Hospital ABC

My first day of interviews in Mexico City featured a tour of the main campus of Hospital ABC (I will visit the Santa Fe campus next week).  It has quite an interesting history. 

In the morning, I had the opportunity to speak with the CEO of the hospital, Alejandro Alfonso, the COO, Yadira Hernández, the head of Community Outreach, Dr. Blanca Velázquez, and the Corporate Director of Operations, Javier Fernández.  We discussed current issues with hospitals in Mexico, the effect of Seguro Popular, and what might lie in the future.

                                                            With Dr. Yadira Hernández

I then took a tour of the entire medical center, guided by the head of hospitality, Humberto Astorga. It was very impressive.  The building itself is LEED certified, including a solar panel garden on the roof top.  The hospital layout is divided by specialty, with a premium placed on making the complex as patient friendly as possible. By example, this includes family waiting/relaxation areas in each section, and a chemotherapy ward that is adjacent to a broad glass wall with a vista of the surrounding mountains and laid out in what approximates about ten small living rooms, each with a flat-screen TV, a couch, and a lounge chair.

                                                              With Humberto Astorga

The other stand out aspect is the "Yo Soy" (I Am) program, which requires all staff to present themselves to the patient by first name and address the patient by their name.  If that's all it was, of course, the program would not be that impressive. But, as Humberto told me, it's much more.  The important part is the patient-first attitude, where the patient is treated as if they were a family member.  As we toured, it was clear to me that the program had become fully ingrained in the hospital's culture.  In tandem with this was the acronym of CUIDAR, (Spanish, to take care of) which was indicative of the hospital's ethos. Translation: Warmth, teamwork, integrity, discipline, attitude of service, and responsibility. "Cuidar" should be the watch word for all of us in healthcare.

Our last stop on the tour was the Brimex clinic for those who remained uninsured (with the advent of Seguro Popular, Mexico has officially achieved universal coverage, but in reality there are some people - like adolescents - that remain not fully covered).  ABC is a private hospital that typically only sees insured patients, but this clinic within the hospital is quite similar to Casa de Salud (or perhaps a better example is the JFK Clinic at Mercy Hospital in St. Louis).  The main difference is they confine themselves to a five kilometer radius from the hospital, which happens to be an area of particular need. 

I then spoke with Guillermo Reyes, Vice President of Strategic Planning.  He told me how, in addition to the typical clinical measurements of impact, the hospital is measuring "social return on investment." For example, if they are able to resolve a cleft palate for a child, they use a matrix they created that indicates the savings generated by the procedure, which can be monetary (e.g. money to treat complications related to oral health) or social (e.g. avoidance of having the child bullied).  I look forward to examine this more closely, as I want to better capture the overall value that Casa provides to the St. Louis region through its services.

I ended the day at the hospital with the Chief Medical Officer, Dr. Elías Horta.  We had a broad ranging discussion, including the hospital's efforts to cut costs through waste reduction, the training and sanctioning of physicians, the role of the hospital for Mexico in its capacity as a teaching hospital, and the potential future roles for non-physician providers.

My final interview of the day was at the office of Dr. Gudelia Rangel, Migrant Care Coordinator for the Secretariat of Health.  Dr. Rangel was called away on business, but her deputies, Daniela Nuñez and Hilda Sosa, were able to cogently discuss the sensitive issue of the Central American child refugee crisis, the efforts of Mexico to programmatically address public health, and potential collaborations between Mexico and Casa de Salud by way of the Mexican Consulate in Kansas City. 

                                                With Hilda Sosa (left) and Daniela Nuñez

In all, it was a very good first day, and I am indebted to my two program organizers, Marisol Marroquín and Paulina Trápaga, for the excellent job they've done in organizing my itinerary and guiding me through the day.