Transcript The Danish Healthcare Quality Programme

The Danish Healthcare Quality Programme
Danish Institute for Quality and
Accreditation in Healthcare
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21 July, 2015
Healthcare in Denmark
5,5 million inhabitants
1 Ministry of Health
5 administrative regions
98 municipalities
60 public hospitals
3,700 GPs
3,700 dentists
245 pharmacies
Etc.
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Ministry of Health
The Ministry is in charge of
administrative functions
in relation to organisation
and financing of the health
care system, psychiatry and
health insurance as well as
the approval of pharmaceuticals and the pharmacy sector.
Prevention and health promotion are also part of the Ministry’s remit.
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Accreditation in Healthcare
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5 Regions: Healthcare
 Somatic hospital service
 Psychiatric hospital service
 Health insurance
 General practitioners
 Specialists
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Accreditation in Healthcare
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98 Municipalities: Healthcare
 Preventive treatment
 Homecare
 Nursing homes
 Rehabilitation on an out-patient basis
 Treatment of alcohol and drug abuse
 Local dental care
 Special dental care
 Social psychiatry
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Financing
85 per cent of healthcare costs are financed through taxes.
The regions cannot levy taxes directly; they are financed through
contributions from the state and the municipalities.
GPs (private) operate wholly within the public healthcare system. 3,700
GPs and 3,700 dentists have contracts with the public healthcare
service.
The public authorities have entered into agreements with approximately
160 private hospitals in Denmark and abroad where patients can receive
treatment if the public healthcare system is unable to provide treatment
within two months.
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The Danish Healthcare Quality Programme,
DDKM
The Danish Healthcare Quality Programme was originally established by
the national government and the regional governments.
The vision was to create a quality programme which could include all
Danish healthcare services and operate across the various sectors.
The aim of the project was to improve the quality within the individual
sectors - but also within the citizen’s journey across the sectors.
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Accreditation in Healthcare
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IKAS
IKAS, The Danish Institute for Quality and Accreditation in Healthcare,
was established in 2005.
IKAS develops, plans and manages the Danish Healthcare Quality
Programme. The development of accreditation standards is carried out
in collaboration with healthcare professionals across the country.
IKAS is governed by a board with representatives from the Danish
Health and Medicines Authority, the Ministry of Health, the Danish
Regions, LGDK (Local Government Denmark (a national association of
municipalities)), the Danish Organisation of Private Hospitals and the
Association of Danish Pharmacies.
The Danish Healthcare Quality Programme is approved by ISQua.
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Accreditation in Healthcare
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Status
Public and private hospitals:
First version 2009 - 2012
Second version 2013 - 2016
Community pharmacies:
First version 2009 - 2012
Second version 2013 - 2016
Pre-hospital sector:
First version 2011 - 2014
Municipalities:
First version 2011 - 2014
Next: GPs, specialist practitioners and dentists.
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Accreditation in Healthcare
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Method
DDKM is an accreditation system.
DDKM is not meant to be unnecessarily normative which implies a free
scope for the individual institution. Thus, the programme does not
determine how to create quality development – it outlines goals to
improve the quality.
Not only does DDKM focus on healthcare services it also focuses on the
processes and structures for the patient pathway.
DDKM combines and uses already existing data collected in the Danish
Healthcare system. For example, national quality data bases, Danish
Patient Safety Database (DPSD), The Danish National Indicator Project
and the Danish National Satisfaction Surveys.
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The template
Title
Standard
Purpose
Application area
Fulfilment of standard
Step 1: Guidelines
Step 2: Implementation and use of
guidelines
Step 3: Quality surveillance
Step 4: Quality improvement
References
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Accreditation in Healthcare
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Preparation
Phases in DDKM
Implementation of
accreditation standards
Accreditation
Standard development
Midterm
visit
Implementation of the
accreditation process
 Standard development
 Hearing
 Editing
 Pilot test
 Editing, preparation of
accreditation standards
 Handing over the standard
material
 Reception and division of
accreditation standards
 On-site survey
 Report – feedback to the
institutions
 Self- evaluation
 Follow-up/initiatives in case of
quality flaw
 Action plans
 Publication
 Self-assessment
 Mock survey
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Accreditation in Healthcare
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A regulated society
DDKM is characterised by absence of details about employment,
working conditions, safety for employees, buildings etc.
The reason is that these areas are regulated by laws, collective
agreements etc.
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Survey and survey report
A number of surveyors conduct the on-site survey. The survey team
prepares a survey report including a recommendation about
accreditation status.
The survey finishes with at feedback meeting where the survey team
informs the institution about significant findings.
The final decision about awarding accreditation status is made by an
independent accreditation committee.
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Accreditation status
Accredited: If the standards in all essentials are complied with, and
any shortcomings in the compliance based on an overall assessment are
regarded for less significant.
Accredited with comments: If not all standards are fulfilled but when
these in all essentials are expected to be fulfilled within reasonable time.
An adequate fulfilment is assessed via a focused return visit or by
submission of documentation.
Not accredited: If the institution within reasonable time does not meet
the requirements of the accreditation standards to an adequate degree.
It is particularly important that the institution ensures the users’ safety
and statutory rights. Safety means safety against damaging events and
safety against damages due to insufficient efforts from the institution.
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Accreditation in Healthcare
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