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https://www.gestaoeproducao.com/article/doi/10.1590/0104-530x2315-19
Gestão & Produção
Original Article

The influence of contingencies factors strategy and structure in the enterprise risk management in a hospital

Influência dos fatores contingenciais estratégia e estrutura na gestão de riscos corporativos em um hospital

Marcia Zanievicz Silva; Francisco Carlos Fernandes

http://dx.doi.org/10.1590/0104-530x2315-19 Gest. Prod., vol.26, n1, p.0, 2019
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Abstract

Abstract Founded on the premise that Enterprise Risk Management (ERM) as a Management Control System (MCS) and according to contingency theory, the design and the use of MCS tends to vary according to the organizational context. The aim of this paper is to describe how the contingency factor strategy and structure are interrelated with the control and presence and processes of ERM in a health organization. The methodology has a qualitative approach and, as a research procedure, the study of the case. Two theoretical propositions are presented to data analysis. Data were collected through interviews, observations, and documents. The theoretical propositions are: i) the kind of strategy adopted by the organization, typified according to Miles and Snow´s adaptive cycles interfering in the processes and in the controls of ERM; ii) the organization structure interfere in the processes and in the controls of ERM. The investigated hospital is a philanthropic entity distinguished as the general hospital of high complexity that is related to the Brazilian Sistema Único de Saúde (Unified Helth System). The main conclusions found in the study were: health area managers have bigger expertise regarding the use of controls and processes of ERM when compared to the administrative area managers; the strategy is the contingency factor that guides the way the organization is positioned against the risk management. The risk management supported in health certification systems revealed useful to minimize problem inherent to professional bureaucracy. In this case, the risk management helped to control inner characteristics related to the hospital professional structure, as well as, the organizational structure, defined by the formalization degree of tasks, contributing to the risk management.

Keywords

Enterprise risk management, Contingency theory, Strategy, Structure

Resumo

Resumo Apoiado na premissa de que o Enterprise Risk Management (ERM) é um Sistema de Controle Gerencial (SCG) e que, de acordo com a teoria de contingência, o design e o uso do SCG tende a variar de acordo com o contexto das organizações. O objetivo deste artigo é descrever como os fatores contingenciais estratégia e estrutura se inter-relacionam com a presença de controles e processos de ERM em uma organização de saúde. A metodologia possui abordagem qualitativa e adota-se o estudo de caso como procedimento de pesquisa. Duas proposições teóricas foram formuladas para análise dos dados. Por sua vez, os dados foram coletados por meio de entrevistas, observações e documentos. As proposições teóricas são: i) o tipo de estratégia adotada pela organização, tipificada de acordo com os ciclos adaptativos de Miles e Snow interferem nos processos e controles do ERM; ii) a estrutura organizacional interfere nos processos e nos controles do ERM. O hospital investigado é uma entidade filantrópica, classificada como hospital geral de alta complexidade e é conveniada com o Sistema Único de Saúde (SUS). As principais conclusões encontradas no estudo foram: os gestores da área de saúde possuem maior expertise quanto ao uso de controles e processos do ERM, quando comparados aos gerentes da área administrativa; a estratégia é o fator contingencial que orienta a maneira como a organização se posiciona sobre a gestão de riscos. A gestão de riscos, apoiada em sistemas de certificação de saúde, revelou-se útil para minimizar problemas inerentes à burocracia profissional, neste caso, a gestão de riscos contribui para a controlar características internas relacionadas à estrutura profissional dos hospitais, bem como, a estrutura organizacional, definida pelo elevado grau de formalização das tarefas, contribuindo para a gestão de riscos.

Palavras-chave

Gerenciamento de riscos corporativos, Teoria da contingência, Estratégia, Estrutura

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