CISA participated in the “The 21st century hospital – hospital management: governance, alternative models and healthcare system impacts” workshop organised by FESA with this event preceded by a visit made to the CISA headquarters.

There was debate on the overall objectives for healthcare systems, with reference to the definition of a hospital put forward by John S. Billings, with descriptions of the different scenarios and trends in the healthcare sector. This, in turn, highlighted how technological developments, the professionalization of management, the prolonging of lifespans, education, prevention and the limitations on resources have all greatly shaped, and not always positively, changes to the healthcare sector and its services on a global scale.

There were also examples such as the older, large scale hospitals, built in various countries, and identifying some of the aspects that led to their poor operational performances, including an excess of beds, budget shortcomings, the lack of coordination and communication between departments, problems with autonomy and the poor evaluation of needs, among others.

There was also the occasion to discuss the origins of medicine and the evolution in the functions of hospitals and their respective models with a particular emphasis placed on the importance of discussing the reform of hospital management. Following on from such ideas, the discussion focused on hospital culture and the scope for hospitals to become “palaces of medical power”. This then extended to concepts such as the healthcare industrial economic complex (the healthcare industrial and service sectors), the administrative models (technocratic model versus managerial model), the type of healthcare service provider organisations, hospital financing and organisational performance incentives.

Discussion then turned to the differences between innovative and traditional hospitals, conveying how indicators for innovative hospitals generally attain better performance standards than their traditional peers and correspondingly highlighting how, despite the greater expense involved, the cost/benefit really does prove higher with irrefutable evidence of the importance of investment in health and healthy lives.