The work 'The management team and patient safety', by Antonio Burgueño Jerez, proposes a structured vision of the functions of management to integrate safety into health strategy and governance
The publication of the To Err is Human report in 1999 marked the beginning of an international movement that spurred the development of strategies, standards, learning systems, and improvement programs worldwide… READ MORE
Antonio Burgueño Jerez, author of The Management Team and Patient Safety, argues that management leadership must translate into concrete functions and organizational structures to integrate clinical safety into hospital strategy.
Patient safety has been a high priority on the healthcare agenda for years, but Antonio Burgueño Jerez believes there is still work to be done. This work consists of clearly defining the role of those who lead healthcare organizations . This is the central idea behind "The Management Team and Patient Safety ," a publication in which the director of Enclave Salud and Proyecto Venturi applies over two decades of experience working with hospital management teams to the field of management . READ MORE
Most indicators, action plans, institutional objectives, and organizational measures have been built around this time variable. They measure how many patients are waiting, how long they have been waiting, and how the delay evolves in each care process. From this perspective, the main challenge is to reduce access times and improve the system's responsiveness.
However, there is a much less explored issue: what happens to patients while they wait to be seen. Their clinical condition may change, new needs may arise, frailty may increase, social circumstances may change, or the uncertainty associated with the care process itself may increase.
The Venturi Project believes that private healthcare and contracted services will continue to be an essential part of the Spanish healthcare system's actual capacity to respond. The new regulatory framework will require a shift towards much more precise, predictive, and structured planning models for healthcare capacity.
Following the analysis of the Draft Law on Public Management and Integrity of the National Health System presented by the Ministry of Health , at Proyecto Venturi we believe that this new regulatory scenario reinforces the need to move towards structural planning models of the healthcare response capacity of the Spanish health system.
Over the past few years, the conversation surrounding Artificial Intelligence applied to breast cancer has primarily taken a technological approach. The debate has focused on the ability of algorithms to detect lesions more accurately, improve radiological interpretation, and accelerate certain diagnostic processes. However, as the clinical approach to breast cancer evolves, it is becoming increasingly clear that the real challenge lies not only in technological capabilities, but also in the growing complexity of the care process itself and the clinical decisions that underpin it.
Artificial intelligence has become a major focus of innovation in the field of breast cancer . Advances in image analysis, early detection, risk prediction, biomarker identification, and diagnostic support are increasingly featured in conferences, scientific publications, and digital transformation strategies.
The surgical waiting list has become one of the most visible indicators of the healthcare system's performance. However, its interpretation continues to focus on two figures: the number of patients on the waiting list and the average waiting time. Both are relevant, but neither fully explains what is really happening.
Today, the healthcare system has over 849.000 patients on its surgical waiting list. At the same time, it performs more than 2,6 million surgeries annually from that same list. In other words, the system operates on approximately 11.000 patients every day from the waiting list. And yet, the list persists. READ MORE
The draft bill on Public Management and Integrity of the National Health System, approved by the Council of Ministers, continues to face criticism. In addition to objections from politicians and the private healthcare sector, the "Venturi Project" has now raised concerns, warning that tightening the conditions for using contracted services could limit the system's actual capacity to respond at a time marked by healthcare pressure and long waiting lists.
A report by this group of experts argues that the regulation stems from a tightening of the conditions for resorting to indirect management or complementary collaboration models…
We spoke with Antonio Burgueño, director of the Venturi Project and Enclave Salud, about the state of healthcare in Spain. The Ministry of Health is expanding breast cancer screenings to women between 45 and 75 years old. This is good news, but it raises a question: will the system be able to implement this initiative without creating longer waiting lists? Burgueño says that while more consultations and surgeries are being performed, it's not enough because the waiting list continues to grow.
The draft bill on Public Management and Integrity of the National Health System, presented by the Ministry of Health, reinforces the need to move towards structural planning models for the healthcare response capacity of the Spanish healthcare system, according to the Venturi Project initiative , following an analysis of this regulatory framework. This legislation establishes a context in which indirect management and collaborative models will be subject to more rigorous evaluation, justification, and prior evaluation processes.
Proyecto Venturi believes that the healthcare system will need a greater capacity to anticipate demand scenarios , size resources, and plan healthcare responses well in advance.
The year 2026 should mark the definitive shift from analysis to implementation. The healthcare system no longer has much room for delay.
Over the past few years, the Venturi Project has been uncovering the structural causes of healthcare pressure in Spain: from the overload of primary care and delays in initial consultations to the increasing strain on operating rooms and the intensive—sometimes excessive—use of diagnostic tests. After several years of analysis, modeling, and comparison of results, the Venturi Project has made it possible to organize and understand, based on empirical evidence, how the healthcare system actually works.
Spanish healthcare system and where its imbalances occur.
Waiting time and patients on the waiting list: two interdependent dimensions of surgical access
The analysis of surgical access in Spain relies primarily on two indicators: the number of patients on the waiting list and the average waiting time. Both are published periodically and form part of institutional monitoring, thus serving as a benchmark for assessing the system's evolution.
Two dimensions of the same reality: the responsiveness of the healthcare system
Breast cancer care in Spain is functioning well, with clear progress in diagnosis and survival, but also significant room for improvement. The increase in incidence, regional variability in screening, and organizational limitations in diagnosis and follow-up are shifting the burden of care towards continuity of care and coordination between levels of care. The analysis identifies opportunities for improvement in equity, traceability, and efficiency, without requiring large increases in resources.
A comparative analysis as part of the Patient Safety Promotion Project confirms that this role still lacks an established international regulatory framework.
The role of the Patient Safety Officer is not uniformly recognized internationally, but rather appears in a scattered and heterogeneous manner. This is one of the main conclusions of the study ' The Role of the Patient Safety Officer: Competency Manual, Functions and Specialized Training' , framed within the Patient Safety Promotion Project , which reveals a “fragmented reality”.
Breast cancer care in Spain has improved significantly in terms of diagnosis, treatment, and survival, but it continues to face significant structural challenges. The Venturi Project report highlights a sustained increase in incidence, still insufficient and uneven screening coverage across regions, and growing strain on radiology and primary care due to the increasing number of women living with the disease. Although the system has sufficient technical capacity, problems persist regarding equity, traceability, diagnostic efficiency, and care coordination, requiring a reorganization of resources and processes to consolidate a fairer, more effective, and sustainable model.
Enclave Salud is conducting a study to analyze how breast cancer screening is carried out in Spain, focusing on the effectiveness of the model, the protection of health data, and public trust in the program. Its director, Antonio Burgueño , pointed out that "in Spain, we're talking about 20 million women over the age of 20. The protection of the screening's reach, due to age limitations, is currently limited to eight million potential participants. Eight million who could attend screenings, but they don't necessarily go directly." This is a small number considering that the number of new cases of breast cancer continues to rise. READ MORE
New Medical Economics, November 2025
Unlocking access to healthcare: an overview of outpatient medical practice
For years, the major problems of the Spanish healthcare system have been sought in hospitals, surgical waiting lists, or emergency rooms. But the reality is different: the real point of contention lies much earlier, in medical consultations, both in primary care and in specialist clinics.
Healthcare waiting list data directly reflects the system's actual capacity to respond to healthcare demands. The publication of data from June 2022 shows a high volume of patients on waiting lists and a trend that requires rigorous interpretation: behind the apparent reduction in average waiting times, there may be an increase in demand, the emergence of hidden healthcare needs, and limitations in the system's capacity to resolve these issues. A correct understanding of these indicators is key to improving the quality of care and guiding more efficient and humane management of the healthcare system.
…becoming a consolidated model of analysis and thought. Those initial reports emerged as an immediate reaction to the pandemic: to assess the accumulated demand for healthcare and to warn of the consequences of halting activity in an already strained system.
The metaphor was clear: as in the physical principle that gives it its name, when the system's capacity is limited and cannot accommodate all activity, it is necessary to accelerate the response capacity, aligning input and output volumes at each point in the care process, and finding ways to accomplish more with the same resources… READ MORE
Improving the present and future of Spanish healthcare is a necessity that has a solution; it doesn't require miracles or alien technology. What does seem to be lacking is political will and the ability to leave egos at the door . The Venturi Project , led by Antonio Burgueño , after five years of in-depth analysis, has published a report on the matter. It not only identifies the problems of the National Health System but also offers concrete solutions. These are solutions that can't be improvised at a press conference or over coffee with supporters. Creating this document required extensive study, analysis, and collaboration… READ MORE
