4 - PaSQ Proposal for a Permanent Network on Patient ... Coordination... · a Permanent Network on...
Transcript of 4 - PaSQ Proposal for a Permanent Network on Patient ... Coordination... · a Permanent Network on...
Peter Bandura
WP7 Leader
MoH of the SR
PaSQ Proposal for
a Permanent
Network on Patient
Safety and Quality
of Care
Brussells
March 12 -13 2015
European Union Network for
Patient Safety and Quality of Care
ObjectiveThe objective of the document is to present a
proposal for a sustainable network on Quality
of Care and Patient Safety involving Member
States and European stakeholders.
This permanent network should contribute to
the provision of safe and high quality
healthcare for all EU citizens
European Union Network
for Patient Safety and
Quality of Care
The permanent network should contribute to the provision of safe and high quality healthcare for all EU citizens in the framework of the following EU legislation/initiatives:
Directive on the application of patients' rights in cross-
border healthcare, and namely provisions relating to
standards and guidelines on quality and safety in full
respect of national competencies in organising and
delivering healthcare
Council Recommendation 2009/C 151/01 of 9 June
2009 on patient safety, including the prevention and
control of healthcare associated infections
European Directive 2005/36/EC on Mutual Recognition
of Professional Qualifications
Other EC initiatives in the field: Options promoting EU
standards for health services
Context
European Union Network
for Patient Safety and
Quality of Care
Council
Conclusions on
Patient Safety
WELCOMES the work of the European Network for
Patient Safety and Quality of Care (Joint Action PaSQ)
on the implementation of the Council Recommendation
2009/C150/01 as regards the exchange and
implementation of good practices in Member States;
RECOGNISES a need for continued and sustainable
collaboration at EU level on patient safety and quality
of care;
Develop further work on the dimensions of quality
in healthcare, taking into account existing
knowledge, including the work of the "Joint Action
on patient safety and quality of care" (PaSQ);
Finalise by December 2016 a framework for a
sustainable EU collaboration on patient safety and
quality of care, also taking into account the results
of the "Joint Action on patient safety and quality of
care" (PaSQ);
Context
The expectedoutcomes , MS and stakeholders needswere expressed through :
PaSQ Contract for sustainability
PaSQ Network sustainability survey
PaSQ Exchange mechanism data collection
Rational
The expected
outcomes
mentioned in
PaSQ contract for
sustainability
To build a permanent collaborative network on Patient
Safety (PS) that will be enlarged to address quality and
safety issues and reinforced by assuring long-term
Member States (MS) engagement in the PaSQ
network, together with the EU stakeholders and
European Commission
To achieve a sustainability of the Network by
implementation of
a collaborative business model with
a financial sustainability approach
Rational
Results of WP7 Sustainabilitysurvey:
1. Patient involvement
2. Reporting and learning system
3. Medication safety
4. Implementation ofsafe practices
Which Patient Safety and Quality of Care issues
would you like to discuss as first priority with
other EU Member States?
0 2 4 6 8 10 12
Patient empowerment/ involvement
Reporting and learning systems
Medication safety
Safety practices
Implementation of safe practices
Safety strategy and culture
Accreditation
PS - education
PS and Q indicators
Exchange mechanisms
Other
Sustainability
Q and S of specific HC services
Selected toolls by NCPs and stakeholders( WP7 SustainabilitySurvey)
1. Face to face interactions
2. Web based tools
What kind of tools would you consider to be the
most efficient to address these issues between
EU Member States?
0 2 4 6 8 10 12 14 16
Face to Face interactions
Web based tools
Tools to drive standardisation/unification
Exchange mechanism
Established/ institutionalized network
Tools to involve patients
Database of safety practices
Other tools
No tools defined
The role of EC:
1. Coordination
2. Support MS
3. Co-financing
What could be the role of the EC in
implementing these tools?
0 1 2 3 4 5 6 7 8 9 10
Other
Supporting member states in implementation
policies
Creating the supporting platform/portal
Education
To ensure the continuous co-financing of the
network
Supporting member states in
cooperation/networking
Sharing good practices and further developing the
exchange mechanisms
Coordination/Leadership role
Conclusions: Patient involvement and reporting and learning systems
seem to be of particular interest for National Contact
Points
The tools proposed to exchange about these topics
should promote face to face interactions and to a lesser
extent web based tools. These exchange tools seem to
be more popular than standardization/unification tools
The supporting role of the EC (coordination, fundingD)
should be maintained
WP7 Network Sustainability Survey
Main points ofinterest:
1. Accreditation
2. Reporting and learning
Main points of interest expressed by MS
regarding GOPs they want to share
Topics of learninginterest:
1. Accreditation
2. Reporting and Learning
3. PatientInvolvement
Learning interest of MS by topics
48
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25
25
23
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19
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18
12
11
9
8
7
0
0 5 10 15 20 25 30 35 40 45 50
Accreditation
Patient Safety system
Incident reporting and learning system
Quality indicators
Clinical guidelines or pathways
Patient involvement
Quality improvement project
Audit system
Patient empowerment
Clinical risk management
Patient surveys
Quality management system
Professional learning program on quality and safety
Inspection
Patient complaint mechanism
Professional licensing
Centre licensing
Peer review
Other
PaSQ network is currently demonstrating that the approach of knowledge exchange and mutual learning can efficiently contribute to decrease inequities in the provision of safe and high quality care in the EU in accordance with point 2 & 7 of Art 168 of the LISBON Treaty
By sharing experiences and solutions in Pacient Safety
and related aspects of Quality of Care, MS, regions and
health care facilities can benefit from the knowledge
and experience of others.
Sharing solutions to ensure patient involvement is a
special topic to be addressed.
A selection of good practices for implementation,
building on PaSQ WP5 experience with a preference
for those that are relevant to the needs of most MS and
their respective health care systems.
Principles of a future approach to improve Patient Safety
and Quality of care in the Member States
Principles :
KT is about sharing, learning and exchanging information, knowledge, skills, and experiences related to Patient Safety Good Clinical Practices and Good Organisational Practices
PaSQ database of good practices (PaSQ WP 4 & 6)
Exchange Mechanisms created during PaSQ:
o Wiki; Reports on PSPs and GOPs
o Multiple partner collaboration
o Webinar/Online project sharing Information and
discussion meeting
o Workshop
o Study tours
o Twining programs
Participation on a voluntary basis
Non binding recommendations
Knowledge Transfer will happen trough:
A sustainable system for knowledge transfer (KT) system will be developed building on the PaSQ tools and methods for sharing and learning across boarders in EU with a specific focus on 4 priority key functions identified by member states:
1. Patient and public involvement and
empowerment
2. Implementation of selected Patient Safety
Practices in clinical settings
3. European peer review system for Care
Quality Improvement organisations
4. Sharing of Patient Safety Solutions and
Issues: SEaL
Key functions
Sustainable system for
knowledge transfer
Principles
� Involvement of patients at relevant level
� Individual (micro),
� organisation (meso) and
� policy (macro) levels
� Barriers and facilitators for patient ’ involvement in
the sustainable network
� Integrate evidence base from EMPATHIE mapping
study
� Patients organisations’ feedback (EPF)
1. Patient involvement
Selection criteria Demonstrated their effectiveness
Transferability with regard to health care systems and
health care contexts
Feasibility of implementation within PaSQ
Existing implementation tools
Patient involvement
Corresponding to MS needs
2. Implementation of selected Patient Safety
Practices in clinical settings
A selection of 4 Safe Clinical Practices was chosen for implementation in 18 European Member States:
1. WHO Surgical Safety Checklist
2. Medication Reconciliation
3. Multimodal intervention to increase hand
hygiene compliance
4. Paediatric Early Warning Scores (PEWS).
Implementation of selected Patient Safety
Practices in clinical settings
: 220 HCOs from 18 EU countries are recruited and take
part in WP5 implementation.
The big amount of recruited HCOs shows that there is a
deep interest in implementing the SCPs selected for
WP5 in the MS.
The implementation of the selected PSPs increases the
patient safety culture in HCOs.
In order to guide the HCOs through the WP5
implementation process, a tool box for each SCP was
developed.
Implementation of selected Patient Safety
Practices in clinical settings
Principles :• Organised by CQIO for CQIO
• Participation on a voluntary basis
• Non binding recommendations
• Communication at national, regional and local level.
3. European peer review system for Care
Quality Improvement Organisations (CQIO)
Objectives :
Standards and principles:
• To help organisations to identify gaps and initiate
improvements
• To share principles, exchange solutions and create a
community
• To give external recognition and credibility when needed
• Established by PaSQ network
• Adapted from the main international organisations
(International Accreditation Program, European
Partnership for Supervisory OrganisationsD) to EU MS
context(s)
• Reviewed on a regular basis
European peer review system for Care
Quality Improvement Organisations (CQIO)
First Steps : 1 -Visits of peers in participating MS to
better understand existing CQIO in the
EU
2 - Drafting of EPRS process and
standards
3 - Piloting of Peer Review in one or
two MS
European peer review system for Care
Quality Improvement Organisations (CQIO)
Description: Based on needs and preferences of MS, proposes
opportunity of rapid response mechanism within
scope of future sustainable EU network on PS and
QC.
4. Sharing of PS solutions & issues:
SEaL (Share, Exchange and Learn)
Principles: SEaL is a web-based system for
1. issuing patient safety issues (incidents) and
2. patient safety solutions (initiatives) within member
states.
Voluntary mechanism of Member States from
putting information into the mechanism through to
accessing and
acting upon the information within it.
Sharing of PS solutions & issues:
SEaL (Share, Exchange and Learn)
1. Patient safety issues
a) adverse events which have required immediate
action at local level to prevent occurence of clinical
incidents,
b) sentinel events which represent potentional patient
safety issues and require local risk assesment to
determine appropriate response
Sharing of PS solutions & issues:
SEaL (Share, Exchange and Learn)
2. Patient Safety Solutions
a) best patient safety practices,
b) upgrades regarding good organizational practices,
c) outcomes of patient safety research,
d) tools and resources for patient safety reform by
dissemination of information without requirement of
immediate response.
Sharing of PS solutions & issues:
SEaL (Share, Exchange and Learn)
Organisation : One network-partner from each Member States acts as
national contact and coordination point. The partner is
responsible for:
validation and uploading of the information into the SeAL
system. National contact points will establish ways of
spreading the alert in their own country to make sure the
information reaches the clinical field, where actions should be
taken..
Sharing of PS solutions & issues:
SEaL (Share, Exchange and Learn)
Figure 1: Overview of the sharing mechanism
Source of data to identify the answers for the questions for furtherdevelopment ofsustainablecooperation:
1. Network sustainability survey
2. Feedback regarding the activities developed in WP4,
5 & 6
3. Specific questionnaire on Drivers and barriers for a
sustainable collaboration
PaSQ proposal for a sustainable collaboration
1. Sustainability survey
PS&QC issues to discuss at EU level The most efficient to address these issues between MS
Conclusions:
� Interest for NCPs: R&LS and Patient involvement, implementation and acccreditation
� Tools proposed to EM: face to face interactions and web based tools
� The supporting role of the EC (coordination, fundingD) should be maintained.
2. Participation to WP 4,5, 6 activities
% Countries. PSP provided: % Countries. GOP provided:
Countries' participation in SCP Implementation : 18 countries; 220 HCOs
3. Drivers and barriers for the collaboration
Main lessonstaken fromPaSQ JA A collaboration including exchange of knowledge and
experiences regarding best practices.
Most interest:
patient involvement, R&L, implementation,
accreditation
Tools for the EM:
face to face interactions & web based tools.
The role of the EC should be
co-financing and coordination.
All the partners except one are willing to collaborate.
PaSQ proposal for a sustainable collaboration
Drivers and barriers
Main actions:
Main drivers: policy support, resources, professionals’
involvement and knowledge sharing
Main barriers: resources, policy support and
communication transfer to clinical levels are considered
the main threats.
A 55% of respondents think that the lack of
communication/information with clinicians is a barrier
for the collaboration.
Main actions proposed: to count on policy support and
resources and to ensure the involvement of relevant
stakeholders (clinicians, patients, managers) through
the creation of a national networking to engage
stakeholders and clinicians and including collective
expertise of a large and diverse membership
PaSQ proposal for a sustainable collaboration
Needsexpressed by stakeholders for further PS and QC cooperation
Higher involvement of clinicians
(from hospital and other
healthcare facilities)
Increased involvement of
PS&QC experts, risk manager
from hospitals or frontline health
care workers.
Agenda pushed closer to
healthcare provider and patient
organization.
PaSQ proposal for a sustainable collaboration
Next steps -Networkdevelopment
� Involve field level (Health Care professionals,
patients) in Exchange mechanism activities
(submission of good practices, organisation of
exchange mechanismD)
� HCOs participating to WP5 implementation
could be considered to be part of the network.
� Involve national decision makers in the launch
of a national network
� Develop Regional/local relays to involve
stakeholders in the field
� Develop Communication with local level
focusing on feedback
PaSQ proposal for a sustainable collaboration
Next steps –Knowledge transfer
Continue with EM
At all levels; clinical (local), regional and national level
Continue to collect PSP/GOP to share
Implementation
Target groups : clinicians, health care professionals,
government officials, administrators, ngo’s
Placement, courses and twining should be
reconsidered
More communication about the Wiki platform and EM,
including a stronger focus on the evaluation of the EM
PaSQ proposal for a sustainable collaboration
Options of collaboration andinvolvement in key functions for the PaSQ PermanentNetwork
Option 1: sharing and exchange of
information (on a voluntary basis).
Participating to knowledge transfer
Option 2: Participating to the
exchange mechanism
Option 3: Voluntary participating to
implementation exercise(s)
Option 4: Participating to
implementation tools development.
PaSQ proposal for a sustainable collaboration
Thank You for YourAttention