Primary Health Care professionals’ perceptions of extended hours at Health Centers in Florianópolis (SC), Brazil

Abstract

Introduction: The extension of service hours at Family Health Units emerged as a proposal to expand access—one of the principles of Primary Health Care (PHC). The city of Florianópolis (Santa Catarina, Brazil) has increased the number of Health Centers with extended hours, particularly since 2019, encouraged by the program Saúde na Hora (Health on the Spot). Today, most of the Health Centers in this municipality operate from 7 a.m. to 7 p.m., bringing about changes in the dynamics of these units and in the daily lives of those who work there. Objective: To investigate the experience of PHC workers in Florianópolis regarding extended hours and how they affect the dynamics of Family Health Teams. Methods: An exploratory-descriptive design was adopted, using a qualitative approach and thematic analysis. Twelve semi-structured interviews were conducted with health professionals. The interview consisted of seven open-ended trigger questions, aimed at understanding how the transition to extended hours occurred and how this change impacted the work process. Following the interviews, transcriptions were prepared and data analysis was performed. The analysis was conducted through five distinct and complementary phases: compilation, decomposition, recomposition, interpretation, and conclusion. Results: Five physicians, four nurses, and three nursing technicians were interviewed, representing professionals from the four health districts of Florianópolis: North, South, Central, and Mainland. A diagram was developed based on the most prevalent responses from the interviews, which was divided into three themes: “management, infrastructure, and human resources”; “access and care”; and “workers,” and subdivided into challenges and potentialities. Conclusions: Extended hours are a potential strategy for expanding access. This study sought to identify how this is occurring and how it is impacting the daily lives of healthcare professionals in Florianópolis. While potential benefits such as flexible schedules, better use of physical space, and greater access to medications were identified, challenges also emerged, such as overload among professionals, fragmentation of care, and loss of a sense of team. Thus, the current implementation of extended hours must be designed using models that do not compromise principles, such as longitudinality and comprehensiveness, and with the necessary human resources, so as not to jeopardize workers’ health or other principles of PHC.