Institucionalização da Avaliação de Tecnologias em Saúde em hospital universitário: contribuições para a gestão e a enfermagem

Cristiano  Bertolossi Marta; Lilian  Reinaldi Ribeiro Pirozi; Thaís  Braga Meira; Márglory  Fraga de Carvalho; Roberta  Monteiro de Sá; Glycia de Almeida Nogueira; Clarissa Coelho Vieira Guimarães; Roberto Carlos Lyra da Silva; Antônio Augusto de Freitas Peregrino

doi:10.1590/SciELOPreprints.18060

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Cristiano Bertolossi Marta Rio de Janeiro State University https://orcid.org/0000-0002-0635-7970
- Methodology
- Conceptualization
- Writing – Original Draft Preparation
- Writing – Review & Editing
Lilian Reinaldi Ribeiro Pirozi Federal University of the State of Rio de Janeiro https://orcid.org/0000-0002-1691-9041
- Conceptualization
- Methodology
- Visualization
Thaís Braga Meira Federal University of Rio de Janeiro https://orcid.org/0000-0003-3502-4144
- Conceptualization
- Methodology
- Investigation
- Visualization
- Writing – Original Draft Preparation
Márglory Fraga de Carvalho Federal University of the State of Rio de Janeiro https://orcid.org/0000-0002-8578-446X
- Conceptualization
- Methodology
- Visualization
- Supervision
Roberta Monteiro de Sá Rio de Janeiro State University https://orcid.org/0009-0001-0805-5239
- Conceptualization
- Methodology
- Visualization
Glycia de Almeida Nogueira Rio de Janeiro State University https://orcid.org/0000-0002-2986-2427
- Conceptualization
- Visualization
- Supervision
Clarissa Coelho Vieira Guimarães Federal University of São Paulo https://orcid.org/0000-0002-7713-7182
- Conceptualization
- Investigation
- Project Administration
- Methodology
- Writing – Original Draft Preparation
Roberto Carlos Lyra da Silva Federal University of the State of Rio de Janeiro https://orcid.org/0000-0001-9416-9525
- Visualization
- Supervision
Rio de Janeiro State University https://orcid.org/0000-0002-6617-480X
- Supervision
- Writing – Review & Editing
- Conceptualization

DOI:

https://doi.org/10.1590/SciELOPreprints.18060

Keywords:

Health Technology Assessment, Evidence-Based Practice, Nursing, Health Management, Unified Health System

Abstract

Introduction: The institutionalization of Health Technology Assessment in hospitals can contribute to bringing scientific evidence, management, and care closer together, improving technology assessment and decision-making processes. In this context, Nursing has the potential to operate at the interface between assessment, evidence implementation, and clinical practice.

Objective: To analyze the implementation of a Health Technology Assessment Unit in a public university hospital, highlighting its implications for institutional governance, decision-making, and the role of Nursing.

Methods: An institutional experience report with an analytical approach and qualitative design. Implementation occurred in six stages: situational diagnosis, strategic planning, team training, organizational structuring, project implementation, and collaboration within networks. The experience was systematized using institutional documents, administrative records, technical-scientific reports, and academic output, analyzed through an interpretive approach.

Results: The implementation of the unit enabled the establishment of formal workflows for technology assessment and deliberation and supported institutional decision-making processes. Four evidence-based clinical protocols were updated, and three partial economic evaluations were conducted. Greater integration of evidence into management processes and the identification of practices potentially requiring review were observed. Nursing participated in the assessment, translation, and implementation of evidence, operating at the interface between technology, management, and care.

Conclusion: The experience demonstrated the potential of institutionalizing Health Technology Assessment to integrate technology assessment, evidence production, management, and care within the hospital context, while also expanding Nursing participation in these processes. Its consolidation depends on organizational conditions, specialized training, institutional sustainability, and the integration of evidence into decision-making processes.

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Author Biographies

Cristiano Bertolossi Marta, Rio de Janeiro State University

Nurse. Specialist in Health Economic Evaluation from the University of Brasília / Brazilian Ministry of Health (2024). Postdoctoral fellow at the Aurora de Afonso Costa School of Nursing, Fluminense Federal University (EEAAC/UFF). Permanent faculty member of the Professional Master’s Program in Medical Physics, Department of Radiological Sciences, Rio de Janeiro State University (UERJ). Evaluator for the National Higher Education Assessment System of the Anísio Teixeira National Institute for Educational Studies and Research (Inep/BASis). Member of the Committee for the Evaluation of Products and Procedures of the National Committee for Health Technology Incorporation into the Brazilian Unified Health System (CONITEC). Director-Councillor of the Regional Nursing Council of Rio de Janeiro (2024–2026 term). Full Professor and Coordinator of the Nursing Administration Area, Department of Nursing Fundamentals, Faculty of Nursing, Rio de Janeiro State University (DFEN/FENF/UERJ). Member of the Laboratory for Economic Evaluation and Health Technology Assessment (LAETS), Alfredo Pinto School of Nursing, Federal University of the State of Rio de Janeiro (EEAP/UNIRIO). Lead Researcher of the Center for Economic Evaluation and Health Technology Assessment (NAETS) at Rio de Janeiro State University (UERJ), a UERJ/CNPq Research Group and NATS/REBRATS member.

Lilian Reinaldi Ribeiro Pirozi, Federal University of the State of Rio de Janeiro

Nurse, PhD and Master of Science from the Federal University of the State of Rio de Janeiro (UNIRIO), with specialization in Pediatric Nursing and Stomatherapy. She works in educational management at IFF/Fiocruz and as a consultant in Health Economics and Outcomes Research (HEOR). She is a member of the Center for Economic and Health Technology Assessment at UERJ (NAETS/UERJ) and the Brazilian Network for Health Technology Assessment (REBRATS), with specialized clinical experience in maternal and child health nursing.

Thaís Braga Meira, Federal University of Rio de Janeiro

Nurse, PhD in Sciences and Master’s degree in Health and Technology from the Federal University of the State of Rio de Janeiro (UNIRIO). Specialist in Health Promotion from Fluminense Federal University (UFF). Currently Substitute Professor in the Department of Public Health at the Federal University of Rio de Janeiro (UFRJ) and Coordinator of the Diabetes Education Unit at the Luiz Capriglione State Institute of Diabetes and Endocrinology. Member of the Board of the Brazilian Diabetes Society – Rio de Janeiro Regional Chapter, and Guest Professor at the Pontifical Catholic University of Rio de Janeiro (PUC-Rio) and Rio de Janeiro State University (UERJ). Her academic and professional activities focus on Public Health Nursing, women’s health, men’s health, child health, diabetes, health education, economic evaluation, and health technology assessment.

Márglory Fraga de Carvalho, Federal University of the State of Rio de Janeiro

Nurse, graduated from Gama Filho University (2005). Specialist in Adult Intensive Care at Pedro Ernesto University Hospital, Rio de Janeiro State University (UERJ, 2008). Nursing Officer of the Military Fire Brigade of the State of Rio de Janeiro (2008–present). Master’s degree from the Graduate Program in Nursing at UERJ (2011) and PhD from the Graduate Program in Nursing and Biosciences at the Federal University of the State of Rio de Janeiro (UNIRIO, 2018). Specialist in New Teaching Methodologies from UniRedentor (2019) and Executive MBA in Operational Management in Organizations from Fundação Getulio Vargas (FGV, 2023). Worked in the Infection Control Service and Hospitality Committee at the Central Aristarcho Pessoa Hospital of the Military Fire Brigade of the State of Rio de Janeiro (November 2022–September 2024). Infection Control Specialist certified by CIAS-UFF (April 2024). Currently assigned to the Center for Studies and Research in Civil Defense (CEPEDEC), through the Scientific and Technological Institute for Civil Defense (ICTDEC), at the Rio de Janeiro State Secretariat of Civil Defense (SEDEC-RJ). Areas of interest include Disaster Health, Economic Analysis, Health Technology Assessment, Infection Control, and Patient Safety.

Roberta Monteiro de Sá, Rio de Janeiro State University

Nurse and lawyer. She holds a master’s degree in Health Law from the Catholic University of Argentina (UCA) and postgraduate specializations in Health Law from the Oswaldo Cruz Foundation (FIOCRUZ) and in Occupational Health Nursing from Veiga de Almeida University (UVA). She is currently pursuing a specialization in healthcare clowning. Her professional activities encompass public health management, conflict mediation in healthcare, bioethics, health litigation, patient safety, healthcare contracts, and occupational health. She is a member of the Center for Economic and Health Technology Assessment at the State University of Rio de Janeiro (NAETS/UERJ) and of the Health Law and Rights of Persons with Disabilities Committees of ABA Nacional. She has experience in public legal assistance in healthcare, prevention of health-related litigation, court orders, higher education teaching, and primary healthcare.

Glycia de Almeida Nogueira, Rio de Janeiro State University

PhD in Nursing and Biosciences from the Federal University of the State of Rio de Janeiro (PPGENFBIO/UNIRIO). Associate Professor in the Department of Nursing Fundamentals at the State University of Rio de Janeiro (DFEN/UERJ). Coordinator of the Cross-Cutting Component of the Nursing Residency Program (HUPE/ENF/UERJ). Member of the Board of the Rio de Janeiro Regional Chapter of the Brazilian Association of Dermatology Nursing (SOBENDE/RJ). Member of the Health Technology and Economic Assessment Research Group (NAETS/UERJ).

Clarissa Coelho Vieira Guimarães, Federal University of São Paulo

Nurse, Master’s degree in Nursing, PhD in Sciences, and postdoctoral researcher in the Graduate Program in Translational Medicine at the Escola Paulista de Medicina, Federal University of São Paulo (EPM/UNIFESP), supported by a CAPES Postdoctoral Institutional Program (PIPD) fellowship. She is currently undertaking a postdoctoral research placement at the University of Coimbra, Portugal, in collaboration with the Health Sciences Research Unit: Nursing (UICISA) and the Nursing School of Coimbra, where she conducts research in Health Technology Assessment (HTA), clinical decision-making, and patient safety. Her main research areas include pediatric nursing, specialized pediatric transport, health technologies, and pediatric critical care, with a focus on integrating evidence-based practice, translational medicine, and value creation for healthcare systems. She has extensive hospital care experience, including pediatric emergency services, Neonatal Intensive Care Units, and Pediatric Intensive Care Units. She served as a Nursing Officer in the Brazilian Air Force, where she also performed hospital management duties, consolidating her experience in leadership and healthcare service organization. She is a member of national and international research groups and of the Paediatric Critical Care Society (PCCS). She currently develops projects focused on Health Technology Assessment, specialized pediatric transport, evidence-based practice, patient safety, and clinical decision-making, integrating research, education, management, and innovation to improve the quality of care and healthcare systems.

Roberto Carlos Lyra da Silva, Federal University of the State of Rio de Janeiro

Nurse, PhD in Nursing from the Federal University of Rio de Janeiro (UFRJ) and Master’s degree in Nursing from the Federal University of the State of Rio de Janeiro (UNIRIO). He holds an MBA in Health Economics and Health Technology Assessment from the Economic Research Institute Foundation (FIPE) and the German Hospital Oswaldo Cruz, completed within the scope of PROADI-SUS/Ministry of Health. He is a faculty member of the Professional Master’s Programme in Health Technologies and Practices (ProTPS) at the Institute of Humanities and Health of Rio das Ostras, Fluminense Federal University (UFF); a research fellow of the Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro (FAPERJ); and leader of the Laboratory of Economic Evaluation and Health Technology Assessment (LAETS), registered in the CNPq Directory of Research Groups.

, Rio de Janeiro State University

Nurse, graduated from Rio de Janeiro State University (UERJ). Full Professor. Master’s degree in Nuclear Biosciences from the Institute of Biology/UERJ; PhD in Public Administration and Health Economics from the Institute of Social Medicine (IMS/UERJ); Postdoctoral training in Biosciences at the Federal University of the State of Rio de Janeiro (UNIRIO). Deputy Head of the Department of Radiological Sciences (DCR/UERJ). Faculty member of the Professional Master’s Program in Medical Physics at UERJ and of the Master’s and Doctoral Programs in Nursing and Biosciences (PPGENFBIO/UNIRIO). Specialist in Occupational Radiation Protection (UERJ), Health Technology Assessment (LAETS/UNIRIO), and Basic Medical Response Preparedness for Radiological and Nuclear Emergencies, International Atomic Energy Agency (IAEA).