This study discusses the problem of surgery cancellation on the economic-financial perspective. It was carried out in the Surgical Center Unit of a school hospital with the objective to identify and analyze the direct costs (human resources, medications and materials) and the opportunity costs that result from the cancellation of elective surgeries. Data were collected during three consecutive months through institutional documents and a form elaborated by the researchers. Only 58 (23.3%) of the 249 cancelled scheduled surgeries represented costs for the institution. The cancellations direct total cost was R$ 1.713.66 (average cost per patient R$ 29.54); distributed as follows: expenses with consumption materials R$ 333.05; sterilization process R$201.22; medications R$149.77 and human resources R$1,029.62. The human resources costs represented the greatest percentile in relation to the total cost (60.40%). It was observed that most of the cancellations could be partially avoided. Planning on management; redesigning work processes, training the staff and making early clinical evaluation can be strategies to minimize this occurrence.

The growing demand and the degree of patient care in oncological outpatient services, as well as the complexity of treatment have had an impact on the workload of nurses. This study aimed at measuring the workload and productivity of nurses in an oncological outpatient service. An observational study using a work sampling technique was conducted and included seven nurses working in an oncological outpatient service in the south-eastern region of Brazil. A total of 1,487 intervention or activity samples were obtained. Nurses used 43.2% of their time on indirect care, 33.2% on direct care, 11.6% on associated activities, and 12% on personal activities. Their mean productivity was 88.0%. The findings showed that nurses in this service spend most of their time in indirect care activities. Moreover, the productivity index in this study was above that recommended in the literature. RESUMEnLa creciente demanda y el volumen de atención en los consultorios externos de oncología, así como la complejidad del tratamiento han causado impacto en la carga de trabajo de los enfermeros. Este estudio tuvo como objetivo medir la carga de trabajo y la productividad de los enfermeros en un consultorio externo de oncología. Estudio observacional, utilizando la técnica de muestreo de trabajo, fue realizado en un servicio de consultorio externo de oncología en la región sur-este de Brasil, donde participaron siete enfermeros. Fueron recolectadas 1.487 muestras de intervenciones o actividades. Se observó que el 43,2% del tiempo de los enfermeros fue consumido en cuidados indirectos, 33,2% en cuidados directos, 11,6% en actividades asociadas y 12,0% en actividades personales. La productividad promedio correspondió al 88,0%. Los hallazgos permitieron concluir que los enfermeros del servicio de consultorios externos de oncología consumieron la mayor parte de su tiempo en actividades de cuidados indirectos. Reveló, además, un índice de productividad superior a aquellos recomendados en la literatura.

Este estudo, de natureza exploratória descritiva, tem como objetivo investigar a ocorrência e as causas de cancelamento de cirurgias programadas na unidade de Centro Cirúrgico em um hospital de ensino de capacidade extra no interior do estado de São Paulo. Os dados foram coletados durante três meses consecutivos em 2004, utilizando-se documentos institucionais e formulário elaborado pelas pesquisadoras. No período do estudo foram programadas 4.870 cirurgias na unidade de Centro Cirúrgico investigada, das quais 249 foram canceladas (5,1%). As principais causas geradoras dos cancelamentos das cirurgias estavam relacionadas ao paciente (57,8%), tais como, não comparecimento (56,3%) e condição clínica desfavorável (34,7%); à organização da unidade (22,1%) devido à falta de leitos disponíveis para internação (29,1%) e ocorrência de cirurgias de emergência (25,5%); à alocação de recursos humanos (17,7%) ou ainda à alocação de recursos materiais e equipamentos (1,6%).

OBJECTIVE To map the sub processes related to turnover of nursing staff and to investigate and measure the nursing turnover cost. METHOD This is a descriptive-exploratory study, classified as case study, conducted in a teaching hospital in the southeastern, Brazil, in the period from May to November 2013. The population was composed by the nursing staff, using Nursing Turnover Cost Calculation Methodology. RESULTS The total cost of turnover was R$314.605,62, and ranged from R$2.221,42 to R$3.073,23 per employee. The costs of pre-hire totaled R$101.004,60 (32,1%), and the hiring process consumed R$92.743,60 (91.8%) The costs of post-hire totaled R$213.601,02 (67,9%), for the sub process decreased productivity, R$199.982,40 (93.6%). CONCLUSION The study identified the importance of managing the cost of staff turnover and the financial impact of the cost of the employee termination, which represented three times the average salary of the nursing staff.