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Research proposal
Objective:
The study aims to identify and compare the overall approach European health regulators take in regulating and assessing patient safety; and to identify further areas for collaborations between EPSO (European Partnership for Supervisory Organizations in Health Services and Social Care) members.
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EPSO working group
Jan Vesseur/ Dutch Health Care Inspectorate
Geir Sverre Braut/ Norwegian Board of Health Supervision
Vaida Momkuviene/ Lithuanian State Medical Audit Inspectorate
Katja Peters/ Academy of Public Health in Düsseldorf
Sandra Eismann/ Care Quality Commission England
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Our early thinking ….
Possible themes to follow up in the questionnaire:
What are the different tasks supervisory bodies undertake in relation to patient safety (e.g. system(s) for notification of events)?
What mandatory safety related reporting is in place in the different countries, and what information is published for patients?
In the different countries, which patient safety initiatives were evaluated and which were most effective?
Focus on hospitals and/or residential settings?
the survey should be a starting point for future collaborations.
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Defining patient safety
Some focus on adverse events and incident reporting
Injuries caused by medical management as opposed to the patient’s underlying disease process (Mello et al. 2005)
Others include organisational leadership, clinical engagement, work-place safety and other, which all contribute to patient safety outcomes.
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Patient Safety Initiatives
Questionnaire – Part A
• What initiative or policy for improving patient safety in hospitals is currently taking place in your country?
• What is the role of your organisation in the initiative?
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Responses from 15 countries/regions
•Norway
•Netherlands
•Belgium
•France
•Lithuania
•Northern Ireland
•England
•Scotland
•Slovenia
•Estonia
•Ireland
•Denmark
•Germany
•Finland
•Sweden
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Patient Safety Initiatives
Patient safety programmes aiming explicitly to reduce adverse events or mortality rates
Scottish Patient Safety Programme aims to reduce adverse events by 30% and mortality rates by 15%
• NHS Quality Improvement Scotland leads and co-ordinates initiative
A programme to reduce preventable harm and death in 5 years by 50%
• Dutch Health Care Inspectorate assess progress of implementation
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Patient Safety Initiatives
Wider quality management programmes, including patient safety:
Initiatives include creating a safety culture, reviewing governance structures, communication and education, sharing learning, include hospital as well as primary health services
• Lithuania: State Medical Audit Inspectorate measures implementation
• Northern Ireland: RQIA conducts reviews and reports on the quality of care
• England: CQC used information for its own regulatory activities
• Estonia: Health Board performs surveillance and enforcement functions
• Norwegian Board of Health Supervision integrates some initiatives into own regulatory activities
• France: HAS oversees implementation of process
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Patient Safety Initiatives
Patients Rights/ Ombudsman
• Slovenia: HIRS deals with offences under the act
• Denmark: National Board of Health receives information from ombudsman and undertakes disciplinary sanctions
International/bilateral initiatives
European Union Network for Patient Safety (EUNePaS), includes all 27 member states
• Health Information and Quality Authority is coordinating agencies for Ireland
EurSafety Health-net for Patient Safety and Infection Protection
• German Dutch co-operation/ Academy of Pubic Health offers guidance and training
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Patient Safety Initiatives
Projects on patient safety
Pilot projects around quality management and patient safety
• Belgium: incorporated in auditing activity
National project on patient safety led by SALAR in Sweden
• National Board of Health and Welfare in dialogue with SALAR
• Additionally: National Board of Health and Welfare starting project on supervising providers in regards to infection control
Guidance issued on importance of patient record keeping
• Finland: VALVIRA issues guidance and lectures in healthcare organisations
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Patient Safety Initiatives - Summary
1. What initiative or policy for improving patient safety in hospitals is currently taking place in your country?
• Patient safety programmes aiming explicitly to reduce adverse events or mortality rates
• Wider quality management programmes, including patient safety
• Patients Rights/ Ombudsman
• Projects on patient safety
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Patient Safety Initiatives - Summary
2. What is the role of your organisation in the initiative?
Measuring progress of implementation
Including information into own regulatory activity
Coordinating
Proving guidance and training
Leading the initiative
Following up complaints
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Focus on patient safety
Questionnaire – part B
Question 3:
When regulating/ supervising hospitals, do you focus specifically on patient safety, or is it part of everything that you do?
When regulating/ supervising hospitals, which areas of patient safety do you look at?
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Focus on patient safety - summary
When regulating/ supervising hospitals, do you focus specifically on patient safety, or is it part of everything that you do?
We focus specifically on patient safety (5)
• Germany, Netherlands, Scotland, Northern Ireland, Sweden
Patient safety is a theme with runs through everything we do (12)
• Lithuania, Norway, Netherlands, England, Estonia, France, Slovenia, Denmark, Sweden, Finland, Ireland, Belgium
We do not focus on patient safety (1)
• Lithuania
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Focus on patient safety - summary
0 0.2 0.4 0.6 0.8 1
Infection control
Reporting of adverseevents
Clinical audits
MedicineManagement
Safety and suitabilityof premises
Work force
Other
When regulating/ supervising hospitals, which areas of patient safety do you look at?
14 responses (excluding Denmark)
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Infection control
How do you supervise/ regulate hospitals’ infection control?
• Which organisation in your country is setting quality standards or developing guidelines in regards to infection control?
• What are you are assessing in regards to infection control?
• Evidence gathering and analysis
• Outcome of your activity
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