World Hospitals and Health Services - International Hospital ...

Editorial
reform. They identify four key strategies to deal with the changes
introduced through the reforms: (a) aligning hospitals, physicians,
and other providers across the continuum of care; (b) using
evidenced-based practices to improve quality and patient safety;
(c) improving efficiency through productivity and financial
management; and (d) developing integrated information systems
that will allow providers to better manage both services and clinical
care.
Daniel B. McLaughlin and Jack Militello continue some of these
themes, looking specifically at the changes that are likely to take
place following reforms in payments systems and the new
emerging competitive marketplace in the USA.
Further south, Bernard F. Couttolenc and Gerard M. La Forgia
also describe the important role that payment systems play in
Brazil in providing incentives for improved hospital performance
under a multipayer and multipayment system.
Moving to the other side of the Atlantic, Nigel Edwards describes
the significant pressures confronting hospitals across Europe and
how they are facing the need to change. They are not well
adapted to deal with the current financial crisis and accompanying
challenges. In many cases, the overarching framework is poorly
adapted to deal with change. He highlights that European
hospitals need strong leadership coupled with bold and
imaginative solutions to deal with the challenges they face in the
near future.
Patrick Bolton and Prue Power provide a vivid example of how
modern information technology and modeling can be used to
simulate the results of various proposed reforms in the Australia
context, allowing policy makers and hospital managers to avoid
costly and damaging mistakes, while identifying opportunities for
positive change.
Bernard Wegmuller and Martin Bienlein echo some of these
themes in the context of the reshuffling of the pack in the Swiss
hospital market and complex private multipayer health insurance
system.
Continuing the theme of reassessing the role of hospitals in
modern health systems, Olufemi M. Omololu and Rafiat O. Olatunji
describe the challenges that face the Nigeria hospital sector. They
emphasize the need to include the hospital sector in countries
where the focus on health care reform is often dominated by
vertical disease programs and agendas set by donors rather than
the need for systemic health systems reform. Lagos State in
Nigeria is taking a step in this direction with its new Health Service
Whatever the perspective, the
hospital is a place that treats
seriously ill patients, has
dedicated staff and struggle
making ends meet in the face of
a insurmountable demand
Reform Law, which includes an emphasis on improving the
functioning of hospitals and new innovative approaches.
Carla Faustino Coelho and Catherine Commander O’Farrell
describe one such innovative approach in Lesotho. When faced
with a need to replace its main public hospital, Queen Elizabeth II,
the country decided to design and construct the new 425 bed
public hospital and adjacent primary care clinic through a public
private partnership (PPP) using a private operator under an 18-
year contract. This included the renovation and expansion of three
strategic clinics in the region and the management of all facilities,
equipment and delivery of all clinical services under the health
network. The creation of this PPP health network and the
contracting mechanism has increased accountability for service
quality, shifted the government to a more strategic leadership and
policy-making role. This PPP has become a model for managing
other public sector facilities and providers in Lesotho.
With this special issue, we are sure that you will be able to have
a quick and comprehensive update on the key challenges facing
the hospital sector in the world. In the 37 World Hospital Congress
hosted by Dubai, November 8–10, 2011 the attendees will have
the opportunity to enlarge their perspective on some of the key
subjects presented in this issue. ❏
04 World Hospitals and Health Services Vol. 47 No. 3