ICO

Participatory direction by objectives (DPO)

The active participation of the professionals in the development of their organizations is the pending subject in many areas of the administration. This has led to situations where the responsibilities that the professionals have, at the moment of making decisions, are few, due to the lack of implication that is established. This fact makes the Participatory Direction by Objectives (DPO) be a tool that makes this necessary participation easier.

Participatory direction by objective (DPO'96)

The dynamics of operation by DPOs was already a tradition in the university hospital of Bellvitge as regards methodology, but it found the problem that it could not reach the end of the process, because it could not negotiate directly the result of the operating Account, due to its budgetary operation.

One of the advantages that the creation of the ICO implies is to be able to negotiate more agile resources utilizing techniques that enable that the DPOs to be a real tool of relation between the direction and the services.

The suggested objectives that have been presented to each service have been elaborated according to:

	Objectives that are established by the Pla de Salut of the Servei Català de Salut.
	The Assistance Offer at the Servei Català de Salut
	The Assistance Activity and Quality Objectives 95.
	Analysis of the service according to PMCs, GDRs and ICD-9-CM facilitated by the Archives and Clinical Documentation Service.

The strategic lines of fulfilment of the DPO's for the services are:

Fulfilment of the negotiated operating Account.

To improve or to maintain the established standards of quality.

To initiate and to monitor three objectives, whose fulfilment improves the organizing aspects of the service.

The following points of emphasis have been identified for the elaboration of the three objectives of quality that each service should pose:

	The satisfaction of the clients/users’ to whom they do service.
	To promote quality and innovation.
	To promote teamwork.
	The responsibility of the professionals, in relation to each area, and in the efficient optimization of the resources.
	To enable motivation.

Dynamics of operation

	A dossier is delivered to the Head of Service and Head of Nurses for its analysis and discussion with the members of the Service.
	They have to revise the operating account to ratify the parameters and to suggest the three objectives of improvement that will serve for evaluating a part of the incentives.
	The lines of research and training will be enumerated to trace ICO’s global program.
	Once tried by the Service, a meeting with the management personnel will be called to formalize the agreements.

Monitoring and evaluation

The management control system of the Institut Català d'Oncologia is based on the monitoring of the objectives negotiated with each Service or Unit, with the monthly analysis and the application of the correcting measures to the deviations, in the case that they exist.
For this, exists a responsible for management of the information, and three types of periodic meetings of monitoring take place:

	Twice a year, in order to analyze the fulfilment of the DPOs.
	Four times a year to proceed to the analysis of the operating account.
	Monthly, for the monitoring of the activity, consumption and pharmacy.