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<p>En este contexto, sus gestores, además de intentar mantener el alto nivel alcanzado en la atención de sus usuarios, se están enfrentado a la sobrecarga relacionada con el parón provocado por la pandemia y reflejada, en el aumento de las listas de espera para una intervención quirúrgica no urgente, con unas cifras que han marcado un nuevo récord histórico, al llegar a 793.521 pacientes (Datos del cierre del año 2022 del Ministerio de Sanidad), o en el 57% de personas que requirieron una cita, y que contestan, que pasó más de una semana hasta que fueron atendidos (Datos de la primera oleada del barómetro sanitario 2023).</p>\r\n
\r\n
<p>Junto a esta problemática, el sector se enfrenta a otros factores, como son el envejecimiento de la población, lo que conlleva un aumento de la comorbilidad y complejidad de los pacientes o la incorporación de tecnología y nuevos fármacos, representando en su conjunto, un serio riesgo para la sostenibilidad del sistema sanitario, al incrementar los costes frente a unos recursos limitados.</p>\r\n
\r\n
<p>Un escenario, en el que también nos encontramos, con la repercusión que conlleva la transformación digital, y a modo de ejemplo, podemos citar algunas de las predicciones de la consultora Deloitte para el año 2025, al pronosticar que el hogar será el lugar habitual para el cuidado/seguimiento rutinario de la salud, realizando de manera virtual muchos de los contactos médico-paciente, con más del 70% de los españoles realizando una consulta por conexión video y quedando los hospitales reservados para tratamientos especializados y emergencias (<a href="https://www2.deloitte.com/es/es/pages/operations/articles/digitalizacion-sector-salud.html"><em>https://www2.deloitte.com/es/es/pages/operations/articles/digitalizacion-sector-salud.html</em></a>).</p>\r\n
\r\n
<p>En un entorno tan problemático cómo el que acabamos de describir, el futuro de la gestión y en concreto de la gestión de la calidad en el sector sanitario, deberá implicar cambios, que afectarán tanto a las estructuras cómo a su funcionamiento. Por estas razones, a continuación, repasamos algunas de las claves que pueden ser relevantes para este proceso.</p>\r\n
\r\n
<p>En primer lugar, el usuario /paciente deberá ser el protagonista del sistema sanitario, lo que debe acarrear una adaptación a sus necesidades, facilitando su intervención efectiva y desplegando las prácticas que tengan valor para ellos. Para llevarlo a cabo habrá que tener en cuenta su experiencia y percepciones, promoviendo su implicación y formación, incluyendo tanto la alfabetización sanitaria, cómo la digital, a través de las escuelas de pacientes y, todo ello, con el fin de promover su participación en la gobernanza del sistema.</p>\r\n
\r\n
<p>En segundo lugar, y relacionado con el anterior, está el desarrollo de la gestión basada en valor. Considerando que el valor lo marcan los resultados que importan a los pacientes, su implantación marcará un cambio en la gestión, según señala José Soto, presidente de la Sociedad Española de Directivos de la Salud (SEDISA), “<em>la gestión sanitaria basada en valor consiste en medir el resultado de dicha actividad, reorientar los sistemas de medición a este enfoque y tomar decisiones en base a estos resultados</em>”.</p>\r\n
\r\n
<p>En tercer lugar, desplegando la cultura de mejora de la calidad que establezca un conjunto específico de valores y normas que compartan nuestros profesionales y directivos y que influya en el modo de comportarse entre ellos y con los grupos de interés clave externos. Una cultura que, en lo relativo a la salud pública, deberá abordar la prevención de los factores de riesgo claves para la salud como la obesidad o el tabaco.</p>\r\n
\r\n
<p>En cuarto lugar, junto con el mantenimiento del alto nivel de calidad científico técnica, es necesario identificar y prevenir o minimizar las prácticas innecesarias, conocidas por “No hacer”, ya que pueden representar un riesgo para el paciente y para la sostenibilidad de la sanidad, elaborando, e implementando estrategias de seguridad del paciente a todos los niveles asistenciales.</p>\r\n
\r\n
<p>En quinto lugar, es necesario desarrollar actuaciones para mejorar la humanización de la asistencia, colocando en su núcleo a la relación con los pacientes y trabajando en adecuar espacios, así como, la propia organización, y todo ello, sin olvidar la importancia del profesional, en el que deberemos reforzar las competencias o habilidades blandas (“<em>soft skills</em>”), como la comunicación o el trabajo en equipo.</p>\r\n
\r\n
<p>En sexto lugar, es fundamental utilizar modelos de gestión cómo el modelo EFQM, que nos ayudaran a responder a las necesidades del presente y también a abordar el futuro, siendo una herramienta de transformación. En ese camino, no debemos olvidar la responsabilidad social de nuestras organizaciones y de forma específica la gestión ambiental, otro elemento clave para la sostenibilidad futura del sector.</p>\r\n
\r\n
<p>En séptimo lugar, la importancia de la comparación y el aprendizaje a través de herramientas como el benchmarking, siendo transparentes e invirtiendo en tecnología de forma progresiva e integrada para posibilitar, entre otras actuaciones, el desarrollo de la atención a la cronicidad y la hospitalización domiciliaria, ya que en conjunto reducen reingresos y costes, mejorando la satisfacción de los pacientes.</p>\r\n
\r\n
<p>Por último, y a modo de resumen, considero que la gestión de la calidad asistencial será un factor crítico de éxito para el futuro del sector sanitario, promoviendo de forma sistemática la mejora continua de sus servicios, minimizando la variabilidad de la práctica clínica, teniendo en cuenta la experiencia del paciente para construir una propuesta de valor para ellos, minimizando las prácticas innecesarias, aprovechando las bondades de la salud digital al incluirla en el desarrollo de estrategias institucionales como las relacionadas con la seguridad del paciente y utilizando modelos de transformación.</p>\r\n
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