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The board of directors: the Criticism of the Karolinskas new model is justified

In Today's Society, beats Karolinskas board of directors determined that economy and performance do not go to the follow up, the number of managers has risen sharply, and the division of responsibilities is unclear and a resource-intensive meeting - and project culture has emerged.

– these flows implies a rather strong fragmentation of the health care system. It is a good idea, but in practice, the new limits have been added, and it is not good. In many respects, this criticism has been justified, says the chairman of the board Håkan Sörman to DN.

a världsomtalad pioneer, when the model of value-based care with the help of the Boston Consulting Group introduced more radically than at any other hospital in the world. Health care would become more efficient, the quality would increase and costs decrease.

But the criticism since the great reorganization began in 2015 has been massive. The departments, units built after the medical specialties that receive a breadth of diagnoses and as it has developed over centuries throughout the world, was taken away.

instead introduced ”patient flows”, where patients with similar diagnosis are cared for by highly specialized doctors and nurses in a narrower niche.

Many have sounded the alarm that the system become dangerously inflexible, to the doctors ' training no longer works. Who is responsible is unclear, the economy is out of control and many people, especially co-morbidity in the patients, does not fit in the slim system.

the number of managers has increased by 30% and the hospital are now being forced to save 1 billion – 400 services need to be removed. In January, the board of directors with an evaluation of the new organization, and a variety of serious deficiencies, which staff sounded the alarm about the, were fixed.

the staff, despite the difficulties, do a fantastic job, often with brilliant results for patients. He does not want to link all the defects to the new organization.

– It could also have to do with how to implement the changes – for example, to not have the information base to patientflödescheferna. It is, of course, very unsatisfactory. It is impossible to keep a budget if you do not have a clue on how it looks.

the Number of flows, jourlinjer and breakdown of the medical specialties must be reduced, according to the board of directors. Master kai fa has also been assigned to review beslutsstrukturen.

" It is important to clarify who has responsibility for various issues, it is as well basic.

with the wish to bring back the old organization – like most of the other hospitals in the world – with clinics that because.

– Would return to the old organisation, it is also a huge change, and the question is if you can cope with it. But if you do not succeed in filling the gaps we now see, it is not possible to exclude, say, Sörman.

Yvonne Dellmark, medical association chairman:

" It is fantastic that the members of the board to see what we have pointed out for a long time.

" Not so far. We want to see concrete changes. We can see that many of our colleagues are extremely strained to be in chaos trying to maintain a patientsäker care. With a simpler organisation where decisions can be taken by a manager with a clear mandate so it can get better care for patients, "she says, and adds:

" We think that it is extremely gratifying to start talking about recreating the clinics.

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