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La planificación estratégica en las organizaciones sanitarias
Abstract
Strategic planning is a completely valid and useful tool for guiding all types of organizations, including healthcare organizations. The organizational level at which the strategic planning process is relevant depends on the unit's size, its complexity, and the differentiation of the service provided. A cardiology department, a hemodynamic unit, or an electrophysiology unit can be an appropriate level, as long as their plans align with other plans at higher levels. The leader of each unit is the person responsible for promoting the planning process, a core and essential part of his or her role. The process of strategic planning is programmable, systematic, rational, and holistic and integrates the short, medium, and long term, allowing the healthcare organization to focus on relevant and lasting transformations for the future.Full English text available from:www.revespcardiol.org
... Es importante asegurar que todo el personal de salud tenga conocimiento de las normas sanitarias mínimas que deben aplicarse en los establecimientos de salud como un componente clave para la seguridad del paciente, del personal de salud, los acompañantes y visitantes [19] . Elaborar programas de formación continuada de calidad para todo el personal de salud del primer nivel de atención en todos los aspectos relacionados con la PCI, que permitan una contención adecuada de cualquier infección transmisible en el futuro [20] . ...
Objetivo: Conocer las barreras en la gestión de los establecimientos de salud que atienden a población indígena y afrodescendiente del Perú. Material y métodos: Se diseñó una encuesta virtual en gestión sanitaria al personal del primer nivel de atención de 89 establecimientos de salud (EESS) de 27 provincias, durante los meses de octubre y noviembre del 2021. Resultados:En el 73 % de EESS, el personal refiere no conocer el plan contra la tercera ola pandémica, 14,8% de EESS el personal refiere no está capacitado en manejo de la COVID-19, en el 22,7% de EESS se reunieron para coordinar cómo enfrentar la tercera ola pandémica, en el 83% de EESSel personal refiere no contar con presupuesto para su plan contra la COVID-19. Conclusiones:Hay barreras en la visión, gestión y presupuesto en EESS que atienden poblaciones indígenas yafroperuano, lo que afectaría la ejecución eficaz de estrategias para el control de la pandemiapor la COVID-19.
Palabras Clave: Servicios de Salud; Pueblos Indígenas; pueblos originarios; COVID-19; Administración Sanitaria; Perú. (Fuente: DeCS-BIREME).
... Por otro lado, los planes con márgenes más amplios de vigencia, pueden suponer una desactualización de las líneas de actuación en relación con las necesidades cambiantes, y por otro lado mostrar una menor actividad o destinación de recursos en esta área. (9) Las carencias en la vigilancia epidemiológica de la Salud Mental a nivel nacional se puede ver reflejada en la desigualdad detectada en la existencia de líneas estratégicas para la Salud Mental de niños y adolescentes, prioritaria y específica en algunas CCAA, pero ausente o entrelazada entre otros objetivos genéricos en la mayoría de ellas, esto podría explicarse en que las necesidades en la salud mental de niños y adolescentes no son iguales en todas las CCAA, pero en ese caso, la Línea Estratégica debería ser equiparable, aunque los objetivos concretos tuviesen variaciones relacionadas con dichas necesidades específicas. (10) La descripción de la estructura y red de recursos para la atención a la Salud Mental de niños y adolescentes también es desigual. ...
Introduccion: La Psiquiatría Infantil es una especialidad relativamente reciente. Es un área importante de trabajo ya que los datos reflejan que la tasa de prevalencia de trastornos mentales en niños y adolescentes se sitúa entre el 15 y el 20 % de la población infanto-juvenil a nivel mundial, o que el 80 % de los trastornos mentales de los adultos tuvieron comienzo antes de los 18 años. En toda España se puede ofrecer asistencia a niños y adolescentes, aunque ésta no se encuentra homogeneizada en todas las Comunidades Autónomas (CCAA). Adicionalmente, España es uno de los dos únicos países de la Unión Europea que no dispone de la especialidad de Psiquiatría del Niño y Adolescente. Al no existir a día de hoy una especialidad propia, el carácter de la atención ofrecida dependerá de la formación particular de cada profesional. Objetivo: Analizar la situación de la atención a la Salud Mental del Niño y Adolescente en España a través de los Planes Estratégicos de Salud Mental Autonómicos. Método: Se analizaron mediante lectura exhaustiva las líneas estratégicas de los 17 Planes Estratégicos de Salud Mental de todas las CCAA. Resultados: Se han encontrado desigualdades tanto en la vigencia y actualización de dichos planes, como en la estructura y oferta de recursos asistenciales y formativos. Conclusión: Hoy en día la especificidad en la atención a la Salud Mental del niño y adolescente se distribuye de forma desigual en España, dependerá de la CCAA en la que resida el niño o adolescente.
... Las organizaciones sanitarias del sector público requieren también que se tomen en cuenta tales particularidades además de las que ya hemos explicado anteriormente y que son propias de los sistemas y servicios de salud. [41][42][43][44][45][46] Para intentar aclarar esta situación, nos valdremos de un ejemplo hipotético en un país imaginario. Veamos: ...
During the last twenty years, a number of failures in the efficient management of resources have been brought to light in the public administration and particularly its healthcare organizations, but these ones were not generally shown in the statistical bulletins. Significant failures such as problems in sustainability of good health systems, many adverse events as a sign of poor quality care, or unjustified variation in medical practice made it clear that the main problem was not the amount of money you have, rather; what you do with that money. As a benchmarking approach, many successful management technologies from other sectors began to be tailored for using them in the public health care organizations. A management approach is something different from budgets cuts; it has nothing to do with eliminating services, restricting access or introducing co-payment; it deals with everything that does not create values for the patient and consume time and resources. Since the end of the 20th century up to now, health management has allowed those public health organizations which have it in place to raise quality and to create opportunities to doing more in health improvement with fewer resources. As it usually happens, the darkness and the light coexist and, sometimes, darkness prevails. That is why it is so important to identify it and to learn how to face it.
... Following its policy of disseminating scientific information to the cardiology community, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Revista Española de Cardiología offers a selection of the most relevant studies presented at the Scientific Sessions of the American College of Cardiology (Washington D.C., United States), specifically the Late-Breaking Clinical Trials. ...
Background. Elevated lipoprotein-associated phospholipase A 2 activity promotes the development of vulnerable atherosclerotic plaques, and elevated plasma levels of this enzyme are associated with an increased risk of coronary events. Darapladib is a selective oral inhibitor of lipoprotein-associated phospholipase A 2. Methods. In a double-blind trial, we randomly assigned 15 828 patients with stable coronary heart disease to receive either once-daily darapladib (at a dose of 160 mg) or placebo. The primary end point was the time to cardiovascular death, myocardial infarction, or stroke. Secondary end points included the components of the primary end point as well as major coronary events (death from coronary heart disease, myocardial infarction, or urgent coronary revascularization for myocardial ischemia) and total coronary events (death from coronary heart disease, myocardial infarction, hospitalization for unstable angina, or any coronary revascularization). Results. During a median follow-up period of 3.7 years, the primary end point occurred in 769 of 7924 patients (9.7%) in the darapladib group and 819 of 7904 patients (10.4%) in the placebo group (hazard ratio [HR] in the darapladib group = 0.94; 95% confidence interval [CI], 0.85 to 1.03; P = .20). There were also no significant between-group differences in the rates of the individual components of the primary end point or in all-cause mortality. Darapladib, as compared with placebo, reduced the rate of major coronary events (9.3% vs 10.3%; HR = 0.90; 95%CI, 0.82-1.00; P = .045) and total coronary events (14.6% vs 16.1%; HR, 0.91; 95% CI, 0.84-0.98; P = .02). Conclusions. In patients with stable coronary heart disease, darapladib did not significantly reduce the risk of the primary composite end point of cardiovascular death, myocardial infarction, or stroke.
... Por dó nde empezar? La formulació n de la estrategia de la organizació n debe ser impulsada por la alta direcció n 21 y dicha estrategia debería ser declinada de forma coherente por cada nivel de organizació n: de la estrategia corporativa (el conjunto de la organizació n) a la estrategia de las unidades (servicios o unidades de gestió n clínica), tal y como se señ ala en el artículo sobre planificació n estraté gica de esta serie 22 . Puesto que uno de los propó sitos del CMI es ayudar a la implementació n de la estrategia, no sorprende que en general se considere que el punto de partida ló gico para desarrollar un CMI en una organizació n sea precisamente el nivel de la alta direcció n. ...
Both prior literature and reported managerial practices have claimed that the Balanced Scorecard is a management tool that can help organizations to effectively implement strategies. In this article, we examine some of the contributions, dilemmas, and limitations of Balanced Scorecards in health care organizations. First, we describe the evolution of Balanced Scorecards from multidimensional performance measurement systems to causal representations of formulated strategies, and analyze the applicability of Balanced Scorecards in health care settings. Next, we discuss several issues under debate regarding Balanced Scorecard adoption in health care organizations. We distinguish between issues related to the design of Balanced Scorecards and those related to the use of these tools. We conclude that the Balanced Scorecard has the potential to contribute to the implementation of strategies through the strategically-oriented performance measurement systems embedded within it. However, effective adoption requires the adaptation of the generic instrument to the specific realities of health care organizations. Full English text available from:www.revespcardiol.org.
Background
Studying the organizational characteristics, factors and features in healthcare organizations will have its prompt in achieving the desired outcomes of the provided services. Addressing these variables, the subsequent study conducts a scoping review methodology to systematically evaluate existing information while focusing on conclusions and gaps representing organizational variables that have been shown to influence the management of healthcare organizations.
Methods
A scoping review was performed to shed the light on the healthcare organizations’ characteristics, features and factors.
Results
Fifteen articles were included in the final analysis of this study. Among the relevant studies, 12 were research articles and 8 were quantitative studies. Continuity of care, organizational culture, patient trust, strategic factors and operational factors are among the explored features that have an impact in the management of healthcare organizations.
Conclusion
This review shows the gaps in the management practice and in the management studies that address healthcare organizations.
Introduction:
Specific Scorecards are a key element to improve strategic lines aimed at enhancing intermediate health outcomes. Their implementation, involving professionals, requires identifying indicators linked to the outcomes of healthcare actions that the scientific literature may endorse. In addition, the inclusion of objectives that can be defined by parameterized by indicators of intermediate results in the health centre program contract, conveys the relevance of health actions and their impact on health.
Objective:
To describe the design, development and outcomes of the specific scorecards of indicators of intermediate health outcomes in the Primary Care information system (eSOAP) in order to promote the involvement of professionals in strategic management from clinical management.
Methods:
Phase 1: description of the process (preparation and publication of 147 indicators, 46 of them of chronicity). Phase 2: observational descriptive study on the use of professionals and managers and data on the intermediate health outcomes obtained.
Results:
A total of 268,849 reports were generated in 2017, with 35,835 reports of specific balanced scorecard (20%) being downloaded in just 6 months. One-quarter (25%) of the indicators of the Centre program contract are intermediate results. The percentage of diabetic patients controlled was 39.2%, and has improved significantly (P<.05) in 5 years.
Discussion:
The specific scorecards with indicators of intermediate outcomes linked to strategic lines and their inclusion in the program contracts enables professionals to become involved in clinical and strategic management and improves the decision making of professionals and managers.
The Pan-American and Iberian Federation of Critical Medicine and Intensive Therapy, A.C. (FEPIMCTI), has prepared its Strategic Plan for the next 5 years. In this Plan, it defines its course towards the future, establishes its long-term objectives and works to achieve success. Its strategic objectives are framed in consolidating the legal, fiscal and administrative structure, the updating of its statutes, the implementation of a process management system encompassed in a quality culture, the implementation of committees of experts, achieving academic excellence by developing training programs and giving visibility to the Federation. Their main values refer to equity, professionalism, respect and social solidarity. The implementation of the Strategic Plan in a collaborative manner must serve as a driving force for change to position FEPIMCTI as a relevant Scientific Society in the Critical Medicine of its member countries.
Resumen: Los gobiernos son los responsables de formular la política pública en salud y que por ende, también el análisis de la construcción, sistematización y desarrollo de las líneas de estas, así como su evaluación. El objetivo es evaluar experiencias de políticas públicas en promoción de la salud, mediante la identificación y análisis de evaluación para la sistematzación de indicadores; con ello identificar las líneas, acciónes y proyectos estratégicos de los direferentes programas estatales de promoción de la salud en México. Metodología descriptiva documental, se analizó 67 programas de promoción de la salud de los Estados de México. Resultados: Se identificaron los procesos de promoción de la salud, entre estás, las actividades de desarrollo organizacional (85,1%), seguido por el de actividades de desarrollo personal (41,8%), y finalmente aquellos de actividades de desarrollo político (44,8%). El 92,5% busca consolidar la promoción, el 68,7% está direccionado a la protección de la salud, y el 5,7% a la prevención de las enfermedades. En conclusión, la evidencia de la promoción y comunicación de la salud es un factor importante para diagnósticar las líneas de acción que deben impulsarse o modificarse para influir en los determinantes de la salud pública.Palabras clave: Políticas públicas; Comunicación y promoción en salud; Evaluación; Modelos.Abstract: Governments are responsible for formulating public health policy and therefore, also the analysis of the construction, systematization and development of the lines of these, as well as their evaluation. The objective is to evaluate experiences of public policies in health promotion, through the identification and analysis of evaluation for the systematization of indicators; with this, identify the lines, actions and strategic projects of the state health promotion programs in Mexico. Descriptive documentary methodology, 67 health promotion programs of the States of Mexico were analyzed. Results: Health promotion processes were identified, among them, organizational development activities (85,1%), followed by personal development activities (41,8%), and finally those of political development activities. (44,8%). 92.5% seeks to consolidate the promotion, 68,7% is directed to the protection of health, and 5,7% to the prevention of diseases. In conclusion, the evidence of the promotion and communication of health is an important factor to diagnose the lines of action that must be promoted or modified to influence the determinants of public health.Keywords: Public policies; Communication and promotion in health; Evaluation; Models.
Resumen
La Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva, A.C. (FEPIMCTI), ha elaborado su plan estratégico para los próximos 5 años. En este plan define su rumbo hacia el futuro, establece sus objetivos a largo plazo y trabaja para alcanzar el éxito. Sus objetivos estratégicos se enmarcan en consolidar la estructura legal, fiscal y administrativa, la actualización de sus estatutos, la implantación de un sistema de gestión de procesos englobados en una cultura de calidad, la puesta en marcha de comités de expertos, lograr la excelencia académica mediante la elaboración de programas formativos y dar visibilidad a la Federación. Sus principales valores hacen referencia a la equidad, profesionalismo, respeto y solidaridad social. La implantación del plan estratégico de forma colaborativa debe servir de motor de cambio para posicionar a la FEPIMCTI como sociedad científica relevante en la Medicina Crítica de los países miembros.
Management objectives at times create significant value conflicts that have so far been seldom studied. This article analyses the ethical issues created by the operational objectives of management for physicians who work in Spanish hospitals. These issues are as follows: (1) the current system places quantity above quality, which represents a predominantly economist management perspective; (2) the system is hierarchical, lacks participation and deprives clinicians of decision-making authority; (3) the objectives are focused on outdated activities in terms of the current reality of the healthcare system and should therefore be updated considering, for example, chronicity and the continuity of care. After analysing these issues, we created a proposal for developing management objectives based on prioritizing quality care (which ultimately results in efficient management), developing objectives in a participatory and mixed manner (with group and individual objectives) and designing new objectives in keeping with the current reality of the healthcare system. Putting this proposal into practice is not complicated because the final goal of clinicians and management is to provide optimal health care.
Management objectives at times create significant value conflicts that have so far been seldom studied. This article analyses the ethical issues created by the operational objectives of management for physicians who work in Spanish hospitals. These issues are as follows: 1) the current system places quantity above quality, which represents a predominantly economist management perspective; 2) the system is hierarchical, lacks participation and deprives clinicians of decision-making authority; 3) the objectives are focused on outdated activities in terms of the current reality of the healthcare system and should therefore be updated considering, for example, chronicity and the continuity of care. After analysing these issues, we created a proposal for developing management objectives based on prioritising quality care (which ultimately results in efficient management), developing objectives in a participatory and mixed manner (with group and individual objectives) and designing new objectives in keeping with the current reality of the healthcare system. Putting this proposal into practice is not complicated because the final goal of clinicians and management is to provide optimal health care.
Copyright © 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.
During the last twenty years, a number of failures in the efficient management of resources have been brought to light in the public administration and particularly its healthcare organizations, but these ones were not generally shown in the statistical bulletins. Significant failures such as problems in sustainability of good health systems, many adverse events as a sign of poor quality care, or unjustified variation in medical practice made it clear that the main problem was not the amount of money you have, rather; what you do with that money. As a benchmarking approach, many successful management technologies from other sectors began to be tailored for using them in the public health care organizations. A management approach is something different from budgets cuts; it has nothing to do with eliminating services, restricting access or introducing co-payment; it deals with everything that does not create values for the patient and consume time and resources. Since the end of the 20th century up to now, health management has allowed those public health organizations which have it in place to raise quality and to create opportunities to doing more in health improvement with fewer resources. As it usually happens, the darkness and the light coexist and, sometimes, darkness prevails. That is why it is so important to identify it and to learn how to face it.
Strategic planning provides a sense of direction and can have a significant impact on the future of an organization. Students wanting to serve in leadership positions need to demonstrate a firm understanding of the concepts necessary to work on this complex process. Careful planning also ensures students’ survival in a competitive business environment. This article explains the importance of the strategic planning process to health care undergraduate students, while providing a methodical approach for introducing and teaching these concepts to them. Explaining the key concepts to students and carefully planning/dividing the strategic planning process into sequential steps, encouraging students to work in collaboration with managers and leaders of business organizations, and helping them collect and analyze information about an organization can also be used by instructors in their management and business classes.
Leadership is different from management, but not for the reasons most people think. Leadership isn't mystical and mysterious. It has nothing to do with having "charisma" or other exotic personality traits. It is not the province of a chosen few. Nor is leadership necessarily better than management or a replacement for it. Rather, leadership and management are two distinctive and complementary systems of action. Each has its own function and characteristic activities. Both are necessary for success in today's business environment. Management is about coping with complexity. Its practices and procedures are largely a response to the emergence of large, complex organizations in the twentieth century. Leadership, by contrast, is about coping with change. Part of the reason it has become so important in recent years is that the business world has become more competitive and more volatile. More change always demands more leadership. Most U. S. corporations today are overmanaged and underled. They need to develop their capacity to exercise leadership. Successful corporations don't wait for leaders to come along. They actively seek out people with leadership potential and expose them to career experiences designed to develop that potential. Indeed, with careful selection, nurturing, and encouragement, dozens of people can play important leadership roles in a business organization. But while improving their ability to lead, companies should remember that strong leadership with weak management is no better, and is sometimes actually worse, than the reverse. The real challenge is to combine strong leadership and strong management and use each to balance the other.
In 1979, a young associate professor at Harvard Business School published his first article for HBR, "How Competitive Forces Shape Strategy." In the years that followed, Michael Porter's explication of the five forces that determine the long-run profitability of any industry has shaped a generation of academic research and business practice. In this article, Porter undertakes a thorough reaffirmation and extension of his classic work of strategy formulation, which includes substantial new sections showing how to put the five forces analysis into practice. The five forces govern the profit structure of an industry by determining how the economic value it creates is apportioned. That value may be drained away through the rivalry among existing competitors, of course, but it can also be bargained away through the power of suppliers or the power of customers or be constrained by the threat of new entrants or the threat of substitutes. Strategy can be viewed as building defenses against the competitive forces or as finding a position in an industry where the forces are weaker. Changes in the strength of the forces signal changes in the competitive landscape critical to ongoing strategy formulation. In exploring the implications of the five forces framework, Porter explains why a fast-growing industry is not always a profitable one, how eliminating today's competitors through mergers and acquisitions can reduce an industry's profit potential, how government policies play a role by changing the relative strength of the forces, and how to use the forces to understand complements. He then shows how a company can influence the key forces in its industry to create a more favorable structure for itself or to expand the pie altogether. The five forces reveal why industry profitability is what it is. Only by understanding them can a company incorporate industry conditions into strategy.