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

26

26

25

25

23

23

23

22

21

19

19

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


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


: 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


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


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


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:


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



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.



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..



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.


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


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.


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


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


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.


Thank You for YourAttention

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