The State of the art on Patient Safety at European Level Zoi Kolitsi Member of PSWG; EUNetPaS WP 2 Leader EKEVYL, Greece ENRICH CONFERENCE, THESSALONIKI, 12.06.09 EUNetPaS is a project which has received funding from the European Union in the framework of the Public Health Programme
Overview of presentation 1.Patient safety in the EU agenda Many achievements already. Continuation of action at EU level. 2. EUNetPaS 3.From Patient Safety to Quality of healthcare Start of the journey. What can/should we do at EU level? 2
What do citizens believe? Half of European citizens consider that a medical error is likely to occur in a hospital in their country Most respondents seem to believe that it is the responsibility of the health care system to ensure the quality of treatment although a substantial proportion also recognises the role of patients in avoiding medical errors. Source: Eurobarometer 2005 Medical errors 3
There is sufficient evidence In EU 27, between 8 % and 12 % of patients admitted to hospital suffer from adverse events whilst receiving healthcare*. ECDC: 4,1 million affected patients a year in the EU, and 37 000 deaths are caused every year as a result of hospital acquired infections. A high economic burden on limited health resources. A large proportion of adverse events are preventable Systemic factors account for a majority of adverse events. * Source: Clinical report "Improving Patient Safety in the EU" prepared for the European Commission, published 2008 by the RAND Cooperation. 4
Legal basis for EU support Article 152 (public health) Community action shall be directed towards ------ preventing human illness and diseases, and obviating sources of danger to human health ----- The Community shall encourage cooperation between the Member States ----and ---- lend support to their action. Community action in the field of public health shall fully respect the responsibilities of the Member States for the organisation and delivery of health services and medical care. 5
Co-operative Approach Open co-ordination method HLG with its workgroups Patient Safety [and Quality of Care] Working Group EC supportive approach to Member State collaboration Public Health Programme EuNetPaS 6
Patient Safety: a soft law` approach at EU level: In December 2008, the Commission adopted: A Communication on patient safety. On June 9th, the EPSCO Council adopted a recommendation on patient safety, including the prevention and control of healthcare-associated infections. 7
Areas of focus of the Recommendation Support the development of national patient safety policies and programmes. Empower and inform citizens and patients. Establish or strengthen reporting and learning systems on adverse events. Include patient safety in the education and training of health professionals. Develop and promote research on patient safety. Classify, codify and measure patient safety. Share knowledge, experience and best practice at European level. 8
After Council adoption? How to implement in Member States? How to monitor impact? How to acheive sustainability of Member State and shared action on patient safety? How to address wider healthcare quality issues at EU level? 9
EUNetPaS: an EU network A platform at EU level for collaboration and networking between: - 27 Member States - international organizations - stakeholders in the field of Patient Safety (decision makers, health care professionals, patients, researchers ) Addressing main elements of the Recommendation 10
of National Networks National Institutions on Patient Safety (PS): Health Care Quality agencies Dedicated PS agencies or Department Decision makers and financers Healthcare professionals Patient representatives Research teams on PS National platforms 11
Objectives of EUNetPaS HAS EUNetPaS, 27 countries Coordinated network Dissemination Promotion SITUATION ANALYSIS DEVELOPMENT OF CONCEPTS INTERVENTION STRATEGIES PILOT STUDIES in FIVE COORDINATED NETWORKING AREAS Medication Errors Reporting and learning systems Patient safety culture Education & Training 12
Commission Européenne WP9: communication WP 8 : Coordination WP10: Evaluation WP1 culture WP2 education WP3 reporting and learning WP4 medication Safety Decision makers HC professionals National Platform National Contact Point Research Patients Consumers 13
WP1 Patient Safety Culture Netherlands CBO (leader), Spain, Lithuania, European Fed. of Nurses (EFN), European Society of Quality in Healthcare (ESQH), OECD collect and exchange information regarding PS culture practices and indicators in MS. define and evaluate instruments for assessing PS culture in health care organizations of MS. 14
WP2 Education and Training Greece EKEVYL (leader), UK, Spain, Germany, Ireland, Lithuania, European Patient Forum (EPF), European Doctors (CPME), EFN (Nurses), ESQH (European Society of Quality in Health Care) Promote PS Education and Training which is inspired by our common principles and values through building a platform for the mutual exchange of experience and knowledge on methods of planning and implementing sustainable awareness and education programmes for healthcare professionals and for involving patients and caregivers reaching out to decision makers in Higher Education to promote the integration of these learning methods and interventions in undergraduate and postgraduate medical and nursing curricula. 15
WP3 Reporting and Learning Systems DK National Board of Health (leader), Sweden, Lithuania, Greece, Portugal, Netherlands, UK, Finland, Slovakia, Italy, Poland, Hungary, Norway, Latvia, Germany, Romania Analyze and share information on reporting and leaning systems Propose a rapid alert mechanism 16
WP 4 Pilot Implementation on Medication Safety European Federation of Hospitals HOPE (leader), Finland, Belgium, Austria, EFN (nurses), PGEU (pharmacists) + EAHP Pilot testing: Lithuania, Denmark, Netherlands, France, Portugal, Greece, Ireland + Italy Identify good practices in reducing medication errors in hospital, select a number of those and implement them in hospitals (3 hospitals in each of the10 participating member states) Create a community with those hospitals to exchange at the level of the health professionals directly involved in clinical care 17
EUNetPaS Outcomes and Deliverables Promote coherence at EU level through recommendations and proposition of common tools Culture measurement tools, Guidelines for education and shared programmes and materials Library of methods for reporting and learning systems implementation Rapid response mechanism for sharing high priority patient safety issues or solutions between all member states Medication safety recommendation 18
EUNetPaS Outcomes and Deliverables Impact: Make available existing knowledge and knowhow Acquire new knowledge Evaluate the uptake of tools and recommendations Develop a EU community of Hospitals involved in PS Create a sustainable European Network on PS 19
Added Value of EUNetPaS for Regions and Local Providers Share information and experience Promote YOUR best practices at EU level Obtain feed back on the Patient Safety Recommendation Influence EU strategy and convergence of health systems 20
EUNetPaS Contact Information EUNetPaS website and extranet: http://www.eunetpas.eu Greek National Contact Point: EKEVYL: tgiannouli@ekevyl.gr Coordination: HAS (France) j.bacou@has-sante.fr, m.galbraith@has-sante.fr 21
Acknowledgement to EUNetPaS 46 partners! 22
Sustainability: A life after EUNetPaS? AT THE CROSS ROADS OF EUNetPaS Achievements Capitalize on the existing Network, its resources and gained inertia Capitalise on experience and optimise parctices AND EU Agenda: Emerging needs for policy support Ap 23
Patient safety vs quality Patient safety is a key foundation of good quality healthcare «Two sides of the same coin» 24
Quality a variable landscape in the EU Multitude of definitions. Differences in scope of quality action across Europe. Different levels of political commitment. Significant disparities in quality strategies. Lack of clear and transparent information. Lack of comparable process and outcome data. 25
Quality challenges What do we mean by quality healthcare? At which levels do we want to address quality? Where is the EU added value? Various EU policies and legislation have addressed healthcare quality but no overarching approach previously. 26
Patient Safety & Quality of Care Working Group Had until 2008 been a patient safety working group. Still includes all 27 Member States but now has a bigger stakeholder membership. Met for the first time in April 2008. Need to agree terms of reference on quality aspects. 27
Quality at the EU level draft terms of reference sharing of good practice in reducing outcome variability. the creation of a patient-centred healthcare environment that respects the rights of patients and which treats all patients and their families with dignity; an increase in the quality of life of the patient at every stage of the patient pathway: including development of comparative data and quality improvement strategies in primary care, secondary care, mental healthcare, palliative care and disease prevention. an increase in patient involvement in healthcare: including the provision of clear and comprehensive information on efficacy and clinical outcomes; the building of health literacy; and support for self-management of chronic disease. 28
Conclusions MS and the Commission have recognised the importance of patient safety. EU added value assisting Member States in their efforts to achieve safer care has led to clear action. EU Networks play an important role in accelerating policy implementation in MS From Patient Safety to Quality of Care 29