Challenges in the Care to the Injured Worker at SUS: From the Anger Network to the Shared Construction of a Care Line

In this chapter, we address the Change Laboratory (CL) conducted at the network of public health-care institutions in charge of working accident-injured workers in a town in the state of Sao Paulo. According to Engestrom’s expansive learning, this activity comprises a network of systems called “boundary crossing,” as different services share aspects of the same work object. Ethnographical research revealed a fragmented health-care network, which did not have coordination between services or shared responsibilities for injured workers’ cases. Based on the results of applying this Boundary Crossing CL on the development of a new health-care model, we discuss the methodological innovations and the lessons about ease and difficulties learned by the researchers during this experience. It is worthy of note to highlight the tension between the current municipal management model and the formative methodology in the context of an intervention with health professionals from many different services, with different levels of development. We conclude that such obstacles affected the participants’ expectation of implementing the changes they collectively elaborated.