Quality Management in Hospitals

Transcription

1 Quality Management in The way to excellence Peter Kappert President Berlin, 24th 25th June, 2013

2 CONTENT Importance of Quality Management in Quality Aspects Influencing Customer 5. (SLH)

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4 Healthcare in Switzerland SWITZERLAND HEALTHCARE SYSTEM HIGHLIGHTS HUMANITARIAN AID Foundation of Red Cross (Henry Dunant, Geneva, 1863) HOSPITAL TRADITION Rehabilitation in the Alps, since the Middle Ages HOTEL STANDARD Hotel School Tradition HEALTHCARE QUALITY Life expectancy, Access, AND RESPONSIVENESS Fairness in financial contribution TECHNOLOGY Leading in Bio-, Micro-, Nanoand Health Technology INDUSTRY Pharmaceuticals, Medical Technology, Orthopedic and Dental Implants in Quality Int. Hospital Influencing Accreditations

5 Swiss Research / Innovation SWITZERLAND HEALTHCARE INNOVATIONS 1 st Heart Pacemaker (1958) Ake Senning 1 st Cerebral vascular bypass surgery with surgical microscope (1967) Gazi M. Yasargil, Neurosurgery s Man of the Century 1 st Balloon angioplasty (1977) Andreas Gruentzing 1 st Percutaneous coronary intervention (1986) Ulrich Sigwart Orthopedic surgery innovations Maurice Mueller, Orthopedic Surgeon of the Century in

6 Swiss Healthcare System KEY FIGURES Costs per year (2010) USD 62 Billion In % of GDP 11,4 % o UK: 8,3 % o France: 10,8 % o USA: 16,0% o Germany: 10,4% o Italy: 8,7% Employees - total: (every 7th working person) - in hospitals: Private Practicioners in

7 Swiss Healthcare System HOSPITALS IN SWITZERLAND Public and private hospitals Income per year: USD 19,5 Billions University Beds Private Hirslanden (13) Swiss Leading (19) Others 56% 24% 20% Private hospitals Income per year: USD 3,4 Billions (18% market share) 129 /institutions Beds in

8 Importance of Quality Management in

9 in EXAMPLE: SITUATION IN SWITZERLAND Legal requirement: Compliance of hospitals with approved quality management standards Non-compliance insurers (theoretically) will not finance the hospital s services Nationwide valid criteria are currently being established today: various approved quality management instruments: o Outcome measurement instruments (in various cantons) o Minimum requirements of the Swiss Hospital Association 2012: New financing system of inpatient care (Swiss DRG) significantly more demanding quality requirements. in

10 in QUALITY POLICY IN SWISS HOSPITALS all go beyond the government requirements Reasons: competitive position, image, management ambitions engage in process/structure/outcome quality, often also in social quality Importance of quality accreditations increases o An official approvement by a neutral body increases the hospital s credibility in the market (e.g. insurers) o Quality certificates help patients to judge/compare hospitals in

11 in IMPORTANCE OF QM IN SWITZERLAND AND EUROPE Government requirements regarding quality standards are being established and are getting more and more demanding. Social and private insurers require proven fulfillment of government and sometimes higher requirements The public/media more and more ask for transparency and evidence regarding hospital quality (mortality rates, quality reports, etc.) The hospital s documentation of the delivered quality increasingly serves as a basis in litigations. in

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13 EXAMPLE: SONNENHOF HOSPITALS Achievement and maintenance of the membership accreditation of (SLH) association required the establishment of an organisation-wide quality management system Sonnenhof s steps o Improvement of structure quality: Organizational structure, infrastructure o Process quality: ISO 9001, yearly audit by an accreditation company specialized in healthcare o Implementation of medical outcome measurement instruments o Yearly publication of a quality report o Implementation of additional quality management systems, such as CIRS, ISO EN (for laboratories), EKAS (occupational health and safety) o Implementation of TQM in

14 QUALITY MANAGEMENT STEP BY STEP Solitary QMS QMS with (international) accreditation TQM SLH CIRS Patient surveys etc. ISO JCI ACI TAS ACHSI etc. EFQM etc. in

15 LESSONS LEARNED The decision by management to implement a QMS with external / international accreditation creates (the often necessary) pressure to act towards quality improvement The QMS to be accredited should be implemented organisationwide (no isolated, incoherent solutions), as it is an opportunity to establish a consistent level of quality throughout the hospital. TQM is successful only with a solid basis (structure/process/ outcome quality) Quality is to be overseen by the hospital s top management It is necessary to assign accordingly educated Quality Managers in

16 LESSONS LEARNED (cont d) It is important not to overload the hospital employees with activities regarding QMS implementation and accreditation. Before starting any QMS activities, the respective project needs to be planned carefully (goals, time-line, project teams etc.) As soon as the main accreditation is achieved, additional QMS may be implemented. All employees have at least basic knowledge about quality management and about the implemented QMS. Internal quality assessment teams are established. in

17 SOME KEY QUALITY MEASUREMENT INSTRUMENTS Patient satisfaction surveys: in-house questionnaires accompanied by periodical science-based surveys conducted by external institutes Hotline for complaints (for patients, relatives) Physician satisfaction surveys, employee satisfaction surveys (social quality) Employee suggestion system Internal quality audits performed by educated quality managers Anonymous Critical Incident Reporting System (CIRS) Medical outcome quality measurement with changing parameters, permanent complications statistics in

18 QMS must be continually maintained in order to guarantee a high quality standard in healthcare. Yearly audits of the main QMS are a necessity. in

19 Quality Aspects Influencing Customer

20 Quality Aspects Influencing Customer MAIN REQUIREMENTS OF A HOSPITAL S CUSTOMERS The two main groups of a hospital s customers are its patients and its referring physicians A study performed in 2008* revealed the following main customer requirements: Patients: medical excellence; attention/concern/kindness (patient focus); hygiene and cleanliness Referring physicians: medical excellence; good communication between the hospital and the referring physicians; accessibility of the hospital s physicians * Zielgruppenanalyse Klinikqualität im Marketing, rotthaus.com 2008 in

21 Quality Aspects Influencing Customer REACTION TO THE REQUIREMENTS The increasing competition in the hospital market urges hospitals providing top quality medical services to aim at achieving the same quality level in hospitality. Discerning patients expect beside medical excellence a comfortable stay in the hospital and outstanding hospitality services for themselves and their families. In their membership accreditation criteria, put emphasis on this fact. They require a solid organization control, medical excellence, and outstanding hospitality services. in

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23 (SLH) Characterized by excellent medical care services provided through first-class infrastructure and highly qualified staff. Founded in 1999 by three leading private hospitals in Switzerland. Today: 22 Swiss and 2 international members (JSC Medicina, Moscow; RAK Hospital, Ras al Khaimah). SLH support/require international hospital quality certifications. Vision: establish an international association of leading hospitals. A candidate hospital becomes an accredited member of SLH, once it has successfully passed an audit by an independent auditor who is officially certified by Swiss authorities. in

24 (SLH) BENEFITS FROM SLH ACCREDITATION Get better patient outcomes due to improved quality of healthcare services Establish a culture of continuous quality improvement Get a focus of outcomes and strive for best practice Get higher patient satisfaction due to improved quality of hospitality services Improve the competitive position in the healthcare market Recruit exceptional healthcare professionals Profit from international SLH marketing initiatives in

25 (SLH) ACCREDITATION PROCESS A key prerequisite of prospective SLH members is an extensive quality assessment. The member hospitals must prove continual improvement. Triggered by evidence that quality standards are not fully met, SLH may perform an unannounced audit of a hospital. Adherence to the demanding SLH guidelines is regularly re-audited. in

26 Hospital Castle Mammern (aerial view) Private Hospital Meiringen (outside view) Hospital Linde (outside view)

27 Hospital Gut (room view) Hospital Sonnenhof (room view) Hospital Generale Beaulieu (room view)

28 Hospital Pyramide am See (hallway, entrance) Clinique de La Source (hallway, entrance) Hospital Villa im Park (hallway, entrance)

29 Hospital Merian Iselin (medical excellence) RehaClinic Zurzach (medical excellence) Hospital Engeried (medical excellence)

30 SLH Consolidated Facts & Figures No. of patients Inpatient, acute Patients 50'133 Inpatient, nursing care Patients 8'408 Outpatient Patients 170'020 No. of days in hospital Acute Days 353'868 Nursing care Days 170'872 No. of beds Total Beds 1'834 Day cases Beds 63 Acute Beds 1'665 Nursing care Beds 115 Total Turnover of Member : 700 Million US Dollars Average length of stay Acute Days/Patients 15.7 Nursing care Days/Patients 105 in

31 Conclusion Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives. William A. Foster

32 Thank you for your attention! FOR MORE INFORMATION, PLEASE VISIT