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HOSPITAL CARE in 2010 A substantiated vision. On the authority and assignment of NVZ Dutch Hospital Association. drs S.P.M. de Waal Boer & Croon/Public SPACE. Trends. Medical curative supply. Stakeholders. BASICS OF THE STUDY. 1. Researched Trends. (Macro) economy and purchasing power
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HOSPITALCARE in 2010A substantiated vision On the authority and assignment of NVZ Dutch Hospital Association drs S.P.M. de WaalBoer & Croon/Public SPACE
Trends Medical curative supply Stakeholders BASICS OF THE STUDY 1
Researched Trends • (Macro) economy and purchasing power • Medical technology and treatments • Demography and patient populations • Mobility E-health • Education and job market • Political affiliation and influences of European Union 0.1/SWA/Deventer
Stakeholders • Society/political opinion • Pressure groups/NGOs • Health insurer(s) • Public Administration • Insurance • Policy principles • Minimum levels • Corporate Governance • Quality and failure 0.1/SWA/Deventer
Modular Open & connected 1 2 Professional and high risk 3 Medical curative supply 2010 • Patients • Diseases • Professionals • Technique • Organization and management • Accommodation • Four dominant paths of development, own strategic choices needed! Medical clinical setting of the future Civil enterprise 4 0.1/SWA/Deventer
Core Trends Concrete possibilities • Self-guiding in patient logistics • Seamless care chain • Small-scale techniques (diagnosis, alert) • Further development in outpatient treatment • Telemedicine • Hospital Control Room • Specialists in the neighbourhood/shop • Hospital-at-home • General practitioner • Case manager • Vertical and horizontal alliances in the whole industrial column (including HRM, real estate, insurance, pharmacy) Open and connected Curative care home-to-home including prevention 0.1/SWA/Deventer
Core trends Concrete possibilities • Diversification of financing and entrepreneurship • Different routines and specialties with high logistic demands • Mobility and Europe • Power patient AND power doctor • ‘War for talent’ • Small scale org • Feeling of ownership • General hospitals and specialties • Concessions on acute care • Hospital owned ambulance service • Shop-in-the-shop, satellites, PMC units, boulevards • General specialist • Active de-concentration • Separation care/real estate-development Modular Core influence Management Government Entre-preneur-ship Collective insurance Routine and purchasing power Speciali-zation and technique Patient Doctor 0.1/SWA/Deventer
Otolaryngologist Dental surgery Gynaecology/ fertility Urology Cardiology Pulmonology Orthopedics Surgery Cosmetic surgery Ophthalmology Which specialties can perform stand-alone? Nasal septum correction, earduct, removal adenoids/tonsils, paranasal sinuses Implants, dental surgeries IVF, abortion Sterilization man, prostate surgery Non-invasive treatments Non-invasive treatments Endoscopic surgery, hernia, tennis elbows, ankle and knee ligaments Groin rupture, navel rupture, varicose veins, stomache balloon Various surgeries cataract, laser treatments 0.1/SWA/Deventer
A la Carte… • Specialization in : chronic afflictions (heart clinics) or tropic/rare diseases (Havenziekenhuis Rotterdam) • Specialization in technique: gene technology, robotics, non-invasive treatments • Specialization in demography: elderly care, migrant care • Centers of excellence: international acknowledged excellence (George Pompidou Hospital in Paris) • Specialization in sector: corporate hospitals,private clinics,cash-driven specializations • Specialization in real estate management: shop-in-the-shop, satellites, dual-use of real estate 0.1/SWA/Deventer
Core trends Concrete possibilities • ‘War for talent’ • Internationalization and normalization job market • Risk diversification in care chain • Legal claims and publishing • Reputation management • Part time personnel/ professionals • PR strategy with professional excellence • Broad range of contracting, rewarding and control of professionals • Hospital as principal of education • Temporary licenses/concessions • More specialist nurse • Michelin system of quality Professional and high risk Illuminative Example: airline company: • Position pilot • Accident regulations 0.1/SWA/Deventer
Organizing the professionals • Unique or just rare? • Monodisciplinary or multidisciplinary treatment? • Attitudes of Enterpreneur or employee? • Added Value organization for core process? • Reputation, Branding and Identification • Technology • Legal shell • Staff Management and Recruitment • Customer Continuity • Power over the market/ who owns the brand? • Varieties in contracts and remuneration • Range of structural models • Divisions in Competences (clustering, steering)? 0.1/SWA/Deventer
Core trends Concrete possibilities • Legitimacy gap of politics • Anticipating at public responsibility • Back to the roots/communityfeeling • Rationing, here to stay • Power and impact of NGO(-like) actions • Participation in social/civil activities/debates • Broaden and deepen the accountability-structure and information (corp.governance) • Alliances with pressure groups and individual health insurers • Excellent employership • ‘Neighbourhoodstrategy Civil entrepreneurship 0.1/SWA/Deventer
De fundamentals of Civil Enterprise Excellent Operational management : • Good financial monitoring, no leaks, no financial secrets • Cost structure in accordance with benchmarks Public values and transparency on target: • Public priorities are watched (emergency care, waiting lists, medical quality) • No misappropriations with public funding • Public capacity is (medically, legally) objectively attributed to the public demands (Growing) opportunities for ‘additional’ or portfolio-activities • Both commercial and societal. Own strategy necessary 1 2 3 0.1/SWA/Deventer
Current Steering in Care (Netherlands) • Much legislation, little room for decentralization • Planning of supply, independent from demand • Stringent and scarce due to outside care policy (premium = collective burden) • Sector itself very collectively organized Dissappearance of citizen’s trust Demotivation of employees Slow progress of system changes New policy is ‘too little, too late’ 0.1/SWA/Deventer
Strong forces press upon the system • Health Care is not just about cost but also investing: • Employers/economic development • Prevention • Actual purchasing power increases, and ‘leaks’ abroad: • Pensions • New policies • Buying power of citizens and their priorities Current Care Steering Competition on the job market is cutthroat Modern patient wants another type of care (consumerism) More private funding and public impotence ask for more private, differentiated (civil) entrepreneurship 0.1/SWA/Deventer
Personal vision and ambitions Excellent Operational and Professional Management Public Transparancy and Compliance Analyse strategic opportunities Hospitals must make their own strategy! 0.1/SWA/Deventer
Public SPACE is an initiative of Boer & Croon Boer & Croon Corporate Strategy Consults top management on strategy and complex organizational changes Boer & Croon Executive Managers Provides on temporarily basis with experienced and independent final responsible managers Boer & Croon Corporate Communication Makes communication on the highest organizational level debatable, resolvable and embeddable Boer & Croon Corporate Finance+ Supervises mergers and co-operations. Carries out valuation and search processes for candidates and assists with the integration Boer & Croon Process Managers Guides and supervises complex change and decision processes Boer & Croon Professional Governance Provides with chairmen and members of the boards of management and of supervisory boards Public SPACE International consultancy and research center in the field of Strategies for Public And Civil Entrepreneurs InterMaat Masters in Change Provides on temporarily basis with change managers, project managers and operational managers Academy for Young Executives Management development programs for young talent NeXtrategy Designs and implements internet and e-business strategies EIM Executive Interim Management Joint Venture with Egon Zehnder. EIM is our network of management and consultancy firms in Europe, the United States and Australia About 300 professionals are employed at Boer & Croon in the Netherlands and about 150 professionals in Europe. 0.1/SWA/Deventer