Diapozitiv 1

1


Quality framework - Slovene perspective
Metka Teran, MD Ministry of Health of the
Republic of Slovenia, Department for Quality
Kranjska Gora, 6 June 2008
2
Content

• Facts about Slovenia
• Overwiev of formal background
• Presentation of activities to date
• National policy, current activities
• Working plan for Board for Excellence development
  and Department for QHC at the Ministry of Health
  of the Republic of Slovenia

3


Facts about
SloveniaPopulation 2.007.711 (july 2008
est.) Life expectancy at birth
population - 80.5 years male -
76.5 years female - 82.8 years
Infant mortality rate 4.3 deaths/1.000 live
births GDP/per capita (PPP) 27.300
(2007) Inflation rate 5.6 Unemployement rate
(registered) 8,4
Kranjska Gora, 6 June 2008
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GDP dedicated to health 8,3 Proportion of
public expenses in total expenses for health
(Slovenia 78,6, EU 77,4) Proportion of
private expenses in total expenses for health
(Slovenia 21,4, EU 22,6)
Kranjska Gora, 6 June 2008
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Health status
Noncommunicable disease Disease burden
() Neuropsychiatric disorders
26 Cardiovascular diseases 17 Malignant
neoplasms 16 Causes of death () Cardiovascular
diseases 41 Malignant neoplasms 26 Injuries 8
Kranjska Gora, 6 June 2008
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Human resources
Health professionals per 10.000 population
MD 21.6 (5 GP - EU-15 average 10.2) Registered
nurses 71 (EU-15 average 67) Dentists 6
(EU-15 average 6.4) Pharmacists 3,9 (EU-15
average 7.9) Performance per citizen Visits
6.4 Drug recepies 7
Kranjska Gora, 6 June 2008
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New legislation in 1992 Healthcare Services Act
and Healthcare and Insurance Act

• National health insurance system
• Private practice
• Personal general practitioner
• Medical Chamber

Healthcare Services Act Clinical audit
January 2008 Patients Rights Act ? right to
appropriate, quality and safe medical care
Kranjska Gora, 6 June 2008
8
Miran Rems, BSc, MD, General Hospital
Jesenice Andrej Robida, DSc, MD, FACC, Ministry
of Health
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Miran Rems, BSc, MD, General Hospital
Jesenice Andrej Robida, DSc, MD, FACC, Ministry
of Health
10
Miran Rems, BSc, MD, General Hospital
Jesenice Andrej Robida, DSc, MD, FACC, Ministry
of Health
11


National Policy for the Development of Quality in
Healthcare Objectives

• Setting up structures at the organisational level
  Commissions, Boards for quality, organisation
  chart
• Providers level of healthcare activities
  quality indicators, standards, clinical
  guidelines, self-assessment
• Structures at the national level

Kranjska Gora, 6 June 2008
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• Mandatory reporting on Quality Indicators for the
  years 2006 and 2007
• Number of patients falls from bed per 1000
  nursing days
• In-hospital pressure ulcers per 1000 hospital
  admissions
• Waiting time for Computer Tomography
• Waiting time for discharge from hospital
  (treatment finished)
• Unplanned hospital readmission in 7 days after
  discharge for the same or similar diagnosis
• - MRSA

Kranjska Gora, 6 June 2008
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Number of patients falls from bed per 1000
nursing days
Kranjska Gora, 6 June 2008
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Patients experience
Intitut za biomedicinsko informatiko
Kranjska Gora, 6 June 2008
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Board of Excellence at the Ministry of Health
(November 2007)

• preparing professional guidelines and
  instructions for achieving and sustaining
  permanent excellence in Healthcare
• professional assistance during self-assessment by
  EFQM model or any other modified model for use in
  Healthcare,
• stimulation and orientation of systematic efforts
  for the development of excellence management in
  Healthcare
• project coordination and linking of efforts for
  improving excellence management in Healthcare
• enabling healthcare providers to compare their
  level of management excellence of Healthcare
  internationally
• exchange of best practices at home and abroad
• preparing criteria for best results reward
• presenting news and achievements of best HC
  providers

Kranjska Gora, 6 June 2008
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National Body for Quality in Healthcare

• development of quality indicators,
• establishment of reporting of sentinel events,
• organisation and planning of patients
  experience surveys,
• participation in international projects,
• promotion of accreditation,
• promotion of implementation of clinical
  pathways,
• cooperation with the Department

Kranjska Gora, 6 June 2008
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Urgent tasks

• to establish the national quality body in
  healthcare,
• to achieve greater cooperation of quality
  assurance coordinators in Slovenian hospitals,
• to develop existing and prepare new quality
  indicators in healthcare,
• to prepare uniform guidelines for clinical audit,
• to prepare simple reporting forms of sentinel
  events,
• to raise awareness of the professional and lay
  public on the importance of non-punishment policy
  with the purpose to prevent undesired events,
• 7. to participate in international projects
  (e.g., the PATH project managed by the WHO
  regional office)

Kranjska Gora, 6 June 2008
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Raising questions

• What kind of institution do we need?
  (independent, part of the Institute of Public
  Health, part of the Health Insurance Institute of
  Slovenia,)
• 2. What kind of indicators do we need? How many?
• 3. Do we need uniform guidelines for clinical
  audit? (our own, special,...)
• 4. How do we raise awareness of professional and
  lay public on non-punishment policiy?
• 5. What about rewards for best professionals and
  institutions?

Kranjska Gora, 6 June 2008