(I originally published this article in Linkedin)
I initially titled this article as "Why most of the current hospitals will be obsolete shortly?" but I decided the statement as negative and hence the above title. However, the content of this article still revolves around the old title.
Currently, most hospitals in most countries operate as insulated or disengaged structures within the community. Even within the hospitals, many departments/divisions work as silo structures with minimum links (depending on protocols and need) with other units in the hospital. Both of these aspects have contributed to increasing costs and risks to patients. The burgeoning tide of an aged populace, patients with chronic diseases and rising costs of medical technology and specialised workforce has led to a perfect storm for many hospitals.
So where does this take us to? There are various solutions from the elimination of waste, better use of existing resources and update of clinical protocols to minimise costs and decrease risks to patients. However, there is so much these measures can do to avoid making many hospitals outmoded imminently. These actions have to be expanded to encompass a radical rethink of how hospital services are delivered and how the hospital is configured within.
For the sake of brevity, I will focus on three essential elements:
1) The first measure is to reconfigure the current set-up, which has units in hospitals organised by disciplines i.e. Medicine, Surgery, Paediatrics. This separation of groups by disciplines has passed its due date. This configuration has led to miscommunication amongst staff, barriers to effective treatment and waste of meagre resources. The new approach is to organise units around diseases or body systems. For example, Cardiac Sciences or Diabetes or Respiratory Sciences.., etc. Setting up units/departments as such will bring together clinical professionals of different backgrounds to focus on a united purpose and allow for best use of equipment and resources common to all.
2) The second measure and perhaps 'the definitive' element of a hospital of the future is to have integrated care in it is the truest sense. What this means is the co-location of health services at all levels in the same campus. This means the provision of general practice, allied health and acute level services in the same vicinity with linked electronic records. This will not only ensure continuity of care but also decrease inconvenience and expenses for patients. The other benefits are decreased risks to patients that come with the transfer of records and handover from a different system. Further, provision of such integrated care will lead foster an environment of innovation.
3) The third aspect of planning and delivery of hospital services in the future is likely to be controversial. This measure involves closing down or amalgamation of hospital services in many regional or rural centres. The operation of hospital services in many regional or rural locations has led to unsustainable expenditure and compromises with patient safety. There is a need to move away from a mindset of delivering impractical hospital services in such centres. The hospitals here are to be replaced by a strong primary care set-up accompanied by referral centre to transition/transfer patients who require secondary or tertiary care.
I would like to hear what you think about these propositions? Please comment below.
Health System Academic