The inspiration for this article came from the feeling of sharing important issues previously not mentioned so openly. It was through my participation, as a listener in November/2022, in the webinar organized by Healthcare Alliance and with the support of SindHosp e IQG (Instituto Qualisa de Gestão em saúde) where it was possible to follow a rich debate between health professionals focused on Patient safety.
Fundamental issues were addressed, such as the warning that, currently, in Health Institutions, the process models and protocols imposed and implemented on Quality and Patient Safety they normally do not fit into the reality of these institutions and generate bureaucracy without satisfactory results.
Even today, the motto in healthcare institutions is “Command and Control”.
The processes and protocols are designed at higher levels and imposed on the professionals who will execute them. Many, however, “don’t buy the idea” because they are out of touch with reality in their routines and don’t apply them. Professionals do not participate in these issues and are “ordered” to comply and work as a team, an uncomfortable situation for many of them.
Such protocols and processes are imposed from the top down. Leaders and directors think about the subject, write and approve it, and only communicate it to the health professionals who will apply such protocols. All without the leaders' prior knowledge of the institution's routines, without understanding the diversity of its processes. We remember that each of them is in a different phase of maturity, with restricted models only to identify competencies.
This situation leads us to an important point: it would be essential to involve all health professionals at the forefront of the processes in the development of care protocols and Quality and Patient Safety, taking into account all the differences for applicability, the reality of institutions and existing processes, and encouraging teamwork. Because these professionals are not prepared for this type of work in their academic training.
So how do you make this gear work? And how to generate Quality for Patient Safety, even before implementing Digital Transformation?
Only after reevaluating existing processes and restructuring with interprofessional collaboration, should the implementation of technology/digital transformation be continued, remembering that it is associated with CULTURE + PEOPLE + DIGITAL COMPETENCE.
It is important to highlight the need for healthcare executives to know and understand social technology + physical technology.
This entire system is DIGITAL HEALTH: making processes more agile and digital with Patient safety.
Healthcare institutions want to carry out digital transformation, but executives still lack digital competence.
Health was born to be interdisciplinary, so there needs to be professionals prepared to work as a team and, later, go digital.
With the use of CHA (term for KNOWLEDGE + SKILL + ATTITUDE) in all spheres of institutions, this journey would be facilitated.
In this sense, a change in mental model is important — mindset — of Health leaders and decision-makers, and the management need to keep up with the reality of integrated management.
With all this change associated with in-depth knowledge of internal processes, interprofessional collaboration of those involved in the protocols and processes of Quality and Patient Safety, the implementation of digital transformation and automation in hospitals it becomes viable, without major pain, and becomes part of the reality of Health.
Read more about Culture Lean at the Hospital.
Valeria Macabelli
Opuspac Corporate University
Opuspac Ltda
