Dra. Leticia Moral: private hospital network makes efficient, innovative, and patient safety oriented healthcare possible

Editor’s Note

Quironsalud is the first private hospital network in Spain. It owns 45 hospitals and 80 medical centers. Quironsalud and Helios (the first hospital group in Germany) are part of Fresenius Group. The union of both companies results in the first private hospital group in Europe, and one of the top five in the world. As the Chief Medical Officer of Quironsalud, Dra. Letricia Moral is happy to share with our readers her great insights in hospital management and her valauble experience accumulated through serving in a sound private hospital network system (Figure 1).

Figure 1 Dra. Leticai Moral.

Personal experience in hospital management

JHMHP: When did you start working in Quironsalud hospitals and what attracted you?

Dra. Moral: I joined Quironsalud in July 2014, attracted by the most interesting and innovative healthcare project existing in Spain at that moment: to create the biggest (and the best) private hospital network in Spain and one of the top three in Europe. In February 2017, Quironsalud joined the Fresenius Group, starting a new stage of this exciting project.

JHMHP: Could you introduce to us about your role as Chief Medical Officer in Quironsalud hospitals? What are the most challenging/rewarding parts in this position?

Dra. Moral: My team oversees the quality and scientific strategies of the company, also is responsible to promote (and support) medical research. In the past, private hospitals in Spain were not oriented to research. Doctors worked in private sector just focused on clinical practice, while education and research were done at public hospitals. Quironsalud is committed with the increase of scientific level of private hospitals. Eight hospitals are university hospitals. A total of 835 clinical essays (34% phase I and II) were performed in Quironsalud hospitals, and 1,051 scientific articles were signed by Quironsalud professionals. All these numbers will be increased in a short term. I am really convinced that a good clinical practice is not possible if it is not linked with education and research.

JHMHP: How would you describe your management style?

Dra. Moral: I am a passionate person and I try to transmit this passion to my team. My goal is to motivate them to give the best of themselves. Sometimes I am hard and too oriented to results, but I try to be fair.

JHMHP: Are there any hospital administrators who have inspired you?

Dra. Moral: I had the privilege to work with Rafael Matesanz, the founder of Organización Nacional de Trasplantes de España. Thanks to his work, Spain is the world leader in organ donation and transplantation. The “Spanish model” is a reference for many countries when trying to increase organ donation and transplantation. I also worked with Victor Madera, the founder of Quironsalud, an entrepreneur and a visionary. Starting with a small clinic in a small city, he created Quironsalud in less than 20 years.

JHMHP: What are the performance indicators that you value most when leading your team?

Dra. Moral: Good working environment, achievement of the objectives on time and innovative proposals for new projects. When all of this happens, I think we have done a good work.

JHMHP: How do you manage your time and maintain work-life balance?

Dra. Moral: I must confess that this is not my strength. I spend too much time on work, but I really love my job. I like to spend time with my friends and family, walking through the countryside and through the city, Madrid is a great city to know. But my main hobby is to travel all over the world, to know different countries, cultures and people. When I worked as a consultant I had the opportunity to spend long time in LATAM and Emirates. Sometimes I miss this wandering life.

Hospital management in Europe

JHMHP: How would you comment on the hospital management system in Europe in general?

Dra. Moral: Bureaucracy, lack of innovation and lack of stimulus for professional development are frequent situations in many countries. Lack of specialized professionals and sustainability are the main challenges for the European healthcare systems.

JHMHP: What would you say is a widespread problem or challenge that you can see in hospitals or healthcare institutions in Spain right now? And what steps have been taken to overcome these challenges?

Dra. Moral: Politics has an excessive influence in healthcare and public hospital management. In the short term I don’t expect substantial changes. But in the opposite, private hospitals are growing, attracting good professionals and more and more patients. It is a good opportunity for companies as Quironsalud, which have really involved with innovation, good clinical practice, safety and patient experience.

JHMHP: We understand that to maintain a sound hospital management system requires various tasks, such as distributing resources in an equitable and judicious way, as well as evaluating the outcomes and efficacy of service and treatment sustainably, to name just a few. What strategies or methods can be involved to make these possible?

Dra. Moral: To stablish clear priorities based on public health, an affordable portfolio of services, an explicit prioritization system (quality or similar), benchmark on quality, safety, patient experience and efficiency indicators and a human resource strategy oriented to the development of healthcare professionals. Our group is also deeply involved in “digitalization transformation”, including the use of big data in planning and providing clinical services.

Healthcare in Quironsalud

JHMHP: As a world-class healthcare provider, what aspects of Quironsalud hospitals are you most proud of when introducing the network to readers or colleagues from outside of Spain?

Dra. Moral: I’ll try to resume in a few words—experience and safety patient oriented, innovative and efficient.

JHMHP: What methods have Quironsalud hospitals applied to offer quality care for patients worldwide?

Dra. Moral: Our strategy covers the main aspects of healthcare quality. All the hospitals have annual objectives in patient experience, patient safety, innovation and research. These objectives are continuously monitored (for example Net Promoted Score is used to monitor patient experience in all the hospitals). Achievement of goals impacts in performance evaluation of managers at hospitals, regional and national level.

JHMHP: Could you share with us the importance of projects such as the public private partnership (PPP) in Quironsalud hospitals?

Dra. Moral: Quironsalud manages three PPP hospitals in Madrid: Hospital Universitario Infanta Elena, Hospital Universitario Rey Juan Carlos, Hospital General de Villalba. Fundación Jimenez Diaz, the biggest hospital in our group, woks mainly for Madrid Regional Administration. All of them are leaders in patient experience, patient safety and effective care, as you can see in Observatorio de Resultados de la Comunidad de Madrid.

JHMHP: Are there any major projects underway in Quironsalud hospitals in 2018 that you would like to share with us?

Dra. Moral: It is difficult to name just one. Integrating Quironsalud quality strategy with Helios quality strategy is one of the major projects. Last December we started to work with peer review as a tool to improve clinical practice. Leaders from some hospitals act as the “peer review” team, and work with professionals from other hospitals to review clinical practice in elected processes.

JHMHP: Where can we know more about Quironsalud hospitals?

Dra. Moral: This website (https://www.quironsalud.es) will help you know more about Quironsalud hospitals.

Expert Introduction

Dra. Leticia Morali is the Chief Medical Officer of Quironsalud.

Work history

• Chief Medical Officer of Quironsalud;
• Partner and project director in Globesalud (2007–2014) and Mensor (now Indra Group; 2004–2007);
• General Director of Servicio Madrileño de Salud (2001–2004).

Education

• Master in Hospital Management. Escuela Nacional de Sanidad, España;
• PhD in Medicine and Surgery, Specialist in Psychiatry.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Hospital Management and Health Policy for the series “Meet the Experts: the Cutting Edge in Hospital Management”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jhmhp.2018.03.02). The series “Meet the Experts: the Cutting Edge in Hospital Management” was commissioned by the editorial office without any funding or sponsorship. Vivian Kong reports that she is a full-time employee of AME publishing company (publisher of the journal). The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

(Interviewer: Vivian Kong, JHMHP, jhmhp@amegroups.com)