The current economic landscape requires structural and, mainly, behavioral changes in Brazilian businesses. The scenario created by big economic powers shows the difference between Brazilian industries and service sectors when it is compared all business issues, such as competitiveness, productivity and innovation, with others countries. Technological innovation consists in a critical factor for competitiveness and for the global economic development; moreover, it can be found in industrial sectors (which are responsible for materialization and organization of operational system of production process) and in service sectors (which organizes all gained contracted activities). Innovation should not be included only in these two economic sectors; however, it has to be included in the economic thought of all countries. It has to be highlighted the fact that innovation is not the unique factor of competitiveness, but, 977 INDEPENDENT JOURNAL OF MANAGEMENT & PRODUCTION (IJM&P)http://www.ijmp.jor.br v. 8, n. 3, July -September 2017 ISSN: 2236-269X DOI: 10.14807/ijmp.v8i3.522 productivity and knowledge make the same impact in competitiveness as innovation does. Besides, external and internal demands predict trends in terms of searching products and processes and strategies and these three items achieve better interaction between market and productivity control. In a global context, Brazil, specially, has a lot of techniques to learn in terms of how to work with its resources in an adequate way, whether they are natural or not. That is why studies about critical factors for competitiveness are determined for the Brazil's sustainable growth.

XXXVII ENCONTRO NACIONAL DE ENGENHARIA DE PRODUCAO "A Engenharia de Produção e as novas tecnologias produtivas: indústria 4.0, manufatura aditiva e outras abordagens avançadas de produção"

The theoretical debates in the literature point to the need of innovations in hospital services. The objective of this article is to identify the conditions of services that facilitate or hinder the process for different types of innovation in hospital services. For this, case studies were developed that allow the identification of the types of innovation found in the physical rehabilitation outpatient clinics of the Occupational Therapy unit (OT) of the Orthopedics and Traumatology Institute (OTI) of the Clínicas’ Hospital of the Faculty of Medicine of the University of São Paulo (HCFMUSP). The data collected reveal that the results of hospital services are related to the process of developing innovations in the various stages of the workflow, from the generation of ideas to the diffusion within the hospital unit. On the other hand, the review of the literature based on the reverse cycle of Barras and the complements of Gallouj and Djellal show that the paths of innovation in hospital services and innovations in industrial organizations are opposite. Therefore, the results of the analysis of the five cases selected for study reveal that, under the integrative approach, a process change leads to a product change. Thus, the article concludes that, in hospital services, innovations are born within the organizational structure as well as in external contact with professionals, researchers and surgeons.

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