Transcript regulating patient safety

Assessing and
regulating patient safety
Sandra Eismann via Alex Mears
The Care Quality Commission
• The Care Quality Commission is the regulator for England
• Created 1st April 2009 (just over a year old)
• Remit covers all aspects of health (NHS and privately owned) and
adult social care
• Does not include medical or clinical personnel (other bodies do that)
• Registration-based model- initial registration then ongoing monitoring
of compliance
• Information is delivered to field staff through statistical risk model into
the Quality and Risk Profile (QRP), indicating risk level for a number
of outcomes for each service/ provider
• QRP used by field staff to prioritise regulatory activity
• QRP uses information from many sources including users of services
Regulation and assessment
• The regulation or supervision of healthcare has been present in much
of Europe for many years
• Levers for change differ:
• Improvement of performance and quality- through setting
ambitious standards and targets
• Minimally acceptable standards- improves the poor performers
but does not go further
• Accountability for performance and value for money
• All levers require information and judgement leading to intervention
or enforcement where appropriate
Patient safety
• Focus for regulatory efforts
• Core domain of quality in healthcare (with effectiveness and patient
experience)
• Requires system-wide change to effect improvement
• Influenced by:
• Organisational leadership
• Clinical engagement
• Work-place safety
• Other influences
Proposed research
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•
Fits between existing work by Savio (very high level, principles) and Alex (at indicator
level in patient safety)
Three sections for the proposed research
• Summarise and compare high-level regulatory approach of EPSO members
• Background on regulatory approaches
• Types of regulatory intervention, based on Wouter Sparreboum’s research
• Principles of regulation, based on Savio Toson’s survey
• Identify and compare high-level regulatory approaches of EPSO members to
patient safety
• Unpack regulatory approaches using patient safety as a vehicle
• Possibly use Donabedian categorisation of quality (structure, process,
outcome)
• Use of a short electronic survey, followed up by telephone interviews if
necessary
• Proposal for areas for further collaboration & development
• Using information gained from the previous sections
Proposed steps
1. Engage EPSO partners
2. Collate and structure background information on regulatory
approaches, fitting EPSO members into this typology
3. Develop structured questionnaire looking at regulatory approaches
to patient safety, hopefully through an EPSO working group
4. Send out questionnaires, then collate and analyse responses
5. Compare and identify common approaches to patient safety
6. Agree findings via consultation
7. Identify areas for further collaboration
8. Write final report
Limitations
•
Limited to EPSO members and to healthcare
•
Partly based on existing research (albeit of high quality)
•
Information may not be available for all EPSO members
•
Focus only on top-down regulatory driver of improvement. Bottom-up
approaches and other drivers are not heavily considered
Outputs and first steps
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•
Outputs
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The primary output will be a report to be presented by Sandra at the EPSO
meeting in London in October 2010
•
It is also anticipated that a research paper will be written and submitted to a
peer-reviewed journal
First steps
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The proposal has been signed off within CQC
•
Initial discussion with EPSO board members took place in May 2010, with
support forthcoming
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Presentation to EPSO meeting in Tallinn, May 2010
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Any members interested in being involved in the working group should contact
Sandra or myself:
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[email protected]
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[email protected]
Lopp.
Tänan teid!