health production. Amplified investigation of health needs with formulation of questions and hypotheses in the identification of problems and care production. Development of educational practices that respect and consider the previous knowledge of all the people involved. Educational practices that take into account the individual sociocultural context and the service’s, institution’s or network’s context. Knowledge and learning production based on the reality of health work and on problems of the daily routine, with encouragement to critical and reflective thought and transformation of practices. Generation and dissemination of knowledge that is relevant to the provision of healthcare for people and to the quality of the produced services. Utilization of mistakes and successes as subsidies to improve performance. Facilitation of access to information and a communication policy that promotes communication channels between professionals and services of the healthcare network. Development of clinical audit in the perspective of a problematizing learning. |
9.83 |
0.41 |