Tuscany HPH conference ... from paternalism to partnership

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Lo scenario futuro della rete HPH
internazionale Il valore degli ospedali per la
promozione della salute in Toscana Conferenza
Regionale Della Rete HPH Toscana 10 Maggio 2006,
Firenze Oliver Gröne Technical Officer, Quality
of Health Systems and Services
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Questions
How do Health Promoting Hospitals (HPH) link to
WHO Strategy? What are the directions of the HPH
Network? How can HPH development be sustained in
the future?
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• WHO Strategy
• - WHO Regional Office for Europe 52
  Member States, 850 million Citizens.
• - Biannual Collaborative Agreements with 29
  Member States.
• Supporting Member States in developing their
  health systems.

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• WHOs areas of work that relate to Health
  Promoting Hospitals

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• Hospitals for Europe working party
• Every 10th patient
• suffers from preventable harm

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How are hospitals doing

• Research in hospitals
• Harvard Medical Practice Study
• Utah Colorado Study
• Australia
• Canada
• Denmark
• Japan
• New Zealand
• Singapore
• UK

Adverse events caused by negligence 2.9-3.7
Adverse events 7.5 16.6
Preventability gt 50
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Research on patient experiences

• Germany, UK, Australia, Canada, New Zeeland,
  US
• 7-10 of patients developed an infection while
  hospitalized (except for Germany)
• 19-26 of patients reported communication gaps
• gt10 reported medical and medication error
• 60 errors estimated to occur outside the
  hospital

• Safety risks
• Poor care coordination
• Deficiency in care of chronic conditions

C. Schoen, R. Osborn, P. Trang Huynh, M. Doty, K.
Zapert, J. Peugh, K. Davis. Taking the pulse of
health care systems Experiences of patients with
health problems in six countries, Health
affairs, 2005
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Resolution WHA55.18

• URGES Member States
• to pay the closest possible attention to the
  problem of patient safety
• to establish and strengthen science-based
  systems, necessary for improving patient safety
  and the quality of health care, including the
  monitoring of drugs, medical equipment and
  technology

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• The Health Promoting Hospitals strategy can be
  considered to complement existing quality and
  safety initiatives.

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Functions and goals of Health Systems
Sustaining Health Promoting Hospitals?
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How can we establish a strategic link with
these current challenges without loosing the
vision and principles of the Health Promoting
Hospitals Network?
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Independent Secretariat

• Project management at WHO Collaborating Centre
  for Evidence-based health promotion in
  Copenhagen, Denmark.
• Responsibilities
• Administration of members
• Internal and external communication strategy
• Database update and development, and
• Monitoring of membership fees.

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Research at WHO CC Copenhagen

• Introduction of HPH strategies and standards,
• Identify evidence of successful health promoting
  activities,
• Advice on teaching and training of staff in (E-B)
  health promotion,
• Further development of standards and indicators
  for health promotion in hospitals.

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Transparent Governance

• HPH General Assembly to establish
• guidelines for the HPH Network,
• criteria for membership, strategies, and
  objectives.
• task forces.
• Constituted of representatives of national,
  regional and thematic HPH Networks, Task Forces,
  and international coordinating institutions (WHO
  and WHO CCs).

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Transparent Governance

• Steering Committee to support strategic HPH
  Network development
• Strategic planning actions on strategy,
• Collaboration between network coordinators,
  Task Force Leaders, Working Groups, and
  external partners
• Input to scientific conferences
• Preparation of documents and General Assembly.

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Transparent Governance
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Internationalization

• Development of International HPH Network mostly
  with the support of European hospitals.
• But Increasing interested from other continents.
  New networks and applicants
• Australia, Canada, South Africa, Taiwan, USA
• In the future the HPH Network will remain
  international with stronger participation of
  hospitals from other continents.

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Quality standards and indicators for HPHs

• Systematic identification of priority areas and
  implementation of projects using the HPH
  Self-assessment tool. Application
• Possible annual self-assessment
• Systematic derivation of three health promotion
  activities from periodic assessment
• No public disclosure, but recognition of
  achievement and benchmarking.

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Conclusion
With the setting up of the new HPH secretariat,
the network has become more independent from
WHO. Main trends for the network are improved
transparency, internationalization and systematic
implementation of health promotion using quality
standards and indicators. Health Promoting
Hospitals are no longer a baby of WHO they need
to become a strong partner for WHO.
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Conclusion
WHO puts stronger emphasis on strengthening
Member States health systems. HPH can
collaborate through ministerial requests and
contribute to piloting tools and shaping health
systems. HPHs could also contribute through
thematic foci, such as a year on patient safety
from the perspective of Health Promoting
Hospitals.
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Thus, the relationship is changing from
paternalism to partnership.