AKESO Holding | Governance and Financials

Empowered board and ubiquitous data spur quick decisions

In June 2020, a few months after the COVID-19 outbreak hit Eastern Europe, the board of directors of AKESO holding met in a conference room at the company’s headquarters in Prague. The country’s hospitals were on the cusp of being overwhelmed by a surge in cases. AKESO owns and operates two hospitals in the Bohemia region, and the board was actively monitoring the situation at both facilities, including the efficacy of changes it had made to patient-intake protocols, staffing, and other safety measures necessitated by the crisis.

The discussion moved on to how the pandemic might impact the planned expansion of one of the hospitals, a project that would double its bed capacity. The executives saw a future in which a resurgence of COVID-19 or another pandemic might test the system in the future, and they wanted to get ahead of it.

“We reviewed the lessons we had learned from the spring phase of the pandemic and we wanted to take them into account with the project,” says Frantisek Vlcek, an executive member of the board. The question was: Could they design the new hospital wing to be convertible, so that it could be turned into an infectious disease treatment ward at a moment’s notice? “We were on the 15th or 16th version of the design for the project at that point, but it was immediately decided by the board to change it. Basically we were like, ‘Let’s go for it.’”

Three things were going in the board’s favor. One, AKESO’s founder and chairman of the board, a Greek entrepreneur named Sotirios Zavalianis, hated bureaucracy and had a long history of encouraging quick decisions at his companies. At AKESO’s biweekly board meetings, he encourages non-director executives from the company’s three main business units to join and observe, so that they understand the thinking behind the decisions made there. “Many times we don’t even make minutes from the meetings because they take more time and energy than it takes to come to a conclusion,” Vlcek says.

“Many times we don't even make minutes from the meetings because they take more time and energy than it takes to come to a conclusion.”

Two, the company is governed on a project basis, and it owns every facet of those projects. In addition to operating the two hospitals and an oncology center, AKESO holding owns a construction company, as well as healthcare logistics companies that help manage pharmacies and provide biomedical and diagnostics equipment. When the decision was made to tweak the hospital design, the company’s own architects were tasked with the job. In fact, one of the main reasons AKESO holding was formed in 2017 was to bring all of those businesses under the same banner, enabling better coordination and efficiency in matters such as negotiating with the country’s seven healthcare insurance funds.

Finally, the board is armed with reams of real-time data, thanks to a project Corporate Chief Executive Officer Milan Rufer took on in 2017 to harmonize and customize AKESO’s data collection using a popular business intelligence platform. At each board meeting, Rufer is constantly turning to his iPad to reveal information as diverse as how many people have been vaccinated for COVID-19 at its facilities, how each room in the hospitals are used, and how many procedures each physician is conducting each day in each minute. “Analysis comes first in every decision we make, and this capability allows us to make very quick decisions because we have all of the information we need right at our fingertips,” Rufer says.

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