Health Promoting Hospitals: 18 HPH Core Strategies and their implementation

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Health Promoting Hospitals18 HPH Core
Strategies and their implementation

• Jürgen M. Pelikan (juergen.pelikan_at_univie.ac.at)
• Karl Krajic, Christina Dietscher, Peter Nowak
• Ludwig Boltzmann-Institute for the Sociology of
  Health Medicine,
• WHO-CC for Health Promotion in Hospitals Health
  Care, University of Vienna

Investing in Health for the Future Positioning
health promotion in health care provision
supporting effective implementation 12th
International Conference, Moscow, May 26-28, 2004
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Overview

• Framework of WG
• Comprehensive Concept of HPH
• 18 Core Strategies
• Implementation by (Quality) Management
• Relationship Strategies and Standards
• Further information

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Framework for and Product of the Working Group

• Basic documents
• Ottawa HP
• Budapest HPH
• Ljubljana HC
• Vienna HPH
• Jakarta HP

• WHO network experiences
• Pilot and model projects
• National / regional networks
• Models of good practice
• Guidelines and recommendations

• Developments in Health promotion
• Empowerment
• Health literacy
• Healthy Alliances
• Evidence based HP
• Quality assurance of HP

• Developments in Health care
• Cost containment by quality development
• Quality management systems
• Evidence based health care
• Q-Instruments (standards, guidelines, tools)
• HPH

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The Comprehensive Concept of HPH ....

• reorients (quality) management of the hospital at
  the systematic achievement

• of the optimal somatic, psychological social
  health gain that can be influenced / reached by
  the hospital

• (measured as clinical outcome quality of life,
  personal satisfaction health literacy impact
  of hospital on health)

• for patients, staff citizens of the community.

• By strategies of HP quality management HP
  strategic (re-) positioning of the hospital.

• By developing services empowering persons

• for HP self-management (i.e. maintenance
  development) of their health for HP lifestyle
  development

• and for HP co-production of health for HP
  illness management

• and by creating/ developing supportive hospital
  ( community) settings.

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HP initiatives in hospitals follow general
Health Promotion Principles, defined by a WHO-WG
on evaluation of HP initiatives

• HP initiatives have to be
• Empowering Enabling individuals and communities
  to assume more power over the personal,
  socioeconomic and environmental factors that
  affect their health
• Participatory Involving all concerned at all
  stages of the process
• Holistic Fostering physical, mental, social and
  spiritual health
• Intersectoral Involving the collaboration of
  agencies from relevant sectors
• Equitable Guided by a concern for equity and
  social justice
• Sustainable Bringing about changes that
  individuals and communities can maintain once
  initial funding has ended)
• Multistrategy Using a variety of approaches
  including policy development, organizational
  change, community development, legislation,
  advocacy, education and communication in
  combination
• (Rootman et.al., 2001)

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18 HPH Core Strategies
The health of which stakeholders should benefit
from the HPH Core Strategies ?
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18 HPH Core Strategies

• The health of which stakeholders should
• benefit from the HPH Core Strategies ?
• The health of hospital patients

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18 HPH Core Strategies

• The health of which stakeholders should
• benefit from the HPH Core Strategies ?
• The health of hospital patients
• The health of hospital staff

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18 HPH Core Strategies

• The health of which stakeholders should
• benefit from the HPH Core Strategies ?
• The health of hospital patients
• The health of hospital staff
• The health of all other people in the
  community, possibly in contact with the hospital

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18 HPH Core Strategies
From what types of strategies should the health
of the stakeholders benefit?
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18 HPH Core Strategies

• From what types of strategies should
• the health of the stakeholders benefit?
• From HP quality development strategies,
  improving the HP characteristics of existing
  hotel clinical core services of the hospital.

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18 HPH Core Strategies

• From what types of strategies should
• the health of the stakeholders benefit?
• From HP quality development strategies,
  improving the HP characteristics of existing
  hotel clinical core services of the hospital.
• (B) From HP strategic (re-)positioning of the
  hospital by investing more into specific HP
  services projects for patients, staff
  community

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18 HPH Core Strategies

• From what types of strategies should
• the health of the stakeholders benefit?
• (A) From HP quality development strategies,
  improving the HP characteristics of existing
  hotel clinical core services of the hospital.
• Oriented at communication interaction
• processes
• Enabling for HP self management

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18 HPH Core Strategies

• From what types of strategies should
• the health of the stakeholders benefit?
• (A) From HP quality development strategies,
  improving the HP characteristics of existing
  hotel clinical core services of the hospital.
• Oriented at communication interaction
• processes
• Enabling for HP self management
• Enabling for HP co-production in health care

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18 HPH Core Strategies

• From what types of strategies should
• the health of the stakeholders benefit?
• (A) From HP quality development strategies,
  improving the HP characteristics of existing
  hotel clinical core services of the hospital.
• Oriented at communication interaction
• processes
• Enabling for HP self management
• Enabling for HP co-production in health care
• Oriented at the material, social cultural
• structures of the hospital
• Development of a HP hospital setting

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18 HPH Core Strategies

• From what types of strategies should
• the health of the stakeholders benefit?
• (B) From HP strategic (re-)positioning of the
  hospital by investing more into specific HP
  services projects for patients, staff
  community
• By offering educative HP services
• Enabling for HP illness management

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18 HPH Core Strategies

• From what types of strategies should
• the health of the stakeholders benefit?
• (B) From HP strategic (re-)positioning of the
  hospital by investing more into specific HP
  services projects for patients, staff
  community
• By offering educative HP services
• Enabling for HP illness management
• Enabling for HP life style development

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18 HPH Core Strategies
HP by ...

• From what types of strategies should
• the health of the stakeholders benefit?
• (B) From HP strategic (re-)positioning of the
  hospital by investing more into specific HP
  services projects for patients, staff
  community
• By offering educative HP services
• Enabling for HP illness management
• Enabling for HP life style development
• By participating in HP community development
  projects for improvement of the material, social
  cultural structures of the community
• Development of a HP community setting

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18 HPH Core Strategies
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18 HPH Core Strategies
1. Objectives of strategy 2. Indications for
strategy 3. Main topics / routines selected
examples, guidelines and evidence
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Which subsystems of a hospital have to be
HP-quality assured improved by HP-Quality
Management (HPQM)?

• Management
• Human resource management
• Finance management
• Purchasing management
• Safety occupational health
• management
• Quality Management
• Health Promotion Management
• Etc.

• Hotel services
• Nutrition
• Cleaning
• Etc.

• Other Support services
• Transport
• Maintenance
• Waste management
• Etc.

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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)
Explination
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)
Explination
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)

• 1. Definition

S1 Define HP criteria/standards for structures
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)

• 1. Definition

S1 Define HP criteria/standards for structures
P1 Define HP guidelines/ indicators for
processes
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)

• 1. Definition

S1 Define HP criteria/standards for structures
P1 Define HP guidelines/ indicators for
processes
O1 Define HP targets for Outcomes/impacts
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)

• 1. Definition

S1 Define HP criteria/standards for structures
P1 Define HP guidelines/ indicators for
processes
O1 Define HP targets for Outcomes/impacts
2. Evaluation/ Monitoring
S2 Evaluate for HP of structures
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)

• 1. Definition

S1 Define HP criteria/standards for structures
P1 Define HP guidelines/ indicators for
processes
O1 Define HP targets for Outcomes/impacts
2. Evaluation/ Monitoring
S2 Evaluate for HP of structures
P2 Evaluate for HP of processes
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)

• 1. Definition

S1 Define HP criteria/standards for structures
P1 Define HP guidelines/ indicators for
processes
O1 Define HP targets for Outcomes/impacts
2. Evaluation/ Monitoring
S2 Evaluate for HP of structures
P2 Evaluate for HP of processes
O2 Evaluate for HP of outcomes impacts
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)

• 1. Definition

S1 Define HP criteria/standards for structures
P1 Define HP guidelines/ indicators for
processes
O1 Define HP targets for Outcomes/impacts
2. Evaluation/ Monitoring
S2 Evaluate for HP of structures
P2 Evaluate for HP of processes
O2 Evaluate for HP of outcomes impacts
3. Development/ Improvement
S3 Develop improved HP structures by OD, PD,
TD
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How can (Quality) Management assure improve
comprehensive HP of a Hospital? gt 7 HPQM
Strategies
Quality functions/ activities for quality of Structures of services ( settings) Processes of services ( settings) Outcomes/ impacts of services ( settings)

• 1. Definition

S1 Define HP criteria/standards for structures
P1 Define HP guidelines/ indicators for
processes
O1 Define HP targets for Outcomes/impacts
2. Evaluation/ Monitoring
S2 Evaluate for HP of structures
P2 Evaluate for HP of processes
O2 Evaluate for HP of outcomes impacts
3. Development/ Improvement
S3 Develop improved HP structures by OD, PD,
TD
X
X
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How can a comprehensive HP-QualityManagement-Syst
em be quality assured?
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Relationship of the five Standards of the
Standard WG to the Strategies of the Putting into
Practice WG

• 1. Management policy
• HPQM strategies
• 2. Patient Assessment
• PAT 1,2
• 3. Patient Information and Intervention
• PAT1, 2, 4, 5
• 4. Promoting a healthy Workplace
• STA 3, 1,2
• 5. Continuity and Cooperation
• COM 1, 2, (PAT6, STA6, COM6)

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Further information

• WHO-Collaboration Centre for Health Promotion in
  Hospitals and Health Care
• http//www.hph-hc.cc/
• Folder Download gt Draft of Working Group
  Strategies
• Paper of Working Group Standards
• http//www.euro.who.int/document/e82490.pdf