Last week, I was invited to speak at and participate in the World Congress of Nephrology 2026 in Yokohama, Japan. The conference brought together 6,700 delegates from across the world.
As is my usual practice when attending conferences abroad, I made time to visit a local hospital. I wanted to better understand how they manage patient journeys and the immense responsibility of maintaining, and improving, national health outcomes.
I had the opportunity to visit the Yokohama City University Medical Center (YUMC), a 655-bed hospital that also serves as a key disaster response centre. Its emergency department is designed to handle large volumes of patients efficiently. When I arrived at 4pm, I was welcomed by Dr. Kyota Nakamura, an emergency specialist, Director, and Clinical Professor in the Department of Quality and Safety.
What struck me immediately was how quiet the main foyer was. This is where admissions, cashier services, and the pharmacy are located. There were only about three patients walking around. This stands in stark contrast to what we typically see in Malaysia at the same time on a weekday.
Dr. Nakamura explained that the hospital handles around 2,000 outpatient visits daily across 26 clinics spread over three floors. Despite this volume, patient flow is highly systematic, allowing consultations to proceed quickly and efficiently. The process begins when patients check in using their appointment card at a machine, which issues them a queue number and a pager. The pager alerts them when it is almost their turn. Patients can move freely around the hospital, including to the lab or cafeteria, while waiting. Before seeing the doctor, they simply return the pager to the clinic staff.
One simple but thoughtful innovation stood out in the restroom. There is a glass partition with a doorbell system, allowing patients to place urine samples for collection without needing to walk long distances. For elderly patients especially, this reduces unnecessary movement and discomfort. The clinic waiting areas are comfortable and carpeted. The chairs can be converted into makeshift beds within seconds, a feature designed for emergency or disaster situations.
As part of my visit, I also toured the dialysis unit. It is a 10-bed facility operating in two shifts, serving mostly elderly patients who undergo life-saving treatment three times a week. I was then shown an administrative unit where around 30 staff members coordinate care for patients coming from other prefectures. This team includes social workers who assist patients in accessing financial support and welfare services. They work closely with government agencies to ensure that patients can focus on treatment, without the burden of navigating complex systems. This coordination ensures that when patients arrive at the hospital, their care journey is seamless, with minimal waiting time.
During a ward visit, I observed that a 42-bed ward is supported by a nursing team of 28 staff across three shifts. Patients are accommodated in single, double, or four-bed rooms, each with access to appropriate facilities. A shared shower area is located near the nurses’ station, allowing for quicker response in case of emergencies such as falls. The ward also includes a small communal space where patients can sit, talk, and interact, with a vending machine nearby.
Reflecting on this visit, what impressed me most was how much the hospital values patients’ time. Healthcare professionals here understand that patients need not only treatment, but also respect, dignity, and compassion.
Interestingly, many of the systems are not yet fully digital, with upgrades planned for 2027. Yet the processes are designed around human needs, not just clinical efficiency. Every element of the system is intentional. It ensures that patients move smoothly through care, without unnecessary waiting, frustration, or confusion.
This is one of the most impressive healthcare facilities I have visited. It demonstrates what it truly means for health and care to be integrated, just as intended by World Health Organization. One cannot exist without the other. Much of this success is driven by the work of Dr. Nakamura and his team in the Quality and Safety department. They continuously engage with patients to understand their pain points and improve services accordingly.
In the end, digital systems are just tools. True healthcare is built around people. When systems are designed with patients in mind, they become not only efficient, but also compassionate. For both patients and healthcare professionals.
