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.

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. 

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.

Recommendations of physical exercise and its relation to mental health

Andrés Fontalba

The Lalonde report marked a milestone in the 1970s, highlighting the importance of lifestyles in health, over the characteristics of the health system or the biology of the person and proposing a change of the model based on the “cure” for one that boosted "health promotion". Among the lifestyles, most related to health is physical exercise. Plato already warned us: "The lack of activity destroys the good condition of every human being, while movement and physical exercise preserve it."

Escape the biomedical bubble

Cristina Roure

One of the most recurrent citation in clinical management is the Porterian concept of health value, which must be established based on the interest of the patient and not the rest of agents, read professionals, managers, researchers, administration, biomedical industry, etc. According to this concept, the ultimate purpose of research and innovation in health should be to provide maximum benefit to patients and society. However, as I commented in my last blog post, I often prioritized research and the real needs of patients, but society goes in different ways.

We ask patients to change their habits, but what about us?

Anna Sant

The management of cultural change is one of the most critical factors in the implementation of programs to improve the quality, safety and experience of the patient. The same thing that happens to our patients when we ask them to modify their behaviour to have a healthier life happens to health professionals in our work environment: it’s not easy for us to change the way we do things.

In the process of change, there is a particular moment in which we already know the correct protocols, and we are clear about the systems and behaviours that we must address. Even so, after an initial period of systematic implementation, we tend to return to old routines, those that seem more natural and familiar to us.

Management according to Elon Musk. Tesla, SpaceX and SolarCity

Tino Martí

Elon Musk is one of the trendiest entrepreneurs and undoubtedly the most controversial one at the moment. He is the leader of Tesla, SpaceX and SolarCity, three young, ambitious and dynamic companies that show how far they are willing to go to change the world through the internet, renewable energy and the race to Mars.

In 2018, he made it to the headlines for different reasons. First, proposing technical solutions to rescue children trapped in Thailand and end up insulting their monitor. Second, and probably the most popular, with the announcement via tweet to privatize Tesla for $420. In the American financial and stock market context, privatizing a publicly-traded company means repurchasing all its shares. The action elicited strong reactions, and the board of directors concluded his position. Shortly afterwards, Musk again announced problems in the production of Model 3 and wanted to assure the market that he is giving it everything by announcing his strenuous workday: 120 hours per week. To top it off, in a live radio interview, he accepted smoking marijuana. No one can say that he goes unnoticed, regardless of his apparent privacy.