Is it possible to humanize health organizations?

Jordi Varela
Editor

Today, more than ever, the human part of the contact between patients and clinicians is taking centre stage, from health centres to critical care units and, therefore, the former must strive to be more accessible, while the latter has to demonstrate that the services they go beyond sophisticated clinical practice. Right now, we are at a point where the technical preparation and dedication of clinical professionals cause admiration, but it must be recognized that, with few exceptions, the warmth in human treatment has a lot of room for improvement.

The spider caught in its web

Health systems strive to write health plans and strategic plans, in which a lot of experts define high concepts, usually the mission, vision and values and outline strategies and objectives to reorient the provision of services towards community health, patient-centred care, multidisciplinary teamwork and, ultimately, towards a more valuable clinical practice. However, later comes the moment of truth, that of budgets, contracts and organization charts, and the web that the weight of history has been weaving, acquired customs, corporate behaviour, resistance to change and the pressure of exacerbated consumerism means that noble intentions become mere speeches and some pilot experiences never receive the desired push.

The influence of organizational culture

Víctor Montori says that he has an infallible indicator to perceive the penetration of humanism among hospital workers. He says that when he arrives at a centre that he does not know, he stands in the middle of the reception room adopting a disoriented posture and counts the time that passes until a worker asks how he can help him. His research, with a very simple methodology, has shown him that there are organizations with always busy professionals for whom the people in the corridors are just a noise that disorients them from their obligations, while others, rather few, have dedicated themselves to deploying, among their employees, the habits of a welcoming culture.

The importance of letting brains into the work

Brendan Martin, head of Buurtzorg Britain & Ireland, writes in a Corporate Rebels post that a group of innovators who had redesigned the garbage collection system in many American cities had told him that the success of the changes relies on knowing how to create an adequate climate so that workers did not need to park their brains at the entrance to work. Martin states that, unfortunately, in most hierarchical organizations, such as the English NHS, officials have been trained to do what they are told and not what they think would be best, and thus many of them are engulfed by the prevailing bureaucracy and they are not able to look up to see that there is a disoriented person in the middle of their hospital reception. On the other hand, that action is not defined in the task list of the civil servants does not help at all.

To promote the friendly face of health organizations, it is first necessary to evolve the prevailing hierarchical-bureaucratic model towards one that is more respectful of workers and, in addition, to promote a welcoming culture.