HealthManagement, Volume 20 - Issue 5, 2020

Fighting the Pandemic in Brazil - Experience of Largest Hospital Network

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Founded in 1977 by cardiologist Jorge Moll, Rede D’Or São Luiz (RDSL) is today the largest private hospital operator in Brazil, with 37 hospitals, including high-level Star units, and 5,200 operational beds. In the face of the pandemic, RDSL has been supporting the public system and participated in the creation of over 1,100 new beds for public patients. spoke to Paulo Moll, RDSL CEO and the founder’s son, about the hospital management in the COVID-19 era and leadership during a crisis.

What has RDSL done and is doing to be prepared for the COVID-19 crisis?

We set up a COVID-19 response committee in January. Since then, we have been working on two effort areas. Within the first one – administrative and epidemiological – we have created a mathematical model to predict the development of the disease, in addition to reorganising administrative operations and purchases of supplies, from medicines to intensive care equipment. In the other area, care delivery, we have established guidelines for the COVID-19 patient care and separated the flows, equipment and areas of care for such patients. We have also activated a telemedicine service with monitoring and guidance capabilities, and organised intensive training of our employees.

All of our units have a predetermined service guideline, as well as exclusive flows for patients with suspected COVID-19 infection. We expanded our emergency departments and separated the internal flow of COVID-19 patients. Overall, by now we have served more than 30,000 COVID-19 patients.

What practical steps has RDSL taken to ensure the safety of its staff and patients?

We train our employees intensively and use state-of-the-art personal protective equipment so that everyone is adequately protected. In addition, we have rolled out a psychological call centre system to support our team. Further on, all of our employees are covered to receive COVID-19 treatment, if needed, and that distinguishes us from other institutions.

RDSL is proud of its ‘Smart Track’ system of examining patients admitted for emergency care. Have you been able to use it with COVID-19 patients?

The flows of patients with suspected COVID-19 infection are exclusive and independent from the flows of other patients. With this separation of flow and the expansion of the emergency departments, not all of them remained with the architectural structure that supports our ‘Smart Track’ system. However, it is based on speeding up care and security with double-checking of patients by two different doctors, and this has been maintained for all patients.

RDSL has a practice of getting feedback from the staff and patients through surveys. Are there any plans to conduct such research for RDSL’s COVID-19 care delivery?

The patient’s perception of the care received is something we highly value, and we continue to promote this monitoring even during the pandemic. The result is very positive and rewarding, as we saw that our efforts were felt and recognised by our patients and their families. Remarkably, RDSL patient satisfaction increased to over 70 in Net Promoter Score (NPS) all over the company, and above 95 in our Star units – slightly higher than our historical scores.

There are several new facilities that RDSL is involved in setting up for COVID-19 care. What is the thinking behind undertaking such resource-demanding projects now?

In fact, RDSL has created, together with partners from the private sector, more than 1,100 new beds for public patients. In Rio we have built and are managing 400 beds in field hospitals, 200 of which are for intensive care. But we have also activated many other permanent beds in various public and philanthropic hospitals. In addition, we have donated mechanical ventilators and personal protection equipment as well as financial resources to help the public system to fight the pandemic. In all states of Brazil where we have a footprint, we created action plans to support local governments. So far, more than R$ 270 million (€45 million) have been invested, with a little more than R$ 170 million from RDSL and another R$ 100 million (€29 million) from other private sector partners.

We are market leaders, and we are doing what we believe is the right thing, helping our society to get out of this terrible situation.

It is important to note that the above were social investments, with no economic or financial return for RDSL. We have also invested approximately R$ 300 million (€51 million) internally in the reorganisation and expansion of beds to serve our regular customers. Altogether it is a huge cash flow effort, but we are a robust and well-capitalised company that believes in our country and in our sector.

What are the ‘must-have’ qualities for a leading healthcare organisation to efficiently operate during a crisis of such scale?

Resilience and management speed. Without these two qualities, no company survives in today’s world.

There has been much volatility in the public health leadership of the country recently. If you were in charge of Brazil’s public health policies, what would you do to control the epidemic?

It is not my role, as we are a private company, but we can see that the tools that helped other countries with the best results were social isolation, the expansion of population testing, and the increase in the number of hospital beds using field hospitals or activating beds in existing hospitals.

What has the ‘leadership during a pandemic’ been for you personally?

A time of great learning and of testing our resilience and speed in the management of our company. Beyond that, it has been an extraordinary opportunity to unite our 100,000 employees and third-party workers towards the same goal: to fight COVID-19. And I can already say they have done a wonderful job.

You were initially unwilling to join the family business in healthcare, but then got deeply involved. Has the pandemic made you reflect in some way on your career choice?

It has only reinforced the importance of having a member of the controlling family within the operation. The decision was right, and I hope to continue collaborating with the company for a long time.

What is the approach to hygiene, social distancing and other preventive measures in the Moll family?

The same protective measures that any person in society must take. Social isolation, wearing a mask when going out, washing your hands, reinforcing the hygiene of goods that come from outside, and paying more attention to the most vulnerable people, such as the elderly and people with comorbidities.

Currently, organisations systemically important to the country’s public health, such as RDSL, are bearing a lot of responsibility. How do you personally feel about this?

Those who work in the healthcare sector already have a sense of social responsibility as the main driver of their work. We already knew that. Today more people know. It is important for the healthcare sector to get due attention. In every country in the world, including Brazil, there are and will be patients and healthcare providers. We will do our best for our company and our country, and remain firm in our mission of providing high-quality healthcare to our population. 

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Management, Leadership, hospital system, COVID-19 Fighting the Pandemic in Brazil Experience of Largest Hospital Network

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