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Alberto de Rosa

Alberto de Rosa, English

Together, a step ahead of the virus

13 marzo, 2020 • By

As a society, we are facing a global crisis caused by the COVID-19 coronavirus, a public health threat that originated China and spread across several countries to neighbouring Italy, France and Spain and is now a global pandemic. It is this century’s first crisis deserving of the name.

I’m not a doctor and cannot offer medical advice, but I can, as a healthcare manager at the head of a healthcare group, give my opinion on what is certainly an exceptional situation, one that is putting health organisations and professionals to the test.

While its essential to stay calm and not panic, it is equally important to take preventive measures and use common sense, even social isolation in certain circumstances, because some people are at higher risk of getting very sick from this illness, including older people and people with health problems. And because governments and local authorities are tasked with ensuring that public services continue to operate. And one of those priority services is health care.

The fear of decision-making in some countries has wasted precious time that could perhaps have prevented at least some of the consequences. Public convenience cannot put vulnerable populations, and above all the healthcare system as a whole, at risk. In Spain, the government’s position as of Sunday, 8 March, was centred on a “containment phase”. Everything suddenly changed on Monday, 9 March, and a series of decisions have been made since then, likely motivated by the growing number of cases in Spain.

The Spanish healthcare system is complex. Healthcare is a responsibility of the autonomous communities. But from my point of view, national public health transcends the regional sphere, because the level of movement and circulation in a country as developed as Spain is tremendous. And it is precisely at this point when a government must demonstrate that it can handle a crisis, set an example of responsibility and take the lead to determine, from the state level, the comprehensive policies and actions that are required nation-wide. For too many days now the public has been receiving contradictory messages—some football matches were played behind closed doors while others before a limited crowd, events with large crowds like bullfights were celebrated but only a certain number of fans were allowed to watch a basketball game—in a random, confusing and often contradictory set of measures from national health authorities. Not only is it important that the public listen to the authorities, but public health decisions must be coordinated as well.

Because it’s about prevention, not panic. And, above all, being a step ahead of the illness. And learning from the mistakes (and successes) of others. But we can’t be a step ahead of the virus if we suddenly take three steps sideways and two back. We must move forward in the fight against this crisis together, in the same direction.

An example of this type of decision is the cancellation of Valencia’s Fallas celebrations, which came late for some and for others was a decision not entirely justified by the number of cases in the region.

But I repeat: it’s better to prevent, to bolster support for healthcare professionals and help strengthen the healthcare system, than to regret in a few weeks’ time that we were not brave enough to do what needed to be done. It’s likely that we’ll never know what would have happened if other decisions had been made. But my personal position is clear; when it comes to health and safety, I prefer to be tough and make drastic decisions rather than regret inaction later.

I would like to ask the public for their patience and understanding. We are likely to be facing a tough few weeks ahead, but I’m confident that we’re going to win this battle. Let’s be cautious, follow the instructions from the authorities and shift our thinking from the individual to the risk you could pose by infecting your friends, family and colleagues with a potentially dangerous virus.

And I want to finish this blog post the way I should have started it, by expressing the deep pride I feel for the exceptional efforts of healthcare professionals who, once again, are examples to follow, people who serve as the public’s first line of defense in a crisis as severe as the one we are experiencing. And I would especially like to thank all the professionals at Ribera Salud for their commitment, professionalism and hard work. Everyone is demonstrating a commendable level of professionalism, dedication to service and solidarity among colleagues, and I am extremely proud to lead a team like the one Ribera Salud has in all hospitals.


Alberto de Rosa, Opinión

Todos juntos, un paso por delante del virus

11 marzo, 2020 • By

Nos enfrentamos como sociedad a una crisis global por el COVID19 o Coronavirus, un problema de Salud Pública que nació en China y se ha ido extendiendo por distintos países hasta llegar a la vecina Italia, Francia o España y se ha convertido ya en una epidemia global. Probablemente es la primera que merece este nombre en este siglo.

No soy médico, por lo que no puedo dar recomendaciones de salud, pero sí que puedo, como responsable de un grupo sanitario y gestor de la Sanidad, dar mi opinión sobre una situación, sin duda excepcional, y que nos está poniendo a prueba a organizaciones y profesionales que velamos por la salud de la población. 

Creo que lo primero que hay que hacer es no caer en alarmismo pero también es verdad que es fundamental tomarse en serio las medidas de prevención y aplicar el sentido común, recurriendo incluso al aislamiento social para según qué circunstancias, porque es un virus que ha demostrado su agresividad con determinados colectivos con enfermedades asociadas y grupos de edad. Y porque además, las autoridades y los gobiernos tienen que garantizar el mantenimiento de los servicios públicos. Y uno de estos servicios prioritarios es la Sanidad. 

El temor a tomar decisiones en algunos países ha supuesto perder un tiempo precioso que quizás podría haber evitado al menos una parte de las consecuencias. La comodidad de la ciudadanía no puede poner en riesgo a grupos de población frágil y, sobre todo, al sistema sanitario en su conjunto. En España, hasta el domingo 8 de marzo, parecía que el discurso oficial giraba en torno a una “fase de contención”. Sorprendentemente, el lunes 9 de marzo todo cambió y se han tomado decisiones en cascada desde entonces, probablemente obligadas por la evolución del número de casos en España.

El sistema sanitario español es complejo. La Sanidad es una responsabilidad de las comunidades autónomas. Pero desde mi punto de vista, la Salud Pública trasciende el ámbito regional, porque el nivel de movilidad y comunicación en un país tan desarrollado como España es enorme. Y es ahí cuando un Gobierno debe demostrar que puede manejar una crisis, dar ejemplo de responsabilidad y tomar las riendas para decidir, desde el ámbito estatal, las políticas y actuaciones necesarias, de manera unitaria en  todo el país. Durante demasiados días como sociedad nos ha chocado que algunos partidos de fútbol se celebraran a puerta cerrada y otros con público restringido, o que se autorizaran eventos multitudinarios como las corridas de toros pero se limitara el acceso a un partido de baloncesto, en una suerte de medidas de Salud Pública aleatorias y un tanto contradictorias. Es muy importante que los ciudadanos hagamos caso a las autoridades, pero también que todas las decisiones sobre Salud pública estén coordinadas.

Porque no se trata de alarmar sino de prevenir. Y lo más importante es ir un paso por delante de la enfermedad. Y aprender de los errores de otros (y también de sus aciertos). Pero no se puede ir un paso por delante si de repente damos dos pasos a un lado y uno atrás. Debemos avanzar en la lucha contra esta crisis todos juntos, en una misma dirección. 

Un ejemplo de este tipo de decisiones es la cancelación de las Fallas en Valencia, que para algunos llega tarde y para otros no está del todo justificada por el número de casos que hay en esta zona. 

Pero insisto en el mensaje que he dado antes: más vale prevenir, afianzar el soporte a los profesionales de la salud y ayudar a reforzar el sistema sanitario, a que nos arrepintamos dentro de una semanas por no haber sido valientes y hacer lo que era necesario hacer. Seguramente no sabremos nunca qué habría ocurrido de haber tomado otras decisiones. Pero personalmente tengo claro que en temas de salud y seguridad prefiero ser duro y tomar decisiones drásticas que no arrepentirme después. 

A la ciudadanía le pediría paciencia y comprensión. Probablemente afrontemos todavía unas semanas duras, pero estoy seguro de que vamos a ganar esta batalla. Seamos prudentes, sigamos las indicaciones de las autoridades y pensemos no ya en nosotros, sino en que podemos transmitir una enfermedad a familiares, amigos y compañeros de trabajo que puede ser grave.

Y quiero acabar esta entrada al blog del modo en el que seguramente debería haber empezado: proclamando el profundo orgullo que siento por el comportamiento excepcional de los profesionales sanitarios que, una vez más, están siendo un referente, situándose en primera línea de defensa de nuestra sociedad en una crisis tan importante como la que estamos viviendo. Y, permítanme, quiero agradecer especialmente a todos los profesionales de Ribera Salud su compromiso, profesionalidad y capacidad de trabajo. Todos están demostrando un nivel de responsabilidad, vocación de servicio y solidaridad entre compañeros que es encomiable y me siento muy orgulloso de liderar un equipo como el que Ribera Salud tiene en todos los hospitales y centros sanitarios. 


English

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.