OBJECTIVE: The strategic démarche approach questions the dissociation between the strategic direction and the operational level of an institution, in search of a continuous and flexible planning of projects. The objective of the study is to describe the application of this approach in the evaluation of a hospital unit. METHODOLOGICAL PROCEDURES: The approach was adapted to and applied at a mother and child unit of a public state hospital in the municipality of Serra, Northeastern Brazil. Hospital management analysis was conducted with the indirect involvement of institutional agents, who acted as key informants from April to July, 2006. Besides the meetings with key informants, data was also collected from the following sources for the year 2005: Inpatient records from the obstetric center, maternity and nursery wards, statistical report of the perinatal outcomes from the mother and child unit; records from the ambulatory care unit for breastfeeding. RESULTS: The most valued segments were: The Neonatal Intensive Care Unit, The Obstetric Surgery Center, and The Obstetric Center. The Program of Humanized Care for the Mother and Newborn was also highly valued. The main weaknesses pointed out were the low level of articulation with the network (partnership with municipal network); the lack of hospital beds and technological investment necessary for responding adequately to the demand; excessive professional rotation due to temporary assignments and the deficient implementation of the humanization policies, compromising the strategic success factors of the segments. CONCLUSIONS: The results indicate the method's potential for discussing the hospital mission and performing analysis of hospital management, pointing out strategies for improving the quality and competitiveness of the segments and for greater integration and insertion in the service network.
Maternal-Child Health Services; Health Management; Health Personnel Management; Quality Management; Hospital Planning; Strategic Planning
