After 4 years’ research, the Hospital Clínic in Barcelona has implemented a prehabilitation program to reduce complications after surgery and accelerate patient recovery. The aim of this pioneering program is to optimize the physical condition of patients who will undergo surgical intervention. It seeks to improve patients’ functional reserves through a program of tailored physical training and by encouraging physical activity. The program is supplemented with nutritional and psychological support to deal with the stress of the operation. The efficacy of prehabilitation (PreHab) to reduce surgical complications, and facilitate post-surgical recovery, has been demonstrated. Deployment of PreHab, as a mainstream service at Hospital Clínic de Barcelona, is showing effectiveness and potential for cost savings. However, there is a need for PreHab refinement to address regional scalability.
During XPatient Congress in Barcelona, Fernando Ozores from BuenaIdea and Stimulo partner during 3 days Design Thinking workshop, presented the main conclusions to the audience.
Role of Design Thinking for adoption of integrated care: Scalability of a prehabilitation service
We generated a roadmap for three DT sessions, each of a five-hour duration, aiming to address the core aims of the study, namely: i) identify actionable factors modulating regional scalability of Prehab; ii) enhance efficiencies of the service with the use of information and communication technologies (ICT), and, iii) design a business model contributing to sustainable adoption of the service. The ultimate aim was to foster regional scalability of Prehab in Catalonia (ES) (7.5 m citizens).
Firstly, we performed a survey aiming at gaining insight into the organizational aspects of the PreHab structure (PreHab unit) and service workflow at HCB. The survey was carried out with professionals involved in the design and management of the service. It also included other healthcare professionals having direct contact with the patients enrolled in the service, including: anesthesiologists, physiotherapists, nurses and psychologists. Secondly, we carried out in-depth face to face interviews with five patients and their respective caregivers who had participated in PreHab, aiming at capturing the patient experience perspective of the service.
The three DT workshops included all the stakeholders’ profiles, namely: healthcare professionals and managers, designers, health-technology agents, business school representatives and policy makers, as described in detail below for each session.
The Ethics Committee for Clinical Research at HCB approved the study (HCB/2016/0883). The interviews were recorded and informed consent was understood, accepted and signed by all patients and caregivers. The study was registered at ClinicalTrials.gov (NCT02976064).
Design thinking methodologies were useful for defining the traits of a general strategy for the regional deployment of the prehabilitation service, which has demonstrated effectiveness and potential for cost-savings at Hospital Clinic of Barcelona. Moreover, the approach shows high potential for service refinement in other complex healthcare interventions.
About XPatient Congress
XPatient Barcelona Congress is hosted by the XPA Barcelona (Patient Experience) appeals to all those companies, institutions, start-ups, entrepreneurs, research groups and foundations working on initiatives that improve the experience of the patient or caregiver and have a case of success, experience or technology to show within the framework of the congress, that, together with treatment safety and effectiveness, it is the third pillar of quality in medical care.
- Communicate the work and conclusions of the workshops carried out by the Practice Community
- Detect good practices and promote their implantation in the Catalan health system
- Bring out the research that is being carried out in the field of improving the quality of care
- Become the annual meeting point for professionals who work on improving quality care and service companies with solutions for this sector