The 7^th meeting of Teikyo-Harvard Symposium

The Healthy Hospital:

Maximizing the satisfaction of patients, health workers, and the community

The life expectancy and the duration of healthy, independent living in Japan is the world’s longest.  Japan is also characterized by unusual equality in health indices among people, as well as a relatively low percentage of the GDP going to health expenditures.  In 2000, the World Health Organization recognized Japan as the country with the world’s best health system.  Japan achieved this by universal health insurance coverage, easy access to healthcare, and minimal cost.  There was also appropriate use of technology, as well as a relatively small number of highly paid physicians.  However, these past successes are now being threatened because of increased demands from patients, an aging population, a shortage of physicians, and gradually mounting health expenditures.  Medical practitioners are forced to work long hours, and this increasing workload damages good patient-doctor relationships, and sometimes even results in medical errors.  For some talented young people, medicine is seen as a less attractive career.  Some physicians, especially those in gynecology, surgery, pediatrics, and emergency medicine, have left their jobs because of demands that were too great, and an increasing risk of litigation.  In turn, this has led to some hospitals being closed.  Thus the healthcare system in some communities is threatened.

In the face of these challenges, Teikyo University will open a new hospital in May 2009.  This is a courageous step during difficult times, including the global economic crisis.  The new Teikyo University Hospital is designed to be one of the great academic medical centers in Japan.  It will provide cutting-edge medicine, and will be a center of excellence combining high standards of medical practice with the education of the next generation of medical students and doctors.  It aspires to the best traditions of the teaching hospital; it will produce new knowledge, as well as pass on this knowledge to the next generation of medical practitioners.  Related to this ambition is a desire to exemplify the best strategies of hospital organization and health policy.  This new teaching hospital will also create new opportunities for Teikyo’s medical faculty.  They will strive to meet both clinical and academic objectives.  This hospital, located in Tokyo, will be a link to other centers of excellence throughout the world.

Teikyo University has been working together with Harvard University since 1993.  This partnership includes collaborative research, exchanging students and faculty, research training for Japanese physician-scientists at Harvard, and a distinguished series of joint symposia alternating between Boston and Tokyo .  The first Teikyo-Harvard Symposium took place in Tokyo in 1994, and was titled “Environment, health, and medical care for the 21^st century.”  Subsequent symposia have alternated between Tokyo and Boston biannually.  Teikyo University also has an alliance with the University of Cambridge and the University of Oxford in the UK .  We also organized an event in Cambridge as a joint symposium of four universities.  In 1998, the third symposium focused on “Evidence Based Medicine.”  This symposium in Tokyo effectively introduced this topic to Japan .  The result is a continuing Center for Evidence Based Medicine located within Teikyo University .  Subsequent symposia have focused on such diverse topics as healthy aging, as well as the prevention and mitigation of disasters.

We now present the 7^th symposium, which will focus on the “Healthy Hospital.”  Designed to coincide with the dedication of the new Teikyo University Hospital , this symposium will emphasize health in general.  It will include a focus on the individual and the community, as well as discuss factors affecting the organization of hospitals and the quality of care.  Especially, we recognize that the hospital is not only a place for “sick” people, but a place where diagnosis and treatment should be offered with comfort and support, and thus result in ultimately satisfied patients.  But the satisfaction of patients should not be achieved by the personal sacrifice of medical professionals.  Their lives and careers must also be fostered.  Only satisfied medical workers can provide satisfactory services.  Finally, the satisfaction of patients and healthcare workers must be coupled to the satisfaction of the surrounding community.  Partnerships must be developed, which include the community as a key component in promoting health and well being.

The Ottawa Charter for Health Promotion, introduced by the World Health Organization in 1986, declared that health promotion goes beyond health care.  The charter puts health on the agenda of policy makers at every level of government.  The Charter asked them to be aware of the health consequences of a wide range of decisions.  There must be a broad coalition to maintain health, and to diagnose and treat disease.  The responsibility for health promotion should be shared among individuals, community groups, health professionals, as well as health service institutions and appropriate government agencies.  Based on these ideas, we offer the metaphor of a “Healthy Hospital” as the central theme of our 7^th symposium.  A healthy hospital must connect to individuals and to the community.  Only then will we maximize the health and satisfaction of patients, health workers, and the community.

The 7^th symposium will include speakers addressing the interface between patients and doctors, with hospitals, as well as their interactions with communities and society at large.  Of course, the doctor-patient relationship is fundamental in the process of diagnosis.  Effective communication among patients and physicians is central to recovering from disease and maintaining a healthy lifestyle.  Medical education and a strategy to provide adequate numbers of well trained physicians and other health care providers are essential, and modern methods of information technology and simulation strategies are important.  Second is the topic of the organization of hospitals.  The new Teikyo Hospital is equipped with the most advanced information technologies (IT).  Systems are designed not only to promote efficient medical care, but also to increase the satisfaction of patients and hospital workers, as well as to prevent medical errors.

The third component of our symposium focuses on communities and society.  An essential topic in the 2008 Toyako G8 summit was health policy.  At this summit, Japan reflected on its achievements, and reflected on how Japanese paradigms can be characterized and disseminated to the world.  This part of the summit was organized by Harvard and Teikyo faculty.  The June symposium will also address community healthcare in Japan, and pay special attention to postgraduate medical education, and to the challenge of allocating physicians equitably throughout the country.  We will learn from the experience of the British National Health Service, which faced numerous challenges, but is now recovering.  In conclusion, we welcome anyone who is interested in promoting the highest possible health standards in Japan and globally.  Together, we will search for strategies to improve and develop the hospital and the medical care system of the 21^st century.  Please participate in the 7^th Teikyo-Harvard Symposium.