Publication: Proyecto de gestión de un servicio de cirugía general en un hospital de nueva creación. Análisis del funcionamiento
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2018-04-16
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Universidad Complutense de Madrid
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Abstract
Un servicio clínico es un conjunto funcional definido por la actividad asistencial que realiza dentro de los conocimientos y técnicas de una especialidad concreta. Los responsables de los Servicios hospitalarios reciben la denominación de Jefes de Servicio. La especialidad de Cirugía General y del Aparato Digestivo (CGD) abarca varios ámbitos de aplicación, destacando toda la patología quirúrgica de los siguientes aparatos, órganos y sistemas: digestivo, endocrino, mama, abdomen, piel y partes blandas, cabeza y cuello. Un Servicio hospitalario de CGD cumple con todas aquellas funciones asistenciales, organizativas, docentes, investigadoras y de gestión relacionadas con dicha especialidad. La gestión clínica como elemento teórico se sustenta en el análisis de la información y busca especialmente la eficiencia en las actuaciones sanitarias. La puesta en práctica de las teorías de la gestión no siempre es fácil; dichas teorías no sirven de igual manera para todos los hospitales. Las peculiaridades de los dirigentes, de los profesionales y de los pacientes hacen que se tengan que adaptar ciertos parámetros en los que se basa la gestión clínica. Los criterios en que se basa la gestión de un servicio médico son los siguientes: proyecto bien estructurado y realizable, perfil del jefe de unidad, liderazgo, conocimientos en gestión, perfil de los facultativos, conocimientos de la especialidad y habilidades técnicas, motivación y satisfacción de los profesionales, etc. En Sanidad a los profesionales les corresponde ser efectivos y a los directivos ser eficientes, ya que se introduce el concepto del coste. Ese nuevo cambio en el paradigma obliga a conocer y colaborar en la gestión e intentar ser eficientes. En la actualidad al Jefe de Unidad se le exigen conocimientos de la especialidad y de gestión. El jefe debe asumir la parte correspondiente de la responsabilidad y de los riesgos de la gestión, pero respaldado por la dirección. Destaca la importancia del equipo sanitario y no sanitario con el que se trabaja. Es vital la implicación en los objetivos comunes y el grado de satisfacción es importante en el trabajo diario. En el año 2007 la Presidencia de la Comunidad de Madrid decidió que se pusieran en marcha 6 nuevos hospitales con el fin de facilitar la asistencia a los pacientes. Su cartera de servicios no sería completa, para lo cual necesitarían de hospitales de referencia. Estos hospitales nacieron como Empresas Públicas y, además, con una gestión mixta, que consistía en que la parte sanitaria era responsabilidad de la Consejería de Sanidad y la no sanitaria era gestionada por los equipos de las empresas constructoras del centro. La creación de una Unidad de CGD dentro de un nuevo proyecto de asistencia sanitaria especializada constituye una situación que puede presentar un cierto grado de complejidad, ya que debe integrar una gran cantidad de factores...
The creation of a General Surgery and Digestive System Unit incorporated within a new project represents a situation of lights and shadows. The objetive of this doctoral thesis is a practical exercise of my knowledge about the clinical management of a Unit, based on the theoretical lessons and the experiences of having worked in seven hospitals of the Public Health System. The clinical management as a theoretical element is based on the analysis of the information and seeks especially the efficiency in our actions. The implementation of management theories is not always easy, nor does it work in the same way for all hospitals. The peculiarities of leaders, professionals and patients make it necessary to modify some of the basic parameters on which clinical management is based. In 2007, the Presidency of the Community of Madrid decided that 6 new hospitals would be set up to facilitate patient care. Their portfolio of services provided would not be complete, for which they would need reference hospitals. These hospitals are born as Public Companies and also have mixed management, which is that the health part would be the responsibility of the Ministry of Health and the non-health would be managed by the teams of the construction companies of the centre (Sacyr). The criteria on which the management of a medical unit are based are the following: Project well structured and achievable. Profile of the Unit chief. Leadership. Knowledge in management. Profile of the practitioners. Knowledge of the specialty and technical skills. Motivation and satisfaction of the professionals. In health, the professionals must be effective and the executive directors are required efficiency, as the concept of cost is introduced. This new paradigm change forces us to know and collaborate in the management, and try to be efficient. At the moment the Unit Chief is required knowledge of his specialty and management. The Chief must assume the corresponding part of the responsibility and the risks of the management, but backed by the executive directors. We must also emphasize the team of health and non-health personnel with whom we work. Their involvement in common objectives is vital and their degree of satisfaction will be important in daily work...
The creation of a General Surgery and Digestive System Unit incorporated within a new project represents a situation of lights and shadows. The objetive of this doctoral thesis is a practical exercise of my knowledge about the clinical management of a Unit, based on the theoretical lessons and the experiences of having worked in seven hospitals of the Public Health System. The clinical management as a theoretical element is based on the analysis of the information and seeks especially the efficiency in our actions. The implementation of management theories is not always easy, nor does it work in the same way for all hospitals. The peculiarities of leaders, professionals and patients make it necessary to modify some of the basic parameters on which clinical management is based. In 2007, the Presidency of the Community of Madrid decided that 6 new hospitals would be set up to facilitate patient care. Their portfolio of services provided would not be complete, for which they would need reference hospitals. These hospitals are born as Public Companies and also have mixed management, which is that the health part would be the responsibility of the Ministry of Health and the non-health would be managed by the teams of the construction companies of the centre (Sacyr). The criteria on which the management of a medical unit are based are the following: Project well structured and achievable. Profile of the Unit chief. Leadership. Knowledge in management. Profile of the practitioners. Knowledge of the specialty and technical skills. Motivation and satisfaction of the professionals. In health, the professionals must be effective and the executive directors are required efficiency, as the concept of cost is introduced. This new paradigm change forces us to know and collaborate in the management, and try to be efficient. At the moment the Unit Chief is required knowledge of his specialty and management. The Chief must assume the corresponding part of the responsibility and the risks of the management, but backed by the executive directors. We must also emphasize the team of health and non-health personnel with whom we work. Their involvement in common objectives is vital and their degree of satisfaction will be important in daily work...
Description
Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 26/09/2017