The Planning and Management of Health Services   Working on the interface Jos é Francisco García Gutiérrez OPS/PAHO HSS/HR...
My apologies ….but we do need to get to know each other <ul><li>Name </li></ul><ul><li>Work </li></ul><ul><li>Expectations...
To understand my discourse <ul><li>Remembering </li></ul><ul><li>a friend and </li></ul><ul><li>a good man </li></ul><ul><...
Tony Judt remembered
 
 
<ul><li>From  MACRO </li></ul><ul><li>to  MESO </li></ul><ul><li>and  MICRO </li></ul><ul><li>… and certain  digressions <...
 
Evidenciators, Calidators, Implementators, Proceseitors, Genderators & Determinators     What´s next?
S m a ll   d i g re ss io n s
A new syndrome:  Power Point Toxicity Funny but banal !
<ul><li>From  MACRO </li></ul><ul><li>to  MESO </li></ul><ul><li>and  MICRO </li></ul><ul><li>… and certain  digressions <...
Moving into the mud! <ul><li>Managers </li></ul><ul><li>Health professionals </li></ul><ul><li>Patients </li></ul><ul><li>...
Moving into the mud! <ul><li>Management </li></ul><ul><li>Good clinical practice </li></ul><ul><li>Patients Patnerships </...
HEALTH MANAGERS The dark side of the force?
Manager ´s Triangle <ul><li>Budget control </li></ul><ul><li>Priority goals </li></ul><ul><li>Social peace </li></ul><ul><...
Citizen ´s Triangle <ul><li>Accesibility (24/7) </li></ul><ul><li>High quality care  </li></ul><ul><li>Unlimited care </li...
The low moral among the professionals
 
FROM 2
 
Julian Tudor Hart <ul><li>“ My medical education began three times. What I learnt at medical school was no use in the hosp...
MEDICINE 2.0 <ul><li>Jay Parkinson at work! </li></ul>
Changing practice Cambio de prácticas clínicas
 
Are you wearing a wrist watch ? …  why ???
From  Baby-Boomers     to  G e n e r a t ion  2 0 2 0
 
 
 
The Side B
<ul><li>If  reform is the answer… </li></ul><ul><li>What was the question ? </li></ul>
Is  HEALTH  a consumer good?  …and  health care?
 
<ul><li>IF YOU ARE THE PATIENT, </li></ul><ul><li>What type of care do you want to receive? </li></ul><ul><li>The other fr...
The other framework Model Paterna- listic Informative  Shared Ro  l e No informed Partially informed Well informed Active ...
That Old Dilemma <ul><li>From desire to reality </li></ul><ul><li>o </li></ul><ul><li>From reality to desire </li></ul>
Pictures of the future  of health care
Dangers of predicting the future <ul><li>Sam Goldwyn Mayer </li></ul><ul><li>“  I never make predictions, especially about...
Why bother with the future? <ul><li>&quot;If you think that you can run an organisation in the next 10 years as you've run...
Why bother with the future? <ul><li>“ The future belongs to the unreasonable ones, the ones who look forward not backward,...
Why bother with the future? <ul><li>The point is not to predict the future but to prepare for it and to shape it (more or ...
The future of health  care systems
STREET VISIONS
 
Fee for service for the rich Marks and Spencer style managed care  for the middle classes Safety net service for the poor
“ McDonalization” of medicine
 
<ul><li>“ Two roads diverged in a yellow wood. And sorry I could not travel both”   </li></ul><ul><li>Robert Frost </li></ul>
Where do we want to go?
 
Official Frameworks <ul><li>Patient centered </li></ul><ul><li>Evidence based </li></ul><ul><li>Supported by systems </li>...
Six L ines  4 a New Code   <ul><li>Safe and reliable care </li></ul><ul><li>Service redesign and transformation </li></ul>...
 
 
 
 
Final thought <ul><li>If you aren’t confused you don’t know what’s going on </li></ul><ul><li>Jack Welch, former CEO  </li...
THANKS 4 YUR ATTENTION
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Health Services at the crossroad

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A very personal view about health systems and services,

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Health Services at the crossroad

  1. 1. The Planning and Management of Health Services Working on the interface Jos é Francisco García Gutiérrez OPS/PAHO HSS/HR Nassau, 24 November 2011
  2. 2. My apologies ….but we do need to get to know each other <ul><li>Name </li></ul><ul><li>Work </li></ul><ul><li>Expectations </li></ul><ul><li>Hobbies </li></ul>
  3. 3. To understand my discourse <ul><li>Remembering </li></ul><ul><li>a friend and </li></ul><ul><li>a good man </li></ul><ul><li>Tony </li></ul><ul><li>Judt </li></ul>
  4. 4. Tony Judt remembered
  5. 7. <ul><li>From MACRO </li></ul><ul><li>to MESO </li></ul><ul><li>and MICRO </li></ul><ul><li>… and certain digressions </li></ul>
  6. 9. Evidenciators, Calidators, Implementators, Proceseitors, Genderators & Determinators What´s next?
  7. 10. S m a ll d i g re ss io n s
  8. 11. A new syndrome: Power Point Toxicity Funny but banal !
  9. 12. <ul><li>From MACRO </li></ul><ul><li>to MESO </li></ul><ul><li>and MICRO </li></ul><ul><li>… and certain digressions </li></ul>
  10. 13. Moving into the mud! <ul><li>Managers </li></ul><ul><li>Health professionals </li></ul><ul><li>Patients </li></ul><ul><li>Citizens </li></ul>
  11. 14. Moving into the mud! <ul><li>Management </li></ul><ul><li>Good clinical practice </li></ul><ul><li>Patients Patnerships </li></ul><ul><li>Citizens Engagement </li></ul>
  12. 15. HEALTH MANAGERS The dark side of the force?
  13. 16. Manager ´s Triangle <ul><li>Budget control </li></ul><ul><li>Priority goals </li></ul><ul><li>Social peace </li></ul><ul><li>Are you willing to add anything else? </li></ul>
  14. 17. Citizen ´s Triangle <ul><li>Accesibility (24/7) </li></ul><ul><li>High quality care </li></ul><ul><li>Unlimited care </li></ul><ul><li>Low cost (or free!) </li></ul>
  15. 18. The low moral among the professionals
  16. 20. FROM 2
  17. 22. Julian Tudor Hart <ul><li>“ My medical education began three times. What I learnt at medical school was no use in the hospital. What I learnt in the hospital was no use in general practice” </li></ul>
  18. 23. MEDICINE 2.0 <ul><li>Jay Parkinson at work! </li></ul>
  19. 24. Changing practice Cambio de prácticas clínicas
  20. 26. Are you wearing a wrist watch ? … why ???
  21. 27. From Baby-Boomers to G e n e r a t ion 2 0 2 0
  22. 31. The Side B
  23. 32. <ul><li>If reform is the answer… </li></ul><ul><li>What was the question ? </li></ul>
  24. 33. Is HEALTH a consumer good? …and health care?
  25. 35. <ul><li>IF YOU ARE THE PATIENT, </li></ul><ul><li>What type of care do you want to receive? </li></ul><ul><li>The other framework </li></ul>
  26. 36. The other framework Model Paterna- listic Informative Shared Ro l e No informed Partially informed Well informed Active Undecisive Pasive Information
  27. 37. That Old Dilemma <ul><li>From desire to reality </li></ul><ul><li>o </li></ul><ul><li>From reality to desire </li></ul>
  28. 38. Pictures of the future of health care
  29. 39. Dangers of predicting the future <ul><li>Sam Goldwyn Mayer </li></ul><ul><li>“ I never make predictions, especially about the future.” </li></ul>
  30. 40. Why bother with the future? <ul><li>&quot;If you think that you can run an organisation in the next 10 years as you've run it in the past 10 years you're out of your mind.&quot; </li></ul><ul><li>CEO, Coca Cola </li></ul>
  31. 41. Why bother with the future? <ul><li>“ The future belongs to the unreasonable ones, the ones who look forward not backward, who are certain only of uncertainty, and who have the ability and the confidence to think completely differently.” </li></ul><ul><li>Charles Handy </li></ul><ul><li>(quoting Bernard Shaw) </li></ul>
  32. 42. Why bother with the future? <ul><li>The point is not to predict the future but to prepare for it and to shape it (more or less) </li></ul><ul><li>Myself (sorry!) </li></ul>
  33. 43. The future of health care systems
  34. 44. STREET VISIONS
  35. 46. Fee for service for the rich Marks and Spencer style managed care for the middle classes Safety net service for the poor
  36. 47. “ McDonalization” of medicine
  37. 49. <ul><li>“ Two roads diverged in a yellow wood. And sorry I could not travel both” </li></ul><ul><li>Robert Frost </li></ul>
  38. 50. Where do we want to go?
  39. 52. Official Frameworks <ul><li>Patient centered </li></ul><ul><li>Evidence based </li></ul><ul><li>Supported by systems </li></ul><ul><li>Safe & On time </li></ul><ul><li>Effective & Efficient & Equitative </li></ul>
  40. 53. Six L ines 4 a New Code <ul><li>Safe and reliable care </li></ul><ul><li>Service redesign and transformation </li></ul><ul><li>Leadership and business management </li></ul><ul><li>Clinical improvement and innovation </li></ul><ul><li>Patient partnerships </li></ul><ul><li>Learning, education and culture </li></ul>
  41. 58. Final thought <ul><li>If you aren’t confused you don’t know what’s going on </li></ul><ul><li>Jack Welch, former CEO </li></ul><ul><li>General Electric </li></ul>
  42. 59. THANKS 4 YUR ATTENTION

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