A decade has passed since the region of Andalusia began its journey down the road towards Quality and the consideration of Quality as an inherent element in the concept of public service and the health system. From the beginning, Quality was considered both an essential value and an inalienable objective which, in the long term, would lead to strategic, cultural change at the heart of the healthcare organisation.
The strategies initiated in the Andalusian Public Health System in 2000 were therefore the beginnings of a strategic model which evolved into a First Quality Plan where Quality was considered a driving force for profound transformations in a public health system oriented primarily towards the citizen. As with any modern, developed society, this idea became central to a health system in which progressively more informed and demanding citizens play a more participative role. These first building blocks provided the framework for the development of diverse initiatives, new rights and guarantees for the citizens, innovative formulas for management and care, professional development initiatives and technological advances which have resulted in a more agile and transparent health system.
The desire to continue transforming the public health system to make it more personalised, innovative and accessible led to the initiation of the Second Quality Plan which, in the spirit of continuity, consolidated the strategies which had proven to be of value, while at the same time, incorporated new elements and formulas for organisation and management as well as for technological and organisational innovation, knowledge, communication and participation with the citizen. In this Second Plan, the focus was on the professionals and on the inestimable role they play as the source of one of the more defining aspects in the perception of healthcare quality: the care and treatment received by the citizen.
After more than a decade of quality strategies we can feel confident about the path we have taken and satisfied with our achievements. This path of continuing improvement, however, is inexhaustible. It possesses its own dynamic and rationale and continually presents us with challenges. It requires a permanent capacity for anticipating the trends and needs of the future while, at the same time, providing a personalised, creative, quality health system which satisfies current expectations.
In this context and taking into account what we have learned from previous strategies, the Quality Plan of the Andalusian Public Health System has been conceived as an instrument of participation and consensus whose origin lies in the desire to intervene in three strategic scenarios: the citizens, the professionals and, as the central area for convergence, the healthcare organisation itself.
In the citizen scenario, the lines of quality are aimed at reinforcing the role of the users in exercising their autonomy and participation in their own health. The objective is to provide a trusting, collaborative environment which fosters communication and shared decision-making with shared responsibility in the use of services and in the exercising of individual rights based on the exchange of available knowledge and a special consideration for personal values.
The second scenario focuses on the creation of a renewed relationship between the professionals and the healthcare organisation - an exchange model which on the one hand promotes the autonomy of the professionals and their commitment to quality and excellence in the healthcare they provide – based on the clinical management model; on the other hand, the organisation’s commitment to responding to their needs and expectations to foster as much as possible their professional development in a climate of permanent knowledge exchange and innovation.
The relation between the citizens and the healthcare professionals is born and consolidated within the healthcare organisation - a space for convergence where values, responsibilities, knowledge and decisions are all shared. The third scenario, therefore, is the organisation itself; it is seen as a necessary “shared space” which a sustainable, equitable, supportive, mature health system must be able to provide in order to work steadfastly in a spirit of cooperation, sensitivity and respect towards the health and quality of life of all the citizens of Andalusia.
A “shared space” is not merely a neologism that has brought about a new plan; it is an invitation to all those involved, be they the citizens, the professionals or the organisation itself, to commit themselves to the on-going search for new scenarios to allow us to continue along the road towards quality and continuing improvement in the public health services of Andalusia.