Baker's Decalogue for high-performance healthcare organizations

Jordi Varela
Editor

 

Americans trust that competitiveness is the essence of human activity, which has made them the world's leading power, with China's permission. This principle, however, has not worked for them when they have applied it, without palliative, to their health care system, which is showing clear signs of poor performance: it’s very costly, it’s inequitable and it’s showing poor results. For this reason, some public health care organizations such as Veterans Affairs and Medicare, or private, such as Mayo Clinic, Cleveland Clinic or Kaiser Permanente, are trying to put sanity, analyzing what are the keys to improve the performance of the system.

Serenity Management

Salvador Casado

Three studies for a portrait (Mick Jagger), 1982. Francis Bacon

The global pandemic we are living through has been a time of tension, shock, worry, uncertainty, storm, haste and noise. Its management at the political, social and health levels seems to have been very improvable due to the great level of complexity it has entailed for everyone. Many things have been done, many things have been said and many things have been wrong. What we have perhaps missed is more serenity. For this reason, it would be pertinent to reflect on how we could improve the management of serenity in the healthcare world, given that this remedy is a good countervenom to the nouns that began this dissertation. 

Health expectations influence the result

Andrés Fontalba
 

In search of the perfect woman, Pygmalion fell in love with his Galatea statue. Such was his wish, according to Ovid's account in The Metamorphoses, that the statue became human. When the Pygmalion effect occurs, the expectations we have influence our behaviour and our way of acting is precisely what causes the expected result. Our own beliefs also influence other people and thus we seek that our expectations become true with behaviours that tend to confirm them. This effect is also known as "self-fulfilling prophecy" and it means that we will do everything possible to make what we believe will happen finally come true.

Nutrition and health: confusion is served

Cristina Roure

Red and processed meat, so reviled for years in all healthy eating guides, is back to happy days. Recently, the United States Department of Agriculture abolished the initiative promoted by Michelle Obama that proposed the inclusion of fresh fruits and vegetables in school cafeterias. The reason was to defend the freedom of the individual and the educational centres to offer a more nutritious meal following the preferences of the American population.

Could test cascades be avoided after an incidental finding?

Jordi Varela
Editor

 

Incidental findings resulting from a diagnostic test or screening are being a headache for modern medicine, a problem that is only growing hand in hand with the refinement of imaging technology and genomics. In some cases, the investigations that follow the incidental findings indicate the existence of silent pathologies, or in the initial phase, and timely clinical intervention is effective, although in often, the cascades of tests that are derived end up being unproductive, as well as potentially dangerous, for patients. It’s a phenomenon that generates anguish in hypothetical patients and burnout in professionals, who don’t know how to stop it, since once there is a probability that what is found is dangerous, the pressure to reach the end is unstoppable. Unfortunately, the evidence shows that there is no evidence that compliance with clinical practice guidelines is capable of ending these cascades once they have started and, on the other hand, it has not been possible to demonstrate that the establishment of economic penalties or co-payments can stop the phenomenon.