The Danish Healthcare Quality Programme a unique model

1
(No Transcript)
2
The Danish Healthcare Quality Programme - a
unique model

• The Danish Healthcare Quality Programme, DDKM, is
  a unique quality development and safety system.
• The Danish quality programme aims to include
  all Danish healthcare services. Not only will it
  improve the quality within the individual sectors
  - but also within the citizens/patients journey
  across the sectors.

3
Who are included?

• In the long term, the Danish QualityProgramme
  aims to include all Danishhealthcare services
  and operate across
• the various sectors.
• The Danish Healthcare Quality Programme is a
  collaboration between the national government and
  the regional governments - covering the public
  hospital services. The programme will be
  implemented in 2009.
• Pharmacies, municipalities and private hospitals
  have also entered into an agreement of being part
  of the Danish Quality Programme.

4
The Danish Healthcare Quality Programme

• The Danish Healthcare Quality Programme is a
  strategy to implement a system which aims to
• prevents errors and promote high quality
• apply best practise to the daily work
• build bridges between the health sectors
• improve the quality of a patients journey
• create continuous quality development
• Therefore, the Danish Healthcare Quality
  Programme is based on accreditation.

5
What is accreditation?

• Accreditation can be defined as
• Quality assessment where an acknowledged
  authority assesses whether an activity, service
  or institution meets a set of joint standards
• Det Nationale Begrebsråd for Sundhedsvæsenet,
  2006 the Danish Committee defining technical
  terms for the Healthcare System

6
Accreditation standards

• IKAS develops accreditation standards for quality
  at international high level in the Danish
  healthcare sector. The development is carried out
  in collaboration with healthcare professionals
  across the countryv.
• The Danish Healthcare Quality Programme is
  approved by the international accreditation
  organisation International Society for Quality in
  Healthcare (ISQua).

7
Collects and combines

• The Danish Healthcare Quality Programme collects
  and combines data already available in the Danish
  healthcare sector.
• It integrates the national quality databases,
  adverse events, The National Indicator Project
  and the National Patient Satisfaction Surveys.

8
Current updating

• The Danish Healthcare Quality Programme is
  constantly under development. New areas will be
  included and revised versions of the
  accreditation standards published every third
  year or when needed.

9
What describes a standard?

• An example of a standard within medication
• Drugs used in acute situations are easily
  accessible.

• An accreditation standard is a standard for good
  quality.

10
Each standard contains
11
The Standard - built like a staircase with four
steps

• At the bottom and 1st step, the guidelines are
  prepared. It can e.g. be a business mission,
  politics, plans or guidelines depending on the
  focus area of the accreditation standard.
• When at step 2, the target group must know the
  guidelines and work accordingly.
• At step 3, the quality surveillance of step 1 and
  2 takes place, e.g. through audit (record audit),
  reporting to quality databases, log books or
  observations. The standard describes the
  requirements.
• At the 4th and top step the results from step 3
  are analysed and will be used as specific
  quality improvement initiatives.

12
Indicators

• Example of an indicator at step 3
• The medical record contains documentation that
  the three initial prescriptions of medication
  during hospitalisation at the unit clearly sets
  out the dosage to be administered.
• Guidance
• The indicator is included in the semi-annual
  audit of records at the surgical, intensive care
  and other somatic care units as well as
  psychiatric units.

• Indicators, assessment points, are attached to
  each step.
• The indicators must ensure that the standard is
  implemented and used.

13
The quality circle

• The purpose of the whole accreditation process is
  to initiate a never-ending circle of quality
  improvement.
• Quality improvement is planned, plan
• it is executed, do
• it is examined, if it succeeded, study
• and then acted upon, act.
• It might be necessary to correct mistakes and
  may be it is necessary to improve the quality.

14
TAK-system

• The entire process is supported by the it-based
  TAK-system (an abbreviation for the Danish
  Tværgående Akkreditering og Kvalitetsudvikling).
  
• TAK is provided by IKAS and includes all
  accreditation standards. The system can be used
  to divide the standards into relevant units etc.,
  and among others, the system provides an overview
  of how far you are in the process.
• TAK will currently be developed to be able to
  support all parts of the accreditation process.

15
Status

• The First Version of the Danish Healthcare
  Quality Programme for public and private
  hospitals is completed, and implementation will
  begin during summer of 2009.
• The First Version of the Danish Healthcare
  Quality Programme within the municipalities
  (primary sector) is ready for implementation by
  the end of 2008.
• The First version of the Danish Healthcare
  Quality Programme for pharmacies is completed and
  was handed over for implementation in December
  2008.

16
Accreditation

• When the organizations have implemented the
  accreditation standards which constitute the
  Danish Healthcare Quality Programme, they must
  undergo an external survey.
• A team of specially trained healthcare
  professionals will assess the level in which the
  organizations
• meet the standards. Accreditation is bases on
  the
• surveyors assessment.
• Accreditation takeplace every third year.

17
Cross-Border Quality

• Some of the accreditation standards focus on the
  transition between the different sectors.
• The Danish Healthcare Quality Programme aims to
  improve quality within the sectors and across
  the sectors to ensure better and more coherent
  patient journeys.

18
How many standards?
Public and private hospitals104 standards
within 37 themes. Examples hygiene, management,
nutrition, documentation and lung cancer.
Municipalities 31 standards. Examples
medication, stroke patients and documentation.
Public pharmacies 40 standards within 10 themes.
Examples patient information, communication,
management and documentaion.
19
IKAS

• IKAS, The Danish Institute for Quality and
  Accreditation in Healthcare develops, plans and
  manage the Danish Healthcare Quality Programme.
• IKAS and the Danish quality programme is a
  strategy of the national and local governments
  and the stakeholders.
• IKAS is governed by a board with representatives
  from the National Board of Health, Ministry of
  Health, the Danish Regions, LGDK( the national
  association of municipalities) and the Danish
  Organisation of Private Hospitals.
• IKAS is situated in Aarhus and employs app. 30
  staff, mainly health professionals.