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TABLE 1: Gulf Cooperation Council (GCC) Countries MM 2011 Population KSA UAE Qatar Oman Kuwait Bahrain 26 5.15 0.85 3 2.6 1.2 0-14 29% 20% 22% 31% 26% 20% Stats taken from the OA World Factbook Age 15-64 68% 79% 77% 66% 72% 77% 65+ 3% 1% 1% 3% 2% 3% Median age 25 30 31 24 28 31 PPP 2009 GDP US$ BB 622 246 151 76 137 30


GDP on healthcare


5.0% 2.8% 2.5% 3.0% 6.8% 4.5% Per 1000 population Physicians 0.94 1.93 2.76 1.9 1.8 1.4


Hospital beds


2.20 1.9 1.4 1.9 N/A 1.9


FIGURE 1: ?


healthcare sector in the GCC. The above changes are all macro-level. What we are focusing on here


is changing mindsets, without which, the industry will remain plagued with its old ways trying desperately to adapt to the new reality. When we talk about change management, we usually refer to the efforts made by managers to introduce change, focusing on behaviour and culture to change the way people look and think about their work. Well, it’s time we flipped the equation and changed sides: how can we change the mindsets of managers? Those trying to introduce change in the first place? Healthcare delivery is structurally changing. Archaic ways of managing


and delivering care can no longer cope with the changing environment, cost constraints, expectations and prospects. One analogy that comes to mind is the musical chairs game (see figure 1). This traditional group game of having a number of chairs (n) arranged in a circle where participating players (numbered n+1) are asked to move around the chairs while the music plays. People playing the game will to have to find a chair to sit on the moment the music stops. By virtue of the fact that there are fewer chairs than people, one person will be left out and hence will be asked to leave the game. Imagine the public healthcare delivery system as the chairs around which patients circle until all resources are exhausted and they would either go to a private healthcare institute or just endure pain. We are trying to turn this set inside out: we want to make the healthcare delivery system circle around patients


036 HOSPITAL BUILD & INFRASTRUCTURE MAGAZINE ISSUE 1 2012


FIGURE 2: ?


in a true patient-centred fashion, so that patients themselves, empowered with knowledge, will be able to choose the best way to receive healthcare that would be suitable for their circumstances and life style. It’s the reverse of the musical chairs game, if you like (see figure 2).


DEFINING PATIENT-CENTRED CARE (PCC) There are several definitions for PCC. The definition of the Institute of Medicine (IoM) is a well-accepted one: ‘providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions’. Add to that the fact that we in healthcare can no longer deliver what the patient needs single-handedly in a job-shop fashion as it used to be the case decades ago. Healthcare delivery is a function of organization design – teamwork plays a vital role in ensuring quality of care; where quality is defined by how closely outcomes meet patient’s expectations. The IoM goes on to offer a list of services and aspects that constitute the PPC approach:  Compassion, empathy and responsiveness to needs, values and expressed preferences  Co-ordination and integration  Information, communication and education  Physical comfort 


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