Mobilis in Mobile
The book Twenty Thousand Leagues under the Sea written by Julio Verne is set in the Nautilus submarine, commanded by Captain Nemo, whose motto was: "Mobilis in Mobile". Its translation from Latin is: "Moving in the Mobile"; it means being able to keep moving inside something that also moves, moving according to your own will, even when surrounded by motion, moving like a fish - and not like a jellyfish - inside the sea around us.
Nowadays, the environment where Brazilian Hospital Organizations are established is one of breathtaking movement. Their assumptions, strategies and objectives must be constantly adapted to their environment, lest they should succumb to the frequent and severe crises that ravage them.
Hospital Management is one of the most complex areas of administrative science because it involves a range of controls that extends from the most varied and complex routine of patients’ assistance to the production of a large number of balanced and customized daily meals, passing through the acquisition, storage, dispensing and application of medications, gathering, cleaning and distribution of clothing, always under strict control routines.
The University Foundation of Cardiology (Fundação Universitária de Cardiologia), aware of the priorities and daily concerns with its survival, the insufficient funding, the inability to incorporate desired technology and the virtual impossibility of satisfactory fulfillment of responsibilities, concluded that an innovated model was required to overcome such issues.
This new approach should be committed to the interests of the parties involved: Society, Health Authorities, Public and Private Health Systems, physicians, health assistants, suppliers and other institutions.
The proposal is for a combination of hospitals in networks, with close proximity to care or geographical focus, which can arrange the services offered in line with market expectations, the health system, the user and the service provider organization.
Once the offer is organized and an ideology of partnership and networking is incorporated, hospital organizations are more likely to assimilated innovative concepts and management tools that contribute to the streamlining of costs and enhancement of skills and services offered.
Based upon the logic of partnership and network it is possible to develop the discussion of innovative concepts such as: Does a hospital need a clinical laboratory or test results? A laundry unit or laundered clothes?
A modern and efficient information system is able to efficiently carry out several kinds of remote services, both with quality and in real-time, not only by rationalizing and downsizing facilities, but also by reducing costs and qualifying results, thus contributing to the sustainability of the institutions, to fulfill their social purpose and meeting the expectations of the stakeholders involved.Considering those assessments and findings the University Foundation of Cardiology began the process of setting up the network in 1998. In this same year two general hospitals in the metropolitan area of Porto Alegre were incorporated. Later, in 2006, a third hospital in a town close to Porto Alegre (the state capital) was integrated.
Presently, affiliated hospitals to this network are:
- INSTITUTO DE CARDIOLOGIA DO RIO GRANDE DO SUL
- HOSPITAL PADRE JEREMIAS DE CACHOEIRINHA
- HOSPITAL DE ALVORADA
- HOSPITAL DE VIAMÃO
- INSTITUTO DE CARDIOLOGIA DO DISTRITO FEDERAL
- PROGRAMA SAÚDE DA FAMÍLIA – PREFEITURA MUNICIPAL DE PORTO ALEGRE
Currently, the foundation holds a network of five hospitals with 500 beds and is responsible for the supply of three thousand (3,000) direct jobs and for more than seven thousand (7,000) indirect jobs.This new management approach has allowed significant savings of scale and has consistently contributed to the building of sustainability of the whole complex.
As president and surgeon of the University Foundation of Cardiology, my daily tasks and surgeries are quite overwhelming. It is, therefore, important to structure a team/staff to provide technical and administrative support to a network of this magnitude.
In October, FUC – University Foundation of Cardiology started to administrate the Porto Alegre City municipality´s program of Family Health, with 85 teams of health care in areas of basic necessities.
Thus, our institution has been trying to adapt to the changes of modern scenarios, ensuring its growth, sustainability and future, honoring its role in local society.
Dr. Ivo Abraão Nesralla