Four premises to arrive at the autonomous organization of your team

Pere Vivó

Lack of agility, rigidity, slowness, excess of indicators, contradictory orders, ineffectiveness... are some of the historical and structural pathologies of the health care system, as Salvador Casado pointed out in the post "Primary Health Care Centres management notes".

Primary Health Care Centres management notes

It is not the same to sail with no wind as it is to sail with a swell, it is not the same to manage a health unit in calm weather as in a pandemic. But it is useful to learn from storms because, as the sailor knows, they never come alone. 

Europe's public health systems are huge structures that could be likened to a fleet with hospitals as huge ships and Primary health centres as smaller, more agile ships. In these days of disruption with a shower of protocols from the general command but without a clear vision of what we were up against, each unit did what it could. Some maneuvered quickly, others less so; some did so skillfully, others were overtaken by circumstances.

Primary care: the law of reverse healthcare 49 years later

@varelalaf

The current primary care operation system guarantees citizens that they will be able to see their family doctor, or whoever replaces them, whenever they deem it convenient and, in this way, doctors, in their day to day, are faced with an agenda full of unfiltered visits, a source of widespread dissatisfaction, both for the neediest patients who feel under-served, as well as for doctors, who waste too much time in resolving matters that are not their own, not forgetting that, in this scenario, nurses are relegated to a secondary role.

Self-management is the way

In traditional companies, such as health companies, power is very concentrated. Individuals above distrust those below because they believe that if they allow them the autonomy they will blow their budgets and, as a result, professionals have simply become rigid gears in the machine with virtually no room to make decisions. For their part, politicians always find reasons to distrust managers in case of any budgetary deviation or up-tick in citizen unrest - waiting lists for example. Managers, fearful of their predicament, concentrate power in a few subordinates to maintain tight control of objectives whilst rejecting any innovations from those below due to suspicion of increasing expenses or creating scandals.

Blockchain and crypto management

Tino Martí

In the 2018 edition of the Mobile World Congress has drawn to a close. Among the different technologies exhibited this week at the mobile fair, the chain of blocks or blockchain has appeared tangentially. Announced as the new revolution in the digital world - which some consider as disruptive as the internet - the block chain is the technology that allows the popular bitcoin crypto currency to work and whose value has reached unimaginable value (exceeded $ 18,000 last December).

But what is really the block chain and how can it be of interest to the readers of Advances in Clinical Management?

Blockchain is a distributed database system that allows transactions between agents to be both secure and anonymous by means of a trusted timestamp in the distributed public registry (distributed ledger). Although its best known application is to carry out operations with cryptocurrencies such as bitcoin or ethereum, the chain of blocks can also be used to manage valuable elements such as certificates, insurance or votes, and is being widely experienced in different sectors such as finance, logistics or food.

Could we organize ourselves in a different way?

Frederic Laloux, in "Reinventing Organizations", a revealing book, at least for me, invites us to rethink the way we manage companies. The age of the internet, he says, has precipitated a new vision of the world that contemplates the possibility of a distributed intelligence instead of a vertical hierarchy. According to Laloux we should be able to invent a more powerful and meaningful way of working together if we would change our belief system.

In the first part of the book, the author makes an evolutionary analysis of the way in which humans organize companies, which I found colourful and insightful, and that is why I have prepared a summary (for more details I recommend going to the tables that are at the end of chapters 1.1 and 2.3):