Driving Institutional Humanization Through Collaborative Governance: A Technical Report From a Portuguese Primary Care Unit.

The humanization of patient care depends not only on the attitudes and behaviors of individual professionals but also on the organizational conditions in which healthcare professionals work. Following the 2024 reform of the Portuguese National Health Service (Serviço Nacional de Saúde, SNS) and the creation of Local Health Units (Unidades Locais de Saúde, ULSs), primary care organizations were incorporated into more integrated and decentralized governance structures. This technical report describes the implementation of a collaborative governance model between ULS Estuário do Tejo and Family Health Unit (Unidade de Saúde Familiar, USF) Gago Coutinho during the 2025 institutional incentive cycle. The model was designed to translate institutional humanization into practical organizational mechanisms by combining shared priority setting, local needs assessment, centralized procurement support, and investments in professional development, workplace conditions, and team cohesion. The process enabled the unit to fully utilize its available institutional incentive allocation, transforming allocated resources into concrete interventions, including specialized training in family-centered care for autism spectrum disorder (ASD), infrastructure and ergonomic improvements, and a team-building initiative incorporating a community donation component. This experience suggests that institutional incentives can function as health policy instruments when supported by collaborative governance and administrative decoupling. Although this is a single local implementation report, it provides a practical framework for primary care organizations seeking to align professional well-being, organizational performance, and humanized care.