Avances en la gestión del bloque quirúrgico. El papel del coordinador de quirófano / Advances in operating room management. The role of operating room director

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How geographical information systems analysis influences the continuum of patient care.

As the vast repository of data about millions of patients grows, the analysis of this information is changing the provider-patient relationship and influencing the continuum of care for broad swaths of the population. At the same time, while population health management moves from a volume-based model to a value-based one and additional patients seek care due to healthcare reform, hospitals and healthcare networks are evaluating their business models and searching for new revenue streams. Utilizing geographical information systems to model and analyze large amounts of data is helping organizations better understand the characteristics of their patient population, demographic and socioeconomic trends, and shifts in the utilization of healthcare. In turn, organizations can more effectively conduct service line planning, strategic business plans, market growth strategies, and human resource planning. Healthcare organizations that use GIS modeling can set themselves apart by making more informed and objective business strategy decisions.

Priority-setting in health authorities: moving beyond the barriers. The Calgary experience.

The objective of this study was to identify key issues relevant to the development and implementation of a macro-level priority-setting framework (i.e., across broad service areas) within the Calgary Health Region. We used rigorous qualitative methods, including focus groups, meeting observations and interviews to identify views of decision-makers. Key issues relevant to macro-level priority-setting included: application of evidence, incentives, physician involvement, public involvement and application of values. Detailed insight into each of these issues was derived, including how best to handle related barriers to priority-setting in health organizations and important lessons for framework development. These lessons learned should provide insight for similar activity in other jurisdictions.

Establishing an integrative medicine center.

Cast a wide net, and include internal and external customers in planning. Keep communicating about the results of the needs assessment and each plan as it emerges. Ask everyone involved for feedback. Employ clinicians with experience and solid credentials, and have a plan for measuring outcomes.

Off-balance-sheet financing can generate capital for strategic development.

To manage their real estate portfolios effectively and obtain funding for strategic development, IDSs should consider adopting off-balance-sheet financing strategies, such as sale-and-leaseback transactions, synthetic leases, and joint-venture arrangements. Under these approaches, real estate assets are moved off of the organization's balance sheet via a partial or complete transfer of ownership to a third-party entity. The organization typically retains a satisfactory degree of control over the assets as lessee in sale-and-leaseback and synthetic-lease arrangements, or limited or minority partner in a joint venture, while freeing up cash to use for other strategic purposes.

IDS conversions to for-profit status: structuring the deal.

Not-for-profit integrated delivery systems (IDSs) may convert assets to for-profit status in a variety of ways, but typically choose from three basic conversion structures: sale of assets, joint ventures, and lease or management agreements. To select the optimal conversion structure, not-for-profit IDS executives should understand the forces driving their organization's desire or need to effect such a conversion and examine the legal, business, and political implications of each option in light of the organization's particular circumstances.

Best practices in managing organized delivery systems.

The U.S. Department of Veterans Affairs (VA), a large public-sector healthcare delivery system, is following the lead of the private sector in seeking a more integrated approach to providing patient care. The belief is that new entities known as organized delivery systems (ODSs) will produce better, more cost-effective care. Toward this end, VA has reorganized its facilities into 22 networks. The purpose of this paper is to provide VA policymakers and managers with information about building and managing an integrated delivery system for the nation's veterans based on findings from the Health Systems Integration Study (HSIS).

Maternal mortality and the problem of accessibility to obstetric care; the strategy of maternity waiting homes.

One of the major causes of maternal mortality is the distance and consequent delay in treatment of childbirth complications. Some developing countries are attempting to reduce delays in treatment by moving women at risk into maternity waiting homes (MWHs), located near a hospital, a few days prior to the date of confinement. This paper illustrates some typical examples of MWHs in different countries. The approach of MWHs is appropriate in some settings but it requires a high degree of coordination between peripheral prenatal care services and second and third level health care facilities. This study discusses some of the issues related to the successful functioning of MWHs, and provides an analytical framework for the planning, management and evaluation of these facilities.