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EF: You were appointed during the pandemic, what were some of the key lessons from managing through this critical time?

RC: After the challenges faced, our main objective is to be efficient with our resources. To achieve this, we must be able to control and manage the operations in terms of reducing queue times. A shorter time means less costs. COVID made us grow fast in the capability for smaller queue times for patients in the emergency room waiting for a bed, but also, we had to use our resources on a day-to-day basis for remodelling the entire operation. For example, we could start the week with 70 ICU beds but finish with 110. This is the kind of effort that you must have. Of course, it was not possible to maintain the same level of efficiency that we have normally, but we did our best. As a new executive, it felt like an MBA, I had to learn to be comfortable with making big decisions with little information and in a short window of time. The circumstances called for an executive that would be able to make these types of decisions in that scenario, and this is what is expected from me. I did my Master in Pandemic Administration and from this experience, I will be able to manage other crises in a structured way and address the problems. For every agile change, we must implement in healthcare management, we express 1-3 key methods that we use with our stakeholders daily on a crisis committee. We learned how to do this during the pandemic and now this methodology is also applicable to other crises. We have experienced great results from this way of working.  During the pandemic, we realized that our business is medicine. To do good medicine, you need to use a multitude of people, including non-medical people. It is of fundamental importance to bring the doctors, especially those that can form an opinion in the group, to the frontline and capacitate them to be able as a group to make inputs in the impactful decisions. This is a huge challenge; it is not easy. Doctors are very focused on doing their clinical job and so we asked them to share one hour a week with us to analyze and discuss. For these meetings to work, you must be able to engage them with the big picture of the hospital management, and then introduce small problems for them to process in the group and generate solutions. You must show them data, strategy and then discuss the small things because, at this point, they understand the importance of their participation. You need to play the big cards and show them that they are participating in something big.  

EF: What was your mission when you were appointed?

RC: The hospital is recognized as one of the best hospitals in Brazil due to its prestigious history, and for us to keep it within the top ten hospitals, we need to implement great changes. With the infrastructure, we must be able to make a complete digital transformation. Most importantly, we will have to put the care of the patient at the centre of the process and our people at the centre of the organization’s strategy so they will use their skills in a meaningful way. All of this must be implemented in a sharp period in order for it to be successful. When you have a big challenge to fulfil and time is important, you must have the ability to be ready to be a leader the entire time and use every opportunity to inspire and give directions to everyone. Achieving the big goals depends on the small gestures that can seem unimportant.  

EF: Can you elaborate on your digital transformation initiatives and how do you see the role of digitalization in the future?  

RC: Digital transformation is a pillar of healthcare that when people discuss the subject can mean different things. They may be discussing automation or digitalization of processes. Very frequently people do not understand one of the caveats of the digital transformation which is rapidly increasing costs in storage and bandwidth. It can be a problem in the economy and a drive for inflation. Although I realize these difficulties, I am also completely on board. There is no way back, telemedicine is already a reality. I am sure that it provides access, practicality from the client’s perspective, and that it can augment the quality of care provided. The digital transformation we need is to transform or complement our structure with digital health business, a completely different thing. For a hospital like Mãe de Deus, that has half a century, it is more difficult to adapt to this than a new institution that starts with a blank page. Idealizing your business as a health business from the scratch and you have the necessary mindset for a digital business, you will probably have a leaner structure and a more efficient way of providing digital access.  Our institution pre-dates digitalization we already have a way of doing things, we now need to be able to transform and convince the organization that this new way will have to coexist with the old way to have the best possible future. Our digital presence started this year with an app called Mãe 360, we already have a considerable number of patients booking appointments and special diagnoses through the app. I was able to book a neurology appointment for my father during a lunch whilst he was discussing his issues.  I am sure we need to plant our flag in the digital era, and we will need to collaborate with other players that had a digital approach from the beginning. Through these collaboration efforts, they will benefit from our wealth of experience, and we will benefit from understanding how they are implementing digital business, we will be paying with knowledge. An example is our collaboration with ‘Laura’, a healthcare business with the mission of implementing Artificial Intelligence in healthcare, every bed in our hospital is equipped with an alarm system with AI that can demonstrate the probability of a patient’s clinical deterioration within an hour or day. Our initial results have been excellent.  

EF: What would you like the Hospital to celebrate its 50th year and how do you want to be remembered for this period?

RC: That our hospital will be able to be part of a big healthcare ecosystem as a big player specialized in the high-end applications of medicine whilst other organizations in the ecosystem are achieving the best in their specific fields. For example, I would love our structure for diagnosis to be a big building with the best equipment for diagnostics, although I would also like to see this for another institution within the ecosystem.  

I would like to be remembered as being a part of a team, not only the executive that led Mãe into the next era. I am not in the business for personal recognition or to have my team abide by my rules. I want them to thrive and do the best they can.

March 2022