Transformation at Barcelona's Vall d'Hebron University Hospital to face healthcare's biggest crisis

To understand the keys to the case "COVID-19 Management at Vall d’Hebron University Hospital" and its usefulness for business school students, we spoke with Prof. Jaume Ribera of IESE and Dr. Albert Salazar, managing director of the hospital. 

IESE Publishing: Why write a case study on COVID-19 management in a hospital?
Jaume Ribera: At present, there is nothing else in print about a hospital's management of this pandemic. We've been able to see a real-life example of how the crisis is unfolding and how it fits into the hospital's strategy for the future.
Albert Salazar: Unfortunately, the pandemic is not over yet, so the challenge of confronting it and managing it continues. This case covers the first wave, but it presents lessons learned to face future waves and changes to the hospital's strategic plan. The case also reflects on how we've transformed our organizational structure to function better, with less hierarchy, putting the needs of the patient at the center.

I.P.: Why choose the Vall d'Hebron University Hospital?
J.R.: This Barcelona hospital wasn't the only one to successfully manage the health crisis, but it's notable as Catalonia's largest public hospital. More than 40,000 people pass through it each day. In addition, those responsible for running the hospital offered a degree of openness and many hours of interviews so that we could write a case that's very true to life.

I.P.: What's the educational value of this case?
J.R.: It's an extremely compelling case for students because it allows us to analyze the phases of a crisis (preparation, detection, immediate action and recovery). That makes it ideal for considering which measures, applied mid-crisis, should be further consolidated and what else might be used to tackle COVID-19 or future pandemics.
A.S.: Contributing to this case has allowed us to put order to all the actions we undertook during the first wave and learn from them. There was a high degree of improvisation, with mere hours for planning, never more than 24-48 hours. Having a case study allows for reflection and a look at the lessons learned to make improvements.


A radical transformation

Management of the pandemic has been based on two axes, according to Dr. Salazar: "the need to work on any project in collaboration with all the region's actors and, internally, to strengthen multidisciplinary teams. COVID-19 has shown us that breaking the traditional silos, sharing knowledge and working jointly across specialties, levels, doctors and nurses, can make it possible to achieve far superior results in terms of patient care."

In Vall d’Hebron, the transformation started very early, even before there was a single case in Catalonia. The hospital anticipated the arrival of the epidemic with protocols and contingency plans that proposed up to a dozen scenarios in which, in the worst cases, ICU occupancy could be tripled and the total number of hospital beds could be doubled.

By the end of January 2020, a coordinating committee was created, made up of members of the hospital's management team as well as experts in the specialties most relevant to the novel coronavirus. In addition, an emergency public procurement model was designed in order to obtain the necessary PPE supplies, services and materials in time.

To mitigate the risk of contagion, it was decided that about 800 administrative professionals would begin to work remotely, appointments would be conducted virtually (or by telephone), the home delivery of medications would be promoted, and certain visitations would be suspended. The hospital allowed visitors to see non-COVID-19 patients within limited time slots, but COVID-19 patients were only allowed visitors in end-of-life situations.

COVID-19 management at Vall d’Hebron University Hospital joins the more than 200 case studies written by IESE professors in the last three years, reflecting IESE's aim of always being up-to-date in the analysis of business problems that arise in the classroom, which include cases on current topics in companies such as NetflixBarça and Spotify, among many others.