[Towards excellence in hospital management. A description of strategical management model]

Abstract

Background and objective: Health services are evolving from the traditional view of paternalistic medicine towards a more informed and participatory patient-provider relationship. This situation includes the empowerment and participation of patients and their families in health management, including their joint responsibility in the development of health services. The objective of this article is to describe the experience in a large teaching hospital in Spain on the application of a model that focuses on a three-fold approach to healthcare management that includes the experience of the patient.

Material and methods: This approach is identified by the initials EMC2 transforming the E of excellence into 3main areas of improvement: methodology, clinical knowledge and client, or patient, experience. the model has been implemented in different areas: childbirth, asthma care, outpatient clinics, and operating theatre.

Results: In the case of childbirth, there was a reduction in caesarean sections, episiotomies, induction of delivery, mean hospital stay, and number of deliveries with instrumentation. The Net Promoter Score went from 82 to 86. There was also an improvement in the areas of patient experience, hospital procedures, and clinical knowledge. Qualitative improvement results were obtained in other areas such as, asthma management, outpatient visits, and the operating room.

Conclusions: This model can be applied to different areas. It promotes patient-focused practice, as well as system sustainability, efficiency, effectiveness, and level of satisfaction with the health care process.

Keywords: Clinical knowledge; Conocimiento clínico; Excelencia; Excellence; Experiencia del paciente; Gestión hospitalaria; Hospital management; Management methodology; Mejora de la calidad; Metodología de gestión; Patient experience; Quality improvement.