Situational analysis of a Speech, Hearing and Language clinical school at a federal university in Bahia: a focus on problems

Andrade, Natalia Vital de Sales; Matos, Catharina

doi:10.1590/S0103-7331202333060.en

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Physis: Revista de Saúde Coletiva

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ORIGINAL ARTICLE • Physis 33 • 2023 • https://doi.org/10.1590/S0103-7331202333060.en copy

Situational analysis of a Speech, Hearing and Language clinical school at a federal university in Bahia: a focus on problems

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This work describes a situational analysis of a Speech, Hearing and Language clinical school at a federal university in Bahia, examining how it functions and coordinates with the municipal health system in Salvador, Bahia. It is a descriptive case study, whose methodological strategy is based on Carlos Matus’ Situational Strategic Planning (Planejamento Estratégico Situacional: PES) with a Focus on Problems. Our methodological strategy employed document analysis, participant observation, semi-structured interviews and a focus group with institutional actors. The results indicate weaknesses in four of the five categories of analysis, which were: infrastructure, funding, organization, and management. These have led to failings in student training and in the institution’s integration with the municipal health system. Of the twenty identified problems, ten related to the institutional actors’ capacity for both governance and governability, in other words, problems that are amenable to intervention. We conclude that the clinical school must institutionalize the practice of situational strategic planning to combat improvisational practices and enable it to effectively fulfil its two important functions: teaching and healthcare.

Keywords:
Speech; Hearing and Language Therapy; Clinical School; Unified Health System; Situational Analysis

DOCUMENT TYPE	QUANTITY
Contract for the agreement between the clinical school and the SMS	01
Annual Operational Plans	03
Minutes of clinical school meetings	04
Management reports	16
Productivity bulletins	19
Minutes of meetings of the commission to monitor the agreement	06
The clinical school’s internal regulations	01

COMPONENTS	PROBLEMS
INFRASTRUCTURE	Insufficient physical space
	Inadequate physical space
	Lack of human resources
	Lack of equipment and supplies
	Lack of equipment maintenance and inadequate cleaning
FUNDING	Insufficient funding
	Lack of regularity in the transfer of funds
	Lack of actor knowledge of the modus operandi for the release of funds from the SMS agreement
ORGANIZATION	Failings in teaching-service coordination
	Insufficient regulatory documents
	Failings in coordination between the clinical school and the municipal health system
MANAGEMENT	Inadequate management model
	Lack of management experience or qualification to coordinate the clinical school
	Inadequate fulfilment of the qualitative and quantitative target percentages agreed between the clinical school and the SMS
	Mismatches between quantitative goals and service responsiveness
	Absence of planning and programme management practices
	No institutionalization of administrative and technical meetings
	No meetings to discuss clinical cases as part of the SHL work process
	General inadequacy of the roles of clinical school actors
	Disorganization in the secretarial work process

PHYSIS - Revista de Saúde Coletiva Instituto de Medicina Social Hesio Cordeiro - UERJ, Rua São Francisco Xavier, 524 - sala 6013-E- Maracanã. 20550-013 - Rio de Janeiro - RJ - Brasil, Tel.: (21) 2334-0504 - ramal 268, Web: https://www.ims.uerj.br/publicacoes/physis/ - Rio de Janeiro - RJ - Brazil
E-mail: publicacoes@ims.uerj.br

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[1] Editor: Rosângela Caetano

ZONES I. Within governability capacity	I. Within governance capacity - Absence of planning and programme management practices; - Failings in teaching-service coordination; - Insufficient regulatory documents; - Failings in coordination between the clinical school and the municipal health system; - Inadequate management model; - Inadequate fulfilment of the qualitative and quantitative target percentages agreed between the clinical school and the SMS; - Mismatches between quantitative goals and service responsiveness; - No institutionalization of administrative and technical meetings; - No meetings to discuss clinical cases as part of the SHL work process; - Disorganization in the secretarial work process.	II. Outside governance capacity - Lack of management experience or qualification to coordinate the clinical school.
II. Outside governability capacity		- Insufficient physical space; - Inadequate physical space; -Lack of human resources; - Lack of equipment and supplies; - Lack of equipment maintenance and inadequate cleaning; - Insufficient funding; - Lack of regularity in the transfer of funds; - Lack of actor knowledge of the modus operandi for the release of funds from the SMS agreement - General inadequacy of the roles of clinical school actors

CONSEQUENCES	Failings in teaching-service coordination; Insufficient regulatory documents; No institutionalization of administrative and technical meetings; No meetings to discuss clinical cases as part of the SHL work process; Disorganization in the secretarial work process; Failings in coordination between the clinical school and the municipal health system; Nascent nature of activities for health promotion and the prevention of risk and injury; Low turnover of user slots; Low effectiveness in treating users; Fewer gains in student training
PROBLEM	Absence of planning and programme management practices
CAUSES	Inadequate management model Lack of a qualified management professional Insufficient work time to dedicate to management Insufficient funding Bureaucratic barriers to the transfer of agreement funds The public university budget crisis The clinic’s low visibility at the ICS and UFBA