Browsing Articles Written by

Alberto de Rosa

English, Opinión

Tripping twice (or a thousand times) on the same stone

26 febrero, 2020 • By

I have spoken several times on this blog about waiting lists, and this time I want to start with public recognition of the transparency exercise undertaken by the Generalitat. Even when the data isn’t good, there is no doubt that transparency is essential in a mature society that aspires to progress. Unlike many, I like to recognise and appreciate other people’s work when they do things right.

The publication of the waiting lists by department may have generated a certain level of controversy and debate, but these advances in transparency by the public institutions are fundamental in order to search for solutions to the problems: just like in Healthcare, when there is a clear diagnosis, the correct treatment can be applied. If you cheat at Solitaire, you’ll always be deceived.

The information made public by the Conselleria de Sanidad (Department of Health) has allowed us to learn that there are hospitals with an average waiting list of five months (154 and 140 days). And given that the average is almost half a year, that means that there are people who wait a year or more… something which is incomprehensible in the year 2020. The average waiting time in the Community of Valencia is 86 days, which is a slightly better figure in comparison to last year, which shows that, beyond the inefficient government policies, the professionals are always committed to offering good healthcare to the citizens. For them to have the necessary tools is another story. As the regional secretary stated at an appearance, “operations don’t take place in the offices, they take place in the operating theatres”. I couldn’t agree more.

However, beyond these general details, there are two points that I would like to highlight. The data provided by the Department of Health clearly reflects that the concession model significantly contributes towards the reduction of average waiting times, with tremendously favourable and positive data. I have read some comments that question these figures, coming from people that I have not seen in my day-to-day work in healthcare management during 30 years of experience in the sector, ladies and gentlemen that have never asked or learned about the reality of healthcare offered by the public-private collaboration model. In politics, as in almost all scopes of life, we must first learn the reality in order to later have a valid opinion and not just talk about what we’ve heard or follow scripts, which, by the way, are written by more people who have never seen the reality of what they are now discussing as though they are authorities on the subject.

These types of people are the ones who believe that the best way to hide the failure of their management is to question the success of others. Mediocracy is a way of life for some. What a shame.

Well, let me tell you that the Department of Health itself recognises, in this publication of waiting lists by health department, that the Ribera Salud hospitals are positioned among the top three in the Community of Valencia. That is to say, at our hospitals, citizens wait for half the amount of time than the average in hospitals in our region and up to four times less than the longest waiting lists. The numbers are stubborn.

There is another point of information that must be highlighted and that is interesting to analyse in this scope of Healthcare: the decreased quality of care at Hospital de la Ribera just 20 months after the Department of Health took over direct management. The waiting lists have moved from 57 to 78 days in less than two years, and those who wait for longer than 90 days have tripled in number, despite having hired almost 900 people. And this is only just getting started, despite the commendable work that I know the professionals at La Ribera are carrying out. The fact that something (or many things) are failing is evident.

I know that some people find it difficult to understand that it is important to have an open mind in order to seek new formulas that can help us, as a society, to improve the healthcare system and, above all, to make it sustainable over time. We must be flexible. And brave. To publish the waiting lists by department might be the first step, but bravery is necessary in order to make decisions.

If there are many indicators that clearly describe a situation, the problem is not the data but rather the underlying cause behind the data. I understand that I can get repetitive about these types of analyses, but it is necessary because sometimes we are forced to undertake positive pedagogy. When we talk about waiting lists, we’re not talking about numbers but about people.

This leads me to the appearance by the regional secretary of healthcare technology and efficiency, Concha Andrés, on February 10th, where the solution she suggested for current waiting lists was to send patients to hospitals with shorter waiting times. Given that she has not contacted either of the Ribera Salud hospitals, both positioned among the three hospitals with the shortest waiting times, I will take this opportunity to offer the healthcare clinics in our group to help them to improve the waiting times for patients in the Community of Valencia.

Cataracts, bunions, hernias and whatever is required in Traumatology, Ophthalmology, Otolaryngology or General Surgery. I’m sure that may of these ailments with the longest waiting lists are suffered by older patients, and we cannot allow political prejudice to have a negative impact on those who deserve our utmost respect for everything they have contributed, and continue to contribute, to our society.

For this reason and for the good of all of our citizens, I will never stop trying to be constructive and positive and trying to build bridges and collaborations with the public administration, always in favour of quality, efficient and sustainable healthcare.


Alberto de Rosa, Opinión

Tropezando dos (o mil) veces en la misma piedra

25 febrero, 2020 • By

He hablado en varias ocasiones en este blog de las listas de espera y en esta ocasión quiero comenzar con un reconocimiento público al ejercicio de transparencia que ha hecho la Generalitat. Aunque los datos no son buenos, sin duda la transparencia es imprescindible en una sociedad madura que aspira a progresar. Y a diferencia de muchos, me gusta reconocer y agradecer a los demás su trabajo cuando las cosas las hacen bien.

La publicación de las listas de espera por departamentos puede haber generado cierta controversia y debate, pero estos avances en la transparencia de las instituciones públicas son fundamentales para buscar soluciones a los problemas: como en Sanidad, cuando se tiene un diagnóstico claro, se puede aplicar el tratamiento. Si haces trampas al solitario, vivirás engañado siempre.

La información hecha pública por la Conselleria de Sanidad nos ha permitido conocer que hay hospitales que tienen cinco meses de espera media (154 y 140 días). Y como la media es de casi medio año, eso quiere decir que hay personas que esperan un año o más… algo inconcebible en el año 2020. La media de espera en el conjunto de la Comunidad Valenciana se sitúa en 86 días, que es una cifra algo mejor que el año anterior, lo que demuestra que más allá de las políticas ineficaces de los Gobiernos, los profesionales están siempre comprometidos en ofrecer una buena atención sanitaria a los ciudadanos.  Otra cosa es que les den las herramientas necesarias. Como dijo la secretaria autonómica en su comparecencia, “no se opera en los despachos, sino en los quirófanos”. Y no puedo estar más de acuerdo.

Sin embargo, más allá de estos datos generales hay dos apuntes que quiero destacar. Los datos aportados por Sanidad reflejan con claridad que el modelo concesional contribuye significativamente a la reducción de las listas de espera medias, con unos datos enormemente favorables y positivos. He leído algunos comentarios que ponen en cuestión estas cifras, procedentes de personas que no he visto en el día a día de la gestión sanitaria en mis 30 años de experiencia en el sector, señoras y señores que nunca han querido preguntar ni mucho menos conocer de cerca la realidad de la atención sanitaria que ofrece el modelo de colaboración público privada. En política, como en casi todos los ámbitos de la vida, hay que conocer la realidad para luego opinar con fundamento y no hablar de oído o siguiendo argumentarios, escritos por cierto, por personas que tampoco han conocido  nunca la realidad sobre la que sientan cátedra.

Este tipo de personas son las que creen que el mejor modo de disimular el fracaso de una gestión es poner en duda el éxito de otra. La mediocridad como bandera siempre para algunos. Qué pena.

Pues déjenme que les diga que es la propia Conselleria de Sanidad la que reconoce en la publicación de las listas de espera por departamentos de salud que los hospitales de Ribera Salud se sitúan entre los tres mejores de la Comunidad Valenciana. Es decir, en nuestros hospitales los ciudadanos esperan dos veces menos que en la media de hospitales de nuestra región y hasta cuatro veces menos que los que más lista de espera acumulan. Los números son tozudos.

Hay otro dato que también es importante destacar e interesante analizar de esta información de Sanidad: el empeoramiento en la atención en Hospital de la Ribera solo 20 meses después de comenzar la gestión directa de la Conselleria. Sus pacientes han pasado de esperar 57 días a 78 días en menos de dos años y los que esperan más de 90 días se han triplicado, a pesar de haber contratado a casi 900 personas. Y esto no ha hecho más que empezar, a pesar del encomiable trabajo que me consta que realizan los profesionales de La Ribera. Que algo (o mucho) está fallando, es más que evidente.

Sé que a algunos les cuesta entender que es importante tener una mentalidad abierta para buscar nuevas fórmulas que nos ayuden, como sociedad, a mejorar el sistema sanitario y, sobre todo, a hacerlo sostenible en el tiempo. Hay que ser flexibles. Y valientes. Publicar la realidad de las listas de espera por departamentos puede ser el primer paso pero se necesita valentía para tomar decisiones.

Si muchos indicadores describen claramente una situación, el problema no son los datos sino qué los ha originado. Entiendo que puedo ser reiterativo con este tipo de análisis, pero es necesario porque hay quien nos obliga a seguir haciendo pedagogía positiva. Cuando hablamos de listas de espera no hablamos de números sino de personas.

Y esto me lleva a la comparecencia de la secretaria autonómica de Eficiencia y Tecnología Sanitaria, Concha Andrés, el pasado 10 de febrero, en la que  planteó como solución a las listas de espera actuales enviar enfermos a hospitales con poca espera. Dado que no se ha puesto en contacto con ningún hospital de Ribera Salud, ambos situados entre los tres con menor espera, aprovecho este blog para ofrecerle lo centros sanitarios de nuestro grupo para ayudarles a mejorar los tiempos de espera de los pacientes de la Comunidad Valenciana.

Cataratas, juanetes, hernias y lo que necesiten en Traumatología, Oftalmología, Otorrinolaringología o Cirugía General. Estoy seguro de que muchas de estas dolencias con más espera están vinculadas a personas de edad y no podemos permitir que un prejuicio político perjudique a quienes merecen nuestro máximo respeto, por lo que han aportado y lo que aún aportan a la sociedad.

Por ello y por todos, no me cansaré de intentar ser siempre constructivo y positivo y tratar de construir puentes y vías de colaboración con la administración pública, en favor siempre de una asistencia sanitaria de calidad, eficiente y sostenible.


English

We all create the future together

21 enero, 2020 • By

The future belongs to the brave. Ronald Reagan said this phrase, so frequently repeated by coaching experts, to the North Americans after the Challenger tragedy in 1986. His message was clear: We can never give up, we must always be looking forwards, work hard, get up after every fall, keep moving and never stay still. It is difficult, but of course, if you have help, it is easier.

This help is the great value contributed to society by Lanzadera and, if you allow me, the companies that form part of its Corporate program, in order to boost innovative projects in various sectors: from health to aerospace engineering, including nutrition and logistics. Ribera Salud has already started two work with two teams of young entrepreneurs who have been selected from among the Lanzadera experts and our technology subsidiary, Futurs, for their initiatives to revolutionise and improve healthcare for citizens. This is based on an app, Serenmind, to facilitate self-guided psychological treatment, with monitoring by a professional for all citizens; and a platform, HumanItCare, to gather, organise and analyse the information of people with chronic diseases in order to improve their quality of life and their health results.

When we were invited to participate in the Corporate program by Lanzadera, we immediately noticed that their philosophy perfectly fit in with the mission, vision and values of Ribera Salud. We have a responsibility to the society that we serve. The possibility of participating in the selection of innovative projects in the health sector and of helping the creators to develop them in our hospitals allows us, once again, to stay one step ahead of society’s needs, which are always changing and increasingly demanding.

At the same time, this has allowed us to directly interact with an eco-system around innovation and entrepreneurship that the businessman Juan Roig has highlighted, once again giving a first-hand example of the importance of bravery in the business world and in life. And we have found so many brave people throughout the difficult process of choosing between the dozens of projects presented, just in the health sector! From here, I would like to congratulate all of you and encourage you to keep working hard to meet your goals.

For Ribera Salud, without a doubt, this experience has been an incentive to grow better every day and to offer maximum quality healthcare. We are proud to participate alongside great companies such as Airbus, Mercadona and Facsa in a project for business support for young entrepreneurs that will help them to develop their projects here, in Spain. We are all firmly focused on boosting, attracting and retaining talent in our country in order to offer the best service for our citizens. With this support for innovative initiatives, we give back to society part of the trust that we have received from it. We are connected by one single goal: to help to build a better future for the society we serve.

The various public administrations ought to observe Lanzadera as an example to be followed, as well as the firm focus of Juan Roig to consolidate a genuine entrepreneurial “hub” in the city of Valencia, the province of Valencia and all over Spain, starting with the creation of the EDEM University, continuing with the Lanzadera projects and culminating with Angels Capital, the society used to invest in these entrepreneurial leaders. So, yes. The companies participating in the Corporate program by Lanzadera are also contributing our grain of sand so that new entrepreneurial initiatives can come to light and be successful, because they contribute towards improving our activity while always providing better results for our citizens.

At Ribera Salud, good health results alone are not enough, given that nowadays we are working with very high standards and models, always aiming to improve healthcare for our citizens. Professionalism, integrity, passion, innovation and responsible and sustainable health management are in our DNA, based on the 5 P’s that we apply to the medicine that we practice: preventive, predictive, personalised, participative and population-based.

The future is now and we are building it with hard work, effort and passion.


Alberto de Rosa, Opinión

El futuro lo creamos entre todos

20 enero, 2020 • By

El futuro es de los valientes. Esta frase, tan repetida desde hace unos años por expertos en coaching, se la dijo Ronald Reagan a los norteamericanos tras la tragedia del Challenger en 1986. Su mensaje era claro: No hay que rendirse nunca, hay que mirar  siempre hacia delante, trabajar duro, levantarse después de cada tropiezo, avanzar y no quedarse estancado. Cuesta, pero está claro que si te ayudan, es más fácil.

Y esa ayuda es el gran valor que hoy en día aportan a la sociedad Lanzadera y, permítanme, las empresas que participamos en su programa Corporate, para impulsar proyectos innovadores en diferentes sectores: desde Sanidad hasta ingeniería aeroespacial, pasando por Alimentación y logística. Ribera Salud ha empezado a trabajar ya con los dos equipos de jóvenes emprendedores que han sido seleccionados, entre los expertos de Lanzadera y los de nuestra filial tecnológica, Futurs, por sus iniciativas para revolucionar y mejorar la asistencia sanitaria de los ciudadanos. Se trata de una aplicación, Serenmind, para facilitar tratamiento psicológico autoguiado, con el seguimiento de un profesional a todos los ciudadanos; y una plataforma, HumanItCare, para recopilar, ordenar y analizar la información de enfermos crónicos para mejorar su calidad de vida y sus resultados de salud.

Cuando nos invitaron a participar en el programa Corporate de Lanzadera, enseguida nos dimos cuenta de que su filosofía encajaba perfectamente con la misión, la visión y los valores de Ribera Salud. Tenemos una responsabilidad con la sociedad a la que servimos. Y la posibilidad de participar en la selección de proyectos innovadores en el ámbito de la Sanidad y ayudar a sus creadores a desarrollarlos en nuestros hospitales nos permite, una vez más, ir un paso por delante de las necesidades de la sociedad, siempre cambiante y con un nivel de exigencia cada vez más alto.

Al mismo tiempo, nos ha posibilitado interactuar directamente con un ecosistema alrededor de la innovación y el emprendedurismo que el empresario Juan Roig ha puesto en valor, dando ejemplo una vez más en primera persona, de la importancia de la valentía en el mundo empresarial, como en la vida. ¡Y cuántos valientes hemos encontrado en el duro proceso de selección entre las decenas de proyectos presentados, solo en Sanidad! A todos os doy desde aquí la enhorabuena y os animo a seguir trabajando duro para conseguir vuestra meta.

Para Ribera Salud, sin duda, esta experiencia es un incentivo para ser cada día mejores y ofrecer una atención sanitaria de la máxima calidad. Es un orgullo participar junto a grandes empresas como Airbus, Mercadona y Facsa en un proyecto de apoyo empresarial a jóvenes emprendedores que les ayuda a desarrollar sus proyectos aquí, en España. Todos apostamos firmemente por potenciar, atraer y retener el talento en nuestro país para ofrecer un mejor servicio a los ciudadanos. Con este apoyo a iniciativas innovadoras, devolvemos en parte a la sociedad lo que ella nos da con su confianza. Nos une un solo propósito: ayudar a construir un futuro mejor para la sociedad a la que servimos.

Desde las diferentes administraciones públicas se debería tomar ejemplo de Lanzadera y de la firme apuesta de Juan Roig por consolidar en Valencia, en la Comunidad Valenciana y en España un auténtico “hub” emprendedor, que comienza con la formación en la universidad EDEM, continúa con la aceleradora de proyectos Lanzadera y culmina con Angels Capital, la sociedad con la que invierte en esos líderes emprendedores. Y, sí. Las empresas que participamos en el programa Corporate de Lanzadera también aportamos nuestro granito de arena para que nuevas iniciativas empresariales vean la luz y tengan éxito, porque contribuyen a mejorar nuestra actividad pero esta mejora redunda siempre en los ciudadanos.

En Ribera Salud no nos conformamos con los buenos resultados de salud que ya hoy da nuestro modelo y trabajamos con el listón muy alto, pensando siempre en mejorar la atención sanitaria a los ciudadanos. En nuestro ADN está la profesionalidad, la integridad, la pasión, la innovación y la gestión responsable y sostenible de la Sanidad, basada en las 5 P’s que aplicamos a la Medicina que practicamos: preventiva, predictiva, personalizada, participativa y poblacional.

El futuro es hoy y se construye con trabajo, esfuerzo e ilusión.


English

Condemned to wait?

2 enero, 2020 • By

The year is ending with the worst waiting lists in the recent history of Spain. The Ministry of Health has published this information by autonomous communities on September 30th and the balance is shocking. The average waiting time on a national scale has moved from 93 to 115 days in just one year. This is to say, patients have to wait almost a month longer to be operated than they did in 2018.

It is true that this is a situation we have been experiencing for many years in the public system. Too many years. It is a genuine curse, meaning that the Spanish health system is not effective and is causing serious harm to its citizens, who ought to be the focus of the system and yet feel like they are victims of it.

More than half a million Spaniards (671,494 in June) will spend this Christmas waiting for a surgical intervention that, on average, will be delayed by almost four months. Some people wait a year.

I worry that, if after a fifth of the 21st century we still have the worst waiting lists in history, all signs point to this being a structural problem rather than circumstantial.

But as Einstein said: “If you are looking for different results, don’t always do the same”. And that is exactly what our politicians are doing. It is incomprehensible to listen to them talking about solutions as ineffective as paying professionals to attend to patients on the waiting list outside of their usual working hours. Why? Because this measure is outdated, it goes against an efficient management model, it implies an obsolete personnel policy and has been proven to be completely ineffective. When I started to work in the health sector, in 1990, it was already being said that working overtime was not the solution, as the system itself promotes working extra hours, lack of family balance and excessive working hours, with the consequent reduction in safety at work for the professionals. Also, genuine bottlenecks are created because it is only applied to professionals in surgical specialties when others, such as GPs or paediatricians have the same problems with waiting lists.

Another of the measures proposed by the politicians time and time again, as if this were “Groundhog Day”, are the crash plans. There are governments that resist the establishment of stable and efficient overtime in the private sector and apply these types of temporary measures, thinking that this is a circumstantial problem, when that is not the case. The crash plans have also been shown to be inefficient in the long term, as they do not reduce the lists.

So what is the solution? We can’t perform magic, but we must all be brave: The governments, to apply new management formulae in the public system, such as the Ribera Salud model, or at least tools that have been proven efficient such as modern management of human resources; and the private initiative, to innovate and offer the best healthcare to citizens, with long term collaboration formulae with the public administration. Administrations and companies must always place the patient in the centre of the system and motivate and encourage professionals to reach their goals, including quality of care, delay, suitability of facilities, waiting lists, etc.

The waiting lists are a structural problem, and if we want to face the new challenges of the Healthcare Sector with determination, we must get to the bottom of the problem, to the active ingredient of the system, the professionals. We must give them the importance they deserve and rewards that are not only economical but also professional recognition, flexibility and family balance, training and research, as well as variable compensation. It is necessary to align the objectives of the professionals with those of the organisation, to open the services in the morning and in the afternoon and to do away with the rigidity of a public system that resists modernisation of its modus operandi. Also, it is important that we work together on our focus on technology as a tool to facilitate work for professionals and to improve the care and information for patients.

While we continue to apply the same responses to the same problems, the result will not change. The clearest evidence that things can be done differently is the Report by the Court of Auditors of the Generalitat Valenciana, where this advisory board for the Government of Valencia ensures that the waiting list at the Torrevieja hospital is three times shorter than the average in Valencian hospitals.

At Ribera Salud, we are brave. We aren’t perfect, but we always make an effort to improve and to offer the best healthcare. And that, in the end, is truly placing the citizen at the centre of the system and giving importance to the principal asset of the system, the professionals, so that they can lead the process of change.

Given the current time of year, I’d like to take this opportunity to wish a very merry Christmas to all the readers of this blog and a happy New Year.