Aplicación de un modelo de gestión empresarial en un servicio central hospitalario público. Experiencia de cinco años

Abstract

The current healthcare system is reaching a peak in performance. Available resources tend to be insufficient to make the health care as it is today: universal and free. New technologies and its use is sometimes not justified, the emergence of new drugs and the tendency to investigate funding for assistance can make in the medium term, a predictable system failure._x000D_ Politicians have been warned of the change and have begun to speculate on health models, and pressure is transmitted to the managers of health facilities who have been forced to improve their operating accounts. Outsourcing experiences, have been made some of which are limited to the central non-care (laundry, kitchen, storage, etc.) However other loaning outsource are sent to private laboratories that are managed by closed-priced packages. Scale economies play an important role in the sector and it is not uncommon for certain techniques of blood samples to travel several hours to their processing units. This reality: outsourcing and concentration is being introduced gradually in the sector._x000D_ In the document you will find the development experience of nearly 10 years of managing a clinical laboratory in an institution adapting to future professionals involved in the _x000D_ change. The most relevant conclusions of the thesis are:_x000D_ 1. The criteria of economic management of hospital services, today are not marked by the profesionals. Several causes prevent that heads of departments assume their responsibilities relating to economic management. Amongst them to be highlighted is:_x000D_ – The lack of delegation of financial items that perform directions._x000D_ – The lock of preparation of the professionals in the fields of management._x000D_ – The completely negative reinforcement received from the management for "Successful management" (management by objectives)._x000D_ – The null or merely symbolic value of the annual budget._x000D_ 2. The hematology and microbiology services in general, considerer that with a good technical know how is sufficient . It is necessary to adapt to the needs of the times and not only to have good products, but it is necessary to manage the resources well, to obtain for more competitive products. Unlike hematologists, microbiologists and immunologists, biochemists (doctors, pharmacists, analysts) have been incorporated into new developments and lead, with extensive advantage, the change in the laboratory._x000D_ 3. Some managers believe, without much criteria, that the outsourcing of the laboratory services may be able to balance their economic accounts and feel it is best a fixed expense budget rather than the risk posed by one’s own laboratory. The economic cost of the laboratory is intrinsically linked to the added value generated for the company's global. A good definition of goals and a correct monitoring of these will result in a better overall management of the hospital._x000D_ 4. The concept of "Taifa Kingdoms" which some directors or managers of headquarters, have will without doubt, result in the loss of competitive capacity and inadequacies with the environment. This loss of competitive capacity is such you can think of outsourcing criteria and / or absorption of the managers of the centers._x000D_ 5. Laboratories and other central services have been considered classically as cost centers or centers of consumption. When involvement of professionals in the business concept becomes total we can start talking total about profit centers._x000D_ 6. The current trend in medicine is a commitment to expanding technology, abandoning the traditional concept of history and physical examination to give more value to the more sophisticated "monoclonal antibody". The role of laboratory professionals is not to make many determinations, the best price, but to make those determinations suitable for the patient and which would give an added value. The literature shows excessive use of laboratories and, probably, from these they should do sessions / information campaigns to clinicians on the cost of inefficiency._x000D_ 7. The economy scale sometimes has a limit and is exceeded, but at an increasingly high cost._x000D_ 8. The product portfolio of each center is modulated by demand generated by their clinical and interests of physicians in the laboratories. Strategic alliances with one's competitors in thesector can afford to expand product portfolios and improve scale economies ._x000D_ 9. Each laboratory should have its star products, which must be differentiated in the industry and partly to justify its raison d'etre, these star products are the currency of exchange in strategic alliances._x000D_ 10. The value of the team leader must not only meet criteria of technical and scientific excellence, which are assumed, but the main capacity of the new leader is the knowledge services staff that is responsible and the ability to pull together the interests ofprofessionals, the company and its own in a single direction. If the leader is not capable of this, his work has a limited horizon.

Date of Award	14 Dec 2000
Original language	Undefined/Unknown
Supervisor	Miquel-Lluís Rutllant Bañeres (Director)