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Marija Bošnjak: Raising Standards in Healthcare through a Holistic Approach to Children’s Health at Poliklinika Salvea

Marija Bošnjak, Salvea
Marija Bošnjak, Salvea

Poliklinika Salvea is a clinic located in the west of Zagreb that provides healthcare for its youngest patients through a holistic approach. By offering a breadth of services tailored to individual patient needs, this ambitious team is introducing new trends in the healthcare services market in Croatia, placing the patient, or as they say, the person, at the center of their entire operation.

The realization of the opening of the Poliklinika was quite fast, yet thorough. What were the biggest challenges for you during this process and how demanding was it?

Although the idea of the Poliklinika had existed for some time among the owners, the actual realization took less than a year. The process involved a lot, from establishing a business strategy, finding suitable premises, obtaining building permits, constructing and equipping the raw space in accordance with legal and medical standards, recruiting and hiring a team of doctors, nurses, assistants, subspecialists, procuring high-quality equipment, to establishing external collaborations and setting up a quality, sustainable, and efficient system. In just over a year, we opened over 20 specialties and related fields focused on children’s health and established cooperation with nearly 50 experts in this area. As a Master of Pharmacy and Economics, this project has allowed me to combine my two greatest passions, previous knowledge and experience, and it fulfills me every day to proactively create healthcare as it should be in terms of quality and patient approach. Additionally, we are continuously working on expanding our service offerings so we can say that in a way we are also building the healthcare of the future.

When you talk about quality and patient approach, what steps have you taken to offer a new standard of healthcare services in Croatia?

First of all, we have tried to avoid all the well-known challenges that arise in healthcare. Our doctors have enough time to dedicate to patients and have access to top-notch technology. We considered all parameters to achieve the highest level of quality. From the Poliklinika’s premises, where attention is paid to every detail to create a pleasant environment, for which we recently received an international award, to being equipped with the most modern ventilation systems to ensure our patients feel safe, to top diagnostic devices selected by eminent Croatian pediatric specialists and subspecialists, to the careful selection of staff who love working with children, nurture a passion for pediatrics, and are genuinely dedicated to the youngest patients. We have also carefully structured processes in the Poliklinika considering the complete patient experience, from the first contact with the Poliklinika to the patient’s exit. We have introduced numerous services that have not been represented in pediatric clinics until now. We approach health integratively and want to be a model of holistic treatment for children. We strive to give healthcare a new dimension where a visit to the doctor can be relaxed, pleasant, and even fun, where you are treated as a family member.

Through your work, you emphasize the importance of a patient-centered focus in the healthcare system. This is a common theme in our healthcare, but is it really like that in practice? Is enough attention given to the patient?

Although the patient is often the focus of discussion in healthcare, only one in six Croatian citizens believes that this is truly the case. Often, the patient must seek information from multiple sources, visit various institutions and doctors, and gets lost in the complexity of the system. Statistics show that the average Croatian citizen in good health lives until the age of 59, and Croatia unfortunately ranks as the ninth worst country in the European Union in terms of the share of life lived in poor health, with an average life expectancy of 76.7 years. Citizens rated healthcare in 2024 with a score of 2.7 out of a possible 5, which is significantly lower than in 2020 when the score was 3.3. This shows that there is room for improvement in healthcare services and a greater focus on the patient from the earliest days. We need to think about what we, as active participants in healthcare, can do to help them lead a healthier and more fulfilling life. Our contribution to the patient should be in the form of efficiently addressing their problems, achieving the best possible treatment outcomes, activating all necessary stakeholders in healthcare, and fostering communication among professionals, a more dedicated and humane approach to patients, as well as education and work on health literacy for patients and parents.

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Poliklinika Salvea

How does the Poliklinika dedicate itself to the patient and how do you specifically approach educating parents and increasing health literacy in families?

We approach the patient primarily as a person. Patient-centered health emphasizes the wholeness of the human being, and not just treating the symptoms of illness but considering its cause. We take into account the broader environment of the patient and strive to achieve their full biological potential. We actively educate parents from the very first examination and work on the health literacy of the entire family. We publicly discuss the topics that concern us most regarding the health of the youngest.

In our commitment to patients and their families, we care about their overall experience. From initial information about the Poliklinika and scheduling appointments, team collaboration, and organizing clinics through a circular arrangement of rooms, to proactively checking whether the patient’s condition has improved. Upon arriving at the Poliklinika, after a warm and friendly encounter with our nurses, the conversation continues with the doctor who strives to carefully listen to the concerns of parents and patients, diagnose, and efficiently resolve the issue for which the patient came, taking into account all relevant information that can contribute to an even better quality of life for the patient. The doctor aims to further educate the parents and, if necessary, involves top specialists from various fields so that parents receive all important information in one place. We strive to empower the entire family with enough knowledge so that together we can achieve good treatment outcomes.

You place great importance on patient experience. Is there a way you evaluate parents’ satisfaction with the service provided?

As we know that our main product is actually the service we offer, you can evaluate the quality of your visit on-site. We truly want to always be transparent with our clients and appreciate every verbal and written comment we receive from parents. After the visit, patients and parents can evaluate their satisfaction through internal surveys, where we monitor the cognitive evaluation and emotional response of parents and children. One of our greatest strengths is our culture, which we actively manage and whose foundations we essentially nurture, where the relationship between employees is such that great importance is given to open communication and feedback among colleagues. Given that we live a culture of feedback, patient and parent reviews are always more than welcome. We know that this is crucial for the constant improvement of processes and that communication needs to be two-way in order to meet, and we hope exceed, our patients’ expectations.

How do you encourage a warm approach to patients and engagement in this direction among the employees of the Poliklinika?

One of the important topics today is the humanization of medicine. We consider medicine a humane activity, but as we face numerous challenges brought by modern times, we need to continuously invest our mental and emotional resources in this direction, that is, develop empathy and understanding to maintain that status. For this approach, it is necessary to consider the broader field of medical ethics and morals. Medicine is in the service of life, and the person is the main object of medical action. Healthcare should serve the person, and biomedical science should help the medical professional think about the true and authentic good of each patient. Healthcare institutions should be places where patients can find comfort and encouragement, which includes the commitment, dedication, and humane touch of every employee. At the Poliklinika, we place great importance on employee satisfaction because a satisfied employee means a satisfied patient. In addition to regular team meetings, we also organize internal Balint groups where awareness is built around recognizing and understanding the psychological elements of patient needs. This is extremely important for adequately implementing a holistic approach. Hippocrates believed that health is harmony between the mind, spirit, body, and our environment, and that a person should be approached holistically, which takes into account this broader understanding of a healthy lifestyle.

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Poliklinika Salvea

Can you explain the holistic approach to us?

The holistic approach takes into account the broader dimension of treatment. Modern medicine seeks to expand its perception to the influence of all factors affecting a person’s physical, spiritual, or mental health. Anything that causes imbalance in the body is subject to the holistic approach, which aims to empower the individual to live their full potential. Achieving balance is one of its main goals. An important concept in the holistic approach is salutogenesis, a medical approach focused on factors that support health and well-being, relating to strengthening resources that actively promote health. This concept helps shape the individual’s sense of coherence, making it easier for the person to cope with stress and less susceptible to developing diseases. In the holistic approach, we try to find out what the cause of the condition is, rather than just focusing on the disease. As a practical example, let’s take obesity. Different patients may have the same underlying diagnosis, but also different reasons that led them to the illness. A variety of factors can influence obesity: poor diet, physical inactivity, hormonal imbalance, chronic inflammation, certain medications, or genetics. The holistic approach, along with prevention and considering the broader picture of the problem through teamwork of several specialists, leads to an integrative approach and accumulation of knowledge to provide the patient with quality care at the highest possible level.

How is the holistic approach implemented at the Poliklinika? Why did you choose primary pediatrics as the foundation of your business?

The holistic approach to health needs to be supported primarily organizationally. We recognized primary pediatrics as the foundation of such an approach, and accordingly, the level of business. It covers most issues related to the protection and promotion of children’s health. The primary pediatrician is responsible for implementing preventive activities and establishing all necessary measures to improve health at all levels, from physical to mental. Other specialists with whom we have strengthened primary pediatrics, primarily pediatric subspecialists such as cardiologists or neuro-pediatricians, specialists such as otorhinolaryngologists or dermatologists, physiotherapists, psychologists, speech therapists, as well as health and other institutions, and associations with which we collaborate, are key to resolving all situations, all in cooperation with primary or general pediatrics. Among all of them, mutual cooperation and exchange of opinions and information are nurtured, all for the benefit of the patient’s condition.

When we talk about primary pediatrics as the foundation of the business, we must consider that the scope of the primary pediatrician is not only at the patient level but also has an impact on prevention, treatment, and raising awareness of issues related to the child population through public health contributions. We conduct public health activities through various research, collaboration with other institutions, forums, educational materials, and media. Prevention includes counseling on care and nutrition, vaccination, systematic examinations, early detection of developmental disorders, visual impairment, deafness, or control of chronic diseases.

What are the key activities you carry out in public health contributions related to the child population?

Along with primary pediatrics, subspecialists in all areas of child health, and a team approach, we want to engage in topics of healthy upbringing, empower parenting, include both mothers and fathers and caregivers, so that together we can provide children with a safe and healthy upbringing. We want to reduce the fear of the white coat, and accordingly, we have created a picture book that can be found in bookstores and libraries throughout Croatia. We place great importance on the mental health of children and families, which is why we have established collaborations with psychologists and psychotherapists. We have launched numerous support and educational groups led by experts in each individual segment. We know that the period of pregnancy and postpartum is challenging for every woman, so we are launching support groups for mothers, designed to provide new mothers with a safe space to share all the feelings and challenges they face. One of the burning issues in Croatian healthcare is obesity, so we want to unite forces, initiate serious discussions on this topic, and actively involve parents in building a safe and healthy future for their youngest. The multidisciplinary approach to treating obesity in children, which includes experts from various fields, such as nutritionists, endocrinologists, kinesiologists, psychologists, and others, leads to a transformation of lifestyle habits, not only for the child but for the entire family. Baby handling education, helping parents cope with infant colic, is a large number of topics through which we will go together to provide families with maximum support. With all these activities, we want to be a model of a comprehensive approach to patient treatment and continuously set new trends in Croatian healthcare.

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Marija Bošnjak, Salvea