10 proposals to transform our hospitals

Nacho Vallejo
 

The history of the NASA pirate group

In the 1980s, the space agency NASA began work on the development of space shuttles. Responsible for landing man on the Moon, it zealously maintained the use of the Apollo-era operating system. At that time, a group of young engineers who had recently joined the agency questioned whether the system was going to be able to respond to the challenges posed. Calling themselves "the Nasa pirates", they proposed an alternative mission control. The agency's mantra "we've always done it this way, so it must be the best" didn't stop these rebels from writing their own "manifesto" challenging the status quo.

Transforming our health system requires continuity and coherence

Nacho Vallejo
Atenció integral 

Photo of Alexas. Photos in Pexels

“Transforming health care requires continuity and consistency.” This is the title of a Harvard Business Review article written by Mark Britnell. Dr. Britnell is an executive of KPMG International and a global health systems expert. He dedicated his professional life to this field and has worked in more than 80 countries, a circumstance that has allowed him to gain first-hand unique experience of healthcare models. In 2000 he was appointed chief executive of University Hospitals Birmingham NHS Foundation Trust where he was responsible for the design of the largest NHS hospital. He is also the author of the book In Search of the Perfect Health System.

Improving organizations' culture; avoiding inertia

Nacho Vallejo
 

Image of Sasin Tipchai a Pixabay

The culture of a healthcare organization is still an abstract concept. It aims to incorporate unwritten rules, beliefs, or values workers share. It's the personality of the organization and, in institutions such as hospitals, it can even be different between services or professional categories, it can be linked to the baroque nature of our hierarchies and, above all, to the traditional one: "Here it has always been done that way."

Taking action in patient-centred care

Nacho Vallejo

 

Frame of the series New Amsterdam

Talking about patient-centred care in our healthcare organizations may sound hollow or a tradition of good intentions. There are very attractive topics such as "patients first". In any case, putting patients first, abandoning traditional medical paternalism, has at times become an excuse to configure a variety of intentions that risk being left in symbolic speeches. I believe that one of the reasons that don't allow progress in this task is the need to specify it in actions that the ordinary professional can understand and carry out, checking its benefits and its results.

Care for chronic patients during the pandemic. 5 proposals from hospitals

Nacho Vallejo

Image by Parentingupstream from Pixabay

Faced with the difficulties of a third wave of the pandemic, clinicians again need to express their concerns. And not only because of the exponential increase in the number of COVID-19 patients but also because of the feeling of once again leaving behind the care of patients with chronic health problems. It’s a situation sadly favoured by the collapse of primary care and hospitals.

Five-point plan to increase the value of clinical practice

Jordi Varela
Editor

In an article recently published in Clinical Medicine, Five recommendations to increase the value of clinical practice, I proposed a plan with a view to a more valuable clinical practice and, given the timely topic, I allow myself to partly reproduce in this post. You should note that this plan does not support pilot tests or halftones, but should be implemented with a perspective of in-depth organizational change, aiming to generate an institutional profile of value and excellence.

Providing courage, balance and humanity in the emergency services

Nacho Vallejo
 

@varelalaf

Urgency is a unique environment in healthcare. It works intending to deal with situations that can put the person's life at risk, but it’s also a "safety net" or, as we have defined it on some occasion in this blog, "a refugee camp of the health system". The care for people in this field of health isn’t only due to pathological and physiological disorders, but sometimes those who go to the emergency room do so as a consequence of dysfunction of our healthcare system that manifests itself with "collateral damage" derived from poor accessibility and, in other cases, from an excess of activity.

Training is essential for change management

Nacho Vallejo

The actors who intend to get involved in the orchestration of changes in our healthcare system tend to agree on the difficulties and barriers that limit the development of improvement strategies for healthcare organizations. We have already seen it in previous posts on this blog, where we asked ourselves what has become of the professional's experience and how to "unclog" our institutions.

Some proposals to reduce the things we do without reason

Nacho Vallejo

Reducing unnecessary tests and treatments in our organisations can be a complicated task, especially in its implementation. To facilitate its development, and in line with the previous reflection on the search for things we do without reason, we have new references that can serve as support.

Canadian Choosing Wisely's Diving into Overuse in Hospitals campaign aims to sensitise institutions to participate in this analysis by making changes (small or large) to reduce this excessive use. On their website, professionals have access to a large number of resources such as a "starter kit", webinars and other exciting supports.

In search of the things we do without reason

Nacho Vallejo

In healthcare, there is usually a special appreciation for tradition or antiquity, which does not always translate into better clinical care. The reality is that there are things that we professionals do without the contrast of adequate evidence or, simply, without these actions providing sufficient value.

The Choosing Wisely initiative was launched a few years ago from a private North American institution. It was necessary to suggest to the scientific societies of that country the development of recommendations on clinical practices that both doctors and patients should rethink.