Abstract 150 Foreword In fact, our integration of processes and continuity in healthcare is already in itself an improvement in the quality of the service we provide; yet if we have basic Throughout the year 2000, the IMAS (Municipal Health information on the population we are caring for, that Care Institute) has been mapping out the Health Care ought to enable us to make ongoing improvements in Plan that is to guide our activities and action as far as healthcare. IMAS. Memòria 2000 Memòria 2000 IMAS. the year-2003 horizon. The main principles of this plan call for us to focus on providing increasingly Furthermore, because there are various IMAS comprehensive care in the Hospital del Mar’s healthcare facilities in different areas of the city, we Abstract Abstract catchment area. Facilities and programs for primary can complement our top-priority work of attending to healthcare, specialized care for acute illnesses, mental the population in our area of influence with an active health and social healthcare will gradually be brought role in the healthcare service system of each zone together into a single healthcare concept for the where IMAS facilities are located. population in the Ciutat Vella and Sant Martí area of influence. The IMAS has further strengthened its nucleus of development (the Hospital del Mar and the IMIM) by There have been considerable changes in the joining the Biomedical Research Park project, of which demographic structure of this area’s population in it will be the base, because the IMAS can provide the recent years, with a high index of aging in Ciutat Vella prestige of the research the IMIM capitalizes on and the but also an influx of population from the new Diagonal day-to-day clinical environment where this research Mar areas and the growing influence of the immigrant can be done. Our partnership with the Autonomous population. The IMAS’s response to this new situation University of Barcelona and Pompeu Fabra University includes making adaptations in several of our services will contribute a set of synergies between healthcare available to the population so as to respond more fully activity, teaching and research that will be thoroughly to local needs. consolidated by the investment and innovation that are going into the creation of the Biomedical Research We have various guidelines that are the basis for some Park. We will be helping to set Barcelona on the front of the features of the transformation that is already line of European biomedical research. underway: We have the proven quality of IMAS’s staff and a stable • Continuity in care for the ill who are elderly and have labor framework, so the 2001-2003 Health Care Plan is insufficient social support. possible, beyond any restraints of any other kind. • Comprehensive tracking of those aspects of health José Cuervo i Argudín that are specific to women, with special emphasis on President of the Board of Directors women immigrants, from primary care to tracking and monitoring in pregnancy and childbirth. • The integration of mental healthcare into the health activities for the population. • While integrating hospital care for the acutely ill with comprehensive patient care, we will focus hard on care for acute disease and emphasize work toward superspecializing in highly complex, high-tech aspects of the area. These proposed outlines for transformation must of course fit into a current general framework of budgetary rationalization, and so the added complexity in technology and health care will stem from our attaining higher levels of efficiency and effectiveness. 151 Introduction Last year steps were already being taken to accomplish some of our future objectives on how to implement this new framework. It was a year of very heavy The real hallmark of the year 2000 was our definition investment, twice the sum of recent years past. The of the framework for our activity in upcoming years. 1.114 billion pesetas invested enabled us to do work on This framework will call for a series of changes the surgery block, the emergency block and various designed to improve healthcare for the population in hospitalization units, striving to improve the quality of Memòria 2000 IMAS. our area of influence with the concentration of the the care we offer patients and their families. specialized services on offer at the Hospital del Mar. These changes will also be evident in the field of Through these investments, medical equipment has Abstract research with the construction of the Biomedical been upgraded to pave the way for a more intensive Research Park, which will boost the IMAS’s research investment effort toward the tertiarization of the activity. The teaching line will also enhance its capacity Hospital del Mar’s activity in upcoming years. with the expansion of specializations. The second phase of improvements in the IMAS In the year 2000, we had a rise in ambulatory activity Teaching Unit involved another major investment, with with the increase of day hospital activity and the renovation of the library and the completion of ambulatory major surgery. At the same time, construction and installation of new equipment for the hospitalization activity was more complex in the year classrooms and laboratories. 2000 and was done with fewer days of hospitalization. There was an increase in the number of childbirths and Raimon Belenes i Juárez in OB-GYN and pediatrics as a whole, mainly motivated Managing Director by the improved relationship between hospital and community through community programs and the Jordi Varela i Pedragosa increased presence of the younger population (mainly Manager immigrant population). Our penetration in our area of influence continues to grow, especially in ambulatory activity (57% of the IMAS’s outpatients consultancy activity comes from the IMAS’s area of influence), working through community programs that improve the relationship between the population and health services. With the integration of the hospital’s specialists in primary care and the women’s health program, our relationship with the population in our catchment area has become better and better. The consolidation of our staff, with several invitations for applicants to definitively cover jobs formerly occupied by temporary assignment and the signing of the labor agreement for the years 2000-2003, laid an optimum foundation for embarking on the plan’s guidelines. Until December 31st 2000 the Managing Director was Dr. Ricard Gutiérrez i Martí. 152 Strategic Positioning population, especially the population closest to it. The integration and full implementation of the teaching and research functions linked to this main activity or Introduction activities complementary to it also constitute an essential part of the IMAS’s mission. The Municipal Health Care Institute (IMAS) was created IMAS. Memòria 2000 Memòria 2000 IMAS. in 1983 as an autonomous organization under the local This definition means that the IMAS must have a administration. It was made subject to public law and complement of professionals, technological equipment was endowed with a distinct legal capacity and assets and facilities, and a model of organization based on the Abstract Abstract of its own and the power to act in the pursuance of its cultivation of knowledge, experience, professional objectives. The Institute’s purpose was to provide direct responsibility and the service culture, within the management for the Barcelona City Council’s framework of one of the city’s outstanding scientific healthcare services. In 1988 the City Council and healthcare institutions. transferred its authority over the IMAS to the Barcelona Health Consortium (CSB), an authority run Each of the IMAS’s centres must carry out its own by the Autonomous Government of Catalonia in project yet seek to provide care as part of the rest of conjunction with the Barcelona City Council. In 1997 the health system, in accordance with the general the Barcelona Health Corporation was created under needs of the group whose purposes and objectives it the framework of the CSB, and since then it has been shares. the Barcelona Health Corporation that has held authority over the IMAS. Vision At present the IMAS has two acute illness hospitals The IMAS’s service offer policy must be based on six (Hospital del Mar and Hospital de l’Esperança), one main points: social health centre (Geriatric Centre) and one mental health centre (Psychiatric Institute), in addition to the 1. Comprehensive coverage (within the sphere of the Teaching Unit of the Faculty of Medicine of the IMAS’s authority) of the health needs of the Ciutat Autonomous University of Barcelona, the Human Vella and Sant Martí population by means of an Biology studies at the Pompeu Fabra University, the integrated service system. Nursing School attached to the University of Barcelona and the School of Professional Health Care Training in 2. Design of a differentiated care project for each of Bonanova. For research the IMAS has the Municipal the other centres, which are the Hospital de Institute of Medical Research (IMIM). In short, the IMAS l’Esperança, the Geriatric Centre and the Psychiatric is a health, teaching and research organization that Institute. employs nearly 2,000 people and operates an annual budget of over 21 billion pesetas. 3. A health care plan that responds to the population’s demands, the centre reorganization strategy explained The IMAS offers its services in over 40 medical and in the two points above, and the accumulated surgical specializations, and its service list includes the experience of the institution’s own staff and services. vast majority of the clinical lines covered by major health groups. 4. Organizational development promoting participation and shared responsibility by the staff in overall clinical Plans are underway for the future under the guidelines management. of the IMAS 2003 Plan passed by the Board of Directors in December, 1999.