Better Quality for Better Hospitals
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Alexandre Lourenço's keynote on "Better Quality for Better Hospitals", at the 42nd World Hospital Congress, organized by International Hospital Federation, Lisbon 27th of October 2023.
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Better Quality for Better Hospitals
- 1. Alexandre Lourenço www.alexandrelourenco.eu Better quality for better hospitals Building Hospital Resilience through Quality of Care
- 2. National quality framework Lead by the General Directorate for Health National Accreditation program
- 5. Patients with controlled diabetes 70,3 % VS Conventional primary care units Model B Family Health Units 41,5 %
- 7. … emerged paradox of framentation. © 2022 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 8. Inability to provide patient centred care © 2020 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 9. 9 Poor coordination at the interfaces between different parts of the system © 2020 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY Hospital Long-term care Primary care Public health Communit y health care Mental health care At the interfaces between care services, we see: Failure to share information Duplication of effort Errors Delays Poor quality care Source: Adapted from OECD, 2018
- 15. "There is nothing so useless as doing efficiently that which should not be done at all."
- 16. High-value care means providing the best care possible, efficiently using resources, and achieving optimal results for each patient. JAMA 2015;314(22): 2462 © 2020 ALEXANDRE LOURENÇO CONFIDENTIAL AND PROPRIETARY
- 17. Harmonics, a stroke care ecosystem harmonicsproject.eu
- 20. Stages of developing health services delivery Conventional care Selective PHC; vertical organization; management of production; quality of inputs Disease-oriented Disease management; linkages; management of resources; quality of outputs Coordinated services Care management; horizontal; management for performance; quality of processes Integrated services Whole-person; collaborative; management for outcomes; quality of outcomes
- 23. Integrated Delivery Care Preventive Healthcare and Public Health Interventions
- 25. Alexandre Lourenço www.alexandrelourenco.eu More care quality through integrated delivery models
Editor's Notes
- Good morning To be high value or not to be is the title of my today’s presentation. How to lose high-value care in ten simple steps.
- Gestão por Objetivos/ Contratualização Interna Para alcançar resultados específicos a partir da definição desses objetivos departamentais, as organizações podem usar um processo chamado gestão por objetivos (MBO). O termo e o conceito foram introduzidos pelo especialista em administração Peter Drucker (1954). MBO é um conceito de gestão integrada, contendo elementos da função de planeamento juntamente com gestão participativa, colaboração, motivação e controle. É o processo de estabelecimento de metas colaborativo pelo gerente e subordinado. O grau em que os objetivos são alcançados desempenha um papel importante na avaliação e recompensa do desempenho do subordinado. O MBO demonstra as inter-relações das funções gerenciais e a abordagem de sistemas de gestão. Portanto, o MBO também é discutido em outros capítulos deste livro. Esta seção, no entanto, está principalmente preocupada com o significado de MBO em relação ao estabelecimento e alcance de objetivos.
- At the same time, the hospital services are more differentiated, medical professionals get more specialized, medicines and treatment are more precise. Healthcare is more and more centered on the professionals role and bureaucracy then on the person.
- a new paradox emerges. The dichotomy of high differentiation and increased disintegration, particularly for patients with multimorbidity and aged.
- This approach (integrated care) is complemented by the concept of people-centred models of care, which focuses on meeting the health needs and expectations of people throughout the life-course. It aims to balance the rights and needs of patients with their responsibilities and capacity as stakeholders in the health system. [Describe the route from conventional care to integrated services]
- We are pretty fare from high-value care. A system that is more and more detached from individual and population needs. Ignoring that today’s needs differ from those observed in the past. Population aging and multimorbidity, the increase in citizens’ expectations, fiscal constraints in a context of low economic growth and inflation, the emergence and re-emergence of infectious diseases, or even the digital society, pose new and essential challenges to a structurally inflexible and rigid health system. A system that has proven incapable of promoting health and preventing disease, eliminating variability and inequity in access, and providing integrated care focused on people’s needs. A system like this bridge in Choluteca, Honduras, could not adjust to the river course.
- First of all, if we want to lose something, we need to know what that thing is. So, when we talk about high-value care, we mean providing the best care possible, efficiently using resources, and achieving optimal results for each patient. That is, best care, best use of resources, best outcomes, for each patient.
- We know that the same configuration of care will only permit the same functions to be provided. The pandemic contingency catalyzed care structural change and allowed healthcare to perform different functions.
- It is at this point that managers need lead health systems to change configuration and perform complex functions, like people centered.
- Good morning To be high value or not to be is the title of my today’s presentation. How to lose high-value care in ten simple steps.