Rethinking the hospital: drivers of change and innovative responses



The basic design of health systems, and subsequently the structuring of hospital as a health care organization, takes place between the late nineteenth and early twentieth century. Undoubtedly, both elements-health system and hospitals, have undergone many changes. However, all have been natural changes or incremental improvements. Using the concepts from quality management, could be described as a process of continuous improvement".

Antares Consulting believes that noadays there are several big structural changes, which may alter this process of "continuous improvement" or incremental evolution of health systems and in particular the hospital. In this context, we have gather serveral drivers that produce change in the healthcare organization. These changes plus a deep economic crisis which highlights (even more, if possible) the debate on the sustainability of the health system in particular and the general welfare.


Given these changes, we wondered: How the hospital will evolve in the coming years? Will be as a natural evolution process? We will observe a disruptive change? We banned a future prospective exercise, always uncertain. Although there are high-quality works based on this method and also some curiosities; predictions are always uncertain about the future, and they may lead to errors on the possible scenarios. We have chosen a pragmatic approach: see the innovations that are already have take place, as a result of such changes. We try to present them in this report as the attributes that we will see in the hospital of the future.


The report ends with a reflection on the implications for management that will set the future of hospital.


In summary, this report provide elements for discussion to the possible evolution of the hospital and its role in the health system, at this time with these profound changes. One question that remains unanswered is, who will lead this change?. The severity and last of the economic crisis and its impact on the government deficit and particularly in the health system, can accelerate it.  Furthermore, these changes can be imposed from out of the system by the surrounding pressure or being led from within. Certainly, the risks and results of adapting either models of change are very different.


(Report in spanish)


Joan Barrubés, Esteban Carrillo, Eduard Portella. Antares consulting

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