The Frankfurt School of Finance & Management The Institute for International Health Management The MBA in International Healthcare Management

Transcription

1 The Frankfurt School of Finance & Management The Institute for International Health Management The MBA in International Healthcare Management Academic Programmes Professional Programmes Seminars Executive Education Corporate Programmes & Services Research International Advisory Services F r a n k f u r t S c h o o l. d e

2 Agenda Highlighting the historic development Current state Lessons learned 2

3 Highlighting the historic development Since the 1970s - External quality assurance based on tracer diagnosis - Started with few high volume, mainly surgical procedures: hernia repair, cholecystectomy, femur osteosynthesis covering already 40% of inpatients - In the following decades data collection was constantly extended and getting more complex, outpatient sector was covered as well The 1990s - Start of internal quality management projects based on transfer/adaption of either industrial systems/ tools such as DIN-EN-ISO 9001 ff., EFQM or hospital specific systems like KTQ This Century - Foundation of a new institution in charge nationwide Federal joint committee(gba) supported by - Institute for Quality and Efficiency in Health Care (IQWIG) - Institute for applied Quality Advancement and Research in Health Care (AQUA) - Mandatory quality reports for hospitals since More and more data to be published by law 3

4 Current state.. The Federal Joint Committee (G-BA) Highest decision-making body of the joint self-government of physicians, dentists, hospitals and health insurance funds in Germany Issues directives for the benefit catalogue of the statutory health insurance funds (GKV) for more than 70 million insured persons and thus specifies which services in medical care are reimbursed by the GKV Specifies measures for quality assurance in inpatient and outpatient areas of the health care system (sublegal binding norms) Scientific support from the Institute for Quality and Efficiency in Health Care (IQWIG) Funded by the so-called system surcharges. These are composed of a surcharge for each billable hospital visit (also for direct payers) and from an additional increase in the fees for outpatient medical and dental care 4

5 Current state.. External Quality Assurance Goal - Improvement of medical and nursing performance of hospitals and enabling comparison and benchmarking Method - Documentation, reporting and analysis/ data validation of currently 390 valid quality indicators in several service areas, longstanding experience in Germany (more then 30 years) - Cross sector comparison of healthcare services delivered (in-/outpatient) - In case of noticeable data a structured dialogue of experts with hospital executives is initiated (peer review) - Binding for all hospitals licensed by the statutory health insurance funds (GKV) - There is nothing like it to document quality in hospitals around the world 5

6 Current state.. Quality Reports Goal - Information, transparency and orientation on inpatient service quality of/ for patients/ people insured the physicians admitting and caring after discharge health insurance companies - Chance for the hospital to present services and quality of care (competitive instrument in the marketing of services) Method - Since 2005 all hospitals licenced by the statutory health funds have to publish a structured quality report every two years - In 2010 the results of approx. 50% of the inpatient service indicators surveyed (182 of 390) had to be published - The Federal Joint Committee issues directives for content, scope and data format of the reports 6

7 Current state.. Internal Quality Management System (mandatory since 2002) Goal - Introduce and sustain an instrument to improve quality and efficiency - Patient oriented process optimization Method - Free choice of the hospital operator within total quality management principles - Patient orientation - Responsibility and Leadership - Efficiency - Process orientation - Employee orientation and - participation - Target oriented behaviour and flexibility - Error prevention and management - Continuous improvement process "Plan-Do-Check-Act" 7

8 Lessons learned!? Despite the nationwide system in place, - walking the extra mile trying to manage quality will always require a corresponding state of mind - Stakeholders discussions are ongoing about how (methods), how much (workload) and who is in charge (control) - Quality Management in the formerly closed shop and expert=physician controlled system of Health Care is leading to a transparency of structures, processes and results that had not been existing before and that does make several medical professionals feel uncomfortable - Validity of all data collected and indicators defined is crucial in order to ensure a basic acceptance by and compliance of professionals involved 8

9 Vielen Dank für Ihre Aufmerksamkeit! Thank you for your attention! Oliver Wagner M.D. ; Ph.D. Medical Head of Healthcare Management Frankfurt School of Finance & Management Sonnemannstraße Frankfurt am Main Germany o.wagner@fs.de F r a n k f u r t S c h o o l. d e F r a n k f u r t S c h o o l. d e