Management Challenges in a New Hospital

Author:

Xenophon Karageorgiou

Managing Director, General Hospital of Thebes

E-mail: [email protected]

It happens all too often, although illogical, that a relocation from an old and smaller hospital to a new and bigger one takes place without modifications on the operational basis of departments obligations, numbers of all personnel categories (you still have the figuresof the past, but now for higherdemands) and required (increased) number of equipment and devices, mainly medical ones.

The 3rd CSF (Community Support Framework) to the National Economies was focused on the reorganization and completion of structures and infrastructures (foundations) of the National Health Systems, and on the utilization of the new biomedical technology that will lead to the improvement of effectiveness and quality of health services.

Where is this concept headed? The new hospital usually has many new devices, that give more accurate results than those of the old installation, new accommodation facilities, better than the old ones, better measures of safety and hygiene, better allocation of patients’ beds than the previous building, better arrangement of space in relationship to transfer and treatment of the patients, better directions and better quality of food. All of this results in an improved service offering.

Unexpectedly perhaps, the new hospital also has higher maintenance costs (rooms, medical and other equipment,etc.), relative difficulty in solving technological problems, as there are modern, computerized, electronic devices, possible absence of admission of and/or information on patients, relatives, etc. These reduce the initial improved situation, reducing it to a minimization process. So what we face are two different and contradictory routes. The consequences of the accomplished actions are, if the transfer to the new and bigger building is done without a timely increase in required personnel, then the n e w requirements are heavier, and hence:

a. You do not only have gradual disappearance of all the positive results described previously, but,

b. You also have undesirable growth of the negative phenomena (see before), and

c. You lose the reason for your existence, which is the aim to serve the needs of people well, sending them to other health units, public or private.

So, the role of the manager is to decrease the negative consequences, confronting the existing problems from the very beginning and increasing the positive points of the new situation at the same time.

The Tools?

1. Timely hiring and training of the required senior staff, i.e. capable of helping from the first moment of starting the job. Sometimes the obstacle is not only the excessive bureaucracy, but the actual ‘colleagues’.

2. Rapid installation of the entirely new medical and other electronic equipment. The main obstacle here is not having experienced staff to operate them.

3. Education and training of a certain number of persons. The obstacle to overcome is the probable unwillingness to attend.

4. The creation of a ‘’culture of change’’. The obstacle here may be all those who reject every proposal of change for their self-interested reasons.

5. And of course the required amounts of money, and political support.

The Strictly Medical Part of the Project

As one of the requirements is the minimization of medical errors, and thus the longer duration of human life, significant importance and care should be taken of this. Not only subconsciously, but consciously, the new hospital is expected to give better service to all its users, so the unavoidable mistakes will not be easily forgiven. This means a new obstacle to be overcome.

And what about the cost effectiveness? At the beginning it is hard to achieve good financial figures, but, as time goes by, this should start happening. Cost effectiveness has to be a permanent goal, whose attainment will give wider possibilities. Possibilities not only for the manager, but mainly and essentially for all of the users, on a medium and long-term basis.

Conclusion

The challenge is great, the effort should be strong. We will reap the benefits, they are going to be the highest ever achieved. The joy of creation will be our reward for the persistent attempts. It is worth the effort, even if it is followed by conflict during the on-going transition period of replacing the inadequate with ‘state of the art’.