Why do we need models to understand the healthcare reality?
Healthcare organizations operate within an increasingly complex and changing reality.
An aging population with a greater prevalence of chronic diseases and multimorbidity; a more diverse and multicultural society with different needs, expectations, and ways of relating to the healthcare system; changes in lifestyle habits and disease patterns; and an increasingly informed and demanding citizenry.
At the same time, the demand for healthcare is increasing, new diagnostic and therapeutic technologies are emerging, the possibilities for care and follow-up outside of healthcare facilities are multiplying, and new digital and artificial intelligence tools are being incorporated. All of this coexists with limited resources, difficulties in obtaining certain professional profiles, and organizations that must coordinate multiple levels, services, and healthcare facilities.
But the complexity does not only stem from the fact that there are more and more factors, but from the fact that they all interact with each other.
Models, frameworks, indicators, and assessment tools help us organize available knowledge, establish relationships, and build a vision upon which to make decisions. Therefore, methodology is not merely a technical matter. The way we observe and analyze an organization shapes what we are able to see within it and, consequently, the decisions we can make.
An additional challenge arises: the healthcare landscape is evolving, and our models for understanding it must evolve as well. This doesn't necessarily mean replacing what already exists, but rather incorporating new perspectives, sources of knowledge, and analytical capabilities that allow us to respond to increasing complexity.
Are our analytical models evolving at the same pace as the reality we seek to understand? This question is at the heart of the origin and evolution of the Enclave Salud Methodological Model, a framework that integrates different tools, sources of knowledge, and analytical capabilities to understand reality, evaluate it in a structured way, and support decision-making in healthcare systems.
The methodological model forms the common basis upon which Enclave Salud develops its various lines of work. Based on this methodology, different intervention models have been built, adapted to the specific needs of the healthcare sector, ranging from managing healthcare demand to patient safety and designing customized projects.
The 7 elements of the methodological model
The methodological model is structured around seven complementary elements that allow for an organized approach to analyzing a complex healthcare reality. Each element addresses a different need: identifying and analyzing available knowledge, understanding care processes, working with data, establishing frameworks, determining the starting point, and translating the analysis into concrete objectives and actions.
Documentary Search and Analysis (Meta-analysis)
Structured analysis of documentation, available evidence and existing frameworks, aimed at contextualizing the problem, identifying patterns and avoiding decisions based on fragmented information.
Data Modelling & Scenarios
To understand the behavior of the system, anticipate stresses, and assess the potential impact of different decisions before their implementation.
Patient journey processes
Detailed analysis of the patient's actual journey throughout the care process, identifying points of friction, organizational mismatches, and opportunities for improvement with clinical and operational impact.
Evaluation tools
A set of questionnaires and information gathering tools that allow for the evaluation of the degree of development, maturity, and alignment of processes, practices, and organizational structures with the defined objectives.
Framework
Conceptual basis of the model, which defines common principles, criteria and objectives, providing coherence, comparability and a shared language for decision making.
Evaluation report template
Standardized structure to synthesize the results of the analysis and evaluation, facilitating their understanding, traceability and effective use by management and decision-making teams.
Goal prioritization tool and action plan
An instrument that allows you to organize objectives and actions based on explicit criteria, available resources and time horizon, transforming analysis into actionable decisions and plans.
They are not isolated tools nor a rigid sequence of application. Their combination and level of development depend on the object of analysis and the needs of each project.
The function of each element and its contribution to the analysis, evaluation, and decision-making process are described below.
1. Document search and analysis
It is defined as the initial phase of the model oriented towards the identification, selection and critical analysis of the evidence available in relation to the object of study.
It integrates sources of a heterogeneous nature —scientific literature, technical reports, clinical guidelines, regulations and institutional strategies— that are subjected to a systematic evaluation process in terms of methodological quality, validity and contextual relevance.
Its function is not limited to the collection of information, but establishes the state of existing knowledge , allowing the empirical framework of the analysis to be defined and identifying gaps in evidence, inconsistencies or areas of uncertainty relevant to the subsequent development of the model.
2. Reference framework
It constitutes the conceptual and normative structure that delimits and interprets the phenomenon analyzed.
It includes operational definitions, theoretical models, reference standards, classification systems, and applicable regulatory instruments. Its purpose is to establish a common analytical language and ensure interpretive consistency across sources, levels of care, and organizational contexts.
From a methodological perspective, it acts as a conceptual anchoring system , ensuring the comparability of results and their alignment with current institutional and strategic frameworks.
Learn more about the frame of reference
3. Care processes (Patient Journey)
It refers to the analytical reconstruction of the patient's journey through the healthcare system , understood as a structured sequence of events, clinical decisions, and organizational interactions.
The analysis is broken down into care phases, identifying transition points, actors involved, variability in clinical practice, and dependencies between levels of care.
This approach allows incorporating the dynamic dimension of the system, facilitating the identification of structural inefficiencies, discontinuities in care, and variability that is not justified from a clinical or organizational point of view.
4. Data Modelling and scenarios
It consists of formalizing the analyzed reality through data structures and analytical models that allow its quantitative representation.
It includes the definition of variables, the structuring of analytical databases, the modeling of relationships between system components, and the construction of counterfactual scenarios.
This element allows not only the description of the system's behavior, but also the simulation of its evolution under different assumptions , incorporating a predictive and comparative dimension into the analysis.
5. Assessment tools
Set of instruments aimed at the systematic measurement of the performance of the system or process being analyzed.
They are operationalized through indicators of health outcomes, quality of care, efficiency, accessibility, equity and patient experience, among other relevant domains.
Its function is to transform structured information into evaluative evidence, allowing comparative judgments to be made regarding previously defined standards, objectives, or reference values.
6. Evaluation report template
Define the formal structure for the synthesis, organization, and communication of the results of the analysis.
It establishes criteria for prioritizing information, sequencing findings, and articulating conclusions, ensuring traceability between data, analysis, and interpretation.
From a methodological perspective, it acts as a device for transferring analytical knowledge to decision-making processes, ensuring its readability by different professional profiles.
7. Prioritization of objectives and action plan
Final element of the model oriented towards translating the analysis into structured operational decisions.
Based on the evidence generated, areas of intervention are identified, prioritization criteria are established based on impact, feasibility and available resources, and a timed action plan is defined.
Its function is to close the analytical-transformational cycle of the model, connecting the production of knowledge with its effective implementation in the health system.
Each element contributes a key piece. Together, they form a robust, flexible, and results-oriented method.
Strategic analysis, benchmarking, and reference models allow for a better understanding of the healthcare reality, the identification of relationships, the evaluation of alternatives, and support for more coherent and informed decision-making.
Integrating analytical capabilities, knowledge, process standardization, evaluation, and prioritization allows for building a more structured view of increasingly complex realities.
Multiple applications in healthcare
The Methodological Model can be applied to different areas and levels of the healthcare system . Its usefulness is not determined by a specific application, but by its capacity to structure the knowledge necessary to understand, evaluate, and act upon a given reality.
It can be used, among other areas, to analyze healthcare organizations and services, care processes, organizational models, capacity and demand, quality and patient safety, technology integration, outcomes, continuity of care, or policy and strategy planning and evaluation.
Each situation raises different questions and may require different sources of knowledge, frameworks, tools, and analytical capabilities. The methodology provides a structure for integrating them coherently.
From the origin of the model to its evolution
Our methodological framework was initially developed within the Impulso Project , with patient safety as its founding purpose. From the outset, the framework was designed to understand care processes, decision-making under constraints, and the risks generated by mismatches within healthcare systems. As this work progressed, it became clear that patient safety could not be fully addressed without understanding how systems respond to demand.
This approach led to the birth of the Venturi Project, applying the same methodological framework to the analysis of health capacity, system efficiency, and healthcare response under pressure.
Today, the framework remains open and evolving , supporting current initiatives and enabling new applications that are already under development.
In complex healthcare settings, without a common methodological framework, it is difficult to know where we are, what to prioritize y how to move forward coherently.
The methodology provides structure, criteria and continuity, allowing the transition from analysis to ordered and prioritized decisions.
Antonio Burgueño Jerez,
Director of Enclave Health
(LinkedIn)
