The Role of the Oral Health Coordinator in Contract Management

Abstract

Introduction/Justification: Good health management is essential to ensure a more effective and better quality public service for the population. The municipal oral health coordinator is the manager of dental services, among the main activities developed by oral health coordinators are "the coordination of human resources; management of dental material, supplies and equipment; consolidation of procedures; planning of care goals and oral health promotion and prevention; production and monitoring of indicators; and preparation of technical reports1.". To be a good manager, it is essential, in addition to knowledge of public health, to have notions of public administration legislation and an understanding of administrative processes. To ensure the perfect functioning of oral health, the coordinator who manages his or her contracts for the provision of dental services is able to follow up, monitor and control the quality of services. In Ituiutaba, a municipality in the Triângulo Mineiro, the contract of the accredited Regional Dental Prosthesis Laboratory (LRPD) only started to function effectively when it was closely monitored by the dentistry coordinator. Objectives: To report how the municipality of Ituiutaba managed to increase its production of dental prostheses, improve quality, while maintaining the contract value. Activity developed: The accreditation of the LRPD of Ituiutaba was approved by the Ministry of Health in 2019, for the production range of 20 to 50 prostheses per month. A public call was made and the first laboratory accredited to provide services was located in the south of Minas Gerais, more than five hundred km from the city served. All the terms established in the service provision contract were defined by the oral health coordinator, however the management was done by the financial department of the health department and the role of the coordination was only to check production reports. With the distance and the lack of interest of the laboratory providing the service, production was always below the minimum registered, spending months without delivering any parts and most with many defects. In an agreement with the financial director of the municipal institution, the oral health coordinator took over the entire management of the contract and, with the help of the legal department, managed to cancel the contract, making it impossible for the same provider to participate in a new bidding process. A new term of reference was written, after a new public call, the laboratory that took over the service was under the full responsibility of the dentistry coordination, maintaining the value of the prostheses offered by the Ministry of Health. As a direct contact between the coordinator, who is a dental surgeon and effective servant of the municipality and the owner of the current provider, a new flow was established. Although it is also located in another municipality, the owner undertook to send his staff monthly to Ituiutaba, to carry out joint efforts, where dentists and prosthetists work together, combining the laboratory phase with the clinical phase, leaving only the acrylization and metal casting to be carried out in the city where the LRPD is located. With the new service provision system, we produce more than one hundred pieces per month and reduce the number of rework to less than twenty percent of the pieces made. Final considerations: "In the Unified Health System (SUS), management is a basic pillar for the system to function in an equitable and universal way. Oral health is an integral part of this system and presents a structural organization of management that needs to be monitored and improved1." It is of utmost importance that the oral health coordinator knows about the particularities of management and is aware of everything that involves the sector he manages. The involvement of the coordinator in all stages of contracting the provision of LRPD services provides a more efficient service to a greater number of people.