WP 6 QUESTIONNAIRE PART 3: Good Organizational Practices Rosa Suñol, MD PhD Avedis Donabedian Research Institute
WP 6 QUESTIONNAIRE PART 3 WP6 Contents: - Objectives - Questionnaire - Results - Conclusions
WP 6 QUESTIONNAIRE PART 3 - Objectives To collect information about: WP6 The most relevant Transferable Good Organisational Practices to be shared by EU Member States through Exchange Mechanisms in PaSQ Perceived needs of EU Members for learning from Transferable Good Organisational Practices through the Exchange Mechanisms The information presented will set the basis for arrangement of Exchange Mechanisms and collaboration networks in the EU regarding Healthcare Quality Management Systems.
WP6 WP 6 QUESTIONNAIRE PART 3 - Questionnaire contents Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Organisation that will be sharing the GOP Title of the GOP Does the GOP impact in any of the following quality dimensions? Indicate the level where this practice has been implemented. Clinical setting where it has been implemented Describe GOP objectives Describe GOP target population Describe GOP methodology Timeframe for proper implementation (based on experience) Q10 Please describe the implementation tools related to this GOP that are available Q11 Describe the implementation cost (based on experience). Q12 Method used to measure the results Q13 Results obtained (data) Q14 Analysis of the results Q15 Did you find implementation barriers? Q16 Please describe Q17 Describe the strategies used to overcome the barriers (If needed) Q18 Other information about the GOP that you would like to add
WP6 WP 6 QUESTIONNAIRE PART 3 Results
DESCRIPTION OF RESPONSES European Union Network for 146 Good Organizational Practices submitted GOPs submitted by Member State United Kingdom Sweden Spain Slovenia Slovakia Romania Poland Netherlands Italy Ireland Hungary Germany France Finland Estonia Denmark Cyprus Croatia Belgium Austria 9 2 3 5 1 1 6 7 12 4 4 3 1 2 5 4 4 1 4 68
Organizations sharing the GOP: European Union Network for Regional level; 33% Stakeholders ; 16% National level; 51% Stakeholders 24 National level 74 Regional level 48 Table 6: Types of organisations providing GOP Type of organisation No. GOP Accreditation Body 2 Healthcare Provider 20 Healthcare Provider & National Agency 2 Healthcare Quality Agency 20 Ministry of Health 29 National Agency 3 Professional Association or Society 14 Regional Authority of Health 49 University or Research Agency 7 TOTAL 146 (QA_8)
GOPs by topic Quality improvement project Clinical guidelines or pathways Accreditation Patient Safety system Incident reporting and learning system Clinical risk management Patient involvement Professional learning program on quality and safety Quality indicators Patient empowerment Patient surveys Audit system Quality management system Patient complaint mechanism Inspection Centre licensing Professional licensing Peer review 1 1 4 3 3 3 2 6 11 11 11 10 9 8 8 15 15 25 0 10 20 30 40 Number of GOPs related to the topic Total number of GOP = 146
Quality dimensions impacted by the GOPs submitted Equitable 78 Acceptable 83 Accessible Efficient 91 94 Effective Safe 112 118 0 50 100 (One GOP could impact several dimensions)
GOPs implementation level Local 9,6% Regional 34,2% National 56,2% National level : practices implemented at national level + practices at national and also at any other level (regional, local or both). Regional level practices implemented at regional level + practices at both regional and local levels. Local level only includes practices implemented at this specific level,
Implementation barriers Over 60% of the respondents reported that they found some barriers during the implementation phase. Main barriers: Funding, budget or resources constraints - impacted on 23 GOPs Resistance to change or lack of motivation from staff 21 GOPs Lack of knowledge, expertise or training for staff - 13 GOPs Lack of time from staff, extra work needed to implement the GOP 12 GOPs Lack of safety culture, fear of punishment -12 GOPs Limitations due to the design or the methods of the strategy 10 GOPs Lack of access or knowledge to technical, electronic equipment 8 GOPs Lack of leadership commitment, involvement or participation - 7 GOPs Coordination, communication, consensus and management 3 GOPs No value added visibility 3 GOPs Political or legal barriers 3 GOPs Results not measured 3 GOPs Poor clinical documentation - 3 GOPs
Implementation barriers Barriers classified by GOP topic Table 10: Implementation barriers by topic* Topic Total No. of Implementation % barriers GOPs barriers found Accreditation 15 8 53,3% Clinical guidelines or pathways 15 7 46,7% Clinical risk management 11 10 90,9% Incident reporting and learning system 11 10 90,9% Patient empowerment 8 6 75,0% Patient involvement 10 5 50,0% Patient Safety system 11 9 81,8% Patient surveys 6 4 66,7% Professional learning program on quality and safety 9 2 22,2% Quality improvement project 25 17 68,0% Quality indicators 8 4 50,0% *The table only includes topic categories with more than 5 GOPs that had data about implementation barriers
Learning interest Other 0 Peer review 7 Centre licensing 8 Professional licensing 9 Patient complaint mechanism Inspection 11 12 Professional learning program on quality and safety Quality management system Patient surveys 18 19 19 Clinical risk management Patient empowerment Audit system Quality improvement project Patient involvement 21 22 23 23 23 Clinical guidelines or pathways Quality indicators Incident reporting and learning system Patient Safety system 25 25 26 26 Accreditation 48 0 5 10 15 20 25 30 35 40 45 50 Total = 365
GOP submitted versus learning interest Inspection Incident reporting and learning system Clinical risk management Clinical guidelines or pathways Centre licensing Quality management system Audit system Quality indicators Quality improvement project Professional learning program on quality and safety Professional licensing Peer review Patient surveys Patient Safety system Patient involvement Patient empowerment Patient complaint mechanism Accreditation 0 10 20 30 40 50 60 wishing to learn GOPS submitted TOTAL Nº GOPs submitted 146 Nº Wishing to learn 365
CONCLUSION: The information collected regarding the 146 GOPs submitted and the perceived needs of Member States for learning from Transferable Good Organizational Practices was a useful basis to organize Exchange Mechanism in further steps of this project.