Higher quality with efficiency gains.
Photograph: Pexels
Text: Mariano Anthony Davies
Denmark is investing in a major structural and organisational reform of the Danish healthcare sector to establish a sustainable sector. In this sector, hospitals are an integral part of a coherent healthcare system that supports patients as active partners in their treatment.
The programme consists of 16 new hospital projects and has been allocated EUR 6.6 billion (2019 prices). The focal point of the transformation of the Danish healthcare sector is that patients should spend as little time as possible at the hospital. Hospitals are for highly specialised treatment. Non-specialised treatment should take place outside hospitals as outpatient treatment.
Treatment outside the hospital is less intrusive for patients and more cost-efficient than hospitalisation. With a greater share of patients treated outside the hospital, hospitals will be able to focus their resources on the critically ill or injured, who need highly specialised care. This will raise the quality of care while at the same time pushing for patients to become active partners in their treatment.
The investment, therefore, facilitates a new hospital infrastructure with larger but fewer hospitals, which in turn have stronger, highly specialised professional environments with the capacity—both in terms of staff and equipment—to handle even the most critical and complex cases. This means closing hospitals, and the goal is to limit the number of hospitals with emergency departments by downsizing from 40 to 21.
Higher quality
A core idea of the new hospital infrastructure is the principle of treating patients at the lowest practical cost level while increasing the quality of highly specialised care. Merging hospitals into fewer units with large population bases of over 300,000 inhabitants supports the development of highly specialised professional environments for medical research and training. In the trade-off between proximity and quality of hospitals, Denmark has chosen the latter—even if it entails closing down local hospitals—as it believes that the positives outweigh the negatives.
Higher quality is a constant target in any healthcare system. In Denmark, the Super Hospital Programme supports this pursuit in various ways, as described below. Putting the specialist in front of Emergency healthcare services plays a crucial role in modernising the organisational structure at the hospitals. To guarantee that all patients receive appropriate treatment in case of sudden injury or illness, the reformation of the hospital infrastructure includes the establishment of 21 joint emergency departments staffed with specialists on a 24-hour basis.
The objective of the new emergency departments is to improve quality and provide complete treatment for a larger share of patients without the need for further hospitalisation. The joint emergency departments will be able to draw upon medical specialists from all relevant fields 24/7, and the appropriate specialist will see the patient immediately. In many cases, this will result in faster and more accurate diagnosis and will make it possible to provide complete treatment within the emergency department without referring patients to specialised hospital departments. In addition to the restructuring of emergency departments from 40 to 21 larger units, several smaller emergency clinics have been established in areas remote to the nearest hospital.
"Denmark's Super Hospital Programme aims to raise the quality of care by focusing hospital resources on highly specialised treatments and shifting non-specialised care to outpatient settings, empowering patients as active partners in their healthcare journey."
Efficiency gains
To ensure that the potential for efficiency is met, approval of each project application was conditioned on specific targets for future efficiency gains. The expert panel set a specific target for each project based on the type of project, the region's suggestions for initiatives to increase efficiency at new hospitals, and previous initiatives undertaken in the region to increase efficiency at existing hospitals. Planning to realise efficiency gains and building the hospital are simultaneous processes.
Solutions have been designed in collaboration with clinicians to meet both the actual needs of the patients and the health system in general. Some examples of how the regions plan to achieve efficiency gains are:
Reducing the number of beds.
Merging and restructuring departments.
Joint emergency departments for faster treatment.
Optimising patient flows through better IT infrastructure.
Constructing energy-efficient buildings.
Installing high-tech logistics primarily aims to optimise resource use. Danish solutions for just-in-time logistics include systems for locating and tracking staff and equipment, solutions for automating basic and repetitive tasks, and solutions for guiding patients around the hospital. These help avoid delays and peak times in the hospital process. Intelligent solutions for handling samples help hospitals reduce their sample turnaround time and subsequently speed up patient diagnostics.
Fully automated laboratories improve sample flow by handling and sorting all blood samples without any manual handling, thereby minimising the risk of errors and freeing up time for value-adding tasks such as patient-related work.
EUR 330 million per year will be freed up for re-investment in the healthcare sector, providing a financial boost for the entire sector. This will substantially contribute to creating a future-proof and sustainable healthcare system with world-class quality treatment.
At present, six projects are fully complete and in operation, while several other hospitals are in partial operation. The last project in the programme is expected to be completed in 2025.