Health care system Transformation. Facing the challenge of strategic adjustment

Empowering transformation in health care. Preparing for a new role model of the health care system and the use of disruptive technologies. The need for effective communication of the strategic objectives and development of the new ability of Transformation. April 2015

Background:
After a thorough study, a public health authority was facing a dual challenge of addressing a sustainable increase in demand, both quantitatively and qualitatively, and also maintaining budgetary stability.
The ultimate decision was to expand capacity by increasing the number of available beds and services capacity in depth and scope, without reducing the quality of care in their five fundamental parameters : 1) Safe; 2) effective; 3) patient-centered; 4) equitable and 5) efficient.
Moreover, the situation of the organization had several major problems:
• The strategic management process was inmature and developed within a poor framework, limited exclusively to comply with the annual budget and its indicators, being the latter as an end in themselves.
• The behavior of the organization suffered from a lack of a comprehensive approach, causing waste of resources by executing activities that did not add any value. In fact, the objectives of the organization were fragmentary and its components had their own theory, often divergent, about what had to be done. Internal conflicts were resolved with zero-sum games, «who doesn’t win the game, loses»
• And finally, a previous process, trying a 1st transformation had failed due to three main reasons: 1) there was not effective communication; 3) the process was not planned using short-term goals that may motivate people to keep on changing, and 3) the organization’s c-suite declared victory prematurely.

Challenges:
Budgetary stability required to achieve an optimum balance between the necessary skills (be those existing, or to improve or to develop) and the most appropriate structure to deploy them effectively and efficiently.
In addition, the need for a new capacity: versatility came up in the process. This new ability, will allow the entire organization to anticipate changes, for example, in genomics, new technologies and the new role of the health care system model.
In transformation process, external agents of different nature, such as private clinics, vendors, freelancers, other public administrations, will be involved, and concerned. A comprehensive approach should also be adopted by those external actors with whom relevant information would be shared in a properly manner.

The effective communication became the corner Stone for the success of Transformation facilitating the unity of effort and resources concentration on what really matters, is to say: the common objective.

Results
The success of the first phase of the Transformation to achieve the selected targets was achieved; more health care capacity and new capabilities were developed; the improvement potential of the process called «single medical consultation» was able to achieve rates of 50% improvement after 18 months, which in turn increased dramatically the level of quality that was perceived by patients or users.

The levels of quality and safety while maintaining budgetary stability were reached by the deadline and many of the processes reached results that were much better than expected.
The objective of creating a new capability for versatility, also achieved results much better than expected, thanks to the satisfaction and pride of belonging to the «Demonstration Project» and the effective achievement of the objectives, both issues, indeed, constituted a very stimulating

point in order to meet and face the challenges that exist in the changes to seize coming opportunities.

The driving force that enabled the organization to achieve success was to place Communication as the central pillar of Transformation, as the corner stone for the entire flow of activity in the organization .
The following benefits for a powerful, healthy, motivated and effective organization were added thanks to the Transformation process

1. Everyone knew what the common goal was, getting as a result, the comprehensive and results-oriented approach and the commitment of all components surpassing the initial distrust, caused by the previous failed transformation process.
2. As a result, improved strategic management process from a focus on the annual budget execution disconnected from internal processes, organization’s results and strategic objectives, to be an organization open to respond to the circumstances of the environment through dynamic and flexible resource allocation approach and able to assess and decide on strategic alternatives.
3. It was internalized that barriers in health care processes due to organizational approaches are artificial. Patients go across service and level care and the system has to keep on tracking him at all time. The internalization of this concept of horizontal flow of activities, favored improvement rates above 50% improvement in all processes,moving from 2 months to 18 depending on both the technical and organizational complexity and the respective frequency of process execution.
4. All components internalized that the results are always outside the organization.

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