Members of KVL, Ltd., Kordíky work intensively since 2007 on the vision and concept of the Next Generation Hospitals ("NGH") and the possibilities of its realization particularly in Banska Bystrica region.

KVL, s.r.o.

KVL Company, Ltd., Kordíky, was established and is based on practical experience and beliefs of its members. These beliefs and experiences state that:

exteriér Sketch of Next Generation Hospital

Concept

General concept of the Next Generation Hospital is based on megatrends in medical care:

  1. shortening the average length of stay in hospital ( Alos )
  2. management of constantly increasing number of non-surgical acute patients in "emergency" or "day care"
  3. management of constantly increasing number of surgical patients under day surgery,
  4. decentralization of the diagnostic process
  5. management of chronic patients (eg, asthma, hypertension, diabetes, rheumatism) in "home care".

Development of health care is apparently heading to the point where majority of hospitalized patients will be those who require intensive care, invasive diagnostics and complex risky operations.

Despite a gradual decrease in the number of beds, Slovakia is a country with a high number of poor quality and poorly utilized beds.

graf1 graf2

The main concept axioms

of the Next Generation Hospital

  1. If there will be a new hospital in Slovakia, the other one must be closed due to the final financial resources and the current excess of hospital capacity.
  2. replacing hospital = hospital significantly smaller (at least 30% fewer beds). In applying purely single rooms with facilities and space for family person, there is a possible reduction of up to 50%

Other principles

of the Next Generation Hospital

  • no corruption,
  • no unnecessary space
  • no unnecessary device
  • no unnecessary employee
  • no unnecessary transport,
  • no unnecessary treatment,
  • no unnecessary stress,
  • no unnecessary pain,
  • no unnecessary expenditure
  • no debt

For maximum utilization of hospital beds in the next generation hospital, a system of floating beds is required. This means that there are not classically structured departments according to their specialization, but each room is a department. Nursing process is unified (both conceptually and materially), and significantly more autonomous than the current one (transfer of competence from doctors to nurses).

Why Patient-oriented hospital

interior
Sketch of Next Generation Hospital - interior

Historically, the doctor - patient relationship in the Austro - Hungarian region evolved towards a dominance of the doctor as strong, infallible authority and a submissive position of the patient. In socialism, this state was reinforced even more. It penetrated into the dispositions and organizational structures of hospitals, into thinking, feeling and behavior. Hospitals primarily provide comfort and ego enlargement of health professionals (doctors’ and nurses’ offices, working hours, low patient’s awareness levels, atomization of care without synthesis, the emergence of a growing number of departments that do not communicate with each other, "culture" of waiting, slim empathy, arrogance in communication, high rate of error, disappearance of Christian principles, emphasis on academic careers and cult leaders – predominantly in university hospitals). It is interesting, that a strong feeling of lack of appreciation occurs as a by-product by health professionals.

In contrast, for example in the U.S., this relationship exists as a relationship between a servant (doctor) and a serviced person (patient). In many cases,
western European countries copy this approach.

From this perspective, we can distinguish three virtual types of hospitals:

Type of hospitalPathologicBureaucraticNGH
Structure:„Power(ego) - oriented“„Rule oriented“„Patient oriented“
Co-operation:Colleague=competitorFormal„Team work“
Talent:Winding-upignoresupport
Reliability (risk):avoidancelimitedshared
Innovation:rejectedproblemsimplemented
Errors:scapegoatjusticeexamination, systematic measures

In Slovakia, especially in cases of university and tertiary hospitals, pathologic type prevails.

Although the orientation of the next generation hospital at the patient is actually a significant change in thinking, in the beginning, until the patient's comfort and safety as priority number one will become commonplace, necessary reference points in the form of practical principles sets and structures of the Next Generation Hospital are needed (in a logical order from arrival to the hospital):

exteriér Sketch of Next Generation Hospital - exterior at night

Why Banska Bystrica

Banská Bystrica - námestie SNP

KVL members

foto Ladislav Laho

Ladislav Laho - doctor, pediatric intensivist, was in the years 2005-2008 the founder and director of the Children's University Hospital in Banska Bystrica, which provides qualified tertiary healthcare for children in the region of Central Slovakia and between public hospitals and is not only exceptional for its quality, but also for its economic efficiency. Nominated for the prestigious Manager of the Year 2007 award.

foto Radomír Vereš

Radomír Vereš acted as CFO at FD Roosevelt University Hospital in Banska Bystrica and also at Children's University Hospital in Banska Bystrica. Now he is in charge of CFO at private health insurance company. He is a member of the Slovak Chamber of Tax Advisors and the Slovak Chamber of Auditors.

foto Ladislav Laho

Marián Kováč - ENT and Head and Neck Surgery, is the founder of one of the first one-day surgery in Slovakia, which has implemented the largest number of surgical procedures under the one day surgery regime in Slovakia. A Committee member of the Slovak Association of one day surgery, a committee member of the Slovak Otolaryngology and Head and Neck Surgery Association and a member of the European Academy of Facial Plastic Surgery.

Epilogue

A new generation of anything is usually a continuation of the old one. It is a question of the situation, which elements it takes over from the old one and which elements it refuses. Usually, it takes qualities needed to survive and rejects things which are disabling.

If we want to build an honest, patient-oriented hospital capable of life and having a future (sustainable) in Slovakia, we can take only a few things: Part of professionalism, morality and common sense. We must reject a lot: architecture, authority, hierarchy, organizational patterns, patterns of behavior, cynicism, feelings of injustice, frustration, selfishness, stealing, corruption, bureaucracy and political influence.

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