Monday 30 December 2019

In the end, everything requires trust

Joan Escarrabill



Book stores are still important. Despite social networks and the avalanche of information, good libraries are still a source of surprises. If a book store doesn't surprise - if you only find common or the latest ones - you won’t return. 

When visiting the Central del Raval in Barcelona, I have never left without having found surprises. The latest is Comprender la Democracia (Understanding Democracy), by Daniel Innerarity. Eighty dense pages, with meaning and suggestive ideas. It is essential to read books from different disciplines to be able to establish parallels and systematically avoid shared and inbred ideas. Therefore, when we talk about patient participation, it is very useful to do so from a conceptual framework away from clinical practice. Now more than ever it is convenient to reflect on participation based on a conceptual framework described by people who think about democracy. 

Monday 23 December 2019

When the health care does not work well, better not have?


Andreu Segura



Almost twenty years ago, the report of the Institute of Medicine “To err is human" estimated that medical errors caused more annual deaths than AIDS, breast cancer or traffic accidents. A few days ago, at The Lancet, Margaret Kruk and her Harvard global health team warned us that poor health care is causing five times more deaths than AIDS in countries with fewer resources. Even more deaths than those of people who die without being able to access health.

It is obvious that to be useful, health activities must have a positive effect on the health of the people served. In health and survival or, even more precisely, in survival in good health. Elementary. As it is also to think that this value depends largely on doing things right. And it is not enough to have facilities, equipment and health personnel. They need to work properly.

Monday 16 December 2019

Primary care: reforms based on innovation








The primary care reform initiated in Spain in 1985 was inspired by the Alma-Ata statement that WHO had proclaimed a few years earlier. The need for change was evident since the previous model was characterized by access difficulties, the predominance of curative care, medical orientation focused on diseases and the absolute lack of teamwork. Thirty years later, primary care is in a crisis of exhaustion due to multiple factors, of which the lack of budgetary endowment, the ageing of the population and the rigidities and bureaucracies of which it has been endowed stand out, and for a long time the call for reforming the reformed has been heard and create a new model more appropriate to the present day.

Monday 9 December 2019

How to build an agile experience for the patient?

Glòria Galvez





Our environment is subject to constant changes that organizations try to adapt to by becoming agile institutions, capable of developing projects quickly and flexibly. According to the report by the McKinsey consultancy, agile organizations are recognized by five key elements:
  1. They are committed to open innovation, co-creating with different actors, from their professionals to the clients of the organisation.
  2. Foster networks of autonomous people, free to devise disruptive proposals; a model of red arch versus one of hierarchy. 
  3. They prefer to be quick and take risks than fall into excessive planning. 
  4. The style of leadership gives prominence to people and encourages development talent. 
  5. Integrate technology as a resource that provides agility to formulate new proposals. 
Some organizations undertake small transformations related to innovation or patient experience, but few dare to make a global transformation adopting an agile methodology. 

Monday 2 December 2019

The urgencies and the elderly








Reflections (and proposal) in the face of the impending winter emergency crisis

@varelalaf
If nothing is done, vulnerable people will increasingly go to the emergency room because of their multi-pathology, the presence of certain symptoms that are difficult to manage from home or the problems of their environment, they call 061 increasingly often. And that is how hospital emergency services become refugee camps within health systems. A clinical trial conducted in 24 French hospitals, which included more than three thousand people over 75 years of age in a clinically critical situation, showed that the centres most likely to enter older people in critical units, in addition to not reducing their long-term mortality term, neither improved their functional capacity or their quality of life.