A conversation between Monika Dobrzeniecka and Dr. Krystyna Piskorz-Ogórek, MD, Director of the Provincial Specialist Children’s Hospital in Olsztyn.
The Provincial Specialist Children’s Hospital in Olsztyn has been recognized as the best-managed public hospital in Poland within its budget segment. However, its success goes far beyond financial performance – it is the result of an effective strategy, efficient processes, and staff open to innovation. Together with Dr. Krystyna Piskorz-Ogórek, MD, we take a closer look at the challenges of implementing new technologies and the hospital’s vision, in which innovation and team collaboration genuinely enhance the quality of care and managerial effectiveness.
Monika Dobrzeniecka: The Provincial Specialist Children’s Hospital in Olsztyn has been recognized as the best-managed hospital in Poland [according to the ‘Management Leaders – Best-Managed Public Hospitals by BFF Banking Group’ ranking in the category: Hospitals in Poland with a budget of PLN 200 million – 399 million]. What key management actions contributed to this success?
Dr. Krystyna Piskorz-Ogórek, MD: Achieving strong management outcomes in the hospital was possible thanks to the implementation of an effective strategy based on the balance and interdependence of five pillars: building the hospital’s financial efficiency, the clinical pillar, the care environment, the work environment, and ongoing active communication with the external environment.
The execution of this strategy was made possible through the engagement of senior and mid-level management, specialists, and quality teams responsible for implementing processes.
All decisions are made based on risk assessment as well as financial and clinical effectiveness. The strategic and managerial planning process is carried out in cooperation with the heads of departments and units.
Today, I can proudly say that staff identification with the hospital and creating a friendly work environment are key to building the trust of patients and their caregivers. They are also crucial to achieving the desired clinical and financial results, as well as to the organization’s development.
Another extremely important component of our success is the stability of the management team and the support of the founding body – the Self-Government of the Warmian-Masurian Voivodeship and the Marshal of the Voivodeship. This alignment has enabled, and continues to enable, the creation of a development-oriented policy for the hospital based on the health needs of the pediatric population.
You mentioned the key pillars of the hospital’s strategy and collaboration with the teams. Could you share a situation in which you faced a difficult strategic decision – for example, introducing a new department or reorganizing processes – and how you managed to carry it out without disrupting care for the children?
The strategic directions for the hospital’s development are defined by our multi‑year strategic plans, which we develop together with the heads of hospital departments and units. The hospital is continuously evolving, both in terms of infrastructure and clinical capabilities.
Decision‑making in management is a key process, but in healthcare it carries particularly high risk. This is why all my strategic decisions have always been preceded by epidemiological, staffing, and financial analyses, as well as an assessment of the feasibility of their implementation.
Investment planning and implementation processes are always established as a team effort, involving specialists, department heads, head nurses of the respective units, and the technical division. A well‑planned investment, thoroughly prepared for execution, can be carried out while maintaining continuity of operations and patient care.
The reconstruction or modernization of a single department entails a temporary reorganization of work in other departments. This is done in such a way that the work proceeds optimally and safely for patients, while ensuring uninterrupted care. It is a demanding process, but one that is possible to execute – and one that we regularly apply in our practice.
Since we’ve talked about strategic planning and investments carried out while maintaining continuity of care, I’d like to ask about another aspect – the BFF ranking highlights the financial efficiency of hospitals. What challenges do you face when introducing innovations within budget constraints? How does the Provincial Specialist Children’s Hospital in Olsztyn implement innovation in everyday patient care while ensuring financial stability?
Financial efficiency is the foundation of the BFF ranking. However, as a manager, I combine activities in such a way that the hospital achieves not only financial efficiency but also clinical effectiveness, patient and caregiver satisfaction, staff satisfaction, and safety of care. These elements are interconnected – and this is where innovation and modern technologies come into play.
It is challenging to reconcile the limited level of NFZ (National Health Fund) financing, which does not account for the use of modern technologies and innovations that increase hospital costs. However, within the healthcare system, such technologies can reduce the overall cost of treatment when measured against clinical outcomes, while also improving satisfaction for patients and their parents.
Examples? We have introduced expensive technologies and innovations in the surgical treatment of rare diseases in children in the head and neck region. Reconstructive procedures are preceded by implant planning in a 3D system, and the surgery itself is performed using integrated neuronavigation, neuromonitoring, video angiography, and an advanced 4K camera. For the hospital, this naturally means higher treatment costs, but for the patient – greater safety, fewer procedures, lower risk of complications, and a ‘tailor‑made’ implant that optimizes treatment outcomes.
What does this mean for the system? Lower patient treatment costs when calculated against the overall clinical result – because the patient does not need to undergo multiple procedures to finally adjust the implant to their needs.
For the healthcare system, this translates into lower overall treatment costs – since the patient does not need to undergo several surgeries just to achieve an optimal fit.
Hence the conclusion: expert centers equipped with advanced technology and specialists should receive higher reimbursement rates compared to centers without such capabilities. Ultimately, the payer spends less – because the patient chooses an expert center where fewer procedures and hospital stays are needed, and the treatment process and outcomes are optimized.
Similarly, in our Genetics and Molecular Biology Laboratory, we have implemented advanced systems for gene mutation identification supported by AI algorithms. Diagnostics are based, among other tools, on proprietary genetic panels developed by our specialists, dedicated to diagnosing autism, intellectual disabilities, epilepsy, RASopathies, or craniosynostoses.
The situation mirrors the previous example – the lack of differentiated funding for hospital treatment of patients diagnosed in expert rare disease centers using modern, costly technologies results in increased treatment costs for the hospital. However, this approach enables faster and more accurate diagnosis, optimization of the number of hospitalizations and consultations, and ultimately – reduced treatment costs for the NFZ budget.
To sum up, our specialists across multiple fields are ready to implement innovations, but we must maintain a balance between modernity and the hospital’s financial stability until the healthcare system introduces differentiated financing for patients with rare, chronic, or multi‑system diseases, depending on the advanced technologies used to improve health outcomes and care safety.
Indeed, innovation cannot succeed without an engaged team. How does the Provincial Specialist Children’s Hospital in Olsztyn cultivate a culture of openness to change? How does the Management Board motivate the staff to implement new solutions?
Implementing innovations relies above all on the willingness and engagement of specialists across different fields. As the management of the Provincial Specialist Children’s Hospital in Olsztyn, together with department heads, we continuously foster a culture of openness to change, to adopting new solutions, and to innovation.
During weekly meetings, specialists share clinical experience as well as knowledge gained at national and international congresses, conventions, and conferences. Our staff also participate in international bodies and scientific societies.
These activities are rewarded and recognized, and specialists are nominated for distinctions and awards. Additionally, the hospital’s social media channels and the regular newsletter “Przyjaciel Dzieci” highlight the achievements of our specialists, the technologies they use, and the innovations implemented – which also helps build trust in our center. All of this contributes to creating a hospital environment that is friendly and supportive for employees.
Innovation is often discussed in the context of medical equipment, but the most important advances happen within processes. Could you share an example of an organisational or procedural change that improved patient comfort or made the staff’s work easier?
Process innovations are another group of changes that have a significant impact on the quality of patient care. We are introducing further improvements in this area in parallel.
One example is the process for handling outpatient patients, including those with special needs. Registration is available through the e‑patient portal, and patients receive an SMS reminder about their appointment three working days in advance, along with contact details should they need to cancel. This allows the appointment slot to be used by another patient from the waiting list.
Access to laboratory test results is provided via the e‑portal, and the outpatient clinic has been equipped with information kiosks and a queue management system synchronized with e‑registration. The system takes into account the needs of people using wheelchairs, as well as blind and partially sighted patients, and those with hearing impairments. Audio announcements are transmitted through induction loops, and information about how to use the kiosks and navigate the clinic is available in sign language.
The outpatient clinic has also been equipped with visual navigation paths, and the communication routes have been adapted for blind and partially sighted individuals – including FON systems, Braille signage, and tactile maps. Essential information and messages are also provided in sign language. Around 200 staff members have been trained in communication with patients with special needs, including 50 who completed a sign language course.
We have created a patient assistant position within the specialist outpatient clinic to support caregivers and patients on site, including providing support in sign language. We have also appointed a patient accessibility officer within the hospital.
The organisational changes introduced have been very positively received by patients’ caregivers and have improved workflow and comfort of service. They have also contributed to increased staff satisfaction, as personnel no longer need to spend time on tasks handled by the new processes. Moreover, a satisfied patient means a satisfied staff.
Finally, I would like to look toward the future. From a 5–10‑year perspective, which changes and innovations do you consider crucial both for the quality of care and for managerial efficiency?
In the organisational area, a good solution would be to place greater emphasis on developing centers that provide comprehensive patient care, with a clear separation between pediatric care and adult care.
I see this as ensuring continuity of care for children with chronic and rare diseases within pediatric centers up to at least the age of 26, without the need to submit individual requests to the National Health Fund. It also means creating multi‑specialty competence centers — interdisciplinary facilities for both children and adults – so that comprehensive diagnostics and treatment in one place can guarantee full health outcomes.
I assume that the use of AI in managerial decision‑making will increase, for example in monitoring treatment costs, identifying budget overruns, organising the work of operating theaters and planning procedures, as well as in analysing staff workload.
I also view organisational change as the progressive automation of processes, both administrative – such as the circulation of medical and non‑medical documentation – and clinical, for example the coordination of care for chronically ill patients.
In the clinical area, the 5–10‑year perspective should bring the development of clear care pathways for patients with rare diseases, as well as rules for the functioning of expert centers, including differentiated financing for diagnostics and treatment using expensive technologies.
Genetic, histopathological and imaging diagnostics supported by artificial intelligence will become standard. AI will also be more commonly used for creating medical documentation, such as voice‑generated records.
The use of robots will increase in patient interaction, internal hospital transport and cleaning of communication routes – for example, bots for registration or MOXI‑type robots.
I believe that operating rooms will be equipped with advanced technologies that ensure safe care, such as cameras, neuromonitoring systems and other integrated equipment enabling access to patient data from any location.
Time will tell how accurate these predictions are, but many of these ideas are already emerging in our hospitals and within startup projects. However, not all of them meet the expectations of management boards or clinicians. That is why continuing cooperation among hospitals within the MCSC Hospital Innovation Leadership competition is such a good practice. It is a way to actively seek solutions that can be truly useful in practice.
Thank you for the conversation.
The Provincial Specialist Children’s Hospital in Olsztyn has been one of the co‑organisers of the MCSC Hospital Leadership Innovation competition since its very first edition. For those who want to create real change in the healthcare system, MCSC has become a place where ideas meet practice.
We invite Polish hospitals to join the 5th edition of the competition — for more information, please contact: mcsc@imid.med.pl
Interview by:
Dr. Krystyna Piskorz-Ogórek, MD – Director of the Provincial Specialist Children’s Hospital in Olsztyn; specialist in pediatrics and healthcare management; inspector for the CMJ Accreditation Centre in Kraków. Author of numerous publications in public health and pediatric care; laureate of awards for management and healthcare development, including Super Medicus, Healthcare Market Manager, Leader of Change in Healthcare, and Laurels of the Best of the Best. Under her leadership, the hospital is evolving into an interdisciplinary pediatric competence center, specializing in rare diseases, neurodevelopmental disorders, and care for patients with vascular anomalies.
Monika Dobrzeniecka – communication and marketing expert at the Institute of Mother and Child, specializing in translating innovation and technology into accessible language. One of the coordinators of the MCSC Hospital Leadership Innovation competition, responsible for brand development and visibility. She supports startups and public institutions in effective relationship‑building and implementing modern solutions within the healthcare sector.